The Sacramento County grand jury blasts the county's handling of in-home health care services, saying in a report released today that fraud in the program "is reported to be rampant and out-of-control."
The In-Home Supportive Service program, which provides health care to the elderly, blind or disabled in their own homes, has seen its administrative costs double to $24 million over the past four years but lacks any background checks on providers or social workers and has done little to prevent fraud, the report concludes.
"Almost every person who was interviewed, and there were many, spoke of rampant abuses of the IHSS system," said a cover letter from grand jury foreman Donald Prange Sr. "At best, it is (a) dysfunctional system plagued by upper management who refuse to make meaningful changes or even to look into matters that will be beneficial to the truly needy people it is pledged to help."
The 18-page report found a variety of problems with the program, but focused largely on fraud and a lack of accountability.
"Currently, IHSS providers have no meaningful oversight, no assessment of skills to meet client needs, no monitoring of the validity of service hours, and no background checks ...," the grand jury report found. "The provider aspect of the program has been characterized by a witness as ' ... an employment program for ex-felons and a breeding ground for fraud.' "
The county's oversight and fraud prevention efforts are "almost non-existent," the report found, and the grand jury recommends disbanding the program's internal fraud unit and giving its $1 million budget to the sheriff and district attorney to create an independent task force of fraud investigators.
Sheriff John McGinness said he supported the recommendation, adding that the IHSS program has been used as a "cash cow" by unscrupulous providers and that a message needs to be sent that taxpayer funds must be protected.
"I'm fully supportive of it," McGinness said. "It's appropriate that we take a hard stand on protecting taxpayer funds."
The grand jury report, titled "IHSS: For the Needy, Not the Greedy," studied major facets of the program, which employs 219 county staffers and provides services to 21,290 recipients.
Under the program, which is funded jointly through federal, state and county resources, "providers" are hired to go into homes and help people with their health needs.
The providers are paid $10.40 an hour and frequently are family members or acquaintances of the people they are being paid to help, the report found.
"There are no qualifications to become a provider," the report found. "There is no assessment of the provider's ability to provide care, no criminal background check, no tuberculosis test, nor any training ...," the report found.
The grand jury said it found cases of fraud that included claims for payment by providers who were incarcerated, claims by different providers seeking payment for the same services at the same time and claims for services to recipients who were dead.
The report said only cases involving fraud of more than $1,500 are pursued by the district attorney. But it found that over the past five years fraud cases under $1,500 amounted to $1.13 million, and only $186,245 was ever collected.
The report is available at www.sacgrandjury.org
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