Solano County Health & Social Services*

R1

– The Solano County Board of Supervisors and County Administrative Officer hold Health and Social Services Department management personnel, particularly within the ODAS office, accountable for IHSS program compliance. Response to First Finding and Recommendation – The Department of Health & Social Services disagrees wholly or in part with the finding. The recommendation will not be implemented because it is not warranted or is not reasonable. IHSS is a statewide program administered by each county under the direction of the California Department of Social Services (CDSS). The State of California has judged the Solano County IHSS Program to be in compliance. With respect to the IHSS Program Integrity and Anti-Fraud activities of Solano County, the May 3, 2017 State of California, Department of Social Services All County Information Notice (ACL) 1-26-17 (Appendix A) "Release of the In-Home Supportive Services (IHSS) Program Integrity and Anti-Fraud Report for Fiscal Year 2014/15", (Appendix A, ), specifically states for medium-sized counties' completed fraud investigations, "Solano County reported the most fraud investigations completed at 107 cases." Additionally, it should be noted in the same ACL, the medium-sized counties of Solano, Kern and San Joaquin reported a combined 50 percent of the Referred for Administrative Action cases, indicating robust activities in this area. In the year 2015, the ODAS Bureau examined the workflow of the IHSS Program to optimize cost effective operations. IHSS Program casework is now on an electronic file maintenance software process. IHSS will continue to embrace and incorporate compliance review recommendations by internal and external partners to ensure improved delivery of service for IHSS intakes and reassessments. Second Finding and Recommendation

R3a

– The Special Investigations Bureau be transferred to the District Attorney's Office.

R3b

- The current 'Purchase of Service Agreement for Investigation of Welfare Fraud' between the Solano County H&SS Department and the D.A.'s Office be rewritten to specifically include investigation and prosecution of IHSS program fraud. Response to Third Finding and Re

R4

– The Solano County Public Authority require that the IHSS electronic time card is a condition of employment for all providers. Granting of the power of proxy second signatures to the IHSS electronic time card should be limited to instances that meet the legal standard requiring a notarized power of attorney for a financial transaction. Response to Fourth Finding and Recommendation – The Department of Health & Social Services disagrees wholly or in part with the finding. The recommendation will not be implemented because it is not warranted or is not reasonable. By statewide rules described in the State of California, Department of Social Services All-County Letter No.: 17-76 dated July 14, 2017 (Appendix E), the use of electronic timesheet (ETS) is highly encouraged but it is not mandatory. The California Department of Social Services(CDSS) acts as the payroll agent, and it establishes the rules for the IHSS program, including how IHSS electronic time sheets are utilized. CDSS is the only entity that has authority to impose rules or egulations for IHSS providers regarding conditions of employment. ETS is an optional service in which the consumer and provider must both agree to use e-timesheets. There is a mechanism in place that alerts the Program Integrity Unit staff if a provider has had a complaint of suspected fraud. Under Welfare and Institutions Code (W&I Code) section 12301.6 (Appendix F), the Solano County Public Authority is established as the employer of record for negotiations purposes only and may not require electronic timecards as a condition of employment as IHSS providers are not considered employees of the Courity for any purpose. Currently, under W&I Code section 12301.24 (Appendix G), the only condition of employment for an IHSS provider is that he or she complete an enrollment process, which includes attending an in-person orientation and passing a Department of Justice Background Check (known as a Livescan) under the conditions set forth in W&I Code section 12305.81(Appendix H.) The State's Case Management Information and Payroll System (CMIPSII) does not allow more than the number of authorized hours to be paid. It is the responsibility of the IHSS recipient (the employer) to select the IHSS provider (the employee). As the employer, the IHSS recipient can hire anyone who meets the IHSS provider enrollment requirements and can meet the needs of the recipient. If the IHSS consumer (the IHSS recipient, or employer) does not receive services from the IHSS provider (the employee), it is the responsibility of the IHSS consumer to monitor, hire, and if needed select another provider. Fifth Finding and Recommendation

R5

- Program integrity and regulatory compliance be the primary focus of H&SS management to ensure IHSS program sustainability. Response to Fifth Finding and Re