Who Will Care for the Caregivers?

By Kamal Menghrajani

Some people who care for vulnerable older adults are in dire economic straits, according to a new study [PDF] from the UCLA Center for Health Policy Research.

Hundreds of thousands of people provide care – from cooking and cleaning to bathing and dressing – for adults with disabilities or long-term illnesses who receive benefits from Medi-Cal. As it turns out, those who get paid for this work may not be pulling in enough money to make ends meet.

Geoffrey Hoffman, a researcher at the Center and lead author of the report said, “These paid Medi-Cal caregivers have incomes that are quite low compared to other Californians, about half as much monthly household income.”

He continued, “A third of them do not have health insurance. A number of them live in poverty or near-poverty, and, among those, a third of them have what is called ‘food insecurity’ – not enough food to put on the table every month.”

At issue is the amount that Medi-Cal is paying these caregivers. Even if you add income from other jobs, they earn a little over $11 per hour on average -- close to minimum wage, and about two-thirds of the median income in California -- making it difficult for them to live on their earnings. Many believe that the value of the care they provide is much greater than what they earn, but monetary constraints have led California lawmakers to decrease financial support for these services.

In 2011, the state budget cut the Medi-Cal caregiver reimbursement program – In-Home Supportive Services – by 3.6 percent. State officials had also planned a 20 percent decrease in the number of hours a caregiver could work, but that cut has been blocked by a judge for now.

Hoffman worries these trends could affect the quality of care available to those who need assistance. “If the caregivers are having trouble putting food on their own table, then they’re not going to provide the type of care we want for our grandparents and our spouses in this state.

As these caregivers themselves begin to age, Hoffman said he is also concerned that those who are economically disadvantaged will end up costing the system more money later on, making it even more difficult for Medi-Cal and Medicare to stay solvent in years to come.

“This aging population [of caregivers] is going to lead to great burdens on the health care system. So the sooner we address the problem today, the better off we are for our older adults’ health ... in the future."