Feb. 2: Tighter screening being sought for Minnesota's caregivers

More than 200,000 workers who care for Minnesota's most vulnerable residents could soon undergo heightened criminal background checks as part of a new state effort to reduce abuse, neglect and fraud at state-licensed facilities.

The Minnesota Department of Human Services (DHS) is seeking broad new authority from the Legislature to collect fingerprints and to conduct FBI criminal background checks on prospective employees of child-care centers, homes for the disabled, and other sites that care for the needy.

The new powers, if granted, would amount to the most far-reaching enhancement of the state's screening of caregivers since the DHS began conducting criminal background checks in 1991. People who commit crimes in other states, for example, would be less likely to slip through the cracks.

"This is about protecting the public," said Jerry Kerber, inspector general for DHS.

One of the goals is to curb the rising complaints of maltreatment in licensed facilities, such as day-care centers and nursing homes. The number of maltreatment reports received by DHS has increased 18 percent over the past two years, to 5,273 in 2013. About two-thirds of the substantiated cases involve neglect.

The rising number of maltreatment reports has created a large backlog of complaints for DHS to investigate, though it has made some progress in recent months. The state had 601 pending cases of maltreatment in the year ending July 1, 2013, down from 628 from the previous year.

The proposals, which have the support of Gov. Mark Dayton and several influential DFL legislators, could nonetheless face stiff resistance when the Legislature convenes in late February. Already, civil libertarians are raising privacy concerns about a giant computerized database of fingerprints and other personal information on tens of thousands people with no criminal histories.

"If Target or Neiman Marcus can't control your data, then why would we think that DHS would do a better job?" asked Charles Samuelson, executive director of the American Civil Liberties Union of Minnesota.

DHS already conducts more than 270,000 criminal background checks a year of caregivers, but the system has critical gaps. As the Star Tribune reported last fall, nurses in Minnesota can practice for years before any past crimes are detected by employers, exposing vulnerable people to danger.

Currently, many caregivers undergo criminal background checks only when they are hired or move to a new employer. As a result, serious new crimes can go undetected if a caregiver never switches jobs, or if corrections officials fail to report them. The criminal checks are also confined to courts in Minnesota, which means that a nurse or practitioner could commit a crime in another state and still avoid disqualification.

The system also results in unnecessary duplication. Because background checks are tied to employers, the state ends up conducting multiple background checks on thousands of employees who have no criminal histories. Some people have been reviewed more than 120 times, according to DHS estimates.

"We have been relying on a system that is flawed," Kerber said. "What we have found out is that we don't get all of [the convicted criminals]."

The DHS is also seeking legislative permission to collect fingerprints of all newly hired caregivers in state-licensed programs starting in October. The state would also start conducting FBI checks on new personal care assistants, or PCAs, who care for the elderly and people with disabilities. About 105,000 people are enrolled as PCAs in Minnesota.

The state expects to pay for the myriad changes with a $3 million grant from the federal Centers for Medicare and Medicaid Services.

Kerber said the state is initially focusing on PCAs for the FBI background checks because they have had a higher rate of criminal offenses, as well as more turnover.

"Here [PCAs] are in people's homes often without any supervision or oversight and providing very intimate care," Kerber said.

Rep. Tina Liebling, DFL-Rochester, chair of the House Health and Human Services Policy Committee, said she supports the proposals but is concerned about the state and FBI "collecting zillions of fingerprints on innocent people."