Not anymore. If you're a CEO with more money than time to spend, you're in luck. USA Today's Small Business blog mentions a couple of agencies who can place a well-qualified nanny in charge of your children's lives--or even a full-on domestic executive, to run your life and home(s), too. Here's that list, plus Leslie Morgan Steiner's DC mentions, plus some others, all broken down by city:
Atlanta: Domestic Placement Network
Boston: Beacon Hill Nannies
Edina, Minneapolis, etc: College Nannies & Tutors [wasn't this also on Spectravision?]
NYC, The Hamptons, Palm Beach: Hampton Domestics ["as featured on VH1!"]
San Francisco Bay Area: Town & Country Resources
Washington DC: White House Nannies
The World: International Nanny Association
Hunting for a new nanny? These small firms have you covered [usat]