California’s Home Care Regulations

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The Home Care Services Consumer Protection Act of 2013 was just signed by Governor Jerry Brown, and requires agencies providing custodial care to older adults and people with disabilities to conduct background checks on workers, provide 5 hours of training, list aides in an online registry, and obtain a license certifying their compliance with basic standards.

Background Checks

Research has indicated that those who apply to work in long-term care are 3 times more likely than the general population to have a criminal record, and that 25% of caregivers accused or convicted of crimes had committed previous offenses. While many home care agencies already claim to do background checks, the range of quality and usefulness of the checks were questionable. Doing a thorough, effective background check requires laborious, time-consuming research from a variety of sources. Those in favor of the new regulations see it as an essential part of the process in protecting their loved ones.

home care regulations


Critics have long argued that the home care industry has been too lightly regulated. The Direct Care Alliance and Paraprofessional Health Institute represent home care workers nationally, and officials from both organizations have expressed their support for enhanced training for care-workers. Although 5 hours of training is a solid start, Steve Edelstein, PHI’s national policy director, said he wonders how much could be accomplished in that short time frame. Currently, PHI is working with several states to implement a 77-hour model curriculum for personal care aides.


Under this new legislation, California home care agencies would have to obtain a license from the California Department of Public Health by 2014.  In order to obtain a license, a company must show that it can provide skilled services to people in a temporary or permanent residence. First time home health licenses are provisional for 1 month, and then the care provider must pass an inspection and provide employment records showing the company employs certified home health aides practicing under supervision. The provider must also develop treatment plans for all its patients, keep and store detailed medical records on its clients, and keep track of all pharmaceuticals it provides to its patients.

Caregiver Registry

The portion of this law that seems to be causing the most concern among home health care agencies is the online registry, which is a database of home-care workers with licenses. Agencies are claiming that this registry is unnecessary and will add hassle and extra expense. Another concern is that there is a high turnover rate within this industry, and because agencies will need to keep the database current, they will have report to the state whenever a caregiver is hired or leaves an agency. The registry will also disclose the names of employees to competitors and union organizers, and the concern then follows that the goal of this is to unionize home care workers in California.

Extra Costs

Imposing these extra regulations upon home care agencies will make the field safer for patients, which is the ultimate goal, but it also may backfire as costs make these services more expensive and therefore unaffordable for some families. It also may reduce the pool of workers and make it more difficult for the elderly and persons with disabilities to get the necessary services. Ideally a balance will be found to provide a measure of safety and protection for patients while not hindering the opportunity for home health care agencies to run viable, successful businesses.

Pablo Buki is the President of Igea Software, leading the way in home healthcare software since 2003. Igea’s groundbreaking technology has transformed clinical visits and patient care.