A $325 million county program that provides care for the elderly and disabled will undergo reform under a plan adopted Tuesday by the San Diego County Board of Supervisors.
The board unanimously approved a plan to reform the troubled In-Home Supportive Services Program.
Critics of the program call it wasteful, fraud-ridden and ineffective for the patients it was designed to help.
The basic idea of IHSS is to provide care for severely impaired people in the comfort of their homes instead of at medical facilities, which would be more costly for taxpayers.
California pays most of the cost of IHSS, but Supervisor Dianne Jacob estimated earlier this year that the county was on the hook for $43 million because state funding fell short.
"It's a state program that's out of control, that's gone beyond its original intention," Jacob said.
She said no one with the program has any accountability.
Only about 5,000 patients in the county meet the criteria for IHSS, the supervisor said. However, there are 25,000 recipients of such services in the county, according to Pam Smith, the county's director of Aging and Dependent Care.
Workers who help the patients do not undergo background checks, and there is no review of their timecards, Smith said.
Reforms approved by the supervisors will include background checks and fingerprinting for those on the IHSS payroll, she said.
Smith said $1.4 million in state funds are available for the county to make home visits to make sure IHSS patients are receiving the necessary care.
Supervisor Pam Slater-Price said there are limits to the public's largesse, and that annual increases in IHSS costs are diverting money from other programs designed to help seniors and children.
The county reforms are in line with changes being made in the program at the state level.
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