Wednesday, July 25, 2012

Personal Care Assistants – How Much Do You Know About Your Home Health Provider?

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. 

Currently, these services are not regulated by any agency and caregivers are not subject to background checks.  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. 

States across the country have enacted statutes and regulations for personal care services.  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.

This past legislative session, I drafted and submitted legislation that would have regulated personal care assistants.  It would have required all personal care assistants to be subject to a national background check as a condition of certification and employment. It would have also allowed for the biannual renewal of registrations.  Those renewals would be granted as a matter of course with proof of completion of continuing education unless the Department of Human Services (“DHS”) finds that the registrant has acted or failed to act in a manner that would constitute grounds for suspension or revocation of a certificate.

Also, my legislation would have authorized DHS 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 would have provided criminal penalties and fines for those who fraudulently serve as a personal care assistant. 

Unfortunately, the legislation did not pass this year.  I am determined to better protect our seniors and committed to pushing for this important legislation next year.

From my viewpoint, this is a safety issue for our most vulnerable citizens.  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 basic training, as well as individualized training to suit the needs of their client. 

Due to the nature of the business, seniors and other Medicaid-funded populations rely heavily on personal care assistants, which can make the relationship ripe for exploitation and abuse.

Even without this legislation in place, you can still insist that your personal care attendant provides you with a background check and any other information you are legally entitled to in helping make your decision on whom to have in your home helping you with daily tasks. 

My office has also created a new and easy way for patients and citizens to report Medicaid Fraud and Patient Abuse.  Available at, the newly-created Medicaid Fraud and Patient Abuse Complaint Form allows individuals to report instances of Medicaid fraud and patient abuse electronically to the Attorney General’s Medicaid Fraud Control and Patient Abuse Unit for investigation and referral.
The Medicaid Fraud and Patient Abuse Complaint Form enables you to submit information regarding the subject of the complaint, the suspected fraud and a brief description of the events that occurred.
Complaints are reviewed on a daily basis by members of the Medicaid Fraud Control and Patient Abuse Unit.  Forms may also be submitted anonymously by the complainant. In addition to the online form, individuals may continue to contact the Medicaid Fraud Control and Patient Abuse Unit at (401) 274-4400 extension 2269.
We know there is fraud and abuse in the Medicaid system, but it often goes unreported because people may not know where to turn for help. This online complaint form is a valuable resource for patients, families, health professionals and all taxpayers to report possible fraud and abuse in our Medicaid system.

Together, we can ensure that seniors can choose to live in their own home safely.