#GREYMARKETRISKS There are many risks to hiring a home health aide “under the table” When a family member employs a home health aide in their home they become the employer. Salary Risks – All Department of Labor laws apply to the home health aide as your employee. Any person in your employment must be paid for all hours of work according to the Fair Standard Labor Act. Aides must be paid for all hours worked. Live-in aides must be paid overtime- no flat daily rate. Tax Risks - As a private employer, the individual or family is required to pay Social Security, Unemployment and Payroll Taxes. It is the responsibility of the hiring individual to be sure that the aide truly is an independent contractor and is therefore paying their own taxes. Failure to meet this obligation may involve civil fines and the possibility of criminal penalties. Liability Risks – The family member, as the employer, becomes responsible for any liability due to an injury to the person being cared for, or any other person on the premises. If the home health aide were to be injured, or even if the HHA injures another person, the family would bear the full responsibility for all costs and compensation. If the home health aide drives and is in a car accident while performing work duties all liability falls to the family. Abuse and Exploitation Risks - Families often do not have the time or the resources to do criminal background checks, or to contact references, if they even think to ask for references. A reference from a friend is often just “she was so nice” Without background checks the risks for manipulation and exploitation are markedly greater. Care Risks - A family member who hires privately is responsible for the duties of the HHA. HHAs are only trained to provide care under the supervision of a registered nurse. They are not legally allowed to administer medications or certain treatments. Any harm done while operating without proper supervision could result in civil or criminal penalties. There is also no backup care plan/coverage for holidays, sick days, vacation day if you hire outside of an agency. Financial Risks – Paying money to someone “under the table” is not a legal disbursement of funds. If the family needs financial help from Medicaid for care in the future, and these disbursements fall into the 5-year look back period, they will be counted as gifting and may cause a penalty, or even a disqualification for Medicaid funding.

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