For individuals who require ongoing care but are able to remain at home, home care agencies can provide additional assistance. They can provide a range of services from limited companionship services to care by a registered nurse.
Depending on the services required, skilled home care can include physical, speech or occupational therapy, rehabilitative services, medication administration, wound dressing, meal preparation and/or administration, transportation, hygienic services, housekeeping, or companionship. When the aide is providing solely medical care, it is sometimes distinguished as home health care.
Home care can also include non-skilled services which can include cooking, cleaning, bathing assistance, reminders to take medications, grocery shopping, laundry, errands, pet care, plant care, companionship, and more. Home care can either be paid by Medicaid or private pay.
In Colorado, home care agencies are licensed by the Department of Public Health and Environment. All home care agencies must be licensed or registered with CDPHE. The department distinguishes providers as home care agencies and home care placement agencies. Home care agencies are direct employers of aides, in that they hire the staff, are responsible for assessments, care plans, training, supervision, unemployment compensation, social security benefits, insurance and other employer activities. By contrast, home care placement agencies are paid a referral fee and then refer an independently contracted home care provider to the elder. This means that the individual is the employer and is responsible for all of the supervision and training of the aide, as well as unemployment compensation, self-employment taxes, bonding and insurance.
Both Medicare and Medicaid may provide some home care benefits in certain circumstances. Medicare pays the home health agency a set amount for a specific diagnosis (for home health aides, skilled nursing care and therapists). The services provided must be medically necessary and ordered by a physician, while the individual must be homebound. Individuals who go to adult day programs, and religious services and still be deemed homebound. Agencies accepting Medicare must be licensed by CDPHE. Home care agencies are surveyed by Medicare on quality of care. Findings are available at www.medicare.gov
Medicaid will pay for a broader range of home care services, including personal care (such as bathing, grooming and hygiene). Agencies accepting Medicaid must be licensed by CDPHE. To receive Medicaid home care, individuals must meet financial eligibility criteria by completing the Colorado Peak or submit the print application to the county department of human services, have the service prescribed by a physician and be approved using the ULTC 100.2.
Surveys, occurrences and complaints are available from Medicare and from the Colorado Department of Public Health and Environment.