• E-mail
• Print
• Comment
• Font Size
• Digg
• del.icio.us
• Discuss article

Screening Lax for Employees in Elderly Care

Posted on: Thursday, 22 September 2005, 21:01 CDT

Sep. 22--Want to work in a daycare center? A school? A group home for the disabled or mentally ill? Under Rhode Island law, employees in these jobs must pass a national criminal-records check with fingerprinting to ensure that they don't have a checkered past.

People who do not meet that level of scrutiny, however, could still end up caring for the vulnerable -- in nursing homes.

There is no state law requiring nursing homes, adult daycare centers, home-nursing agencies, and other state-licensed facilities for the elderly to do full criminal-background checks on employees.

Instead, the long-term care industry only has to check state criminal records.

"If you're a criminal in Seekonk, you escape our notice," said Donald C. Williams, the Health Department's director of health services regulation. "Whether a state criminal check is adequate -- the department would have some questions."

Rhode Island is far from alone in not requiring nationwide checks. Only nine states have laws requiring long-term care businesses to do national background searches, according to the most recent reports from the Office of Inspector General for the Department of Health and Human Services. In Rhode Island, that bothers some legislators and members of the public who have tried to change the law so that people who care for the elderly are scrutinized as well as people who care for children.

But as has happened nationally, Rhode Island lawmakers have resisted requiring complete criminal-history checks in nursing homes because of the cost of fingerprinting: $29 per employee. The nursing-home industry supports fingerprinting but wants the state to pay. Some legislators want employees to pay. In other sectors, either employees or employers typically pay.

Just this year, Rhode Island legislators did not pass a bill, proposed by Lt. Gov. Charles J. Fogarty, that would have required applicants for jobs in state-licensed elderly-care facilities to pass a national criminal-records check with fingerprinting if the job involved routine contact and time alone with residents.

After concerns about costs, the bill died in committee. The General Assembly, however, did pass a law requiring fingerprinting for massage therapists.

"I shake my head in disgust," said Sen. Joseph M. Polisena, a Johnston Democrat who sponsored the bill. A House version also withered in the Finance Committee.

"It's a slap in the face to the elderly," Polisena said. "I say to heck with the cost; someone has got to pay."

At times, it seems like everyone but elderly-care workers are being screened; even Hurricane Katrina evacuees brought to Rhode Island had to undergo national criminal-records checks, though fingerprinting was not done.

Rhode Island requires fingerprinting in 12 different job categories. Employees have the prints done through the attorney general's office, which sends the images to the Federal Bureau of Investigation. The FBI charges a fee to analyze the prints and quickly say whether an employee has ever been arrested or convicted. Among them are jai alai concessionaires, racetrack workers, burglar-alarm installers, foster parents, gun owners, and people working with children or the disabled in state-licensed facilities.

Under state law, employees who work in schools, for instance, can be disqualified for a job because of certain crimes, such as sexual assault, felony drug offenses and embezzlement, but it's left up to the employers to make the call.

Rhode Island ranks sixth nationwide in people 65 and older, and has more than 9,000 residents in nursing homes. Williams said most long-term care employees are dedicated, but the field also draws workers who have few other alternatives. Last year, the state received 330 complaints about employees in nursing homes -- abuse, neglect, theft and other offenses, he said.

In the past year, three employees at a Woonsocket nursing home were indicted on neglect-related charges in the death of a 93-year-old woman. A nurse in East Providence was charged with felony neglect in the death of an 85-year-old woman, and a South Kingstown nursing-home janitor pleaded guilty to raping three women, two of them physically helpless.

"Quite frankly, I don't want to disparage CNAs [certified nursing assistants], but there is a high level of criminal convictions [among them] -- petty theft, assaults, and those sorts of things," he said.

Earlier this month, the Health Department updated its regulations for certified nursing assistants, to reflect the state law: CNAs, who provide direct care to frail people who are often helpless, are not required to get full criminal-background checks to be registered to work in the state -- though if the CNAs come from another state, the Health Department checks to see that their registration was in good standing in that state.

Providence lawyer Jeffrey Padwa had not realized the state was not doing national background checks on CNAs. He went to the Health Department to complain. After all, Padwa runs national background checks on his Little League volunteers.

Nursing-home owners worry about hiring people with criminal records, but say they can't afford to do fingerprinting and believe the background checks should be reimbursed by Medicaid.

"We're all concerned, we're definitely concerned," said Al Santos, director of the Rhode Island Health Care Association, the lobby for for-profit homes. "You would think that the state would be concerned. They're the ones that don't want to pay for it."

Jane Hayward, managing director of the Rhode Island Office of Health and Human Services, said "we are going to be looking at this issue over the next several months." She said the state will "look at what the differences are between departments and whether it does make sense in a very mobile society . . . to think we ought to be doing national background checks. If that's the case, we need to look at what the resources are and how it needs to be organized."

Nationally, Sen. Herbert Kohl, a Wisconsin Democrat, has tried since 1998 to pass a national law mandating fingerprinting for nursing-home employees, but his bills have failed. Last year, however, his efforts resulted in a federal pilot program in which states could apply for money to do the fingerprinting. Rhode Island's attorney general's office applied for a grant but didn't get one. The pilot is set to end in two years.

Paul Greenwood, an expert in elder abuse and a prosecutor with the District Attorney's Office in San Diego said that in the meantime, the growing home health-care field draws people just out of prison because of the minimal background checks.

"Sadly," he said, "I do believe that in some aspect people feel that children are very, very precious and need to be protected, but that the elderly don't qualify as a precious segment of the population that need to be protected."

-----

To see more of the The Providence Journal, or to subscribe to the newspaper, go to http://www.projo.com.

Copyright (c) 2005, The Providence Journal, R.I.

Distributed by Knight Ridder/Tribune Business News.

For information on republishing this content, contact us at (800) 661-2511 (U.S.), (213) 237-4914 (worldwide), fax (213) 237-6515, or e-mail reprints@krtinfo.com.

Source: Providence Journal

More News in this Category