June, 2004
My last column ended with the warning that we must keep up the pressure opposing the Governor's proposed cuts to the In Home Supportive Services (IHSS) program. Apparently, at least some of our policy makers are listening, because on May 20th 2004, the Assembly and Senate Budget Subcommittees both voted to reject the proposed cuts for this program. This was very encouraging news and one more step towards the goal of preserving these services for people with disabilities and seniors. It occurs to me that, I have been writing about this program for such an extended period of time that it would be useful to give a brief overview of where things currently stand.
Anyone who knows me will tell you that I have a tendency to start on page 5, and talk way too fast, when what I really need to do is start on page 1 and move through my explanations more slowly, so I can be sure people are following me. This becomes even more important when I'm writing columns and hoping that readers can follow along. What can I say? I'm a work in progress....
O.K, so, let's start on page 1. There are still many issues left to resolve when it comes to this program. Perhaps the most important of which is the issue of wages and benefits for workers. The Governor's proposal to end all State participation in wages and benefits for workers is still alive and well. If approved, it would bring provider wages back down to minimum wage. Counties with current contracts will maintain State participation in IHSS until their contracts run out. So, eventually wages will be brought down to minimum wage throughout the State.
Let's think about that for a second...IHSS workers earn an average wage of $8.50 an hour statewide. The highest paying County in the State is Santa Clara with a wage of only $10.50 an hour. Obviously, no one is getting rich working for the IHSS program, bringing the wages down even further is not only insulting, it's life-threatening for people who need home care.
Some have said that the proposal to reduce wages and benefits is directed at the State's home care unions because the Governor thinks they have too much influence on State politics. What the Governor fails to realize is that wages and benefits are consumer issues as well. The amount of wages and benefits offered to workers directly correlates to reduced turnover, a larger pool of workers and ultimately better health for consumers. I've said it before, and I'll say it again....home care keeps people out of nursing homes, and keeping people out of nursing homes saves the State a lot more money than they spend on this program.
O.K, O.K. I'll get off my soapbox...before I fall off.... but suffice it to say that wages and benefits for workers in this program, should be higher, not lower and the Governor's proposal will destroy the capacity of this program to reach the goal for which it was originally intended, to keep people out of institutions.
The Governor has also proposed "quality assurance" measures for the IHSS program. While there are ways every program can be improved, this proposal equates quality with a reduction in IHSS hours for people who need them, making this proposal more about cost containment than anything else. The Governor would like to see a 5% to 10% decrease in hours for consumers, and plans to hire 18 additional staff to investigate fraud within the program. Hmmm...will the new employees of this so-called "fraud unit" be paid minimum wage? I don't think so...
While a reduction in IHSS hours for recipients may appear to reduce costs, such appearances can be deceiving when you consider that many consumers need more hours than they are allocated by the State. Not to mention the costs to health care providers when consumers cannot get the care they need at home and develop additional health problems as a result.
This proposal brings up more questions than it answers. What Counties are already investigating fraud and what have we learned from them? How much will it cost to pursue fraudulent cases? Has there been an evaluation of this program that would justify the effort and expense of a fraud unit? Just a few things to consider if you are really concerned about the quality of this program.
If you would like more information about these proposals or other disability issues and join the CCCIL Advocacy Action Network. Members of the Network take part in advocacy activities to provide input to local, State and Federal policy-makers on issues of crucial importance to the disability community. Give me a call and I'll fill you in.