The short answer Iowa requires state criminal history checks plus child and dependent adult abuse registry checks for home health and in-home care employees under Iowa Code § 135C.33, with DIA/HHS evaluations allowing employment despite certain records.
What Iowa requires
Iowa
Statutory requirement. Iowa Code § 135C.33 requires employers, including home health agencies and providers of in-home services, to run an Iowa Division of Criminal Investigation record check and child abuse and dependent adult abuse registry checks through the single contact repository (SING) before employment.
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Evaluation process. If a criminal conviction or founded abuse record surfaces, the person cannot be hired unless the Department of Health and Human Services/Department of Inspections, Appeals & Licensing performs an evaluation and determines the record does not warrant prohibition of employment.
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Registry checks. Employers must also verify the Iowa Direct Care Worker/CNA registry for aides and confirm no abuse findings; dependent adult abuse registry findings are broadly disqualifying absent an evaluation.
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Name-based checks. Iowa's system is name/DOB-based through SING rather than fingerprint-based; FBI checks are used only when the state check indicates out-of-state history warranting it.
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The federal baseline (applies in every state)
Federal
No universal federal mandate. There is no federal law requiring criminal background checks for private-pay home care workers; requirements are set state by state. HHS OIG found wide variation in state home health background check requirements, and Medicare Conditions of Participation for home health agencies defer to state law on screening.
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National Background Check Program (ACA Section 6201). Section 6201 of the Affordable Care Act created the CMS National Background Check Program, which awarded grants to more than 25 states to build fingerprint-based, comprehensive background check systems for direct patient access employees of long-term care providers, including home health agencies and personal care providers.
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FCRA obligations. When an agency uses a consumer reporting agency (third-party background check vendor), the federal Fair Credit Reporting Act requires a standalone written disclosure, the applicant's written authorization, and the pre-adverse action / adverse action notice process (copy of the report and Summary of Rights) before rejecting a candidate based on the report.
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OIG exclusion list (LEIE). Home care providers that bill Medicare or Medicaid must not employ or contract with individuals excluded from federal health care programs. HHS OIG maintains the List of Excluded Individuals/Entities (LEIE); CMS and state Medicaid agencies expect screening at hire and monthly thereafter, and payments tied to excluded persons are subject to recovery and civil monetary penalties.
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