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Receive and accept the Internal Control Review of the In-Home Support Services (IHSS) Program
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Published Notice Required? Yes ____ No _X _
Public Hearing Required? Yes ____ No _X _
DEPARTMENTAL RECOMMENDATION:
The Auditor Controller’s Office (ACO) recommends the Board of Supervisors receive and accept the Internal Control Review of the In-Home Support Services (IHSS) Program.
SUMMARY/DISCUSSION:
In accordance with the Internal Audit Division Fiscal Year 2016/17 Audit Plan, the ACO performed an internal control review of the In-Home Support Services (IHSS) Program. The review included evaluating the adequacy and effectiveness of IHSS internal controls, the procedures used to carry out assigned responsibilities, and compliance with applicable policies and standards.
IHSS is a statewide program administered at the County level by the Department of Health and Social Services under the direction of the California Department of Social Services (CDSS). IHSS is an entitlement program. This means interested individuals have the right to apply for IHSS services and are guaranteed services if they meet the financial and functional eligibility criteria. The program was created with the goal of providing those with limited income who are disabled, blind, or over the age of 65, with in-home care services to help them remain safely at home.
Based upon the ACO’s review, there were areas identified within the IHSS program requiring improvements to be in compliance with program mandates and to better achieve program objectives. Specifically, the ACO determined:
(1) The Supervisor’s review and approval of intake cases was not always documented;
(2) There is no process in place to randomly check provider’s timesheets;
(3) The process for administering directed mailings did not meet State requirements;
(4) Required unannounced home visits were not performed in FY2015/16.
(5) Managing fraud referrals needs improvement. This includes timely investigation of cases referred for suspected fraud and referring cases with potential overpayments of over $500 to the Department of Health Care Services (DHCS) for investigation;
(6) The minimum number of State required desk reviews and home visits were not completed; and
(7) Errors were noted on the Quarterly Quality Assurance/Quality Improvements report submitted to CDSS.
Pages 8 through 16 of the report provide a detailed description of the opportunities for improvement and the related recommendations. The recommendations will assist the parties to improve the effectiveness in administering the IHSS program.
FINANCIAL IMPACT:
The acceptance of this audit report has no financial impact.
ALTERNATIVES:
The Board of Supervisors could elect to not receive the report as presented. This alternative is not consistent with sound public policy and is therefore not recommended.
OTHER AGENCY INVOLVEMENT:
The Department of Health and Social Services has reviewed and accepted the report. Management’s responses are included within the Report. The County Administrator’s Office has reviewed the report.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION