Budget Cuts

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Who Will Care for the Caregivers?

By Kamal Menghrajani

Some paid caregivers are barely making ends meet. (Getty Images: Justin Sullivan)

Some paid caregivers are barely making ends meet. (Getty Images: Justin Sullivan)

Some people who care for vulnerable older adults are in dire economic straits, according to a new study [PDF] from the UCLA Center for Health Policy Research.

Hundreds of thousands of people provide care – from cooking and cleaning to bathing and dressing – for adults with disabilities or long-term illnesses who receive benefits from Medi-Cal. As it turns out, those who get paid for this work may not be pulling in enough money to make ends meet.

Geoffrey Hoffman, a researcher at the Center and lead author of the report said, “These paid Medi-Cal caregivers have incomes that are quite low compared to other Californians, about half as much monthly household income.”

“This aging population [of caregivers] is going to lead to great burdens on the health care system.”

He continued, “A third of them do not have health insurance. A number of them live in poverty or near-poverty, and, among those, a third of them have what is called ‘food insecurity’ – not enough food to put on the table every month.”

At issue is the amount that Medi-Cal is paying these caregivers. Even if you add income from other jobs, they earn a little over $11 per hour on average — close to minimum wage, and about two-thirds of the median income in California — making it difficult for them to live on their earnings. Many believe that the value of the care they provide is much greater than what they earn, but monetary constraints have led California lawmakers to decrease financial support for these services.

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Governor’s Budget: Health and Social Services Cuts

(Jupiterimages: Getty Images)

(Jupiterimages: Getty Images)

California’s Governor Jerry Brown released his budget for the 2012-13 fiscal year today and it includes “painful” cuts in healthcare and social services.

Reaction has been swift from groups that work on behalf of the poor and disabled.

From the HHS Network of CA, a coalition of organizations including the Western Poverty Law Center and Health Access:

We are appalled that Governor Brown’s solution to California’s budget crisis is $2.5 billion cuts to essential health and human services. Since 2008, California’s health and human services have suffered an astounding $15 billion in cuts, and this budget only continues the gutting of the social safety net that so many Californian families depend on. From our quick analysis, the Governor is making a $946 million cut to CalWORKS, an $842 million cut to MediCal, a $163 million cut to In-Home Supportive Services, a $447 million cut to child care, and $87 million in cuts to various other HHS services.

From Darcel Lee, Executive Director of the California Black Health Network:

Once again, the proposed budget balances the deficit on the backs of our most vulnerable communities,” said B. Darcel Lee,  (CBHN). “The number of uninsured in California grew to 7 million last year. At a time when so many families are struggling to make ends meet, we can’t afford to take away basic support programs for working families.

From the California Medical Association, reacting to the planned transition of children and teenagers in the Healthy Families Program to Medi-Cal:

“On one hand, Governor Brown is advocating for a 10 percent cut in Medi-Cal. On the other hand, he wants to add just under a million more young people to the program, which data shows is already struggling to meet the needs of the existing patients,” said Dustin Corcoran, CMA CEO. “The Medi-Cal provider network will simply not be able to accommodate this large influx of kids and teens. It’s unclear how anybody wins in that scenario.”

The governor is also calling for new taxes to close the budget deficit.  From Jean Ross, Executive Director of the California Budget Project:

The Proposed Budget includes major reductions in a number of critical areas, especially support for low- and middle-income Californians who need health coverage, child care, help in moving from welfare to work, or help financing a college education. Still, the governor should be commended for a balanced approach that calls for new revenue, instead of taking a cuts-only approach to addressing the state’s fiscal challenges.


How Lawsuits Can Stymie Some Trigger Cuts

By Sarah Varney

(League of Women Voters: Flickr)

(League of Women Voters: Flickr)

Trigger cuts have been the weapon of choice in many recent budgetary negotiations, most famously as the Congressional ‘Super Committee’ failed to come to agreement last month.

But in California, where Governor Jerry Brown yesterday announced nearly a billion dollars in additional reductions to state spending, that budget gun is jammed, as advocates for the elderly and mentally and physically disabled have managed to thwart the automatic reductions by asserting that the state’s severe cuts — some $15 billion to health and human services since 2008 — are beginning to violate federal law.

That defense has largely been the result of an aggressive legal strategy by disability rights groups, something witnessed recently when the state aborted a plan to eliminate funding for adult day health care centers in the face of a lawsuit by Disability Rights California. The centers offer health care services, shared meals and exercise among other activities and, most experts agree, help keep seniors and disabled people out of nursing homes.

The state cuts are running headlong into the Americans with     Disabilities Act.
But that’s not the only place where state lawyers are busy. Officials in Sacramento are also preparing to defend the recent decision by state lawmakers to reduce what it pays doctors who care for Medicaid recipients before the U.S. Supreme Court. Legal advocates also successfully sued in federal court to stop $100 million in automatic cuts to the state’s home care program for the disabled and frail seniors known as In-Home Supportive Services. A hearing has yet to be set.

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