The Home Care Services Protection Act (AB-1217) was passed into law on October 2013, which resulted in California becoming the 25th state to require licensure for “private-duty,” or non-skilled, homecare. Effective Jan. 1, 2016, the intention of the new bill is to provide protection for the consumers of non-skilled home care services, who are typically vulnerable elderly or disabled individuals.
By definition, non-skilled home care services include the following activities: bathing, grooming, and dressing assistance; toileting assist; mobility assist (transfers, walking, or moving about); medication reminders; companionship; errands; and household assistance, such as light housekeeping, laundry, meal preparation and clean-up, and pet care.
Companies that send their employees into an individual’s home to provide non-medical services are now called Home Care Organizations (HCOs), and they must be licensed by the Community Care Licensing Division (CCLD) of the California Department of Social Services (CDSS). The private-duty aides who work for the HCOs are now called Home Care Aides (HCAs) and must be registered with CDSS. The new law also requires the state to provide an online registry for consumers to view the license status of an HCO or the registration status of an HCA.
Home Care Organizations (HCOs) are required to complete an application for licensure, which includes verification of worker’s compensation coverage, general and professional liability insurance with at least $1,000,000 coverage per occurrence and $3,000,000 aggregate, and an employee dishonesty bond with a minimum of $10,000 coverage. Once an HCO is licensed, it is subject to unannounced visits by the CDSS to verify the organization is providing and maintaining the appropriate training, record keeping, and insurance coverage.
Home Care Aides (HCAs) must now undergo criminal background clearance through the CDSS prior to becoming registered. The HCAs must provide proof of TB testing to the HCO and must complete at least five hours of initial training by the HCO prior to working with a client. The initial HCA training must include education for infection control and emergency procedures, as well as training on client rights; elder abuse prevention, detection, and reporting; and safely assisting clients with personal care, hygiene, and home upkeep.
Companies that refer private-duty aides, who are not their employees, to provide care to clients in their homes are considered Direct Referral Agencies (DRAs) and are not considered or allowed to be licensed HCOs at this time. The workers they refer may either be registered (HCAs) or not registered. DRAs are not required to carry insurance, perform background checks, or provide training or oversight for the caregivers they refer. This ultimately transfers increased risks to their clients, who are often vulnerable in a climate in which there is a lack of standards and oversight. For this reason, it is important for consumers to be educated and cautious in their home care services hiring practices.
For information on Keen Home Care, please call 562-438-5336.
Machelle Thompson, PT, CMC, President, and Geriatric Care Manager, Keen Home Care, has been a senior advocate for more than 25 years, working as a Physical Therapist, Nursing Home Administrator, and Geriatric Care Manager. Her company, Keen Home Care, provides in-home caregiver services and consulting for seniors and their families (call 562-438-5336 for more information).