Health Care for Saints

Now the state must find money to pay for health plans for people who care for the elderly and disabled

Richard Devylder knows firsthand the importance of home health-care workers: They feed, bathe, dress, change catheters and take people to the doctor.

All the embarrassing little details of our everyday lives which we all hope we can always handle ourselves; but which most of us -- some of us sooner, many more later -- will need help doing.

Devylder now chairs the Los Angeles County Personal Assistance Service Council. This county-appointed board administers the county system that supervises the placing of what are now 73,000 home caregivers. These are the people who give intimate assistance in the homes of close to 100,000 disabled and elderly people. As a man with neither arms nor legs, Devylder notes that he himself has spent a lot of time in the consumer‘s end of the business.

Now, he says, he’s glad to be able to be helping people in the profession that has so helped him. And they need some help, Devylder says. For one thing, they don‘t get paid much -- $6.25 is the set wage: That’s minimum wage plus a recent, state-approved 50-cent raise over the minimum wage. More to the point -- and not without irony -- few or none of the county‘s 73,000 home-care providers have any health-care plans of their own.

That’s right. As one caregiver put it last week -- she was testifying at the Tuesday Board of Supervisors meeting in favor of the health-care benefits motion of Supervisor (and newly appointed board president) Gloria Molina -- said, “I‘m a health-care worker just like all the others; but when I need to see a doctor, I don’t have a doctor to see.”

Others recounted their long hours spent, as one put it, “waiting in that line at County” for medical treatment. That wasted time in line could be better spent taking care of patients, another caregiver testified.

Yet now that the supervisors have approved the concept, the final decision goes to the Legislature, which, the board hopes, taking into account the savings that home care affords the state health system, will vote to fund the care for care providers. Molina spokesman Miguel Santana said that Assemblyman Gil Cedillo was involved in putting together the package. I called last week to ask how he was doing on this one, but he still hasn‘t got back to me on it.

To Devylder, however, the case for health benefits for home-care workers is flat-out inarguable: “Medical benefits are important -- in many ways, more important than higher wages,” he said. Devylder sees the benefits as a further vital step in the upgrade of the caregiver’s work that began with a bang last June, when the Service Employees International Union organized a home-care bargaining unit in the form of its new Local 434b. This unionization of tens of thousands of unaffluent caregivers was widely reported -- from this paper to The Wall Street Journal -- as a millennial breakthrough in the re-empowerment of organized labor. Most impressively, the SEIU‘s organizational success -- one of the largest in union history -- was accomplished with some of the lowest-salaried workers in the state.

The supervisors supported this creation of a union organization for the diffuse and underrecognized care workers. But preparing the way for the SEIU’s feat also posed challenges that it took even a friendly board majority years to surmount. For instance, with the help of Supervisor Zev Yaroslavsky, the county created an employing organization for the health-care providers -- a sort of “straw boss” public employer with which the union could negotiate. Thus Devylder‘s Personal Assistance Service Council was born. Technically, the PASC is the profession’s county employer of record.

But Devylder and his panel often seem to be advocating for the entire underpaid occupation of home care. Devylder‘s objective is to see the entire profession more stabilized, with higher standards, more developed job skills and, perhaps most importantly, a decrease in its high job turnover.

This may be partly because many of those who care for the sick or elderly do so part time, balancing their home-care jobs off against family or other employment. Molina suggested that “If health benefits were available to home-care providers, we might be [better] able to attract and retain experienced and qualified providers.”

Her motion, however, seeks health care only for those working at least 150 hours a month. That’s almost 36 hours a week, which is very nearly full-time employment.

Santana calls the gradual upgrading of the entire county home-care profession “a deliberate and incremental process.” But, once again, the final say, and the health-benefits funding allocation itself, must come from the state. Santana and Devylder share the hope that the Legislature will come around to their side. They point out that better basic home care means lower state health-care costs, because it reduces the need for the more expensive alternatives of hospitalization, nursing home and home nursing care, all of which receive state subsidies. “And home care is often preferred to hospital care,” Santana adds.

I know that given the choice and the need, I‘d certainly prefer to be home. For many, it’s simply more efficient and strengthening to be taken care of in a familiar environment. It‘s what both the county representatives and health-care consumers want. And in this aging population, with its rising life expectancy, the demand for home care isn’t going to slack off.

So it‘s time for the state to get with the program, right? What do you say there, Assemblyman Cedillo?

City Hall Survives Doomsday

December 7 was one kind of day of infamy. Very locally speaking, December 8 was another. It was the day that the Los Angeles City Council managed to schedule itself four major and highly contentious items on the same agenda.

This made for a nightmare of congestion and frustration for everyone from the parking attendants in the basement to the visitors who waited -- and waited -- outside the packed Council Chamber to speak or listen.

Many of us saw this logjam coming months ago, when the Sunshine Canyon landfill-extension issue was continued to that date, which also included a re-hearing on the issuance of Mello-Roos housing-development bonds for the contentious Playa Vista project. Along the way, the meeting schedule further acquired the ornery Greek Theater lease and, for good measure, a Van Nuys golf course.

City Hall was, unsurprisingly, crammed. Sunshine Canyon alone filled the entire morning and ran into lunch time. Then came the final three acts. It was a long time to stand in the Council Chamber lobby waiting to have your say on that golf course.

Now most of the people who spoke December 8 had a chance to speak before, at one or another committee -- or even council -- meeting. Yet, particularly with Sunshine Canyon opponents, you felt the frustration that their point was not getting across. Even though the eventual council vote was a hairbreadth 8-7.

Sunshine was one of the two neighborhood issues (most anti--Playa Vista speakers didn’t come from the immediate surrounds of that massive project; the Greek issue was about who runs the place, not how the place is run) that day. I wondered if things would have turned out otherwise if the new charter‘s neighborhood councils were up and running.

That’s a complex question, given that Sunshine Canyon is a lab-specimen case of NIMBY. However discreetly it‘s done, reopening this dump on the northern city-county border to the city’s disposables won‘t enhance the lifestyle in nearby Granada Hills.

But an active 12th District neighborhood council might have kept alive the key issue behind Sunshine: Despite a decade’s recycling, L.A. produces far too much refuse. The new half-square-mile dump is to last 25 years. By 2020, lame duck Dick Riordan promises, the city will recycle 70 percent of its trash.

But can we count on the unforeseeable future members of the City Council to remember that promise? And, for that matter, what‘s supposed to happen to that other 30 percent?


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