Guidelines for Direct Care Workers
Mission Statement
To help individuals maintain their lifestyle with dignity and promote the highest quality of life that is achievable while living in the comforts of their own home or independent community.
Elders Choice of PA Philosophy
Our philosophy is based on client choice and preservation of self-determination with regard to living arrangements and other choices. Maintaining the dignity of the individual client throughout the process is primary.
Equal Employment Opportunity Policy
In order to provide equal employment and advancement opportunities to all individuals, employment decisions will be based on merit, qualifications, and abilities. Elders Choice of PA does not discriminate in referrals of employment opportunities or practices on the basis of race, color, religion, sex, national origin, age, disability, or any other characteristic protected by law.
The Agency will make reasonable accommodations for qualified individuals with known disabilities unless doing so would result in an undue hardship. This policy governs all aspects of employment, including selection, job assignment, compensation, discipline, termination, and access to benefits and training.
Any employee or independent contractor with questions or concerns about any type of discrimination in the workplace is encouraged to bring these issues to the attention of Elders Choice of PA management. Employees can raise concerns and make reports without fear of reprisal. Anyone found to be engaging in any type of unlawful discrimination will be subject to disciplinary action, up to and including termination of employment.
Any complaints of discrimination may be filed with the Office of Equal Opportunity and/or the Pennsylvania Department of Health 717-783-1379 or the Pennsylvania Human Relations Commission.
Medical Examinations of Direct Care Providers
It is the policy of Elders Choice of PA, Inc. that all direct care workers providing home care and referred by our Company must have an updated TB test or chest x-ray.
Immigration Law Compliance
Elders Choice of PA is committed to employing and referring contractors that are only United States Citizens or aliens who are authorized to work in the United States. We do not unlawfully discriminate on the basis of citizenship or national origin.
Harassment Policy
Statement of Purpose
While all forms of harassment are prohibited, the Company is committed to providing a workplace free of discrimination and harassment based on race, color, religion, age, sex, national origin, disability, or any other protected status or characteristic. Offensive or harassing behavior will not be tolerated against any employee. This policy extends to our direct care workers, clients, and families.
Harassment Defined
The prohibition against offensive or harassing behavior applies to all employees, supervisors, and direct care workers who are referred to live-in cases.
The prohibition against offensive or harassing behavior applies to all employees and supervisors and extends to all direct care workers. Offensive conduct or harassment that is of a sexual nature or based on race, color, religion, age, sex, national origin, disability, or any other protected status characteristic is prohibited. This includes, but is not limited to, any of the following conduct:
- Physical actions, written or spoken language, and graphic communication;
- Any type of physical contact when the action is unwelcome or unwanted by the recipient;
- Expectations, requests, demands, or pressure for sexual favors;
- Slurs, jokes, posters, cartoons, and gestures;
- Verbal abuse or inappropriate language of a sexual nature or related to a particular gender or class;
- Inappropriate sexual flirtations, touching, advances of propositions;
- Graphic or suggestive comments about an individual’s dress or body;
- The display of sexually suggestive comments about an individual’s dress or body;
- The display of sexually suggestive objects or pictures, including, but not limited to, nude photographs;
- Any other conduct that creates an intimidating, offensive, or hostile environment for a particular gender or class.
All reports of inappropriate conduct will be promptly and thoroughly investigated, and Elders Choice of PA will act to ensure that any improper conduct ceases immediately and corrective
action, up to and including termination of employment. Elders Choice of PA will inform the complaining employee or direct care worker of the resolution of the complaint.
All complaints will be treated confidentially to the extent of an effective resolution. No individual will suffer adverse employment consequences as a result of making a good-faith complaint or taking part in the investigation of a complaint. An individual who knowingly alleges a false claim against another will be subject to the full range of corrective action, up to and including termination.
Substance Abuse Policy
Purpose
It is the policy of Elders Choice of PA to create a drug-free, healthful, and safe workplace. The use of controlled substances is inconsistent with the behavior expected of employees. Direct care workers subject all employees, as well as our clients, to unacceptable safety risks and undermine Elders Choice of PA’s ability to operate effectively and efficiently.
Procedure
The use, possession, sale, or transfer of illegal drugs or alcoholic beverages on Company property, in Company vehicles, or while engaged in Company activities is strictly prohibited for all employees and pertains to direct care workers as well.
Employees and direct care workers who take over-the-counter or prescribed medications are responsible for being aware of any effect the medication may have on the performance of their duties and must promptly report to their supervisor the use of any medication that is likely to impair their ability to do their job.
Off-duty use of alcohol or drugs that adversely affect the employee’s or direct care workers’ health and work performance, the safety of others, or Elders Choice of PA reputation, is strictly prohibited.
Drug and alcohol tests will be administered when an employee’s observed behavior raises a reasonable suspicion of drug or alcohol use, resulting in impairment on the job. In regards to direct care workers, the client and/or responsible party could request that the direct care provider have drug testing per their request. Testing could be administered after any accident or occurrence that results in an injury on the job or involving a vehicular accident involving a Company vehicle. Direct Care Workers authorized to drive client and/or family vehicles also apply.
Submission to drug and alcohol testing upon request is a condition of employment. Employees who refuse testing will be terminated immediately without exception. Also, employees are to inform Elders Choice of PA of any criminal drug statute conviction no later than five days after such a conviction.
Grievance Policy and Procedures
When you have grievances, complaints, or problems related to your employment or if a direct care provider has concerns related to their live-in case, Elders Choice of PA management will make every effort to address and resolve the problem or complaint. If you are unable to resolve your concerns, you may bring it to the attention of the President.
Ethics Policy
The purpose of this policy is to ensure that all employees abide by legal and ethical standards in their business practices. All employees and contracted direct care providers are to conduct themselves with honor and personal integrity. Respect for the rights of others and refrain from behavior in your business and personal life that might be harmful to you, your co-workers, the Company, or viewed unfavorably by clients, customers, or the public at large. Employees and Contractors are encouraged to act in accordance with the highest standards of professionalism at all times. All employees must conform to ethical and legal standards to abide by the law and preserve the Company’s reputation. Failure to adhere to this policy may result in disciplinary action, including discharge from employment or removal from the direct care worker provider list. Refer to Conduct and Rules
Care Giver Conduct and Work Rules
Purpose
To ensure orderly operations and provide the best possible work environment, the Company expects employees, as well as, direct care workers to follow rules of conduct that will protect the interests and safety of all employees, direct care workers and the organization including customers’ living in the community.
It’s not possible to list all the forms of behavior that are considered unacceptable, but some examples of infractions of rules of conduct that may result in disciplinary action, up to and including termination of employment and/or removal of a contractual direct care worker from a case. Some are the following:
- Theft or inappropriate removal or possession of property
- Working under the influence of alcohol or drugs without a prescription while on duty, at work, or at a client’s residence
- Possession, distribution, sale, transfer, or use of alcohol or illegal drugs in the workplace or while on duty at a 24/7 live-case
- Fighting or threatening violence
- Negligence or improper conduct leads to damage to property owned by the employer or clients
- Violation of safety or health rules
- Possession of dangerous or unauthorized materials, such as explosives, knives, or firearms, in the workplace
- Unauthorized absenteeism or any absence without notice
- Unauthorized disclosure of confidential information
Safety Policy
At Elders Choice of PA, all employees, direct care workers and customers are our most valuable asset. Health and safety are top priorities both in the workplace and in the homes of our clients. All injuries and illnesses, whether it is an employee, contractor or customer, must be reported
and documented on the incident report within 24 hours. The company will comply with safety laws and regulations as they apply to our operations.
Electronic Mail Policy
All company information must be accessed using a password. All email messages are not confidential in nature, and employees should have no expectation of privacy regarding any message that is sent or received through the Company’s E-mail. Emails that contain discriminatory or offensive content of a religious or sexual nature are strictly prohibited. Report to management any emails that are offensive in nature.
Suspected Client Abuse, Neglect, and Exploitation Policy
It is the policy of Elders Choice of PA to educate and provide ongoing training for all staff and direct care workers on laws and regulations regarding the reporting of suspected abuse, neglect, and exploitation involving vulnerable adults. Any suspected case of elder abuse or neglect will be reported immediately to the Area Agency on Aging Protective Services Unit of the county where the person resides.
Procedure:
All staff or direct care workers suspecting elder abuse or neglect will immediately inform the President or, in his or her absence, their designee. The President or designee shall be responsible for making an immediate report of the suspected abuse to the appropriate County Protective Services Unit.
- The President/Director, or his or her designee, will notify the individual’s family or guardian of the incident and our mandate to report.
- The Worker suspecting abuse will complete the “Suspected Abuse and Neglect Reporting form” within 24 hours. A copy will be placed in the client’s file pending the outcome of the investigation.
- The President/Director or his or her designee will be responsible for completing any paperwork or documentation.
- When deemed appropriate, the Worker will remain in contact with the Protective Service Unit to offer support in their efforts to investigate.
- The President/Director will ensure that appropriate disclosure and cooperation occurs.
II. Elders Choice of PA is a Home Care Registry
A Home Care Agency is a business entity or part thereof that supplies, arranges, or refers trained caregivers to provide activities of daily living, instrumental activities of daily living, or specialized care in the consumer’s place of residence or another independent living environment, for which the registry receives a fee. Elders Choice of PA also provides non-medical care planning and case management services for all clients.
Elders Choice of PA, Inc. is a licensed Home Care Registry in the State of Pennsylvania and is fully Bonded. Elders Choice of PA has a Comprehensive General Liability Insurance Policy.
Elders Choice of PA is located in Harrisburg, Pennsylvania. We are a referral service that arranges and refers trained caregivers to assist with activities of daily living to individuals and couples 18 years and older living in their own private residences or independent living communities.
Prior to referring a direct care worker to provide services to a consumer, the direct care worker has to demonstrate competency by passing a Competency Examination developed by Elders Choice of PA, Inc. The competency test will be placed in your file upon completion, and all direct care workers will be reassessed annually thereafter.
It is the responsibility of the direct care provider to conduct themselves in accordance with the Ethics and Conduct Work Rules within this manual.
III. Independent Caregiver Policies and Procedures (Direct Care Providers)
All caregivers must adhere to the policies and procedures that are applicable as stated in the first section of this manual. Elders Choice of PA is the referral agency and we must ensure that you understand and agree to abide by all applicable policies and procedures even though you are not employed by Elders Choice of PA, Inc.
Non-Discrimination Policy and Procedures (as applicable)
Under Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, and the Age Discrimination Act of 1975, Elders Choice of PA will not, directly or through contractual arrangements, discriminate on the basis of race, sex, color, ancestry, national origin, religious creed, handicap, or age in its admissions or its provision of services and benefits. Our Company will not discriminate on the basis of disability in admission, access, treatment, or employment. Discriminate on the basis of age in the provision of service unless age is a factor necessary for achieving a statutory objective.
In delivering non-medical healthcare to clients, and when working with clients, meets the policies and procedures set forth by the Equal Employment Opportunity Commission for care delivery, grievance procedures, and communicating with persons with limited English proficiency or sensory impairments.
Any complaints of discrimination may be filed with the Office of Equal Opportunity 717-783-6514, the PA Department of Health 866-826-3644 or the Pennsylvania Human Relations Commission 717-787-4410.
Disability Accommodation
Elders Choice of PA is committed to complying fully with the Americans with Disabilities Act (ADA) and ensuring equal opportunity in employment and referrals for all Elders Choice of PA personnel and independent contractors for qualified persons with disabilities. All employment and referral practices and activities are conducted on a non-discriminatory basis.
Hiring and referral procedures have been reviewed and provide persons with disabilities meaningful employment opportunities. Pre-employment or referral inquiries are made only regarding an applicant’s ability to perform the duties of the position.
Post-offer medical examinations are required only for those positions in which there is a bona fide job-related physical requirement. They are given to all persons entering the position only after conditional job offers. Medical records will be kept safe and confidential.
Reasonable accommodation is available to all disabled employees and direct care workers where their disability affects the performance of job functions. All employment decisions are based on the merits of the situation in accordance with defined criteria, not the disability of the individual.
Qualified individuals with disabilities are entitled to equal pay and other forms of compensation as well as in job assignments, classifications, organizational structures, position descriptions and lines of progression.
Elders Choice of PA is also committed to not discriminating against any qualified employees or applicants because they are related to or associated with a person with a disability. Elders Choice of PA will follow any state or local law that provides individuals with disabilities greater protection than the ADA.
This policy is neither exhaustive nor exclusive. Elders Choice of PA is committed to taking actions necessary to ensure equal employment opportunities for applicants with disabilities in accordance with the ADA and all other applicable federal, state, and local laws.
Foreign Language, Speech, Hearing, and Visually Impaired Individuals
Elders Choice of PA, Inc. is committed to ensuring that anyone with any language barriers, disabilities, or impairments is given reasonable accommodations by providing clients with the necessary resources and services to help their lives be more meaningful. As case managers, our goal is to ensure that we access community services and programs that can help support our clients in their daily lives. Elders Choice of PA has compiled a resource list and uses this list for clients when applicable.
HIPAA
HIPAA (Health Insurance Portability and Accountability Act of 1996) provides for the privacy of client information. All Caregivers must sign a Confidentiality Statement and a Caregiver Confidentiality and Responsibility Acknowledgment Agreement, which is kept on file. Elders Choice of PA, Inc. will continue to be a trusted, non-medical resource, a top priority at our company.
HIPAA regulations protect client and family information, including the following: names, all elements of dates directly related to the individual, telephone numbers, electronic mail addresses, social security numbers, medical history, account numbers, and vehicle identifiers.
Guidelines for Caregivers regarding “HIPAA”. The Caregiver will keep all information regarding the client in a secured area at the client’s home, such as the non-medical care plan. The caregiver will not discuss the client in public areas or at home with his/her (caregiver’s family) or with other people who accept this with prior authorization from the client. The Caregiver will not give their family or friends the clients’ phone number without approval from the clients.
Policies and Procedures for Direct Caregivers
Direct Care Providers Referral Criteria
All potential applicants must fill out an Elders Choice of PA Informational form. Once the informational form is received, a face-to-face interview will be scheduled. Prior to Elders Choice of PA referring any direct care provider to a case, all and without any exceptions, shall be subject to a criminal background check.
Criminal Background Checks
If you have been a resident of Pennsylvania for two years, Elders Choice of PA will require a State Police background screening. If you are not a Pennsylvania resident, caregivers will need to have an FBI fingerprint. If any background check shows a prior conviction, the Department of Aging will then have to provide a letter of determination of eligibility for hire or roster based on a review of a federal criminal history record.
The applicant shall swear or affirm in writing that the applicant is not disqualified from employment or referral to a case. Refer to the Provisional Hiring Section for more standards.
Also prior to placement, the contractor will provide at least two job related references in the healthcare field and submit any certifications or licensing to be placed in their file.
Health Screenings
It is the policy of Elders Choice of PA to ensure that each direct care worker and office personnel with direct consumer contact provide documentation confirming they have been screened for and are free from active MTB.
Elders Choice of PA screens all applicants in accordance with CDC guidelines for preventing MTB in healthcare settings. This will be done prior to any job placement or referrals.
Elders Choice of PA staff or direct care workers with direct consumer contact shall update the documentation at least every 12 months, and the negative TB test or chest X-ray will be placed in the individual’s file. Elders Choice of Pa provides a TB form to all applicants who provide hands-on care.
Continued Criteria for Direct Care Worker’s
All appropriate documentation is necessary such as a valid driver’s license or non-driver identification. A social security card is required. A green card, permanent resident card, passport or citizenship papers are necessary also. Elders Choice of PA will ensure that all direct care providers documents will be kept in a secure place. Elders Choice of PA will not refer illegal aliens. Elders Choice of PA complies with all immigration laws.
All Direct Care Providers files will be kept by Elders Choice of PA for seven years. After seven years, the files will be shredded.
Provisional Hiring for Non-Pennsylvania Residents
Elders Choice of PA shall not refer a direct care worker until they meet the competency requirements set forth by the PA Department of Health. A direct care provider shall be monitored by the client and/or responsible party, NOT Elders Choice of PA, Inc. The consumer gets to interview the direct care worker, negotiate the direct care worker’s fees for their services, hire them, and observe them. If the consumer is unsatisfied with the direct care worker’s services, the consumer could remove that caregiver and request a new caregiver interview.
Elders Choice of PA shall have no knowledge about the applicant that would disqualify the applicant under 18 Pa.C.S. 4911, and the applicant shall swear or affirm in writing that the applicant is not disqualified from referral to a case. Elders Choice of PA provides the Caregiver with this form.
The period of provisional hire of direct care worker by the consumer and/or their representative who is and has been, for a period of 2 years or more, a resident of Pennsylvania shall not exceed 30 days. The period of provisional hire of an individual who has not been a resident of Pennsylvania for two years or more shall not exceed 90 days. Elders Choice of PA receives a letter of certification from the Pennsylvania Department of Aging stating that there is no past criminal history, and our agency will give the documentation to the consumer.
If the information obtained from the criminal history report reveals that the individual is disqualified from referral under 611.23, the individual shall be removed from Elders Choice of PA roster immediately. If the individual also fails to provide the criminal history report within the time period, the individual shall be removed from our roster.
Training Requirements
Elders Choice of PA has developed a “Competency Examination.” Elders Choice of PA recruits and screens caregivers who have at least two years of experience working in the home health industry. Direct care providers will provide all prior training and certifications at the time of application and that will be placed in their file.
All caregivers will participate in the mandatory competency test before being referred to a case. Once the direct care worker demonstrates that they passed the competency requirements, their examination will be placed in their file. Caregivers will also be expected to have an annual competency exam.
Identification Badges
All healthcare workers referred or placed by Elders Choice of PA, Inc. delivering direct care to a consumer are required to wear identification badges that include the following information: a recent photograph, your first and last name and maybe middle initial if you have one, the badge will show designated title such as direct care worker or certified nursing assistant and our agency name, Elders Choice of PA, Inc. Exception: If you have a religious belief that would not allow you to have your picture on your badge, you must notify the agency immediately.
Consumer Protections – Prohibitions
It is the policy of Elders Choice of PA. that no individual, as a result of the affiliation with our registry, may assume power of attorney or guardianship over the consumer. If the client does not have a designated legal representative and any individual attempts to coerce them into this type of arrangement, Elders Choice of PA will immediately remove you from our roster and notify the Area Agency on Aging Protective Services Unit.
It is prohibited for any direct care provider to require or allow any consumer to endorse checks in their name. Elders Choice of PA will again remove you immediately from the roster and report that individual to the Area Agency on Aging Protective Services Unit.
Check writing and using a consumer’s credit card is prohibited. The caregiver will be terminated immediately from the registry roster.
Direct Care Providers Services List
Companion and Homemaking Services:
- Conversation, companionship, and friendship
- Meal preparation and clean up
- Ensure the freshness of foods and beverages
- Light housekeeping
- Laundry and linen washing
- Grocery shopping and general shopping
- Errand services
- Medication reminders
- Medical appointments
- Respite care at a minimum of two weeks
- Safety monitoring and supervision
- Help with clothing selection and clothes shopping
- Transportation is only provided by the clients’ vehicle
- Recreational activities and crafts
- Escort on social outings
- Removal of garbage
- Retrieve mail
Personal Care Services:
- Assisting with bathing
- Assisting with grooming
- Assisting with toileting
- Incontinence care
- Assisting and supervising with walking, transferring, and positioning
Tax Obligations
Caregivers are not employees of Elders Choice of PA.All direct care providers work directly for the consumer. Elders Choice of PA is a referral agency. As a referral agency, Elders Choice of PA does not pay any taxes on your behalf, and we do not provide workmen’s or unemployment compensation. You must discuss your financial relationship with the client and/or the responsible party to whom you provide the direct service. Most families consult their accountant or attorney
about the client/caregiver relationship. As a Home Care Registry, we receive a daily fee from the client and/or family for your referred case. The PA Department of Labor standard classifies all 24/7 live-in caregivers as household employees, so the direct care providers can be paid directly by the client and/or their responsible party as a household employee. Taxes should be deducted directly from your paycheck.
Payments to Caregivers
Elders Choice of PA does not negotiate daily rates or other items that the caregiver deems necessary. Elders Choice of PA, Inc. will set up interviews for client opportunities. The direct care providers interview the potential client and discuss their fees and other terms with the consumer. When the consumer selects the caregiver and agrees to all the terms, the client and direct care worker fill out the” Care Provider Initial Cost form,” the client, caregiver, and agency get a copy. Elders Choice of PA, Inc. does not get involved with negotiating between client and caregiver. Our copy is placed in the caregiver’s file.
All caregivers will negotiate with the client and/or their responsible party their payment schedule. Caregivers are usually asked to be paid weekly but that is mutually agreed upon between the direct care worker and client/family.
All raises, bonuses, and gifts of any kind are mutually agreed upon between the caregiver and the client/family and are not the responsibility of Elders Choice of PA.
Caregivers are prohibited from being involved with a client’s financial matters. Caregivers are prohibited from using clients’ credit cards and debit cards. Direct care workers are prohibited from becoming a client’s power of attorney. Elders Choice of PA will remove you from the roster if this occurs.
Break/Vacation Time
Caregivers should give their clients and agency notice before taking a break or vacation just in case the client wants Elders Choice of PA to refer a temporary caregiver for the time they are on vacation.
Holiday Pay
It is up to the Direct Care Workers to negotiate holiday pay with the consumer or their agent.
Length of Time for Live-In Services
Caregivers and the client determine how long the direct care worker will stay prior to taking a break. The Direct Care Worker will discuss with the client/family first and then inform us and if the client wants us to bring in a temporary caregiver, they will let us know. The date and days for vacations are up to the direct care worker NOT Elders Choice of PA, Inc.
The Caregivers should provide ten days- notice to their client if they decide to leave the case. Less than ten days’ notice in the event of a family emergency, lack of payment, or possible harm to the caregiver.
Request for Change of a Case
You may request to be withdrawn from a case for valid reasons. First, Elders Choice of PA will work with the caregiver and client to remedy the situation before removing a caregiver from the case. Direct Care providers should provide their client and/or representative 10 days advanced written notice before leaving their job unless the consumer has failed to pay for services or the caregiver’s health and welfare of the direct care worker is at risk.
Removal from a Case
Clients have a right to be part of the selection process of their direct care provider. It is the policy of Elders Choice of PA to have the client and/or their responsible party accept or reject, at their discretion, any care provider that is referred by Elders Choice of PA.
Reminder: Elders Choice of PA is a referral agency. The client has the authority to hire or fire a direct care worker at their discretion!
No Workmen’s Compensation Package
All caregivers must ensure that they have medical insurance in the event that they need to see a doctor. The caregiver releases Elders Choice of PA from any financial responsibility in the event of a work-related injury while working on a referred case.
Revisions as of December, 2022