California needs to expand and enhance its continuum of services for its aging population. There are frequent news stories about the lack of vigilance in monitoring care, whether it be nursing homes, assisted living or in-home care, and much work needs to be done to shore up our delivery and monitoring systems.
Medical service guidelines were developed for Medicare, the primary payment source, while none exist for the state and private funded sources, which pay for the non-medical services, such as home care. Home care licensure is sorely needed.
But AB 1217, the Home Care Consumer Act, is not the answer.
AB 1217 deceives the consumer by claiming protection through licensure for home care, yet it exempts over 75% of all home care services, targeting only a portion of the private home care agencies, of which there are two models: those that employ their aides and assume all employer liabilities (the employer model), and those that just pay the aides a gross wage and transfer all employer liabilities to the client (the referral agency). The latter are exempted from the bill's coverage, yet such an agency will be permitted to represent itself "to be a home care organization by name, advertising, soliciting, or any other presentments to the public" and may "imply that it is licensed to provide those services" without being licensed under this bill.
This union-sponsored bill was written to affect only the employer model, one small sector -- representing less than 20% of all home care. No rationally operated agency will continue the employer model when it can opt out of licensure by flipping to the referral agency model. Consequently, as agencies switch to the referral model, this bill will erode Medicare and Social Security -- the pillars of our safety net for seniors -- and will remove workers compensation coverage for thousands. Moreover, this puts consumers at risk as they unknowingly assume all employer responsibilities for the worker.
We need home care licensure under the California Department of Social Services that offers regulations similar to other states and in licensure for hospitals, nursing homes and assisted living. There should be full consumer disclosures and a certification process for agencies that choose not to employ their workers. And we need a joint home and assisted living non-medical aide certification curriculum and fingerprinting system under DSS. We need to safeguard the existing entitlements and protect for our aging population from all exploitation.