HomeMy WebLinkAboutM-22-615 - IHSS Fraud MOU 22-23 Final.pdf M-22-615
1 INTER-DEPARTMENTAL AGREEMENT
2 THIS INTER-DEPARTMENTAL AGREEMENT is made and entered into this
3 day of , 2023, by and between the COUNTY OF FRESNO, through its
4 DEPARTMENT OF SOCIAL SERVICES, hereinafter referred to as "DSS" and the FRESNO COUNTY
5 DISTRICT ATTORNEY, hereinafter referred to as "DISTRICT ATTORNEY", both separate
6 departments of the COUNTY OF FRESNO.
7 WITNESETH:
8 WHEREAS, DSS and DISTRICT ATTORNEY have a need for coordination for investigations of
9 Early Prevention of In-Home Supportive Services (IHSS) fraud; and
10 WHEREAS, DISTRICT ATTORNEY has agreed to establish and organize an IHSS Special
11 Investigative Unit (SIU) for the purpose of early fraud prevention and suspected violations of law in
12 connection with the matters for which the IHSS program has responsibility as defined in Exhibit A,
13 "Summary of Services", attached hereto and by this reference incorporated herein and made part of
14 this Inter-Departmental Agreement, and to function as a liaison between the IHSS program and law
15 enforcement agencies (Welfare and Institutions Code § 12305.71); and
16 WHEREAS, DISTRICT ATTORNEY has the facilities, equipment, and personnel skilled in the
17 provision of such services,
18 NOW, THEREFORE, in consideration of their mutual covenants and conditions, the parties
19 hereto agree as follows:
20 1. SERVICES
21 A. DISTRICT ATTORNEY agrees to provide all early fraud prevention services as
22 specified in this Inter-Departmental Agreement and as set forth in Exhibit A.
23 B. DSS shall work with the California State Department of Health Care Services
24 Fraud Unit to obtain investigative services as needed with the California State Attorney General
25 providing prosecutorial services. DSS may request additional services from DISTRICT ATTORNEY,
26 which are not otherwise provided for in this Inter-Departmental Agreement, in writing, email is
27 acceptable, which DISTRICT ATTORNEY, at its sole discretion, may choose to provide. If DISTRICT
28 ATTORNEY is unable to provide said additional services to DSS when requested, DISTRICT
1 - COUNTY OF FRESNO
Fresno, CA
I ATTORNEY shall provide written notification, with justification or reason for declination of services,
2 within five (5) days to DSS. Compensation for any such additional services shall be mutually agreed
3 upon in writing as determined by the County of Fresno District Attorney, or designee and DSS Director
4 or designee.
5 C. All costs to DSS for services provided are auditable based on State and Federal
6 regulations.
7 2. TERM
8 This Inter-Departmental Agreement shall become retroactive to June 1, 2022 and shall
9 terminate on June 30, 2023.
10 3. TERMINATION
11 A. Non-Allocation of Funds - The terms of this Inter-Departmental Agreement, and
12 the services to be provided there under, are contingent on the approval of funds by the appropriating
13 government agency. Should sufficient funds not be allocated, the services provided may be modified
14 or this Inter-Departmental Agreement terminated at any time by DSS providing DISTRICT ATTORNEY
15 sixty (60) days advance written notice.
16 B. Without Cause - Under circumstances other than those set forth above, this
17 Inter-Departmental Agreement may be terminated by either party upon the giving of sixty (60) days
18 advance written notice of an intention to terminate. However, termination of this Inter-Departmental
19 Agreement shall not affect any active case services pursuant to this Inter-Departmental Agreement,
20 which shall be handled to their conclusion by DISTRICT ATTORNEY.
21 4. COMPENSATION
22 DSS agrees to pay DISTRICT ATTORNEY and DISTRICT ATTORNEY agrees to
23 receive compensation for 50% of total cost for services provided pursuant to Paragraph One (1) of this
24 Inter-Departmental Agreement and as identified in said Exhibit B, "Budget." For the term of June 1,
25 2022 to June 30, 2023, in no event shall actual services performed under this Inter-Departmental
26 Agreement be in excess of Two Hundred Ninety Five Thousand Eight Hundred Fifty Two and No/100
27 Dollars ($295,852.00). It is understood that all expenses incidental to DISTRICT ATTORNEY's
28 performance of services under this Inter-Departmental Agreement shall be borne by DISTRICT
- 2 - COUNTY OF FRESNO
Fresno, CA
I ATTORNEY, including but not limited to any and all personnel, equipment and supplies required in the
2 performance of these services.
3 5. JOURNAL VOUCHER REIMBURSEMENT
4 A. DISTRICT ATTORNEY shall request reimbursement from DSS based on an
5 invoice and a Journal Voucher submitted quarterly via email to: dssinvoices(a)co.fresno.ca.us, by the
6 151" of each quarter for the prior quarter's expenditures. Prior to submission to DSS, the Inter-
7 Department Journal Voucher and invoice shall be reviewed, approved, and signed by an authorized
8 DISTRICT ATTORNEY representative who is authorized to certify actual services were performed and
9 reimbursement requested represent actual costs. Requests for payment shall include supporting
10 programmatic and financial documentation with information including but not limited to monthly activity
11 reports, a year-to-date statement and back-up documentation, a summary of charges which DISTRICT
12 ATTORNEY is seeking reimbursement, and copies of the supporting documentation for the period(s)
13 during which costs were incurred.
14 B. Reimbursement for services rendered under this Inter-Departmental Agreement
15 shall be in arrears and shall not be made until said Journal Vouchers, invoice, and supporting
16 documentation, as identified hereinabove, are received and reviewed by DSS. If the Journal Voucher
17 or invoice is incorrect or is otherwise not in proper form or substance, DSS shall have the right to
18 withhold payment as to only that portion of the invoice that is incorrect or improper. DSS agrees to
19 reimburse DISTRICT ATTORNEY quarterly in arrears, within forty-five (45) days after receipt and
20 verification of DISTRICT ATTORNEY's invoice.
21 C. Once the journal voucher and backup documentation have been reviewed and
22 approved for payment by DSS, DSS Finance shall prepare an Inter-Department Journal Voucher to
23 reimburse DISTRICT ATTORNEY for their expenditures. The Inter-Departmental Journal Vouchers
24 shall be subject to County, State and Federal audits.
25 D. All costs shall be supported by properly executed payrolls, time records,
26 invoices, vouchers, orders or other accounting documents pertaining in whole or in part to this Inter-
2 7 Departmental Agreement and they shall be clearly identified and readily accessible. The support
28 documentation must indicate the line item budget account to which the cost is charged.
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1 6. MODIFICATION
2 Any matters of this Inter-Departmental Agreement may be modified from time to time by
3 the written consent of all the parties without, in any way, affecting the remainder.
4 7. NON-ASSIGNMENT
5 Neither party shall assign, transfer or subcontract this Inter-Departmental Agreement
6 nor their rights or duties under this Inter-Departmental Agreement without the prior written consent of
7 the other party.
8 8. MEDICAL PRIVACY
9 All services performed by DISTRICT ATTORNEY under this Inter-Departmental
10 Agreement shall be in strict conformance with all applicable Federal, State of California, and/or local
11 laws and regulations relating to confidentiality including, but not limited to: California Welfare and
12 Institutions Code Sections 10850 and 14100.2; the CDSS Manual of Policies and Procedures, Division
13 19-0000; the California Department of Health Care Services (DHCS) Medi-Cal Eligibility Procedures
14 Manual, Section 2H; and the Medi-Cal Data Privacy and Security Agreement between the California
15 DHCS and the County of Fresno, Agreement No. A-19-429, by this reference incorporated herein, to
16 assure that all applications and records concerning program recipients shall be kept confidential and
17 shall not be opened to examination, publicized, disclosed, or used for any purpose not directly
18 connected with administration of the program. Agreement No. A-19-429 is available upon request or
19 can be viewed at: http://www.co.fresno.ca.us/MediCalPrivacV/. DISTRICT ATTORNEY shall inform all
20 its employees, agents, officers, subcontractors, Board of Directors members or partners of this
21 provision; and that any person knowingly and intentionally violating this provision is guilt of a
22 misdemeanor.
23 9. RECORDS
24 DISTRICT ATTORNEY shall assume responsibility for maintaining detailed records to
25 support its invoices to DSS for services provided under this Inter-Departmental Agreement. DISTRICT
26 ATTORNEY shall provide DSS with access to said records for audit purposes. Furthermore,
27 DISTRICT ATTORNEY shall retain said records for a minimum of six (6) years following the expiration
28 of this Inter-Departmental Agreement. In the event of any outstanding State of California or Federal
4 - COUNTY OF FRESNO
Fresno, CA
1 audits or exceptions, DISTRICT ATTORNEY agrees to retain its records until such audits and
2 exceptions are finalized.
3 10. COMPLIANCE WITH APPLICABLE LAWS AND REGULATIONS
4 DISTRICT ATTORNEY, its officers, consultants, subcontractors, agents, and
5 employees shall comply with all applicable State, Federal, and local laws and regulations governing
6 projects that utilize Federal Funds.
7 11. NONDISCRIMINATION
8 During the performance of this Inter-Departmental Agreement, shall not unlawfully
9 discriminate against any employee or applicant for employment, or recipient of services, because of
10 race, religion, color, national origin, ancestry, physical disability, medical condition, marital status, age
11 or gender, pursuant to all applicable State of California and Federal statutes and regulations.
12 12. RELATIONSHIP OF PARTIES
13 It is understood that this is an Inter-Departmental Agreement by and between two (2)
14 separate departments of the County of Fresno and is not intended to and shall not be construed to
15 create a relationship of agent, servant, employee, partnership,joint venture or association.
16 13. ENTIRE AGREEMENT
17 This Agreement, including all Exhibits, constitutes the entire Inter-Departmental
18 Agreement between DSS and DISTRICT ATTORNEY with respect to the subject matter hereof and
19 supersedes all previous agreements, negotiations, proposals, commitments, writings, advertisements,
20 publications, and understandings of any nature whatsoever unless expressly included in this Inter-
21 Departmental Agreement.
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1 IN WITNESS WHEREOF, the parties hereto have caused this Inter-Departmental Agreement
2 to be executed by their signatures below.
3 ATTEST:
4 COUNTY OF FRESNO COUNTY OF FRESNO
DEPARTMENT OF SOCIAL SERVICES DISTRICT ATTORNEY
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8 Sa, a BudbV, Director L a A. mitt p,Dfitrict orney
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Fund/Subclass: 0001/10000
21 Organization: 56107630
Account/Program: 7295/0
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— 6 — COUNTY OF FRESNO
Fresno, CA
Exhibit A
COUNTY OF FRESNO
IHSS FRAUD
SUMMARY OF SERVICES
ORGANIZATION: Fresno County District Attorney
SERVICES: IHSS Early Fraud Prevention
CONTRACT PERIOD: June 1, 2022 —June 30, 2023
CONTRACT AMOUNT: $295,852
ADDRESS: 3127 N. Millbrook Avenue, Fresno CA 93703
TELEPHONE: (559) 600-5045
DISTRICT ATTORNEY: Lisa A. Smittcamp
Protect Description:
The Fresno County District Attorney's office (DA) shall provide to the Fresno County Department
of Social Services (DSS) the following services through this Inter-Departmental Agreement:
1. Early Fraud Prevention services; and
2. Reporting on outcome of case disposition; and
3. Training and Provider Orientation Outreach.
Through this Inter-Departmental Agreement, the DA shall receive state and/or federal funds
through DSS for reimbursement of IHSS early fraud prevention activities.
Early Fraud Prevention — incidents that require a preliminary investigation and education
awareness to a provider and/or recipient about IHSS rules and regulations, which are alleged to
have been violated and would constitute fraud if continued or involved a larger dollar amount.
DA Responsibilities:
DA responsibilities shall include, but not be limited to, the following:
1. Staffing
a. The DA shall provide two Senior DA Investigators and one Investigative Technician
position for the IHSS Early Fraud Prevention Program.
2. Early Fraud Prevention
a. Investigate a minimum of 25 Early Fraud Prevention referrals each month per
senior investigator. Referrals may include but are not limited to overstated claimed
hours, fraudulent electronic signatures on electronic timesheets within the
Electronic Services Portal (ESP), and accounts fraudulently opened in ESP.
b. Perform field investigations of suspected fraudulent activities as described above
by gathering, assembling, preserving, and reporting facts and evidence.
Exhibit A
c. Locate fraud suspects, witnesses, and other informational sources; evaluate all
statements.
d. Provide education to individual(s) about the rules and regulations of the IHSS
program and advise individual(s) of the potential consequences that would result
from a repeat offense.
e. Submit Early Fraud Prevention dispositions, including the above information and
all activities completed or not completed, to DSS within 60 days of receiving the
referral (see Section 4, Reports).
f. Appear at Fair Hearings as needed to describe physical and/or cognitive abilities
of person(s) investigated.
3. Training and Provider Orientations
DA will attend all scheduled in-person IHSS Provider orientations and IHSS Social Worker
induction trainings of IHSS Program and IHSS Public Authority staff to provide education
regarding "red flags" to look for in determining fraudulent conduct. Information to be
presented includes but is not limited to:
a. Fraudulent activities within the IHSS program
b. DA's Early Fraud Prevention activities and processes
c. Process of reporting suspected fraud
4. Reports:
DA shall submit reports to DSS as follows:
a. Early Fraud Prevention dispositions shall be returned to DSS upon completion of
activity and within 60 days of receipt. Reports shall include detail of activities
completed and not completed, and if not completed a detailed description of why.
These reports shall include, but not be limited to, the following information:
i. Use of appropriate language interpreter services
ii. Unsuccessful attempts to make contact
iii. Source of report
iv. Description of home and recipient and/or provider, including any noted
safety concerns
v. Details from interviews with all parties and witnesses
vi. Observations of recipient and their functional abilities
vii. Accurate demographic and geographic details
viii. Mandated Reports completed for suspected abuse or neglect
1. SOC 341 — Report of Suspected Dependent Adult/Elder Abuse
2. BCIA 8572 — Suspected Child Abuse Report
b. Provide the DSS Finance Office with the quarterly DPA 266 Fraud Activity
Investigation Report and all relevant information pertaining to Early Fraud
Prevention investigations (column 5, All Other Programs).
5. Meetings:
DA shall meet with DSS program monthly to triage referrals, exchange pertinent
information, resolve problems and work together to effectively coordinate services.
Exhibit A
DSS Responsibilities:
1. DSS shall provide in-service training for new DA staff to orient them to procedures and
regulations related to the IHSS Program as needed.
2. DSS shall ensure that DA is provided with all relevant information on each IHSS Program
beneficiary and provider under investigation or prosecution.
3. DSS staff shall meet with DA staff as often as needed to exchange pertinent information,
resolve problems and work together to effectively coordinate services.
4. DA shall update the IHSS& DA Fraud Referral Tracking log on a regular basis. Information
on the log includes, but is not limited to:
a. DA and IHSS case numbers
b. Date of referral
c. Triage date
d. Investigator assignment date
e. Closure date
f. Reason for closure
g. Outcome of investigation
Exhibit A
Performance Outcomes:
Performance Measure Expected Level of Performance
Performance Measurement 1:
Referral Dispositions
Measurement Parameters: DA is expected to provide the disposition of
DA shall provide disposition or update on all completed referrals and updates on ongoing
referrals received from DSS. investigations for 100/o of referrals each
month.
Data Source:
IHSS & DA Fraud Referral Tracking log
Performance Measurement 2:
Early Fraud Prevention
Measurement Parameters: DA is expected to complete a minimum total of
DA shall complete a minimum of 25 Early 50 Early Fraud Prevention reviews per month
Fraud Prevention reviews each month per and provide dispositions of these referrals to
Senior Investigator. DSS within 60 days of receipt.
Data Source:
IHSS & DA Fraud Referral Tracking to
IHSS FRAUD SUMMARY OF POSITIONS
FY 2223
ORGANIZATION: FRESNO COUNTY DISTRICT ATTORNEY
SERVICES: IN HOME SUPPORTIVE SERVICES INVESTIGATION AND PROSECUTION
CONTRACT PERIOD: JUNE 1, 2022 -JUNE 30, 2023
BENEFITS TOTAL SALARIES
NO.of REGULAR AND BENEFITS
JCN TITLE POSITIONS SALARIES
1760 Senior District Attorney Investigator 2 $228,734 $237,578 $466,312
1758 Investigative Technician 1 $46,294 $44,418 $90,712
SUBTOTAL REGULAR SALARIES and BENEFITS 3 $ 275,028 $ 281,995 $ 557,024
TOTAL REGULAR SALARIES and BENEFITS 3 275,028 281,995 557,024
Overtime $523
TOTAL SALARY COSTS $557,546
IHSS FRAUD BUDGET DETAIL
FY 2022-23
ORGANIZATION: FRESNO COUNTY DISTRICT ATTORNEY
SERVICES: IHSS EARLY FRAUD INVESTIGATION AND PROSECUTION
CONTRACT
PERIOD: JUNE 1,2022-JUNE 30,2023
Account No. Account Name Amount
6000 Salaries and Employee Benefits
6100 Regular Salaries $ 275,028
6300 Overtime 523
6350 Unemployment Insurance 166
6400 Retirement Contribution 223,448
6500 OASDI Contribution 20,977
6550 Workers'Comp Contribution 3,110
6600 Health Insurance Contribution 33,857
6670 Benefits Administration 436
Total Salaries&Employee Benefits $ 557,546
7000 Services and Supplies
7039 Mobile Communication 2,473
mobile radio network access
7101 Liability Insurance 1,500
7265 Office Expenses 500
routine office supplies
7268 Postage 100
costs of mailing correspondence and legal documents
7286 PeopleSoft Human Resources Charge 418
7287 PeopleSoft Financial Charge 554
7295 Professional and Specialized Services 1,500
costs may include copies of vital records,court reporter/transcript services,
court interpreters,and skip tracing services
7296 Data Processing Services 12,772
computer network access,phone network and hardware,cellular voice and data
and software license renewals
7415 Transportation,Travel&Education 2,000
transportation,mileage,meals,and registration for program related in-state traveUtraining
7416 Transportation&Travel-Fleet 12,341
program investigator vehicle operation and maintenance costs
Total Services and Supplies $ 34,158
Total Appropriations $ 591,704
50%Match 295,852
DSS Reimburse 50%of cost 295,852