Rules slash pay of live-in caregiver
By Rebecca Cook
Associated Press
SEATTLE — The ranch house with the white picket fence was a dream home when Karen Hammer and Chuck Barzen bought it together 10 years ago.
Associated Press
But when Barzen suffered a stroke, Hammer shelved her own dreams so she could take care of him. She gets the 6-foot, 200-pound Barzen out of bed, dresses him, bathes him, changes his diapers, cooks his meals, cleans his clothes, and does all else necessary to keep him healthy and out of a nursing home. For this, the state pays her $8.43 an hour.
Karen Hammer provides care for Chuck Barzen in their Seattle home. A stroke left Barzen dependent on a caregiver but Washington state has cut Hammer's monthly check from about $900 to about $300.
Last fall, responding to budget pressures, the state cut her monthly paycheck from about $900 to about $300. Over the past seven months, Hammer, 62, and Barzen, 69, have slid deeper into poverty. Their van was repossessed and they're constantly ducking calls from creditors.
Now they're selling the house.
"We can't keep living like this," Hammer said. "I'm tired of being poor."
She's not alone. Recent changes in the way Washington state calculates home-care hours for clients have left many of them in a lurch. Legal challenges are pending for hundreds of elderly and disabled people who say they're not getting enough hours of government-financed help.
State officials say they're simply trying to make determining home-care hours more fair and consistent across Washington. But some advocates for the elderly and disabled say the new system is hurting those who need help the most.
Like many other states, Washington pays for home-care services under its Medicaid program. About 24,000 elderly and disabled people get government-financed care so they can live at home.
The costs of home care are about a third of the cost of nursing-home care. Long-term care is one of the biggest budget drivers for states.
In California, Gov. Arnold Schwarzenegger has proposed cutting $454 million in support for in-home caregivers next year, although he's seeking to fill in the cut with more federal money. Oregon tightened eligibility requirements for home care.
Last year, and again this year, Washington state gave home-care workers a raise. But the state also capped enrollment in the program, made eligibility requirements stricter and instituted a rule that says home-care workers who live with their clients can't get paid for chores such as meal preparation, laundry and shopping. The live-in worker would be doing those things anyway, the state's reasoning goes.
The "shared-living" rule makes no sense to Hammer.
"Because we live in the same house, they think I would wash his clothes with my clothes. Not! He's incontinent!" said Hammer, who thinks the people who make the rules should follow around a home-care worker for one day: "They don't realize you're dedicated to one thing, and that's that person."
Penny Black, home-care services director for the state Department of Social and Health Services, defended the rule.
"When someone is living with a client, certain tasks can be subsumed when you're doing tasks for yourself," Black said. Even when a client such as Barzen is incontinent, requiring extra laundry, and diabetic, requiring special meal preparation, the worker shouldn't get paid for that extra effort, she said.
"We felt that those extra kinds of tasks were 'de minimis'," Black explained, using a term that means, roughly, "a trivial matter."
Barzen's attorneys think the policy violates state and federal laws that guarantee disabled people the right to choose their caregivers. They say Barzen is being penalized with fewer hours of paid help for choosing a caretaker who lives across the hall instead of one who lives across the street.
"For Mr. Barzen, few decisions are more significant than his choice of the person that will provide the care he needs to continue to live every day outside of a nursing home," wrote Dan Krische, who represented Barzen for free at an administrative hearing in March.
The judge upheld the state's decision to cut Barzen's hours. Hammer and Barzen are appealing to the Superior Court, challenging the shared-living rule.
But the stress of living on $300 a month has taken a toll on Hammer. She's given up every luxury and semi-luxury she can think of; she hasn't filled some of her own prescriptions for months.
Even if they ultimately win in court, Hammer and Barzen have lost a lot. When they sell the house, they plan to move to Montana where Hammer once lived. And they're afraid of starting over.
