Advocates are hoping a new Arizona law will help protect seniors from the exploding but largely unregulated in-home care industry.
Sponsored by state Sen. Nancy Barto, R-Phoenix, the law requires nonmedical in-home caregiver agencies to disclose to consumers information about background checks, training, cost of services and hiring and firing policies on an annual basis.
“This is a good first step towards transparency towards those who provide in-home care for vulnerable individuals. I think there needs to be even a little bit more but this is a good start,” said Laura Oldaker, CEO of By Your Side Senior Care in Tucson and an Arizona In-Home Care Association board member.
“We have already started giving the disclosure to any new clients that we have. They seem to really appreciate it. They don’t know to ask for it.”
The law, signed by Gov. Doug Ducey on April 1, applies to nonmedical in-home care agencies in Arizona, and not to private, individual caregivers.
The disclosure form is not required from specific home health services, senior living facilities, and clients who receive services through federal or state programs, including Arizona Health Care Cost Containment System (AHCCCS), Arizona Long Term Care System (ALTCS) or Division of Developmental Disabilities (DDD).
“Does the company do background checks? If they do, what is their protocol when it comes to individuals that have glitches? The idea is to educate the consumer,” said Mark Young, president of the Arizona In-Home Care Association (AZNHA).
“Not all nonmedical home care companies do background checks. But if they do, they can see what the policy is.”
Unregulated and unlicensed
If agencies fail to give the disclosures to consumers, they are breaking the law. Failure to comply with the law will result in a Class 3 misdemeanor and a maximum 30-day sentence.
The general assumption is often that nonmedical in-home care agencies are required to do criminal background checks on their employees, but that’s not true, Young stressed.
“This is kind of a step towards empowering the consumer. So if you are the kind of consumer that has issues or you realize the agency you hired didn’t provide (the disclosure), you would contact the Attorney General’s Office,” Young said.
Young said members of Arizona’s in-home care industry have been working to educate legislators about problems with a lack of transparency for the last seven or eight years.
“We are not licensed and we are not certified,” Young said.
Vulnerable to abuse
He estimates Arizona has about 600 nonmedical in-home care agencies in the state, about three times more than a decade ago.
People often do hire in-home caregivers for medical-related reasons, even if the caregivers technically fall into the category of nonmedical.
“There are a lot of medically-related components that require the need for our services,” Young said. “Someone who is having cognitive challenges, maybe they need someone who comes in and helps with bathing and clothing and making meals. That’s the stuff that we can do.”
Problems that can and do occur because of a lack of regulation include financial, mental and physical abuse.
Law a first step
Most other states have licensure and certification requirements for nonmedical caregiver agencies, Young said.
“We are very much in the minority,” he said. “And we’re one of the fastest-growing states with our older population.”
Oldaker said she believes the next step Arizona should take is regulating individuals who are privately hired as caregivers.
“That is a really big hole we have right now,” she said. “There are a lot of good ones out there, but there are others who are nefarious and they don’t work for agencies and they prey on older adults.”
Oldaker said a registry of caregivers might help. She isn’t sure licensing is the best way to go in Arizona because the process can be lengthy and there is a shortage of caregivers.
Employee training varies
Each agency sets its own standards for caregiver training, since there are no state requirements.
Oldaker said her agency provides certification through 40 hours of training, in addition to 12 hours of continuing education per year.
By Your Side employees must also be trained in first aid, CPR and undergo tuberculosis testing annually. The agency also does background checks and drug testing.
“We usually do a little more than what most companies do out there,” Oldaker said.