Black-shirted agents target Alzheimer's Patients: A "New Day" In Sacramento

Some Challenges (0.00 / 0)

Steve said: "Here's an estimate she could have used, but didn't:  In Sacramento County during fiscal year 2006-2007, there were fewer than 400 reports of suspected fraud out of 17,000 IHSS clients: a rate of only about two percent."

This seems like poor logic.  The existence of "400 reports of suspected fraud" would not reflect the percentage of actual fraud, but rather the actual number of reports.  Two other categories exist: (1) fraud that is known but not reported and (2) fraud that is unknown but existent.

Steve said: "Treating Alzheimer's patients like common criminals may be a low point in the history of our state's criminal justice system."

I didn't see anywhere in the news reports that Alzheimer's patients are treated like criminals.  Was there something that I missed?  Was an Alzheimer's patient treated poorly by the Task Force or the D.A. in Sacramento?

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by: Local_Observer @ Sat Nov 21, 2009 at 01:15:27 AM UTC

RE: some challenges (0.00 / 0)

Local Observer Says: "The existence of "400 reports of suspected fraud" would not reflect the percentage of actual fraud, but rather the actual number of reports.  Two other categories exist: (1) fraud that is known but not reported and (2) fraud that is unknown but existent."

The question is whether the amount of known fraud or fraud that can logically be suspected justifies spending huge amounts of taxpayers' money on so-called "anti-fraud" campaigns. The answer in Sacramento County and throughout California is NO.

Local Observer Says: "I didn't see anywhere in the news reports that Alzheimer's patients are treated like criminals."  

Guess you missed the earlier reports that all recipients of IHSS homecare--including Alzheimer's patients--have to be fingerprinted and are subject to unnanounced home visits by uniformed agents. Now that's treating them like criminals (or at least parollees).  

Furthermore, unlike most other public employees, low-wage homecare providers are now required to pay for their own background checks.
 

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by: stevefromsacto @ Sat Nov 21, 2009 at 01:34:04 AM UTC

[ Parent ]

I See... (0.00 / 0)

I see.  I think I must have misread your initial statement because it said:

"Scully said she has no estimate for how much fraud exists in the in-home care program.

Here's an estimate she could have used, but didn't: In Sacramento County during fiscal year 2006-2007, there were fewer than 400 reports of suspected fraud out of 17,000 IHSS clients: a rate of only about two percent."

Putting your challenge to Scully you suggested that "an estimate she could have used (Steve)" ... "for how much fraud exists (Scully)" turns out to be "only about two percent (Steve)" leading me to assume that you believed the percentage relating to 400 reports of fraud equaled the percentage of actual fraud.  Perhaps you just weren't as clear as you meant to be.

Steve said: "Guess you missed the earlier reports that all recipients of IHSS homecare--including Alzheimer's patients--have to be fingerprinted and are subject to unnanounced home visits by uniformed agents. Now that's treating them like criminals (or at least parollees).  

I thought you were speaking here of something DA Scully, herself, had developed.  Sounds like a state-wide set of mandates that may or may not come to fruition with lawsuits and the like.  I understood that fingerprinting social service recipients is a long-standing tradition.  Is there something new here or just a new population being brought into that scheme?

Also, I keep reading everywhere - such as here: http://www.disabilityrightsca.... - that "County social workers will be required to conduct unannounced home visits for certain high-risk IHSS cases."

Is this what you are referring to?  That seems like Social Workers are required to make these unannounced visits in special cases, but not that Criminal Investigators were required to do so.  (Of course, if I understand law enforcement, generally they don't call first when they come to interview, do they?)

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by: Local_Observer @ Sat Nov 21, 2009 at 02:24:37 AM UTC

[ Parent ]

A little more clarification (0.00 / 0)

1) Don't know as I agree with the statement that fingerprinting social service recipients is a long standing tradition. I don't think Medicaid recipients, for example, get fingerprinted. But I could be wrong about that.

2) The requirements for fingerprinting, background checks, etc. are indeed state mandates, but DA Scully and a few other counties (such as San Diego) seem to be taking special enjoyment in implementing them.  Other counties, however, have not been so eager. For example, I understand that San Luis Obispo County officials turned down anti-fraud funds from the state beause they don't need them.

3) Sadly, this mattter of unannounced visits has gone  beyond the original intent of having social workers involved. State investigators from the Department of Health Care Services and other agencies--some in uniform--are making these visits. Many have been shifted away gfrom investigating nursing home graud. And, contrary to the language about doing this in "special cases," there have been reports of random checks by agents.

4) Finally, while it is true that law enforcement doesn't announce its visits,  I don't think Ms. Scully and others have thought about the consequences of having a uniformed agent pounding on the door of an elderly person with dementia.  

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by: stevefromsacto @ Sat Nov 21, 2009 at 03:28:31 AM UTC

[ Parent ]

Hmmm... (0.00 / 0)

"1) Don't know as I agree with the statement that fingerprinting social service recipients is a long standing tradition. I don't think Medicaid recipients, for example, get fingerprinted. But I could be wrong about that."

I haven't heard of any Medicaid recipients being fingerprinted, but recipients of cash-based benefits have been and are.  Ironically, although this program is a MediCal-based program (non fingerprinted program), it is entirely a cash-based program (fingerprinted type).  I think that's where the difference seems to be.

"2) The requirements for fingerprinting, background checks, etc. are indeed state mandates, but DA Scully and a few other counties (such as San Diego) seem to be taking special enjoyment in implementing them.  Other counties, however, have not been so eager. For example, I understand that San Luis Obispo County officials turned down anti-fraud funds from the state beause they don't need them."

As I understand it the Counties actually have to demonstrate how they will use the funds available from the State in order to secure the funding - it's not just you-asked-for-it-you-get-it - and those Counties with no program in place are unable to even do the asking because they have nowhere to put the money once they receive it.

"3) Sadly, this mattter of unannounced visits has gone  beyond the original intent of having social workers involved. State investigators from the Department of Health Care Services and other agencies--some in uniform--are making these visits. Many have been shifted away gfrom investigating nursing home graud. And, contrary to the language about doing this in "special cases," there have been reports of random checks by agents."

Are the agents doing random checks or visits based upon a fraud referral of some kind or just showing up at random homes?  And are we talking Sacramento County or other Counties?  What kind of visits have taken place in uniform and from what agencies, exactly?  I haven't heard about that.  What can you share with me?

"4) Finally, while it is true that law enforcement doesn't announce its visits,  I don't think Ms. Scully and others have thought about the consequences of having a uniformed agent pounding on the door of an elderly person with dementia."

That does sound scary.  Have there been any reports of "uniformed agents pounding on doors" of people with dementia?  Is there any safeguard in place that you know of to ascertain what kind of recipient the investigator is going out to visit?

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by: Local_Observer @ Sat Nov 21, 2009 at 06:19:56 AM UTC

[ Parent ]

Let's not lose sight of the big picture (0.00 / 0)

As a matter of fact, reports from San Diego County state that uniformed agents are knocking on doors. One IHSS client, a quadriplegic, reported that he was threatened with having his services cut off unless he responded immediately.  He was told by the agent that the visits were "random" and not based on any special circumstances.

But let's not lose sight of the big picture. The issue is whether the real incidence of fraud in IHSS, not illogical estimates and hyped individual cases but REAL numbers--justifies putting low-income elderly, blind and disabled people through all this and spending tens of millions of dollars of taxpayers' money.

I don't believe that either the governor or DA Scully have shown this to be the case. I do believe they are using this issue to score political points. I also think the governor may be trying to drive people out of the program. He originally wanted to throw more than 400,000 people out of the program, but the Legislature refused. Could it be that he's trying to do administratively what he couldn't do legislatively?

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by: stevefromsacto @ Sat Nov 21, 2009 at 17:49:47 PM UTC

[ Parent ]

Interesting (0.00 / 0)

That is an interesting story out of San Diego.  Do you have any links to any articles about that?

From the way you describe it it sounds like an investigator of some kind (IHSS?, DCHS?) knocked on a door and threatened to cut off services if the person didn't respond to the knocking?  I'd like to see more about this.

My understanding of MediCal (I was a MediCal worker years ago) as a program is that a person is required to cooperate with any questions as to initial eligibility or continued eligibility status or have services cut off and that is within the parent program - MediCal - so it stands to reason that would be the same requirement in IHSS.  No?  It sounds like there is nothing new here, then, with regard to the requirement to cooperate with determining eligibility.

But in the San Diego case, I wonder if the investigator didn't fully know what kind of client they were dealing with.  Again, was it an IHSS or DCHS or local MediCal investigator?

And do you know if the procedures of local Sacramento County investigators is to find out first what kind of IHSS client they are dealing with before knocking on doors?

As to the larger picture issue, I guess we need to see what the numbers are to make that determination.

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by: Local_Observer @ Sat Nov 21, 2009 at 23:46:50 PM UTC

[ Parent ]

more clarification (0.00 / 0)

The investigator was from DCHS. He left a phone message for the quadripeligic gentleman threatening to cut of IHSS benefits unless his call was returned immediately. During the subsequent interview, the investigator said he oculdn't understand why they would be called on to investigate a person like this, but that the visits were being done at "random."  

The investigator also said he had been working on nursing home fraud but was transfered to IHSS fraud. Good to know that we've fixed nursing home fraud.

Another example: A woman in El Dorado County had been caring for her adult son under IHSS.  Unfortunately, he died recently. Several  weeks later, she received a letter from the county demanding that she be fingerprinted.
Nice compassion,eh?

There are other ways to learn about these cases than from the media.  Hopefully, some reporters will soon uncover these and other outrages and let the public know.

You said: "I guess we need to see what the numbers are to make that determination."  I just wonder why we couldn't have determined what the real numbers are BEFORE we allowed this huge waste of taxpayer dollars and the demeaning of nearly half a million vulnerable Californians in name of "fraud prevention."      

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by: stevefromsacto @ Sun Nov 22, 2009 at 17:42:37 PM UTC

[ Parent ]

Verification? (0.00 / 0)

Re: San Diego: It doesn't make sense to me why the investigators would just go on random visits to random clients when there must be a very limited # of investigators working the entirety of San Diego County considering how few there are in the entire State and they all no doubt are working actual fraud complaints enough to keep them busy so the story seems awfully fishy.

Do you know if the same sort of 'randomness' applies here in Sacramento County?

Re: El Dorado County: I believe all recipients and all providers received the same letter from the State (DSS) - not individual Counties - explaining the fingerprinting issue at the same time.  It would seem to me that the lag time between (a) the death of recipient and (b) the paperwork wending its way through the system up into the State database is responsible for the fact that the State notification went out to this recipient.  The State database wouldn't know about the death of the recipient until the County knew about it and put it through their system and I imagine there is a lag for that.

Do you know anything more about this case?  Was that the issue here?

You say there are other ways to learn about these cases.  Where are you hearing about them?  Can you put any links to articles or the like on this site?

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by: Local_Observer @ Mon Nov 23, 2009 at 00:45:17 AM UTC

[ Parent ]

Enough Obfuscating (0.00 / 0)

OK, a few simple questions:

What is the percentage of actual, proven fraud in the IHSS program?

Does this justify these onerous new restrictions on low-income elderly blind and disabled?

Simple yes or no answers will do.

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by: stevefromsacto @ Mon Nov 23, 2009 at 16:55:47 PM UTC

[ Parent ]

No Obfuscating (0.00 / 0)

I don't think I'm obfuscating.  Quite the opposite, I'm seeking clarification of some of your points.  In some cases you have some information that helps to explain your concerns (anecdotal evidence in two Counties).  In other cases it appears that you are simply extrapolating uncorroborated events with what must be taking place here in Sacramento.

And it seems that you haven't yet provided any evidence that any Sacramento County agency is doing anything that looks like what your title suggests is going on.

Perhaps I am misunderstanding your points and all you mean to imply is that the State has mandated certain activities that concern you and Sacramento County hasn't done anything that would be concerning to you.  Do I understand you correctly here?

As to the #s, I don't have them.  Perhaps such will be forthcoming?  I understand your economic concerns.

Nice discussion, anyway.  These are issues that we should all be concerned about and I think we can agree on two things here: (1) Ensuring appropriate services for the appropriate recipients and (2) Preventing, Detecting and Prosecuting actual fraud that harms the program, its recipients and providers and the tax payer.  Yes?

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by: Local_Observer @ Mon Nov 23, 2009 at 21:15:04 PM UTC

[ Parent ]