Hire Directly or Use a Provider: Ask These 4 Questions Before Deciding
When families are seeking services for a loved one with a disability, they typically have a choice to make: hire support staff directly or use a provider like Mosaic. It’s a tough decision that requires careful consideration.
Pat Costigan, Mosaic’s Vice President of Service Line Management, shared four questions families should ask when determining the path that’s right for them.
1. Are we comfortable handling employment, payroll and hiring on our own?
Costigan said that when families hire directly, they must be prepared to take on some Human Resources responsibilities.
“There are workers’ rights, Department of Labor considerations, tax implications for both parties, and other legalities to consider,” he said. “Some state programs offer a broker or support person to help navigate some of that, but it’s up to the family to reach out and start that process.”
When families choose Mosaic, Costigan said, they don’t have to worry about any of that. Mosaic takes care of all of the employment-related to-dos.
“We vet employees and independent contractors with background checks and other pre-employment screening to make sure they are qualified,” he said.
Once they’re on board, Mosaic’s direct support staff receive training and have access to professional development opportunities.
2. What happens when a staff member calls in sick, quits unexpectedly or takes a vacation?
When families need support for their loved one with a disability, reliability is an important consideration.
Whether you hire a caregiver directly or go through a provider, staff will occasionally call in sick or resign unexpectedly. The main difference is who handles the backup plan:
- Hiring Directly: You are responsible for finding coverage.
- Using A Provider: The agency handles alternate arrangements.
“It’s one thing to hire someone to provide care; it’s another to ensure they are always available when you need them,” Costigan said.
Many families choose Mosaic for peace of mind during unexpected situations.
“If a Mosaic caregiver is not available for whatever reason, we find a replacement and make sure people’s needs are met,” Costigan said. “If a family hires someone directly, they have to find an alternate arrangement for their loved one.”
Mosaic provides 24/7 on-call support to our caregivers 365 days of the year. If there is an emergency or a caregiver isn’t available, Mosaic can provide the support needed through a robust network of direct care providers who can step in.
Costigan said many times when a family hires help directly, they have identified a family member, friend or another person already to be a backup. Often, that works out just fine, but Costigan recommends that families have a plan in place in case something changes or they suddenly become unavailable.
3. Which option will result in better outcomes for my loved one?
Costigan said many families believe their loved one will receive more personalized care if they hire someone directly. That’s not always the case.
“There are good providers that help you do that, too,” Costigan said.
Mosaic knows that every person has unique needs, values and goals for their life. Our services are not one-size-fits-all. They are tailored to the individual.
We spend time getting to know each individual and family. We ask questions to understand what really matters to them, and we work with them to make those things a reality.
When a person joins Mosaic, we work to understand their unique dreams, goals and priorities through conversations and questions to determine Personal Outcome Measures® (POM). They then use what they learn to build their individual services plan and track progress toward achieving what matters most to them.
Developed by The Council on Quality and Leadership, an organization focused on improving the quality of life for people with intellectual, developmental, and psychiatric disabilities, the POM is a tool Mosaic adopted to understand what’s important to the people we support.
4. Are we comfortable navigating the Medicaid system?
The Medicaid system is complex, and it will likely get harder to navigate as states make budget decisions to adjust for less federal funding.
“State budgets are getting tighter,” Costigan said. “That often means new rules or oversight. Mosaic handles that. That’s what we do every day.”
Mosaic has a robust compliance program that meets all local, state and federal regulations.
“If a family has the time and the experience, they can do it,” Costigan said. “My question is, do you want to?”
Ultimately, the choice to hire directly or use a provider like Mosaic is personal.
Trusting a loved one’s care to Mosaic, which has been providing services to people with intellectual and developmental disabilities and other diverse needs for 113 years, also opens the door to a new type of relationship.
“With Mosaic managing the day-to-day care, they can be mom, dad, brother, sister, housemate or whatever the relationship is, again,” Costigan said. “We take care of the administrative duties so they can enjoy time together as a family.”
Mosaic provides services to nearly 5,000 people with intellectual and developmental disabilities and other diverse needs across 12 states in more than 825 communities. These services enable people to thrive in their communities, hold jobs, gain autonomy, and accomplish other goals and dreams that are meaningful to them. To locate services near you, visit Find Services.