Caring for the Caregivers

Date: April 11, 2000
To: Board of Supervisors 
Subject: Caring for the Caregivers  

Summary: 
Child care workers take care of our children, one of our most valuable assets. In Home Supportive Services (IHSS) workers take care of our parents, grandparents and others not able to care for themselves. And foster parents provide an invaluable service by caring for children that, for whatever reason, are not with their own parents. Yet, despite these critical roles - often times, these caregivers go without much needed healthcare. Today's action will take the first step towards improving access to healthcare for those caring for this region's most vulnerable populations.

Recommendations:
SUPERVISOR DIANNE JACOB:
1) Direct the Chief Administrative Officer to investigate the total number and financial impact of child care workers, IHSS workers, and foster parents who are currently accessing CMS (County Medical Services) and report back to the Board in 60 days.

2) Direct the Chief Administrative Officer to develop an RFP to provide a basic low-cost health plan for child care workers, IHSS providers and foster parents and report back to the Board of Supervisors in 60 days.

Fiscal Impact:
There is no fiscal impact as a result of this request.

BACKGROUND:
Child care workers take care of our children, one of our most valuable assets. In Home Supportive Services (IHSS) workers take care of our parents, grandparents and others not able to care for themselves. And foster parents provide an invaluable service by caring for children that, for whatever reason, are not with their own parents. Yet, despite these critical roles - often times, these caregivers go without much needed healthcare.

Many working in the fields of child care, In Home Supportive Services, or foster care provide critical services to some of the most frail and vulnerable populations in society today. However, because of limited finances and wages, many cannot purchase health benefits for themselves or their families.

With many making under $6 per hour, it is often impossible for child care workers, IHSS workers and foster parents to pay for health benefits at the end of the month. As a result, many go without. In the end, the County ends up paying many times more what it would have paid, had the caregiver had access to preventative care.

Last year, the County of San Diego spent $52.2 million in CMS funding for indigent healthcare. This year, $56.7 million is in the proposed budget. The time has come to redirect some of these dollars into preventative care, to provide treatment before an illness becomes a crisis.

Last year, approximately 479 IHSS providers accessed CMS at a cost to the County of approximately $560,000. By analyzing the numbers of IHSS workers, child care workers and foster care workers accessing CMS, the County of San Diego will better be able to gauge the total dollar amount spent on uninsured caregivers. And, by utilizing these dollars more effectively - through a sliding scale, low cost health plan - the County can save taxpayer dollars while helping to make a dent in the current 600,000 uninsured that reside in this region.

The 1998 Partners in Health report documented that nearly one in four San Diegans under 65 are without healthcare coverage, and yet most of these are in households that have someone in the labor force. It went on to state that the single biggest reason for the lack of insurance is that many of these employees simply do not earn enough to afford insurance.

The Improving Access to Healthcare Feasibility Report, also on today's Agenda, addresses the need to provide healthcare for this county's caregivers as an essential element in expanding healthcare in this region. The timing of today's action is critical in taking the first step towards improving access to healthcare for those caring for this region's most vulnerable populations. I urge your support.

Respectfully submitted,


DIANNE JACOB
Chairwoman, Board of Supervisors