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Background Checks For In-Home Care Workers Often Optional


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In many states, there are no requirements that home health workers undergo any kind of background check before providing in-home care to individuals with disabilities, a new report finds.

Ten states — Alabama, Connecticut, Georgia, Hawaii, Montana, New Jersey, North Dakota, South Dakota, West Virginia and Wyoming — lack any mandate for home health agencies to vet their workers against criminal databases before sending them out on the job, according to findings from the U.S. Department of Health and Human Services’ Office of Inspector General.

In the remaining 40 states and the District of Columbia, a patchwork of protections are in place.

“State requirements for background checks vary in terms of what sources of information must be checked, which job positions require background checks and what types of convictions prohibit employment,” Brian P. Ritchie, acting deputy inspector general for evaluation and inspections, wrote in his findings.

Currently, federal law does not require background checks or bar workers with criminal records or a history of abuse from working in the home health industry, the report said.

Investigators asked officials in all 50 states and the District of Columbia if they require home health agencies to conduct pre-employment or periodic background checks on workers and if any criminal convictions disqualify applicants from employment.

In cases where some level of screening is mandated, only 15 states require checks to be completed before employment commences and just as many states have systems in place for periodic checks of existing workers.

Rules in 35 states bar individuals with specific convictions from becoming home health workers but differ on which offenses disqualify prospective employees.

Of the states that reported having no background check requirements, officials in four states — Connecticut, Georgia, Hawaii and West Virginia — told investigators that they plan to implement such safeguards.

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Comments (6 Responses)

  1. vmgillen says:

    Background checks are only useful if there’s background to check. Often, Agencies hire people who were quietly fired from their previous employ for abuse – but not reported to the police. Fact of the matter is, no one has a record, until they do… background checks in and of themselves do not keep people safe – they MAY stop repeat offenders, though.

  2. ann m says:

    If the agency bills Medicare/Medicaid, the CMS rules require pre-employment background checks…

  3. dan allison says:

    does your organization help with getting legislative going to help with the mental challenged adults in Indiana who have care givers ,who get fired but are not charged with crimes to come up with a registry to put these people on and make it legally mandated to do so. Kentucky has a registry to put bad people on list but how can we get this going here . already talk to my legislators and got no where

  4. maggie dee says:

    CA has background checks. If you are found to have a criminal background there is a rocess you wil have to go through to ascertain what, when…some means you don’t work in home care others you might find work.

    Advocates their thoughts are: Progressies…they think it is not important or at best a real pain. CA is a little more strict with those who cross state lines to escape their criminal misdeeds. While it takes some time to catch up on the person’s past.

    Those who are conservative: WANT the “protection” of knowing the past history of a person. I favor the criminal check as there are those who WILL pray on unknowing seniors and the non-verbal. Maggie

  5. Heather says:

    Mandatory background checks I feel are part of the first line of defense in ensuring the safety of our individuals. However, as vmgillen points out, if they weren’t caught, who would actually know. With that being said, Healthcare in general needs to continuously evaluate their employees not only for work performance, but moral integrity as well. Perhaps there was a case where someone had been accused of something and it was unfounded, or someone could have been accused and convicted of something. It is the responsibility of the employer to dig deep into what the circumstances were, what happened and why?. Nothing in this world is black and white, we must look at the grey area to get the complete picture. Hearing people out certainly breeds a better work relationship. When one builds trust amazing things can happen.

  6. Rhonda Bechtel says:

    I truly believe this should be a federal law mandating criminal state background checks of all states an individual lived in plus a FBI check, and also a child abuse clearance check to work in any kind of home care situation. abusive persons will abuse an older person, child, handicapped person…quicker than they would harm someone that’s not any of those things. and can be clear headed and not afraid to tell on the home care worker if its not working out. as it is now, it is just a ticking time bomb…

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