Californian Governor Arnold Schwarzenegger has proposed background and fingerprint checks for home health aides for the elderly and disabled.
The move is to come into force as early as next week, but organizations in the business are crying foul, saying they are not yet ready and stress that the application process under the new provisions would be time-consuming.
The delay could mean some elderly and frail patients would go without care, they warn.
''This has created chaos and uncertainty for frail elderly and disabled people,'' said Assemblywoman Noreen Evans, who wants a three- to four-month delay.
County officials said the new rules have caused confusion and concern for patients and their healthcare providers.
''Our lobbies are flooded, telephones ring continuously, and staff have insufficient information to provide answers,'' Linda Haugan, assistant administrator for San Bernardino County Human Services, said in a letter to the state. ''This has created a major disruption.''
County officials say there are several key logistical problems.
The new rules require prospective healthcare workers to undergo an orientation session that will require counties to hire new staff and office space. Meanwhile, some counties say the new enrollment forms haven't been provided yet.
Officials in Los Angeles County, where more than 185,000 people receive in-home care, said they received the latest instructions just a day ago, giving them a week to prepare.
With more than 4,000 new applications each month for in-home care workers, the inability to approve new providers ''will create an extreme hardship on aged and disabled individuals,'' Philip L. Browning, director of the county Department of Public Social Services, said in a letter to the state.Administration officials referred queries about the program to the state's Department of Social Services, which has been hustling to start the new application process.
Lizelda Lopez, the department's spokeswoman, said the looming deadline was set by the Legislature during budget negotiations and should come as no surprise.
''Nobody denies these were very aggressive time frames,'' Lopez said. But she said the department has been working with the counties for months to enact the new procedures. ''We didn't start talking to them yesterday.''
While the screening of the applicants is to start in a week, the state's more than 376,000 existing care workers would have to undergo the new background checks by June next.
Advocates for the elderly and disabled say the administration's rush to begin the checks, part of an anti-fraud effort Gov. Arnold Schwarzenegger pushed during last summer's budget negotiations, seems to have an ulterior motive: dissuading new patients and providers from participating in the $5.5-billion government-funded home healthcare program.
The In-home Supportive Services program has been caught in a tug-of-war between the Schwarzenegger administration, which contends that it is rife with potential fraud, and Democrats in the Legislature who see it as a humane and cost-effective alternative to nursing homes and other institutionalized care.
Coloring the debate is the fact that the in-home program is a big growth sector for labor unions, which traditionally have supported Democratic candidates and causes while reliably opposing those backed by Schwarzenegger and other Republicans, writes Eric Bailey in Los Angeles Times.
Schwarzenegger tried during the summer budget fight to cut aid to 90% of the program's participants, but Democrats kept the program largely funded while going along with the anti-fraud effort.
''My question is whether this is an attempt by the administration to do what the Legislature would not allow it to do,'' Assemblywoman Noreen Evans said and warned the move would only mean chaos and uncertainty for frail elderly and disabled people.