Subscribe Donate

Tag: IHSS

Home | Newsroom |

California could boot thousands of immigrants from program that aids elderly and disabled

In Bell Gardens, Raquel Martinez said she has relied for nearly three years on a program that pays an assistant to help her make it safely to her frequent appointments at the MLK Medical Campus.

Martinez, 65, is blind and has cancer. If she did not have the help of her support worker, Martinez said, she would struggle to navigate the elevators and find the right office. Her assistant also helps her with groceries and other daily tasks such as housekeeping, she said, tending to her 21 hours a week.

“I was in need of a lot of help,” Martinez said in Spanish.

As budget cuts squeeze the state, California could yank such assistance from elderly, blind or otherwise disabled immigrants who have relied on the state’s In-Home Supportive Services program.

IHSS pays assistants who help people with daily tasks such as bathing, laundry or cooking; provide needed care such as injections under the direction of a medical professional; and accompany them to and from doctor’s appointments. It aims to help people remain safely in their own homes, rather than having to move into nursing facilities or suffer without needed care.

Gov. Gavin Newsom has proposed cutting immigrants in the country illegally from the IHSS program, estimating it would save California nearly $95 million as the state stares down a $44.9-billion budget deficit.

The proposed cut has outraged groups that advocate for immigrants and disabled people, which argued it would be a shortsighted move that would jeopardize Californians who need day-to-day support, put them at increased risk of deportation and ultimately drive up costs for the state.

READ MORE

Update on the 2020-21 California Budget

On Monday, June 15th, the California Legislature met the state constitutional deadline for passing the 2020-21 budget by approving a new state budget. At this time, it is unclear if the Governor will support the budget, as no deal has been announced.

The Legislature approved this budget to uphold its constitutional duty, but it is not the final version. The COVID-19 pandemic has caused unprecedented economic and public health uncertainty, and it has highlighted and exacerbated every existing inequity the state has failed to address. On top of the pandemic, social unrest calling for justice and equality for Black people has created a demand for leaders at every level to do things differently to dismantle entrenched white supremacy. If the Governor and Legislature simply ram through a budget deal, it will disproportionately harm Black people and other communities of color – as the economics of this state always do.

Forthcoming actions on this budget by the Legislature and Governor must take into account the needs of ALL Californians. The state’s economics must change — that includes increasing revenue through taxes on extreme wealth, and not making cuts to the programs millions of Californians rely on.

The budget approved by the Legislature rejects the vast majority of cuts proposed in the Governor’s May Revision budget, and includes several program expansions sought by advocates. The Legislature’s budget includes a trigger mechanism that is substantially different than the one proposed by the Governor. The trigger approved by the Legislature would not take effect until October 1, 2020, and will be “triggered” if the U.S. Senate and President fail to approve the $14 billion in assistance to states that the House of Representatives approved last month, on a bi-partisan basis.

To bring the budget into balance if federal leaders fail to deliver additional funding, the Legislature’s trigger would utilize reserve funding, deferrals of school funding, delays in previously approved spending, and state employee compensation reductions. It would not include most cuts to health programs, CalWORKs, SSI, IHSS, or programs for elders, which were proposed by the Governor. More details are available here.

The Legislature’s budget does include some program corrections, restorations, and expansions — notably, it ends the exclusion of immigrant workers with Individual Tax I.D. Numbers (ITINs) for the state Earned Income Tax Credit (CalEITC), restores the CalWORKs lifetime limit for adults to 60 months, provides another $350 million for homeless programs, and provides COVID-19 inspired CalFresh program simplifications and out-of-office technology advancements. All of these proposed changes are subject to ongoing negotiations, and until a “deal” is announced, we won’t know if they are in the final budget.

For health care, Western Center supports the Legislative budget’s rejection of cuts proposed in the Governor’s May Revision. The Legislature’s budget protects the health of California’s elders and communities of color in several ways. It does not reinstate the senior penalty by raising the Medi-Cal Aged & Disabled income limit, per last year’s budget. It rejects Medi-Cal benefit cuts and limits estate recovery, which disproportionately seizes homes from Black, Latinx, and API families. It also restores funding for the Black Infant Health program and for health navigators, and expands Medi-Cal to elders regardless of immigration status, though, Western Center would like to see that implemented sooner.

The Legislature’s budget recognizes the need to address the state’s homelessness crisis for unhoused community members, while also preventing additional homelessness. The budget allocates resources for traditional interventions, as well as funds to increase permanent housing options through the expansion of the low income housing tax credit, acquisition of hotels and motels which may appropriately serve as longer-term housing resources, and funds for the provision of legal assistance to low-income households that may be threatened with displacement or eviction. Given the magnitude of California’s housing challenges, which are compounded by the COVID-19 pandemic and ensuing responses, we look forward to building on this foundation.

PRESS RELEASE: California plaintiffs win case against state for failing to provide federally-mandated In-Home Supportive Services

FOR IMMEDIATE RELEASE

State must reimburse or pay Medi-Cal recipients and conduct statewide outreach to thousands of Californians who may be eligible for in-home services

 

LOS ANGELES — Thousands of Medi-Cal beneficiaries with significant disabilities will now be able to access affordable Medi-Cal care at home, rather than going to a nursing facility. In-home care provides greater stability and health outcomes for individuals and families, and it is cost-effective for the state; but it can be prohibitively costly to pay for out-of-pocket. As a result, married people with disabilities often have to make a draconian choice: impoverish themselves and their spouses or go to a nursing facility.

“My wife and I live primarily on a fixed income of pensions and social security; we exhausted our life savings and retirement accounts paying for my care,” said plaintiff Patrick Kelley, a 68-year-old U.S. Army veteran living with spastic quadriparesis. “My wife’s ability to work was severely limited by her caregiving responsibilities to me. We spent almost all of her limited income paying for my in-home care.”

Thanks to the successful lawsuit against the state, married people with disabilities will now learn about their right to Medi-Cal eligibility so they can stay at home with their spouse, receive care, and be reimbursed through the state’s Medi-Cal program for In-Home Supportive Services (IHSS). The court ruling makes it clear that the state must fully implement a federal law, known as the expanded spousal impoverishment protection, which should have been implemented as part of the Affordable Care Act in 2014.

“This ruling will dramatically improve the quality of life for disabled Californians and their family caregivers and will prevent many Californians from falling into poverty due to the high cost of in-home care,” said Kim Selfon, IHSS Client Advocate at Bet Tzedek. “Caregivers selflessly care for their disabled spouses with courage and compassion, often to the detriment of their own finances and health. They and thousands of others will now have the support they need to continue caring for their loved ones at home.”

The two plaintiffs’ situations illustrate the diversity of the thousands of individuals that will be impacted by the outcome of this case.

“The judge’s decision is a boost to Welfare and Institutions Code section 10500, which says agencies must secure for every person the aid to which they are entitled. As California’s population ages, in-home care will become increasingly important to the future of the state,” said attorney Cori Racela of Western Center on Law & Poverty.

Plaintiff Matthew Reed is a 63-year-old man with multiple sclerosis, Bell’s Palsy, and vascular dementia from a stroke. Due to the severity of his disabilities and medical condition, Mr. Reed is eligible for Medi-Cal home services, and should have had access to care without out-of-pocket costs under spousal impoverishment protections. Instead, he was required to pay more than $1,500 per month for care, which he cannot afford.

“If the spousal impoverishment rule had been implemented as it should have, Matthew could have been found eligible for free Medi-Cal and IHSS,” said Matthew Reed’s wife, Vicki Reed. “That means my son or I could have earned IHSS wages, sparing us incalculable stress and anxiety and giving us better options for Matthew’s home care and more financial resources. I don’t want any other families to go through what we have gone through.”

The Affordable Care Act set a deadline to expand spousal impoverishment protections to home-based care starting January 1, 2014. However, the Department of Health Care Services (DHCS) failed to issue any guidance about the rule until July 2017, after Mr. Kelley and Mr. Reed brought this lawsuit.

The ruling in Patrick Kelley & Matthew Reed v. California Department of Health Care Services, et. al., was issued by a Los Angeles Superior Court judge on January 14, 2020. It concludes that DHCS must a) notify beneficiaries who could benefit from the rule, particularly those denied or discontinued from Medi-Cal because DHCS failed to implement the rule on time; b) create a process for people to be found eligible for IHSS retroactively to the date they applied for Medi-Cal; and c) allow impacted individuals to be paid for home services they were entitled to during the delay period.

“Choosing between remaining at home without needed services, impoverishing oneself and one’s spouse, or moving into a facility separate from loved ones is no choice at all,” said Claire Ramsey, Senior Staff Attorney at Justice in Aging. “This ruling means relief for many who have struggled to stay at home and in their community and receive the services they need.”

MEDIA CONTACTS:

For plaintiffs: Allison Lee: Bet Tzedek, alee[at]bettzedek.org

Courtney McKinney: Western Center on Law & Poverty, cmckinney[at]wclp.org

###

About Bet Tzedek

Bet Tzedek is committed to providing free legal services to those that need them most. Bet Tzedek attorneys and advocates help people of all communities and generations secure life’s necessities. Wherever people are in crisis, Bet Tzedek’s core services and rapid response programs provide stability and hope. Founded in 1974, Bet Tzedek – Los Angeles’ House of Justice – helps over 50,000 people each year.

 

About Justice in Aging

Justice in Aging is a national organization that uses the power of law to fight senior poverty by securing access to affordable health care, economic security, and the courts for older adults with limited resources. Since 1972 we’ve focused our efforts primarily on fighting for people who have been marginalized and excluded from justice, such as women, people of color, LGBTQ individuals, and people with limited English proficiency.

About Disability Rights California

Disability Rights California (DRC) is the agency designated under federal law to protect and advocate for the rights of Californians with disabilities. The mission of DRC is to advance the rights, dignity, equal opportunities, and choices for all people with disabilities. www.disabilityrightsca.org.

About Western Center on Law & Poverty
Western Center on Law & Poverty fights for justice and system-wide change to secure housing, health care, racial justice and a strong safety net for low-income Californians. Western Center attains real-world, policy solutions for clients through litigation, legislative and policy advocacy, and technical assistance and legal support for the state’s legal aid programs. Western Center is California’s oldest and largest legal services support center.

This will close in 0 seconds