This is a scenario that plays out in hundreds of households across Colorado every day. Your elderly loved one has just been released from the hospital after an unexpected surgery.
You are told that they will need help around the house as they recuperate. You are only given a day, maybe two, to find a home care aide. Someone to help them prepare meals, bathe, get in and out of bed, and everything they need to stay safe and comfortable in their home. You look in the phone book for care providers. You assume that the agency you are calling is licensed, that their workers have been through criminal background checks and that they have adequate training for the duties they will perform.
But not all agencies that place home care workers are licensed, and your loved one could be at risk.
In 2008, the Colorado legislature passed a law requiring that Home Care Agencies, which use employees, be licensed through the Colorado Department of Health and Environment. But it did not require Home Care Placement Agencies (HCPAs), which use independent contractors, to do so.
In order to close this loophole, the Home Care Placement Agency Task Force was formed to study the issue. After several hearings of expert testimony, this thirteen member panel of legislators, state department representatives, home care industry leaders and consumers concluded that licensing HCPAs was critical to assure the safety and quality of care for some of our most vulnerable citizens – the elderly and the chronically ill. This recommendation is currently before two legislative interim committees – the Health Care Task Force and Legislative Council – which will decide whether to sponsor it as a bill next session.
Foremost, licensing of Home Care Placement Agencies is about safety. Without proper oversight of HCPAs, citizens are at risk of exploitation and abuse by such home care aides. While we believe that the vast majority of HCPAs and home care workers have a genuine concern for their clients and want to do their best for them, there are some that gravitate to this field because they see seniors and disabled as easy prey.
Proper oversight, through licensing, of HCPAs will help protect vulnerable clients. HCPAs and their contractors should be required to undergo thorough multi-state criminal background checks. High standards of training should be required. There must be sanctions for violating licensure rules.
Licensing Home Care Placement Agencies would also provide choices for consumers. There is a national movement toward “consumer-directed care,” where the client is a partner with the caregiver in deciding what type, how much and how care is provided.
Many HCPAs are uniquely positioned to provide workers that fit a client’s specific needs. But currently that choice is not available to many clients because most Long-Term Care insurance policies will not pay for care provided by unlicensed agencies. Consumer-directed care can also save money. By tailoring services, clients can stretch their home care budgets by a substantial amount.
Some of Colorado’s HCPAs already adhere, by choice, to the same requirements as the licensed Home Care Agencies, but not all. Those that do are also seeking licensure. They want all HCPAs to play by the same rules and believe it would be good for the public and their industry. They are willing to pay the fees associated with licensure so the cost would not be a burden to our cash-strapped state.
Most of us want to stay in our homes as we age, maintaining our independence. We want choice as to the type of care we get. We want choice as to who we choose to provide that care. And we want to be assured that the workers we bring into our homes are thoroughly screened and properly trained. Licensure of Home Care Placement Agencies will help provide us with these choices in a way that is both safe and affordable.
Cynthia Stone and Margaret Atencio both live in Denver. EDITOR’S NOTE: This is an online-only column and has not been edited.
