Safe at Home? Developing Effective Criminal Background Checks
and Other Screening Policies for Home Care Workers
As an increasing number of services to older adults and individuals with disabilities are being provided in the home and community rather than in institutions, there has become a greater awareness of the need to monitor the individuals providing those services. One tool to assure high-quality workers is the use of a pre-employment criminal background check. This project gathered and analyzed information on state requirements for criminal background checks for home care workers whose services are eligible for reimbursement through the state’s Medicaid program. In general, these are workers paid through the state’s Medicaid state plan personal assistance option and workers paid through a state’s Medicaid home and community based services waiver programs. These workers may be employed by an agency or employed as individuals. In some cases, state statutes and regulations apply to privately funded workers in addition to those funded by Medicaid or other public programs, and the charts and text below indicate the scope of state policy. While the focus is on paid workers, the project also determined whether state rules applying to employees are used when individuals volunteer in a home care role.
NCSL’s study focuses exclusively on state laws and regulations as policy vehicles and builds a base of knowledge through a comprehensive review of these policy vehicles. This narrative categorizes the states’ policy decisions and provides information about differences and similarities in background check policies across the states, especially on topics where many states have policies.
This chart provides a state-by-state list of statutes governing criminal background checks for home health workers. The chart gives the statute number (with links to the statutory text); lists whether the check is mandatory and what exemptions apply; who pays for the check; and summarizes disqualifying offenses.
This document expands upon the information given in the State Chart, providing a narrative with additional relevant details not covered in the chart.
States vary widely in how they define certain criminal actions. This chart explains how these crimes, grouped together in the State Chart, are defined and their relevancy to the background check process.
NCSL thanks AARP for their support in this project.