January, 2004
Sometimes I wish I could be one of those people that have all their Christmas shopping done by June. You know the type, all their ornaments are homemade, and their cookie cutter collection would make Martha Stewart green with envy. I've come to accept that I will never have the time for that level of preparation for the season. Things seemed even more rushed this year, as I hit the mall looking for gifts. I knew I'd been shopping too long, when I realized I was seriously considering getting my 25-year old brother a Jumbo Snoopy Pez Dispenser for Christmas. He would appreciate the thought behind any gift, but he would definitely wonder what was going through my mind when I bought it for him. Not long after that I gave up and went home...leaving Snoopy at the store.
As crazy as things are this time of year, things seem even crazier in Sacramento. Which brings me to the topic of this month's column...the Governor's proposal for the elimination of the In Home Supportive Services (IHSS) Residual Program. Some of you may remember my column last month that gave a brief explanation of the IHSS program and it's importance to people with disabilities. Here's a brief review. The program provides services to eligible people with disabilities and seniors that enable them to live in their own homes rather than institutional settings. It has two components, the larger Medi-Cal Personal Care Services Program (PCSP) and the smaller IHSS Residual Program. A person who needs help with bathing, a personal care service, would be eligible for PCSP funding. But if he needs only non-personal care services like meal preparation, house cleaning or grocery shopping, those services are funded through the Residual Program. Services provided by PCSP are federally reimbursable under Medicaid, while the Residual Program is State and County funded.
Governor Schwarznegger has called for the elimination of the Residual Program based on the fact that there is no federal reimbursement to the State and County for services provided to recipients and the amount of people served is smaller than in the PCSP part of the program. Both of those things are true. The Federal government does not currently reimburse the State or County for the expenses of the Residual Program. The PCSP does serve more people. However, those facts alone do not illuminate the brutality of the Administration's proposal.
Here's what they aren't telling you. If the Residual Program is eliminated, over 74,000 California residents will lose their home care services. The Program pays the wages of parents who provide care for their minor children with disabilities and individuals providing care for their spouse. If those caregivers are forced to seek work outside the home because they can't be paid for the care they provide, their family member faces almost certain institutionalization. In point of fact, children and adults served under this Program tend to be persons with the most severe disabilities who are at a particular risk of institutionalization because of a lack of alternative providers. They may require protective supervision because of behaviors due to mental or cognitive disabilities that put them at risk of injury. The Residual Program currently pays for protective supervision services. The PCSP component of the IHSS program will not pay for protective supervision under any circumstances. If the program is discontinued, a recipient who receives protective supervision, or any recipient who receives services that do not involve personal care could see their care hours cut drastically.
The Residual Program also pays the difference between the Aged, Blind and Disabled Medically Needy Maintenance Need Income Level (MNIL) and the SSI/SSP grant level. For those of you drowning in alphabet soup, let me explain the above. Currently, the State pays the amount between the MNIL, ($600 a month for individuals and $934 a month for couples) and the SSI/SSP grant level, (currently $778 for individuals and $1, 382 for couples).
According to Protection and Advocacy Inc. (PAI), a Bay Area disability rights law firm, if the Residual program is eliminated, the monthly share of cost for individuals in the Medi-Cal PCSP program will drastically increase to all income over the MNIL, leaving an individual with only $600, and couples with $934 per month. The consequence of this proposed reduction in the amount of money people have to live on each month would be mass institutionalization. Some stakeholders disagree with PAI's assessment, saying that the impact would not be so drastic, but they agree that this is nonetheless an important issue.
So, what can you do about it? If you or your loved one receives IHSS, contact me and we can work together to determine how this cut will impact you and to tell your story to our State Legislators. Call (831) 757-2968 (voice) (831) 757-3949 (TDD) or email me at ddallimore@cccil.org.