California seniors can unknowingly be put in the hands of caregivers with criminal histories due to shoddy screening and a hole in the state's regulations, according to a report released yesterday by the state Senate Office of Oversight and Outcomes.
The report, titled “Caregiver Roulette: California Fails to Screen those who Care for the Elderly at Home,” [PDF] found that California is one of only a few states in the country that doesn’t regulate its in-home care agencies, which provide non-medical support such as bathing, eating, and basic hygiene to the elderly. While day care centers and nursing homes are subject to state oversight, independent caregiver agencies only need a business license to operate.
Many in-home care agencies claim to conduct background checks for new hires but in several cases barely screened applicants, according to the report. The report also found some agencies approved caregivers who they knew had criminal convictions. Of 64 recent criminal cases involving caregivers, 27 percent had previously been convicted of crimes.
“There is a convergence of trends that is leading to an epidemic of abuse, particularly financial abuse, of elderly clients in this industry,” said John Hill, an author of the report and a principal consultant in the Senate Office of Oversight and Outcomes.
For the report, Hill sifted through Craigslist ads for in-home care services and found that ads were being posted by people with felony convictions for methamphetamine trafficking and major theft. In 2009, there were an estimated 1,200 in-home care agencies throughout the state, according to the California Association for Health Services at Home, which represents in-home agencies.
Home care providers can get certification from the association, which has the ability to perform background checks. But the report found that only about 19 percent of these agencies are certified by the association. The remaining 81 percent conduct their own screenings of caregivers. Hill said the majority of these agencies resort to Internet background checks.
“You can understand why these agencies would want to use cheap Internet screening because it won’t bust their budgets and it’s instantaneous,” Hill said. “But Internet searches are not worth much.”
The lax regulatory landscape is ripe for abuse, worries Kellie Ikenberry, whom Hill quoted in his report. Ikenberry said her parents were victimized by a caregiver with a criminal background who stole from them.
“Maybe there needs to be some regulations that say you don’t get to just walk in off the street and live in someone’s home,” Ikenberry said. “Government has to protect these elderly people.”
According to the report, there has been confusion about how to implement a 2008 law meant to help seniors and their families conduct their own background checks through Department of Justice databases. That means that most people who hire caregivers through Internet sites like Craigslist are hiring people who have not been fully vetted.
The oversight office recommends that the government create a registry allowing clients to find caregivers who have voluntarily been screened, which could help seniors steer clear of those with criminal pasts. It suggests implementing a public outreach program to educate the public about how to request and understand a Department of Justice background check. It also recommends a state law to allow agencies to disclose caregiver convictions older than seven years.
State lawmakers have recently introduced two bills in the state Legislature that would regulate caregiver agencies. The last caregiver regulation bill to be introduced died in committee in 2007.
“Right now, seniors are being thrown out into a market where they don’t know how to do proper background checks or screening and the agencies themselves haven’t done a thorough job,” Hill said.