While the new rules still aren't clear and there are concerns about charging providers and clients, board members agreed that they'd lobbied for such broad reforms over the last several years in order to protect seniors and other clients.
“We are the county that initiated this, we are the county that asked for this,” said Supervisor Rob Brown. “They've created this legislation based on what Lake County has been pushing.”
Ruth Valenzuela, field representative with Assemblyman Wes Chesbro's office, discussed the new regulations with the board on Tuesday.
The new rules – which promise “significant changes” to the IHSS program – resulted from legislation enacted in July, Valenzuela said.
She explained that the legislation established some service reductions and changes, expansion of quality assurance and anti-fraud activities, reduction in support of public authorities and federal stimulus funding.
Gov. Arnold Schwarzenegger has been looking at the anti-fraud regulations for a long time, said Valenzuela.
However, she pointed out, “The burden is on the counties to do all these things.”
As of Nov. 1 the counties are supposed to begin implementing the changes, even though the rules aren't clear and the state hasn't given the counties the tools they'll need, said Valenzuela. “It's a real problem for a lot of counties, including Lake,” she said.
One of the biggest challenges relates to background checks, which will be required of all IHSS providers – not just those who are in a public registry, such as Lake County has. The local registry only includes those who volunteer for a $1 an hour more in pay, as Lake County News has reported.
There are costs for these services, but no mechanism for the county to charge to recoup the funds, Valenzuela said.
Besides costs, there's a concern about being able to get all new providers – estimated at 40 a month – run through the Department of Justice background checks. Valenzuela also noted that all providers must have the checks by next July 1.
Another gray area is who will be allowed to provide services. Those convicted of felonies will be excluded, said Valenzuela, adding that the state hasn't yet identified “what is acceptable and what is not acceptable, which is causing a lot of problems for counties.”
There will be unannounced home visits – which already have begun in some cases – to certain providers based on concerns over fraud, Valenzuela said.
The system also has a hangup about post office boxes, which aren't supposed to be acceptable for receiving providers' checks. However, as was pointed out during the meeting, in some areas of Lake County post office boxes are required because rural delivery isn't available.
Fingerprints will be required on time sheets, with both providers and recipients supposed to be fingerprinted for the program at their own expense. Valenzuela said new IHSS providers won't be paid until they've passed through all the background checks and training.
Chesbro and Assembly member Noreen Evans authored SB 69 to delay implementation and ask for stakeholder input so counties can determine what tools they need to implement the program. While it passed the state Assembly unanimously, it failed in the Senate, although reconsideration has been granted, Valenzuela said.
She said she wanted to know what the county's concerns are about the program so they can be forwarded to state officials.
Brown said the measures needed to be taken. “It has to be done because this is about protecting recipients.”
Valenzuela noted during the discussion that materials for the new program still are only available in English, with Spanish documents expected.
With the estimated cost per provider for a background check at $32,the board supported picking up those costs.
“For years we've been talking about these kinds of reforms,” said Supervisor Anthony Farrington, who didn't want to delay in implementing the program changes.
Michelle Dibble of the county's IHSS Public Authority said the county received the instructions on the program changes on Oct. 31 – a Saturday – in order to implement them by the following day, Nov. 1.
The county has implementation issues, including having to tell 10 providers that they may not be paid because it's unclear if they'll be allowed to participate. The county hasn't received the necessary tools for provider orientation, with Dibble explaining that the state gave them a CD that has information that conflicts with the criteria for the background checks.
“Our staff is poised and ready to act as soon as we have those things in place,” she said.
“We really have asked for this to be done for a couple of years, and now they have pretty much done exactly what we have asked to be done,” said Supervisor Jeff Smith, who wanted clarification on the issues but also wanted to move forward right away.
He added that he wanted to see the program ready to move forward by the start of the year, and was willing to see the county start to move its IHSS providers through the background checks at a pace of 300 per month in order to meet the July deadline. The IHSS Advisory Committee recently estimated there are nearly 1,600 IHSS providers in Lake County.
Brown supported paying for the background checks. Farrington estimated it would only cost between $18,000 and $20,000 for the county to pick up the cost.
“I think it is a good investment,” Farrington said.
“We're already paying a lot more right now,” said Brown, who maintained that the costs to investigate fraud against IHSS clients has a greater cost.
Andy Rossoff with the Senior Law Project, who has worked on IHSS-related issues over the years, said the background and fingerprinting fees are a lot of money to come up with when a person is unemployed.
He also was concerned that the delays would prevent seniors from getting the help they need.
Rossoff said there has been exhaustive discussions at the local level about what crimes shouldn't disqualify a person from being a provider.
He urged the board to take some time in deciding how to move forward. “Be careful of what you get,” he said. “You may be causing more trouble with the implementation if you do it without a lot of thought.”
County Administrative Officer Kelly Cox told the board that the county does need guidelines for the program changes from the state. “We really need them to act – soon,” Cox said.
Dibble was directed to get further information from the state on how the program is to operate and report back to the board early next month.
She also was directed to write a letter to the state offering county feedback on some of the new regulations based on local experience with IHSS.
E-mail Elizabeth Larson at
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