When a stroke five years ago left Raquel Lopez partially paralyzed and often confused, her daughter committed to caring for the woman in her Gilbert home.
The daughter, also named Raquel Lopez, quit her job as a manager of a McDonald’s restaurant to care for her 61-yearold mother, for which she is paid $7.88 per hour for 40 hours per week.
"I would feel very guilty if I sent her somewhere if I could take care of her at home," said the younger Lopez, 30, who is married and has three schoolaged children. "Plus I’m at home with my kids and I get paid for it."
The elder Raquel Lopez is one of 1,300 clients of the Maricopa Attendant Care Program, one of three programs in the county which pays the relative to care for an elderly or physically disabled person.
The program also pays trained caregivers to provide in-home care for the elderly and physically disabled. Seventy percent of the program’s clients are cared for by a family member.
"The whole focus is to keep people safe in their own homes," said Sandra Kelly, director of Maricopa Attendant Care Program. "The client thrives. There’s not a sense of desolation and loneliness there is sometimes in a nursing home."
The 10-year-old program — one of the first of its kind in the country — saves the county and state hundreds of thousands of dollars by allowing clients to forego nursing home care en lieu of care at home.
A client such as the elder Lopez, who requires 40 hours of care, costs the county health care system about $24,000 annually, Kelly said.
The average annual cost of nursing home care in the Valley is $58,400, according to a 2002 survey conducted by General Electric Capital Assurance Company.
Pat Walz, chief financial officer of Maricopa Integrated Health Systems, said the program saves the county thousands of dollars — significant savings in the face of the umbrella agency’s financial woes.
Benefits also are emotional. The younger Lopez values the relationship her children have with their grandmother. The four watch Spanish-language TV together, and the elder Lopez often tells her grandchildren stories from before she suffered a stroke.
"It teaches them to be respectful and to be caring of other people," Lopez said. "They’re learning to take care of a parent in case something happens to me."
Arizona was one of the first states to pay family members to care for an elderly or disabled person in their own home, said Alan Schafer, manager of Arizona Long Term Care System, the state’s Medicaid long-term care program.
When the state’s attendant care program began a decade ago, the practice of paying family members to care for their loved ones was prohibited by the federal Centers for Medicare and Medicaid, which regulates the attendant care program.
However, an exception was made for Arizona which already had programs encouraging the practice.
Since that agency changed its policies four years ago and allowed family members to be paid to provide this care in their home, other states have jumped on board, Schafer said.
"Sometimes (family members) are the most reliable providers," he said. "They’re dedicated and committed."
Mercy Care and Evercare offer similar programs in Maricopa County.
Maricopa Attendant Care Program requires clients be eligible for Arizona Health Care Cost Containment System, which means they cannot earn more than $1,656 per month, and must prove to be medically eligible, Schafer said.
A case worker determines how many hours of care each client needs. Family members are paid for a maximum of 40 hours.
Attendants are screened for tuberculosis and drug use, must maintain certification in CPR and first aid and demonstrate they can perform the tasks the client requires.
Supervisors and case workers visit the homes regularly to ensure the client is in good care and offer the attendant and client help in accessing other services.