Napa moves against elder care abuse

June 23, 2011

By Meda Freeman

With reports of elder abuse rising, Napa County is taking the lead in protecting seniors from unscrupulous or predatory caregivers by becoming the first in California to require criminal background checks for home-care aides.

Starting July 1, in-home assistants who help elderly or disabled adults with bathing, dressing and other daily tasks will need to pass background screenings and buy annual permits to work anywhere in the county. Local law enforcement officials and senior advocates say the new law will arm vulnerable consumers with crucial information and help close an alarming gap in the oversight of California’s private-care industry.



This article is one in an occasional series on aging with dignity, independent living and public policy that affects both. For a complete archive of the articles, click here.



“This ordinance will save lives,” said Napa County District Attorney Gary Lieberstein, who refers to the fatal stabbing of a 70-year-old paraplegic woman in Pleasant Hill last year as an extreme but real example of the risk elderly and disabled people take when they take strangers into their homes.

Lieberstein said Mary Jane Scanlon hired Diane Warrick through a Craigslist post, unaware her new helper’s experience included taking hostages in Napa County, battling police in a shoot-out and then spending four years in a state hospital for the 1997 stand-off.

If Warrick’s violent history had been exposed during a background check, “no one in their right mind would have hired her,” Lieberstein said. Instead, Scanlon let Warrick move into her home, and six months later, Warrick stabbed her defenseless boss in the chest. Warrick was convicted of second-degree murder in March and sentenced to 31 years to life in prison.

Elder abuse is a label that applies not only to violent crimes but also to property crimes like theft and forgery and psychological abuse like coercion and intimidation. Experts say the prevalence of elder abuse in California is difficult to quantify because it often goes unnoticed or unreported, and when abuse is alleged, any number of law enforcement or social service agencies might investigate, depending on the nature or setting of the report.

“We’re certainly getting increased reports of abuse, but whether that’s an increase in awareness or an increase in the problem, we don’t have a way of knowing,” said Lisa Nerenberg, chairwoman of the California Elder Justice Workgroup, which advocates for stronger reporting and support services. “And not only are we seeing more cases, we’re seeing cases of more complicated abuse.”

The issue of elder abuse is only expected to grow as baby boomers age. California’s senior population will double to about 6.4 million by 2025, with the majority of boomers hitting their 80s around 2030, according to government projections. As a result, home care for the elderly is one of the fastest-growing job markets.

Caregiver Roulette,” a recent investigative report by the California Senate Office of Oversight and Outcomes, explains California does regulate nursing care in private homes but is among a minority of states without regulations for the agencies and individuals who provide help with grooming and day-to-day chores. A business license is all that is required of the private agencies that place these caregivers in homes.

The report describes how dependent adults were swindled out of their savings or otherwise victimized by personal helpers with criminal records never disclosed to their elderly employers. When Principal Consultant John Hill investigated Craigslist ads posted by helpful-sounding caregivers he found some of their backgrounds included embezzlement, methamphetamine sales, child abuse, theft, battery, prostitution and other activities a potential client would want to know about.

According to the report, there is a state law that lets the elderly or disabled request a Department of Justice background check on a potential caregiver, but the law has not been widely publicized and there is no clear system for helping the public make the request or interpret the results.

Oversight Office investigators recommend the Legislature consider passing a law regulating home care, creating a statewide family-care registry and establishing more consistent standards for background checks conducted by private agencies.

Lawmakers introduced two bills this year to close the current regulatory gap. The state Senate recently approved SB 411 by Senator Curren Price, D-Los Angeles, which would require licensure and accreditation for in-home care agencies and criminal background checks and state certification for providers. An Assembly committee is now reviewing the bill. The other bill – AB 899 by Assemblywoman Mariko Yamada, D-Davis – would require licensure of home-care agencies and background screenings for caregivers, but this bill is on hold in the Assembly appropriations committee.

Lieberstein, Napa’s prosecutor, said that until there is statewide oversight, other local governments also might be motivated to enact caregiver ordinances.
“Prevention starts at home, and we weren’t willing to sit around and wait for a state law to be passed,” he said.

Napa’s Board of Supervisors and each city council adopted a caregiver ordinance with identical provisions, so home aides from St. Helena to American Canyon are subject to the same requirements. They will need to apply for a $20 permit through the Napa-Solano Area Agency on Agency and pay a $90 fee for their first background check. The permit will be good for one year only, and background checks will be required every year at renewal.

Representatives of the state’s largest union of home-care aides said members support increased oversight but would prefer any new requirements be statewide. .
“While we appreciate efforts on all levels to establish standards of work and care, we feel like an individual county approach is not the best way forward,” said Laphonza Butler, president of SEIU’s United Long Term Care Workers of Northern California. “The state should establish one standard so the industry can be clear.”

Joe Hafkenschiel, president of California Health Services at Home, another association of caregivers, agrees. “The problem I see in doing it on a county by county basis is we could have different requirements in different counties. I think it’s better to do it on a statewide basis.”

Napa County, meanwhile, has launched a marketing campaign to raise awareness of its new law, and outreach includes a YouTube dramatization of caregiver-hiring gone bad. Officials say the goal is to educate residents about this new safeguard, not to round up unlicensed caregivers.

“We’re getting the word out that people are supposed to see the caregiver’s permit, and if they don’t have a permit, it’s a red flag,” Lieberstein said.

Ruth Marsh of Napa said a vetting process for home aides would have been a big help when she needed a caregiver for her mother. Marsh ended up hiring someone referred by a clerk at the supermarket and soon noticed antiques and other valuables disappearing from her mom’s home. The caregiver denied taking the items, but Marsh eventually fired her.

“She cried, ‘I love your mom so much. I’d never do something like that.’ She was a good actor.”

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