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No Background Checks Needed for Home Health Workers in 10 States

As the population ages, “home health-care worker” has become one of the fastest-growing occupations in the U.S. Some 3.5 million Americans received home health care through Medicare in 2012 (cost: $18.5 billion); many more get similar services through Medicaid or pay home-care agencies directly.

Most states have some rules to keep violent criminals from caring for vulnerable people in their homes, but 10 states—Alabama, Connecticut, Georgia, Hawaii, Montana, New Jersey, North Dakota, South Dakota, West Virginia, and Wyoming—require no background checks at all, according to a memo (PDF) published last week by Medicare’s chief watchdog. In the rest, home health agencies are governed by a patchwork of safeguards that vary from state to state.