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When they don't agree on things? 2 sisters are POA
One Medical
2nd Financial

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You will have to read the documents. My guess is the health care proxy hires and the financial POA pays the bill along with other bills for your parent. Needless to say, it would be better if both sisters agreed on things. After all, the expense has to fit into the parent's budget.
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Is the argument over ~what~ kind of care is needed, or how much should be paid for it? As Geewiz says, the best solution is that both sisters agree, but the next is to find a reasonable compromise that provides the parent with the best available care. You might be able to find a Senior Care Manager who would come in, assess the situation and make recommendations for the care, giving you an unbiased opinion. Be careful though, that they're independent of any care providing agencies, otherwise they'd be less than biased.
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123, are you part of the family and the caregiver? You should contact an elder law attorney to assist with the preparation of a caregiver agreement. The attorney can also assist with drafting the agreement and determine appropriate pay. The agreements must have specific inclusions to be in compliance with your state regulations. One of the requirements on some states is that payment to a family caregiver must be comparable to what agencies charge. Many times families try to budget these expenses, but in reality, it is going to cost what it costs. I don't think an agency would reduce their fees to try to stay within a budget.
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I'd like to pipe in and say that you don't have to hire an agency-related caregiver. What that provides, often, is more security and peace of mind that the potential caregiver is qualified, but .. there are lots of qualified people, without degrees and certifications (I know, I'm one of them) out there. It just takes good screening and interviewing and reference checking.
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