Hire the Helper Directly or Through an Agency? Count the Payroll Papers Before You Choose

You can hire a non-medical caregiver yourself, which makes the family the household employer, or you can buy the hours from an agency, which usually makes the agency the employer. The hours at the door look the same either way. The papers behind them do not. Before you compare hourly figures, decide which set of papers you are willing to own.

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.

This guide is about the paperwork, not the care itself. A hired or in-home non-medical caregiver may remind a parent when a dose is due and may pick up a prescription as an errand. Handing out, administering, sorting, or managing medicine stays with the family, the doctor, and the pharmacist. Whichever route you choose, put that line in the written job description in those words.

What You Take On If You Hire Directly

When you hire a helper personally, you become the household employer. The IRS publication titled Household Employer's Tax Guide lays out the federal duties. Read it first, then check off each duty that applies to your house:

Before the first shift, collect the employee's Form W-4 for withholding and complete Form I-9 for employment eligibility verification, which USCIS publishes. Confirm the pay rate and the schedule in writing, and keep a time record that both of you confirm each week.

During the year, you are responsible for withholding and paying the household employment taxes that apply. At year end, the employee needs a wage statement, and your household employment taxes are reported on Schedule H with your federal return. The thresholds that decide whether a given tax applies change over time, so look up the current figures on the IRS pages rather than trusting a number you read somewhere else.

Ask the Missouri Department of Labor whether a household employer here must carry workers' compensation and whether unemployment insurance applies to the wages you pay. Then ask the harder question: if the helper is hurt in your home, who pays, and what happens to your savings if no one does?

What the Agency Usually Keeps

An agency that employs the aide typically handles withholding, the wage filings, and the unemployment and workers' compensation coverage. That is the trade. Your papers move to the service agreement and to the insurance documents the agency provides.

Ask for a certificate of insurance in writing and check that the coverage names the agency and the work performed in your home. Ask whether the agency screens and bonds its workers and what the screening covers. Ask the replacement rule: what happens when the aide is sick, quits, or is removed, and how quickly a replacement arrives. Ask how the agency handles a complaint and whom you call when it is not resolved.

Compare the Papers, Not the Hourly Figure

Draw two columns on one page. In the first, list each paper that a direct hire requires. In the second, list the same papers for the agency route. For every row, write the name of the person or company responsible for it. Rows left blank after you have asked are your answer. A hire with no one behind the paperwork is the costly option even when the hourly figure is lower.

If a public program pays any part of the hours, its rules decide whether you may hire a family member or a particular person, and whether the family is the employer at all. Check the Missouri Department of Social Services or the program's own page before you interview anyone. Do not assume that a route that worked for another family works for yours.

Where to Stop and Ask

How household wages are taxed depends on your own return, so take the job description and the pay records to a tax preparer. If a dispute with a worker begins, or you are unsure whether a written agreement binds your parent, that question belongs to a lawyer, and the Missouri Bar's lawyer referral listings are a place to start. This guide does not give legal or tax advice, and it does not give medical advice. Those answers come from the professionals named here, not from this page.

Free Help Before You Commit

Before you sign with anyone, take your two-column list to free help. The Local Help With Paying for Care page names the St. Louis-area offices that answer these questions without a sales pitch. For Medicare questions, the Missouri SHIP counselors can review coverage with you at no charge. For the sources behind each claim in this guide, see the Sources page, and for how the desk checks its claims, see How We Write.