On Tuesday, California Department of Social Services (CDSS) Director John Wagner urged all the IHSS providers to visit their county IHSS office to re-enroll.
The process is required by California's 2009 Budget Act passed by the Legislature. Wagner said the legislation included “a significant anti-fraud initiative” that had as one of its requirements a new IHSS provider enrollment process. State officials said the legislation is meant to “ensure the integrity of the program and protect client safety.”
Starting last Nov. 1, all new IHSS provider applicants were required to complete all four elements of a new process before being eligible to receive payment for services provided to IHSS recipients, the state reported.
Due to the large number of existing providers, state officials said the law allows any providers that were already working or applying to work prior to Nov. 1, 2009, through this June 30 to re-enroll in order to continue to receive payment from the IHSS program.
Tristan Brown, political director for California United Homecare Workers – the union that represents many IHSS workers, including those in Lake County – said the enrollment requirements are a concern for both clients and their providers alike.
“Providers have always had difficulties and concerns with the new anti-fraud enrollment measures because of the cost that have been associated with them,” he said, with the background checks costing $50 and higher depending on location.
He said those kinds of costs prove to be significant blocks for households already dealing with large medical costs, and also are limiting for clients because it potentially infringes on their caregiver choices.
“It can become a very intimate relationship, from a provider to a consumer,” he said, with clients wanting to have the freedom to choose who they want.
Brown suggested that the requirements were the product of “some overzealous district attorneys” and the Republican Caucus.
“We're not seeing this rampant fraud that they suspected,” he said, suggesting it was a “far-fetched idea” from the beginning, and a tactic to use IHSS as a bargaining chip to get other political concessions, which may become apparent in the upcoming budget process.
“It's a shame that our state's elderly and disabled are used in that fashion,” he said.
Steve Citron, manager of adult and housing services for the Lake County Department of Social Services, said the four-step process begins with providers filling out an enrollment form. They are then fingerprinted with the automated Livescan system.
From there, the prints are sent to the California Department of Justice, which then conducts a criminal background check on the individuals, he explained.
Citron said providers must then go through an orientation and sign another form – which the state said acknowledges the IHSS program requirements – to complete the process.
The California Department of Social Services reported that the level of enrollments under the new process has increased exponentially in recent months due to the action steps and outreach by the state, the counties, the public authorities and provider representative organizations.
As of June 9, approximately 330,000 providers have begun the reenrollment process, including more than 225,000 who have completed the process, including fingerprinting and a background check, according to the California Department of Social Services. Approximately 20,000 have taken no steps to re-enroll and risk losing their provider status.
In Lake County, 1,189 IHSS providers had completed the enrollment process as of June 9, according to numbers provided by the state. That number includes 941 existing IHSS providers and 248 who are new.
Approximately 360 local IHSS providers have pending enrollment status – 300 of which are current and 60 new providers, the state reported.
Under the process, eight local IHSS providers – six who already had been in the system and two others who were signing up for the first time – were deemed ineligible, according to the state.
Citron said Lake County's IHSS Public Authority started the reenrollment process for local providers last December, and has been sending out notices every month both to providers and service recipients alike reminding them of the state mandate.
Since then, the county has been doing about 200 reenrollments a month, Citron said.
As for completing the process, “I don't think it's going to be a problem in Lake County,” he added.
On Wednesday, the California Department of Social Services posted on its Web site a notice letter to counties extending the deadline for the reenrollments under certain circumstances.
If providers had started at least one of the four enrollment steps by the June 30 deadline that they will be allowed to complete the process by Dec. 31, the letter stated.
The reason for the extension appears to be one of workload. “Although the rate of enrollment completions has been rapidly increasing, the volume of provider enrollment forms, orientations, and criminal background checks are more than can be processed by June 30, 2010,” the letter explained.
What's still not entirely clear is the future of a state plan to fingerprint IHSS clients as well, which was contained in legislation the state passed last year, Citron said.
Noting that the plan “doesn't make a lot of sense,” Citron suggested it was “overkill” to prevent some kind of fraud that public authorities haven't seen.
The state put aside money and went out to bid for portable fingerprinting devices that could be taken to peoples' homes, Citron said.
The plan was going to require “a huge amount of money,” and the state Legislature has indicated that it doesn't plan to fund the fingerprinting program for the coming fiscal year, he said.
Last month, a Senate budget committee voted against spending $8.2 million this fiscal year to start that process, which is expected to cost $41.6 million over a seven-year contract, according to a May 10 Sacramento Bee report.
Because there is no funding for the fingerprinting devices and a great deal of uncertainty about the requirement, nobody has started fingerprinting clients, according to Citron.
“It doesn't make a lot of sense,” Citron concluded.
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