Hundreds of home care agencies that assist elderly or disabled individuals with basic tasks such as dressing, bathing and housekeeping are about to fall under state scrutiny for the first time.

The Pennsylvania Department of Health published regulations Saturday to provide minimum standards for nonmedical home care agencies. More than 400 home health agencies that employ skilled individuals such as nurses and therapists have already been regulated.

With the backing of the largest association representing home care providers, the Legislature approved a measure in 2006 that extends state oversight to agencies delivering more basic home assistance. Their work also includes such tasks as preparing meals and transporting clients to appointments.

The legislation and new regulations do not apply to self-employed individuals who have a direct relationship with a client. But employers who send multiple direct-care workers into homes will have to pay a $100 licensing fee and ensure their aides have criminal background checks and tuberculosis screenings.

The employees will have to pass a competency test or receive training on basic skills and knowledge in assisting clients. The state has also established a new consumer hot line for clients to report complaints about service providers, most of whom are hired directly by clients or their relatives.

Though some new costs are involved for the industry, Pennsylvania Homecare Association Executive Director Vicki Hoak said they bring basic consumer protections that are justified.

And she noted a benefit will be realized from having the licensed agencies all listed eventually on the state health department's Web site, to help consumers find them.

"I think the timing is good," Ms. Hoak said. "As Pennsylvania's elderly population grows, this whole consumer movement to remain at home as long as possible, to age in place, has made the demand for these services really strong."

Stacy Mitchell, the health department's deputy secretary for quality assurance, said state officials have been in contact with more than 400 agencies they know of that fall under the new regulations, but twice that number may exist in the state. The department is trying to spread the word and have all agencies apply for a license by a Feb. 10 deadline.

The state is not out to punish those that do not comply, Ms. Mitchell said, but if agencies ignore requests to apply for licensing, they could face cease-and-desist orders.

"Our goal is to get them licensed or put them out of business," said Ms. Mitchell, noting the department is counting on licensed facilities following the rules to report any competitors they know of who ignore the new requirements after Feb. 10.

She said the health department has added staff who will be responsible for reviewing the home care providers. They will investigate complaints, require deficiencies to be corrected and conduct annual reviews that include phone surveys of the agencies' clients to assess their satisfaction.

The state hot line for consumers to file complaints about agency-provided home care has been set up at 1-866-826-3644.

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