Bill Text: CA AB1801 | 2009-2010 | Regular Session | Introduced
Bill Title: In-home supportive services: quality assurance and fraud
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2010-04-13 - In committee: Set, second hearing. Hearing canceled at the request of author. [AB1801 Detail]
Download: California-2009-AB1801-Introduced.html
BILL NUMBER: AB 1801 INTRODUCED
BILL TEXT
INTRODUCED BY Assembly Member Yamada
FEBRUARY 10, 2010
An act to amend Section 12305.84 of the Welfare and Institutions
Code, relating to public social services.
LEGISLATIVE COUNSEL'S DIGEST
AB 1801, as introduced, Yamada. In-home supportive services:
quality assurance and fraud prevention.
Existing law provides for the county-administered In-Home
Supportive Services (IHSS) program, under which qualified aged,
blind, and disabled persons receive services enabling them to remain
in their own homes. Existing law requires the State Department of
Social Services, in collaboration with the State Department of Health
Care Services, the California State Association of Counties, the
County Welfare Directors Association, and stakeholders representing
consumers and providers, to convene a workgroup to develop and issue
a report evaluating the implementation of quality assurance and fraud
prevention and detection activities enacted from 2004 to the
present. Existing law requires the department to provide this report
on or before December 31, 2010.
This bill would, in addition, require the department to continue
to provide this report after December 31, 2010, on an annual basis.
This bill would also require the department, in consultation with
the above-mentioned entities, to identify stable ongoing funding
sources for IHSS services, solicit recommendations for improving the
delivery of long-term care services, as described, and solicit
recommendations regarding the role the IHSS program would have in
accomplishing those improvements. It would require the department to
report these findings and recommendations gathered as a result of
these efforts to the Legislature on or before May 1, 2011.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares all of the
following:
(a) On June 22, 1999, the United States Supreme Court issued a
decision in the case of Olmstead v. L.C. by Zimring (1999) 527 U.S.
581, finding that the unjustified institutional isolation of people
with disabilities is a violation of the Americans with Disabilities
Act (ADA). The Olmstead decision established the responsibility of
states to ensure that people with disabilities, including seniors and
children, receive care in the most integrated setting.
(b) The In-Home Supportive Services (IHSS) program, which is the
cornerstone of California's efforts to comply with the Olmstead
decision, is a statewide public program providing essential personal
care and domestic services to approximately 450,000 aged, blind, or
disabled Californians who are unable to remain safely in their own
homes without assistance. There is ample evidence that the IHSS
program is successful at keeping people out of more costly and less
desirable out-of-home placement in nursing homes or other
institutions.
(c) IHSS is a complex program and has undergone substantial change
over the past five years. Mechanisms have been put in place to
improve IHSS program integrity with the enactment of the IHSS Quality
Assurance Initiative, in Senate Bill 1104 of the 2003-04 Regular
Session, and the Anti-Fraud Initiative, in Assembly Bill 19 of the
2009-10 Fourth Extraordinary Session.
(d) California faces challenges to meet the needs of seniors and
persons with disabilities to live independently in the setting of
their choice that is responsive to their gender, age, and cultural
and ethnic heritage. The challenges facing the IHSS program are best
viewed in the context of California's changing demographics.
Currently, the state has 4,000,000 people over the age of 65, the
largest older adult population in the nation. This figure is
projected to increase by 172 percent over the next 40 years, with
most of the growth occurring in the next 20 years. As the population
ages and individuals become less able to care for themselves, there
will be an increasing demand for personal assistance services.
(e) These challenges must be addressed by identifying financial
and structural barriers to improve IHSS program integrity that
consistently promotes home-based care over institutional care.
SEC. 2. Section 12305.87 is added to the Welfare and Institutions
Code, to read:
12305.87. (a) The department, in consultation with the State
Department of Health Care Services, the California State Association
of Counties, the County Welfare Directors Association, and
stakeholder organizations representing consumers and providers, shall
do all of the following:
(1) Identify stable ongoing funding sources that would be
dedicated to IHSS services to meet the projected caseload associated
with the growing population of seniors and people with disabilities
in California.
(2) Solicit recommendations for improving the delivery of
long-term care services in a manner that reduces the overall costs
for long-term care and avoids placements in expensive and
inappropriate institutions.
(3) Solicit recommendations regarding the role the IHSS program
would have in accomplishing the improvements described in paragraph
(2).
(b) The department shall report the findings and recommendations
gathered pursuant to subdivision (a) to the Legislature on or before
May 1, 2011.
SEC. 3. Section 12305.84 of the Welfare and Institutions Code is
amended to read:
12305.84. (a) Upon enactment of this section, the department
shall convene a stakeholder group and begin a process with this group
to develop and issue a report evaluating the implementation of the
quality assurance and fraud prevention and detection activities
enacted from 2004 to the present. The department shall include and
collaborate with the State Department of Health Care Services, the
California State Association of Counties, the County Welfare
Directors Association, and stakeholders representing consumers and
providers.
(b) The department shall provide this report to the Legislature on
or before December 31, 2010 , and annually thereafter .
(c) The stakeholder group shall do all of the following
:
(1) Review the annual error reports issued and state-level quality
assurance activities to date required by Section 12305.7 and review
and evaluate the implementation of county quality assurance
activities required by Section 12305.71, including a review of the
number of instances, amounts, and causes of overpayments and
underpayments identified by quality assurance activity at the state
and county level from enactment to date.
(2) Review information available regarding prevention and early
detection of fraud, the latter as defined by
Section 12305.81 12305.8 .
(3) Collect and review information regarding referrals of
suspected fraud to the State Department of Health Care Services
pursuant to Section 12305.82, and subsequent investigative efforts,
including cost-benefit information regarding these efforts, as well
as the number of fraud cases handled locally.
(4) Collect and review information regarding final convictions for
fraud, including all of the following:
(A) The amount of funds involved in the conviction.
(B) The basis of the fraud conviction, including whether it
involved services not provided or falsified consumers or providers,
or both.
(C) Aggregate information regarding the number and source of
individuals responsible, including, but not limited to, state
employees, IHSS providers, consumers, county workers, or others.
(5) Provide recommendations on options for preventing errors and
fraud for both the state and county levels, and recommendations for
early detection strategies to combat fraud in the program.
