Don’t Let California’s Diversity Slip Through the In-Home Supportive Service Safety Net
By Assemblywoman Lorena Gonzalez
When it comes to delivering care to the aging population of a diverse state like California, a one-size fits all approach isn’t the best for our seniors or the most cost-effective for state taxpayers.
California’s successful In-Home Supportive Services program meets the needs of fragile seniors and people with disabilities throughout our state – particularly areas of great linguistic and ethnic diversity like the Mid-City South Bay communities found in the 80th Assembly District that I represent – by delivering client-driven care that respects each person’s language and cultural needs.
But if two proposals contained in the May Revision of the state budget are enacted, the IHSS program will be eroded and health of seniors like 86-year old Nam Nguyen of City Heights will be compromised.
Just a few years ago, Nam, who lives with Alzheimer’s disease, was living in a care facility. Nam is wheelchair bound, and without the support she needed to thrive, her health was deteriorating. Speaking only Vietnamese, Nam had a hard time communicating with the staff. She wasn’t able to stomach the unfamiliar food offered in the facility.
Through the Vietnamese community, Nam connected with Christine Nguyen (no relation), who became Nam’s caregiver through the In-Home Supportive Services Program. Now, living in Christine’s City Heights home, Nam’s health and happiness have improved. Nam is able to communicate her needs to Christine in her native language and her nutrition has improved because Christine prepares Vietnamese dishes that are familiar to Nam.
To meet the needs of a diverse state and to conserve taxpayer dollars by helping aging seniors and people with disabilities to stay home an out of far more costly institutional care facilities, we must protect and invest in smart care like IHSS. The IHSS program empowers clients to choose the caregiver that best meets their needs and stay healthy in their homes where they remain connected to familiar communities.
Earlier versions of this year’s state budget, however, would impose one-size-fits all solutions that disproportionately hurt elderly IHSS clients like Nam and undermine the continuity of care that helps keep clients with complex needs out of the hospital.
Even though state revenues are surging and the state has a multi-billion dollar budget surplus, the May revision maintains deep, across-the-board cuts to care that were made in the darkest hours of the state budget crisis. The cuts would leave each of California’s 450,000 seniors and people with disabilities who count on IHSS short of the care the state has determined they need to live healthy at home.
What’s more, our state cannot afford the proposal to put an additional strain on the most vulnerable IHSS consumers like Nam that require the most care. Some lawmakers are tempted to circumvent a new federal rule that says IHSS caregivers must be paid overtime like all other workers by adopting a cap on the number of hours each caregiver like Christine can work each week. That means people with complicated conditions like Alzheimer’s disease must find additional caregivers if they require more than 40 hours of work per week.
For elderly people who suffer from dementia, for example, the switch in caregivers can be confusing, upsetting and destabilizing. If a client is unable to find their own caregiver to take over after 40 hours, they must rely on a temporary pool set up by the state with no assurance that language or cultural needs will be met, even though these are critical to the client’s health.
Continuity of care has always been at the core of the IHSS program – with consistent and compassionate care, caregivers work to keep our seniors and people with disabilities healthy at a fraction of the cost of nursing homes. Undercutting IHSS hurts our older generations at the same time it hurts taxpayers by increasing health costs.
California is a growing and aging state: our population is increasingly composed of diverse people and a growing proportion of elderly residents. Nowhere are these trends more apparent than in my San Diego area district, where 50 languages are spoken in City Heights alone. I am proud to join caregivers, seniors and people with disabilities to stand up for cost-effective and strong In-Home Supportive Services care and ask my colleagues in the State Capitol to support overtime to ensure continuity of care as well as a restoration of funding for this critical component of our California’s safety net.
California State Assemblywoman Lorena Gonzalez, D-San Diego, represents the 80th Assembly District, which includes Mid-City and South Bay neighborhoods in the cities of San Diego, Chula Vista and National City, and chairs the Assembly Select Committee on Women and the Workplace.
My friend was accepted for In Home Supportive Services in December 2013. To date her caregiver, who is fully enrolled in the program, has not been paid. It seems like they don’t know what they’re doing. It took forever, after being accepted into the program, that we got a letter stating that we could actually start the program. I was paying the caregiver all the time up to then. Now the caregiver is trying to get paid going back to that December acceptance date. This program is a bureaucratic mess in terms of the time delays and also lack of communication. Her social worker has never returned one call. If our caregiver wasn’t willing to hold off on being paid by the month, I’d still be paying her. This program could be very helpful for seniors wishing to stay in their homes. But it takes forever for it actually to go into effect. Somewhat reminiscent of the time delays with the VA. Hmmm.
Thank you , thank you for your help in protecting the rights and securing community home care for our old folks… This is an important issue and many layers of flexible solutions can be practiced for the best interests of our aging, and dying, family members , NOT for the convenience of a bunch of impersonal bureaucrats.