Posts Tagged ‘health care’

by Nick Jiles
May 3, 2010

Since the 2009 summer press conference addressing his proposed cuts to California’s IHSS program Governor Schwarzenegger has been relentless in his condemnation of an allegedly fraud-ridden program which he and his cronies claim is depleting the state’s tax revenue. The governor has no made no secret of his disinterest in closing tax loop holes for some of California’s most profitable corporations or in entertaining the thought of enacting oil tax legislation, both of which would generate much needed revenue but would be in stark contrast to the anti-working class agenda which has embodied his tenure in Sacramento. Perhaps no greater example of his recent attack against California’s working class is his latest effort to eliminate the IHSS program, justified by the blatant lies that comprise his anti-fraud campaign. Armed with fallacious rhetoric and testimony from a handful of county District Attorneys hiding behind the secrecy of Grand Jury findings the governor has championed one number, 25.

The governor speculated that fraud in the IHSS program was as high as 25% statewide, an alarming number for any program receiving state and federal tax revenue. Despite the efforts to ignore his critics, who have proposed such ludicrous measures as validating his estimation with actual data/empirical evidence, the governor has propelled his anti-fraud propaganda forward, using tax revenue to enforce anti-fraud policies and substantiate the urgency of dealing with such a sensitive issue that he claims lacks conclusive data to support his critics. Comments from governor Schwarzenegger’s July 6th, 2009 IHSS Fraud Press Conference included the following, “There is, of course, hesitation amongst the legislators. They say, “Well, we have to do some more studies,” and, “I don’t think we should jump to quick conclusions here,” and, “I don’t think we should make this part of the budget.”

Perhaps the “hesitation” of the governor’s critics could be attributed to the fact that one significant inquiry (unless one considers arbitrary statements from district attorneys as anecdotal evidence) has been made pertaining to fraud in the state’s IHSS program, a statewide audit commissioned by the governor himself in 2007-2008. The audit succeeded in providing an eerily powerful contradiction to the governor’s recent statements regarding the IHSS program. Of the 41 counties which participated in the quality assurance review, conducted by the California Department of Social Services (CDSS), nearly 24,000 (23,823) cases were reviewed in attempt to uncover fraud/activities requiring further investigation. Of the cases reviewed, just over 1,000 (1,076) required further investigation and of that number only 557 cases were referred to the California Department of Health Care Services for review. Schwarzenegger’s supporters point to the inadequacies of the audit’s methodology, pointing out the insufficient resources available to adequately find fraud and using such figures as the relatively low amount of home visits conducted during the audit (3,883) to justify the shortcomings of the audit’s conclusion (to be discussed in further detail below). How convenient! Conduct an audit to reveal the ubiquitous fraud of the IHSS program and then dismiss the audit’s findings when you they don’t return the desired results!

One might wonder: Why did the governor fail to mention the results of the audit to the public? Or perhaps even more troubling, how do public officials whose job duties require them to know such information support such a clear attempt to misinform the general public? As we’ve come to expect from the governor, logic ceases to exist when it comes to issues affecting the working class and despite the facts there were public officials who came forward, eager to defend the governor’s unfounded speculation. District Attorney testimony which mirrored the ambiguity of the following statement from Ventura County District Attorney Gregory Totten, “The current estimates range anywhere from on the low side, maybe 5 to 10 percent to 25 percent in terms of the fraud that occurs in this program…” is illustrative of the haphazard journey of speculative nonsense that the governor’s supporters have exhibited when discussing fraud in the IHSS program. After all, the confidence exuded by Sacramento County District Attorney Jan Scully sounded somewhat convincing, right? “And what we’ve told them is and I know you’ve used the figure and a lot of us agree with that, 25 percent fraud.” To state than an examination of the six grand jury reports does little to alleviate the unsubstantiated conjecture void of empirical evidence is a gross understatement.

Grand jury report findings are protected from public disclosure by the following legal disclaimer: “Grand jury reports area based upon documentary evidence, and the testimony of sworn or admonished witnesses, not on conjecture or opinion. However, the grand jury is precluded by law from disclosing such evidence except upon the approval of the Presiding Judge of the Superior Court, or another judge appointed by the Presiding Judge (Penal Code Sections 911, 924.1(a), and 929).” Is it not surprising then that the testimony of District Attorneys in agreement with the governor’s anti-fraud efforts, bolstered grand jury findings with sheepish obedience to his estimations of the magic number, 25%? Another principle element of the grand jury findings espoused by district attorneys who provided testimony was the program’s lack of adequate safeguards against fraud.

However, the IHSS Quality Assurance, the progeny of bi-partisan legislation enacted in 2004 and an active participant in the state’s most recent audit, is comprised of state and county officials whose job duties include monitoring the program for fraudulent activities and ensuring the efficacy and quality of care provided via the program. Counties are also supposed to conduct “targeted reviews” which focus on specified IHSS cases that indicate the potential for fraud. Much has also been made of background checks and technological implementations that would protect consumers from the litany of prisoners plaguing the IHSS program. A recent fallacy extolled by the LA Times stated that, “Requiring background checks of providers and hiring more fraud investigators could save the state hundreds of millions of dollars this year alone.” (Op Ed, 7/3/09) The recklessly irresponsible and untrue statement is merely a pathetic attempt to justify the governor’s proposal to spend $26.5 million of California’s tax revenue to investigate fraud that he claimed wasn’t discovered due to lack of available resources at the time of the audit. After reviewing the evidence available (i.e. the state-wide audit discussed above), it is apparent that adding yet another state funded bureaucracy to eradicate the 2% fraud rate that is draining the state’s tax revenue is beyond ridiculous.

Perhaps those who are convinced of the deviant characters serving as IHSS providers statewide and endangering the health of the vulnerable should take into account the following assessment of social workers’ struggles during the Schwarzenegger era, “Catching unscrupulous providers in the IHSS program requires good case management by trained social workers. Unfortunately, the Governor has consistently grossly underfunded the case management oversight in the program throughout his tenure. His budgets fund less than the bare minimum of case oversight — just over 8 hours per year per client to perform a number of activities, including client intake, assessment, provider enrollment, timesheet processing, and overall case monitoring. IHSS social workers often can’t get out to see their clients more than once a year. To make matters worse, the Governor permanently cut county IHSS budgets by another $15 million in 2008-09.” Apparently it’s difficult to find fraud when the very people employed to help monitor it find themselves subject to the governor’s guillotine as well.

Finding one’s way through the maze of guesswork and ancillary commentary of governor Schwarzenegger is easy enough when one has the facts. The people governor Schwarzenegger claims to represent in his efforts to eradicate waste and fraud within the IHSS program are the same people who will inevitably suffer in the event that he realizes his elitist agenda, an agenda that leaves California’s most vulnerable population without the care it deserves. I leave you with the following, the CONCLUSION from the most recent statewide audit of the program, “We continue to see the positive impact of QA and look forward to our continual collaborative efforts to ensure improvement and consistency in the delivery of services for all IHSS recipients and to minimize the potential for abuse or misuse of program funds, to enable more funds to be available to serve those in need.”

-Nick Jiles is an organizer with CUHW (California United Home Care Workers) and can be reached at: nicholasj@cuhw.org

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