Capitol Alert: Brian Nestande: Don't cut in-home care; manage it privately

Three Republicans emerged publicly last week as the unlikely allies of unionized in-home caregivers and recipients who oppose Gov. Jerry Brown's proposal to slash subsidized in-home care.

One of them -- Assemblyman Brian Nestande -- says he believes private agency management could contain the costs.

Nestande told the Bee that he's working on ideas he would like to introduce to a budget committee or present directly to Brown as alternatives to cuts in hours and tighter eligibility requirements.

Nestande, of Palm Desert, was one of three GOP legislators who spoke at a Capitol rally Thursday against the Democratic governor's proposed cuts to In-Home Supportive Services.

"I want to see what other states are doing with IHSS programs," Nestande said Friday in an interview. "I want to find the best way. It may be an agency-based model."

In such a model, private agencies employ caregivers for disabled and frail low-income seniors. The program would still be a government program, Nestande said.

In-home care is a Medicaid benefit paid for with a combination of federal, state, county and out-of-pocket patient dollars. In California, county social workers now authorize hours of care that a recipient requires, and the recipients employ caregivers. The program is managed by counties, with state oversight and wage contributions.

Nestande says that a private agency might reduce costs by various means. He offered an example: If five frail recipients all live in the same area and are authorized by public authorities to have shopping done for them, one caregiver might be able to do the shopping for all five, reducing the total number of hours devoted to the task.

In-home Supportive Services caregivers are unionized in California. In some states that contract with private agencies to manage services, workers are also unionized.

Thursday's Capitol rally was organized by the United Domestic Workers union. Other Republicans speaking at the rally against Brown's proposed cuts were Assemblymen Jim Silva of Huntington Beach and Paul Cook of Yucca Valley. Democrat Sen. Juan Vargas of San Diego also spoke opposing the proposed cuts.

PHOTO CREDIT: Ramon Gaytan of Modesto is pushed by his mother, Manuela Gaytan, as they join a march protesting proposed budget cuts in In-Home Supportive Services at the State Capitol on Thursday, Jan. 27, 2011. Hector Amezcua / Sacramento Bee