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HCSCPA: A Guide to New Home Care Regulations

A newly implemented law is about to change the status quo for Californians who receive home care services, as well as their family and professional caregivers. The Home Care Services Consumer Protection Act (HCSCPA), voted into law over two years ago and signed by Governor Jerry Brown, became effective January 1, 2016. The legislation adds California to the list of 29 states that require licensure or certification of home care agencies.

In a nutshell, HCSCPA provides for licensure and regulation of designated home care providers and their direct care employees. Any organization designated as a Home Care Organization (HCO) is covered by the legislation. The intent of the legislation is two-fold:

1) To provide greater protection to consumers of home care services, including frail elderly and disabled individuals.

2) To provide greater employment protection to home care workers; e.g., provision of training, clarification of employee status and benefits.

And yes, Homecare California is considered an HCO. We are in the process of implementing all required regulations and policies called for in the legislation.

Just what is an HCO? Given that we are talking about government and social service agencies, now might be a good time to define several terms and acronyms (as defined by the California Dept. of Social Services and/or the law):

  • Home Care Organization (HCO) — Any entity that arranges for home care services through “affiliated” home care aidesor HCAs.

  • Home care services — Nonmedical services and assistance provided by a registered HCA to a client who, because of advanced age or physical or mental disability cannot perform these services.

  • Home Care Aide (HCA) – An unlicensed aide who provides in-home care, including residence-based personal or companion care or assistance to the elderly or infirm; e.g., bathing and dressing, companionship, housekeeping, meal preparation, assistance with self-administered medications, etc.

  • Affiliated HCA – An HCA employed by a HCO to provide home care services to a client. Must be listed on the new Home Care Aide Registry.

  • Independent HCA – An HCA who is not employed by an HCO, but who provides home care services through a direct agreement with a client and elects to be listed on the Home Care Aide Registry.

While these definitions may seem narrow, and the law excludes such in-home services as hospice or home health care, thousands of care recipients and providers will be affected. An estimated 1,400 home care agencies are providing services in California, along with approximately 120,000 paid caregivers. While the exact number of older and disabled adults receiving home care services in California is uncertain, the projected number of individuals in California over the age of 85 is expected to double over the next 15 years. Most of these seniors will prefer to receive services at home.

Some of the major requirements of the HCSCPA include the following:

  • Licensure of all HCOs, based upon compliance with rules and regulations and approval of application;

  • Establishment of a public registry of all registered HCAs and applicants, with search capability for consumers;

  • Background checks and TB screening for all affiliated HCAs;

  • Required HCA training in designated areas;

  • Establishment of employer/employee relationships between HCOs and HCAs, rather than HCA status as independent contractors.

As one might imagine, there are associated costs such as licensing fees, training costs, and background check fees for home care agencies, along with a wealth of new paperwork requirements. However, Homecare California takes the position that any requirements that decrease client risk are usually worthwhile, and we will strive to make implementation successful within our own organization. It is worth noting that our extensive training and screening requirements for our care providers are, in most cases, in line with or above new state requirements. For example, we already obtain DOJ and FBI clearances for our caregivers.

If you are personally or professionally affected by the HCSCPA, you will find the state of California’s home care services website an excellent resource. It includes links to sites for everything from the HCA registry to the Caregiver Background Check Bureau. The state has designated the newly formed Home Care Services Bureau as having oversight over implementation and compliance monitoring of the legislation.

We hope that the Home Care Services Consumer Protection Act will provide both consumer and employee protection that will far outweigh its bureaucratic implementation issues. As for Homecare California, we intend to use the guidance of the new regulations to ensure even greater quality care for those we serve.

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