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The obscure California program that loses billions every year to scammers

In an exclusive investigation, we shine a light on one of California’s largest health care initiatives: the In-Home Supportive Services Program, or IHSS.

Thus far, coverage of fraud in California has focused on alleged schemes related to unemployment insurance, hospice care, and food stamps.

IHSS pays family members and other individuals to provide home-based care for the elderly and disabled— at a cost of nearly $30 billion per year.

California offers the program through Medi-Cal, its version of Medicaid, and pays providers with a combination of federal, state, and county funds.

On the surface, IHSS presents itself as an instrument of compassion, directing billions to caregivers who help with cooking, personal care, laundry, and other daily needs inside recipients’ homes.

But a growing number of experts and critics argue that the program is rife with fraud, losing roughly an estimated $6 billion to $12 billion yearly to scammers.

Meantime, the state’s powerful home-care unions collect more than $149 million in membership dues, funneling money into the political network supporting Gavin Newsom and California Democrats.

This is the story of a government that has allowed compassion to become a mask for fraud, creating a self-reinforcing system that keeps the Democratic establishment in power. 

In 1973, California created what became the IHSS program to provide in-home care to the elderly and disabled. The IHSS caseload exploded in the 1980s, prompting the state to impose hour caps on care providers.

IHSS has long been considered a magnet for fraud.

In 2009, then-Gov. Arnold Schwarzenegger estimated that up to 25 percent of IHSS claims were fraudulent. After growth of the program’s rolls exploded in the early 2000s, Schwarzenegger signed legislation aimed at curbing abuse.

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