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Oregon's state capitol building

Contract negotiations between Oregon and the union representing home care workers there have stalled over a state proposal to substantially raise the eligibility requirements for aides to receive health insurance.

A bargaining team led by Oregon Gov. John Kitzhaber (D) wants to require home care aides that provide Medicaid-covered services to low-income elders and people with disabilities to work 130 hours a month for three consecutive months in order to qualify for health benefits. Currently, aides must work 80 hours for three straight months.

The increase in hours would cause 2,000 of the state’s 12,000 home care aides to lose their benefits, according to the Service Employees International Union (SEIU), which represents the aides.

In late December, negotiations between the state and the union reached an impasse, largely because of the insurance issue. Discussions between the two sides will re-open next month.

On January 18, a group of about 100 home care workers staged a protest against the cuts in Kitzhaber’s office.

The governor said that he respected home care workers and collective bargaining rights in general. “We will try to do all we can,” he said.

Budget Woes Cited

Kitzhaber’s bargaining team says that the cuts to home care workers’ benefits are necessary to help close a $300 million budget gap.

Oregon’s in-home care program has been the target of cuts before. On Jan. 1, home care workers saw their hours reduced by 5 percent, a move that saved the state $4 million.

But the SEIU and AARP Oregon say that the newly proposed benefits cuts go too far. The organizations have launched a media campaign asking Oregonians to speak out against the proposed cuts.

“It is extremely disappointing that Gov. Kitzhaber and his team are attempting to reduce benefits for low-wage workers just to save the state a few million dollars,” said PHI Government Affairs Director Carol Regan.

“Beyond that, this is bad fiscal policy,” Regan added. “Reducing low-wage workers’ access to health care will result in higher Medicaid enrollment and put a greater strain on emergency medical care in Oregon. These cuts will simply shift costs, not lower them.”

– by Matthew Ozga

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. Read the full story

Official seal of ARRA

As states struggle to balance their budgets in the face of a deep recession, there has been little good news for long-term care.

At least three states, however — North Dakota, Montana, and Oregon — are using funds from the American Recovery and Reinvestment Act (ARRA) to stabilize and enhance their direct-care workforces. Read the full story

Oregon State Capitol

State leaders in Oregon have announced that they will be combining their state’s tax revenue with federal stimulus funds to create hundreds of new nursing home jobs.

The Associated Press reported (“Federal aid will create nursing home jobs,” March 28) that lawmakers are talking about using a combination of state and federal dollars to help pay for more than 300 new nursing assistants in long-term care facilities in all 36 Oregon counties. Read the full story

When direct-care workers and their clients can’t get the support they need through government agencies, they can always try the courts. That’s what Oregon resident Clay Freeman is doing in a federal civil-rights lawsuit, which would require the state to increase the base pay for some home care aides in the Oregon Home Care Commission (OHCC).

Only by guaranteeing workers a sufficient wage, says Freeman v. Goldberg et al., (pdf) can Freeman hire the help he needs to exercise his federally granted right, under Title II of the Americans with Disabilities Act, to live at home and remain a functioning member of his community. And the wages paid to his workers, the suit says, must reflect the complex levels of care they deliver.

Read the full story