California Passes New Regulations for Home Care Agencies

Despite the opposition of home health agencies, California passed the Home Care Services Consumer Protection Act of 2013 (HCS-CPA). HCS-CPA requires the state to license and regulate home care organizations and register home care aides beginning in 2016. Governor Jerry Brown vetoed a similar bill last year; the new law implemented changes suggested by Brown.

Home Care Fraud

California has the highest population of any state, including nearly five million residents over 65. Home care organizations offer nonmedical services for the elderly who need help performing basic tasks. Traditionally, the home care industry is not heavily regulated. Only 29 states mandate registration of home care agencies, and only 15 states require training for home care workers. Very few agencies perform background checks on the workers they refer to clients. In California, these organizations require only a business license. Older adults and their families have no easy, reliable way of checking the qualifications and adequacy of agencies or caregivers.  The lack of regulation and the fact that care recipients are a growing population of vulnerable citizens makes home care an easy target for criminals.

The New Law

Unions and organizations representing the elderly advocated for the law, which will affect an estimated 1,400 home care agencies and 120,000 paid caregivers. Under the HCS-CPA, California home care agencies have to obtain a state license by January 1, 2016, or face a fine of up to $900 a day. Agencies will be required to conduct background checks on caregivers, assess caregivers’ performance annually, and conduct supervision of their activities in a client’s home every 90 days. Further, caregivers will be required to obtain certification after undergoing a background check, a tuberculosis test, and five hours of basic training. The state will maintain a website of the names and locations of certified caregivers.

Medicare Home Care Scrutiny

CMS announced increased scrutiny of home care agencies in 2011 as the number of home care fraud cases has grown. The HHS Office of Inspector General and Department of Justice maintain a steady stream of home health fraud cases to investigate and prosecute. As a resource for Medicare recipients, CMS offers a checklist for consumers seeking to compare home care agencies that can also be adapted for use by individuals who are not covered by Medicare.