Ttorney General Andrew Cuomo, Senate Majority Leader Joseph Bruno And Assembly Speaker Sheldon Silver Announce Landmark Legislation To Fight Fraud In The Home Health Care Industry And Provide Vital Information To Help Protect Care Dependent New Yorkers

ALBANY, NY (June 11, 2008) - Attorney General Andrew Cuomo, Senate Majority Leader Joseph Bruno and Assembly Speaker Sheldon Silver today announced groundbreaking legislation to fight fraud in the home health care industry and protect New York’s most vulnerable with the creation of a publicly accessible registry of all certified home health and personal care aides in the state.

The New York Certified Aide Registry and Employment Search Act (NY-CARES), introduced by legislative health committee chairs in the Senate and Assembly at the request of Attorney General Cuomo, creates new protections for care-dependent New Yorkers by establishing a central registry of home health and personal care aides that includes background information and sworn proof of proper training.

“My office’s ongoing investigation of the home health care industry has uncovered widespread fraud and corruption throughout the state, endangering New York’s most vulnerable population and costing taxpayers tens of millions of dollars,” said Attorney General Cuomo. “A publicly accessible registry with background information on aides is a critical first step in improving government oversight and ending the fraud in this rapidly growing industry, and I am proud to be working with leaders in both houses of the Legislature to cooperatively address this statewide problem.”

NY-CARES will create an Internet-based registry of home health and personal care aides that would include health care employment history, results of criminal background checks for aides employed through agencies and certifications - signed under penalty of perjury - from senior school officials that the aides completed the required training.

Senate Majority Leader Joseph L. Bruno said, “Creation of an online registry that gives New Yorkers access to information regarding the qualifications of home health and personal care aides is a critical step to providing peace of mind to patients and their families. In addition, this registry will ensure that the State is doing even more to root out fraud and abuse, and being accountable to taxpayers. I congratulate Senator Hannon, the Chairman of the Senate's Committee on Health, and my colleagues in government for this landmark legislation, and commend the Attorney General for his outstanding work on this issue."

Assembly Speaker Sheldon Silver said, “Home health care workers are an important part of our health care delivery system and play a much-needed role in the care of thousands of New Yorkers, particularly among the elderly and some of our most vulnerable populations. Therefore, it is absolutely essential that home health care workers are properly trained and vetted before they are charged with patient care. This registry provides a critical tool for ensuring the best-trained, most qualified caregivers possible are made available. Attorney General Cuomo's investigation of the industry found serious problems and made clear the need for providing better oversight and extending the same protections that exist in nursing homes to care-dependent persons receiving care in their homes."

State Sen. Kemp Hannon, chairman of the Senate Committee of Health and Senate sponsor of the bill, said, “Attorney General Cuomo’s NY-CARES legislation is a crucial first step toward assuring New Yorkers that home-health and personal care aides working in their homes are properly qualified. I am proud to work with the Attorney General and my colleagues to insure New York’s home care recipients are provided safe, quality care.”

Assembly Health Committee Chair Richard N. Gottfried, Assembly sponsor of the bill, said, “The vast majority of home care workers do an extraordinary job taking care of vulnerable New Yorkers. We want to make sure that they all meet that standard, and that home care agencies and the public can be sure of a worker’s education, training, and background.”

Attorney General Cuomo’s ongoing investigation into the home health care industry, known as “Operation Home Alone,” has uncovered thousands of fraudulent home health aide certifications and led to the convictions of dozens of uncertified aides, registered nurses, managers of schools that provided false certifications, agencies that employed aides and nurses and Medicaid recipients complicit in no-show billing schemes. In many of those cases, the aides and nurses were found to have been billing for services they did not provide, providing and billing for services despite lack of proper training and certification, and billing through more than one agency at a time in order to be paid for as much as 36 hours in one day.

NY-CARES addresses the problem of fraudulent certifications by now requiring senior officials of state certified training programs to provide proof they have verified the true identity of each person successfully completing a home health training program, and certifying, under penalty of perjury, that the aide did in fact complete the required training.

Medicaid requires home health aides - who primarily care for elderly patients, administer medication, and provide services such as catheter care, colostomy care and wound care - to successfully complete a training program licensed by the Department of Health or the State Education Department. All such aides much receive a minimum of 75 hours of training, including 16 hours of supervised practical training conducted by a registered nurse. Personal care aides, who assist patients with personal hygiene care, nutrition and meal preparation, are required to take a 40-hour basic training program and receive three hours of semi-annual in-service training.

A registry already exists for nurse aides that work in nursing homes. By creating a registry for home health and personal care aides, NY-CARES will extend the same protections that exist in the nursing homes to care-dependent persons being cared for in their homes.

Moreover, the state Department of Health currently lacks the means to keep track of the number and identity of home health and personal care aides working in the State. NY-CARES will thus provide greater transparency and accountability, which, in turn, will enhance the quality of care delivered to the vulnerable population served by the home health care industry.

AARP New York State Director Lois Aronstein said, “Fraud and abuse have no place in the home health care industry. A central registry will help ensure that care-dependent New Yorkers are receiving quality service by trained and certified home care staff.”

George Gresham, President of 1199 SEIU United Healthcare Workers East said, “Those who take advantage of current holes in oversight of the home health aide system for their own self-serving purposes have no place among the hundreds of thousands of dedicated and selfless homecare workers who are scrupulous about playing by the rules.”

The legislation is also supported by the Healthcare Association of New York State, the New York Association of Homes and Services for the Aging, the Home Care Association of New York State and the Empire State Association of Assisted Living.

Under NY-CARES, the registry will be updated at least every 30 days and home care agencies would need to check the registry prior to hiring an aide. The registry will also include a comprehensive list of all State-approved education or training programs for home care services workers.

NY-CARES calls for the following to be included in the registry:

  • The aide’s name, address, gender and date of birth.
  • The name of the State-approved education or training program successfully completed.
  • The employment history in home care services.
  • Findings of prior instances of physical abuse, mistreatment, neglect, or misappropriation of a patient’s property.
  • Any prior determination by the Department of Health that the person was approved or disapproved for employment in connection with a check of criminal history information.

Provisions establishing and regulating home health care in New York were set forth in Chapter 895 of the state laws of 1977. The aim was to reduce the costs associated with institutionalization and provide patients a greater level of comfort. Last year, Medicaid expended $3.8 billion on home health care services and on average more than 150,000 Medicaid recipients each month received home health care services.

New Yorkers are urged to report cases of suspected fraud to the Attorney General’s toll-free Information and Complaint Helpline, at 1-800-771-7755.


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