Protecting the elderly

If promising results bear out from a federal pilot program to check the backgrounds of elderly care workers, Congress should consider expanding the program nationally.

In 2003, Congress launched a program in which selected states were given seed money to beef up their background checks for workers who care for the elderly. While the workers primarily were employed in nursing homes, the checks also covered those who worked in hospice centers, home health agencies and psychiatric hospitals.

Federal officials had determined that, while most states conducted some background checks for elderly care workers, the systems often had dangerous gaps. Foremost was the failure to look beyond the criminal registries within a particular state.

For example, while each state might maintain its own registry of nurse aides who had records of mistreating or defrauding elderly patients, they often didn't check the names on other states' registries. Most states also require criminal background checks, but, again, the checks often are limited to crimes within the state.

Under the pilot program, Congress doled out $16.4 million to several states to improve their screening systems. And, by broadening the system, many more applicants seeking jobs as health-care workers for the elderly were disqualified.

Michigan, for example, used $3.5 million in federal money to link several databases, including the state's sex offender registry and its nurse aide registry. More than 3,100 applicants in Michigan were excluded during that phase of the search.

The state then sent applicants' fingerprints to the Michigan State Police and the FBI, and about 700 more applicants were excluded. Altogether, those who were excluded amounted to 5 percent of all applicants, a significant number of people who might prey on the elderly.

Also, among those found to have criminal histories, about a quarter had drug or theft offenses. That could be dangerous in nursing homes or psychiatric hospitals where workers might have access to prescription drugs, financial and medical records and other personal information.

Successful screening programs required applicants to submit fingerprints so they could be checked at the national level for criminal histories. Access to the FBI's national database was key, according to federal officials, because workers with criminal backgrounds often moved frequently from state to state to find work that gave them access to the elderly.

The findings indicate a need for nationwide background checks. Nursing home patients can be extremely vulnerable to abuse and fraud, and a national screening system would help root out predatory criminals who take advantage of the elderly.

States have improved background checks for those who work with children, including teachers and day-care employees. They need to do the same for those who work with senior citizens.

By helping to ensure the safety of elderly patients, a nationwide screening system would offer peace of mind to patients and their families. That is an important consideration, especially now that millions of baby boomers are reaching retirement age.


New nationwide screening system needed for health- care workers for the elderly.

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