By Elaine Chen, The Sacramento Bee, May 26, 2020
Despite the difficulties of riding a bus due to her knee and back problems, Valentina Zakatova took one every weekday to Altamedix, an adult day center in Sacramento, before the coronavirus pandemic.
She and her family now are worried that state funding could be pulled from the center’s programming under Gov. Gavin Newsom’s revised budget, limiting her access to a place that makes her feel like a “full person.”
“For people like her who are living their last few years … they will feel very lonely if the government does not care about them,” said her daughter Natalia Chacon.
Newsom’s revised budget plan, announced earlier this month, seeks to close a projected $54.3 billion budget deficit brought on by the coronavirus pandemic. It includes about $646 million in proposed cuts that worry seniors and their advocates because they would reduce health care options and access to programs that allow elderly residents to stay at home and out of nursing homes, which have been hotbeds for COVID-19 outbreaks.
The proposed cuts would undo some of the goals Newsom outlined when he first presented his spending plan in January, when the state had been projected a continued economic expansion that would yield a budget surplus.
Now, “the state is not in a fiscal position to increase rates or expand programs given the drastic budget impacts of the COVID-19 recession,” Newsom’s office wrote in the revised budget.
Patricia McGinnis, executive director of California Advocates for Nursing Home Reform, said the proposed cuts are “taking away the only safety nets that we have to be able for (seniors) to remain at home.”
Newsom is appealing to Congress and the Trump administration for relief, but if California doesn’t get the help, the cuts could take effect.
Here’s a look at the programs that could be affected.
In-home care
California’s In-Home Supportive Services program, which serves 625,000 residents, pays caregivers to help residents with meal preparation, bathing, and other assistance around the house. The budget proposes to cut the number of caregiving hours that each resident receives by 7 percent, saving the state an estimated $205 million in the upcoming fiscal year.
California’s In-Home Supportive Services program, which serves 625,000 residents, pays caregivers to help residents with meal preparation, bathing, and other assistance around the house. The budget proposes to cut the number of caregiving hours that each resident receives by 7 percent, saving the state an estimated $205 million in the upcoming fiscal year.
Scott Boone currently receives 143 hours of care each month from two caregivers through the program. He suffered a stroke several years ago and relies on his caregivers to help him with exercises to increase his range of motion on top of housework.
“I can’t imagine them doing any less,” said Boone, 66, of Oakland. In fact, “I would like to have more hours.”
That’s a common sentiment among participants of the in-home care program, said Elizabeth Zirker, managing attorney at Disability Rights California. Many people who receive the maximum allowance of 283 hours per month still need more care, she said, “so the 7% is reducing from an unmet need already.”
A close friend of Boone, Suzanne Hinman, said “he could not live at home” without in-home care. She’s especially concerned about a reduction in hours because he lives alone and doesn’t have anyone who can immediately help him when his caregivers aren’t around.
Boone is also worried about a pay cut to his caregivers. Caregivers in Alameda County are paid an hourly wage of $14.75 through the program and as low as $13 in other counties, according to the department of Social Services website.
“I think the home caregivers are already underpaid,” Boone said. “They cut the amount any more, it would be a disservice.”
Adult day health care
The state’s adult day health care program, Community-Based Adult Services, funds communal spaces that offer medical care, social work, and recreation to 36,000 Californians. The budget proposes to entirely eliminate the program,which is projected to save $364.2 million in the next two fiscal years.
After the coronavirus pandemic subsides, Zakatova, 78, hopes she’ll be able to return to Altamedix in Sacramento. The adult day health care center is closed but continues to deliver meals and make telehealth calls to many of its 250 clients, said Altamedix’s program director, Sergey Ionov.
During normal times, Zakatova “does not miss any day, because she always feels like a full person over there,” Chacon said. “She always changes clothes. She asks me, ‘Can you buy a new dress or new pants? I will wear (them) for Altamedix.’ ”
“If she loses all these things, I can’t imagine how mentally she will be put down, because it’s not just relationships with people, it’s care, it’s medical services,” Chacon said.
Multipurpose services
California’s Multipurpose Senior Services Program is a broader program that connects seniors with services that can include in-home care and adult day health care, as well as other medical resources, transportation help, and home modifications such as grab bars. The budget proposes entirely cutting the program, which serves 11,000 seniors across the state, for an expected savings of $22.2 million in the next fiscal year.
Shawna Reeves, director of elder abuse prevention at the Institute on Aging, said the program is designed to help seniors receive comprehensive care while living at home instead of in a nursing home.
“These are the things that do exactly what the governor has been telling elders to do: stay at home, stay safe,” Reeves said.
Medi-Cal coverage
Newsom’s revised budget would trim some services offered by Medi-Cal, the state’s health care program for low-income residents.
The budget plan proposes reducing adult dental benefits to 2014 levels, which did not cover services such as partial dentures, gum treatment, and root canals on back teeth. The coverage reductions, which also include eliminating audiology and incontinence creams and washes, in total will save a projected $54.7 million.
Regardless of the state receiving more federal funding, the plan rescinds Newsom’s January proposal to expand Medi-Cal coverage to undocumented seniors and aged, blind, and disabled residents with incomes between 123 percent and 138 percent of the federal poverty level. Withdrawing these expansions from the budget is estimated to save the state $248.2 million.
Claire Ramsey, senior staff attorney at Justice in Aging, said the May budget plan in all “proposes severe and devastating cuts to the very programs that keep older adults and people with disabilities living safely in their home.”
Rosalio Ahumada of The Sacramento Bee contributed to this report.