IHSS

Last summer, I met a lady on the picket lines in front of Psycho Donuts. Janie Whiteford introduced herslf and said she was there to support our advocacy efforts and that she was a member of the Santa Clara County IHSS Advisory Board. I thanked her and asked, "what is the Santa Clara County ISHSA Board?". Several weeks later, I attended an IHSS Advisory Board meeting and I have been attending them ever since.

It seems that there are a lot of people whose first reaction to the acronym, IHSS is similar to mine, "IH-what?" The unfortunate thing is that many of us may have a loved one who is elligible for these programs or may need to call on these services in the future, if they exist. I'm going to try and explain this in layman's terms, which is about how I understand it anyway. IHSS or In Home Support Services provides funds for in home support service workers who provide assistance to the elderly and disabled. The services provided vary from basic support like shopping and transportation to more critical functions such as in home medical support. There is a complicated rating system that I'm not going to try and explain, it'll just confuse the issue. Suffice it to say that the governor proposes to make the rating system much more stringent, thereby making the vast  majority of the recipients ineligible for services. This is all in the name of saving cost.

 Here's the issue, the governor believes there is rampant fraud in the IHSS programs. He believes that people are billing the state for services that are not being rendered to the recipients of the IHSS benefits. Therefore, the governor believes it would be better to eliminate the potential for theft by employing several new steps for qualification.

One new requirement is that all recipients of IHSS benefits be finger printed, along with the service provider. The governor's office says that this is to insure that the people service providers, (ie. nurses, drivers, assistants) don't have criminal records and are not a threat to the people they are caring for.

Another new requirement is that the service provider provide a thumb print along with a signature each time they submit a time sheet; both their thumb print and the thumb print and signature of the person they provided the services for.

Another requirement is that service providers attend a 45 minute introductory video. The video is supposedly designed to be an orientation for program participants, it is actually a video about the perils of defrauding the state of IHSS funds.
So, what does something like this cost?

1. Well, you've got all the administrative "stuff" that goes along with processing 415,000 IHSS workers.
2. Then you've got the bid-process for the company that handled the fingerprinting. (There was a bid process, right?)
3. Then you've got the cost of the fingerprinting itself.
4. Then you've got the cost of the new investigative staff the is needed to catch all of the alleged "crooks" working the system.
5. Do you think the same administrative staff that processes the IHSS workers also support the new investigative staff?...Remember, this is California! Add some new administrative staff to support the investigators, please.
6. Add the cost of the new data-base; equipment and software
7. There is the cost for curriculum translation; videos, presentations and print.....

As you can see, this is a pretty costly endeavor. It must be well worth it to catch the perpetrators of such lucrative crimes against society. After all, these people make a ton of money off of the system, don't they?
Actually, they don't.

In Home Support Service Workers represented by unions such as SEIU and UHW make approximately $12.50 per hour. Yes folks, $12.50 per hour! We have spent tens of millions of dollars, setting up an impenetrable web to apprehend the culprits of major financial crimes against the people of the state of California. That's right, Tens of Millions of Dollars to catch Mrs. Smith's daughter in-law who billed the state for 4 hours of shopping when it was really only 2.5 hours.

 Let's look at this from the governor's perspective. Many of the IHSS service providers are family members. The state should not be providing jobs for people's families. If people need assistance, they should utilize existing resources. Many of the recipient's of IHSS services could go to residential homes. Insurance can and will cover many residential and nursing facilities thereby relieving the state of these cost. The elimination of the IHSS programs will also eliminate the incentive and methodology for fraud.

 From the perspective of the service providers and recipients: The service providers tend to be the relatives of the recipient because it is difficult to get professional assistance and care for a loved on the $12.50 per hour paid to IHSS workers. The amount of service hours per recipient is based upon their IHSS rating. Therefore, many IHSS service providers work less than half- time at these positions.

 As in all government administered programs, there have been a few that have figured out a way to beat the system, a very few. I've been looking for reports on IHSS fraud and I haven't found or read any current figures. However, after fingerprinting hundreds of thousands of IHSS service providers and recipients since this new process begin back in February, there has been no reports of the rampant fraud that the governor's administration claims is costing the tax payers millions of dollars annually. As a matter of fact, no one has been dis-qualified through this new "screening" process.

 On top of the enormous amount of money being spent to catch mythical thieves (WMDs), the proposal to "restructure" the assessment criteria for recipients would mean that approximately 385,000 of the 415,000 recipients of IHSS would be ineligible for future services. That means no one to come over to prepare meals for people who can't prepare their own meals, no para-transit drivers to help get them to doctors appointments or shop for groceries, no one help people with life skills like dressing, hygiene issues, etc..

 So what happens if these services go away? The governor proposes that residential facilities take up the slack. There are several concerns about residential and nursing facilities to consider.

1. This industry is and always has been poorly regulated.
2. This would require another level of government bureaucracy to monitor and regulate facilities
3. There aren't enough residential/nursing facilities to fill the need. This will result in a backlog of people waiting for placement, a flood of new residential facilities seeking licenses and even more issues with poor or non-existent regulation
4. The cost of a residential facility can be anywhere from $5000.00 per month to $20,000.00 per month depending upon individual need. Compare that to $12.50 per hour for an IHSS worker.
5. Not everyone who utilizes IHSS services is elderly. People with developmental disabilities, paraplegic, quadriplegic, and a variety of disabilities affecting people of all ages receive IHSS support. We know that insurance companies will cap their benefits. What happens when a person has maxed out their policy?
6. The issue also adds to the worst unemployment problem we've had in modern California history. Imagine adding another 385,000 people to our unemployment roll. 

I don't understand the benefits to the governor's plan. It doesn't eliminate a problem, it exacerbates many. It doesn't save money, it will cost hundreds of millions. It is interesting that the wealthy often think that people who need assistance are probably out to steal or scam the system.

Our population is getting older and the problems of our society are evolving. Our next major civil rights issues will be geriatrics and education. Unfortunately, we still have other civil rights battles we are still fighting.