Families and advocates testify that home‑care agencies abandon difficult 24‑hour cases; witnesses urge accountability and waiver changes

Family members, ombudsmen and advocates told a March 26 joint D.C. Council roundtable that home‑care agencies are abandoning some of the district's most vulnerable clients — specifically beneficiaries authorized for 24‑hour personal care aide (PCA) services — and urged the council to require stronger enforcement and to expand self‑directed care options.

Holly Eaton, senior attorney for the D.C. Long Term Care Ombudsman Program, summarized interviews and video evidence indicating home‑care agencies sometimes allow aides to “cherry pick” easier shifts and refuse the most difficult 24‑hour cases. Eaton said agencies have tolerated aides who show up to overnight shifts with the apparent intent to sleep. "When the beneficiary or family member expresses alarm and insists they remain awake to provide the care and monitoring they are being paid to provide, the aide refuses to return to the job," Eaton testified.

A family example: Angela Fisher, power of attorney for her brother Charles Fisher, described a case she said illustrated the problem. Her brother, a 2019 stroke survivor authorized for 24 hours of PCA…