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Contra Costa Times
October 5, 2009
By Thadeus Greenson/The Times-Standard
|Humboldt County protesters carry signs that say "Save In-Home Supportive Services" and "Keep Patrick's Point Open"|
Days are about to get a lot harder for more than 850 people in Humboldt County who depend on the state's In-Home Supportive Services program for assistance.
Facing a $26 billion budget deficit, state lawmakers approved more than $53 million in cuts to the state's In-Home Supportive Services program in July as part of more than $15 billion in cuts to state spending. Then, in signing the state's budget, Gov. Arnold Schwarzenegger exercised his line-item veto authority to cut another $28.9 million from the program -- funds intended to cover the costs of clients' help with domestic services like cleaning, meal preparations and shopping.
A county-run program, In-Home Supportive Services allows low-income, dependent adults to receive help from in-home caregivers and is designed to keep the state's seniors and dependent people in their homes and out of more costly assisted living facilities.
In Humboldt County, almost 1,800 people, from infants to centenarians, rely on IHSS for help with everything from cooking and cleaning to taking medications and bathing.
But, the combination of about $82 million in funding cuts to the program means some major changes are on the way, and some charge the changes are being handed down in a somewhat arbitrary way that does little to ensure that those with the greatest need retain services.
The county is required by the state to assign each of the program's clients a score -- called an overall functional index -- based on their ability to perform 11 physical tasks and three mental functions.
Clients who rate as a “one” are considered the most independent, and clients who rate at “five” are considered to be almost totally dependent.
The problem, local officials have said, is there are many things the scores don't take into account. The scores were designed as a way to compare counties' administration of the program, not to diagnose patients' needs or assess risk. Essentially, local officials say, the scores were designed to be a quality control tool, not to offer a complete assessment of patients' independence.
”They just don't give a complete picture,” Ninon McCullough, a supervising public health nurse at adult services, said in a previous interview with the Times-Standard.
However, the function index will be the barometer that determines who continues to get services through the program and who does not.
Under the new program guidelines, which are slated to go into effect Nov. 1, anyone with a function index below “two” will no longer receive in-home services. Anyone with a functional index score below “four” will lose domestic services, like help with housekeeping, laundry and shopping.
In Humboldt County, a total of 360 clients with functional index scores below “two” are slated to no longer receive their combined 11,361 monthly hours of services. And a total of 501 clients will no longer receive more than 6,000 monthly hours in domestic service assistance, according to numbers provided by the Humboldt County Department of Health and Human Services.
Cindy Calderon, a systems change advocate at Tri-County Independent Living, said many of those people will be at risk of having to enter assisted living facilities.
”This is huge because it will affect people's lives,” she said, adding that Tri-County has tried to get the word out, but many clients don't even know the reductions are on the way. “It's going to be a very nasty surprise when folks get those notices.”
The state is slated to begin sending out those notices in the coming weeks, notifying clients that their services have been reduced, or cut entirely. Calderon said Tri-County Independent Living will host a free workshop put on by Disability Rights California from 3 to 5 p.m. on Oct. 16, during which clients will learn how to appeal their notices and request a hearing.
”They are doing these trainings all around the state, and we called them and asked them to come here,” Calderon said. “What we're trying to do here is get the word out to people that change is coming, that there are steps you can take to protect yourself and your services, but you need to come in and get educated.”
Meanwhile, Disability Rights California is also challenging the state's budget cuts in court, having joined other disabled and senior-rights groups in filing a lawsuit in San Francisco federal court Thursday, challenging the state's plan to reduce aid to a total of 130,000 people in the program statewide.
Charging that the cuts amount to a violation of federal disability rights, the groups are requesting that a hearing be held on the case as soon as this week to consider an injunction to stop the state from mailing the notices alerting clients that their services will be cut.
The lawsuit claims that the Americans with Disabilities Act was created to eliminate discrimination against people with disabilities and the cuts to IHSS will actually increase the segregation endured by those who receive services.
”The proposed cuts are especially biased against people with mental illness, developmental disabilities and traumatic brain injury, who may need help just as much as people with physical disabilities,” said Melinda Bird of Disability Rights California, who is serving as lead counsel on the case, in a press release.