Licensing and Bonding for Caregivers

What Licensing and Bonding Does a Caregiver Need to Have?
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If you're choosing a caregiver for an aging parent or loved one, you've probably heard the advice that your caregiver should be licensed and bonded. The implication is that being licensed and bonded means the caregiver is more trustworthy. But what do these terms actually mean?

What kind of licensing/certification programs do caregivers take?

Licensing is a general term that can cover many different kinds of certifications. And the rules for certification vary according to which type of care a caregiver is providing. They also vary from state to state. As a general rule, caregivers who help with the tasks of day-to-day living, such as cooking, companionship, and personal care, may not need to be licensed; licensing or certification is required for home health aides (HHAs), certified nursing assistants (CNAs), and others providing medical care.

Many states are in the process of changing their training and licensing requirements. For example, the state of Arkansas will require 40 hours of training and certification for all paid in-home caregivers.

SEE ALSO: Find In-Home Care Help Near You

Who offers licensing/certification programs for caregivers?

Hiring a caregiver who has completed a certification course gives you the peace of mind of knowing that she has received a certain level of training and completed a testing process. Licensing and certification programs are provided by community colleges and other educational institutions and by national organizations. The American Caregiver Association and the National Caregiver Certification Association both offer online certification programs for nonmedical in-home care providers such as home care aides or personal care assistants.

The American Red Cross offers a number of safety certifications, including a Family Care Program for caregivers -- whether informal or paid -- who care for the elderly in their homes. It includes training in home safety, including how to accident-proof your home, how to move someone safely, and safe bathing. It also includes guidelines for healthy eating and safety instructions for those caring for people with dementia or Alzheimer's. Another American Red Cross program is the certified nurse assistant (CNA) training course, which covers caregiving in both assisted living and in private homes.

Does licensing/certification differ across different types of home care?

SEE ALSO: Find In-Home Care Help Near You

If you hire a caregiver through an agency, you can ask for information on any certifications a caregiver has received. In many states, the agency itself also must be licensed and/or accredited by the state in which it operates. If your home care will be paid for by Medicare, then you are required to use a Medicare-certified home health agency in order to qualify for payment coverage.

One more thing: You can generally assume a caregiver hired through an agency will have undergone medical screening and be certified that her vaccines are up to date. If you are hiring a caregiver privately, you may need to verify this information yourself.

What does "bonding" mean for in-home caregivers?

Now, on to bonding. Bonding is used as a means to reassure you that you don't need to worry about theft. So what does it really mean to be "bonded?"

Bonding is a legal term for a type of insurance taken out from a bonding company that covers theft by an employee. If you hire a caregiver from an agency, it's very likely that they have bonded the caregivers in their employ. Independent caregivers also can bond themselves, though this not as common.

This means that the agency has purchased a bond that will compensate you (the client) should you be the victim of theft by a caregiver. The bonding company would repay you the value of the items stolen up to the amount of the bond. The bonds issued for caregivers are typically $5,000, which means you could theoretically be reimbursed up to $5,000.

Does bonding assure that all missing items are covered?

Bonding is not, however, as strong a protection as it sounds. This is because typically the bonding company does not have to reimburse you unless the theft you've reported has been validated in a court of law. This means the caregiver has to be arrested, charged, and convicted in criminal court before the bond is paid out. As you can imagine, only a small percentage of caregiver thefts get this far in the legal system. And even when they do, theft is very difficult to prove, meaning that convictions aren't guaranteed.

Melanie Haiken

Melanie Haiken discovered how important it is to provide accurate, targeted, usable health information to people facing difficult decisions when she was health editor of Parenting magazine. See full bio

5 months, said...

Why do people think they are not accountable to HIPPA??? They are giving meds and have very personal information about the patient. I know a caregiver who violated HIPPA telling spouse, family and neighbors about his care for a very wealthy prominent patient, and no one seems to think they are accountable to HIPPA.

9 months, said...

I am looking to become an independent contractor as a home health aide/certified nursing assistant. I also want to be Medicaid/Medicaid certified and be able to take other insurances If not able to pay directly. I know I need to purchase certain insurance, getting bonded, and negotiating contracts. How do I go about doing all of this?

almost 2 years, said...

I live on Tustin California I have Tustin license to take care or been caregiver independent contractor they I need state of California license to work

over 2 years, said...

Thanks for the info. Generally speaking caregivers are not just female. I noticed you had a lot of "she" in the writting. I get the gist, I just want to take away thestigma we male cargivers get. The info you provided has helped already. I completed with my last client and while seeking another I wanted more training. .even though in have 7 plus years it never hurts to b learn more.

about 3 years, said...

I have end stage liver disease and don't trust many people so how can I get my caregiver paid for. She cooks, cleans, and has been to every appointment I have because however those trips back and forth are adding up so fast. Lights got cutoff two days ago. I cant pay it so I guess the only other to do is give it to Lord and let him handle it,

about 4 years, said...

Thank you for this article, so informative when the time comes to have to seek out assistance. As my brother's care partner I did have to seek out experienced help to assist us (I was ok with status quo, he wasn't). I've been fortunate, and blessed, he lets me know when something isn't working for him any longer. Yes, that's my cue to make changes on this journey of AZ. He's aware of changes, this I believe, and my goal is to try to alleviate as much of the negativity and stress that comes along with it, for him and me. My first instinct was to seek out reputable agencies and I believed my mission would be an easy one, it turned out to be a challenge. They had protocols to follow but were quick to advise me, "We can do this." I was more than willing to follow rules; papers to complete, their assessments needed, their confidence of experience being impressive. This meant adhering to their timeframe for their services and care requirements, usually at least 4 hours a day, 2 times a week and going thru many (if needed) of their personnel to find the right fit. I have found with this disease things change, less help may be more beneficial than more at a given time, that's where we're at right now (not to say things won't change). Rules on time and finding the right fit could mean a waste of precious time, as well as cost to consider. I wanted to complete this mission quickly, this was something my brother was eager for and I wanted to make it happen. I didn't feel an abundance of people in and out or idle time would be good for him and this is what I saw happening. I had to get tough, following a 3 strike and you're out rule with their right fit. No shows happened, at the last minute, which became a quick deal breaker. I wasted some time, even though I was relentless; realizing the need to trust and reach out to others for their assistance and guidance. I learned what's important is finding the right person (agency or not) who is experienced and dedicated to their profession, they will do what is needed in real time, that's what matters. Trust is crucial. Respect for all. Observe what they do, listen, ask questions, they shouldn't mind and you will learn from them. Yes, the right fit is important and you will know it, sense it immediately. My mission was accomplished for my brother and me, prayers answered. One day at a time. God Bless All Caregivers