Debate on regulation of home health-care services
The dispute centers on the difference between "companion care" providers, who generally are smaller companies and are not supposed to perform medical duties, and larger employers of home health aides, who are more closely regulated, offer more hands-on care, and are authorized to serve Medicaid recipients.
Proponents of the bill recently passed by the Senate argue that the state should require "companion care" companies to be accredited by a state-recognized body.
They say workers supplied by these companies - who are supposed to spend time with elderly residents but not engage in physical contact or provide medical care - sometimes go beyond their level of training.
The council serves as the statewide association representing nonprofit home care providers, which employ many home health aides who perform duties such as changing bandages. Council members generally provide care to Medicaid patients, which means that these companies must be accredited under federal law.
Wessel said the bill would close a loophole that allows some companies to provide care without effective oversight and would improve the financial standing of these companies by requiring annual financial audits.
But opponents say state and federal regulators and law enforcement already have the ability to provide oversight by cracking down on fraud.
They contend that the bill would benefit larger care providers at the expense of smaller businesses that provide companion care.
Jean Bestafka, CEO of the Home Health Services Association of New Jersey, which represents 250 predominantly small providers, would like to see the Legislature consider a bill that would recognize companion care providers but not require accreditation.
"It's very expensive to have care at home," and the new bill would increase those costs by introducing accreditation and audit fees, Bestafka said.
Bestafka estimated that the annual costs could be $10,000 to $20,000 for accreditation and $15,000 to $30,000 for an audit.
Supporters of the bill contest these numbers.
Barbara Cording, executive director of an existing accreditation body - the Commission on Accreditation for Home Care - said her organization charges businesses between $1,792 and $4,704 for annual accreditation, depending on the amount of service provided.
Cording said state and federal fraud investigations do not have the same purpose as accreditation, which sets standards that require care providers to follow the industry's best practices.
She said her organization requires that aides have training and be regularly tested, and that accredited providers allow patients to file grievances over allegations of faulty care.
The bill's sponsor, Sen. Nellie Pou (D., Bergen), said during a June hearing that the bill would reduce the incidence of abuse.
The Senate passed the measure, 21-13, on Aug. 19, with only one Republican senator, Samuel D. Thompson, voting in favor. The Assembly version of the measure has been referred to the Health and Senior Services Committee.
Read more of Andrew Kitchenman's health stories at njspotlight.com