Independent Provider The Independent Provider: Testimony before the October 1985 Homemaker-Home Health Aide Hearing 1111 Delphina Lopez M y name is Delphina Lopez, and I'm from Rialto, in the County of San Bernardino, California. I have one point I want to make sure that this committee hears. As you know, most of us homemakers are women of 45 years in age or older who are widowed. We have nobody to provide for us and we have children to take care of and raise in some cases, even single women and single parents. I speak on their behalf. Most of us have children who are still going to school. We're raising them without any benefits or proper wages. We can't make it. As you know, most of us accept that the wages for home attendants are very small. The reason I say this is to increase awareness, because most of us have very low wages and are not making enough to pay for what we need. Everything is going up except our wages. We have no benefits of any kind, and, as you know, we understand that California is not the only state with problems like this. Maybe most of you who are from other states have the same problem that we do here in California. The low wages are hard on us. The state may think it's saving money. They're not Editor's Note: These two texts represent testimony given at the hearing on homemaker-home health aide issues that was held during the National Association for Home Care Annual Meeting in Las Vegas, Nevada, October 1985. The hearing was held under the auspices of the Foundation for Hospice and Homecare. Delphina Lopez and Glenda Ponder are both independent providers of Homemaker-home health aide services in California. 40⚫ CARING⚫ April 1986 really saving anything because, by not letting Frankly, I would rather work and make the I'm sure that everyone up there feels the same way I do. We also have to make sure that our clients are well taken care of. But how can we do this when we have all of these problems to think about? How can I go into a home and say I'm going to give better care when I'm worried about what I'm going to bring home, the infections and the sickness that I might catch? If we have something to back us up, we know we can count on giving them better health and a better life. It will extend their lives and the quality of those lives. This is what we want, to make sure that our clients are well taken care of, because without us they really don't have anybody. We are their lives. We are the ones who prolong their lives, and without us, they have nothing. Believe me. Several of my clients tell me every day--and I hear it every day-what would they do if they didn't have me there to do for them what I do: the washing, the cooking, the cleaning. the bathing, every now and then combing their hair and making them look good, telling them a kind word, and telling them how I feel about them because they are a part of me. Glenda Ponder I'm Glenda Ponder, and I'm from Goshen, California in Clery County. I want you to know I feel it's an honor and a privilege to come here and to tell these gentlemen and the rest of you about the IP (independent provider) system because, believe me, I'm a homemaker and I know. I draw, on the average, $3.55 an hour. With that I try to take care of the two severely impaired clients that I have. Between the two of them their client hours are 178 per month. That's split two ways. That's hard to do, you know, but we do it. I have so many things that I want to say. and if I get a little emotional, please forgive me because I feel like the job that I am doing is so important. I have a job that not too many people out there would recognize as being so important, but I am taking care of people who have made our history. To me that is important. To think that I have the honor and the privilege to take care of some senior citizen who has made our history here, you bet it's important, and I'm proud of my job. I just wish that there were other people who could be as proud of my job as I am, like the social services department and some of the county supervisors who think we're ignorant and don't know too much. Well, we might be, but if we are, we're ignorant with love. That's one thing about it. As an IP, the state tries to tell us that the client who's receiving SSI is our employer. Now, have you ever heard of anyone drawing SSI and being someone's employer? Did you know that an IP homemaker has no official employer, so we can't get credit. If we want to open a bank account somewhere, or replace the old, worn-out jalopy that we're driving, which most of the time we have to push to work, we can't get credit to buy it because we don't have an employer. We talk about the $3.55 an hour that the IP gets; you've heard other women here say today that that's with no benefits. That's right-it isn't. We do not have any insurance coverage whatsoever. We don't have any sick time. We have to go to work whether we're able to or not because we don't have anyone to relieve us. Who's going to take care of our client? Someone has got to take care of them. Independent Provider They're not able to take care of themselves. But we go on to work because we don't have anyone to back us up, to send out someone to sub for us. We can't afford to get sick because, if we do, our clients have to stay home by themselves. They might have to do without breakfast, lunch, or dinner. You know, they're old and they're frail. I think the IHSS program is great; we need it. But I also think it needs a lot of help. Yet I haven't had one soul come to me and ask me, do you have an opinion on what should be done with this program? I guess they think I'm not intelligent enough to give my opinion. I've got some good opinions on what should be done. I feel that some of these people who are making very high wages with the social service department and other official agencies should come down and work and take care of some of these clients and see what we do and how important our jobs are. The state tells the county how many hours they can let us have for a client, but it might be a year before we get someone out there to see if we even showed up or not. You know, we homemakers, or whatever they want to call us, we have to be pretty good people, and the majority of us are pretty honest, because people don't spend any time checking on us. They don't spend any time training us. Most of us have a sense of how to care because we're mothers. So we go in and we do like we do for our children because that is what most of these senior citizens need. There's something that I would like to say here: As far as I am concerned, we've heard about contracting systems. Speaking as an IP, I would much rather have a contracting company tell me what to do and where to go than not have anyone tell me anything. At least the contracting companies assign you to clients. They give you mileage. They pay you with a higher salary. You do get some benefits. And at least we have someone to report to if we go in and find our client down on the floor, something wrong with him, because most of these client's families aren't around. Most of these clients' families are out working. We don't have anyone to report to. I want to thank you very much for giving me the opportunity to come up, but I want to say this in closing: everything we homemakers, or whatever name you decide to give us, do with our clients, 99% of us do it through love. Thank you. O CONNECTICUT COMMUNITY CARE, INC. August 12, 1986 The Honorable Edward R. Roybal Chairman U.S. House of Representatives Dear Representative Roybal: Thank you for the opportunity to present testimony at the With regard to the additional questions that you sent in 2. adequately? If not, what protections are needed to What impact has cost containment and the move to DRG's Answer: Secondary to the implementation of DRG's, home 4. 3. What effect do staff turnovers and low wages, particularly among home care aides, have on quality care and how can problems be corrected? Answer: The home care aide position is a low status, low pay- found at C.C.C.I. that engaging para-professional staff in At what point do you believe that a quality assurance system becomes so burdensome that it is counterproductive? The Answer: If a quality assurance system is extremely rigid and This If you have further questions, please feel free to communicate with me at your convenience. This is in response to your letter with respect to your hearing on the issue of home health care quality. I appreciated your report on the hearing, for as I have stated before, I agree that this is an important issue. We are working on a statement for the record, as you requested, and that will be forwarded to you in the near future. If your staff has any questions in the meantime, please have them call Ms. Patricia Knight, Deputy Assistant Secretary for Legislation (Health) at 245-7450. Again, I appreciated your letter and apologize for the delay in responding. Sincerely, Otis R. Bowen, M.D. |