State Cuts to IHSS Brutal; Clients Must Appeal to Save Benefits

by Paul Hogarth on September 28, 2009

The human cost of the state budget cuts are about to be felt, and it isn’t pretty. On November 1st, thousands of blind, elderly and disabled California adults and children who rely on in-home supportive services (IHSS) will lose their benefits – unless they appeal to argue their needs. Supplemental Security Income (SSI) recipients already took a $30-40/month cut in their incomes in May, but now they stand to lose the assistance that keeps them alive – simply because they are deemed “too functional” to need them. Clients can request a hearing to keep their IHSS benefits and argue their lack of functionality, but the window period is relatively short – and the most vulnerable will obviously need assistance filling out the right forms. Others who don’t lose their IHSS benefits may get their Medi-Cal reimbursements slashed on October 1st, leaving them holding the bag to pay for the same service – while the state doesn’t expect those at the top to “sacrifice” in these hard times.

The IHSS program provides in-home assistance to low-income adults who are over 65 years of age, blind or disabled, and to children who are blind or disabled. Approximately 462,000 Californians receive IHSS services, from an estimated 376,000 providers. In San Francisco’s Tenderloin, having an IHSS worker make regular visits to an SRO tenant can make a real difference in “life-and-death circumstances,” allowing clients to get the attention they need – and stabilize their living conditions so they don’t become homeless.

A typical example is “hoarder and clutterer” cases we get among many SRO tenants in our neighborhood, who often suffer from dementia. Without an IHSS worker checking in on them and helping them with shopping, hospital visits and the like, the problem can only get worse – until their room becomes a health hazard, and the tenant gets evicted.

But as far as Arnold Schwarzenegger and Republicans in the legislature are concerned, it’s more important to cut off IHSS services – than to have a profit tax on oil companies.

This week, all IHSS clients will receive this form from the California Department of Social Services (CDSS.) The purpose is to assess how “functional” the client is, and if they are not deserving of an IHSS worker. An estimated 36,000 recipients with the lowest-assessed needs will lose all their IHSS services on November 1st. If you pass the functionality test, you will lose assistance.

Fortunately, there is an appeal period if the client is deemed “too functional” to receive IHSS assistance. Clients have 90 days to request a hearing to keep their benefits, if they fill out this form. But they really should turn it in before November 1st (when they lose their IHSS benefits), because the state will be obligated to continue their services if they have a pending appeal. Groups are organizing now to get as many clients to file appeals.

But even if a client wins their appeal and continues to get an IHSS worker, the service may end up costing them more. Under state law, many clients already pay for part of the service – but a portion is covered by a Medi-Cal “pre-payment.” Effective October 1st, state law would eliminate the Medi-Cal “pre-payment” – forcing the client to have to pay the difference. Some clients recently received a notice, saying that they will be forced to pay for these services this week. “Since this termination is the result of a change in state law,” said the letter, “it cannot be appealed through a State Hearing.”

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