Agency’s Report Blasts Privatization of In-Home Care

After months of analyzing a plan to turn the county’s home-care program for its elderly and disabled over to a private company, the Social Services Agency has concluded that it would cost--not save--the county money and jeopardize the care of its most fragile residents.

Chicago-based National Homecare Systems promised to save the county between $3 million and $5 million over three years, proposed to pay home-care providers more than the minimum wage they earn now and do a better overall job of caring for elderly, blind and disabled clients.

But in its recently released report, county officials found that turning over the so-called In-Home Supportive Services program to National would do just the opposite.

The private proposal “is very unlikely to produce any savings to the county, would worsen county cash flow problems, would be operated as an experimental program requiring an independent and potentially costly evaluation, would require state and federal waivers, which are unlikely, and could expose the county to risk of litigation and loss of millions of dollars in federal Medicaid funding,” read a portion of the 15-page report.

Social Services officials say they still are accepting public comment on their analysis of the proposal but believe the plan is essentially dead.

“Unless there is new information regarding this proposal or about our analysis that identifies something that’s erroneous in our findings, we don’t see any reason to go any further,” said Dianne Edwards, director of adult and employment services for the Social Services Agency.

Many advocates for the 6,200 elderly, disabled and blind people who are part of the program are pleased with the agency’s scathing rejection of National’s proposal, but say their struggle with National continues.

“I don’t see it as over,” said Roslyn Hawkins of Fullerton, who is the home-care provider for her two severely disabled sons.

“We just see this as such a critical thing,” Hawkins said. “I’m very concerned about the integrity of our program being completely demolished if National takes over, and I won’t think it’s over until National’s left town.”

Robert D. Cummings, executive director of the Anaheim-based Dayle McIntosh Center for the Disabled, also said it is too early for National’s opponents to celebrate.

“I think what was finally revealed was that National, not in any area, showed that this was a better way of providing service to consumers,” he said.

National Program Director Kim Kruser said the company plans to revise its proposal.

“We have no doubt that we can save Orange County a lot of money,” Kruser said. “The proposal we are developing now will be one that will show that in detail. It will also be one that does not require any federal waivers or legislative approvals.”

Since National brought its proposal to the Social Services Agency last winter, the prospect of dramatic changes in the home-care program has stirred concern among families of the disabled.

For many clients, the program is all that allows them to live at home rather than in an institution. Tasks performed by care providers range from bathing and changing diapers for incontinent clients, to household chores such as preparing meals. The majority of those providing the care are relatives of the people receiving it.

National’s assertion that it could complete tasks more efficiently raised fears that intimate care would be administered in a hurried, shoddy and impersonal way.

“I think the service providers and advocates were unanimously very concerned from the outset about this proposal,” said Peggy Witherspoon, director of the Area Agency on Aging. “If you’ve worked with this [elderly] population before--especially if you’ve worked with stroke victims--then you know that speed is often the enemy,” Witherspoon said.

Some county officials, however, are waiting to see how National will amend its proposal before closing the door on the plan.