Fwd: The real cost of minimum wage caregivers' labor

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Dec 12, 2023, 11:56:19 AM12/12/23
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Dear San Diego Neighbor,

65% of voters in District 77 contribute to the millionaire's tax. Majority are over the age of 50, with wishes to pass peacefully in their own home. Sadly, I have met many of my constituents who have not calculated the 1/4-million each year for personal care. By the time a person wishes to enter hospice, they will have to confront an inadequate case management system that is one of the lowest rates of implementation of hospice before someone dies. 

The average pay for agency fees to manage 24/7 care is $35 per hour. The agency then usually pays the worker minimum wage, or an incentive of up to $2.00 above minimum wage, and keeps the difference for administrative purposes. This is not illegal, and is the standard in this industry. 

You can verify this from these leading agencies in San Diego: 

The math of $35/hour is 35*24*7*52=$305,760 per year. This is the standard cost for not being placed in a facility against one's wishes. 

I am proud of UDW/AFSCME Local 3930, "fighting for workers and our community". We have over 600,000 individuals enrolled with the county IHSS program, where they receive eligibility for county-paid caregivers in home. This county program is only for low income people who are on medi-cal. 

In July, a new rule requires the workers to enable location tracking to monitor where they log in and log out on a county app that records timesheets. People are complaining that they must have a smartphone for that, they must have a data plan, or they must be able to log in on the first try without the app crashing. Although fingerprinting significantly reduces fraud, location tracking measures intended to suppress fraud are ineffectively decaying attitudes of workers who no longer want this job. 

The Governor's budget allocates IHSS funds to each county, and workers in each county have a specific rate adjusted to the Recipient (not the worker’s) cost of living. As caregivers are least likely to be able to afford to live where they want to work, commuting to neighborhoods that pay higher is a major barrier. This leaves 1/2-million people on a desperate waiting list for providers. Due to extremely low enrollment, there are at least 100,000 less providers on the public registry than are recipients in need of care. This crisis is leaving people without shift workers they need for daily living, which places the burden on hospitals to manage chronic problems such as frequent falls and nutrition-related weakness. Malnutrition is still the leading cause of death in the elderly and disabled population. 

Who can enroll as a provider? Any adult citizen, or a sibling of a special needs child who is over the age of 14, in some cases. The county requires fingerprinting and livescan of providers who enroll. I polled my professional colleagues on LinkedIn and asked a divisive question about consumer safety: 

Should recipients of direct care supports be informed if their care provider has a criminal record?

Yes, consumer must be informed


No, it violates worker privacy


My opinion on this politically charged issue is that I am especially sensitive to people who are vulnerable, such as the 1-million autistics in the state, especially autistic adults who live alone and suffer from social estrangement. How do they have informed consent to hire a worker without knowing if they will be taken advantage of? 

Consumer safety goes hand in hand with caregiver privacy, but how much privacy is enough? Electronic timesheets with GPS tracking is a clear invasion, but so is the lack of informing the consumer about a criminal record. Imagine if you find out that your mother's caregiver has been using her car to do Uber at night when she was asleep. 

My only possible solution is to (1) inform the recipient of the nature of the crime on record, even if time was served, and (2) offer increased salary commensurate with higher education units to ensure a professional standard equal to higher pay. 

Currently, county caregivers can take free coursework such as CPR, and bill for their time in the online class. I would like to see professional advancement reflected in salary. Caregivers have to spend about 20% of their day's salary for gas to commute to recipients located multiple zip codes away.

 I also propose that the county should offer a commuter shuttle and rideshare vouchers to incentivize workers to be on time for shift work, without personal expense. How many "flat tires" will they need until they lose their job?  Tell me what you think. 


Dr. Henny Kupferstein (she/her)

Save a penny, Vote Henny ! 


Assembly 77 2024 

Coastal San Diego, Candidate

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