Sometimes, the people who fall through the cracks aren’t the ones we’d necessarily expect to. But that’s how it has been for approximately 14,000 adults with middle-range incomes in San Francisco. These adults, some of whom are living with disabilities, face unique challenges when it comes to having access to the home care they need because their incomes surpass the federal poverty threshold, which disqualifies them from obtaining subsidized benefits, but they don’t make enough to pay for private home care.
Take Johanne, for instance. At 50 years of age, she is widowed, disabled and lives alone in San Francisco in a house she’s called home for more than 20 years. Her income exceeds the limit of being eligible for Medi-Cal and In-Home Support Services (IHSS). She makes up to 100% of the median income in her area. It isn’t nearly enough, however, to pay for the home care she needs given her health issues.
For years she has been foregoing home care services to cover her mortgage payments and basic needs. Of course, these sacrifices aren’t without consequence for her. In the past year, she’s suffered two falls and, as a result, her child wants Johanne to move into an assisted living facility.
Thankfully, it’s now possible for stories like Johanne’s to have a happy ending. Support at Home, a recently launched home care voucher pilot program funded by the Department of Aging and Adult Services and administered by Institute on Aging (IOA), allocates resources to this particular demographic of adults with disabilities and aging adults. Fifty percent of the clients served by the Support at Home program are adults living with disabilities and 50% are adults over the age of 60. The program aims to help clients get the home care they need to remain living happily, healthily, and safely in their homes and communities.
How Support at Home Works to Make Community Living Possible
When she found out about the Support at Home program, Johanne suddenly saw a glimmer of hope for her future. There were few things she dreaded more than moving to an assisted living facility, and the prospect of being able to live out her life independently in a way that would put her child’s mind at ease seemed almost too good to be true. She immediately arranged to attend a community meeting hosted by IOA to learn more about how the program worked and the eligibility requirements.
Shortly after the meeting, Johanne called IOA Connect at (415) 750-4111 to self-refer to Support at Home and soon an Assessment Coordinator came to Johanne’s home for an assessment of her living situation and financial need to determine how much home care she required and to discuss how much she would be expected to co-pay. The program expanded her own dollars to purchase more home care than she could on her own while giving her a choice about how she would receive her care. Once she was determined eligible for Support at Home, she could decide whether she wanted to hire an independent provider, like a family or a friend, or choose from a list of contracted agencies to provide her care.
The Tangible Goals of Support at Home
One of the most important aspects of the Support at Home program is that it gives the client a choice—not only a choice for how and when they want to receive their home care, but the choice to remain living independently in the community. All too often, disabled and aging individuals with middle incomes don’t qualify for other subsidized home care programs, so they have no choice but to forego needed care—a move that can have detrimental effects.
Thanks to the combined advocacy efforts of several organizations representing both clients who receive care and domestic workers, such a program exists to serve this at-risk demographic. And while there is a somewhat similar program in New York, Support at Home really is the first of its kind.
With hopes to enroll as many in-need adults as possible, Support at Home Program Director Jeanne Caruso continues to work on targeted outreach efforts. IOA will host another community meeting in October to inform potential applicants about the specifics of Support at Home. The ultimate goal is that the pilot will turn into a well-established, long-term program that will reach and help those who are falling through the cracks to live independently at home for many years to come.
As for Johanne, now that she’s enrolled in the program, she anticipates an improvement in her quality of life thanks to the voucher that Support at Home provides her. Best of all, though, Johanne expects to thrive independently in the comfort of her own home.
At Institute on Aging, we connect adults with disabilities and aging adults with the resources they need to be able to live safely and comfortably in their own homes. For more information on Support at Home and our other services, contact us today.
