More Bad News for Caregivers

The California Medical Assistance Program (Medi-Cal) is the name of the California Medicaid program serving low-income families, seniors, persons with disabilities, children in foster care, pregnant women, and certain low-income adults. It is jointly administered by the California Department of Health Care Services (DHCS) and the Centers for Medicare and Medicaid Services (CMS).

A report, Hidden in Plain Sight: California's Paid Medi-Cal Caregivers Are Vulnerable, showed that in 2009, an estimated six million caregivers in California provided care to a family member or friend with a long-term illness or disability.

Of these, 450,000 persons were paid for the care they provided. Nearly two-thirds of these paid caregivers aided a family member or friend receiving Medi-Cal (paid Medi-Cal caregivers). Many of these paid Medi-Cal caregivers more than likely worked for California's In-Home Supportive Services (IHSS) program.

Despite being compensated, paid caregivers--and paid Medi-Cal caregivers in particular--fared much worse economically.

• Paid Medi-Cal caregivers had the highest rates of poverty: they were most often at less than 100% of the Federal Poverty Level (FPL) and at near-poverty.


• All paid caregivers had the next highest poverty rates, while non-caregivers and unpaid caregivers were more likely to have incomes above 300% FPL.


• Over half of paid Medi-Cal caregivers (57%) and almost half of all paid caregivers (49%) had poverty or near-poverty incomes. The average monthly income for paid Medi-Cal caregivers was $1,970, compared to $4,222 for caregivers who were not paid for the assistance they provided. Paid Medi-Cal caregivers averaged 43 hours of care per week, or approximately $11 per hour.

The report concluded that paid Medi-Cal caregivers lack job stability and have limited resources, especially if they should become sick themselves. Reduced funding for programs affecting seniors and caregivers, such as Adult Day Health Care and In Home Supportive Services, will likely add to the burdens already faced by California's paid caregivers.

The life story of the caregiver is often ignored. Yet we have no shortage of caregiver hardship stories out there. In a profession that is increasingly talking about cultural inclusion, we somehow as an industry needs to promote inclusion by taking responsibility for alerting people to the caregiver plight and rallying support for the caregiver.

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