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What is a Home Care Organization?

A Home Care Organization (HCO) is a non-medical home care entity licensed and governed under California Department of Social Services that arranges home care services by an affiliated home care aide to a client.HCO’s are governed by specific regulations as required by the Home Care Services Consumer Protection Act (HCSCPA). HCO’s direct the actions of an Affiliated Home Care Aide with requirements such as TB testing, training, background check and registration.

What is the difference between an HCO and Domestic Referral Agency?

A Domestic Referral Agency (DRA) is a type of employment agency under the Employment Agency Act that offers clients non-medical home care referrals/caregivers who are independent contractors. DRA’s must disclose the nature of the relationship between the caregiver and the DRA to their clients and inform the client that they may have employer responsibilities depending on the relationship between the caregiver and the client. Caregiver’s referred from a DRA set their own pay rate and can renegotiate their rate at their own discretion and are not under supervision of the DRA.

HCO’s are required to provide a minimum amount of training and supervision to their home care aides and are required to carry a specific amount of general and liability insurance, workers compensation and bond for their employed home care aides.

For more information regarding a licensed HCO vs. unlicensed DRA please go to: http://www.cdss.ca.gov/inforesources/Community-Care-Licensing/Policy/Provider-Information-Notices/Home-Care-Services and click on PIN 18-02-HCS - Licensed Versus Unlicensed Home Care Services Fact Sheet

Could a client be considered an “employer” if using the services of an HCO?
No, the HCO employs their affiliated home care aides and must meet all the requirements under the HCSPA and Industrial Welfare Commission Order No. 15-2001.

Who do I contact if I have additional questions about the Home Care Services Consumer Protection Act?

For more information regarding the Home Care Services Consumer Protection Act, please contact the Home Care Services Bureau by e-mail at HCSB@dss.ca.gov or by telephone at (916) 657-3570, or for information on the Home Care Aide Registry or the background check process please contact the Caregiver Background Check Bureau by telephone at (916) 653-1923.

How does an HCO determine the cost of services?

An initial assessment by the HCO is conducted to determine the level of care required or preferred by the client. For example, if a client requires minimum assistance with daily activities then the rate would be at the minimum where as if a client needs full assistance such as bed transfer, hygiene, bathing, transportation, then the rate would be higher. An hourly or live-in rate may also be discussed during the assessment.

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