Finding and Hiring Direct Caregivers

Direct Caregiver: An assistant to help you with caregiving responsibilities for your child with special health care needs.  A direct caregiver can give respite which is a break, or time off, from your caregiving duties. Or, a direct caregiver can do  personal care services or activities of daily living for your child including meal preparation, feeding, bathing and toileting.

Where Do I Find a Direct Caregiver? 

Word of Mouth: Tell friends, neighbors and coworkers that you’re looking for a direct caregiver. And, reach out to organizations like your faith community, neighborhood association or parent support groups.

Your Child’s School: Talk to teachers, therapists and aides at your child’s current and former schools. Explain that you’re looking and give them a description of the position to share with others.

Colleges and Technical Schools: Find students studying health care, education, nursing, social work or related fields. Mature high-school students may also be an option during school breaks.

Job Boards: These can be online or physical job boards. Respite programs or personal care agencies can help you find job boards in your community.

Community Programs: Contact local programs that serve children like the YMCA, summer camps, after-school programs and swimming or other sports clubs.

Place Ads: Local newspapers, neighborhood newsletters and local Facebook groups are inexpensive ways to find help.

A Good Idea!

Be open minded when you interview potential direct caregivers. Candidates who don’t have years of experience may still be good caregivers if they are bright, motivated and eager to learn about your child.

How do I Pay for Direct Caregivers?

You have choices to cover the cost of direct caregivers. Medicaid personal care services⁺ are funded by your child’s ForwardHealth card, while respite care⁺ can be funded by the Children’s Long-Term Support (CLTS) Program or the Children’s Community Options (CCOP) program. (⁺We have fact sheets on these topics!)

The CLTS Program also allows families to use self-directed supports to let you to choose, hire and manage your workers directly. A fiscal employer agent will then support your family in self-directing your workers.

Can I Hire Family Members?                                                                                                                                                              

If your child is under age 18, Wisconsin Medicaid may allow you to hire a relative as a direct caregiver. For youth over age 18, parents can be hired to provide personal care services.* And, respite programs may let you hire relatives, including older siblings.

(*Special, temporary, pandemic policy changes allow parents of children, under age 18, and on long-term supports, to be paid to provide direct care including childcare, respite and supportive home care. Contact your child’s service coordinator to learn more.)

Interviewing Potential Direct Caregivers

You might be looking for a direct caregiver to help your child with activities of daily living or someone to give you a break from your caregiving. But before you start interviewing, it’s important to know your needs. Think about your family’s routines and your child’s likes and dislikes. The following interview guidelines have more suggestions so you find the best direct caregiver for your family:

How do I Start?

• • • Invite potential direct caregivers to your home to make sure they’re a good fit with your family.
    • Make time for the caregiver and your child to get to know each other.
    • Explain your child’s medical and/or behavioral conditions and ask about their experience with them.
    • Be specific about the days and times that your family needs a direct caregiver.
    • Describe what you are looking for in a worker and what their time with your child will look like.
    • Talk about special rules, or expectations, you have for caregivers. For instance, you may need the worker to call if he/she is running late.

A Good Idea!

Try Role Play: Give candidates a situation, like your child has a seizure in the park, and ask how they react to it. If they don’t know, do they ask you appropriate questions? Are they open to learning? Can they deal with a stressful situation?

Which Questions Should I Ask?

• • • Do they have experience working with children with special needs?
    • If not, have they been a babysitter or a caregiver for a sibling?
    • How many hours are they able to work?
    • Do they have flexibility to work with your family more often or on short notice?
    • For students, will their schedule change each semester?
    • Do they have reliable transportation?
    • Will they need to find a ride? take a bus? or are they close enough to walk or bike?
    • Are they comfortable with all the duties of the position?
    • Can they use equipment? change diapers? prepare meals? and react appropriately to behaviors?

I Found the Perfect Direct Caregiver! Now What?

When you identify a caregiver to provide respite or personal care, a home health care agency or fiscal assistance program will need to hire the person, as Medicaid cannot pay the person directly. The candidate will likely have to complete an application, take part in training, and have a background check done, which could all take several weeks.

Still Have Questions? Need Help Finding Services for Your Child?

• • • CYSHCN: Children’s Resource Centers
    • Well Badger Resource Center or 800.642.7837