The Agency Agreement Sets the Terms: Check the Rate Notice, the Cancellation Charge, and the Insurance Certificate Before You Sign
The schedule the agency describes is not the contract. The signed agreement decides who employs the worker, what a rate change costs you, and what it takes to stop service.
The agency's agreement is the paper that governs your money once the sales call ends. Read it as a billing document, not as a welcome letter. Three lines decide most of the surprises: how a rate change reaches you, what it costs to cancel, and what insurance stands behind the people who walk into the house.
Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.
Who is the employer
Ask first whether the agency employs the aide directly or refers you to an independent worker through a registry. The answer changes who carries the payroll, who bears the injury exposure, and who must supply a replacement when someone calls in sick. Get the answer in the agreement's own words, not as a summary from the phone.
How a rate change reaches you
Find the sentence that says how much written notice the agency gives before its rate goes up, and whether an increase can take effect partway through a scheduled block. If the agreement says nothing, ask for the sentence to be added before you sign. Ask also whether holiday, weekend, or overnight hours bill at a different rate, and where that rate is written down.
What it costs to stop
Write down the notice period you must give to cancel, the charge for a late cancellation, and what happens to any deposit. Find out whether the minimum shift length is billed even when the aide arrives and the parent declines help. A cancellation clause is a price, so read it like one.
The insurance certificate
Ask for a certificate of liability insurance and proof of workers' compensation coverage, and ask that the agency send both directly, not through a copy handed to you. Ask who pays if a worker is hurt in your parent's home and who pays if a worker damages something there. Those answers belong in writing.
The scope line
Have the agreement list what the aide does: companionship, meal preparation, light housekeeping, reminders, and errands such as picking up a prescription. Reminders and errands can be written in. Giving, administering, sorting, or managing medicine is not an aide's job, and the agreement should say that medicine stays with the family, the prescribing doctor, and the pharmacist. A scope written this way protects everyone, including the worker.
What Medicare and the state will and will not pay for
Medicare's home health coverage applies to skilled care under its own conditions, and it does not generally pay for non-medical hours. Read the official Medicare explanation before you assume any part of the agency's invoice will be reimbursed. If a state program pays for some of the hours, that program's billing rules may require the agency's paperwork to match, so check with Missouri DSS before you sign. Missouri DHSS publishes licensing information you can use to confirm that the agency holds any license its services require.
For local comparison help, see the local help page, which points to Aging Ahead and other area resources.
Where the lawyer takes over
If the termination, liability, or arbitration terms are unclear, have a Missouri lawyer read them before you sign. The Missouri Bar can help you find one. Any question about what your parent's body needs belongs to the doctor, not to the agency's staff or the aide.
Before you sign
Get written answers to six questions: who employs the aide, how much notice comes before a rate change, what a cancellation costs, what the minimum billed shift is, where the insurance certificate is, and what the scope says about medicine. Keep the signed agreement in the same folder as the insurance certificate. The desk's method for checking claims is on How We Write.