When California Gov. Jerry Brown recently signed into a law new home-care regulations, that drew a mixed reaction from the California Association for Health Services at Home.
The group, which represents 500 agencies, was happy with the regulations that will help distinguish “legitimate home-care agencies” from services offered via “Craigslist and through the underground economy,” said Dean Chalios, president and CEO of CAHSAH.
The agencies, such as those represented by Sacramento-based CAHSAH, will need to be licensed. Meanwhile, home-care workers who care for elderly and disabled people will have to undergo five hours of training and criminal background checks. It will be a misdemeanor for home-care aides to falsely represent themselves as registered home-care workers. Aides will be required to undergo testing to show they are free of tuberculosis.
But Chalios is concerned with the online registry, calling it an unfunded mandate. The registry is a database of home-care workers with licenses. Chalios said it's unneeded and will add to red tape for home-care agencies. “We'll need to report to the state whenever a caregiver is hired or when they leave the agency,” he said. “And you probably know the turnover rate among caregivers is quite high.”
The industry has acknowledged a high turnover rate that can range from 50% to 100%. Chalios said the industry is concerned about the costs of following this mandate, including licensing fees.
The law is slated to go into effect in January, but Brown may delay it until 2016 to give agencies more time to comply.
A study released in 2012, then updated this year, in the Journal of Applied Gerontology reported that 29 states require licenses for home-care providers. In that group, 26 mandate orientation and 15 mandate training. Twenty-seven states require background checks. The study's authors pointed out an inconsistency in regulations for home-care workers across the states.
These regulations are also being welcomed by workers, including the New York-based advocacy group Paraprofessional Health Institute. PHI recently celebrated the Obama's administration long-awaited decisions to remove the companionship exemption, thus increasing the number of home-care workers covered by federal laws on the minimum wage and overtime pay. That represented a victory for those who felt the home-care industry was too lightly regulated.
PHI already encourages training for workers. Although five hours of mandatory training is a solid start, Steve Edelstein, PHI's national policy director, said he wonders how much could be accomplished in the short timeframe. Overall, the lawmakers in California made a good decision, he said.
“Again, as we try to serve more people with disabilities and elders at home and in other communities, we need to build a workforce that can do that,” Edelstein said. “Policy has been moving in that direction to grow home-community-based services, and I don't know that we've given enough attention to issues of quality assurance and safety.”
Follow Ashok Selvam on Twitter: @MH_aselvam
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