BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 682
                                                                  Page  1

          Date of Hearing:   May 20, 2009

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

                  AB 682 (Lowenthall) - As Amended:  April 30, 2009 

          Policy Committee:                              Human  
          ServicesVote:4 - 2 

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill requires the Department of Social Services (DSS) to  
          evaluate implementation of provisions intended to combat fraud  
          in the In-Home Supportive Services (IHSS) program. Specifically,  
          this bill: 

          1)Requires that, beginning January 1, 2010, DSS dedicate two  
            personnel positions for purposes of evaluating the  
            implementation of IHSS anti-fraud efforts.

          2)Requires DSS to convene a group of stakeholders, including the  
            Department of Health Care Services (DHCS) and the district  
            attorney of the county of Los Angeles, to produce a report to  
            the Legislature by December 31, 2010 that does all of the  
            following with respect to fraud:

             a)   Identify the magnitude of IHSS fraud in terms of total  
               dollars inappropriately spent or removed from the program  
               through instances that resulted in conviction between  
               January 1, 2005 and January 1, 2010.

             b)   Identify the number involved in fraud from several  
               different categories, including providers, consumers, state  
               workers, and county workers.

             c)   Provide recommendations as to the best means possible to  
               combat IHSS fraud, taking into account the magnitude of the  
               problem and the need to protect services for vulnerable  
               populations. 

          3)Repeals this legislation on January 1, 2011. However, states  








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            that the repeal of the legislation does not terminate the  
            obligation of the department to prepare and deliver the report  
            if it is not delivered by the statutorily required deadline.

           FISCAL EFFECT  

          One-time costs in the range $350,000 General Fund for two  
          limited-term dedicated positions and for the workload associated  
          with the stakeholder process and producing the required report..

           COMMENTS  

           1)Rationale  . According to the author, notwithstanding quality  
            assurance measures implemented through the 2004 budget trailer  
            bill, "insinuations of widespread fraud persist."  The author  
            suggests that these insinuations may be unjustified, noting  
            that there is a "disconnect between perception and fact" that  
            is "not acceptable for such a large and growing state program.  
            . . . If we can identify fraud, we can stop it.  But we can't  
            diminish funding for the program based on anecdotal evidence."  
             This bill is intended to collect data and document instances  
            of fraud within the IHSS program.

           2)In-Home Supportive Services Program  . The IHSS Program helps  
            pay for services so that elderly, disabled, or blind  
            individuals can remain in their own homes. To be eligible, an  
            applicant must be over 65 years of age, disabled, or blind.  
            Disabled children are also eligible. IHSS is considered an  
            alternative to out-of-home care, such as nursing homes or  
            board and care facilities. 

            IHSS services include housecleaning, meal preparation,  
            laundry, grocery shopping, personal care services (such as  
            bowel and bladder care, bathing, grooming and paramedical  
            services), accompaniment to medical appointments, and  
            protective supervision for the mentally impaired. 

            IHSS consists of four programs, Personal Care Services Program  
            (PCSP), IHSS Plus Waiver Program (IPW), IHSS Residual Program  
            (IRP), and Medi-Cal Waiver Personal Care Program (MWPCS). The  
            PCSP, IPW, and IRP are administered at the county level by  
            county welfare departments and at the State level by the Adult  
            Programs Division within CDSS. The Medi-Cal Waiver Personal  
            Care Services (MWPCS) Program is administered through  
            Department of Health Care Services. A portion of the costs for  








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            IHSS services are paid by federal funding. The entire program  
            consists of over 400,000 recipients and on average 325,000  
            IHSS workers.
           
          3)Background  . In 2004, as part of the budget trailer bill, SB  
            1104, the Legislature imposed a number of mandatory duties on  
            DSS, DHCS and the counties with respect to quality, cost  
            controls and program integrity within the IHSS program.  Among  
            other things, SB 1104 defined and distinguished between fraud  
            and overpayments, with fraud being limited to traditional  
            prosecutable acts of intentional misrepresentation, while  
            overpayment was defined broadly to include all instances in  
            which providers are paid in excess of the amount for  
            authorized services, whether fraudulent or not.  

            SB 1104 authorized DHCS to investigate fraud in the provision  
            or receipt of supportive services, and required counties to  
            refer instances of suspected fraud to DHCS for investigation.   
            It required DHCS to notify DSS, the county, and the county's  
            nonprofit consortium or public authority, if any, of a  
            determination that a provider has engaged in fraud.
           
          4)Related Legislation . AB 378 (Cook) requires public authorities  
            and nonprofit consortiums, in consultation with their advisory  
            committees and stakeholders, to develop training standards and  
            core topics provided to in-home supportive services (IHSS)  
            providers and recipients. That bill is currently pending on  
            the Assembly floor. 

           Analysis Prepared by  :    Julie Salley-Gray / APPR. / (916)  
          319-2081