Scott is among roughly 900,000 disabled Californians and older adults who rely on In-Home Supportive Services, a Medi-Cal program that pays caregivers to help people stay in their homes. Now, the program faces pressure from two directions: the Trump administration plans to defer $1.34 billion in federal matching funds while Gov. Gavin Newsom is proposing state budget changes that advocates say would shrink access and shift new costs to counties.
Keeping people in their homes provides independence and is more affordable than nursing home care, said Hagar Dickman, a senior attorney at Justice in Aging.
According to the California Department of Health Care Services, in-home support costs roughly $30,000 per person per year, compared with about $137,000 for institutional care.
Under Newsom’s proposal, advocates estimate counties would pick up approximately $233 million in new costs as demand for the program grows.
But cash-strapped counties have little incentive to expand services, said Silvia Yee, public policy director for Disability Rights Education & Defense Fund.
