The Home Care Services Protection Act (AB-1217) was passed into law in October 2013, which resulted in California becoming the 25th state to require licensure for “private-duty”, or non-skilled home care, effective January 1, 2016. The intention of the new bill is to provide protection for the consumers of non-skilled home care services, which are typically vulnerable elderly or disabled individuals.
By definition, non-skilled home care services include the following activities: bathing, grooming, and dressing assistance; toileting assist; mobility assist (transfers, walking, or moving about); medication reminders; companionship; errands; and household assistance, such as light house-keeping, laundry, meal preparation and clean-up, and pet care.
Companies who send their employees into an individual’s home to provide non-medical services, are now called Home Care Organizations (HCO’s) and they must be licensed by the California Department of Social Services (CDSS), Community Care Licensing Division (CCLD). The private-duty aides who work for the HCO’s are now called Home Care Aides (HCA’s) and must be registered with CDSS. The new law also requires the state to provide an online registry for consumers to view the license status of an HCO, or the registration status of and HCA.
Home Care Organizations (HCO) are required to complete an application for licensure, which includes verification of worker’s compensation coverage, general and professional liability insurance with at least $1,000,000 coverage per occurrence and $3,000,000 aggregate, and an employee dishonesty bond with a minimum of $10,000 coverage. Once an HCO is licensed, they will be subject to unannounced visits by the CDSS to verify they are providing and maintaining the appropriate training, record keeping, and insurance coverages.
The Home Care Aides (HCA’s) must now undergo a criminal background clearance through the CDSS prior to becoming registered. The HCA’s must provide proof of Tb testing to the HCO, and must complete at least 5 hours of initial training by the HCO prior to working with a client. The initial HCA training must include education for infection control, emergency procedures, as well as training on client’s rights, elder abuse prevention, detection, and reporting, and safely assisting clients with personal care, hygiene, and home upkeep.
Companies who refer private-duty aides who are not their employees to provide care to clients in their homes are considered Domestic Referral Agencies (DRA), and are not considered or allowed to be licensed HCO’s at this time. The workers they refer may either be registered (HCA’s), or not registered. DRA’s are not required to carry insurance, perform background checks, or provide training or oversight for the caregivers they refer. This ultimately transfers increased risks to their clients, who are often vulnerable in a climate where there is a lack of standards and oversight. For this reason, it is important for consumers to be educated and cautious in their home care services hiring practices.
Machelle Thompson, PT, CMC
Geriatric Care Manager
President - Keen Home Care