Private Aid for the Home-Bound : Government should contract out in-home supportive services. It would save money and provide better nursing.

Promising to save Orange County from $3 million to $5 million over three years, private sector companies recently presented Orange County officials with a proposal to create a public/private partnership to improve services to home-bound elderly and disabled people.

This offer is one Orange County truly cannot afford to refuse.

Private firms, such as National Homecare Systems, seek to contract with Orange County to provide in-home supportive services (IHSS) to the county’s low-income, homebound, disabled and elderly residents--services now provided directly by the county.

The IHSS program in California is a $1-billion project designed to allow this important population to maintain its independence by remaining in the comfortable and familiar surroundings of their homes, and avoid being forced into more expensive nursing homes.

IHSS is one of the most important services the state provides; as is currently operated, however, it is fraught with waste and, in many cases, abuse.

Recipients are expected to hire, train and supervise their own providers. But often, recipients themselves require assistance preparing their own meals and getting dressed. How can they be expected to manage and supervise their care givers? Under the current structure, many of the disabled and elderly in California go weeks and months without the care they need.

A 1991 report by the California Little Hoover Commission found that limitations in county funding prevent IHSS from working efficiently and in the best interests of care recipients. The commission’s findings determined that disabled and elderly persons were at the mercy of untrained, unreliable care givers who were overseen by neither the county nor the state.

This lack of control means counties--including Orange County--may be paying for services that are not being delivered, have not been authorized and may no longer be needed.

I urge the Board of Supervisors to use the private sector to provide services to the county’s home-bound disabled and elderly residents.