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Summaries of health policy coverage from major news organizations

Sacramento Grand Jury Criticizes In-Home Health Services Program

On Monday, the Sacramento County grand jury issued a report alleging that the county's in-home health services program does not adequately protect against fraud or properly screen caregivers, the Sacramento Bee reports.

The In-Home Supportive Services program, funded by a combination of federal, state and county funds, pays for elderly, blind and disabled people of limited means to receive caregiver aid in their own homes.

The program provides services to 21,290 recipients and employs a staff of 219.

Grand Jury Report

The report, titled, "IHSS: For the Needy, Not the Greedy," found that in the past four years, the program's administrative costs doubled to $24 million.

According to the report, caregivers are paid $10.40 an hour and often are family members or acquaintances of the people they are paid to help. However, the report alleges that the county fails to conduct background checks on caretakers and social workers.

The report states, "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 report also found that the county had few safeguards in place to protect against fraud.

According to the report, reports of fraud include:

  • Claims for payment by caregivers who were incarcerated;
  • Claims by different caregivers seeking payments for the same services; and
  • Claims for services to recipients who were deceased.

According to the report, the district attorney only pursues cases of fraud involving more than $1,500.

Cindy Besemer, chief deputy district attorney, said that figure was lowered to $400 about a month ago.

The grand jury recommended suspending the program's internal fraud unit and moving its $1 million budget to the Sheriff's Department and District Attorney's Office to develop an independent task force of fraud investigators (Stanton, Sacramento Bee, 3/24).

County Response

Nav Gill, the county's COO, said that he has not yet reviewed the grand jury report but that the county will investigate the issues raised in the report.

Gill added that the county has been conducting its own internal review of IHSS since June when county supervisors questioned why program costs were increasing at such a rapid pace.

The county has until June 22 to respond to the report.

The Sacramento County grand jury's report is available online (.pdf)

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