By Tony Burchyns, Times-Herald staff writer -
Following an investigation, the Solano County Grand Jury recommends that the county do more to prevent "pervasive" fraud within its in-home supportive services program.
The state-sponsored, county-run program allows people to remain at home who might otherwise require assisted-living. In Solano County, the program serves about 3,000 low-income residents who are 65 or older, legally blind, disabled or unable to care for themselves safely in their homes.
In a report released Wednesday, the grand jury notes "suspected fraud," "training of investigative staff" and "time sheet deficiencies" among several areas of concern. The concerns echo previous grand jury findings.
Also, the grand jury encouraged the county to establish licensing and background checks for private in-home care providers not associated with the county's program.
The program authorizes assistance with daily living activities, such as grocery shopping, house cleaning, cooking, laundry, personal care and transportation. Registered caretakers are paid $11.50 per hour through the county health and services department and are eligible for health benefits. All caretakers in the program must undergo a criminal background check.
The grand jury asserted that fraud within the program is "pervasive." For example, the state recently provided a list of 500 in-home care recipients over a three-year period within Solano County who were in the hospital while their caregiver was receiving compensation.
Also, the grand jury learned that there is no internal process to annotate or monitor care providers who falsify time sheets.
The health and social services department's Program Integrity Unit does not pursue fraud cases under $1,000, the grand jury found. During fiscal year 2011-2012, three fraud cases over $1,000 were referred to the state for possible prosecution. However, none were forwarded to the Solano County District Attorney's Office for prosecution during that time period.
However, District Attorney Don du Bain said his office received one case on March 13, which is under review, involving alleged fraud by an in-home care worker. Two such cases have been prosecuted over the past 10 years in Solano County, du Bain said.
Patrick Duterte, the county's director of health and social services, defended the department's efforts to investigate fraudulent activity. He said that robust fraud prevention measures detected nine cases that were referred to the state in January, February and March.
"We take that stuff very seriously," Duterte said, describing the department's fraud prevention program as one of the strongest in the state. He said the unit was established by the Board of Supervisors in recent years to investigate fraud and ensure quality assurance.
Duterte conceded that the department needs to do a better job reviewing the care and needs of recipients. The state requires that social workers review at least 90 percent of all recipients annually to ensure that adequate authorized services are being provided. As of November, the county's compliance rate was 82 percent.
Due to staffing shortages, not all recipients are seen annually. Duterte said he hopes to reverse the trend by filling vacant positions this year. The grand jury also recommended that the department restart its intern program, which has been dormant due to lack of staff resources.
Noting an increase in seniors needing in-home care, the grand jury also recommended that the Board of Supervisors investigate possible benefits of requiring private caretakers to have a permit.
Napa County, in collaboration with its cities, recently enacted a measure requiring private care providers to pay a fee for an application and a background check. The stated purpose of the policy is to prevent fraud, abuse and neglect of seniors requiring basic personal care.
Asked for her thoughts on the issue, Solano County Supervisor Linda Seifert said she would be interested in a closer review of Napa's ordinance before offering a position.
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