LANSING – Following a sharply critical audit of the state’s Medicaid Home Help Program for elderly and vulnerable adults, two top state officials said Monday the state would begin background checks for home help workers.
However, the only individuals who would be automatically barred from working as home care workers under the program would be those who had committed what the federal government had listed as unacceptable offenses, which would be substance abuse, abuse and neglect of a patient, or health care fraud.
Families will be provided with information about the home care workers based on their background checks, Community Health Director James Haveman and Human Services Director Maura Corrigan said. But aside from convictions for those specific crimes listed by the federal government, a person with even a conviction for a violent felony could be eligible to work as a home aide.
The two directors also said that the audit’s projection that the state may have improperly spent more than $160 million in three-year program was vastly overestimated, and that in the end the state only needs to seek collection for less than $1 million.
The audit was issued on June 17 (See Gongwer Michigan Report, June 17, 2014) and was scathing in its assessment that as much as 18 percent of the funds spent on the program over a three-year period, or about $161 million.
And after finding thousands of workers with felony convictions – in fact, the audit cited figures of 3,786 workers with felony convictions, including 572 with violent crimes ranging from assault to homicide, 285 for sex-related crimes, 1,148 for financial crimes and 2,020 for drug-related offenses – the audit also called for the state to begin background checks on workers.
Haveman said the program, with more than 67,000 participants, is very important to the state, the individuals and their families. The state saves some $50 million in nursing home care for every 1,000 people who can remain in their homes, he said.
Both Haveman and Corrigan acknowledged the state had to improve its performance in helping protect vulnerable adults, as the audit showed.
The two departments are now working on the procedures to enact the background checks, and the policy will begin on October 1. Haveman said the state will pay the cost of the background checks.
The policy is designed to ensure the clients and their families know about the background of the individuals who could work as home aides, Haveman said.
And Corrigan said the state is not starting afresh on the issue, since it had made changes to improve protection for vulnerable children. While the policy will not take effect until October 1, the state is already taking steps to make improvements in terms of protecting program participants.
“We take very seriously all audits and their findings,” she said. “Michiganders deserve better and we are committed to making the changes needed.”
It is important for the state to ensure that families and clients have choice in making their decisions and caretakers, so it is important that they have the information to make a decision.
Only a small percentage of workers would have criminal backgrounds, Haveman said, and many may be family members who will help care for the individual. That should be a decision the families could make.
While the federal government has certain required exclusions, there is nothing in state law that would bar persons from serving as caretakers, even if they have violent felonies in their background.
Such a situation could allow for a “permissive exclusion” by the federal government, and Ms. Corrigan said the question of people with violent backgrounds is a big issue and “one that our departments have been looking at.”
The Legislature may want to look at the issue in terms of adding its own exclusions for some workers, Corrigan said. Asked if she would support including an exclusion for persons with violent felonies, Corrigan said, “I don’t see why my personal views are of the slightest relevance when we are the executive branch executing the law.”
The state did have a registry of background checks, of a sort, under the Michigan Quality Care Community Council, which the state began dismantling in 2011, but Haveman said that setup could not have handled background checks as the state will now handle them.
Marge Robinson, president of the SEIU Healthcare Michigan, which had represented many of the workers until Snyder and the Legislature forbid them from unionizing, said the administration of Governor Rick Snyder had made program worse by ending the previous registry.
In terms of the funds that need to be recouped, Haveman said the initial audit came to its estimate after reviewing a selection of documents. A more thorough single audit has indicated the actual amount lost is more in the range of $900,000.
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