BILL ANALYSIS �
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|SENATE RULES COMMITTEE | SB 930|
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THIRD READING
Bill No: SB 930
Author: Evans (D), et al.
Amended: As introduced
Vote: 21
SENATE HUMAN SERVICES COMMITTEE : 4-3, 04/26/11
AYES: Liu, Hancock, Wright, Yee
NOES: Emmerson, Berryhill, Strickland
SENATE APPROPRIATIONS COMMITTEE : 6-3, 05/09/11
AYES: Kehoe, Alquist, Lieu, Pavley, Price, Steinberg
NOES: Walters, Emmerson, Runner
SUBJECT : In-home supportive services: enrollment and
fingerprinting
requirements
SOURCE : California Association of Public Authorities
for IHSS
Disability Rights California
SEIU-UHW
DIGEST : This bill repeals requirements that In-Home
Supportive Services (IHSS) recipients provide fingerprint
images and that provider timesheets include spaces for
provider and recipient fingerprints, and repeals the
prohibition against providers using a post office box
address to receive their paychecks.
ANALYSIS : Existing law:
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1.Establishes the in-home supportive services program to
provide domestic and personal-care services to aged
individuals and to persons with a disability in order to
assist them to remain safely in their homes.
2.Establishes the Medi-Cal program through which health
care services are provided to qualified low-income
persons.
3.Provides personal care services to IHSS recipients who
are eligible for the Medi-Cal program in lieu of
providing those services under the IHSS program.
4.Requires the Department of Social Services, in
consultation with county welfare departments, to develop
protocols and procedures for obtaining fingerprint images
of all individuals who are being assessed or reassessed
to receive supportive services.
5.Requires that, by July 1, 2011, the standardized
timesheet used to tract the work performed by providers
of IHSS include spaces for the index fingerprints of the
provider and the recipient.
6.Requires that providers complete their enrollment form
using a physical address and prohibits their use of a
post office box address.
7.Prohibits counties from mailing providers' paychecks to a
post office box address unless the county approves a
provider request to do so.
This bill:
1.Repeals the requirement that IHSS recipients provide
fingerprint images at the time of assessment or
reassessment.
2.Repeals the requirement that the standardized timesheet
include designated spaces for the index fingerprints of
the provider and the recipient.
3.Deletes the requirements and prohibitions related to the
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use of a post office box address by an IHSS provider.
Background
There are currently 19 personnel years attached to IHSS
fraud detection, including 14 investigators, two
supervisors, a section chief, an analyst, and an office
technician. The investigators are headquartered in San
Diego, Los Angeles, and Sacramento. The department notes
that all investigators are peace officers and or public
safety officers, responsible for protecting Medicaid
dollars, preserving program integrity, protecting and
serving the public, and take action when necessary.
The Department of Health Care Services (DHCS) reports that
in June of 2010, there were 447,635 recipients of IHSS and
405,328 active providers in the program. During the fiscal
year, the department:
Received 2458 complaints (0.5 percent of the
number of recipients)
Made 347 unannounced home visits in response to
complaints
Opened 193 criminal investigations
Closed 107 criminal investigations with no action
Referred 51 complaints to the Department of Justice
(0.01 percent of the number of recipients)
Referred 577 complaints to other agencies (0.13
percent of the number of recipients)
Initiated recovery of funds in 70 investigations
DHCS is also responsible, working in cooperation with
county district attorneys and others, for identifying
overpayments that may be the result of fraud or errors of
various kinds, including clerical. With nine counties
reporting (counties that include 70 percent of the IHSS
caseload) $4.15 million in overpayments were identified
during the fiscal year and $624,000 has been recovered.
See the table below.
---------------------------------------------
| FY 2009-10 In-Home Supportive Services |
| Overpayments |
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---------------------------------------------
|---------------+--------------+-------------|
| |Identified |Recovered |
|---------------+--------------+-------------|
|Fresno |$149,263.33 |$64,336.26 |
|---------------+--------------+-------------|
|Imperial |$31,312.98 |Not Reported |
|---------------+--------------+-------------|
|Orange |$287,932.99 |$192,290.08 |
|---------------+--------------+-------------|
|Riverside |$106,160.87 |$12,733.00 |
|---------------+--------------+-------------|
|Sacramento |$2,082,828.00 |$83,709.00 |
|---------------+--------------+-------------|
|San Bernardino |$190,101.94 |$139,901.94 |
|---------------+--------------+-------------|
|San Diego |$65,499.28 |$5605.29 |
|---------------+--------------+-------------|
|San Joaquin |$180,233.84 |$10,809.37 |
|---------------+--------------+-------------|
|Los Angeles |$1,102,004.92 |$120,126.16 |
| | | |
|---------------+--------------+-------------|
| | | |
|---------------+--------------+-------------|
|Total |$4,145,245.36 |$623,905.81 |
| | | |
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The 2009-10 estimated expenditures for IHSS was $5.7
billion, including administration, and $5.3 billion
excluding administration (figures contained in the May
Revision). If the rate of overpayment in California's
remaining counties is the same as in these nine counties,
then overpayments, which include clerical errors and other
mistakes as well as fraud, represent about one-tenth of one
percent (0.1 percent) of those expenditures.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Senate Appropriations Committee:
Major Provisions 2011-12 2012-13
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2013-14 Fund
Repeal of three IHSS Over
$50,000 in avoided costs;
Federal/General
anti-fraud provisions unknown, potential forgone savings
SUPPORT : (Verified 5/10/11)
California Association of Public Authorities for IHSS
(co-source)
Disability Rights California (co-source)
SEIU-UHW (co-source)
American Civil Liberties Union
California Alliance for Retired Americans
California Disability Community Action Network
Californians for Disability Rights, Inc.
California Foundation for Independent Living Centers
California In-Home Supportive Services Consumer Alliance
California State Association of Counties
California United Homecare Workers Union, SEIU/AFSCME Local
4034
Communities United in Defense of Olmstead
Contra Costa County
County Welfare Directors Association of California
In Home Supportive Services Public Authority
The Arc
Pamela Hoye
Personal Assistance Services Council of Los Angeles County
United Cerebral Palsy in California
United Domestic Workers of America/AFSCME Local
3930/AFL-CIO
Western Center on Law & Poverty
ARGUMENTS IN SUPPORT : The California State Association
of Counties and the County Welfare Directors Association
write that "the incidence of IHSS fraud is overstated." Of
24,000 cases reviewed (including both randomly selected
cases and those referred for suspicious activity), 523 (two
percent) were referred for further investigation and less
than one percent were found to involve fraud. These
numbers were similar over each of three years. There are
better uses for government funds than these purchases of
equipment and review of fingerprints. Many letters in
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support claim that there is no evidence that the use of
post office boxes results in higher levels of fraud.
CTW:nl 5/10/11 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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