An estimated 882 Humboldt County clients receiving in-home support services may be unaware they could lose domestic care services effective Oct. 1.

The May Revision to the 2008-09 state budget proposed by the governor eliminates meal preparation and clean-up, housekeeping, laundry and food shopping for clients with a functional index score below 4.

Social workers rank low-income adults over age 65, blind or disabled and children who are blind and disabled on a scale of 1 to 5 in their ability to perform 26 basic tasks essential to remaining safely in their homes.

“Most recipients don’t even know what their score is. They may not know they are the No. 1 targets,” said Cindy Calderon, systems change advocate for Tri-County Independent Living. “They need to call their social worker and ask for the SOC 293. It’s a copy of their scores.”

“I’m scared and I’m angry,” said TR Wilson, a disabled activist who sits on the TCIL Board of Directors.”As well-versed as I am, I haven’t heard about a functional index. I can’t wait to find out about that.”

Wilson is a 68-year-old quadriplegic. He is 85 percent deaf, partially blind, incontinent and has lost most of his voice after diabetes preceded a series of strokes and heart attacks.

“I must be a ‘5,’” Wilson said. “How much worse can I get? I need someone to feed me, clean me. I’m functionally inadequate.”

“A ‘1’ means you are independent and able to do whatever the function without assistance,” said Marti Hufft, former program manager for Humboldt County In-Home Health Services. “A ‘2’ means your are independent but need verbal assistance — a reminder to take pills.”

Hufft said there’s a fine line and a lot of gray between a score of “3” and “4.”

“A ‘3’ can walk down the hall with some human assistance, maybe an elbow. A ‘4’ or can do whatever the task is, but the only way they do it is with someone is actually holding them,” she said. “A ‘5’ can’t do it at all.”

Wilson is probably safe from what IHSS California described as an 18 percent reduction in caregiver hours for domestic and related services, but he isn’t immune from cuts to Medi-Cal and cash aid for the aged, blind and disabled, known as SSI/SSP & CAPI.

In addition to absorbing the 10 percent reductions announced in January, the May Revision lopped another $1.1 billion from Medi-Cal and $521.4 million from SSI/SSP and CAPI.

In January 2008, the SSI/SSP payment for aged and disabled individuals increased from $856 to $870 per month.

“I live in a delicate balance,” said Wilson. He receives 9.5 hours of service per day from three caregivers.

“When you remove anything from me right now, that balance is upset.”

Clients who believe the reduction would put them at serious risk of moving to out-of-home care may appeal.

Current law requires the appeal to occur within 10 days of the date of the cutback notice or before the reduction takes effect.

“There are actual budget premise items that only about 20 percent appeal and maybe 25 percent are upheld and thus there’s X number of savings,” Humboldt County Department of Health and Human Services Director Phillip Crandall said. “When I read those, I was struck by how we have drifted from what I think is a basic value in California of how we treat our elderly and disabled. It’s just not right.”

The May Revision also impacts 7,100 IHSS clients in the state who will now have to assume a share of cost for home care services. Calderon estimated that cost would average $427 a month for those with a functional index score of less than 4.

“Nobody can afford that because most are living on $800 a month,” she said. “It’s ridiculous. Fifty-eight percent of IHSS members do not have a family member as a caregiver.”

Even if they had a family member available, Calderon said “expecting someone to give up a job to work for minimum wage is ridiculous.”

The governor called reductions in IHSS “tough” and “painful to make.”

“Why the governor is asking those who have the least to give up the most is beyond comprehension,” Calderon said. “And it’s the fourth year in a row he has done it.”

“This hasn’t happened yet,” Hufft reminded.