What Insurers Can Learn from Pennsylvania’s Workforce Screening Model
How Pennsylvania Applied Underwriting Discipline to Human Services Risk
Human services organizations carry some of the highest-severity liability exposures in the insurance ecosystem – yet those risks are often poorly measured.
When workforce screening fails, the consequences aren’t limited to regulatory noncompliance. They can include abuse allegations, financial exploitation, high-profile litigation, reputational damage, and long-tail claims exposure.
The Pennsylvania Department of Aging took a different approach. Rather than treating employee screening as a basic compliance requirement, the Department applied underwriting-style discipline to how providers are evaluated across the state.
By partnering with C-Screen, Pennsylvania implemented a standardized, defensible framework to assess workforce screening practices across its 52 Area Agencies on Aging (AAAs). The result is a replicable model that insurers, brokers, and regulators should be paying close attention to.
The Risk Most Oversight Models Miss
In human services, risk is deeply personal. Frontline workers often operate:
One-on-one with seniors or vulnerable adults
In private homes or unsupervised environments
With limited day-to-day oversight
When screening breaks down, consequences can include:
Abuse or neglect
Financial exploitation
High-profile litigation
Long-tail claims exposure
Despite this, screening is frequently treated as a one-time onboarding task rather than an ongoing risk control.
From an insurance standpoint, that’s the equivalent of underwriting a risk once – and never reviewing it again.
A Statewide Risk Problem Required a Statewide Solution
Pennsylvania oversees a decentralized network of 52 Area Agencies on Aging, each contracting with local service providers.
This structure supports local delivery, but it also creates aggregated risk at the state level:
Inconsistent screening standards
Limited visibility into provider practices
Liability exposure that rolls up to the Commonwealth
Rather than relying on self-attestations or checklist reviews, the Department sought a method to evaluate screening practices consistently, objectively, and defensibly across all providers.
The solution was not more paperwork. It was better risk measurement.
Applying Underwriting Logic to Provider Oversight
In insurance, underwriting is not about documentation alone – it is about understanding how risk is actually managed.
Pennsylvania applied this same logic to workforce screening.
Through C-Screen’s standardized, industry-specific framework, providers are evaluated not just on whether screening exists, but on how well it is executed. This includes:
Scope and consistency of background checks
Alignment between screening practices and job exposure
Documentation quality and audit readiness
Ongoing monitoring and re-screening protocols
In effect, providers are assessed much like insureds are evaluated before coverage is bound.
This moves screening from passive compliance to active risk governance.
The Role of the 52 Area Agencies on Aging
Each AAA functions as a local evaluator within a unified statewide framework.
The structure mirrors delegated underwriting authority:
Common standards
Consistent criteria
Local application
This model creates comparable, defensible oversight without sacrificing local relationships. It provides transparency at scale while preserving community-level execution.
C-Screen as a Risk Management Tool
While the framework supports compliance, its true value is prevention.
By identifying weaknesses in screening practices before incidents occur, Pennsylvania shifted from reactive oversight to proactive loss control.
From a risk management perspective, this approach:
Reduces frequency and severity of loss events
Strengthens defensibility in litigation
Demonstrates documented due diligence
In insurance terms, this is loss prevention – not claims response.
Why This Matters to Insurers and Brokers
For insurers underwriting human services, healthcare, nonprofit, or public-sector risks, workforce screening is a material exposure driver. Yet it is rarely evaluated with underwriting-level rigor.
Brokers advising these organizations should take note. In an environment shaped by social inflation and nuclear verdicts, insureds that can demonstrate disciplined, documented screening oversight may present a stronger risk profile.
Just as importantly, this model signals a broader shift: public agencies are adopting private-sector risk thinking.
A Replicable Model for Risk-Informed Governance
Pennsylvania’s approach demonstrates that meaningful risk management does not require sweeping reform.
By applying underwriting discipline to workforce screening, the Department of Aging created a scalable, defensible model that:
Protects vulnerable populations
Reduces liability exposure
Strengthens oversight accountability
For insurers, brokers, and regulators, the takeaway is clear:
Screening is not just compliance – it is a core risk control.