Not the way to improve homecare services
Misguided bill would threaten employee privacy, burden homecare companies
When it comes to misnomers, you can hardly beat SB 1051, the bill erroneously entitled An Act Strengthening Home Care Services, which passed the Human Services committee and is now before the General Assembly. Rather than strengthening the homecare industry, this proposal would impose burdensome new mandates, while threatening the privacy of our valued employees.
Homecare agencies currently assist thousands of Connecticut residents who need help to stay in their homes. This low-cost, privately managed service saves the state tens of millions of dollars in nursing home costs, while keeping our fellow citizens healthier and happier.
To provide that help, homecare agencies employ thousands of caregivers selected for their suitability for the job. The careful matching of caregiver ability to client need —a prime advantage of the agency model for homecare— ensures that our employees have the right skills for their particular assignments.
Homecare agencies also offer critical supervision and coordination of service, making sure that vulnerable clients are treated professionally, and that a substitute is immediately available if a caregiver can’t keep an appointment. The agency model has been a success in Connecticut because clients and their families see the advantages we offer and choose our services. We want to make sure that choice is preserved for those who want it.
SB 1051 would require that homecare companies send personal employee data to the state; that data would then become public information, available to labor unions and competing homecare companies. Such disclosure is of great concern, representing a significant threat to the privacy of our caregivers and a serious reporting burden to our industry.
Since the success of a homecare agency depends on the quality of its workforce, a good agency does its best for its employees. At Companions & Homemakers, we offer a company-matched 401K, 80 percent paid healthcare, college scholarships, on-line and on-site training courses, and wellness programs. We are committed to the best interests of the caregivers who work for us, and we will do all we can to fight this invasion of their privacy.
The excuse for gathering this personal data is the need for the state to track training newly mandated by the bill. In fact, agencies recognize the vital importance of able caregivers —that’s why we provide training already, individualized to each employee and situation.
Every homecare job is different, since it’s based on the needs of the individual client. That makes most of the training mandated in SB 1051 pointless. To take a single example, this bill would require that we teach our companions how to cook. In fact, many of our companions come to us already capable in the kitchen; others have no desire to cook, and are not assigned to jobs that involve meal preparation.
Requiring that agencies educate their caregivers is like requiring that Aetna teach its secretaries how to type. The need to succeed in business is incentive enough to make sure employees know how to do their jobs. If mandated training is unnecessary, then surely there’s certainly no excuse for the disturbing disclosure of personal employee information this bill demands.
We are likewise opposed to the unwarranted intrusion into private business threatened by the requirement in SB 1051 that homecare agencies submit cost reports and financial statements to the Department of Consumer Protection. Nothing in the bill justifies such an onerous mandate, which would give businesses access to key information on their competitors.
It’s hard not to question the real intent of this legislation. As a practical matter, the main beneficiaries of an employee list would be those attempting to unionize the industry, who would have easy access to the names and workplaces of potential recruits, and could use our financial information as leverage in negotiations.
Yet homecare is inherently unsuited to collective bargaining. Wages for workers employed under the state’s Medicaid program are limited by the reimbursement rate; working conditions and the work itself varies greatly from home to home and client to client; and schedules are constantly subject to change, based on the needs, health, and desires of the clients.
If the legislature is willing to commit additional resources to improve homecare, we suggest the following:
- Raise the Medicaid reimbursement rate, so that we can pay our caregivers who serve state clients the higher wages we provide to those who work for our private-pay clients.
- Initiate spot checks of provider agencies, including unannounced field examinations, to determine whether providers are rendering adequate care and following all laws and regulations. Let’s enforce the laws already in place before we pass new ones.
- Increase the capacity of DCP to speedily investigate complaints and, when warranted, prosecute unscrupulous providers.
- Monitor complaints in the self-directed homecare program, where individual care recipients choose caregivers from a list and hire and fire them on their own. To our knowledge, this program has no mechanism to indicate why a caregiver was discharged, leaving the next potential client without warning that a caregiver was let go for poor performance, theft, abuse, or some other cause which should disqualify them from homecare work.
- Enact regulations that allow homecare providers to respond to requests for employment references with the whole truth. When caregivers are not worthy to be rehired, we must be able to say so without fear of liability. Too often, caregivers discharged for sound reasons –including fraud, theft, and negligence- -simply move from agency to agency because no prior employer dares give a forthright negative reference for a former employee who has no business caring for a vulnerable population.
In the form in which it was passed by the Human Services committee, SB 1051 would weaken, not strengthen, homecare in Connecticut. It would divert resources away from the actual provision of service and toward the satisfaction of irrelevant bureaucratic mandates. In the end, it could threaten the survival of homecare agencies in their current form, and the continued availability of this popular service option.
We need more choice in the healthcare industry, not less —and we especially need to preserve proven, popular options. Rather than passing this misguided bill, we invite the General Assembly to work with homecare agencies to understand our industry and to focus comprehensively on improving service to Connecticut’s senior population.
Linda Grigerek is Chief Executive Officer of Companions & Homemakers.
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