BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1841
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          Date of Hearing:   April 10, 2012

                        ASSEMBLY COMMITTEE ON HUMAN SERVICES
                                Jim Beall Jr., Chair
                 AB 1841 (Silva) - As Introduced:  February 22, 2012
           
          SUBJECT  :  In-home supportive services providers:  criminal 
          exclusions

           SUMMARY  :  Deletes the authority of an In-home Supportive 
          Services (IHSS) recipient to submit a waiver enabling a provider 
          applicant who has been convicted of specified offenses to be 
          employed as that individual's IHSS provider.  

           EXISTING LAW  

          1)Establishes the IHSS program to provide personal services and 
            home care for approximately 445,000 eligible poor, aged, blind 
            and disabled individuals by approximately 360,000 providers 
            throughout the state to enable recipients to remain in their 
            own homes and avoid institutionalization.

          2)Prohibits, under Welfare & Institutions (W&I) Code Section 
            12305.81, a person from providing supportive services under 
            the IHSS program for 10 years following a conviction for 
            crimes involving:

             a)   Fraud against a government health care or supportive 
               services program; or,

             b)   Child endangerment, pursuant to PC Section 273a, elder 
               or dependent adult abuse, pursuant to PC Section 368, or 
               similar violations in another jurisdiction.

          3)Prohibits, under W&I Code Section 12305.87, a new provider 
            applicant from providing supportive services under the IHSS 
            program for 10 years following a conviction for any of the 
            following:

             a)   A violent or serious felony as defined in PC Sections 
               667.5 and 1192.7;

             b)   A felony for which registration is required under the 
               Sex Offender Registration Act, pursuant to PC Section 290; 
               or,








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             c)   Obtaining public benefits or services by fraud when the 
               amount of aid exceeds $950, pursuant to W&I Code Section 
               10980(c)(2), or fraud in the use of food stamp (CalFresh) 
               benefits in excess of $950, pursuant to W&I Code Section 
               10980(g)(2).

          4)Provides that the prohibitions described in paragraph 3), 
            above, do not apply if the applicant has obtained a 
            certificate of rehabilitation as provided in PC Section 
            4852.01 et seq., or if the conviction has been expunged, 
            pursuant to PC Section 1203.4.

          5)Authorizes an applicant convicted of an offense described in 
            paragraph 3), above, to seek from the Department of Social 
            Services (DSS) a general exception to the exclusions and sets 
            out the procedures to be followed and factors to be considered 
            by DSS in responding to a request for a general exception.

          6)Permits a recipient of IHSS services who wishes to hire a 
            provider applicant who has been convicted of an offense 
            described in paragraph 3), above, to submit an individual 
            waiver of the exclusion, signed by the recipient or the 
            recipient's authorized representative, if applicable.

          7)Requires the county to notify a recipient who wishes to hire a 
            provider who has been convicted of an offense described in 
            paragraph 3), above, of the criminal convictions and requires 
            the notice to include the following:

             a)   An explanation of the exclusions described in paragraph 
               3), above, as well as the waiver process and the process 
               for an applicant to seek a general exception; and,

             b)   A waiver form meeting specified requirements, developed 
               by DSS in consultation with representatives of county 
               welfare departments and advocates for, or representatives 
               of, recipients and providers.

          8)Prohibits a provider applicant from signing his or her own 
            individual waiver form as the recipient's authorized 
            representative unless the individual is the parent, guardian, 
            or person having legal custody of a minor recipient, a 
            conservator of an adult recipient, or a spouse or registered 
            domestic partner of the recipient.








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          9)Provides that a provider hired based on an individual waiver 
            may be employed only by the recipient who requested the 
            waiver, and the waiver shall only be valid with respect to the 
            convictions specified in that waiver.

          10)Immunizes the state and county from liability resulting from 
            granting an individual waiver.

           FISCAL EFFECT  :  Unknown

           COMMENTS  :   

           Background  
          The 2009 IHSS budget trailer bill, ABX4 19 (Evans), Chapter 17, 
          Statutes of 2009 4th Extraordinary Session, included provisions 
          intended to prevent fraud in, and enhance the integrity of the 
          IHSS program.  As a condition of being placed or maintained on a 
          county's IHSS provider registry, ABX4 19 required criminal 
          background checks to be completed for all prospective IHSS 
          providers as of October 1, 2009, and to be completed by July 2, 
          2010 for anyone already a provider on October 1, 2009.  

          Under California law, consistent with federal Medicaid law, an 
          individual may not serve as a provider of services under the 
          IHSS program for 10 years following a conviction for specified 
          crimes involving fraud against a government health care or 
          supportive services program, child endangerment, or elder or 
          dependent adult abuse.  (These are commonly referred to as "Tier 
          1" offenses.)  The 2010 human services budget trailer bill, AB 
          1612 (Committee on Budget), Chapter 725, Statutes of 2010, 
          provided for the additional exclusion, with certain exceptions, 
          of provider applicants for 10 years following a conviction for a 
          violent or serious felony, as defined in the Penal Code, and 
          other specified felony offenses.  These exclusions, referred to 
          as "Tier 2" offenses, apply prospectively, to new provider 
          applicants, beginning 90 days following the effective date of 
          that bill.  The AB 1612 exclusion for prior convictions of Tier 
          2 offenses was enacted as part of a larger budget compromise, 
          and was not vetted through legislative policy committees.  

          With respect to these added, Tier 2, exclusions, AB 1612 
          provided that a recipient who wishes to employ a provider 
          applicant who has been convicted of such an offense "may submit 
          to the county an individual waiver of the exclusion."  The 








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          waiver form must be signed "by the recipient or by the 
          recipient's authorized representative, if applicable ?."  In 
          signing a waiver, the individual agrees that he or she is 
          "accepting the responsibility for this decision and the risk of 
          any potential actions that may occur as a result of this 
          decision."  AB 876 (Valadeo), Chapter 73, Statutes of 2011, 
          added the proviso that, except in the case the parent, guardian, 
          or person having legal custody of a minor recipient, a 
          conservator of an adult recipient, or a spouse or registered 
          domestic partner of the recipient, a provider applicant shall 
          not sign his or her own individual waiver form as the 
          recipient's authorized representative.  Persons convicted of 
          Tier 2 offenses also have the option of seeking a general 
          exception to the exclusions, under prescribed procedures and 
          criteria.

          This bill would delete the provisions by which a recipient or 
          recipient's authorized representative may request a waiver with 
          respect to an individual provider applicant who has been 
          convicted of a Tier 2 felony (Existing Law, paragraph 3, above) 
          within the last 10 years.

           Need for this bill  
          According to the author:

               This bill is needed to protect the IHSS program.  
               Eliminating the individual waiver will eliminate a 
               potential source of fraud within IHSS.  The crimes 
               listed as "Tier 2" crimes are of the type that would 
               eliminate most applicants from consideration for most 
               jobs, public or private.  Employment as an IHSS 
               provider should be no different.  A higher level of 
               scrutiny is needed before murderers, rapists and other 
               felons should be able to get a  taxpayer-funded job  
               working in IHSS recipients' homes.

          (Emphasis in original.)

          Is there new information or data to suggest that the individual 
          waiver process has been problematic?  According to DSS data 
          provided in early March 2012, there are approximately 528,000 
          eligible IHSS providers in the state.  747 prospective providers 
          have been disqualified based on a conviction for a Tier 2 felony 
          and 516 individual waivers have been submitted.  The author has 
          provided no data on the incidence of victimization of IHSS 








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          recipients or substantiated fraud with respect to providers for 
          whom an individual waiver has been submitted.

           Philosophy of the IHSS program
           At the core of the IHSS program is a philosophy that recognizes 
          the dignity of consumers by acknowledging their right to 
          self-determination.  Central to that philosophy are the 
          consumer's rights to hire, supervise, and fire the caregiver of 
          their choice.  AB 1612 was enacted as a negotiated compromise 
          following unsuccessful efforts by the Schwarzenegger 
          administration to bar individuals convicted of any felony and 
          designated misdemeanors from being employed as IHSS providers.  
          With respect to those felonies classified as Tier 2, AB 1612 
          preserved consumers' right to hire caregivers of their choosing 
          through individual waivers.  That right would be eliminated 
          under this bill.  In addition, by eliminating individual 
          waivers, this bill would require IHSS recipients-including young 
          children-to receive services from strangers rather than from 
          parents, adult children, siblings, spouses, domestic partners, 
          and other trusted friends and relatives.

           Opposition  
          In opposition to this bill, the National Employment law Project 
          says that "the current statute regulating IHSS providers strikes 
          the correct balance of protecting vulnerable persons from harm 
          without having an adverse impact on the pool of available 
          workers or impinging on the rights of individual IHSS recipients 
          to choose a provider with complete knowledge of his or her 
          conviction for a Tier II crime.  �This bill] would make it hard 
          for IHSS recipients to be provided with a caregiver of their 
          choice-a caregiver that is frequently a close relative."  In a 
          joint opposition letter, the California State Association of 
          Counties, the County Welfare Directors Association, and the 
          California Association of Public Authorities for IHSS say that:

               A core provision of the current IHSS program allows 
               recipient to identify and hire the caregivers that 
               will be entering their home and providing domestic and 
               health related services. A recipient who knows and 
               trusts their IHSS provider is more likely to establish 
               a long-term recipient-caregiver relationship, thereby 
               achieving the top goal of the IHSS program: to allow 
               those with documented service needs to receive quality 
               care while remaining in their homes. 









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           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          Office of the District Attorney, Sacramento County

           Opposition 
           
          American Civil Liberties Union
          California Association of Public Authorities for IHSS
          California State Association of Counties
          Coalition of California Welfare Rights Organizations, Inc.
          County Welfare Directors Association 
          Lawyers' Committee for Civil Rights
          Legal Services for Prisoners with Children 
          National Employment Law Project
          United Domestic Workers of America - AFSCME Local 3930

           
          Analysis Prepared by  :    Eric Gelber / HUM. S. / (916) 319-2089