Small pay raises for some in-home caregivers, and specific incentives for those working in West Marin, were approved last week by the Marin County Board of Supervisors. The funding fulfills the county’s financial commitment under a new tentative labor agreement between a caregivers union and the county’s office of In-Home Supportive Services, a Medi-Cal program. Effective Aug. 1, I.H.S.S. provider wages will increase from $18 to $19 per hour, with an additional 25 cents per hour added each year for the next two years. By 2027, in-home care providers are set to earn $21 per hour, a nearly 25 percent increase from 2023 rates. The I.H.S.S. program provides long-term care for low-income qualified California residents who are disabled and at risk of nursing home placement. In Marin, federal funding covers half the health benefits and wages for 2,000 I.H.S.S. providers, while the county covers 35 percent and the state covers 65 percent of the remaining costs. “It’s a unique three-party relationship,” said Daniel Eilerman, the assistant county executive for Marin. “We believe this agreement is an important step forward in improving wages for I.H.S.S. providers, who offer an invaluable service to Marin’s growing aging population.” Because the new agreement exceeds a 10 percent wage increase over three years, the county is forgoing a 2018 state budget provision in which the state would have covered 65 percent of non-federal costs. Now, Marin will be responsible for the entire non-federal amount. The deal also introduces incentives through a pilot program designed to recruit and retain specially trained registry providers, particularly those serving West Marin. New registry providers will receive a $250 bonus after their first year on the registry, an additional $200 if their recipient is in West Marin, and $250 upon completing five years of registry work. “We know that recipients in West Marin are harder to reach, so this is one way of hopefully finding professional providers who can provide service out there,” Mr. Eilerman said. If the strategy works, the county may look at enhancing it in the future. Until December, when it was raised to $18, Marin’s hourly pay rate for in-home support workers had been the lowest among Bay Area counties, at $16.95. Marin is also one of only seven counties in California that does not have an office for in-home support workers, meaning they must travel longer distances. Skip Schwartz, the executive director of West Marin Senior Services, identified these two factors—low wages and a scarcity of local providers—as reasons why West Marin’s aging demographic finds itself frequently underserved. “Most I.H.S.S. workers do not live in West Marin, and it’s difficult to find workers willing to come out here,” he said. “The pay rate also continues to be well below the private pay rate.” While advocates for the county’s homebound see the wage increase as an improvement, they say it still falls short of appropriate compensation. Many disabled recipients require around-the-clock, highly skilled care, which is difficult to find for $18 an hour. Maya Friedman, an executive administrator for InSpirit, a nonprofit in Woodacre that supports in-home care for quadriplegics, told the Light that many of her clients end up paying for additional care themselves. “The living wage in Marin really should be more like $26 an hour if we want to support caregivers who live locally,” she said. “You can get paid better by working at In-N-Out or Bank of America, and you’d have a much easier job.”