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 www.riag.ri.gov,
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.
