San Francisco Pilot Program Tackles Home Care Affordability

More than half a million California residents employ home care workers. However, many are finding it more and more difficult to pay for these services, according to a report published by The University of California, Los Angeles’ (UCLA) Labor Center.

A pilot program in San Francisco County, titled Support at Home, is tackling this issue by making home care accessible to area residents, and also ensuring caregivers are provided a fair and decent wage.

The program was created by an alliance of community groups, including the Bay Area Care Council and Long Term Care Coordinating Council. The initiative is also backed by local organizations like the domestic employers network Hand in Hand, and Senior & Disability Action, a group advocating for seniors and people with disabilities.


A Catch-22

For more more than 14,000 older adults and adults with disabilities in San Francisco, paying for home care can be a “financial Catch-22,” according to Jessica Lehman, executive director of Senior & Disability Action.

Many of these citizens make too much money to qualify for the state’s low-income health plan, Medi-Cal, but do not have enough discretionary income to pay for home care services out of pocket, she explained.


“As a result, thousands of San Francisco residents are going broke paying out of pocket for home care, and their attendants are unable to make a living wage,” Lehman said in a press release.

Support at Home addresses these two issues by providing vouchers to help pay for home care serviceslike cooking, grocery shopping, cleaning and bathing—for eligible residents, who can make up to, but not exceed, 100% of the area median income.

The pilot project is administered by the San Francisco-based non-profit Institute on Aging, with funding provided by the City and County of San Francisco through its Department of Aging and Adult Services. In total, Support at Home will provide financial assistance to 175 to 250 San Francisco residents who require home care, according to a press release.

Since its launch in late August, the program already has more than 50 participants, Lindsay Imai Hong, organizer at Hand in Hand, told Home Health Care News.

Now, the group is working to mobilize the program and create awareness in hopes of creating a viable offering for citizens who require home care.

“We’re hoping that it’s going to become a permanent program,” Hong said. “We got approved funding [from the City and County of San Francisco] for two years, and so the hope is that within those two years, we can start to address the need [and] make sure that the delivery of the program is smooth.”

A livable wage

Another component that the program addresses is the wage disparity of home care workers.

The voucher program ensures that participating caregivers are paid fairly, locking in a standard $15-per-hour wage.

“This is a subsidy program so the clients or consumers of home care are required to pay a portion of the wages,” Hong said. “The way that looks in the agency model is that the consumer pays the agency for a portion of the wages of the care, and then the Support at Home program provides a portion of the wages to that home care agency.”

The program also provides training for caregivers in order for them to understand their rights as domestic workers, according to Hong.

“The National Domestic Worker Coalition, as well as the California Domestic Worker Coalition together, have an agreement with the Institute on Aging that any worker that’s hired directly not through an agency but as a direct hire will go through a training whereby they can learn their rights as a domestic worker,” she said. “It’s just another way to ensure that they’re getting treated well, but also [a way for them to] know how to advocate for themselves.”

For Lourdes Dobarganes, a member of La Colectiva de Mujeres, the pilot program ensures fair equity on behalf of home care workers like her. La Colectiva de Mujeres is a group that advocates for immigrant women and connects them to career resources and jobs.

“I am proud of my work, and my work makes it possible for me to meet my basic needs and those of my family,” Dobarganes said at a press conference announcing the pilot program. “The Support at Home program will make it possible for caregiving to be valued with dignified work conditions while the people who need home care can receive those services and live their lives with dignity.”

Written by Carlo Calma

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