This study examined seven basic types of formal home care service providers in California, licensed and unlicensed, delivered by agencies and by individual providers. The primary differences were based on sources of payment, duration of care, supervision of personnel, and state regulation, rather than on statutory definitions of services offered and clients served. Many key officials and providers advocate regulatory reform by extending licensure to unlicensed agencies and providers. Competing special interest groups have not developed a consensus about regulation, leading to a political stalemate. Research has not determined differences in quality, access, and costs of licensed and unlicensed home care providers.
Bibliographical noteFunding Information:
'This research was funded by an AARP Andrus Foundation grant. ^Professor and assistant adjunct professor, respectively, Institute for Health and Aging, University of California, Room N531, San Francisco, CA 94143-0646.
Private pay; Title XX Social Services Block Grant for IHSS; state general funds for Family Survival Project
Three major public programs in California offer home health, personal care, and other services in the home through contractual arrangements primarily with unlicensed agencies and providers. The In-Home Supportive Services program is operated by the Department of Social Services, funded by the federal Title XX Social Services Block Grant. This program offers domestic cleaning services, nonmedical personal care, paramedical services, protective supervision, limited transportation, and removal of yard hazards. To receive services the recipient must be aged, blind, or disabled and receive Supplemental Security Income or State Supplemental Payments or meet income eligibility standards. The amount of care provided in 1988 was limited to a maximum of
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- Consumer groups
- Formal home care
- Licensed and unlicensed home care
- Nurses' registries and individual providers