Advocates for In Home Supportive Services (IHSS) – which provides Californians who are blind, disabled, or over the age of 65 with assistance to enable them to live safely at home – celebrated a recent court victory that rolled-back state budget cuts to the program.  But supporters say that new labor requirements and increased co-payments for IHSS participants will make things harder for the independent contractors who provide the service, as well as their clients.

In October, U.S. District Court Judge Claudia Wilken ruled that the state would violate federal law if it proceeded with cutting IHSS access to an estimated 130,000 Californians, because of the substantial harm that would result.  In the ruling the judge opined that funding reductions could result in essential services being withdrawn arbitrarily, and "people could lose something irreplaceable:  the ability to remain safely in their homes."  If the cuts had been allowed to take place, roughly 40,000 low-income seniors and people with disabilities would have lost all their IHSS services, including personal care; another 90,000 would have lost such services as meal preparation, food shopping and help with laundry and housecleaning.

              At a fall rally on the steps of San Francisco City Hall, IHSS supporters – including disability rights organizations and labor groups – showed their support for service providers and their clients.  Ken Stein, of the Mayor’s Office on Disability, told the roughly 100 participants that “the IHSS lawsuit has stopped the state, at least for now, dead in its tracks.  The emphasis here of course is on stopped rather than dead; think tranquilizer dart.  We still have a long way to go.”

According to Stacey Leyton, a lawyer for the labor unions that represented IHSS providers in the lawsuit, “there have been a lot of studies, by UCSF and others, showing that paying for nursing home care is five or six times more expensive than paying for IHSS.  And people who are in IHSS want to remain in their homes and be part of their communities; they don’t want to go into institutions.  California up until now has been a model for the U.S.” on home health care.  Attempts to cut IHSS are “extremely short-sighted.”  The state will “save money in the short term but it will be much more expensive in the long run.” 

Leyton noted that even with the court victory other challenges remain for IHSS providers and their clients. In late-October the California Department of Social Services announced that it would disqualify as IHSS providers individuals with past felony records and “some serious misdemeanors.”  The rule change followed a mid-September announcement that the state would cut a key subsidy to help cover the cost of IHSS providers.  The Sacramento Bee reported on one 74 year-old woman who “is among about 9,000 frail and mostly elderly Californians who must pay, on average, between $200 and $250 more each month to get the same level of care” as a result of the new policy.

According to Beverly Taylor, a Bayview resident who volunteers with Network for Elders, increases in co-payments will make it difficult for her to afford care for her husband, who has Alzheimer’s.  Taylor’s monthly pension makes her a member of what one City worker called “the upper poor.”  That pension doesn’t cover the mortgage payment on Taylor’s Ceres Street home.  “I can’t see why the IHSS co-pay is so high …I’ve put 50 years into the system [through taxes],” said Taylor, who felt that state budget cuts were being directed at “the ones who are most vulnerable…if I wasn’t getting food from food pantries I wouldn’t be eating.”

Hamdiya Cooks, an organizer with All of Us or None, which advocates on behalf of prisoners and convicts, believes that the new IHSS regulations are directed at the poor and people of color. In an email Cooks wrote, “It seems to me that the new high level restrictions being implemented by the IHSS program targeting already some of the lowest wage health care workers in the state amounts to attempted structural racism.  The new policy that would require IHSS health care workers to pay for their own background check fingerprints is an indication of a system targeting a people already living on the edge of poverty.”

Cooks shares an Excelsior District home with her brother, who was diagnosed with a mental illness when he was nine-years-old.  Now 50, he’s received IHSS services for the past five years.  According to Cook, many of the people she employs to care for her brother have a felony in their past.  “I have had not one problem whatsoever,” Cook said.  Given how challenging it is for individuals with a criminal record to find employment, Cook said that on the job “you are apt to do the best you can.”

According to Health Access California, a health care consumer advocacy coalition, this year the state cut more than $2 billion from California’s public health care system, primarily by reducing or eliminating services for low-income patients and providers, community clinics, HIV/AIDS and other programs.  At the same time California’s largest corporations were provided with tax breaks worth $2 billion annually, according to Jessica Rothhaar, State-Level Advocacy and Organizing Program Director for Health Access.  Rothhaar pointed out that the state’s tax rate was more progressive under Republican governors Pete Wilson and Ronald Reagan than it is today.