San Francisco would have been the second most affected city in the state if the California State Assembly’s Conference Committee on the Budget decided to approve the governor’s proposal to cut $2.4 billion from in-home service care for seniors and disabled residents. Instead, the committee voted Tuesday against a major cut.
Earlier in the week and through the last two days of budget discussions, however, the in-home care program was up for coming to an end
Mission Loc@l took a look at that proposal and it’s impact on San Francisco.
“It’s a real tragedy, ” Patrick Hoctel, executive assistant at San Francisco’s In-Home Supportive Services Public Authority, known as IHSS, said in a telephone interview. “It makes no sense. With IHSS, the state had avoided the cost of expensive nursing home care.”
At present, the state spends on average $10,168 a year for patients who use in-home service care.
The proposed cuts were part of Governor Arnold Schwarzenegger budget plan to close the $24 billion deficit. The program is a statewide publicly funded benefit for low-income seniors and residents of any age who are disabled or blind.
It provides personal assistance so that people can remain “safely” in their homes and is considered a less costly alternative to nursing homes or board and care facilities
If the cuts were approved, Hoctel said, “seniors will only be able to turn to costly nursing homes or at the worst, we’ll find them on the streets.”
Nursing home costs in San Francisco range from $4,000 a month to $10,000 a month.
In San Francisco, 18,460 seniors and disabled residents would have been affected including 611 in the Mission District and Bernal Heights, according to the California Budget Project and the San Francisco Public Authority. In Alameda, 16,580 will be affected. Statewide, the cuts would impact 95 percent of the 440, 000 low income residents who use the in-home service program.
In addition, the proposed cuts would have slashed the wages of care providers to the state minimum wage of $8 an hour, plus 60 cents per hour for health benefits in counties that offer benefits.
At present, the in-home hourly wage and benefits in San Francisco is $13.39 an hour and the minimum wage is $9.79 an hour. Counties will be able to continue providing compensation above the state’s level of support, but would have to use their own funds.
Some 19,200 San Francisco residents provide home care services including 425 in the Mission District and Bernal Heights, according to Donna Calame, executive director, of the San Francisco IHSS Public Authority.
“It will have an effect on the workforce retention,” she said of the proposed cuts. “ If they can get a better job somewhere else they’ll go for it. This proposal is awful.”
The Chinese are the largest ethnic group in the county of San Francisco that use in-home services. They represent 38.7 percent of the recipients, whites including Russians, 28 percent, African Americans, 14 percent, Latino’s 8.9 percent, and other Asian groups 9.8 percent, according to the Public Authority for IHSS.
The cuts to recipients would have redefined the test for aid. The governor’s budget calls for providing services to “only the neediest” which means only 5 percent of the current caseload will continue to receive aid. The aid pays for care such as housecleaning services, errands, meal preparation and clean-up.
When a person becomes eligible for in-home assistance, a county social worker does an interview to determine the types of services needed and the number of hours the county will authorize for each of these services.
This assessment is based on the person’s ability to perform certain tasks with “Ranks 5 and 6 representing the greatest functional limitation,” according to Dan Bizovic, an attorney with Protection & Advocacy. “ Generally, the higher the functional index rating is, the more hours you need per task.”
The governor’s proposal retained the services for only ranks four and above.
That means disqualifying clients who receive a Rank 2, for example, which is for individuals who are: “Able to perform a function but need verbal assistance such as reminding, guidance, or encouragement” according to the guidelines outlined by the state .
It would also have excluded those “who can perform the function with some human assistance, including, but not limited to, direct physical assistance from a provider.”
Some 42.2 percent of the in-home service recipients who live in San Francisco have disabilities that require assistance with housekeeping tasks. And about one-fifth have severe impairments that require more than 20 hours per week of personal care.
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