Home care service providers must report mistreatment of their elderly and disabled clients.
An internal report by the Vancouver Coastal Health Authority in September 2010 found that in the contracts of that time: "Service providers do not have provisions for complaint management," and it urged that these be added in new contracts.
In the audit's management "action" section, the authority replied that, under new rules, providers must report to VCH incidents "in which clients have been exposed to inappropriate or illegal activities by the personnel, including theft, violence, or harassment of any kind." All agencies already had some kind of internal reporting requirement, but this formalizes it.
The VCH and Fraser Health Authority vowed to develop more detailed criteria on what sort of complaints must be reported to the health authorities, and to review the service providers' complaint policies for compliance with VCH policies. These processes are ongoing.
As well, before last April 2010, providers of homecare services did not have to prove that their employees had passed criminal record checks, but today in contracts such proof is required. VCH and its agencies follow the new criminal record legislation that was enacted last year, but the law is silent on the level of criminality that is acceptable in any given situation.
The report by the VCH internal audit branch was obtained by the Courier under the freedom of information law. VCH provides home support services to help people with ongoing health problems to live at home, as independently as possible. These services include assistance in grooming and hygiene, bathing and toileting, mobility and lifting, safety maintenance, medication, nutrition, and family and caregiver respite.
VCH delivered the services either directly with its own staff, or through five contracted service providers, paying these $44 million in 2009/10. There are now three providers with about 1,085 unionized employees, most of them earning the $34.77 maximum hourly rate.
One "high priority" item in the audit notes that in the former contracts, Section 5.5 stated that criminal record checks must be done on all service provider employees, but they were not required to submit proof they actually were: this raised an "increased exposure for client safety."
VCH spokesperson Gavin Wilson told the Courier, "It is highly unlikely that providers were not implementing the practice of criminal record checks prior to the April 2010 agreement." Several of the providers wrote to the Courier to say they actually did such checks long before 2009. The audit also says, "VCH-Vancouver will follow up with providers to ensure 100% of employees have criminal record checks by Dec. 2010," and Wilson says this was indeed done.
Several more topics were raised. The report said VCH knew too little about the providers' insurance coverage, and "VCH may not be protected with adequate insurance." Service providers were not asked to confirm their staff had signed confidentiality forms, so they might not be in compliance with privacy laws. VCH did not audit the providers' data management, so they "may not have sufficient controls over confidential data." The contracts did not require providers to prove they complied with Workers Compensation Board laws. VCH says that all these problems have since been fixed.
Click here to view the full report.
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