In 2003, a thirty-two year old paraplegic gentleman was sitting on a mattress on the floor of his apartment, in need of help to get through the day. A call for help came from the Westminster Police Department to a home care agency requesting help for the man, whose caregiver had stolen all his furniture and left him to rot, all alone. The disabled man, who we will call Bob, had no means of feeding himself, showering or using the restroom—he was stuck, in his own filth for two days. If not for his loving family, located thousands of miles away, Bob may have never been saved.

Bob's father, who live in Minnesota, had hired two caregivers he found in newspaper advertisement. Wanting to be diligent, he flew out to California to meet with the caregivers, interviewed them, checked references and felt confident that these individuals would care for his son like he was there family. Turns out Bob’s family and Bob were deceived. The two caregivers, who faked their information, were actually predators that abused and eventually robbed Bob not only of his possessions, but also of his dignity. This is an anecdote of a single incident of abuse, unfortunately there are many others far too comparable to this, but most don’t end as well.

Every individual that hires a private person or an agency is depending on those individuals to adhere to a high level of decency; they are dependent on that person or that agency to be honest, kind, good individuals. While the world is filled with people that fit that description, we have to acknowledge that we have people who look for opportunities to harm, whether physical or financial, the vulnerable for their own personal benefit.The people most impacted by these crimes are the elderly and those who are confined to their home because of a disability—many of whom have no family.

It is often necessary to distinguish the difference between home health care and home care services. Home health care is typically reserved for medical treatments that are provided in the home. Home health is covered by Medicare and Medi-Cal and typically requires treatment by a licensed or registered nurse. Home health aides, who are certified by the state, can provide some level of care in the home, but a registered nurse must supervise them.

Home care on the other hand is typically defined by all non-medical services, such as assistance with daily living, provided within the home or on occasion, a facility. As a standard, Medicare or Medi-Cal does not cover home care; home care providers are not licensed, registered or tracked by any government agency.

The ease of entry into the industry and the lack of any formal requirements have made the home care industry one of the faster growing business ventures. The home care industry continues to grow by leaps and bounds in California. We have a higher percentage of people living longer and many of these individuals are going to need care. Whether it’s as simple as assistance with daily living activities or 24-hour care, the home care business is not slowing. The home care industry has become a breeding ground for extortion, fraud, theft, rape, and even murder. Those who are looking for prey have targeted the group least capable of defending themselves and currently there are few saviors in sight.

According to the US Census Bureau as of 2009 there is an estimated 36,961,664 people living in the state of California, eleven percent are 65 years and older. In Laguna Hills County California the city I work in there are 32,156 people and 12.1% are 65 years and older. In Laguna Hills California there is a retirement Village called Laguna Woods, and there is an estimated 2,225 home care agencies catering to the elderly population in the Laguna Woods area. An estimate of over7, 000 thousand private caregivers is working or seeking employment in the Orange County CA area. Without some level of regulation, how do we know who these individuals are or if they can be trusted with and by our most vulnerable citizens? That’s why we have to look to the single organization that has vowed to protect the welfare of those unable to protect themselves, the government. Those members of our society with disabilities, illnesses, or our just aging population need our support. It is our responsibility to make sure they are protected from people that wish to hurt them.

Today, California has regulations in place for home health care, palliative care, and hospice; though home care is not currently part of Medi-Cal, the state should be able to implement similar policies that look to regulate those who conduct business as a private contractor or through an agency. This proposal is designed as a tool for implementing a monitoring program that would allow the state to track in home care providers in a manner similar to the method used for home health care.

Currently, the state tracks home health through a certification program, requiring that every home health aide complete specific courses prior to receiving certification as well as acquire specified continuing education courses before their certifications can be renewed. This proposal suggests that a similar program can be utilized with non-medical home care providers.

Home care provider registration could be handled on a state/county level and would track agencies by their tax-ID number and private contractors by their social security number. The county or the state would then post all registered providers to a website that would be accessible to the public. The registrant’s files would record their years of service, continuing education courses, complaints, contact information and their registration status. Every registrant would be assigned an ID number that would be provided to the consumer; the consumer could then search the website for any information that might be relevant to their needs. This would give the consumer the ability to report issues and easily identify the provider.

Prior to receiving their registration ID, the provider would have to submit to a criminal background check, drug and alcohol testing and fingerprinting. A photo ID would be required and kept as part of their record. The registration process would require annual renewals and could help drive revenue for the county/state.

The registration could be for a private contractor or an agency. The agency would be responsible for all the activities of their caregivers. Private contractors, who perform the caregiving services themselves, would have a smaller fee than an agency looking to employ multiple caregivers for services. Again, this would be a revenue builder for the state/county, but more importantly would give the state/county the ability to ensure that their vulnerable citizens are being cared for in an appropriate manner. The registration system would also allow the public to report offenses by a provider, which could then be investigated by law enforcement or Adult Protective Services.

Implementing a registration process would immediately eliminate the most egregious offenders and provide a basis of expectations for those that want to provide home care services.

As more states and local governments struggle to keep up with expenses, this opportunity is win-win. The system is already established, it would only take adding a few additionally elements and with that, the state/county might actually gain a substantial revenue stream.

If you would like to see better protection for our elderly and those who are home bound, and needs help with their daily living, then send this article to your local and state politician.

Let us work together to build a future that provides protection from physical, mental and financial abuse of our elderly population as well as others who depends on family members and paid care attendant.

BE PART OF THE "WE WILL PLEDGE" PROGRAM

I can be contacted at STOP ELDER ABUSE NOW www.seanoc.org