The In-Home Supportive Services program often operates inefficiently and is ripe for fraud and abuse, according to a San Diego County grand jury report released on Tuesday, the San Diego Union-Tribune reports (Cadelago, San Diego Union-Tribune, 4/19).
IHSS relies on county, state and federal funds to provide in-home care to about 440,000 low-income elderly Californians and residents with disabilities (California Healthline, 4/18).
According to the grand jury report, a lack of oversight in San Diego County’s IHSS program has led to fraudulent claims and the emotional and physical abuse of some beneficiaries (Nichols, North County Times, 4/19).
The report also noted that:
* Laws governing IHSS are complex and contain several loopholes that could prevent San Diego County officials from verifying that caregivers are providing services;
* Only about 20% of IHSS beneficiaries in San Diego County are severely impaired and incapable of caring for themselves; and
* Increased enrollment has led county caseworkers to oversee an average of about 300 beneficiaries each (San Diego Union-Tribune, 4/19).
The grand jury report called for San Diego County supervisors to work with state lawmakers to enact changes to the IHSS program. The report recommended:
* Changing eligibility criteria to ensure that beneficiaries “clearly need” in-home services;
* Forming a task force to identify fraud and abuse;
* Hiring interns to provide caseworkers with more time to devote to at-risk beneficiaries; and
* Revising regulations to allow for the validation of caregivers’ timecards (North County Times, 4/19).
Stakeholders Protest Unannounced Home Visits
In related news, IHSS beneficiaries, caregivers and advocates are expressing opposition to a law included in the 2009 state budget package that authorized investigators to make unannounced home visits to IHSS beneficiaries. The law aims to curb IHSS fraud and ensure quality of care.
At a public hearing this week, stakeholders testified that the unannounced visits would jeopardize beneficiaries’ privacy. The stakeholders said that even if lawmakers do not repeal the regulation, they hope to have a voice in how the policy is implemented
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