By Jovan Agee
After the nonpartisan Legislative Analyst's Office today released its report on Governor Arnold Schwarzenegger's proposed 2008-09 state budget, hundreds of Californians—all people who use or advocate for the state's In-Home Supportive Services (IHSS) program—criticized the unnecessary and drastic proposal for 18 percent cuts in vital domestic services. Those cuts would mean that low-income people with disabilities and seniors lose precious hours of help with meal preparation, clean-up, housekeeping, laundry, and food shopping, all of which make it possible for them to avoid or delay costly and unnecessary institutional care.
"Which day of the week should I go without my meals, Mr. Governor? That's what you and other lawmakers are asking me to decide if you go forward with these cuts," said Herb Meyer, 76, a disabled consumer of IHSS services in Marin County.
Individuals eligible for IHSS services have disabilities, are 65 or older, or blind, and are unable to live safely at home without help. The IHSS program uses state, county and federal funding to enable IHSS consumers to hire a caregiver. Most of the people who use IHSS also rely on federal funds called Supplemental Security Income (SSI), and state funds called State Supplementary Payments (SSP). They are among the 1.2 million blind, aged and disabled Californians who, who rely on this income for all of their living expenses; they cannot afford to pay for the home care services the state is proposing to cut.
People who rely on IHSS for home care and SSI/SSP are the targets of multiple cuts in the proposed state budget: the IHSS cut, no Cost of Living Adjustment for SSI; elimination of crucial Medi-Cal services; and cuts to other services and programs they rely on, including Adult Day Health Centers, and Adult Protective Services, among others.
Budget system must change to protect the poor
The coalition of home care supporters who rallied today at the state Capitol spoke out against the domino effect of multiple cuts and the unfair targeting of the poorest Californians.
"We need a fair balancing of this avoidable deficit crisis with a combination approach that includes raising revenue," said Frances Gracechild, Co-Chair of the Quality Homecare Coalition and Executive Director of Resources for Independent Living. "These across-the-board cuts are callous. When it comes to valuable programs like IHSS, state officials should stop blaming it on overspending. Increases in IHSS are largely pushed by demographic changes – California is growing and more people are living longer."
"For all those lawmakers who preach about performance-based budgeting, take a look at the IHSS program," said Joan Lee, Gray Panthers Statewide Liaison. "It saves the state money. It is not only a program that fits with what Californians expect for the most vulnerable residents of our state, but is responsibly managed and a good deal."
"Some of the tax relief that was prematurely given during the early Schwarzenegger administration should be returned by Californians who can afford yachts and expensive, luxury cars," said Bill Powers, Vice President of the California Alliance of Retired Americans.
Gov. Arnold Schwarzenegger cut taxes when he first came into office by what is now nearly $5 billion annually, and has never made up the revenue lost. Reinstating the "car tax" at the center of the Governor's first election in 2003 would have produced more than $20 billion for the state coffers by 2008.
Previous attempts to cut IHSS failed
"The IHSS program has always received bipartisan support, and is widely praised as a model state program for helping the elderly and disabled live independently," said Tyrone Freeman, President of SEIU United Long-term care Workers Union and Chair of the California Homecare Council. "So why attack the funding for this program now? Lawmakers should lead state residents to understand why raising revenue would uphold our nation's and California's values? It makes no sense."
Violation of landmark U.S. Supreme Court decision
The cuts to IHSS and Medi-Cal and SSI/SSP also undermine California's compliance with the 1999 U.S. Supreme Court decision in Olmstead, in which the Court told the states that unnecessary institutionalization of people with disabilities violates the Americans with Disabilities Act.
"How can the governor say he upholds the state's responsibilities to comply with Olmstead and at the same time cut the services which are at the very heart of any compliance?" said Deborah Doctor, Legislative Advocate at Protection and Advocacy, Inc. (PAI).
The cuts also harm workers who provide home care.
"We object to the Administration's prediction that IHSS providers will continue to provide these for free," said Senior Assembly Member Lola Young. "Home care is work and deserves to be compensated. We'll see a higher rate of worker turnover, a loss of services, and a reduction in their quality of life. Workers in the IHSS program already live in poverty and many are eligible for food stamps. Few have access now to health insurance."
"The Governor believes that family providers will continue to do the work for free," said Laura Reyes, President of United Domestic Workers/AFSCME. "I have two problems with that assumption: First, almost half of all providers in this state are not family providers, but they too will be uncompensated for their work. Second, family providers help the state achieve savings through the IHSS program just like non-family providers so why is the Governor trying to target this group of workers. If there were no family and non-family providers the IHSS program would fail to exist and we would see budget deficits like the one this year every year because you would have over 400,000 elderly and disabled people receiving care at a much high cost."
"The cut in IHSS hours means consumers will have a more limited supply of home care providers, making it difficult to remain safely in their homes and possibly forcing them into institutions such as nursing homes," said Gary Passmore, Executive Director of the Congress of California Seniors.
The 2005 report, 'Living Wages and Retention of Homecare Workers in San Francisco' by Candace Howes, shows that wages and especially benefits have a significant impact on the retention of providers. In San Francisco, when wages increased to $9 per hour and comprehensive health insurance was added in 1999, the one-year retention rate for new providers increased from 33 percent to 61 percent between 1998 and 2003.
Because of the Governor's cuts, some IHSS providers will lose their crucial health benefits; the cut in just a few hours of work could put them below the eligibility limits set by the Public Authorities to qualify for health benefits (San Francisco requires 25 hours of service per month and Marin requires 85 hours of service per month).
Background on IHSS
County social workers assess people for IHSS and can authorize up to 283 hours per month of services. Services include housecleaning, meal preparation, laundry, grocery shopping, personal care services (such as bowel and bladder care, bathing, grooming, paramedical services, accompaniment to medical appointments, and protective supervision for individuals whose mental status or cognitive functioning poses a threat to their safety and well-being). IHSS is the largest publicly funded nonmedical program in the nation designed to help impoverished people with disabilities, the elderly, and blind live safely at home.
The proposed cut is a double-hit on consumers in shared living arrangements who have already had their hours reduced. When IHSS consumers live with a roommate or attendant, the assessment of need for domestic and related services related to their safety is pro-rated and reduces the number of hours approved under the program.
Many consumers receive the maximum number of hours authorized for domestic and related services through the IHSS program:
Meal Preparation 8.68 hours/week
Meal Cleanup 1.75 hours/week
Laundry 2.50 hours /week
Shopping For Food 1.00 hours/week
Other Shopping Errands 0.50 hours/week
Total Hours per Week 14.43 hours/week
Total Hours per Week Cut at 18% Equals -- 2.60 hours/week
"The growth occurring in the IHSS program while partially due to changing demographics, is a positive indication that more people are receiving services in the community instead of being placed in nursing homes," said Ed Andreas, Chair, Nevada Sierra Regional IHSS Governing Board.
Proposed cuts contradict state's expensive IHSS Quality Assurance initiative; endanger safety
The Administration's IHSS Quality Assurance Initiative required the State Department of Social Services to develop Hourly Task Guidelines (HTGs), a standard guide and tool for county social workers to accurately and consistently assess service authorizations on a statewide basis and authorize services and time more equitably throughout the state. The HTGs established a normal range of time for certain tasks and a guide for granting time inside and outside the guidelines as appropriate to meet the unique needs of IHSS recipients.
The proposed cuts contradict those Quality Assurance Hourly Task Guidelines
"This proposed 18 percent cut to domestic and related services completely undermines the entire concept of conducting individual assessments to provide sufficient hours to—as the law requires—'ensure the health, safety, and independence of the recipient,'" said John Wilkins, an IHSS consumer in Fresno County and Co-Chair of the Quality Homecare Coalition.
Jovan Agee is the political and legislative director for the United Domestic Workers of America in Sacramento.
Source: California Progress Report
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