Quick Links OCRA OPR PSA DDPSA Website Survey Donate Top 10 Pubs

The Sacramento Bee

January 23, 2010

Sacramento County probe of in-home care turns up 19 felony cases

By Anita Creamer

A task force established to ferret out fraud in Sacramento County's extensive network of In-Home Supportive Services has turned up 19 felony cases in its first four months, according to the District Attorney's Office.

Those cases account for an alleged $315,000 in overpayments among 42,000 caregivers and clients.

"We believe as long as IHSS is in existence, there will always be fraud," said Assistant Chief Deputy District Attorney Laura Green, who's in charge of the district attorney's Stop Target Offenders Program unit, which includes the multiagency task force.

A grand jury report last summer found that along with costs and enrollment increasing, fraud was growing in the county's IHSS program, which helps the disabled and frail elderly continue living independently in their own homes. The Governor's Office has claimed a 25 percent statewide fraud rate in IHSS.

A 2007 state audit, though, found only 1 percent of IHSS cases involved fraudulent overpayment.

And critics of such task forces say the scope of IHSS fraud doesn't warrant the amount of time and public money devoted to them.

"What they're finding is very, very small," said Jean Ross, executive director of the California Budget Project, which advocates for California's poor.

The state approved $10 million last summer for counties to create their own IHSS investigative units. Fresno, San Diego and Riverside are starting up IHSS investigative units, but San Luis Obispo County's social services director has refused those state funds, saying that investigations into IHSS are in large part politically motivated.

"It's good political rhetoric to say there's a lot of fraud," said Tim Holton, Center for California Studies executive director. "If someone is caught, they should be prosecuted. But it's not a substantial problem."

The Sacramento County IHSS task force, California's first, receives $3 million in funds and harnesses the efforts of criminal investigators from a variety of county and state agencies.

The group is continuing to investigate another 145 IHSS participants suspected of bilking the program out of $577,500, said Green.

California's fastest-growing social services program, IHSS will cost the state $1.5 billion this year, with federal funds paying another $4 billion into the program. As the state's population ages, the program is booming. Sacramento County spent $23.5 million last year on IHSS, up from $5.9 million in 2001.

Founded in 1973 as an outgrowth of the disability rights movement, IHSS allows clients to hire and supervise their own caregivers.

"It's not a home health agency with a layer of other management," said Ross. "You're only paying for the service provider, not the supervisory structure. New York has an agency-based model, and it's far more expensive than California's.

"What's often lost in the debate here is that this is a virtually no-overhead program."

Through a painstaking data review – comparing the county's list of 42,000 IHSS caregivers and recipients with county jail inmate lists for specific time periods – the task force has uncovered 57 alleged cases of fraudulently submitted time sheets, Green said.

"We know those providers weren't providing services," she said. "They were in jail. We can immediately stop those payments. Every time we can cut something off in the beginning, that's a huge savings."

Some cases, she said, involve clients accused of hiding income to qualify for the program, which requires that couples have less than $3,000 in assets. Others involve care providers suspected of fraudulently filling out time sheets after a client's death.

In one case, investigators allege the provider was in jail and the client was deceased, she said.

In another case, Green said, a mother is accused of claiming that her adult daughter required 24-hour care, even as the daughter applied for child care services because she was going to school full time.

"With IHSS, you're talking about such a large group of people," Green said. "There will always be people who figure out how to work the system."