By Hillel Aron
By Joseph Tsidulko
By Patrick Range McDonald
By David Futch
By Hillel Aron
By Dennis Romero
By Jill Stewart
By Dennis Romero
When last we wrote of local home health-care workers, there was hope in the air. As you may recall, the Los Angeles County Board of Supervisors asked the state for some health-care benefits for primary health-care givers. Those workers -- 73,000 of whom have registered with the county -- come into your home when you can’t take care of yourself and take care of you. They help many thousands of seniors, people with disabilities, and people of all ages who simply need care during recovery from severe accidents and illness. They do difficult work; they get paid around $6 an hour to feed, clean, medicate and otherwise assist people in their homes. ”The work they do is unremunerative and burdensome,“ said Supervisor Zev Yaroslavsky last week. And in its difficulty and quiet importance, there‘s something saintly about their task.
So why is the state suddenly trying to offload its share of the health-care burden on the counties? Late last year, this column reported that the county was requesting -- via a motion by all the supervisors -- that the state cover some or all of the costs of a health-care benefits program for registered county health-care workers. Many observed that it was not a little ironic that the people who provide basic care for so many of us had no health plans of their own. Assemblyman Gil Cedillo initiated legislation toward that purpose. Supervisor Gloria Molina, who introduced the December Board of Supervisors initiative, observed that what the care workers needed most was their own medical program -- even more than they needed a raise in their minimum $6.25-an-hour pay.
She’s a Democrat. So is the governor. So is most of the Legislature, for what that‘s worth. You usually write about things like this, and go on to other business, because there doesn’t seem to be much standing in the way of their accomplishment. But I should have known better.
The first tip-off that things weren‘t on course was in Governor Gray Davis’ initial budget message, which didn‘t mention health care for care providers, but instead mentioned higher wages for health-care providers. While not a bad thing, this indicated that the governor and the county supervisors were not on the same page as to what the care workers needed.
Then came more detail: The state also wants the perpetually strapped county to pay for the promised care workers’ pay increase. And you had to stop and think: Just how generous can our governor get? ”This is in the face of a $3 billion state-budget surplus,“ objected Miguel Santana, Molina‘s deputy.
”This was supposed to be a partnership,“ noted Yaroslavsky, ”with the state picking up costs.“ Currently, the state picks up 80 percent of those health-care-worker costs, while the individual counties pay 20 percent.
But the crucial datum, said Yaroslavsky, is that the state saves money even under the current system whereby it pays the lion’s share of care costs. That‘s because when disabled people can’t get home care, they have to be moved to nursing homes. And for this care upgrade the state pays more.
All of which makes one wonder just what priority health care has in the Gray Davis administration. Certainly, it stood in the shadow of education in Davis‘ State of the State message. It took the governor many months to appoint his current state health director, and when he did so, he ended up eschewing several nationally prominent choices in favor of Diana Bonta, whose previous career apex had been as health chief for the city of Long Beach.
Insiders suggest that the state’s health division badly needs both new goals and new, strong leadership. There are many reasons for this, including the growing number of people dependent on public health care in urban and poor rural California communities. But we also ought not to forget that, for 16 years, the state health department was a Republican satrapy, dominated by small town--conservative AMA types. If it‘s going to express the higher ideals of Gray Davis’ party, this bureaucracy needs lots of winnowing out.
Otherwise, we‘re going to see lots more brilliant ideas. Like the one about picking the counties’ pockets to boost the wages of the home-care workers who save money for the state.
Billie, We Hardly
The semiofficial reason, of course, why Mayor Dick Riordan recently decided to delete some prominent city managers is that, while he‘s been mulling their ouster for some time, now the new charter will soon empower him to do so more easily. The reported targets include Cultural Affairs General Manager Adolfo Nodal, General Services chief Randall Bacon and freshman City Administrative Officer Bill Fujioka.
Riordan may have long been stalking the former pair, both of them Tom Bradley appointees. Nodal has seemed quite competent in what is an extremely controversy-prone job. But Bacon’s reign over the omnipotent department that supplies the city with everything from gold-leaf names on doors to toilet paper has long been problematic. City Hall scuttlebutt holds that Bacon and Nodal are under such heat (Bacon has announced plans to resign) due to the mayor‘s disappointment with the Los Angeles millennial festivities, in which their departments were implicated. Er, involved. Well, at least you can’t say this problem is likely to come up again soon.