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
AB 682
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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