Home Health Industry Could Use More Regulation, According to UCLA

by David Gorn


UC-Los Angeles researchers yesterday released a study that concluded more regulation is needed among home health care workers in California.

"This is significant, because you're talking about delivery of care at home, in an unsupervised setting, to a population that is vulnerable," said Nadereh Pourat, director of research at the UCLA Center for Health Policy Research.

"There is potential for problems here, and the goal is to see what safeguards are in place," Pourat said. "There's no guarantee that, with licensed or certified people, there will be no harm, either. But it can help provide a safe environment."

Pourat said home health aides are certified by the state and In-Home Supportive Services workers must undergo background checks.

But that's not even close to all of the home health workers in the state, Pourat said. "Anyone can hire someone," she said, through word-of-mouth recommendations or Internet sites. There's no licensure, she said, for non-health-related care, such as homemaking, shopping or cooking services.

The real problem, Pourat said, is that data is lacking on just how many non-licensed home care workers operate in California.

"It's a black box in terms of getting information and data on this group," Pourat said, "really, even estimating how many of them there are."

A bill is pending in the current session, AB 1217 by Assembly member Bonnie Lowenthal (D-Long Beach), which would establish certification of home health workers. The bill has raised privacy concerns because it calls for posting of certification data -- including names of care givers -- online. Other concerns revolve around the possible rise in cost of home health services.

"The concerns expressed have validity," Pourat said. "Licensure can impact price. You're asking people for additional paperwork and effort."

But the reports of negative experiences can't be ignored, she said.

"I think some level of scrutiny is warranted," Pourat said. "You're looking at an important and growing segment of an industry that has no safeguards in it. How things get implemented could make a difference, but a minimal level is probably warranted."

Kathy Janz
AB1217 Lowenthal's Home Care Consumer Act got worst with every amendment. The Senate Rules Co Analyst report stated - the bill removed client rights and key protections. What is left is a very costly licensure for agencies that employ their aides and assume all liabilities. The bill explicitly exempts home care agencies that just issue 1099s, then allow them to represent themselves as licensed, bonded, insured. This is consumer deception not protection. The union wants to eliminate the employer-employ model in favor of the Independent Contractor which puts all the liabilities on the consumer- a senior or a disabled adult. Why deceive the public and circumvent and deny workers compensation, disability, unemployment insurance for the aide and payroll tax deductions and ACA demands is uncomprehendable. It exempts at least 80% of all home care services and targets only the home care agencies that employ their aides , which will force them to convert to the 1099 model.
Tom O'Malley
The home care community agrees that this is an industry that should be regulated. In fact, the California Association for Health Services At Home has sponsored legislation 3 times to regulate the industry in a way that makes sense for consumers, workers, and providers, including via AB 322 this session. AB 322 would have provided for training standards, background checks, insurance protections, and oversight by the Department of Social Services - all items identified in the report as ways to provide a greater level of safety and security to consumers. However, a competing bill which is still pending, AB 1217, seeks to add additional layers of bureaucracy and to create a vehicle for unionization of the workforce by publicizing their work place and location. Note that the funding for this report was provided by the Service Employees International Union, sponsors of AB 1217 and SB 411 before it, which was vetoed by the Governor last year. This is simply politics, not good policy.

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