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Course Details

This CLE webinar will guide counsel through hiring and contracting for in-home care, employee vs. contractor classification (including live-in and agency models), Medicaid/Medicare intersections (caregiver agreements, look-back traps, home-transfer exceptions), and financial/physical abuse prevention and reporting.

Faculty

Description

The panel will discuss how to navigate the regulatory landscape (FLSA domestic-service rules, DOL's 2024 independent contractor standard, proposed 2025 revisions to companionship/live-in exemptions), state/local overlays (domestic worker bills of rights, written contract mandates), and best practices for drafting caregiver/personal care agreements. 

The experts will review how caregiver contracts or personal care agreements support Medicaid eligibility when done correctly, using fair market compensation, contemporaneous records, physician corroboration of need, and tax compliance as a household employer, while avoiding transfers that trigger penalties during the five-year look-back. The panel will cover abuse and exploitation red flags (including POA misuse and undue influence), and mandatory reporting and APS pathways.  

Listen as our panel shares their expertise on handling common scenarios and drafting comprehensive agreements coordinated to Medicare/Medicaid requirements while avoiding misclassification, protecting the client's estate plan, and reducing exploitation risk.

Outline

I. Introduction

II. The home care landscape

A. Private hire, registries, agencies, HCBS waivers, consumer self-direction  

B. Terminology: personal-care aide, home health aide, custodial care, skilled care

III. Employment considerations

A. Status: independent contractor or employee

B. FLSA domestic service rules: companionship, live-in, travel time, sleep-time, third party (agency) or direct employee, recordkeeping requirements

IV. Regulatory landscape

A. New proposed DOL rules for live-in/companion exemptions, counseling

B. State regulatory requirements, e.g. domestic worker rights bills; contract requirements, overtime, breaks, discrimination, harassment, etc. 

V. Drafting contracts for in-home care

A. Core clauses: duties/scope, hours/overnights, wage and OT, breaks, sleep time, travel time, termination, confidentiality/privacy in a private home, incident reporting, and safety

B. Recordkeeping: household-employer taxes, EIN, FICA/FUTA, etc.

C. Background checks and screening; licensures, FCRA notices

VI. Intersection with Medicaid/Medicare planning

A. Personal care/caregiver agreements

B. Look-back and transfer penalties; child-caregiver home-transfer exception; timings

C. HCBS waivers and self-direction; funding services at home

VII. Safeguarding financial and physical abuse or exploitation

A. POA safeguards

VIII. Physical and disease-specific challenges

A. Dementia: capacity fluctuations, consent, wandering/safety, communication; documenting capacity assessments and respecting autonomy

B. Mobility/fall risk and ADLs: task boundaries for aides vs. skilled services

IX. Practitioner takeaways

Benefits

The panel will discuss these and other important topics:

  • Distinguishing employee vs. independent contractor status for in-home caregivers
  • Drafting written caregiver contracts that satisfy DWBR mandates (where applicable) and address wage/hour, safety, privacy, incident reporting, and termination
  • Structuring personal care agreements to support Medicaid eligibility and avoid look-back penalties; counseling on the child-caregiver home-transfer exception
  • Preventing exploitation using APS pathways, bank reporting signals, and POA controls