Quick Links OCRA PSA DDPSA Website Survey Donate Top 10 Pubs

Marin Independent Journal

August 31, 2009

Hundreds in Marin face in-home service cuts

By Jim Welte

Tho Pham cares for his son, Hieu Pham, in their San Rafael apartment on Monday. In-Home Support Services may face state budget cuts. (IJ photo/Frankie Frost)

Six years ago, Herschel Ferguson's life took a devastating turn for the worse. The Santa Venetia resident, now 65, returned home from his San Francisco State internship, felt light-headed and passed out. He'd contracted acute disseminated encephalomyelitis and spent the next three months in the hospital, briefly slipped into a coma and lost feeling in his left arm. His memory often fails him.

Ever since, Ferguson has received 15 hours a week of assistance from a caregiver in his home through the In-Home Support Services program, which is funded by federal, state and county money and is facing a rash of cuts in the wake of the state budget deal reached last month. The cuts were supposed to have taken effect Sept. 1, but have been delayed indefinitely by the state.

"If it wasn't for her, I wouldn't be able to get through life," Ferguson said of his caregiver. "It gives me an idea of what day it is when she comes. I couldn't get along without her."

The IHSS program pays caregivers to help low-income elderly and disabled people whose needs range from bathing and grooming to laundry, shopping and meal preparation. More than 1,600 Marin residents receive such services through the program, and a comparable number of people provide them, according to Kara Beuerman, acting program manager for adult and aging services with the county of Marin. Roughly 250 recipients face losing those services; another 200-300 people could see their service reduced.

Ferguson was among dozens of recipients and providers of in-home support services in Marin to crowd into the community room at the Corte Madera Town Center Monday for a forum on how to navigate the troubled waters created by the budget deal. The forum was organized by the Marin Center for Independent Living, United Health Care Workers West and Disability Rights California. Crystal Padilla of Disability Rights California gave a lengthy presentation on the changes to the formula used by the state and county to determine a recipient's level of need for in-home support services.

Once the cuts go into effect, recipients with a low "functional index score" will have their service cut. The score is based on an annual assessment of each recipient using both medical information and analysis by a county social worker. A separate assessment of how long it takes a recipient to do daily tasks, such as washing dishes and cooking meals, creates a ranking that will cause the additional 200-300 recipients to no longer have certain tasks paid for through In-Home Support Services.

Tho Pham and his wife (not pictured) must provide special care for their son Hieu Pham, Here, Hieu relaxes in the living room of their San Rafael apartment. (IJ photo/Frankie Frost )

Once the cuts take effect, recipients will be able to appeal the state's determination. And that is when things could get ugly, Beuerman told the forum attendees. In recent years, there were about one or two appeals per month, and with as many as 500 people in Marin slated to receive some level of cut, that number will likely skyrocket. A judge in Sacramento comes to Marin once a month to preside over appeals, she said.

"We are anticipating being backed up for months if not years," she said. "We are entering uncharted territory."

Recipients who appeal would not be cut until the appeal is processed, meaning that the state could continue doling out benefits to people long after the cuts go into effect. "That's how the law stands but I don't know what happens when the state runs out of money," she said.

The state has estimated it would save $82.1 million between Sept. 1 and next June by dropping some 100,000 recipients and cutting some services. For each month of delay, the state will lose $8 million in savings, according to state Department of Finance figures.

Tho Pham of San Rafael attended the forum in the hopes of finding out how the cuts would affect his ability to care for his 17-year-old son, Hieu, who is unable to care for himself. Beuerman said the cuts won't affect those who receive state subsidies to care for family members.

"Without this help, he would be isolated and severely impaired," Tho Pham said.