Safe at Home? Developing Effective Criminal Background Checks and Other Screening Policies for Home Care Workers

This PPI report focuses on federal and state approaches to background check screening of home care workers to protect vulnerable adults from harm. 

States increasingly require criminal background checks for home care workers to protect vulnerable adults from harm.  While 46 states mandate some type of background check for Medicaid-funded workers, there is no uniform protocol for screening and disqualifying candidates. Developing sound policies and practices is challenging due to costs, database problems and time constraints.  There has been no robust scholarship on the relationship between criminal behavior and the risk of elder mistreatment.  Research is only beginning to provide a scientific basis for screening policies.

The paper offers an up-to-date assessment of practices, policy considerations and research, and guidance on moving forward, including:

• Implementing promising state-level practices to increase accuracy, speed, cost-effectiveness and fairness to job applicants
• Using multiple, complementary screening tools – not just criminal background screening
• Recognizing that self-directed programs – in which participants recruit, hire and supervise their own workers – may require a different approach.

AARP commissioned additional research by the National Conference of State Legislatures (NCSL) on state criminal background check requirements for Medicaid-funded home care workers.  You can find the following information on NCSL’s website: a detailed narrative on each state’s laws; a 50-state chart with live links to the statutory text; and a narrative summarizing statutory trends and distinctions.