San Diego County In-home Support Services Process Analysis Report
The San Diego County Taxpayers Association has released the San Diego County In-home Support Services Process Analysis report which was conducted by Cobbweb Associates. On March 24, 2009 the San Diego County Board of Supervisors directed the County’s Chief Administrative Officer to develop a proposal to reform the In-Home Supportive Services (IHSS) program. This IHSS Process Analysis was conducted in parallel to the HHSA IHSS Reform Project, independent of the County’s project activities. On November 3, 2009 the Board of Supervisors unanimously authorized implementation of reform actions proposed by County staff and consultant Health Management Associates. Eight of these recommendations were wholly or partially credited to the San Diego Taxpayers Educational Foundation’s process analysis of IHSS including:
1. Modify, acquire or develop a new fraud database to improve internal tracking of fraud cases referred to the District Attorney and State Department of Health Care Services.
2. Establish clear expectations and guidelines for IHSS staff regarding fraud reporting.
3. Enhance IHSS fraud training for IHSS and San Diego IHSS Public Authority staff
4. Fully utilize fraud detection capabilities within new IHSS State computer system through development and use of custom reports, for example use of a report determining if multiple paychecks are being sent to one address.
5. Include new State fraud prevention mandates in all communications to IHSS recipients and providers so they are aware of higher level of surveillance and oversight in the IHSS program.
6. Leverage technology to improve processes including enhancing automatic referrals to the program (external and with partners), improving eligibility determination, and fraud monitoring, improving case management, monitoring of staffing patterns, identifying potential trends, enhancing monitoring, and improving linkages with other data “systems” such as Medi-Cal and CalWIN.
7. Expand performance measurements for the IHSS program.
8. Improve IHSS recipient satisfaction survey by ensuring questions are valid and results can be quantified.
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