Oregon's state capitol building
Thousands of Oregonians who are elderly or living with a disability are being notified that their state-financed home care services will be terminated, or greatly reduced, on August 1.
Oregon Governor Ted Kulongoski has made a 9 percent, across-the-board budget cut to reduce the state’s $577 million deficit for 2009-2011, slashing the Department of Human Services (DHS) budget by $158 million and affecting thousands of elders and people living with disabilities (pdf).
A Loss for Consumers and Home Care Workers
“Absent legislative action, the proposed cuts will fundamentally dismantle a system that has long served as a model for effective, low-cost, quality care in Oregon and across the country,” said Abby Solomon, care provider division director, SEIU Local 503, Oregon Public Employees Union.
“Cuts of this magnitude will result in many seniors and people with disabilities not only losing services, but potentially losing their homes, their dignity, and even their lives,” Solomon continued. “At the same time, Oregon will be adding to the unemployment rolls as they reduce hours available for homecare workers to provide care.”
Eliminating and Reducing Home Care
Among the programs slated for elimination is Oregon Project Independence, which helps more than 2,000 people age 60 and older, or with Alzheimer’s or related dementias, live at home and forestall more costly nursing home admission. The program provides over 20 hours of services, including personal care, homemaker/home care services, chore services, and assisted transportation.
There are also plans to terminate the Medicaid Personal Care Program, which covers the cost of up to 20 hours per month of services for 1,200 Oregonians.
Also on the chopping block is Oregon’s Developmentally Disabled Family Support Program, which provides special equipment, respite, and in-home supports to families caring for a developmentally disabled child. About 1,000 families depend on this program, which helps them keep their child at home rather than in state foster care.
Other state programs will see a reduction in services, such as the In-Home Care Program, which serves 10,500 clients whose personal care assistance will be reduced by 75 percent.
“We expect to see a lot more people out there looking for work. With a reduction in care, a reduction in work, and a reduction in Oregon’s tax base, this is truly a lose-lose situation,” Solomon said.
Rescue by Federal Medicaid Extension Unlikely
According to the Oregonian, the state Legislature’s Emergency Board could “delay some cuts” and may hold “a special session in September to make adjustments to the across-the-board cuts ordered by the governor.”
The newspaper reports that “state leaders say they’re also hoping Congress will appropriate more money. But they’re not counting on it.”
An Associated Press article on the recent National Governors Association meeting in Boston states that the governors did not send another letter to Congress to urge them to extend the Federal Medical Assistance Percentage (FMAP) until June 11, 2011, as they did last February.
Support for extending the FMAP has waned among Republican governors, the article explains, because the “party is facing angry tea party advocates demanding less spending.”
Congress recessed before passing the FMAP, which would have enhanced the federal match to Medicaid.
– by Deane Beebe
Despite a budget crisis, Oregon made significant strides this year in reforming health care. Legislators passed two major reform bills and renewed funding for Oregon Project Independence, a state-run home-care program. 
“My passion for working with people with dementia, for making life better for them, has been my major motivating factor. But over time, I keep saying to myself: ‘It’s the direct-care worker, stupid,’” says Joanne Rader. “The only way to make the lives of people with dementia better is to improve the working lives of the direct-care workers. We need to put the things in place that let them provide relationship-based care.”
