A home care agreement, whether it comes from an agency or is a direct private arrangement, is the paper that says what everyone agreed to. It is easy to focus on the hourly rate and the start date. The terms that decide what your family actually pays, and who ends up handling the gaps, are the ones about changes, cancellations, and absences. Treat those as the main event.

Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.

Who is the employer on paper

Find out whether the caregiver works for the agency or is hired directly by the family. The name on that line decides who handles scheduling, backup, and replacement. Ask the agency to show you where that is written, and ask who you call first when a shift is missed.

The gap day

Read the sick-day and substitute terms closely. Is a replacement guaranteed, or is it a best effort? Is the missed shift still billed? How much notice does the family have to give to cancel, and is the notice rule the same for the family as for the agency? These answers decide who absorbs the cost when plans fall through, which is often the family member who takes the call.

Minimum shifts and rate changes

Look for a minimum shift length, any travel or extra-time charge, and any clause that lets the agency change its rates. Ask the agency to explain each clause in plain words and to confirm the answer in writing. If the rate can change, find out how much notice the family gets and whether the family can end the agreement without a penalty.

What it costs: The Missouri median for non-medical in-home care is $33 an hour, per the CareScout (Genworth) Cost of Care Survey 2025 state data tables, released March 2026. New Plan Care's standard rate is $34 an hour with a four-hour minimum, so a visit starts at $136 (newplancare.com/services).

Check the task list against the rules

Compare the duties listed in the agreement with what your family actually needs. A non-medical caregiver can give medication reminders and pick up prescriptions as an errand. Any line that says the caregiver will give, sort, or manage medicine should be struck or changed, because those tasks stay with the family, the doctor, and the pharmacist. The list should say reminders and errands, nothing more.

Before the signature

Keep the quote, the agreement, and any email that changed a term together in one folder. Ask who receives a copy and who keeps the original. If a clause is still unclear after the agency explains it, have someone who gives professional opinions on contracts review it. This page is a checklist to bring to that conversation, not legal advice.