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Caregiver Sick About IHSS Cuts

Nicanora Montenegro acts as a care giver to her younger sister Gin. Gin, 40, is developmentally challenged and has the mental capacity of a 4-year-old.
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Above: Nicanora Montenegro acts as a care giver to her younger sister Gin. Gin, 40, is developmentally challenged and has the mental capacity of a 4-year-old.

— Next month, thousands of San Diegans suffering from an array of debilitating conditions -- from blindness to mental impairment -- will lose help in bathing themselves, cooking or taking their medication. Governor Schwarzenegger cut In Home Supportive Services to deal with the state's budget crisis.

"Gin, Can you eat a little bit faster? She says opo, opo -- means yes, she doesn't want to be prodded."

But if Nicanora Montenegro didn't prod her younger sister Gin, the day would never start. Gin is 40 and developmentally challenged. She has the mental capacity of a 4-year-old and needs help with just about everything.

Nicanora's mother Felisa is 77. She has heart disease and diabetes. She moves around slowly with the aid of a walker. And she also needs help.

So at 5 o'clock every morning, Nicanora rises from a daybed in the dining room, bathes her sister and then her mother. She dresses them. She cooks for them, helps them eat, takes them to daycare and medical appointments. At night, she watches over them, especially her sister Gin.

Nicanora Montenegro gives her mother, Felisa, her daily medication. Felisa suffers from heart disease and diabetes and depends on her daughter to take care of her.
Enlarge this image

Above: Nicanora Montenegro gives her mother, Felisa, her daily medication. Felisa suffers from heart disease and diabetes and depends on her daughter to take care of her.

Video
Video unavailable. Read transcript below.

Above: Gov. Arnold Schwarzenegger justified cuts to In-Home Support Services with claims of rampant fraud in the system. KPBS investigative reporter Amita Sharma said the actual fraud cases are much lower than the governor claims.

"She sneaks out. She opens the doors in the garage and went into the backyard door and she was rummaging the trashcan and going into empty soda cans and trying to drink them. That's why I sleep. I wake up. I sleep I wake up."

How does this native Filipina with a master's degree in industrial psychology describe her life?

"Highly domesticated.”

Nicanora says she has no choice but to take care of her family.

"My mom is my mom. My sister is my sister. They are my blood. For me my family is very important," she says.

Nicanora does get some money from the state for her care-giving. She is one of 23,000 providers within the In Home Supportive Services program in San Diego County. She receives $1,500 per month for her work. After deductions, she's left with about $900. Nicanora supplements the paycheck by working part-time as a life insurance agent.

"That money that is being given to me is being used to buy food for them, for us,” she says. “That is not even enough for food, the payment of the utilities, how about the car, how about the gasoline, how about all the expenses?”

One of those expenses is medical. Nicanora herself is a diabetic with hypertension. Even though she has health insurance, she's skipping doctor's appointments. She can't afford the co-pay and she can't afford the $200 for her medication.

"Actually this morning, I checked my blood sugar. It's 268 already. All I can do is drink water and reduce food intake until it goes down by itself. That's the only thing I can do."

And things are about to get worse. With Governor Schwarzenegger's $270 million cut to In Home Supportive Services, Nicanora will lose all the money she receives to take care of her mother and sister.

"What will happen to them? They will rot. They will smell and they will not be able to eat properly. Who's going to help them clean the house? Who's going to help them bathe? That will be very difficult. With this situation, I'm already financially burdened and if that is removed, what will happen? What will I do?"

Liselda Lopez is with the California Department of Social Services, which oversees IHSS.

"We're hoping as I mentioned earlier that individuals will work with their communities, with their churches, with their families to figure out a way for the services to continue to be provided in a revised way so if someone can come and help them do the dishes, then that way they can stay in their own home. That's the preference."

But Nicanora believes many of the people affected by the cuts will eventually be placed in institutions which would cost the state much more money.

In the room next door, Nicanora's sister sits on a sofa, repeatedly thumping on a pad as she mumbles. Nearby their mother Felisa rests on a bed and worries.

"I can't do nothing. I cannot cook. It's very hard for me if nobody helps me."

In-Home Care Program Fraud Claims Don't Add Up

Comments

Avatar for user 'LeeCollins'

LeeCollins | September 29, 2009 at 10:31 a.m. ― 5 years, 2 months ago

These are the kinds of cuts that represent the Governor's view of "shared sacrifice." Neither California's corporations nor its wealthiest citizens were asked to share any sacrifice, of course; the caregivers of the neediest among us and the needy themselves did the sacrificing. Somehow, the imposition of a tax on oil extraction is too "burdensome" to the oil giants, yet the most minimal support for the disabled is yanked from them.

And how does the Governor justify this? Neither he nor his Director of Social Services have the courage to call it what it is, and that is their deliberate targeting of the weakest among us in their desire to reduce expenditures. No, they raise this false spectre of "fraud," cloaking their intentions in the counterfeit claim that individuals such as those interviewed for this article are undeserving, that they likely are fraudulent deceivers, violating the public trust. But they are not the ones who violated the public trust. Governor Schwarzenegger, Secretary Belshe and State Director Wagner are the ones who have violated the public trust.

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Avatar for user 'psylence'

psylence | September 29, 2009 at 1:02 p.m. ― 5 years, 2 months ago

"[H]oping [that]...individuals will work with their communities, with their churches, with their families to figure out a way for the services to continue to be provided..."

There are so very many things wrong with that position. The state agency that has overseen these services for many years is now going to rely on HOPE: hope that those they are charged with protecting and supporting will miraculously find the self-reliance, suddenly, to tap the vast, as-yet unmined wealth of community resources that -- somehow, in every individual's case, coincidentally -- were never called upon before these individuals turned to the state for the assistance they needed.

It is because these community and family resources do not exist. Individuals in need have already been relying on family and community resources, and there is nothing more to tap. It is presumptious of the state to think that these individuals did not seek help from those closest to them before turning to state assistance programs like IHSS. Their families are there to help them every day of their lives, giving everything they have, and there is nothing to give they haven't already sacrificed. What's more, leaving these individuals and their families (those who have families; many do not have such resources) to "figure out a way" to keep providing for their basic needs is careless of the state. Planning for care should be left in the hands of experienced caregivers, even if care is provided in part by community resources.

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Avatar for user 'vince64'

vince64 | September 29, 2009 at 9 p.m. ― 5 years, 2 months ago

Thank you KPBS for this story. It is incomprehensible that our society would do this to the people who do this work and who need this care. There are much smarter people than me that need to find a way to help these people live in dignity. I guess the Family Values mantra is just words...

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Avatar for user 'kharris92130'

kharris92130 | October 1, 2009 at 10:23 a.m. ― 5 years, 2 months ago

While sympathetic to the situation of many low-income and disabled persons, I do have a few questions about the report. First of all, the investigative reporter indicated that it costs $55,000 per year to institutionalize someone. What she didn't mention is that a great portion of that amount are fixed costs, like building infrastructure, and depreciation of durable goods, like furniture and fixtures. The only incremental costs would be if additional staff had to be hired to take care of the increased patients.

Also, is the IHSS obligated to confirm immigration status before providing services? Or does it provide service to any who request it? I, for one, am tired of my tax dollars going to provide services to those who are in this country illegally.

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