BILL ANALYSIS �
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|SENATE RULES COMMITTEE | SB 930|
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UNFINISHED BUSINESS
Bill No: SB 930
Author: Evans (D), et al.
Amended: 8/15/11
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
SENATE FLOOR : 23-16, 05/19/11
AYES: Alquist, Calderon, Corbett, De Le�n, DeSaulnier,
Evans, Hancock, Kehoe, Leno, Lieu, Liu, Lowenthal,
Negrete McLeod, Padilla, Pavley, Price, Rubio, Simitian,
Steinberg, Vargas, Wolk, Wright, Yee
NOES: Anderson, Berryhill, Blakeslee, Cannella, Correa,
Dutton, Emmerson, Fuller, Gaines, Harman, Huff, La Malfa,
Runner, Strickland, Walters, Wyland
NO VOTE RECORDED: Hernandez
ASSEMBLY FLOOR : 51-27, 8/30/11 - See last page for vote
SUBJECT : In-home supportive services: enrollment and
fingerprinting
requirements
SOURCE : California Association of Public Authorities
for IHSS
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Disability Rights California
SEIU-UHW
United Domestic Workers of America/AFSCME Local
3930/
AFL-CIO
California Union of Homecare Workers
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; repeals the
prohibition against providers using a post office box
address to receive their paychecks; and, corrects problems
with the provider appeals process.
Assembly Amendments require the county, public authority,
or nonprofit consortium to send the State Department of
Social Services a copy of the state-level criminal offender
record information search response that is provided to that
entity by the Department of Justice for any individual who
has requested an appeal of a denial of placement on the
registry of IHSS personnel or denial of eligibility to
provide supportive services to an IHSS recipient.
ANALYSIS : Existing law:
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
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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
use of a post office box address by an IHSS provider.
4.Requires the county or IHSS public authority to provide
the state Department of Social Services with an
unmodified copy of the Department of Justice (DOJ)
criminal offender record information search response
(CORI) if an IHSS provider or provider applicant has
requested an appeal of a denial of placement on the IHSS
provider registry as a result of a DOJ criminal
background check.
5.Requires the county or public authority to provide an
IHSS provider or provider applicant with an unmodified
copy of his or her CORI with any notice of denial, along
with information on how the individual may contest the
accuracy or completeness of, or refute any erroneous
information in the CORI.
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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 Assembly Appropriations Committee:
Savings of $41.6 million ($21 million GF) spread over
seven years associated with not implementing the
finger imaging requirements. Those savings would be
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offset to an unknown degree by forgone savings
associated with deterring fraudulent activity.
Absent this bill, it is assumed that the
administrations would need to comply at some point
with current law and implement the finger imaging
requirements and the prohibition against providers
using post office boxes. Previous budget estimates
suggest that total costs for finger imaging would be
approximately $41.6 million ($21 million GF) over
seven years. Therefore, this bill removes that cost
pressure.
Though these anti-fraud provisions were never
implemented, the Governor's 2010-11 budget assumed all
of the anti-fraud initiatives adopted in 2009 would
result in approximately $390 million ($135 million GF)
in savings in the first full year. It is unclear how
much of that would have been attributable to finger
imaging and the prohibition against post office boxes.
Proponents of this finger imaging policy would argue,
however, that there are foregone savings of perhaps
tens of millions of dollars associated with this
legislation.
Proponents of this legislation, on the other hand,
argue that there is no evidence of widespread fraud in
the IHSS program and therefore it is unlikely the
level of savings assumed by the previous
administration is realistic.
SUPPORT : (Verified 8/23/11)
California Association of Public Authorities for IHSS
(co-source)
Disability Rights California (co-source)
SEIU-UHW (co-source)
United Domestic Workers of America/ AFSCME Local 3930/
AFL-CIO
(co-source)
California Union of Homecare Workers (co-source)
American Civil Liberties Union
American Federation for State, County, and Municipal
Employees
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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
Insurance Commissioner Dave Jones
In Home Supportive Services Coalition
AARP-California
Access to Independence
ACLU Southern California
California Alliance for Retired Americans
California Association of Public Authorities
California Church IMPACT
Congress of California Seniors
Californians for Disability Rights
California Foundation for Independent Living
California IHSS Consumer Alliance
California Senior Legislature
California Disability Community Action Network
California United Homecare Workers
Dayle McIntosh Center for the Disabled
Disability Rights California
East Bay Community Law Center
Friends Committee on Legislation
Gray Panthers
Independent Livings Resource Center Inc.
Marin IHSS Public Authority
National Senior Citizen's Law Center
Nevada-Sierra-Plumas Public Authority
Northern California ADAPT
Older Women's League
In Home Supportive Services Public Authority
National Association of Social Workers
Pamela Hoye
Personal Assistance Services Council of Los Angeles County
State Independent Living Council
The ARC
Western Center on Law & Poverty
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OPPOSITION : (Verified 8/23/11)
California District Attorneys Association (previous
version)
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
support claim that there is no evidence that the use of
post office boxes results in higher levels of fraud.
ASSEMBLY FLOOR : 51-27, 8/30/11
AYES: Alejo, Allen, Ammiano, Atkins, Beall, Block,
Blumenfield, Bonilla, Bradford, Brownley, Buchanan,
Butler, Charles Calderon, Campos, Carter, Cedillo,
Chesbro, Davis, Dickinson, Eng, Feuer, Fong, Fuentes,
Furutani, Galgiani, Gordon, Hall, Hayashi, Roger
Hern�ndez, Hill, Huber, Hueso, Huffman, Lara, Bonnie
Lowenthal, Ma, Mendoza, Mitchell, Monning, Pan, Perea, V.
Manuel P�rez, Portantino, Skinner, Solorio, Swanson,
Torres, Wieckowski, Williams, Yamada, John A. P�rez
NOES: Achadjian, Bill Berryhill, Conway, Donnelly,
Fletcher, Beth Gaines, Garrick, Gatto, Grove, Hagman,
Halderman, Harkey, Jeffries, Jones, Knight, Logue,
Mansoor, Miller, Morrell, Nestande, Nielsen, Norby,
Olsen, Silva, Smyth, Valadao, Wagner
NO VOTE RECORDED: Cook, Gorell
CTW:nl 8/30/11 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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