Caring for in-home support services

July 03, 2014

Silvia of San Ysidro is an In-Home Supportive Services (IHSS) worker caring for her 87 year-old mother who suffers from dementia. Her mother requires around the clock care, deep patience, a steady routine and unfailing love. The state helps pay for this type of care through the IHSS program because it is both significantly cheaper than out-of-home care, such as nursing homes or board and care facilities, as well as a more compassionate way to help our elderly.

Silvia’s mom’s advanced dementia requires the careful management of emotional and environmental triggers, some of which can evoke angry and depressed episodes. Silvia is best suited to effectively monitor her mother’s wellbeing with love, a familiar face, and an intimate knowledge of her mother’s personality.

Unfortunately, new regulations governing IHSS limit workers to 40 hours of work per week, and as a result, Silvia’s family is struggling to make ends meet. An inability to work overtime means Silvia’s family is required to hire an additional nurse, a financial impossibility. Silvia’s husband already works a full-time, minimum wage job, leaving Silvia with the difficult choice of finding additional employment at the cost of greater attention to her mother.

Silvia’s situation is not uncommon in San Diego or throughout California. There are over 350,000 people who provide in-home personal care assistance to about 440,000 individuals in need across the state. The population helped by IHSS is the most vulnerable: low-income seniors, the blind and disabled, including children with severe developmental disabilities or autism.

Why the overtime limit? In 2013, the federal government issued an order that required overtime pay to home health care employees. Because of the added expense  – $186 million annually – and the state’s fiscal situation, the Governor proposed to cap caregiver pay at 40-hours per week.

For many caregivers like Silvia, this puts an incredible financial and emotional stress on a family. For parents of autistic children, for example, who know their child has serious problems connecting with others, the 40-hour cap creates a tremendous burden. Like Silvia with her mother, parents are understandably reluctant to hand off their children to unfamiliar caregivers. They’ll continue caring for their loved ones while the hourly cap drives them into severe poverty.

As state finances rebound and our economy recovers, the IHSS program deserves to be fully funded, and workers deserve overtime pay beyond their 40-hour work week. It is unconscionable that the program meter out   sub-minimum wage pay. Such investment will even save the state money, as a lack of adequate care will drive patients into care facilities or increase the utilization of hospitalization or emergency room care. Investing in overtime pay for in-home caregivers is the right thing to do. Both they and the patients that they care for deserve this dignity and respect.