Aging With Dignity with In-Home Support
By Dave Rosenberg
Yolo County Supervisor, 4th DistrictEveryone knows that California's population is growing by leaps and bounds. But California's population is also aging, and aging rapidly. Healthier lifestyles, life-prolonging medical advances, and the sheer numbers of baby boomers reaching retirement age will boost the number of Californians over age 65 to nearly 9 million by the year 2030. In addition, the fastest-growing segment of California's older population are those 85 and over. According to the Public Policy Institute of California, this age group is projected to more than double in the next 30 years.
With this growth comes a question: How will families care for their dependent elders, particularly those on limited incomes? Is institutionalization the only option?
Fortunately, there is one social services program that is designed to partially meet this challenge-the In-Home Supportive Services ("IHSS") program. Since 1973, IHSS, which is funded by state and federal dollars and administered by counties, has made it possible for eligible seniors and other dependent adults to avoid institutionalization and continue living safely in their own homes by providing them with the services of a visiting home-care worker. These workers provide help with shopping, housekeeping, cooking, and transportation as well as personal care services such as dressing, eating, bathing, toileting, taking medications, care of prosthetic devices, and even respiration.
Today in Yolo County, the IHSS program provides assistance to over 700 clients each month totaling over 870,000 hours of service per year. The majority (66%) of Yolo County recipients are older women, with the remainder adults under age 55 with a small percentage of children under age 18.
Under state law, eligible dependent adults can receive up to 283 hours of IHSS home-care assistance per month. As in most parts of the State, Yolo County IHSS recipients must find and hire their own workers. This is referred to as the "IP" or independent provider mode of service. At this time, there are approximately 662 IP's providing home-care to the 700 IHSS clients in Yolo County. Under the current system, the recipient is considered the "employer of record".
For many years, home-care workers who are certified as IHSS providers have been paid minimum wage with no benefits. Locating and retaining such workers has been a challenge for many of the frail elderly in our community. However, recent changes in the law will fundamentally change how recipients and workers will be served by this important program. AB 1682 by then Assemblyman, now Congressman Mike Honda, requires all counties to act as or establish an "employer-of-record" by January 2003. Such reform will help in improving the services available to the frail elderly while also improving working conditions for home-care workers.
Recently, the Sacramento County Board of Supervisors took action to establish a "public authority" for its IHSS program, and home-care workers there voted overwhelmingly to form their own union. Yolo County is currently reviewing a number of options to determine the best way to reform our own IHSS program. As required by the enabling legislation, the Yolo County Board of Supervisors will shortly be appointing an IHSS Advisory Committee to assist in that process.
Whatever option is finally recommended and determined, the IHSS program will continue to provide opportunities for aging with dignity. Our elders and the dedicated, unselfish workers who provide this care deserve no less.