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Steps to Selecting a Provider


Think about the types of care and level of supports you need.  This will give you an idea of what skill level you are looking for in a care provider (e.g., sign language, complex medication management, medical support from a Registered Nurse or Certified Nurse Assistant), and what type of care setting would have best support and lowest risks for specific special needs of the individuals (e.g., behavioral, recreational). The following steps are primarily for choosing an individual to provide care in your own home, or at the provider's home. For a facility type of setting, go to In-home / Out-of-home settings

First step: What kind of person are you looking for?


Types of care providers:

  • Domestic employees - sometimes called "family employee" or "home care worker" or "personal support worker," this is a friend, neighbor, or relative who is recruited, hired and paid directly by the family/consumer or by a general business provider/fiscal intermediary such as a brokerage on behalf of the family/consumer.
  • Independent contractors - self employed and generally work for multiple families/customers. Often recruited and hired by the family/customer. They can be subcontracted and paid by a general business provider/fiscal intermediary such as a brokerage on behalf of the family/consumer. They often are certified to provide behavioral supports or other specialized services.
  • Provider agencies - sometimes called "in-home care agency," these are licensed or certified by the State to provide services in individual or group settings.


*** See this chart for the comparison between Domestic Employees and Independent Contractors.

*** See this list of statewide bookkeeping/fiscal intermediary services for assistance in complying with state and federal tax regulations.


Things to keep in mind


According to federal and state labor law, anyone being employed must have a percentage of payment set aside for employment taxes and health benefits. For example, to hire someone as a domestic employee, currently families/consumers must keep a record of payment to the provider for tax withholding and worker's compensation purposes. This type of complex requirement may have been a barrier for families to use in-home supports or respite care.


While The Employers' Guide: Client-Employed Provider Program is for a specific program, serving seniors and people with physical disabilities - some of the information on the employment and hiring roles and responsibilities of the family as an employer is applicable for all age and disability groups.


In February 2010, the Oregon Home Care Commission (OHCC) was charged by the state legislature to act as the "employer of record" for personal support workers, just as it has been for the home care workers since 2000. As the employer of record, the OHCC is responsible for worker's benefits for families/consumers. Work to add the personal support workers to the OHCC Registry and Referral system is projected to be by 2013. As of January 1, 2011, personal support workers will be eligible for worker's compensation coverage for injuries that occur on the job. They will also have access to trainings offered by OHCC.


Some criteria and qualities to keep in mind


Use this list as a starting point to help you identify specific criteria for a domestic employee or independent contractor, important for you and the person you care for:

  • Gender
  • Age range
  • Non-smoker
  • Has a valid driver's license and up-to-date car insurance (if transportation is needed and you are willing to pay for mileage)
  • Likes pets
  • Available times for work
  • Categories of experience in special needs
  • Hobbies/interests

There are some basic factors to consider as you go through the provider selection process. The most important things to keep in mind, however, are your family member's safety and your family's respite needs. The Care Notebook, or a specific task checklist such as this one in the Personal Care Task Checklist, or a care plan can help you organize information for the respite provider to best support your family member - during a specific scheduled time of the day, for normal and emergency medical situations that may arise. This one-page profile, providing a quick snapshot of your family member (e.g., what s/he likes, how best to communicate to him/her) can also be helpful for the respite provider.


Some qualities to look for in a respite care provider:

  • Acceptance and warmth -- Does the person show a real kindness for all people, including individuals who have special needs?
  • Understanding -- Does the person recognize that people are in different stages of physical, mental, and social development? Does the person respond appropriately to your family member's limitations and strengths? (It's a good sign when a potential provider asks questions.)
  • Competence -- Can this person meet the individualized behavioral, feeding, sleeping, toileting and socialization needs of your family member?
  • Patience -- Can the provider be patient when someone receiving care or a respite situation becomes especially challenging?
  • Fun, humor and spontaneity -- Does the provider get on the floor and play with your child? Can the provider talk and laugh with an adult who is receiving care?
  • Good judgement -- Can the person solve problems and make good decisions, in both routine and emergency situations? Can you feel confident the family won't be left with extra problems to take care of after respite care?
  • Stamina -- Will the person be able to actively provide care and interact for many consecutive hours, and still be alert, enthusiastic, and patient?
  • Respect -- Does the person listen to what you say? Will the person follow your family's rules and expectations?
  • Communication -- Is the provider able to ask questions and communicate important information to you?
  • Flexibility -- Can the person use a variety of approaches to meet the special needs of your family member? Is the person willing to shift from previous ways of doing things in order to follow your expectations?
  • Reliability -- Is the person punctual, consistent, and predictable?
  • Confidentiality -- Will the provider keep personal information about your child and family private?

Second step: Where can you locate a provider?


If you do not already know someone who would be a good respite provider, the following are some directories to find care providers. Providers on the directories generally have received some basic training to provide care for adults and children. It is your responsibility as an employer to check references, verify the provider’s experience, and comply with the state and federal tax regulations.

The Oregon Home Care Commission (OHCC) was created by State law in 2000 to ensure the quality of home care services through programs that are funded by the Department of Human Services for seniors and people with physical disabilities. So the original registry was created only to have a listing of home care workers who generally work for consumers who are seniors and people with physical disabilities. Under a new State law passed in 2010, this registry will include personal support workers who generally work for consumers with developmental and mental health disabilities, by 2013.

Currently, this registry is a database of home care workers who have passed a background check within the past two years, and have updated their information within the past 60 days. Information about the home care worker include: smoker/non-smoker; schedule available; types of orientation and training received.


Child care providers generally receive required training through the local CCR&R network, and generally work with children ages 0 to 12. The Inclusive Child Care Program, however, can assist families caring for children up to 18 years old with special needs. Families can use the CCR&R database to find a child care provider who may be experienced and willing to work as a respite provider.

This is a resource directory that has long-term care related type of information for families, caregivers, and consumers. You can use this directory to look for services and providers that may meet your family's choice of respite care - e.g., in-home care agencies, camps for adults and children, adult day service, caregivers support groups.


As it is a new online resource for Oregon since September 2010, if you can not find the information you need, contact your local Area Agency on Aging or Seniors and People with Disabilities office for further assistance.



You may want to advertise your needs at other places including:

  • local newsletters of support or disability groups - e.g., MS Society of Oregon, Parkinson Center of Oregon, Autism Society of Oregon, Alzheimer's Association of Oregon.
  • local community college or university
  • local school district for special education teachers
  • churches/synagogues/temples
  • local newspaper
  • Support service brokerages for the developmental disabilities system
  • Family members or neighbors

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Third step: How do you screen the provider?


If you are using the Oregon Home Care Commission registry, the providers listed have passed a background check within the past two years, and have updated their information within the past 60 days.


To prepare for telephone and in-person interviews, you can use Oregon Home Care Commission's The Employers' Guide for:

  • a sample job application
  • some suggestions for the initial screening on the telephone
  • some possible questions to ask the provider's previous employers
  • some sample questions for an in-person interview

Here is a longer list of sample questions to help you make up your own list of questions that are most appropriate for your family situation. Include at least one scenario that demonstrates a typical situation that could arise during respite care, and ask the potential provider how s/he would respond.


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Fourth step: How do you orient and train the provider?


You know the person you care for the best. This Care Notebook or the Swindell's Care Notebook, can help you organize important information that your respite provider must know - e.g., phone numbers where you can be reached; backup contacts of neighbors, friends or relatives; your family member's most important likes and dislikes; any special medical care needs your family member has.


This one-page profile is a good tool to give the respite provider a quick snapshot of your family member. You can use the Care Notebook as a more detailed reference to normal and emergency medical situations, so the respite provider can be better prepared. It is a good idea to allow sufficient time for training a new respite provider, before leaving him/her alone. This may be 30 minutes or even multiple days, depending on the need of the person receiving care. You can also use a care plan developed with the agency that your family member receives benefits from to communicate specific area of care needs to the respite provider. Be sure to specify areas you would like the respite provider to observe while providing respite care, take notes, and report back to you.


Here is a copy of some key roles and responsibilities for respite care providers.


For additional training to help you better understand your roles and responsibilities as an employer/consumer, visit the Oregon Home Care Commission website.


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