Elderly target cuts in human services, care

Rookie Assemblywoman Holly Mitchell got her initiation into Capitol politics this week when she chaired the first meeting of the budget subcommittee on Health and Human Services: She was met by a spirited crowd of wide-eyed, pleading elderly-health care managers complaining about the governor’s budget proposals.

The Los Angeles Democrat thumbed through a stack of documents – many of them complaints about the cuts. “These are letters I have received in the last 48 hours,” Mitchell said as she thumbed through an eight-inch stack of papers.

The care managers, along with a number of other health care professionals, urged Mitchell and other lawmakers to reject Gov. Brown’s proposed abolishment of the Multipurpose Senior Services Program, or MSSP, which manages health and social services for up to 11,789 disabled seniors every month.

News of the possible elimination of MSSP went down like salt on a $486 million wound already inflicted on the In-Home Support Services program, which brings medical services to seniors in their own homes at a lower cost than receiving the care in a nursing home.

While IHSS may be able to lick its own wounds and limp along, MSSP is slated for the grave as early as June of 2011, freeing up an estimated $19.9 million in the state’s 2011-12 general fund, confirmed Ginni Bella Navarre, adult services specialist for the Legislative Analyst’s Office.

The remainder of the program’s funding consists of federal funds — funds that would go unclaimed by the state upon the program’s elimination.

Case managers for MSSP coordinate health and social services for Medi-Cal recipients over 65 years of age who are certified to live in a nursing facility but instead choose to live at home.

The auditorium-sized room that housed Tuesday’s health and human services hearing was lined with case managers from all over the state’s 41 MSSP sites, including many from the governor’s hometown of Oakland, where the first MSSP site broke ground.

Karyl Eckles, director of the Oakland MSSP site, spent her one-minute time allotment telling the committee about her mother, who died peacefully at age 96 in her own bed. Eckles accredited the graceful death to the MSSP.

Social workers and nurses shared their most grueling memories of MSSP participants – dirty apartments, disintegrating bodies, stacks of neglected bills – and vowed eventual victories to the MSSP.

Eckles’ son, Jason Eckles, joked that Gov. Brown more than meets the age requirement for the MSSP.

“Nobody in here is a spring chicken,” he said.   

But they were preaching to the choir.

The new assembly member nodded attentively beside Assembly Aging and Long-Term Care Committee Chair Mariko Yamada, D-Davis, who sat in on the hearing. Yamada pulled several heartstrings during the discussion, noting that most of MSSP’s participants were women well into their eighties.

“Maybe the amount of money from savings on public employee cell phones could fund this program,” Yamada added.

Many argued that eliminating the program would leave current MSSP participants with no other option than to relocate to nursing homes – a consequence that would cost the state “hundreds of thousands of dollars more,” several people noted.

Advocates noted related programs like IHSS aren’t likely to reach those baby boomers who do not have family or friends to help them apply for and coordinate necessary health services, leaving the most desperate cases in the dark and expensive state-run programs unutilized.

Nursing homes are more expensive than at-home care, the California Department of Aging’s finance department said. But the department also noted that there is no real way of knowing just how many MSSP participants will be forced to flock to local nursing homes, how many will find care management elsewhere, or how many will simply go without care.
In the meantime, there’s an aging budget issue with ailments of its own.

And while nobody likes the details of the governor’s budget proposal, people appeared to be gaining optimism in the plan as a whole.

The number of Californians reportedly satisfied with Gov. Brown’s budget reached 58 percent in the most recent study by the Public Policy Institute of California. But how does that compare with the 75 percent who say they are at least somewhat concerned about the budget’s spending reductions?

Taking the middle ground, the LAO recommended that the Department of Aging, which oversees MSSP, cut $5 million from the program’s budget and negotiate with the federal government to make up for lost funds.