In-home workers under scrutiny
CARE: Tougher screening is weeding out fraud and abuse, but many with criminal records still are allowed in the program.
By Troy Anderson, Staff Writer
Posted: 07/11/2010 05:26:36 PM PDT
Updated: 07/11/2010 05:29:01 PM PDT


New state screening procedures this year have led to thousands of people withdrawing as in-home care providers for the elderly and disabled, leading state officials to suspect that fraud and abuse has been rampant in the program.

The state began this year requiring background checks and fingerprinting of qualified providers under the In-Home Supportive Services program, which helps the elderly and disabled receive care in their homes.

Since then, some 15,000 IHSS providers, out of 408,000 statewide, have declined to re-enroll, state officials said. They suspect many of them were parolees, people using fake identities and undocumented immigrants who would have been caught in the new screening process.

"One investigator told me when they take a break during the orientation (to learn of the new screening procedures) that half the people don't come back," said Patrick Sequeira, assistant head deputy district attorney in the District Attorney's Office's Public Assistance Fraud Section.

"I think the re-enrollments are down because of the increased vigilance and the background checks and fingerprinting."

But even with the new requirements, many criminals - including convicted murderers and rapists - are still allowed to work as in-home care providers for the elderly and disabled, officials acknowledge.

Under state law, the only convictions that bar someone from working as an IHHS provider are elder abuse, child abuse and fraud against a government health care or supportive services program.
Some convicts may apply

State lawmakers are seeking to expand the list of disqualifying convictions to include robbery, rape, murder and other serious crimes, but their efforts have been blocked by legal challenges, county Department of Public Social Services Director Phillip Browning said.

The state Department of Social Services has appealed the court ruling, DSS spokeswoman Lizelda Lopez said.

"It's obviously very troubling to think someone might be caring for an elderly individual would be a convicted felon, or, even worse, a convicted violent felon," Sequeira said.

Under the anti-fraud initiative approved as part of the 2009-10 budget, hundreds of thousands of IHSS providers are now required to fill out a form, participate in an orientation session, undergo a background check and get fingerprinted.

As of Friday, 409,000 IHSS providers statewide had begun the re-enrollment process, including 284,000 who completed the background check and fingerprinting and 125,000 whose re-enrollments were pending. Of those who have completed the process, 531 were declared ineligible due to prior convictions for abuse or fraud.

A total of 15,472 took no steps to re-enroll and will lose their status as IHSS providers, Lopez said.

Pattern of fraud

In Los Angeles County, Browning said, 114,000 of 135,000 IHSS providers have completed the re-enrollment process. Of the remaining 21,000 providers, Browning said he expects to find out next week how many took no action to re-enroll. So far, 113 people have been declared ineligible.

In a recent Sacramento County grand jury report - "IHSS: For the Needy Not the Greedy" - the authors wrote people with criminal convictions constituted most of the providers who committed a "documented fraud." In 2007, the Los Angeles County grand jury found scam artists were "embedded" in the program.

In the past year, a coalition of state and county agencies launched a new crackdown against fraud in Los Angeles County, ramping up from two investigators to 29.

In the first five months of this year, the District Attorney's Office filed 38 felony cases against 41 people involving IHSS fraud - equal to the total number of felony filings in the last three years, according to a memo from county Chief Executive Officer Bill Fujioka.

Last week, a state-county task force battling IHSS fraud arrested 14 people, charging them with theft of more than $500,000 in taxpayer-funded aid programs.

In one case, a mother signed up as an "authorized representative" to receive IHSS funds for her son, who has been in custody for more than four years for murder, prosecutors said.

In another case, the defendant - who lives in Tarzana - was accused of setting up a fraudulent care "provider" who lived in San Francisco.

"I think the grand juries are correct," Deputy District Attorney Lester Kuriyama said. "There is a lot of fraud in the IHSS program."

Union concerned

Scott Mann, a spokesman for Service Employees International Union United Long-Term Care, which represents IHSS workers, said the union's members have no tolerance for misuse of IHSS funds since every dollar is essential in making sure that low-income seniors and the disabled have access to the care they need to live safely at home.

"In addition, in-home caregivers take great pride in the work they do and the care they provide," Mann said. "Any activity that would tarnish that work or their dedication to those they care for is unacceptable."

Los Angeles resident Sandy Varga, a 61-year IHSS patient who is partially paralyzed, said she is concerned about the integrity of the people who care for her and once had a caretaker who stole an old checkbook and cashed the checks. Now, Varga said she only hires caretakers from a county-maintained registry.

"I'm very concerned about it," Varga said. "I'm very vulnerable.

"However, this whole business the governor has stirred up with phony fraud rates and all this money pumped into fraud investigations is misguided and a waste of state money."

Cuts could hurt program

As part of efforts to close a $19 billion budget deficit, Gov.Arnold Schwarzenegger has proposed to cut $750 million from the program that provides services to 460,000 low-income seniors and disabled people statewide. If state lawmakers approve the cut, it would reduce the cost of IHSS this year to $5.2 billion. The state could also lose $1.5 billion to $2 billion in federal matching funds.

While union officials say the proposal could cut services to about half of the recipients, Sequeira said significant cuts could be made without jeopardizing care to those who truly need help.

"If you eliminate the fraud, you could save a considerable amount of money," Sequeira said.

Schwarzenegger spokeswoman Rachel Arrezola said the governor is committed to rooting out fraud, waste and abuse.

"We face a ($19) billion deficit this year, we just had the largest tax increase in the history of the state and the governor is not going to raise taxes this year," Arrezola said. "He understands there are real people these cuts will effect, but it's his job to ensure the state can live within its means."

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