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Don Winant is correctly points out that I am an attorney. My piece is reflective of my advocacy on behalf of clients who have been engaged in the home care industry for decades and are faced with the onerous and expensive requirements brought on by the new regulations. I also have served in an executive capacity in two of the Departments of the State of New Jersey, including in the Attorney General's office, which has promulgated these regulations. For the last 15 years have battled the bureaucracy on behalf of people and businesses who are subject to laws, rule and regulations, which are often overbroad, poorly drafted, arbitrarily enforced and are generally unfair. I may not be qualified to run a home care business, but I am amply qualified to defend one.

To be clear - the data provided in my NJBIZ piece last week is not mine - it was generated by my clients, who are more than capable of evaluating the cost burdens yet to come from these new administrative obligations. Their objection is not to additional controls or scrutiny – they have been regulated by government for years – but to adding costs that offer no meaningful improvement to the quality of life of their clients. Their objection is to the State of New Jersey’s end-run around the applicable statutes that require an “Economic Impact Statement” for every regulation proposed.  Here, that statement was provided but it is virtually boilerplate – it was not based on research or market data. Separate and apart from the home care business – all businesses of this State are entitled to protection from this kind of conduct by the government. Here, my clients and others in this field were denied this protection.  They object to the lack of analysis and transparency. There has never even been a public hearing.

I agree with Mr. Winant – this should be about care.  But he and the accrediting agencies are in a very different line of work than my clients and it does not involve care. By his own admission his agencies review “health care” delivery organizations. Accrediting agencies oversee the administration of the office, not the care provided by it. Moreover, he writes about “patients” because his focus is healthcare, not companionship services. Accrediting agencies overseeing elder healthcare are necessary because of the significant amount of Medicare and Medicaid dollars spent there – the integrity of those monies must be assured. But my clients are privately paid by clients and family members to provide home support and companionship for mostly elderly clients, who can bathe themselves, but might need help cooking a hot meal, changing bed linens or getting to the store or a doctor’s appointment. They do not even dispense medication.  There are no government subsidies and never have been for this line of work. Hence the oversight required by these regulations is more like overkill.

In the end, it’s not the cost of the accreditation certificate. It’s the cost of maintaining that document and the additional personnel that must be hired to do so. These new regulations create an unending paper chase for policy and procedural manuals, forms, org charts, job descriptions and verified certificates.  But from the first office visit by the accreditor, through every one that follows thereafter – accreditation will do nothing to insure the quality of care. The “accreditor” will simply visit the office, look at the files and leave.  The “accreditor” will never do a home visit, never evaluate a client and never train or retrain a homecare provider.  And, beyond obtaining that certificate, now the home care and companionship agency will be subject to an expensive audit; the scope of which, three years after the law was first passed requiring it, still remains unknown.  Mr. Winant’s Letter to the Editor never addresses these costs.

There should be no misunderstanding: as an attorney, I am a paid advocate. The approved accrediting businesses will all gain from these new regulations.

By Lori Grifa, partner at Archer & Greiner’s Hackensack office.

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