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Extracted from Consolidated Report
This investigation was originally published as part of a larger consolidated report containing multiple investigations. View the consolidated PDF for the complete document.
Sacramento County Grand Jury
• 2008-2009
In Home Support Services: “For the Needy, Not the Greedy”
⚠️ Translation Notice: This content has been automatically translated. The original English text is the official version. Translation may contain errors.
⚠️ Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.
Findings 7 findings
F1
Page 38
IHSS does not have adequate program controls to eliminate fraud.
F2
Page 39
Service hours are added without verification of recipients’ health needs and Medi-Cal conditions.
F3
Page 39
The existing fraud investigation process is cumbersome and ineffective.
F4
Page 40
Social workers do not receive adequate training in fraud identification and reporting.
F5
Page 40
Recipients lack sufficient information to make informed decisions about their providers.
F6
Page 41
The IHSS Information Technology Department has recently developed and implemented a software database name ADAM (Adult Data Automation Module). This has immensely improved the intake, evaluation and tracking of IHSS recipients.
F7
Page 41
The Registry, funded last year at $1.6 million, is not cost-effective. The number of employed Registry screened providers is small (less than one percent) as is attendance in various classes.
Recommendations 7
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R1Page 381: Add a supplemental time sheet with clock hour implements versus the current block time accounting to be put in the recipient’s file. A County supplemental time sheet would not require any computer system reprogramming, and the cost would be insignificant.
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R2Page 391: Establish an independent pool of physicians to periodically review recipient files of Medi-Cal and mental conditions to provide both quality control and certification of claimed needs and services.
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R3Page 391: Create an operationally independent task force composed of the County Sheriff’s Department and the County District Attorney’s Office to conduct fraud investigations. It would be funded by $1 million currently being expended on fraud by IHSS.
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R4Page 401: Require management to provide and social workers to successfully complete comprehensive training in fraud detection, with updates to be given annually.
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R5Page 401: Require that all current providers undergo a face-to-face meeting with an IHSS representative to verify identification and to receive a program orientation that is verified by providers’ signatures.
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R6Page 41The IHSS Information Technology Department is commended and should be recognized for their accomplishment.
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R7Page 41Encourage the County Board of Supervisors to evaluate the Registry functions, workload and level of funding. Response Requirements Penal Code sections 933 and 933.5 require that specific