Tuesday, July 22, 2014

Don’t cap hours for in-home caregivers

By Mariko Yamada

Rural Californians face challenges that differ from residents in urbanized areas. Along with beautiful views and wide-open spaces come limits in public transportation, fewer jobs and less access to health care providers.

Contained in Gov. Jerry Brown’s January proposed budget is an item that deals another blow to senior citizens and people with disabilities, especially in rural areas. This proposal should be rejected. Here’s why:

Circumventing a recent federal ruling that brought the state’s In-Home Supportive Services caregivers under the same overtime pay rules that govern nearly every other industry, Gov. Brown has proposed prohibiting this low-wage workforce from working more than 40 hours in a week. The limit would have a devastating effect on California’s 422,000 IHSS recipients, particularly in rural communities.

One of my constituents is Noel S. She is a blind 26-year-old who suffers from several mental disabilities and whose mother, Marilyn, has been caring for her around the clock since birth. Both survive on minimal authorized IHSS wages. Noel’s mother, her primary caregiver, is paid for the maximum number of hours allowable under current IHSS regulations, 260 hours per month, to keep Noel out of nursing home placement. The rest of her care is unpaid.

Under the governor’s plan, a person with chronic conditions or with a severe disability who requires more than 40 hours of care per week must find an alternate caregiver or rely on a state-run temporary pool to assign workers.

Limiting Noel’s mother’s work week is problematic. Besides the “transfer trauma” in transitioning to another caregiver at the end of a theoretical eight-hour shift, this family’s remote, rural location and the low IHSS wage pose significant barriers to accessing quality care. Anyone who has ever cared for a loved one with disabilities also understands that attending to their needs does not always fit an arbitrary “clock time.”

California’s rural communities are already challenged by health disparities. Older rural adults have higher rates of obesity, physical inactivity and food insecurity than their urban counterparts. These factors drive higher heart disease and diabetes rates in rural areas.

The IHSS program is essential for California’s strategy to reduce health care costs by better managing chronic conditions and preventing costly complications that result in hospitalization and nursing home care. The governor’s proposal undermines this commitment to our state’s aging and disabled populations, with troubling disparate impact on rural communities.

Gov. Brown’s proposal also undermines the ability of IHSS consumers to make choices about who provides their care, a decades-long IHSS Program tenet often cited for the program’s success. His proposal threatens to leave severely disabled Californians without care and at risk of costlier nursing home placement. The temp-pool concept is untested on a statewide scale, and there is no evidence as to the ability of caregivers willing to take clients if the job requires driving long distances to do a few hours of work at rates just above minimum wage.

While Gov. Brown has championed the state’s economic recovery, California’s poorest residents have not recovered from years of devastating budget cuts made in the darkest hours of the recession. This is especially true in rural California, where the impact of crippling reductions still hamstring the most basic services like health clinics, public transportation for people with disabilities, or keeping rural roads open and accessible.

California’s budget is back on track, with a projected budget surplus of $6.3 billion to prove it. But our comeback can’t be made on the backs of hundreds of thousands of the most vulnerable Californians. We must reject the governor’s proposal to cap hours for IHSS caregivers and instead work to strengthen the IHSS program, which saves both money and lives.

— Mariko Yamada, D-Davis, represents the 4th District in the California Assembly.

Special to The Enterprise


Discussion | 1 comment

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  • June 03, 2014 - 7:39 am

    I took a great class on gerontology last school year and it made me so made we don't have more basic classes on the subject. It's the millennials who should really be paying attention to this crisis(there are more of them than the baby boomers who are beginning to strain our medical and elder care facilities) going on in the caregiving industry. I think it's fundamentally a cultural problem that we're not educating ourselves on enough to be even close to capable of fixing it. (The guy in congress who represents elders or whatever didn't give the best answer about all the homes the state is tricking bereaved elderly into signing; thus tricking thousands of people into giving their home, via a document with power of law, to the state. The gerontology rep in the state just said, "well, they took the healthcare" when asked about what's the deal with the state taking the homes of medicaid recipients once they've died.

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