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Increasing safety for at-risk adults: screening in-home care providers.

Article Excerpt
Years ago, the director of a program for adults with developmental disabilities asked me to teach a workshop for staff after a male aide molested a wheelchair-bound client in a bathroom. A head nurse at a hospital for frail elders asked for a workshop after a stroke patient was diagnosed with a sexually transmitted disease. "Why me?" I asked the people extending these generous invitations. Good question--my field is child welfare. "Everybody else refused," they answered. Bad answer.

From my perspective as a child welfare social worker, I see unnecessary gaps in screening and hiring practices for in-home helpers who work with dependent adults and frail elders. I have heard the justifications for the status quo from consumers, client advocates, and agency directors and find them unpersuasive and unnecessarily dangerous.

PREREQUISITES FOR WORK WITH MINORS

People wishing to work with children in health and mental health programs, schools, child care, foster care, group homes, and residential programs must submit fingerprints to their prospective employer who, in turn, sends them to the state's Department of Justice for clearance. The clearance includes juvenile court and child protective services cases as well as criminal convictions (Goldman & Salus, 2003; Howell, 1993; Lockyer, 2000). The former may be more relevant than a Department of Motor Vehicles (DMV) or criminal background check because the triggers (for example, crying, enuresis, defiance, and temper tantrums) that lead a parent to abuse a child are apt to abound in work with children.

Once hired, employees must be informed of their responsibilities under the child abuse reporting laws and agree to report reasonable suspicions of abuse or neglect promptly to the appropriate protective agency. They must sign a statement saying they know they are mandated by law to report suspected child abuse and neglect, understand what constitutes abuse...