Home care providers cheer first-ever federal regulations for adult protective services

by Adam Healy

The Administration for Community Living this week finalized the first-ever set of federal regulations governing adult protective services (APS) programs. These programs often work closely with home care providers to help older adults live independently in their communities.

ACL’s final rule received praise from home care advocates, including the National Association for Home Care & Hospice.

“NAHC supports the development of standards for state APS services,” the association told McKnight’s Home Care Daily Pulse, in a statement. “The regulations will help to improve consistency in services across states, better protect the vulnerable elderly, and increase understanding of the APS processes and expectations for those who provide care in the home.”

The new regulations for APS, published Tuesday in the Federal Register, established national data reporting requirements, ethics policies and common definitions to improve information sharing. ACL built upon the National Voluntary Consensus Guidelines for State APS Systems, an existing set of codes that voluntarily bound APS programs, to produce the national regulations.

“For many years, the APS community, Congress and other stakeholders have called for federal guidance, leadership and resources for APS systems,” Alison Barkoff, leader of the ALC, said in a statement. “With the APS final rule, ACL is answering that call.”

Vulnerable population

In establishing national standards, ACL said it intends to provide stronger protections for APS recipients — many of whom are older adults or people with disabilities living at home and in their communities. These individuals are often at risk of abuse, neglect or exploitation. Roughly 1 in 10 older adults living in the community experience some form of maltreatment, according to the Department of Health and Human Services, and few cases are actually reported. APS programs work to connect victims with resources like home- and community-based services providers to aid their recovery, ACL noted in the final rule. 

The new regulations will take effect on June 7, according to the ACL, and regulated entities will have four years to achieve compliance.

Guardianship warning 

ACL solicited feedback for the rule in September 2023. Many commenters raised concerns related to older adults subject to or at risk of guardianship. ACL’s guidelines advised APS providers to exhaust all available community-based resources to help prevent guardianship.

“APS programs should recommend guardianship, whether they themselves are petitioning for guardianship, accepting a court appointment to serve as a guardian, or referring to another entity to petition for or serve as guardian, only as a last resort if lesser-restrictive measures have been exhausted or determined not feasible,” ACL wrote in the final rule. 

APS programs address the following, ACL noted: Medicaid home and community-based services, Older Americans Act-funded programs such as congregate and home-delivered meals, homemaker and chore services, and transportation.”

Older adults at risk of being subject to guardianship also have caught some lawmakers’ attention. Sen. Bob Casey (D-PA) recently introduced the “Alternatives to Guardianship Education Act,” which promotes awareness of guardianship alternatives among healthcare workers and family caregivers.

“Awareness of guardianship alternatives by people that frequently interact with older adults, people with disabilities, and other individuals at risk of guardianship determinations may helpreduce unnecessary guardianship arrangements and preserve decision-making rights,” Casey said Wednesday in a statement.

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Home care providers cheer first-ever federal regulations for adult protective services