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Thursday, October 15, 2009

Mass. Medicaid program has no job requirements for personal care attendants.

Home-care system leaves elderly at risk, auditor says - The Boston Globe
By David Abel
Globe Staff / October 15, 2009

Massachusetts state program that oversees home health care services for about 18,000 elderly and disabled residents is vulnerable to fraud and has employed personal care attendants who have committed felonies, including manslaughter, assault, and threatening to commit murder, according to a report released yesterday by the Office of the State Auditor.

The report also noted that the Mass. Medicaid program is one of only four out of 238 programs nationwide with no job requirements for personal care attendants.

The audit drew criticism from state health officials because it surveyed only 30 patients, whose cases had been previously reviewed for fraud by the federal government.

But State Auditor A. Joseph DeNucci said the findings illustrate why the state should establish job requirements for attendants, including training, education, and criminal background checks, which nearly every other program in the country requires.

“What we have found is that there are serious problems in the program,’’ DeNucci said in a phone interview. “We have to strengthen protections for vulnerable people. I think it’s very important.’’

The report also found that 14 of the 30 patients had hired attendants who either had been convicted of a felony or a court had found sufficient evidence to find them guilty. Of the 82 attendants who worked for the 30 patients between 2004 and 2008, seven had been in prison, 12 were involved in violent crimes, nine had been convicted of drug offenses, 10 committed robbery, nine had restraining orders against them, and four had outstanding warrants.

In all, auditors found 41 acts of violence, 29 crimes of theft, and 26 drug crimes, including heroin distribution and trafficking cocaine in a school zone.

State Representative Barbara L’Italien, an Andover Democrat and former attendant, introduced a bill this year that would allow patients to run a free criminal background check on attendants they hire, create an online database to help consumers find attendants, and establish a surrogate program to help those who cannot oversee attendants on their own. The bill has yet to emerge from committee.

“David Abel can be reached at dabel@globe.com.