State to tighten regs on home-care program

Posted: Wednesday, July 13, 2005

Individuals and agencies providing at-home care for the elderly and disabled are facing tighter standards for their services under proposed new regulations by the state.

The changes would help curb misuse of the Personal Care Assistant program, whose cost has risen from $7.6 million to almost $80 million in the last four years, Department of Health and Social Services Commissioner Joel Gilbertson said Tuesday.

The program aims to allow the elderly and those with disabilities to live independently by reimbursing care assistants who help those in need with basic tasks such as eating, bathing and using the bathroom.

Service historically has been provided by agencies that hire care assistants, but in 2001, the program was expanded to let clients decide who serves as a care assistant and what level of care is provided.

The change has prompted some living in the same household as a family member in need to register as personal care attendants and receive payments for providing basic care.

"We don't need to be stepping in and taking on family obligations," Gilbertson said.

Audits also show some assistants have provided services not covered under the program and in some cases have billed for services without proving they were performed, Gilbertson said.

He said enrollment has grown from about 1,300 in 2000 to about 3,800 presently. And the growth of the program has put stress on other Health and Social Services programs for seniors and the disabled, he said.

Gilbertson said the Legislature this year directed the department to tighten regulations to control the costs.

State medical assistant administrator Jon Sherwood said proposed regulations would prevent agencies from soliciting clients to switch to their service. Gilbertson said it would stop the practice of agencies targeting potential clients with the promise that they will deliver more services than a current provider.

He said the proposed regulations also would use independent nurses instead of relying on agencies to assess the needs of potential clients.

The changes would also eliminate "standby" assistance in most cases, where personal care assistants are paid to remain on site in case a client falls or has an accident.

Gilbertson projected the proposed regulations would slow the growth of the program and cut about 10 percent of its cost.

Pat Luby, advocacy director for AARP Alaska, said he believes the program is working well for most individuals, but some are receiving unnecessary care.

"In the past there's been a perverse incentive to provide everything you can get paid for," Luby said. "That's not a good use of our tax dollars."

Gilbertson said the proposed regulations are out for public comment through Aug. 15. He said he hopes to have them approved this fall and in place by the end of November.

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