The primary responsibility for home care service delivery and quality assessment, however, lies with the states. The purpose of this study is to gather information about current state activities to ensure quality in publicly-funded home care programs for the elderly. More than 135 individuals in state and local programs in 19 states participated in the study. The report is based on telephone and on-site discussions and the review of state documents provided to the study team. It is a descriptive report based on state-provided information and is not intended to be an evaluation or assessment of those programs.
Supportive care includes all other care provided in the home.
Home care programs are now providing an increasing variety of skilled and nonskilled health and supportive services to large numbers of people with chronic illnesses and impairments. Also accompanying this growth in the availability of home care is a rising concern about how to assure that consumers receive high-quality services. Congress addressed home care quality issues in a number of bills introduced during 1987 and 1988. These bills proposed specific quality assurance mechanisms, uniform standards of care, and Federal regulation. Additionally, in 1987, Congress enacted changes to the Medicare program which included a patients' bill of rights and competency testing for home health aides as means of improving the quality of home care funded by that program.