"Policymakers need to see the faces of these vulnerable Californians as they crunch the numbers in budget discussions," Wallace added. "Further cuts are an assault on their independence. Slashing in-home and community care will also increase total health care costs as these seniors increasingly use emergency room care, are hospitalized or enter institutions ” under conditions that could have been prevented."

Budget cuts looming

California, which is home to the largest number of older adults in the country, has several programs funded by federal, state and local dollars to assist low-income adults with disabilities. Proponents of these programs say that while such care isn't perfect, it is far less expensive and more humane than the alternative ” placing seniors in publicly financed nursing homes.

Yet, IHSS program-hours were trimmed by 3.6 percent in January 2011, and they face further across-the-board cuts of 8.4 percent, plus additional targeted reductions in the governor's proposed budget. Adult day health care centers are slated for elimination, and supplemental security income cash benefits are to be reduced for single low-income aged and disabled individuals.

All the older adults in the study receive IHSS support, ranging from 20 hours of in-home help each month to the maximum of 283 hours per month. Most need help with household tasks, such as cleaning and cooking, and personal tasks like getting dressed or taking medications. Many require help getting in and out of bed, bathing and using the toilet. Some who might benefit from adult day health care or other supportive programs are unable to participate because of limited mobility or lack of transportation.

"California's current system to support old and young adults with disabilities at home operates in silos and is not person-centered," said Bruce Chernof, M.D., president and CEO of the SCAN Foundation, which is funding the study. "The Brown administration has an important opportunity to design a more stable, integrated, efficient and person-centered system that can meet the needs of these vulnerable residents throughout the state."

Source: University of California - Los Angeles