The recently passed state budget might be counting its chickens before they’re hatched, according to some in the healthcare industry who are worried about the $4 billion in additional revenue projected by lawmakers.

If the revenue does not come through by December of this year, a series of cuts would be “triggered” in January 2012, including a $100-million cut to the state’s In-Home Supportive Services hours. IHSS, a division of the state’s Department of Social Services, provides in-home services to eligible seniors as an alternative to nursing homes and other facilities.

“For years we were a major target with budget cuts, but it doesn’t make sense because inhome care is five times cheaper than a nursing home,” said Steve Mehlman, communications director at United Domestic Workers Homecare Providers Union. “If they don’t get this revenue, it will trigger some cuts that, from what I understand, would be catastrophic.”

Mehlman said the cost of providing in-home care for an individual is about $12,000 per year, as opposed to nursing homes, which run about $60,000.

“We’re talking about people who are hurt or disabled and the elderly who require in-home care,” he said. “These are people who can’t fend for themselves. So if they’re talking about cuts that are up to 20 percent, for example, we have about 450,000 people who use these (IHSS) services. That’s over 100,000 people moved out of the program. So where do they go?”

‘Cuts would be devastating’

Michelle Kellogg is an inhome caretaker through IHSS who takes care of two elderly women, 75 and 98. Kellogg, a resident of Simi Valley, said her two clients have “become like family.”

“If they didn’t have me, they would not be able to survive,” she said. “They’ve worked all their lives, and with no cost-of-living increase to Social Security they don’t have the means to hire independent care through an agency, so I’m their lifeline. Literally.”

Kellogg is a single mother of two disabled boys and is also battling cancer. She saw her work hours cut by nearly 4 percent at the beginning of the year and said more cuts would be tough to face.

“I’m a Medi-Cal recipient, and it’s difficult when my prescriptions aren’t covered,” she said. “But I can walk and function. For elderly people, more cuts would be devastating.”

Mehlman said he fears the budget cuts to In-Home Supportive Services would place a heavy burden on an already vulnerable population.

“Some people will move to nursing homes under the Medicaid program for low-income people, but that means the taxpayers will pay for the care,” he said. “The problem is that there aren’t enough nursing home beds to accommodate these people.”

Expecting the worst

Kara Partridge Ralston, chief operations officer of the Camarillo Health Care District in Camarillo, said her area is anticipating a surge in people who may need services because of cuts to the in-home care hours.

“ We are the only state- licensed adult day care facility in Camarillo, so we’re seeing the writing on the wall, and we are ready to take care of these people,” Ralston said.

“If state revenues do not come in as high as projected over the next few months, IHSS recipients’ authorized hours could be cut, which means that their providers’ hours would be reduced,” said Kathy Cilley-Wagner, an In-Home Supportive Services program manager for Ventura County.

But Wagner said if the trigger cuts are put in place and clients need to have their cases reevaluated, the state will allow for a review process.

An elderly demographic

George Jones and his wife co-own two Home Helpers franchises that serve Ventura County. His company sends caretakers to the homes of the elderly, mothers with new babies and people who are recovering from surgery.

Services provided by privately funded companies such as Home Helpers are covered by long-term health insurance policies. Jones said California’s budget cuts would impact people who don’t have the long term care.

“It’s a real problem, especially for the elderly,” he said. “They’re going backwards from being independent to having to relinquish that control, and that can raise a host of psychological issues. Their children may live hundreds of miles away and are faced with the fact that their parents are becoming children again, wearing diapers and so on. But who pays for that?”

Jones, who will turn 71 this year, said elder care is an issue that faces all people eventually.