REPORT: Majority of Medi-Cal Paid Caregivers at Economic Risk

An analysis of 6 million caregivers in California who provide services and supports to family members or friends found that those who are paid by Medi-Cal to assist low-income elders and people with disabilities were the most likely to be “economically insecure.”

In Hidden in Plain Sight: California’s Paid Medi-Cal Caregivers Are Vulnerable (pdf), researchers at the UCLA Center for Health Policy Research report that of the 290,000 Medi-Cal paid caregivers assisting family or friends — most of whom are likely to be employees of the In-Home Supportive Services (IHSS) program — more than half (57 percent) had incomes below or near the federal poverty level (average monthly income of $1,970).

The analysis also found that of these paid caregivers for Medi-Cal recipients:

• Nearly a third (31 percent) were uninsured;
• Nearly a third (31 percent) had food insecurity (reduced meal size or skipped meals due to lack of sufficient resources); and
• 16 percent were likely to stay in the job for less than a year, “suggesting a high client turnover.”

The researchers compared Medi-Cal paid caregivers to all paid caregivers, unpaid caregivers, and non-caregivers, finding that Medi-Cal paid caregivers fared the worst on the economic indicators.

Nearly half (49 percent) of all paid caregivers (450,000, which includes the Medi-Cal paid caregivers) in the study had poverty or near poverty incomes.

Little Pay for Hard Work

“Paid caregivers do a lot but get paid very little,” said Geoffrey Hoffman, the study’s lead author. “They play a critical and complex role caring for our aging or disabled parents, grandparents, friends, and neighbors yet can earn only a little more than minimum wage.

“When we talk about caregiving, we should be thinking not only of the supportive services we provide to older adults but also the vulnerable people providing those services,” said Hoffman, who added that proposed cuts to the IHSS program and the downsizing of the state’s Adult Day Health Care program will not only hurt consumers but “will also harm paid caregivers.”

“Of course, all of us promote the value of family members caring for one another through thick and thin,” said San Francisco IHSS Public Authority Executive Director Donna Calame, who is also a PHI board member. “What the larger public — and unfortunately many policymakers — do not understand is that paying family members the relatively low wages we do in IHSS keeps families together.

“Family members are not paid for things like cooking or cleaning the house,” Calame continued. “They are paid for doing things like bathing, dressing, or helping their loved one use the toilet. The average IHSS consumer uses about $1,500 per month. Parents caring for severely disabled children especially save the taxpayer from annual institutional costs of about $250,000-$300,000 per year. That IHSS pays family members is a humane and cost-effective use of public dollars.”

— by Deane Beebe