February, 2004
The response to last month's column regarding the In-Home Supportive Services (IHSS) Residual program was truly heartwarming. I received a number of calls and letters from both recipients and providers of IHSS services expressing their concern regarding the Governor's proposals. I rarely use words like heartwarming to describe anything. The word just seems a little too Rebecca of Sunnybrook Farm for my taste. But in this case, it describes perfectly how it felt to speak to so many people who are willing to work to preserve this program
As many of you may be aware the proposed cuts do not end with the Residual Program. In a move that stunned the disability community, Governor Schwarzeneggar has asked the Legislature to approve a plan that would essentially repeal the requirements of Assembly Bill 1682 that was passed into law in 1999. The law mandates that every County in California establish an "Employer of Record" for In Home Supportive Services providers.
The term "Employer of Record" is used to describe an employer for the purpose of collective bargaining with a union for wages, benefits and terms and conditions of employment only. The establishment of an Employer of Record in each County meant that care providers finally had the ability to bargain with Counties for higher wages and better benefits including health insurance. The large majority of California counties established agencies called Public Authorities to be the Employer of Record for IHSS providers in each County.
Public Authorities are independent public agencies that maintain registries of care providers and match these providers with people with disabilities and seniors who qualify for the IHSS program. While the Governor's proposal does not technically require that Counties eliminate Public Authorities, it makes optional the Employer of Record requirement, and eliminates State funding for the agencies. Counties may choose to continue to fund their existing Public Authorities, but given the dire fiscal crisis that most Counties are facing, it is very likely that many of the agencies will be unable to continue to provide services. It is important to note that the lack of an Employer of Record means that a provider cannot purchase health insurance, even if they want to pay for it themselves.
Unfortunately, the Governor's proposed cuts to IHSS do not end there. He has also proposed to reduce the level to which the State provides a share of cost for IHSS worker wages and benefits to the state minimum wage, currently $6.75 an hour. In theory, this does not directly cut wages, but since Counties will not receive funding to cover the State's share, it is likely that they will be forced to reduce wages and benefits when existing labor contracts come up for renewal. If this proposal is approved, people with disabilities and seniors will have even more trouble finding care providers because providers will be forced to leave the IHSS program in search of higher paying jobs. The long-term effect will be higher health care costs for recipients of care, up to and including hospitalization.
The Governor has based these proposals on the results of an unscientific survey that asserts that up to 25% of all paid services under IHSS may be unneeded. The survey ignores the fact that in order to be eligible for IHSS an individual must be "at risk" of institutionalization, and IHSS hours are authorized as the " minimum that an individual needs to live safely in their own home". Counties conduct yearly assessments, and have quality control and fraud detection as well. If indeed there is a problem with the assessment process, the elimination of the Residual program and a reduction in provider wages does nothing to solve it.
Well, what can be done about this? I recently attended a meeting where a variety of strategies were discussed, or should I say argued about. One idea was to send Legislators a Valentine telling them to "Have a Heart...Don't Balance the Budget on the Backs of People with Disabilities". The majority of advocates in the room immediately shot down this idea. Too Paternalistic...said some...Portrays people with disabilities as vulnerable....warned others. I actually like the idea; after all we are dealing with people's lives here and hence also their hearts. So send your legislator a Valentine today. Make the message whatever you want, but be sure to tell them how the proposed cuts will impact you. If you need help or even a Valentine, please contact me at (831) 757-2968 or ddallimore@cccil.org via email.