AGORA: The private duty marketplace
AGORA: The private duty marketplace
The issue of certification for the private duty home care industry is a somewhat thorny one. Currently, the Joint Commission of Accreditation of Health Care Organizations (JCAHO) and Community Health Accreditation Project (CHAP) are the two main accrediting bodies. Accreditation is not only expensive and time-consuming, but it may be largely irrelevant to receive because both these organizations have more to do with the clinical side of health care than they do with the private duty care sector.
What are the incentives for accreditation? If a nurse decides to become certified as a rehab or wound care specialist, she can bill more for her visits. What does accreditation gain for a private duty care agency?
"Everybody wants accreditation. It’s expensive. I can’t bill for it. I’m not getting paid for having it or recommended for having it, but I may have to have it in order to get certain contracts," says Colleen Sanders, program development manager for Interim HealthCare Services in Fort Lauderdale, FL.
Would Sanders see that as changing if there was another organization specifically designed to accredit private duty home care agencies? Would she feel able to go to those same companies that now require JCAHO accreditation and say, "We chose to go with this other accrediting body because we feel that it much more specific to our type of business?"
"Yes," she says, " if there was an advantage or a true reason for it. Tell me I get national recognition for it, that there’s a system selection of providers based on it. Many private duty agencies are not accredited by JCAHO because the accreditation doesn’t fit their business."
Toward uniformity
All of which brings us back to developing a set of uniform standards within specifically applicable to the private duty industry, because accreditation is based on a set of standards. Sanders views standards development as three different processes.
First, she says, "there needs to be national uniformity. Then would come national standards, and then an outside accrediting body specific to long term home care. There needs to be consistency in job titles. For example, there are only three categories of licensed nurses — RN, LVN, and nurse practitioner. Their titles describe three different kinds of nursing. Even though many nurses work in different specialties, a RN is an RN everywhere. People know it means the same thing whether you live in New York, Minnesota, Washington, or Alaska. People know what the title means. Yet, the same is not true of the care professionals. There are at least five titles for the exact same job in private duty home care. Care professionals — the nonlicensed caregivers — are called home health aides, home care aides, personal care aides, personal assistants, or nursing assistants."
After title uniformity, Sanders believes there needs to be a uniform standard for job training and competency in the home health/private duty home care industry. In future issues of Private Duty Homecare, we’ll look a developing a job training standard, and interview representatives from the existing accrediting bodies.
So, readers — what do you think about this? Write to us, e-mail or snail mail. Addresses are in the back of this newsletter. Phone numbers too.
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