Lifeline Grows Thin : Family Service Agency Forced to Cut Homemaker Visits for Elderly, Shut-Ins

I fall and I run into doorways. I’m so afraid of falling and lying unconscious with nobody to find me. Without Sylvia (a visiting professional homemaker) I’d just sit here and wait for someone to come by.’

--Marie Davis

homebound 92-year-old

Marie Davis is frail.

So frail that she sometimes spends entire weekends in bed, lacking the strength to shop for food that is gone from her refrigerator. So frail that on the rare occasions she ventures out, she often can’t make it up the steps of her apartment to get back in.

“I fall and I run into doorways,” said Davis, 92. “I’m so afraid of falling and lying unconscious with nobody to find me. Without Sylvia, I’d just sit here and wait for someone to come by.”

Sylvia Smith has been coming by regularly for more than five years. A professional homemaker employed by Family Service of Long Beach, she helps Davis shop, read mail, clean house and keep doctor appointments.

“Otherwise I’d have to go to a damn rest home,” said Davis, who lives alone on $525 a month in Social Security benefits and pays nothing for the home-care service.

Smith agrees. “These are the forgotten people,” said the homemaker, who recently had to reduce from 12 hours to eight the amount of time she spends each week with Davis, leaving the woman to fend for herself for more than four days at a stretch.

The cut in hours came after the Family Service program applied for its second annual grant from a special city fund for human services. While last year’s grant was $68,000, this year’s is $20,000. As a result, Family Service officials say, the organization has severely reduced homemaker services--which it provides on a sliding-fee scale--and eliminated their homemaker registry. The registry is a listing of independent home-care providers used each year by about 1,200 elderly and shut-ins for whom Family Service homemakers are not available.

The strain of dividing up the remaining services was so great that the director of the agency’s homemaker program resigned in protest. “The well dried up and . . . I had to play God,” said Diane Bartchy, who resigned June 15. “It was a gut-wrenching experience.”

Donald L. Westerland, executive director of the agency, responded by severely criticizing the method of allocating city funds.

“It’s a crisis of public policy,” he said. “It’s a strange thing to me that we’re talking so much about homelessness and we have these seniors who are in their homes and can’t find the services to (stay) there.”

City officials say the allocation process is fair.

Agencies such as Family Service, they say, were never meant to depend on the city for more than short-term grants to tide them over until other funding sources could be found.

“The city did something good and now we’re being beaten over the head for it,” said Richard Harris, manager of human services for the Dept. of Public Health, which oversees the particular funding in question.

Indeed, Family Service’s financial problems began long before the city was in the picture.

A nonprofit agency, Family Service receives most of its annual budget of $1.75 million from United Way, client fees, government contracts and outside donors. In addition to its homemaker program, the agency provides psychological counseling and drug abuse programs. Traditionally about 35% of the budget has gone for the homemaker service--which began in 1979--and much of those funds came from a special state program set up for the purpose.

Beginning in 1984, however, the funding started to dry up as the state money began to be spread more thinly. So last year, when the city announced it would begin providing some human services funding of its own, the agency applied.

The source of the city grant--allocated by a 15-member citizens Board of Health and Human Services that makes recommendations to the City Council--is the yearly interest received on a $6.65-million municipal endowment from the sale of city land a few years ago to two local hospitals.

Last year’s allocation was about $700,000, of which $68,000 went to Family Service.

This year, however, the picture was different. Because of a drop in interest rates, Harris said, the total allocation came to only $450,000. And where last year’s applicant agencies numbered about 50, this year more than 200 agencies competed for the funds.

For many, the result was a reduction in their grants. In the case of Family Service, the bottom line of $20,000 was less than 30% of last year’s allocation.

“Unfortunately the funds are not adequate for a city this size,” said Rae Gabelich, a member of the board. “Everybody got less money. We did the best we could.”

Westerland, however, sees something far more disturbing in the reduction of money allocated for homemaker services, no matter who provides it.

Specifically, he says, it indicates a set of misguided priorities.

“This isn’t the kind of thing that’s going to go away,” he said of the need for homemaker services. “The city should view this as an ongoing need just like lifeguards or police protection.”

In addition to eliminating the registry, which made about 100 referrals a month, he said, Family Service reduced its total number of monthly homemaker hours and dropped some clients--it went from 7,000 hours distributed among 330 clients to about 5,000 spread among 278 clients. Wherever possible, he said, hours for long-term clients have been reduced rather than dropping them from the program altogether.

While a number of private companies provide similar in-home services to customers willing to pay for them, Westerland said, Family Service is one of the few local nonprofit agencies able to provide such services to low-income senior citizens on a sliding scale ranging from nothing to $5 an hour.

Another local agency--Visiting Nurse Service--provides homemaker care to disabled people of all ages, but only on a short-term basis. And the county’s Dept. of Public Social Service will provide $3.72 an hour to physically impaired people who can arrange for their own in-home care, usually by friends or relatives.

For people like Davis, however, the effect of the cuts has been immediate. Where before she was visited by her homemaker three days a week, she must now make it on her own every Wednesday until Monday.

“I come in on Monday and she has run out of groceries over the weekend,” Smith said. “A few times it’s been hard to rouse her because she’s been in bed for days.”

Adds Davis: “One of these days she’ll find me dead.”