A new “gray market” has cropped up for in-home long-term care aides, a news report finds.

Families facing exorbitant home-care expenses are turning to aides who cost about $12 per hour – far less than the $20 per hour agencies charge for their aides. But these aides typically are untrained and not certified, The New York Times said.

Also, traditional home health care agencies are opening divisions geared to clients who must “pay their own way,” according to the report. Some policy experts are concerned the home health care industry is putting profit above quality. Currently, many states are exploring shifting a portion of long-term care funding to home- and community-based services.