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In-Home Care Program Fraud Claims Don’t Add Up

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Thousands of disabled, blind and elderly people in San Diego County will no longer have help to cook their meals, bathe, change their sheets or take their medicine. Gov. Schwarzenegger cut In-Home Supportive Services to help resolve the state budget crisis. But in slashing the program he also alleged massive fraud.

Thousands of disabled, blind and elderly people in San Diego County will no longer have help to cook their meals, bathe, change their sheets or take their medicine. Governor Schwarzenegger cut In-Home Supportive Services to help resolve the state budget crisis. But in slashing the program he also alleged massive fraud.

Before Gov. Schwarzenegger eliminated more than a quarter billion dollars from In Home Supportive Services this summer, he met with a group of district attorneys to talk about fraud.

"And there's no program than where there's more of that (sic) than with In Home Support Services. And just so you do know of how much money is being spent it's between $4 billion and $5 billion. Some people say there's 25 percent fraud and that will be a billion dollars right there."

To Doug Moore sitting in his San Diego office, those were fighting words.

"I was livid. I wanted to bring him in this room and take him on one on one," says Moore.

Moore runs the union that represents people who work in In-Home Supportive Services also known as IHSS.

"There's not massive fraud like the governor has said in this program. The statistics do not back these claims up."

There are about 460,000 people in the program statewide. From July 2005 through November 2008, there were 5,000 fraud complaints against IHSS. Fifteen-hundred were substantiated. That's a fraud rate of less than 5 percent.

In San Diego County where there are 25,000 seniors, blind and disabled people in IHSS, there were 42 complaints and 14 prosecutions. That's a fraud rate of less than 1 percent.

But investigators say these numbers don't tell the full story.

"The way the system is set up now, the program is ripe for fraud," says Andrew Freshwater, the head investigator of the economic crimes unit in the San Diego's DA's office.

Freshwater says most of the people in IHSS are taken care of by friends and family. If there's collusion, fraud detection is difficult.

"Are you going to fudge a timesheet because your son didn't show up today?"

In recent years, the DA's office has prosecuted two cases of IHSS fraud with losses of over 100 thousand dollars and one case over two hundred thousand dollars. There are instances when people don't show up for work but claim they did by forging their clients' signatures on timesheets.

Along with cuts to the program, the governor put in place new rules to prevent fraud. They include requiring IHSS providers and recipients to put their fingerprints on timesheets and more random visits by social workers.

San Diego prosecutor Michael Groch says the new requirements will likely increase the rate of fraud prosecutions.

"What's really been lacking in the program is the ability to hold people accountable and to investigate these people and to turn them into prosecutable cases which is why we've seen the disparity between the amount of fraud that we know and believe is in the system and the number of cases of prosecution for them."

"There is a political move on the part of some districts attorneys to pad their budgets to create more investigation."

Lee Collins is director of the San Luis Obispo County Department of Social Services.

"I have no doubt that there is some fraud in every program including the In Home Supportive services but there is nothing to suggest that this program compared to any other program is particularly ripe for fraudulent intent. In the absence of data, it's simply trumpeting at a ghost."

Collins accused state officials of making cuts on dishonest grounds.

"But what they've tried to do is to have their cake and eat it too which is to say that we're cutting the program because we think there's a lot of fraud. I think it is its own brand of fraud and the worst most cynical ugly kind of politics because of who they're targeting. it's too easy a target to pick on folks who don't have the ability to fight back."

But one woman is speaking out. She stands to lose funding to take care of her autistic sister and elderly mother.

"I know that I'm fighting for a cause. And I'm fighting not for myself but for all others who cannot talk, who cannot express."

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