Ex-felons as care providers


JUNE 15, 2010


Not long after the Sacramento County Grand Jury described In-Home Supportive Services as an “employment program for ex-felons,” prosecutors learned a number of IHSS providers taking care of aged, blind and disabled people were parolees – including dozens of registered sex offenders.

Assistant Chief Deputy District Attorney Lori Greene and Deputy District Attorney Laura West say law enforcement officials have repeatedly told them parolees and other people with criminal convictions work as IHSS providers.

West, who oversees the Sacramento County District Attorney’s IHSS Fraud Task Force, was further stunned to learn the only convictions that would bar someone from working as an IHSS provider are elder abuse, child abuse and fraud against a government health care or supportive services program.

“People who have serious criminal backgrounds and are on parole have a very hard time getting a job because most employers will want to know about previous felony convictions,” West says. “If you were on parole for armed robbery, rape or child molestation, you probably wouldn’t be able to get a job at McDonald’s, but you can get a job as an IHSS provider.”

The authors of a recent Sacramento County Grand Jury report – “IHSS: For the Needy Not the Greedy” – wrote witnesses told them fraud in the program is “out-of-control” and individuals with a criminal past constituted most of the providers who committed a “documented fraud.”

“Almost every person who was interviewed, and there were many, spoke of rampant abuses of the IHSS system,” Grand Jury Foreman Donald Prange Sr. wrote in the report. “At best, it is a dysfunctional system plagued by upper management who refuse to make meaningful changes or even to look into matters that will be beneficial to the truly needy people it is pledged to help”

The revelations come as Gov. Arnold Schwarzenegger, looking for ways to close a $20 billion budget shortfall, has proposed to cut $750 million from the IHSS program that provides in-home care services to 460,000 low-income seniors and disabled people. The cut, if ultimately approved, would bring total IHSS expenditures for 2010-11 down to $5.2 billion. The state also could lose $1.5 to $2 billion in federal matching funds.

While home-care worker union officials and others say hundreds of thousands of Californians could lose vital services and end up in nursing homes, critics say there is so much fraud in the program that the proposed cuts wouldn’t necessarily result in a loss of services to people who truly need help.

Schwarzenegger also claims fraud is “rampant” in the program – estimated by some to be as much as 25 percent of all dollars expended.

“Fraud in this program is real,” Schwarzenegger’s spokesman Aaron McLear says. “We have and will continue to reform the social programs in this state and with a $20 billion deficit we simply can’t afford these programs at the same level we have in the past. That’s why it’s important to reform the program so resources can be used as effectively as possible.”

In the last few years, grand juries and prosecutors statewide have uncovered fraud and a lack of oversight within IHSS.

“I think the whole program is one that needs to be carefully examined,” state Sen. George Runner, R-Lancaster, says. “This is a very unique program, most states don’t have a program like this and given the economic conditions we have today we need to look very closely at IHSS.”

But Laphonza Butler, president of Service Employees International Union United Long-Term Care, which represents 180,000 long-term care workers, disputes the 25 percent estimate, citing a 2008 report that found only 1 percent of IHSS cases involved fraud. Butler says the $750 million budget reduction will cut services to hundreds of thousands of people and eliminate jobs or reduce hours for more than 100,000 IHSS workers. As judges have blocked similar cuts in the past, Butler says the union is perplexed why the governor continues to push for IHSS cuts, especially when for every $1 the state spends on the program it brings in $2.70 in federal and county funds.

“While this proposed cut is much less than what was originally proposed, it’s still not acceptable and not humane,” Butler says. “When you are talking about frail Californians, vulnerable seniors and people with disabilities, any cut can be the cut that puts someone’s life at risk.”

Deborah Doctor, a legislative advocate for Disability Rights California, also disputes the governor’s contention that fraud is “rampant” in the program, arguing there is no proof for that assertion. Doctor says prosecutors who claim the program is rife with fraud have ulterior motives because their funding is based on making the “representation that the IHSS program is full of fraud.”

“It may be true that there are some people who have some history of a criminal conviction from some years ago who are working as providers,” Doctor says. “It may be that’s because their family members know about that and want them to work as their providers. I think the question would be is what is the nexus between a conviction – when we are talking about sexual offenders from some years ago – and taking care of someone on IHSS? Why would we make a blanket prohibition? We don’t want people who work as IHSS providers who are a danger to IHSS consumers, but our philosophy is that the consumers gets to make a choice.”

The state’s fastest-growing social services program, IHSS pays in-home caregivers – often family members and relatives – to provide services such as cleaning, meal preparation, bathing and grooming. Once someone qualifies, county social workers do an assessment and authorize the number of hours and type of services. The recipient is responsible for hiring the provider. The program operates on an “honor system.” Twice each month, more than 400,000 paper time cards are submitted to the government. Based on those time sheets, IHSS workers are paid $8 to $12.10 an hour with benefits.

“You have people who potentially have serious criminal backgrounds working in an honor system,” West says. “There is no independent verification of the hours worked. It’s an incredible opportunity for those who want to exploit the system.”

Created in 1979 to help people avoid costly nursing care, the number of people receiving IHSS services has more than doubled since 1998-99, increasing from 208,400 to 460,000 now. During that time, the IHSS annual cost per case increased from $6,300 to $13,000 – a cost driven largely by rising wages for IHSS workers and an increase in the average number of authorized IHSS hours per case.

This explosive growth in IHSS caseloads comes as the largest generation in history – baby boomers – starts turning 65 next year. In California, the number of people age 65 and older is expected to increase 90 percent in the next two decades from 4.6 million now to 8.8 million by 2030.

“There is already a great deal of pressure on the service delivery system in the state and the aging of the population will only put more pressure on the system,” says Sarah S. Steenhausen, senior policy fellow at The SCAN Foundation, testified in March at a Little Hoover Commission hearing regarding the system of care for state’s aging and disabled population. “The current (long-term care) system is broken. The system needs reforming, not reversing.”

The calls to reform the IHSS system come as the counties of Sacramento, Los Angeles, San Diego, Ventura, Contra Costa and San Luis Obispo in the last few years have launched grand jury investigations into IHSS fraud. The grand juries have found a variety of abuses, including IHSS recipients acting as their own “providers” and keeping the funds, providers claiming to “work” and receiving funds while the recipient is in a hospital and incarcerated providers collecting payments. The grand juries also found recipients and providers conspiring to increase hours, which were not worked, and split the pay, providers claiming hours when the recipient is dead and the use of fictitious Social Security numbers to create more than one IHSS case for payment.

From August 2009 through May, the Department of Health Care Services received 1,854 IHSS fraud complaints. However, that number doesn’t encompass all IHSS fraud reports throughout the state. For instance, Sacramento County alone received 1,158 IHSS fraud reports from July 2009 through May.

“We’re finding (IHSS fraud) all over the state,” DHCS Deputy Director of Audits and Investigations Bob O’Neill says.

In 2007, the Los Angeles County Grand Jury found scam artists were “embedded” in the program. In the last three years, the county’s Department of Public Social Services has referred about 900 IHSS fraud cases to the state for investigation. Prosecutors say many of those involved in IHSS scams are involved in abuse of programs to help the needy with child care, Section 8 housing and food stamps, as well as assistance through federal and state welfare and SSI programs. By defrauding various programs, prosecutors say welfare cheats can make up to $100,000 a year tax-free.

In a recent case, a Downey couple applied for Medi-Cal and IHSS, but on their application omitted the fact they owned a limousine business, travel agency and satellite installation firm, prosecutors allege. The couple was charged with operating a limousine business while receiving more than $68,000 in medical and welfare benefits, according to prosecutors. In February, the couple pleaded guilty to a felony count of aid by misrepresentation and were placed on five years of probation and ordered to perform 500 hours of community service, prosecutors say.

In her work on the Sacramento County District Attorney’s IHSS Fraud Task Force, West says detectives told her a number of parolees and registered sex offenders they monitor are employed as IHSS providers.

“They wanted to know if they could do that,” West says. “I confirmed they could and they were surprised to hear that. I’ve spoken to a number of people who work in law enforcement who when they are booking a parolee into jail list their job as an IHSS provider. I’ve also spoken to law enforcement officers who go to parole revocation hearings where the parolee says their job is taking care of a family member (as an IHSS provider). They argue that is a mitigating factor why they should not go back to prison.”

Sacramento County Sheriff’s Sgt. Mike Jones, who supervises the Sexual Assault Felony Enforcement Task Force, says SAFE monitors dozens of high-risk sex offenders who are employed as IHSS providers and are “getting paid to take care of people under some very suspicious circumstances.” Oftentimes, sex offenders will get jobs as IHSS providers for relatives who are “barely in need of assistance” and get $900 or more deposited into their bank accounts on a monthly basis, Jones says.

“I have spoken with many of them who are IHSS providers and are receiving funds from the program who can barely even tell me where they are providing in-home care at,” Jones says. “Not to impugn the program, but it’s wrought with fraud to quite an extent.”

In a recent report on the costs and benefits of the IHSS program, the Legislative Analyst’s Office found the program saves the state money for many recipients by keeping them out of nursing homes. A significant portion of IHSS recipients, however, would not face institutionalization in the absence the services, the authors wrote.

“After accounting for both costs and savings to the state and counties, IHSS probably results in net costs,” the authors wrote.

In a further effort to reduce costs, the governor included anti-fraud proposals in the 2009-10 budget to reduce and prevent fraud in the fast-growing program, including background checks and fingerprinting of IHSS workers and recipients. The reforms also called for speeding up the process to match death records with IHSS program records to prevent fraudulent payments after the death of a recipient or provider.

Late last month, the Assembly Budget Committee on Health and Human Services rejected Schwarzenegger’s proposed IHSS cuts. Meanwhile, the governor recently convened a stakeholders group to make specific recommendations on how the $750 million in cuts should be made.

West says none of reforms proposed so far address the fact that parolees and other people with criminal convictions can work as IHSS providers.

“One of our concerns is that we want to make sure people are not unwittingly hiring as providers someone who has a criminal record,” Greene says. “When you work in the criminal justice system, you realize that most people who have accumulated a record over the years of theft and violence can very easily continue along that path. So that’s a concern, but it’s not something we can do anything about based on the current status of the law.”


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  1. John Seiler
    John Seiler 15 June, 2010, 14:31

    Great article. And in the picture of Meg Whitman you used, when did she dye her hair brown?

    Reply this comment
  2. StevefromSacto
    StevefromSacto 15 June, 2010, 16:19

    The real statistics on IHSS fraud are far different than the governor and ambitious DA’s claim.

    For example, in Sacramento County during fiscal year 2006-2007, there were fewer than 400 reports of suspected fraud from more than 17,000 IHSS clients. That’s a rate of only about two percent. Of these reports, 31 cases were deemed worthy of prosecution. That means the rate of prosecutable fraud in Sacramento County for that year was approximately two-tenths of one percent.

    In San Bernardino County, a grand jury found approximately 60 fraud cases a year referred by investigators, in a universe of nearly 20,000 IHSS clients. Even if all 60 cases were eventually proven to be fraud, that would represent a rate of three-tenths of one percent.

    Even the governor’s own “Quality Assurance” survey in 2007 found a less than one percent incidence of fraud in IHSS.

    Any fraud is wrong and should be punished. But for a one-to-two percent fraud rate, the governor wants us to spend more than $40 million for so-called “anti-fraud” initiatives? For this, we should brand nearly 450,000 elderly, blind and disabled Californians and those who care for them as “fraud criminals”?

    Hell, no!

    Reply this comment
  3. StevefromSacto
    StevefromSacto 16 June, 2010, 10:07

    And one more thing…

    It is frustrating in the extreme to read the constant complaining in the right wing media that there are parolees out there who actually have jobs. It sounds as if the Rabid Right believes that these people should not have any rights…including the right to work…once they have served their time and have left prison.

    Maybe the solution is just to keep everyone in prison for life, regardless of their crime? Sounds like a great platform plank for the Republicans.

    Reply this comment
  4. Pray4Peace
    Pray4Peace 17 June, 2010, 15:12

    Thank God for ex-offenders who take on the job of IHSS provider that few of us are willing to do.

    The prisons, especially the immoral for-profit prisons, are upside down. They are rewarded with more business, more employees, and bigger budgets when they fail to do their jobs of rehabiliation and ex-offenders re-offend and are sent back to prison. Failed tough-on-crime policies, like the three-strikes law that does not work as voters intended, are bankrupting us.

    Donovan prison reduced their recidivism rate from 70% to 21% through their rehab programs. At $50,000 per inmate per year, consider the savings we realized because those people did not return to prison. We should measure the success of rehab, drug, and educational programs and fund those that work. It would save us millions in tax payer dollars and more important, prevent new crime and new victims.

    To those people who complain that ex-offenders should get a job, be grateful that many of them are changing diapers for the elderly and infirm.

    Reply this comment
  5. Adament
    Adament 1 July, 2010, 09:09

    I had a coworker who supplemented her (very good) income at our work by received IHSS payments for “taking care of” her mother and grandmother each day. I always thought we were supposed to care for our elderly family members without getting paid for it. While this may not be outright fraud, it is still surely wrong. Neither of the women was disabled to the point they needed real care. She drove them to doctor’s appointments. Her boyfriend of several years cooked (they didn’t marry, because she would have lost the benefits she received for daycare for her son). Her father, still at home and not disabled, did the cleaning. And my coworker got paid for eight hours each day for each woman. Wrong, wrong, wrong.

    Reply this comment
    • Amy
      Amy 14 January, 2016, 21:29

      I do believe you should take care of your parents when they are old. But to judge her for giving up her time and money to cook, clean and care for her parents so they don’t have to be in a nursing home. A nursing home cost $3500-6k a month from the government. Paying her $900-1500 a month to care for them is a substantial savings for the government, our tax dollars and rewards her for helping out. Nowadays, kids are selfish and do not care about their parents. This is also allows the parents to spend time with their families at home. I volunteer in a nursing home and its depressing when NO ONE comes to visit their old parents there..

      BE GRATEFUL for this program. It is so wonderful and benefits everyone. Of course frauds should be prosecuted.

      Reply this comment
    • slim
      slim 27 February, 2016, 13:48


      Reply this comment
  6. Vera Gonzales
    Vera Gonzales 9 October, 2010, 18:49

    My mother went through several providers who stole from her and put her in danger. Our family later found out they had records but yet passed a livescan background , we were told it was her (elderly woman) responsiblity to check on the person that is hired. I found much fraud going on in my mothers senior apt building. Many workers were not doing the hours, many would ask to have hours increased to get more free money and benefits. There is too much fraud going on I have seen it myself. The eldery are afraid to report them because they feel threatened, many are illegal immigrants.

    The whole system needs to change it seems to be a great way for felons to work and have access to eldery people and the little money they have. Something needs to be done these people are stealing.

    Reply this comment
  7. Sandra Siedenburg
    Sandra Siedenburg 3 November, 2010, 08:10

    I was a social worker within the IHSS program. I reported fraud by IHSS providers, IHSS clients, and even by county workers within my office which were substantiated by OCI.

    There is a lot of waste, abuse, and mismanagement within the program. I personally witnessed evidence of physical and fidiciary abuse by IHSS caregivers on the disabled, the elderly and children. A few of my clients even died due to this neglect.

    There are times that I still see the faces of my clients in front of me and I have to push their poor images out of my mind. Yes, I reported everything I saw but to no avail…..I’m still asking WHY?

    Mr. Browning you know I was telling the truth. I can only image what you told the civil grand jury. From what I understand workers in Lancaster wanted to speak to the Board of Supervisors recently about problems within DPSS but you were concerned that you would have to attend and didn’t want to come (I believe) to Lancaster. So concessions were made. What happened to transparency?

    Until the IHSS program is really scrutinized and overhauled clients will continue to be victimized and abused. Fraud will continue to grow. However the catch is if you try to disclose what is happening you will be persecuted and villified. Or worse, you will lose your job.

    Although I blame my job loss on Leo Terrell for his incompetent and unethical legal representation and practices…(Yes, Leo there is a Civil Service Commission and I would have known if I was going to be fired–you could have told me this instead of screaming at me during the mediation that I would be fired)…I believe that there were other forces at play.
    I can safely say that Los Angeles County administrators really do not care about IHSS fraud or abuse. And they will make evry effort to cover it up.

    P.S. Marcia, you told me to be “rest assured”. Honestly I never felt this way and after our last phone call I knew something was horribly wrong. It makes me feel so sad that you didn’t tell me what happened. I really was a good worker and all my evaluations proved this. I’m sorry that you felt you couldn’t tell me. I would have told you the truth.

    Reply this comment
  8. Lynold
    Lynold 4 March, 2011, 23:37

    What a novel idea. Let prisoners take care of prisoners.
    Man why didn’t somebody come up with the idea sooner?
    They are called PA’s. They have them in the military.
    Is it not good enough for prisoners?

    Reply this comment
  9. Cathy Mangum
    Cathy Mangum 18 December, 2011, 17:00

    I live in Texas and go thru an agency that provides me with home health care 22 hours a week. I have not had anyone for 3 months now, my next door neighbor who helps me out just as a kind person applied and the agency said she did not pass the background check.About six years ago she was convicted of theft of a habitat, they say because of that she does not pass the backgrond check. I have had othr people in the past that had records of credit card and check theft and they used them, and they passed.
    Why can’t my friend??

    Reply this comment
  10. Debbie R.
    Debbie R. 26 January, 2012, 13:31


    I disagree. This program helps those who cannot afford the in-home care they need. Do you REALLY know the extent of the aging family members medical conditions? I doubt it. In addition to that, the Mother AND the grandmother need assistance. Which I imagine can become overwhelming for the family. This is NOT wrong, as In Home Supportive services is just that. Services and assistance received in the home versus someone being placed in a facility where they will become neglected, perhaps even abused.

    I have a disabled son who is now 22, confined to a wheelchair. I retired early last year ( as he was no longer eligible to attend school ) so that I could stay home and care for him instead of throwing him in an adult day care program where again, he could become neglected, even abused. There is no way I could do that to him. I miss my job more than anyone knows. And my paycheck. HOWEVER IHSS allows me the income to be home with him and still pay our bills. Maybe not as comfortable as we were, but I thank God for this.

    Whether a person is employed full time, part time or not at all, it is a sacrifice to stay home and care for their family members. If something were to happen to me, I would expect my older son to do the same and take over.


    Reply this comment

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