Choosing an Agency

Your care, your choice

When faced with making a health care decision for yourself or your loved one, it is important to remember that you have choices. Even if a medical professional or hospital personnel recommend institutional care, you can and should explore all your options. The decision about care is ultimately yours. There are many times to consider home care, which can be the right choice for a wide range of health care services:

• Patients of any age being discharged from the hospital who need short-term care to recover.
• Disabled children or adults can choose to receive care at home.
• Chronically ill children or adults can benefit from sophisticated medical treatment in their homes.
• Older adults, disabled or chronically ill people who need both skilled care or personal care assistance to help with daily activities such as bathing, dressing, cooking and shopping.
• Choosing hospice and palliative care

If someone has been diagnosed with a terminal illness, contact your local Hospice or home care agency that provides palliative care. The goal of Hospice and palliative care agencies is to ease suffering and to ensure that the person lives out his/her life as comfortably as possible. These agencies also provide essential support for families of the terminally ill.

Where Do I Begin in Selecting an Agency?

It can seem intimidating to begin searching for an agency, but knowing how to begin can make the process much easier. Here are some simple steps to follow when searching for an agency.

• Gather all the information you can about the person in need of care including existing care, previous care, and any pertinent information about the existing situation.
• Contact one or more home care agencies near where the person lives or where you want to care to be given. HCP has many member agencies that are highly qualified and can provide a wide range of services. You can use HCP’s Find a Home Care Agency search engine to help you find an agency in the area where care is needed.
• Discuss the situation with each of the agencies so you understand your options. Each agency should help you determine what type of care or treatment the person needs based on the situation and your family circumstances. They will provide a nursing assessment, if appropriate.
• Ask the agencies about any government services or programs that fit your situation.
• Ask the agencies to refer you to any appropriate program or service that you may need.
• Based on your conversation, you should be able to determine which agency best meets your needs. Contact them to make the appropriate arrangements for care.

Questions to ask an agency

Although each health care situation is different and it is important to discuss your particular circumstances with each agency, there are questions you can ask each of the agencies:

• How long has the agency been in operation?
• Is the agency licensed, certified, or another type of agency?
• What types of services does the agency provide?
• Is the agency accredited? Professional accrediting means that an agency has met established standards set by the NYS Department of Health or another accrediting body.
• Will the agency provide you with written brochures or materials describing its services, fees, policies and procedures?
• Are services available on the weekends and at night?
• What is the role of the family in the care?
• How does the agency handle emergency situations?
• Will the agency do an in-person assessment of the patient, and if so, when?

Types of Home Care Workers

There are different types of workers employed by home care agencies that provide care in the home, including:

Aides

Home Health Aides (HHAs)

Home Health Aides (HHAs) are the highest level of paraprofessional worker in home care. HHAs are responsible for health-related tasks as well as personal care activities. Health-related tasks include monitoring the client’s health status by taking temperature, pulse, respiration and blood pressure, and assisting with basic health tasks that allow the client to remain at home. HHAs must follow a plan of care and perform tasks outlined by a registered nurse and if problems or changes occur in the client’s condition, they are responsible for immediately notifying the supervising nurse. HHAs are required to complete a 75-hour training program, which includes both classroom and laboratory/in-home training, and attend in-service training throughout the year.

Personal Care Aides (PCAs)

Personal Care Aides (PCAs) provide services to persons needing some or total assistance with everyday tasks, including such things as personal hygiene, dressing, feeding, walking, meal preparation, light housekeeping and laundry. PCAs provide services to help clients stay in the home and live independently. There are two levels of PCAs: Level I and II. PCA I employees perform homemaker functions and have no physical contact with the client. PCA II employees are responsible for all of Level I functions as well as personal care tasks, including assistance with personal hygiene, dressing, walking and transferring. PCA II employees are required to complete a 40-hour basic training course and attend in-service training throughout the year.

Nurses

Nurses provide supervision of aides as well as care in the home, and there are distinct types of nursing professions in New York State that are detailed below.  To learn more about nursing licensing requirements and regulations, visit the NYS Education Department Office of the Professions website .

Licensed Practical Nurse (LPN)
LPNs provide skilled nursing care tasks and procedures under the direction of an RN, nurse practitioner, clinical nurse specialist, physician, or other authorized health care provider.

Registered Professional Nurse (RN)
RNs may perform health assessments; diagnose and treat a patient’s unique responses to diagnosed health problems; teach and counsel patients about their health; execute medical regimens as prescribed by licensed physicians, dentists, nurse practitioners, physician assistants, and podiatrists; and contribute as members of interdisciplinary health care teams and health related committees to plan and implement health care.

Clinical Nurse Specialist (CNS)
CNSs are RNs who have completed advanced clinical nursing education (usually a master’s degree) and are certified by New York State as a clinical nurse specialist. New York certifies CNSs in the following specialties: Adult Health; Pediatrics; Oncology; and Psychiatry/Mental Health.

Nurse Practitioner (NP)
NPs are RNs who have earned a separate license through advanced clinical nursing education (usually a master’s degree) in a distinct specialty area of practice. Nurse practitioners may diagnose, treat, and prescribe for a patient’s condition that falls within their specialty area of practice. Nurse practitioner specialty areas include: Acute Care; Adult Health; College Health; Community Health; Family Health; Gerontology; Holistic Nursing; Neonatology; Obstetrics and Gynecology; Oncology; Palliative Care; Pediatrics; Perinatology; Psychiatry; School Health; and Women’s Health.

Home Care in New York State

New York’s Medicaid home care programs provide a wide range of services to hundreds of thousands of homebound sick and elderly patients throughout the State. At the same time, nearly 180,000 New Yorkers receive home care funded by the Federal Medicare Program. Thousands of New Yorkers purchase home care services privately and through private insurance coverage in both indemnity and managed care benefit plans.

The average home care visit costs significantly less than a day of nursing home or inpatient hospital care. Home care helps decrease rising health care costs, offering opportunities for achieving real cost savings for a broad variety of patients. New York must continue to look to home care as the primary source of long-term care services to keep patients in their homes and communities.

Find a Home Care Agency