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Paid Aides—An Agency’s or Your Own?

Alfred H. “Skip” DeGraff

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At that moment, you, or your representative, become a personnel manager. There are no short cuts. The initial training and each day’s ongoing management and supervision must come from you or your rep during your face-to-face work with each aide—they cannot come from an agency supervisor who can’t be there that often.

Each time you need a new provider, you use the RISHTMP cycle—Recruiting, Interviewing, Screening, Hiring, Training, Managing and Parting with each helper. If you use agency aides, you recruit, interview, screen, and hire the agency—and then proceed to train, manage, and part with the aides it assigns to you. If you personally employ, you perform all the tasks with each of your PAs.

Your decision about using agency aides or your own PAs will also be based on these considerations:

Cost If your providers are funded, often by health insurance or public assistance, the funding source often requires your aides to come from an agency. If the funding comes from your pocket, it’s a fact that agency aides cost at least two or three times that of personally employed PAs.

Ability and willingness to recruit, hire and manage For help recipients who lack the cognitive clarity or willingness to state their needs and then manage the help they need, agencies can be essential. Also, when a recipient’s help needs are temporary, using an agency relieves the need to learn many of the management skills. However, when one’s dependent needs are life-long, learning the skills can be simply an investment in controlling one’s quality of life.

Control Is it important for you to be in maximum control over the quality of who provides your help, as well as the what, how and when of the help you receive? Are you a hands-on, assertive person who wants to live by your own schedule and preferences, or are you comfortable accepting agency policies and schedules about who helps you and when they are available?

Training As mentioned, whether you use agency or personal providers, you or your representative will provide most of the initial training and ongoing management.


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