Saturday, 04 February 2023

Cramer: Seeking supervisors’ support for In-Home Supportive Services

For more than 20 years I have been justifying the existence and worthiness of my child, myself, and those that care for and support us, while under government scrutiny and judgment, every single month. This will not end until death.

My children are 3, 4, 16 and 20 years old. A monetary value cannot be put on the changes to people, programs, policies and services, access to care, removal of barriers, opened doors for others, work with nonprofit and government-based organizations, and countless community based projects, resources and support that we have brought to Lake County because our existence, this is home to my family and me and we care.

People should be able to thrive at their homes, in their hometowns and in rural communities, regardless of vulnerabilities.

In-Home Supportive Services, or IHSS, is a division of Medi-Cal, which is operated by California Department of Healthcare Services, or DHCS.

This is health care that we are here talking about today. That means providers and clients are protected, and obligated, by federal and state privacy policies such as Health Insurance Portability and Accountability Act, or HIPAA, however, I do have some information to share with the public.

California’s Medi-Cal budget is $22.5 billion from the general fund, $118 billion overall. However, I want to be clear that today we are talking about pennies on the dollar in costs to the county, in exchange for invaluable resources and revenues added to our wonderful Lake County communities.

The Board of Supervisors cannot support health and wellness in any aspect for any entity, cause, function, board or committee, without supporting IHSS and everyone involved in it.

IHSS is an essential part of the operations of a County Organized Health System like Lake County operates on in order to receive their funding from the state and federal government.

The people of Lake County elected the Board of Supervisors to be community minded for all people living in Lake County.

If the Board of Supervisors has issues with the IHSS program, how it is funded, how they run essential operations, who uses the program and who is employed by the program, they need to take it up with DHCS and the state and federal governments, not take it out on the struggling, traumatized, vulnerable community members and residents of Lake County that are just trying to survive in their homes.

What is a community health needs assessment, or CHNA? It is a systematic process involving the community to identify and analyze community health needs. The process provides a way for communities to prioritize health needs, and to plan and act upon unmet community health needs.

Lake County has 64,562 residents with 29,267 or 45% of those residents receiving Medi-Cal benefits through Partnership HealthPlan of California, or PHC, which is the organization responsible for managing Medi-Cal through the County Organized Health System.

Of the PHC member population in this county, 21% are ages 0 to 10, 16% are ages 11 to 19, 30% are ages 20 to 44, 22% are ages 54 to 64, and 10% are aged 65 and over.

Eighty-eight percent of PHC members primarily speak English, while 12% are Spanish speaking.

The ethnicity for this population includes 62% white, 24% Hispanic, 3% Native American, 2% African American and 8% others.

Many seniors and disabled adults have PHC as a secondary insurance, and those people were not counted in this survey. I will argue that makes the vulnerable populations of people over 50% of the entire population of Lake County.

What is a vulnerable population? Vulnerable populations are groups and communities at a higher risk for poor health because of the barriers they experience to social, economic, political and environmental resources, as well as limitations due to illness or disability.

The vulnerability of these populations can be measured based on racial and ethnic minorities, the uninsured, low-income children, the elderly, the homeless, those with human immunodeficiency virus, or HIV, and those with other chronic health conditions, including severe mental illness.

Vulnerable populations of people face a multitude of stigmas, judgments, and criticisms from everyone. Society, friends and family members, government workers programs and resources, most of which are supposed to only be there for love, support, and help.

Vulnerable people are more likely to experience abuse, across the life continuum, and often starting in childhood. Poverty is one of the contributing factors that make a child vulnerable. Most children living in Lake County are living in poverty (or below) standards.

Severe housing problems are characterized as overcrowding, high housing costs, and lack of kitchen or plumbing facilities. Twenty six percent of Lake County’s populations are facing severe housing problems, adding to the numbers of vulnerable people living in Lake County.

Fires, floods, public safety power shut-off events and now COVID-19 have not left one resident of Lake County unaffected. We are all traumatized and have experienced more as an entire county than most people face in their lifetimes.

We are Lake County Strong. We were defining emergency preparedness, defensible space, disaster response, shelter in place, essential workers and community mindedness years before COVID-19. COVID-19 brought to light the lives of IHSS workers, and the lives of those that live sheltered in place at home from the rest of the world.

The Board of Supervisors needs to stop making vulnerable people beg for dignity, respect, acknowledgment, support, time or moneys. There will never be any equity among vulnerable peoples (the majority) in the Lake County communities we love, in our homes, and with the rest of society, as long as the Board of Supervisors continues to single out and exclude the IHSS program.

Residents of Lake County need to know that their elected officials have everyone’s best interest in mind, especially now after more than a year sheltered in place from the outside world with no resources or relief.

We have kept our most vulnerable clients healthy and safe during the covid pandemic, often at the expense of ourselves as caregivers.

County programs resources and services, community based organizations and the rest of the residents of Lake County need to know you understand the health care system and the functions of each entity involved. They need to know you support the health and wellness of the communities you’ve been elected to serve as a whole operation, not just in vanity.

Removing homeless off the streets to appear to be supporting people and their health, while failing to help and support working people make happier, healthier homes, is incredibly vain.

Failing to provide a good contract for IHSS workers knowing that there are families dependent upon this income, is counterproductive to all of the adverse childhood experiences work that you support, the poverty education that Dr. Donna Beegle has brought to Lake County, and is a slap in the face to every entity and person involved in health and wellness in Lake County.

Prove that you haven’t been wasting the health care system’s time and money, that you support Lake County residents no matter what their status is, that you value Lake County workers and that you are community minded and Lake County Strong.

Kendra Cramer lives in Kelseyville, California. She plans to present this to the Board of Supervisors at its meeting on Tuesday, June 22, 2021.

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