ElderWeb

The Missouri State Auditor has issued a report showing that some nursing home employees include individuals who are disqualified not only from working in nursing homes, but are prohibited from working with the mentally handicapped, or were determined by the state to have abused or neglected children. The Auditor's office cross-referenced employees of licensed nursing facilities and in-home care providers against three lists: the DA?s disqualification list, the Department of Mental Health?s (DMH) disqualification list, and the Division of Family Services? central registry of child abuse and neglect (CA/N). They found 30 persons working for nursing facilities or in-home health providers, who are also on the Department of Mental Health?s disqualification list, 574 persons caring for our elderly who were listed on the child abuse and neglect registry. These employees were on the registry because the Division of Family Services found probable cause, or a court determined, they had physically abused, neglected or sexually maltreated a child. The severity of their offenses ranged from serious or severe injury to fatalities.

We also noted that current law does not provide that screenings require that the history of child and elder care workers be checked against information from other states, and or require employees in schools to be checked against the listings of abusers. They also noted that it would be an onerous task for individuals selecting personal care services to check backgrounds of employees of large providers and providers with high employee turnover.

The Auditor recommends placing all disqualified individuals (and their social security number) from the Division of Aging Employee Disqualification Listing, the Department of Mental Health Employee Disqualification Listing, as well as individuals who have been determined to have committed a serious child abuse or neglect incident, in a single abuse registry, and also passing legislation which prohibits these individuals from being employed by care providers and schools.

He also recommends:
- Implementing the necessary system improvements to allow for more timely background screening results.
- Requiring care providers and schools to check the abuse registry prior to employment of new individuals.
- Developing an automated process to periodically identify all instances of individuals inappropriately working for care providers and schools.
- Developing procedures to remove those individuals from inappropriate workplace settings.
- Developing procedures to aggressively fine and sanction care providers and schools who employ individuals listed on the abuse registry.
- Developing procedures so that family members can more easily and conveniently determine whether a particular care provider or school is employing individuals listed on the abuse registry. Consideration should also be given to what extent information on the registry should be available to the public.
- Requiring the backgrounds of Family Care Safety Registry registrants who have not resided in Missouri for the preceding three years be checked against information in the registrant's former state of residence. In addition, the state should promote the establishment of a national screening system.
- Establishing a fair and consistent appeal process which considers the nature and severity of the incident which resulted in placing an individual in the abuse registry, and the results of any subsequent rehabilitation.
- Passing legislation to clearly allow background information to be disclosed to state agencies responsible for monitoring provider compliance.