Citing patient safety and the need to protect seniors and other vulnerable populations, Attorney General Peter F. Kilmartin legislation requiring national background checks and licenses for personal care attendants is scheduled to be heard before Senate Judiciary Committee on Thursday, April 11, 2013. The legislation S0461 is sponsored by Senator Michael J. McCaffrey, with a House companion bill (H5538) sponsored by Representative Eileen Naughton. Under the Global Medicaid Waiver, the State of Rhode Island received permission from the Centers for Medicare and Medicaid to offer seniors more options. One goal was to allow them to stay in their own homes longer, and stay out of an institutional nursing home setting.
Recognizing that individuals need different levels of care at home, the system relies on the expanded use of personal care assistants. Personal care assistants do not provide any medical services, but do provide services to help consumers stay in their home, such as grooming, household tasks and transportation.
"For patient safety, especially due to the vulnerability of our seniors, workers in this field need to be subject to a national background check, training and regulation. As more patients return to home under the Global Medicaid Waiver, we need to ensure the most vulnerable are being treated by professional workers to protect them from victimization and exploitation," said Attorney General Kilmartin.
The legislation requires all personal care assistants to be subject to a national background check as a condition of certification and employment. It also requires that PCAs obtain a certificate of registration issued by the Department of Health (HEALTH), and training. It also allows for the biannual renewal of registrations, which would be granted as a matter of course with proof of completion of continuing education unless the (HEALTH) finds that the registrant has acted or failed to act in a manner that would constitute grounds for suspension or revocation of a certificate.
Senator McCaffrey said, "It's important that we take extra precautions as we look to improve Rhode Island's health care system, and this legislation is a solid preventative measure to help shield the elderly from abuse. If enacted, I think it's safe to say that the state's older population will also feel more protected this way."
"One of my top priorities as a member of the General Assembly is to advocate for the protection of our seniors," Representative Naughton said. "This is another step the state needs to take to ensure that the elderly living in Rhode Island can feel safe living in their homes with the people who take care of them."
Although personal care assistants do not provide medical services, they provide assistance with physical activities, such as grooming and bathing, and financial activities, such as paying bills and shopping, as well as companionship for their clients. I think it is necessary, due to the intimate physical tasks required of personal care assistants, that they be required to receive a national criminal records check and basic training, as well as individualized training to suit the needs of their client," continued Kilmartin.
The legislation allows for HEALTH to deny, suspend or revoke a person's certificate of registration in any case in which it finds that there has been failure to comply with the requirements, or that the registrant has been convicted of a disqualifying offense. Finally, the legislation provides criminal penalties and fines for those who fraudulently serve as a personal care assistant.
"From my viewpoint, this is a safety issue for our most vulnerable citizens and a fiscal issue for taxpayers," added Kilmartin. Medicaid Fraud Units across the country estimate that more than 50 percent of reported Medicaid fraud cases involve home care services, yet in Rhode Island, home care Medicaid fraud accounts for only one to two percent of Rhode Island's Medicaid Fraud Unit's case load. "While it would be optimistic to say that Rhode Island has such a low percentage of Medicaid fraud attributed to home care services because these criminal acts are not occurring, it is likely due to the fact that personal care attendants are not aptly regulated. Therefore, there is not an adequate process currently in place to determine whether fraud is taking place," concluded Kilmartin.