State in-home aid to disabled on cutting block

07:50 PM PST on Thursday, November 20, 2008
The Press-Enterprise

More than 9,000 disabled Inland residents who rely on a state program for household help could lose assistance if lawmakers approve Gov. Arnold Schwarzenegger's proposal to cut caregiver wages and payments for some services.

Earlier this month, the governor announced that changes to the state's In-Home Supportive Services program could save the state more than $100 million and help reduce the estimated $11.2 billion deficit. He called lawmakers back to Sacramento for a special session to fix the problem, which he blames on the state's economic downturn and the stock-market collapse.

Changes to In-Home Supportive Services include reducing caregiver wages to the $8 per hour state minimum wage and requiring some higher-functioning clients to pay for household chores now covered by the state. Each county sets its own hourly wage, some of which are higher than the state's minimum wage.

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If approved, the cuts would begin in March.

The $1.5 billion program, operated by the California Department of Social Services, provides a variety of services to an estimated 408,000 elderly, blind and disabled residents statewide who cannot safely live at home without assistance. County social workers determine program eligibility, assess client needs based on their abilities and authorize a number of hours to be paid for each service identified.

Approved clients can hire a relative, friend or agency to perform the authorized services, including house cleaning, laundry, meal preparation and cleanup, bathing and dressing.

In-Home Supportive Services is an alternative to out-of-home care options, including nursing homes.

There are nearly 34,500 Inland residents in the program who received about 3.2 million hours of care costing $33 million last month, according to state records. About 9,300 of those clients, many of whom are poor Medi-Cal recipients, would lose or have to pay for household services.

Oscar Ramirez, spokesman for the state Social Services Department, said everyone knows program cuts dramatically affect people who receive them. But there are no alternatives, he said.

"This department, along with all the other state departments, has to make reductions," Ramirez said. "We want to make cuts that have the least amount of impact on our recipients."

County caregiver labor agreements have led to the biggest increases in the program over the past five years, he said. The state would save $83 million by reducing caregiver pay to $8 an hour, Ramirez said.

San Bernardino County pays program caregivers $9.25 an hour. Riverside County pays individual providers $10.25 an hour. It also contracts with a provider agency, which pays $16.45 an hour.

The state would save another $23 million if it stopped paying for some more able-bodied clients' household chores, Ramirez said. The move wouldn't be an overwhelming hardship because about half of all program clients hire relatives to provide their care, he said.

G.G. Crawley, deputy director of San Bernardino County's Department of Aging and Adult Services, said statistics show that the county's In-Home Supportive Services has grown by more than 100 cases each month since at least August. Program cuts would compromise the program, she said.

"Program cuts may prolong how quickly social workers can assess and authorize client services," said Crawley, adding that many people couldn't afford to pay for the help they get.

Helen Lopez, executive director of the In-Home Supportive Services Public Authority of San Bernardino County, said the labor contract with program caregivers allows the county to revert to the state minimum wage. However, the county would have to come up with $15 million if it chose to make up the difference between what the county and the state pay caregivers per hour, she said.

Program officials know the work caregivers' do is difficult and unpleasant, Lopez said. But she said she doubts the county could make up for possible program cuts.

"The economic environment is a mess," Lopez said. "Every 10 cents in wage increase is $2 million."

Sayori Baldwin, spokeswoman for the Riverside County Department of Public Social Services, said the county would have to come up with $35 million to cover caregiver wages if Schwarzenegger's proposal passes. She said she fears program cuts would endanger clients who could not afford to pay for services they now get.

"If clients are no longer eligible for services, who is going to go in and check on them?" she asked. "We can't assume they all have families to care for them. Some of these people live alone or they are elderly couples who both need services."

Household chores may seem easy, Baldwin said. But they aren't for people with limited abilities, she said.

"These are people who are low-income and on fixed incomes," she said. "They will not be able to afford to have someone come in and help."

Reach Lora Hines at 951-368-9444 or lhines@PE.com

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