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Half-million low-income elderly affected by sweeping cuts to state safety net

October 02, 2009

An 81-year-old San Francisco woman with dementia, little money and an equally aged caregiver sister who is suffering from cancer.

A 72-year-old Riverside woman with Alzheimer's who cannot be left safely on her own, forcing her son to cut back his working hours to care for her.

A 78-year-old Los Angeles man with Alzheimer's whose daughter will have to quit her job to take care of him if day care services are cut.

These are some of the hundreds of thousands of low-income seniors who are likely to lose income - and some of the tens of thousands who will also lose some or all of the in-home and supportive care they rely on - as budget cuts resulting from California's 2009 fiscal crisis go into effect starting Oct. 1, according to a new study by the UCLA Center for Health Policy Research.

Among the most vulnerable: seniors with Alzheimer's disease whose families rely on state-funded Alzheimer's centers that will soon lose all of their state funding. Also impacted are low-income seniors with disabilities, who often rely on a web of safety-net programs that both supplement their incomes and give them access to free or subsidized in-home care, say the authors of the new policy brief, "California Budget Cuts Fray the Long-Term Safety Net."

The research - based on recent data, published research and nearly two-dozen interviews with program and services experts - is the first comprehensive analysis of the likely impact of state budget cuts on California's disabled elderly.

"Our research finds that the state cuts to long-term care services are driven primarily by a quest for saving dollars that disregards the human impact of the results," said Steven P. Wallace, associate director of the UCLA Center for Health Policy Research and a co-author of the study. "These kinds of cuts hit our most vulnerable citizens: seniors with disabilities and low incomes who typically have no resources to fall back on and little in the way of additional family support."

Among the programs particularly affected by the cuts:

* Alzheimer's day care resource centers to lose all state funding
Centers that provide day care for more than 3,200 mostly low-income or socially isolated seniors with Alzheimer's disease will have to curtail hours of service or shut down altogether in response to budget cuts that go into effect Oct. 1.

* Supplemental Security Income (SSI/SSP) cut 8 to 10 percent
SSI is a cash assistance program for more than 500,000 very low-income people who are elderly, blind or permanently disabled. California has always supplemented the federally funded benefit using state funds (SSP). Cuts in the state portion will bring total cuts this year of the combined benefit to 8 percent for individuals (from $907 to $830 maximum benefit) and nearly 11 percent for couples (from $1,579 to $1,407).

* In-Home Supportive Services Program (IHSS) cut 30 percent
This program aids seniors with incomes above what is needed to qualify for SSI but still not high enough to afford in-home supportive services. IHSS provides a subsidy to help defray the costs of in-home personal care and essential household services that seniors are unable to perform without monitoring or assistance. As of Nov. 1, 30 percent of the 445,584 individuals of all ages enrolled in this program will lose some or all of their benefits; about 60 percent are elderly.

"We need lawmakers to rethink these punishing cuts," said Bruce Chernof, president of the SCAN Foundation, which funded the research. "With a rapidly growing older population, we need to make our publicly funded long-term care system more efficient and effective, and this report shows that the cuts do neither."

The state's adult day health care centers, which serve more than 37,000 seniors, were also scheduled for Oct. 1 cuts until a federal judge issued an injunction Sept. 11 preventing California from cutting services until its poor, elderly and disabled clients are provided other Medi-Cal services to prevent their institutionalization. However, many of the seniors who patronize these centers will still endure cuts to their SSI checks.

"It means the meal seniors get at an adult day health care center may be the only meal of the day," Wallace said. "They won't have the income they need to pay for all of their basic necessities."

The cuts to long-term care programs that support the low-income or disabled elderly are expected to shave about $500 million from California's budget. However, Wallace said the cuts may ultimately have the reverse effect, by forcing seniors further into poverty and, ultimately, forcing some into Medi-Cal supported nursing homes.

"As a state, we have two choices," Wallace said. "We can either help seniors live with dignity in their own homes, or we can reduce them to destitution and force them into nursing homes. Either way, the state of California is going to pick up the tab."

University of California - Los Angeles