Lawmakers want to impose new training requirements for workers at homemaker companion agencies, which have ballooned in number over the last decade as more people choose to age at home, but remain largely unregulated.
Members of the Aging Committee have raised a bill that would require these home care workers to complete training on first aid, reporting of abuse and neglect, maintaining a safe environment and other issues upon joining an agency and then every two years afterward. The aides help clients with tasks such as cooking, cleaning, laundry and errands.
The Aging Committee will hold a public hearing on the measure Friday at 9:30 a.m. in the state’s Legislative Office Building.
“These workers are coming into people’s homes, and we need to make sure we have people we can trust and who are trained to help our most vulnerable population,” said Sen. Jan Hochadel, D-Meriden, co-chair of the committee.
“Everybody would like to age at home, that’s where they’re most comfortable. They want the end of their life to mirror what their whole life has been, and we have to make it easier for that to happen.”
Under the bill, new employees at homemaker companion agencies would have to complete at least 10 hours of training on cardiopulmonary resuscitation, first aid, maintenance of a clean and safe environment — including best practices related to dressing, bathing and toileting assistance — identification and reporting of abuse and neglect, and identification and reporting of changes in a client’s condition and service needs. Workers helping people with Alzheimer’s or dementia would have to complete additional training on providing non-medical services to this population.
The measure also requires people already employed in the industry to undergo continued training on those issues at least once every two years. A list of qualifying programs would be drafted by leaders at the Department of Consumer Protection with input from other offices, including the public health and social services departments.
Upon the completion of any training, each homemaker companion agency and worker would have to fill out a form attesting that the employee finished the training and submit the form to the consumer protection department.
“We want a well-trained workforce,” Hochadel said. “We want the best services we can provide.”
Employees currently go through training on mandatory reporting and sexual harassment, and those who work with people in Medicaid waiver programs must complete special training through the state. But other types of instruction are optional.
Tracy Wodatch, president of the Association for Health Care at Home, said homemaker companion agency leaders support the proposed training requirements, but they worry about the added cost. The bill as written does not include state funding for the training. Some of those costs would likely be passed on to the clients, she said.
Wodatch also encouraged lawmakers to add language allowing the training to transfer among agencies. So, if a person is employed by multiple home care agencies, they wouldn’t have to repeat training at each company.
“It doesn’t really account for portability of the training, which we need to make sure is included, because some [aides] work for three and four different agencies,” she said. “We need to make sure, if they’re trained at one, that should be carried over to all the others they are hired to work at.”
Wodatch said she hopes homemaker companion groups have a voice in the final draft of the bill.
“There needs to be more training. It needs to be consistent, and there needs to be some standards and best practices,” she said. “But having them lay it out in a bill like this, versus us coming to the table and working with them on what the content of the training should include — we just want to be able to work with them on this.”
The Connecticut Mirror reported in 2023 that the state’s growing home care industry was operating with little oversight. In 2012, there were 380 registered homemaker companion agencies. By 2022, the number had swelled to more than 900.
Despite that, the industry still operates with little regulation. Unlike nursing home employees and home health aides, who must be licensed by the state Department of Public Health, there is no licensing process for homemaker companion workers. Instead, those agencies must register annually with the consumer protection department.
Managers at the companies are required to conduct criminal background checks on prospective employees but aren’t required to share that information with the state, which does not track who works at the agencies.
CT Mirror reviewed more than 75 complaints against homemaker companion agencies filed with the consumer protection department between 2018 and 2020 and discovered at least half a dozen cases in which homemaker companion agency employees were arrested for allegedly stealing from their clients, more than a dozen findings by DCP investigators of agencies that routinely mis-advertised the services they provided, and seven complaints of clients being left alone for hours at a time.
Many of the DCP investigations led to small fines of less than $5,000 or an employee being fired. Agency officials acknowledged the department had never denied a homemaker companion business’ registration and had never revoked a business’ registration following an investigation.
A recent report produced by the state’s Office of Policy and Management includes recommendations on training and training standards for homemaker companion agencies.
“They’re working with vulnerable populations,” said Rep. Jane Garibay, D-Windsor, co-chair of the Aging Committee. “Sometimes with very complicated issues like Alzheimer’s, how will [employees] know that a person with Alzheimer’s can get violent? What do you do? … We have found that many times, people aren’t trying to be mean or do a bad job – they don’t have the training.”
