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.

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“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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