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Sacramento Bee

December 5, 2009

Viewpoints: Support services fraud is wrong target
Special to The Bee

by Ashley Rodwick

California counties have begun to implement the latest In-Home Supportive Services policy – anti-fraud measures to counter abuse of the system. It's true the IHSS program is ailing, but targeting fraud is not the cure.

IHSS is suffering from a loss of its blood supply – Gov. Arnold Schwarzenegger has cut more than $200 million from the program, leaving thousands of elderly and disabled Californians at risk of losing vital support.

IHSS is an important safety net that keeps California's elderly and disabled out of nursing homes and institutions by providing care at home. Low-wage workers help with tasks like personal care, meal preparation and medical aid, allowing the frail to stay safely in their homes.

But because of budget cuts, IHSS faces a terrible prognosis: stricter eligibility will eliminate 40,000 seniors and disabled from the program, 85,000 others will lose domestic services, such as grocery shopping and meal preparation, 8,000 will be required to pay out of pocket and caregivers will face reduced wages.

Several lawsuits are pending to reduce these program cuts, but rather than trying to find a remedy for this safety net, the governor chooses to target fraud. So far, $10 million has been earmarked to investigate and prosecute dishonest workers, along with $26 million for background checks and mandatory caregiver orientations. The governor claims these measures will save $160 million, but other sources estimate the savings at only $40 million.

All of these treatment efforts are for a problem that might not even be all that prevalent: the governor claims fraud accounts for 25 percent of IHSS costs, while other reports suggest rates as low as 2 percent.

Indeed, IHSS expenditures have been increasing, but this is because California's elderly population is growing, not because workers are making out like bandits. In-home caregivers earn between $9 and $14 an hour, a small expense compared with the average daily cost of $5,000 for institutional care.

While I don't want taxpayer money and the care of our seniors in the hands of unscrupulous swindlers, I would prefer Schwarzenegger devote resources to the thousands of frail Californians who may be forced from their homes, as well as the thousands of caregivers about to join the unemployment ranks.

Besides, the majority of IHSS caregivers are family members of those receiving care. They are hardworking sons, daughters and grandchildren earning low wages while trying to do what's best for a loved one. These families could benefit from a system that devotes fewer resources to fraud lectures and more to care.

IHSS has historically provided California with a low-cost alternative to institutional care for the elderly and disabled – hospitals and nursing homes can cost five times as much as in-home services. It would therefore seem appropriate to support or even expand this cost-effective program.

Instead, Sacramento administers quick fixes like program cuts and fraud prevention. These shortsighted decisions will leave a lasting burden on taxpayers, not to mention the elderly and disabled who are forced into nursing homes without in-home care.

As the IHSS safety net is about to be pulled from under thousands of elderly and disabled Californians, we need to focus on a remedy. Otherwise, the prognosis for California's system of care could be terminal.