Find a
Nursing Home
Residential Care
/ Assisted Living
CCRCs Medi-Cal for
Long Term Care
Elder Abuse
/ Financial Abuse
Find an Elder Law Attorney

"State budget cuts amount to a ‘massive assault’ on home care"

Original source:

Marin Independent Journal

Richard Halstead
Posted: 11/17/2008 10:50:32 PM PST

A 1991 car accident left Ralf Vaughn, 48, of Mill Valley a quadriplegic, and he depends on an in–home support services worker to feed him and attend to all his personal hygiene needs.

"I wouldn’t be able to survive if it wasn’t for in–home support services," Vaughn said. "If it wasn’t for them, I would be in a convalescent home and would lose everything I have."

Vincent Barber of Novato spends about four hours a day caring for Vaughn. Barber, 39, also cares for two other Marin residents.

About 1,300 people work as in–home support workers in Marin, earning $11.30 an hour. Government funding covers health and dental insurance for 280 of these workers who consistently work at least 85 hours per month. But if a budget–cutting proposal debuted by Gov. Arnold Schwarzenegger is approved by the state Legislature, that hourly wage could be cut to the minimum wage: $8 an hour.

If implemented by March 1, Schwarzenegger estimates the cut would save the state $82.9 million in the fiscal year ending June 30, 2009, and $248.8 million the next year.

In addition, Schwarzenegger has recommended making some people who receive in–home support service care pay a larger share of the cost for the service. Most people who qualify for in–home support services, however, are below the federal poverty level, a maximum annual income of $10,400 for a single person, and pay nothing for the service. The governor has also proposed cutting state funding to in–home support service workers for "domestic" chores such as shopping, cooking and washing clothes.

"It’s a massive assault on one of the more important programs in California for keeping older adults and people with disabilities in their homes, independent and out of the evaporating nursing homes," said Larry Meredith, director of the Marin County Department of Health and Human Services.

Madeline Kellner, director of the In–Home Supportive Services Public Authority, said now is the wrong time to cut a government program that provides jobs at the low end of the income pyramid.

"We offer training programs for our caregivers and that allows them to be more skilled and have a career track," said Kellner, a Novato councilwoman. The authority maintains a registry of in–home support service workers and serves as the employer of record for the purposes of collective bargaining for wages and benefits.

If the state implements the governor’s plan, Marin County supervisors would face an unpleasant choice: either slash in–home support service workers’ pay or come up with the $3 million it would take to keep their pay intact.

The county of Marin contributes about 20 percent of the funding for in–home support services’ worker wages in Marin. The state and federal government share the cost equally for the other 80 percent. But it is the county of Marin that negotiates and signs the contract with the United Healthcare Workers union, which represents the workers.

"In our labor contract, there is a re–opener provision around a significant change in state and federal funding," said Marin County Administrator Matthew Hymel. He said it would be up to the Board of Supervisors to decide whether to exercise that option.

Hymel is optimistic that bridge will never have to be crossed. He said Schwarzenegger has proposed deep cuts in in–home support service funding several times before, and in each case the Legislature rejected the idea. The county’s Sacramento lobbyist has told Hymel that legislators seem to be reacting the same way this time.

"This has not gained traction even in the budget subcommittees of the Legislature," Hymel said.

Herb Meyer of Larkspur was among about 150 home care advocates who rallied on the steps of the Capitol in Sacramento on Veterans Day to protest the proposed cuts. A 1993 sailing accident left Meyer a quadriplegic.

Meyer, an outspoken advocate for in–home support services, has attended similar rallies in the past and testified before the Legislature. Despite past success, Meyer said the threat to the program is real: "The Schwarzenegger administration is very serious about it," he said.

The state has never been in more desperate financial straits.

The Legislative Analyst’s Office last week revised to $28 billion the estimate for the state’s budget deficit for the rest of this fiscal year and the one that runs from July 1, 2009 to June 30, 2010. That is $3.5 billion more than the estimate Schwarzenegger used in drawing up his plan. In addition, Schwarzenegger’s plan contained $4.4 billion in tax increases, which Republicans in the Legislature say they will not approve.

"The Republicans have taken the pledge; they’ve drunk the Kool–Aid. They are claiming that under no circumstances will they support a tax increase," Meredith said. "But without new revenues, I don’t know how you do it."

Meredith said it is far less expensive to keep people in their homes than care for them in a nursing facility, and quality of life is higher for people remaining in their homes.

Dale Kemp, an in–home support service worker in San Rafael who cares for her quadriplegic son, said she might not be able to continue caring for him if her pay is cut to the minimum wage.

"He would end up in a nursing facility on Medicare and the state would be paying for it," Kemp said. "He was in a nursing facility six years ago, and it cost four times as much. So home care is a budget solution."