NYT examines 'gray market' for in-home long-term care aides

Many middle-class families facing the "crushing burden of indefinite home-care expenses" have begun to hire in-home long-term care aides through the "gray market," an "over-the-back-fence network of women," although the practice "is fraught with risks," the New York Times reports.

According to the Times, aides hired through the gray market are "usually untrained, unscreened and unsupervised," but they are more affordable than bonded, insured and certified aides hired through agencies.

Aides hired through the gray market might cost about $12 per hour, compared with about $20 per hour for those hired through agencies.

In addition, many families who hire aides through the gray market "cite the loyalty of employees and their ability to work unfettered by regulations," the Times reports.

Meanwhile, traditional home health care agencies have begun "opening divisions geared toward clients who must pay their own way," and "upscale agencies providing trained aides are proliferating solely for the private-pay market, as are national chains with more modest services -- and more reasonable prices," according to the Times.

However, some policy experts have raised concerns that the home health care industry "could put profit above quality," the Times reports.

Val Halamandaris, president of the National Association for Home Care and Hospice, said, "Consumers are always in jeopardy when there's an opportunity to make a lot of money. Sometimes it works out beautifully, and sometimes it doesn't. But nobody's policing it, that's for sure" (Gross, New York Times, 3/1).