YELLOW SHEET Office of the State Auditor of Missouri Claire McCaskill

Report No. 2000-23
April 12, 2000

The following areas of concern were discovered as a result of a review conducted by our office of Care Giver Screenings.

Our elderly, children and mentally challenged often do not have the capability to fully protect themselves from abuse and neglect.  Various state agencies maintain listings of individuals who have been found to have abused or neglected children, the elderly, or the mentally challenged.  We matched individuals on these listings to 1998 employment information and noted instances of illegal, inappropriate, or questionable employment situations.  While several state agencies utilize these listings to some degree, no agency has developed an automated match to identify employers who were not performing the required screenings or who employ individuals contrary to guidelines.  Except for recent legislation regarding certain child care workers, there currently are no laws which require these state agencies to screen for persons being employed inappropriately or illegally.  Instead the laws either require certain employers to perform background checks, or simply state that certain employment situations are illegal.  Also, most of the inappropriate or questionable employment situations identified in our report are not currently unlawful. 

One of the goals of the Family Care Safety Act, and the Governor’s Executive Order 99-05, both enacted in 1999, was to promote family and community safety by allowing access to comprehensive information accumulated by various state agencies.   

We also noted that screenings will not require that the history of child and elder care workers be checked against information from other states, and will not require employees in schools to be checked against the listings of abusers.  Finally, it will be an onerous task for individuals selecting personal care services to check backgrounds of employees of large providers and providers with high employee turnover. 

Additional controls and procedures should be put into place to fully protect the elderly, children, and mentally challenged.  These include: 

• Placing all disqualified individuals (and their social security number) from the Division of Aging Employee Disqualification Listing, the Department of Mental Health Employee Disqualification Listing, as well as individuals who have been determined to have committed a serious child abuse or neglect incident, in a single abuse registry.

• Passing legislation which prohibits these individuals from being employed by care providers and schools.
  
• Implementing the necessary system improvements to allow for more timely background screening results.

• Requiring care providers and schools to check the abuse registry prior to employment of new individuals.

• Developing an automated process to periodically identify all instances of individuals inappropriately working for care providers and schools.

• Developing procedures to remove those individuals from inappropriate workplace settings.

• Developing procedures to aggressively fine and sanction care providers and schools who employ individuals listed on the abuse registry.

• Developing procedures so that family members can more easily and conveniently determine whether a particular care provider or school is employing individuals listed on the abuse registry.  Consideration should also be given to what extent information on the registry should be available to the public.

• Requiring the backgrounds of Family Care Safety Registry registrants who have not resided in Missouri for the preceding three years be checked against information in the registrant’s former state of residence.  In addition, the state should promote the establishment of a national screening system.

• Establishing a fair and consistent appeal process which considers the nature and severity of the incident which resulted in placing an individual in the abuse registry, and the results of any subsequent rehabilitation.

• Passing legislation to clearly allow background information to be disclosed to state agencies responsible for monitoring provider compliance.

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