On Long Island and in Queens, aides accessed through an agency generally bill at $28-$35/hour. Live in aides bill in a different fashion, and it is important to understand under what methodology the aide will be billed under. Some families try to hire aides independently, outside of an agency. While it is possible to find an aide who does not work for an agency, the Home Health agencies perform several valuable services for the family. They screen and train the aides, of course. Perhaps the most important reason to use an Agency is that most families are just not prepared to employ staff (the aide). There are any number of employment and tax laws governing the employee – employer relationship, and it is typically best to leave compliance with these laws to a business that does this all the time.