DEPARTMENT OF HEALTH AND SOCIAL SERVICES
Division of Long Term Care Residents Protection
ORDER
Regulations for Criminal History Checks and Drug Testing for Home Health Agencies
Nature of the Proceedings:
The Department of Health and Social Services, Division of Long Term Care Residents Protection (DLTCRP) initiated proceedings in accordance with 29 Delaware Code, Chapter 101 to adopt Regulations for Criminal History Checks and Drug Testing for Home Health Agencies. On November 1, 2002, DLTCRP published proposed regulations in the Register of Regulations and received written and verbal comments at public hearings on December 2 and December 3, 2002.
Upon review of the comments received, the Division of Long Term Care Residents Protection has revised eight regulations which will be the subject of a further public hearing. The eight regulations withheld from publication as final regulations are Regulations 72.0, 72.101, 72.104, 72.306, 72.307, 72.308, 72.401 and 72.404. Those eight revised regulations appear as proposed regulations elsewhere in this edition of the Register of Regulations.
The remaining regulations are attached and are being promulgated as final regulations. A discussion of the comments received regarding the attached final regulations is in the accompanying Summary of Evidence.
Findings of Fact:
The Department of Health and Social Services finds that the proposed regulations, as set forth in the attached copy, should be adopted as final regulations. Therefore, it is ordered that the proposed Regulations for Criminal History Checks and Drug Testing for Home Health Agencies are adopted effective January 10, 2003.
Vincent P. Meconi, Secretary, DHSS, 12.13.2002
Summary of Evidence:
Comments on the proposed regulations have been received and evaluated as follows:
One comment questioned whether Regulation 72.303 meant that DLTCRP would give the employer the results of the criminal history record check if the employer had paid for it. To clarify, that regulation encompasses both the state and federal criminal history record checks only in circumstances in which the applicant has had a criminal history record check completed within the last five years. If the employer wishes to have another state criminal history check completed, the employer would pay the Delaware State Police to perform that service. However, for the federal criminal history record check, the information on file with DLTCRP would be provided to the employer at no cost.
Another similar comment noted that under Regulation 72.603, actual written reports of criminal history records prepared by the FBI are not released by DLTCRP. The commenter questioned whether that provision applies to state criminal history records; and it does not. Regulation 72.501 states that the employer does receive a copy of the applicant’s state criminal history report.
A comment questioned whether the regulations would prevent a failed applicant from going to a new home health agency and whether the second application would be flagged before DLTCRP paid for a second criminal history record check. While a failed applicant may attempt a second application with a different home health agency, the database check performed by the State Bureau of Identification should prevent duplications.
A commenter stated that the definition of “illegal drug” in the regulations is narrow and makes reference to the drugs referenced in 16 Del.C. §4753A. However, these regulations track the drugs specified in the statute to which these regulations apply with the addition of drugs which are frequently available in health care settings. The drugs defined in these regulations are all tested with a standard ten-panel drug screen.
Also with regard to drug testing, a commenter pointed out that the effect of a positive drug screen is not listed in the criteria for unsuitability for employment. The commenter is correct: the statute is silent on the effects of a positive drug screen. However, an employer is at liberty to determine that a positive drug screen is a bar to employment.
A comment called attention to some inconsistencies between these regulations and previously promulgated regulations for criminal history record checks and mandatory drug testing for persons working in nursing homes. To the extent that inconsistencies exist, DLTCRP will consider amending the regulations promulgated earlier to bring them into accord with these regulations. In particular, the exclusion of sanctions for non-compliance is deliberate since those sanctions are specified in the statute and need not be repeated in regulations and should not be paraphrased in regulations. Similarly, DLTCRP will consider adding “Conviction of any attempt to commit a crime” to the disqualifying convictions in the regulations pertaining to nursing homes and replacing the term “offense” with the term “conviction.”
A comment construed the definition of “Final Employment” in the regulations as intended to encompass every reason that an employer might determine to refuse to accept an applicant for employment. No such implication is intended; rather, “Final Employment” is defined to distinguish it from “Conditional Employment” which is also defined in the regulations.
A comment proposed that the regulation defining “Illegal drug” should be modified to include “any other illegal drug subsequently specified by the Department…” The statute directs that illegal drugs aside from those set out in the statute be specified in regulations. Not only does DLTCRP not have the authority to include a category of unspecified drugs in the regulations, but under such a proposal, those to whom these regulations apply would have no way of knowing when or whether other drugs had been specified as illegal. If further drugs are determined by DLTCRP to be appropriate to add to the list of illegal drugs, that must be done through the regulatory process.
With regard to criteria for unsuitability for employment, a comment suggested that “severity of conviction” be added to the criteria. The severity of a conviction would be included under the category “Type of conviction” in Regulation 72.202a. A comment also stated that the criteria did not include the disposition of an offense. Each item enumerated in Regulation 72.202 specifies a conviction; a conviction is a disposition, and the only disposition of an offense which renders an individual unsuitable for employment.
A comment also proposed that an individual be designated in the regulations to receive information in writing regarding conditionally hired individuals who leave employment prior to the completion of the criminal history record check. Such information may be forwarded to DLTCRP in any form, including by telephone, and it will be appropriately directed.
A commenter stated that the reference in Regulation 72.309 to “data from employers” should be limited to criminal background checks and drug testing information. DLTCRP regards the employment status of an applicant as relevant, and the regulation stands as written.
A comment indicated that the reference to 11 Del.C., §8513 in Regulation 72.601 is incorrect. The regulation is correct as written.
72.0 Purpose
[The purpose of these regulations is to ensure the safety and well-being of residents in this State who use the services of home health agencies licensed pursuant to 16 Delaware Code, Section 122(3)o., and/or private healthcare givers in the resident’s own home or home of residence. To this end, persons selected for employment in these agencies or private homes, effective July 1, 2001, shall be subject to pre-employment criminal history checks and pre-employment drug testing.]
72.1 Definitions
[72.101 “Conditional Employment” pertains to the period of time during which an applicant is working while his/her employer has not received the results of (a) the State criminal history record, (b) the Federal criminal history record, and (c) the drug test. Conditional employment must end immediately if either the State or Federal criminal history record contains disqualifying crime(s) as delineated in Section 72.201 of these regulations. ]
72.102 “Department or DHSS” means Department of Health and Social Services.
72.103 “Employer” is any person, business entity, management company, home health agency, temporary agency, or other organization that hires persons or that places persons in a private residence for the purposes of providing licensed nursing services, home health aide services, physical therapy, speech pathology, occupational therapy or social services.
[72.104 “Final Employment” means employment upon the employer’s receipt of the State Bureau of Identification criminal history record containing evidence of no disqualifying convictions, a report by the Department that there are no disqualifying convictions in such person’s federal criminal record, and the results of the drug testing.]
72.105 “Hire” means to begin employment of an applicant, or to pay wages for the services of a person who has not worked for the employer during the preceding three-month period, or to refer a caregiver to a private residence in return for a finder or placement fee.
72.106 “Home Health Agency” is any business entity, public or private, which provides directly or through contract arrangements, to individuals in their home or private residence, either (a) two or more of the following services: licensed nursing, home health aide, physical therapy, speech pathology, occupational therapy, or social services where at least one of these services is licensed nursing or home health aide services or (b) home health aide services exclusively, provided under appropriate supervision.
72.107 “Illegal drug” for purposes of these regulations means marijuana/cannabis, cocaine, opiates including heroin, phencyclidine (PCP), amphetamines, barbiturates, benzodiazepene, methadone, methaqualone and propoxyphene.
72.108 “Promotion” means any change in job classification that results in additional responsibility and/or an increase in wages. It does not include a change in job status from part-time to full-time.
72.2 Criteria For Unsuitability For Employment
72.201 The following types of criminal convictions (or convictions in another jurisdiction which are comparable under Delaware law) automatically disqualify a person from providing home health services when such conviction occurred within the time periods specified:
a. Conviction of any act causing death as defined in 11 Delaware Code, Chapter 5, Subchapter II, Subpart B with no time limit;
b. Conviction of any sexual offense designated as a felony in 11 Delaware Code, Chapter 5, Subchapter II, Subpart D with no time limit;
c. Conviction of any violent felony as specified in 11 Delaware Code, Section 4201(c) within the last ten years;
d. Conviction of any felony involving a controlled substance, a counterfeit controlled substance, or a designer drug as specified in 16 Delaware Code, Chapter 47 within the last ten years;
e. Conviction of any felony other than those specified above within the last five years;
f. Conviction of any misdemeanor involving a controlled substance, a counterfeit controlled substance, or a designer drug as specified in 16 Delaware Code, Chapter 47 within the last five years;
g. Conviction of any Class A misdemeanor included in 11 Delaware Code, Chapter 5, Subchapter II, Subpart A within the last five years;
h. Conviction of any attempt to commit a crime, as defined in 11 Delaware Code, Section 531, with respect to any of the above listed offenses.
72.202 For other criminal convictions, the following criteria are to be used by the employer in determining whether a person is suitable for employment in home health care:
a. Type of conviction(s);
b. Frequency of conviction(s);
c. Length of time since conviction(s) occurred;
d. Age at the time of the conviction(s);
e. Record since the conviction(s);
f. Relationship of conviction(s) to type of job assignment.
72.3 Employer Responsibilities
72.301 The employer shall ensure that a Criminal History Record Request Form has been completed and that the employer copy is maintained in the employer’s files.
72.302 The employer shall maintain a signed copy of the Receipt/Verification of Providing Fingerprints Form from the Delaware State Police.
72.303 If an employer wishes to have a criminal history record check conducted on an applicant who has been the subject of a qualifying State and Federal background check within the previous 5 years, the costs shall be borne by the employer. Payment shall be made directly to the Delaware State Police. The Department shall, at no cost, provide the results of the Federal Bureau of Investigation information to the employer in the same manner as for any other applicant.
72.304 If a person is fingerprinted under the auspices of these regulations more than once during a five-year period, the costs shall not be borne by the State. If the State is billed for such fingerprinting costs, payment shall be obtained from the employer specified on the Criminal History Record Request Form. Such employer may obtain payment from the applicant.
72.305 If an applicant who has been conditionally hired is separated from employment for any reason prior to completion of the criminal history check process, the employer shall notify the Department upon such separation.
[72.306 Upon receipt of the results of the criminal history record check and the drug testing, the employer shall determine the suitability of an applicant for final employment using the criteria in Section 72.202 unless the state and/or federal criminal history record check has identified a conviction of one or more automatically disqualifying crimes. An applicant for final employment with a conviction of an automatically disqualifying crime shall be terminated immediately.]
[72.307 The employer shall notify the applicant of the findings of the criminal history record check and drug testing.]
[72.308 The employer is required to provide complete copies of all information received from the Department pertaining to an applicant to the individual in need of care or his/her guardian upon placement of the applicant.]
72.309 The Department reserves the right to obtain data from employers on the employment status of applicants covered under these regulations.
72.4 Applicants’ Responsibilities
[72.401 Applicants are responsible for completing all information accurately and completely on the Criminal History Record Request Form and any form provided by the employer for use in obtaining mandatory pre-employment drug testing. Any applicant who refuses to complete one or more of these forms shall be deemed to have voluntarily withdrawn his/her application.]
72.402 The applicant is responsible for having his/her fingerprints taken and for returning a Receipt/Verification of Providing Fingerprints to the Delaware State Police Form to the employer.
72.403 The applicant is responsible for informing any potential employer if he/she has already been fingerprinted in accordance with these regulations. The cost of additional
fingerprinting, exceeding the one fingerprinting per five-year period required by these regulations, shall not be borne by the State.
[72.404 The applicant is responsible for submitting to the required drug testing and providing verification to the employer.]
72.5 Department’s Responsibilities
72.501 When the Department has received all necessary documentation, it shall perform a review and ensure that the employer receives a copy of the applicant’s state criminal history report and issue a written summary of the federal criminal history report. If conviction of a disqualifying crime is included on the state or federal criminal history report, the Department shall notify the employer immediately, prohibiting either the hire or continued conditional employment of the applicant.
72.502 Upon notification that an employer intends to hire a person who has previously had the criminal history check conducted by the Department, the Department shall review the criminal history on file and shall review the applicant’s criminal history via the Criminal Justice Information System for any subsequent criminal information. If the review reveals a disqualifying conviction subsequent to the original review, the applicant shall be disqualified from employment with the new employer and the previously listed employers shall be notified of the recent conviction and encouraged to make personnel decisions based on the new information.
72.6 Confidentiality
72.601 In accordance with 11 Delaware Code, Section 8513(c), the Department shall receive information from the State Bureau of Identification pertaining to the identification and conviction data of any person for whom the Bureau has a record solely for the purpose of determining suitability for employment of the person whose record is received.
72.602 The Department shall store written and electronically recorded criminal history record information in a secure manner to provide for the confidentiality of records and to protect against any possible threats to their security and integrity.
72.603 The Department shall not release to employers, as defined in Section 72.103 of these regulations, copies of actual written reports of criminal history records prepared by the Federal Bureau of Investigation.
72.604 The following procedure shall be used to permit the review of criminal history record files by any applicant:
a. An applicant shall submit a request in writing to the Department for the on-site review of his/her criminal history record file.
b. An applicant shall make an appointment to review the record at the Department in the presence of a Department employee. The applicant shall present photo identification at the time of the review.
c. Written documentation of the date and time of the review and the names of those present shall be filed in the criminal history record file of the applicant.
d. Upon completion of such a review, the Department shall return criminal history records (written or electronic) to secure storage.
72.605 Criminal history record information shall not be disseminated to any person(s) other than the applicant, his/her employer or subsequent employer(s) as defined in Section 72.103 of these regulations, or the Department.
72.606 All employers shall store criminal history record information in a secure manner to provide for the confidentiality of records and to protect against any possible
threats to their security and integrity.
72.607 Employers shall limit the use of criminal history record information to the sole purpose of determining suitability for employment.