Lansing — A state audit has found nearly 3,800 convicted felons working in the homes of disabled adults, about two years after Gov. Rick Snyder’s administration abolished a union-backed program that included criminal background checks of some workers.
A scathing state Auditor General’s report released Tuesday on the Medicaid Home Help Program found 572 home help aides with violent crime convictions ranging from assault to homicide, and 285 workers with sex-related convictions as of January 2013.
Disability advocates were not surprised by the number of felons assisting the state’s most vulnerable adults because a previous background check system ceased after the Snyder administration eliminated funding for a home care council that forced workers to join the Service Employees International Union.
“This administration eliminated that council primarily because it was affiliated with unionization,” said RoAnne Chaney, associate director of the Michigan Disability Rights Coalition.
To get on the now-defunct optional registry, workers had to get background checks, Chaney said. But they were only required to disclose their criminal history if a potential Medicaid client asked for it during an interview, she said.
A critic of the former Michigan Quality Community Care Council, or MQC3, said it was not intended to keep dangerous felons out of the homes of the 70,000 disabled adults who rely on home care aides for assistance with bathing, dressing, cooking and cleaning.
“They created the MQC3 for one reason and one reason only — and that’s to create this dues skim,” said Patrick Wright, vice president of legal affairs at the Mackinac Center for Public Policy, which fought the SEIU’s organization of 40,000 home care workers. “Everything else was just thrown on to make it look like it was doing something important — and even that it couldn’t do properly.”
In response to the audit, the Michigan Department of Community Health is developing new policies regarding background checks and the types of crimes that may disqualify someone from being a home help aide, spokeswoman Angela Minicuci said.
Minicuci could not say which crimes would get an individual disqualified from getting a Medicaid-funded job because the policy has not been finalized.
“I think it’s safe to say that our top priority is that there is no abuse or financial exploitation of adults in the program,” she said.
After discovering a lack of background checks, state auditors conducted their own criminal history probesusing a Michigan State Police database and found 2,020 drug convictions and 1,148 convictions for financial crimes such as embezzlement, identify theft and fraud.
“By not conducting criminal history checks, DCH (Community Health) and DHS (Human Services) may be unaware of unsuitable individuals who may pose harm to their vulnerable client population,” state auditors wrote.
The Department of Human Services jointly administers the program with the Department of Community Health. The department is reviewing the auditor’s list of in-home care providers with criminal histories and conducting “well being checks” of disabled clients to ensure they have not been abused or defrauded, Human Services spokesman Bob Wheaton said.
“We’re in the process of doing that right now,” he said.
An unknown number of the 3,786 aides with criminal histories — representing about 6 percent of the statewide home care workforce — are relatives of disabled adults, officials said.
“The clients’ ability to hire relatives poses a unique circumstance in that clients may be fully aware and accepting of their relatives’ criminal history,” the auditors wrote.
Chaney cautioned against policymakers rushing to block all felons from being employed in the program, which pays about $8 an hour.
“Do you hold every infraction somebody may have done 30 years ago against a person forever? And who’s decision is that? Chaney asked. “Do we want it all made by bureaucrats or should it be left up to the person and their family? There are not easy black-and-white answers to that.”
Minicuci said the department is trying to craft its new policy to give individuals the flexibility to hire family members, even if they have a criminal past.
“Obviously we still want to maintain the ability of individuals to have independence and choice, but we also want to make sure they’re safe,” she said.
Hollis Turnham, Midwest policy director for PHI, a national nonprofit that advocates for long-term care, said the infrastructure was in place to expand the background checks, but the registry was “collateral damage” in the Mackinac Center’s quest to end the forced unionization of home care workers.
“MQC3 was one of those opportunities to bring more resources to home help recipients and their workers,” she said. “And it no longer exists.”
Turnham urges state officials to do background checks.
“If you’re going to have somebody coming into your home on a regular basis to deliver services, you need to know a lot about their background,” she said.
Auditors also took the departments to task for improperly paying in-home care providers an estimated $160 million over three years without getting proper documentation or ensuring the patient received the care for which they were paid.
A lack of records supporting the payments, auditors said, could force the state to repay the federal government more than $96 million in shared costs for the program.
The Department of Community Health disputes the auditor’s estimate of improper payments and has concluded the state will have to repay the federal Centers for Medicare & Medicaid Services “a maximum” of $900,000, Minicuci said.
Minicuci said the department is rectifying the problems and trying to recoup money from providers who were “inappropriately reimbursed” for services that either weren’t perform or were duplicated.
“We have a taken a lot of steps to address a lot of the concerns raised in this audit,” Minicuci said.