Welfare Fraud involves acquiring welfare benefits that are undeserved. Either the recipient is collecting benefits under their own name, but does not actually qualify for the benefits, or they are collecting the benefit on behalf of someone who is not actually going to receive the funds. Our office has a team of investigators dedicated to uncovering such fraud so that funds will be available to those who truly need it.
There are aged, blind or disabled persons who are limited in their ability to care for themselves and cannot live safely at home without assistance. This group includes those individuals who, with assistance, would be able to return to their home from a state hospital, skilled nursing facility, or a board and care home. The appropriate assistance may be provided through a county administered program known as the In-Home Supportive Services Program ( IHSS). The primary function of the IHSS program is to keep the elderly, blind, and permanently disabled, in their own home setting for as long as possible as opposed to In-Patient Long Term Care . This program is Medi-Cal driven and funded by the federal, state, and county governments, but administered by the local county. In San Joaquin County, this function is performed through the Human Services Agency (HSA).
IHSS fraud involves individuals who submit fraudulent time sheets for work they did not perform or were not authorized to perform. In San Joaquin County, allegations of fraud are investigated by the IHSS Fraud Task Force. This collaborative venture is comprised of California Medi-Cal Fraud investigators from California State Department of Health Care Services (DHCS), investigators from San Joaquin County District Attorney's Office Investigations Bureau (SJCDAI), the San Joaquin County District Human Services Agency (HSA), In-Home Supportive Services Unit (IHSS) Quality Assurance Fraud Unit staff, and their fraud investigators.