AARP Pennsylvania

Pennsylvania Home Care Providers Come Under State Regulations

New law requires training for home care workers

By: David Warner | Source: AARP Bulletin Today | March 1, 2010

Hnede Kobbah assists Robert Kreiling, 92, five times a week at his home in Morrisville. Her duties include fixing meals and taking care of a chronic wound on his foot. Pennsylvania has recently begun licensing home care providers. Photo by Katja Heinemann/Aurora Select

Home Care Providers Come Under State Regulations
 Hnede Kobbah stands at the sink washing the breakfast dishes and making coffee. Robert Kreiling, 92, sits nearby in his wheelchair." Bob," she gently reminds him, "your medicine." Kreiling, who lives in a second-floor apartment in Morrisville, admits he doesn’t really like taking his medicine, but appreciates that Kobbah insists.

Hnede Kobbah stands at the sink washing the breakfast dishes and making coffee. Robert Kreiling, 92, sits nearby in his wheelchair.

"Bob," she gently reminds him, "your medicine."

Kreiling, who lives in a second-floor apartment in Morrisville, admits he doesn’t really like taking his medicine, but appreciates that Kobbah insists.

Kobbah, a home care worker employed by Special Care of Bucks County, travels 31 miles from Philadelphia to tend to him five days a week.

"She puts up with me," Kreiling jokingly said of Kobbah, 37. "She’s a good companion, always in a good mood."

During her five-hour shifts, Kobbah cooks breakfast and lunch for Kreiling. She also drives him places—mostly to the cemetery where his wife, Elaine, has been buried for three years—or to a nearby shop to pursue his coin-collecting hobby.

Kreiling is one of an estimated 750,000 Pennsylvanians who receive some type of home care each year, according to a 2006 University of Pittsburgh study. In any given week, roughly 190,000 state residents receive home care.

A new law requires home care agencies to be licensed by the state, something AARP Pennsylvania and the Pennsylvania Homecare Association (PHA) sought for almost 15 years.

"We really needed to have some kind of consumer protection," said Vicki Hoak, PHA executive director. "There was no oversight, no assurances—who is that person walking through the door to care for your 85-year-old mother?"

She called the law a significant milestone for the home care industry, giving it the same legal status as hospitals, nursing homes and hospice agencies.

Home care workers typically are not licensed to provide medical treatment.

Rather, their services allow clients to continue living at home by helping with daily activities such as bathing, medication management and transportation.

The new law requires workers who come into private homes to have personal care training, be tested for tuberculosis, have criminal background checks and wear identification badges.

The law sets up staggered deadlines for compliance, with criminal background checks and tuberculosis testing to be completed by summer. Training can go on for two years. Agencies that employ home care workers will have to document that their employees have satisfactorily completed the state’s competency requirements.

The law also will require home care workers to report "adverse events" to the state Department of Health. Those include signs of abuse, a fall, any time an ambulance is called for the client, and if nobody is home when the home care worker arrives for the day.

Hnede Kobbah assists Robert Kreiling, 92, five times a week. Part of her time is dedicated to helping him get out of his house in Morrisville by taking him grocery shopping, to the post office, and to the cemetery where his wife is buried. Photo by Katja Heinemann/Aurora Select

Kobbah, a native of Liberia, continues what she said is a family tradition—caring for other people. Her mother for years has helped ill children and older people with no families.

"He’s all alone," said Kobbah. "He doesn’t have anybody."

Kreiling smiled as Kobbah began filling the washing machine.

"I consider her my family," he said. "I see her every day."

 

Summary:
• A new law requires home care agencies to be licensed by the state. Workers would have to receive special training.
• About 750,000 Pennsylvanians receive some type of home care each year.
• The law does not apply to family members, nonprofit organizations or private arrangements.

In the coming months, Pennsylvania’s Health Care Facilities Web page, which is searchable by county and city, will add licensing information on the home care agencies. In the meantime, Hoak’s organization advises people to ask companies whether they are licensed.

The law’s provisions are "what people want," said Ray Landis, AARP Pennsylvania advocacy manager. "They don’t want to be in a nursing home if they can get care at home."

Home care clients pay by the hour. A 2009 study by MetLife found the national average was $20 an hour. In the Pittsburgh area it was $19 per hour; in Philadelphia, $18.

Medicare and Medicaid don’t pay for such care, and most insurance companies don’t cover it either. The exception is long-term care insurance that specifically allows for home care. But the PHA’s Hoak said only a small percentage of people have that coverage.

Diane Menio, executive director of the Philadelphia-based Center for Advocacy for the Rights and Interests of the Elderly, said most home care is provided by family members or by private arrangement. Those care providers, as well as those supplied by nonprofits such as church groups, do not fall under the new law.

David Warner is an editor and writer living in Jenkintow, Pa.