Organizing Home Care: - School of Social Service Administration

Draft Paper Not for Citation or Quotation with Authors’ Permission 4/24/2007
revealed that one in five was homebound. 44
In early 1951, Illinois moved to displace some of the cost of homemaker services
from counties reluctant to spend their own monies to federal funds attached to the
categorical aid programs (aid to the blind, elderly, disabled, and dependent children).
New York subsequently joined its petition to the federal Bureau of Public Assistance
(BPA) to apply such monies to pay for homemakers. Relying on an earlier argument for
the role of homemaker service in maintaining family life, BPA then generalized the
maintenance function of homemakers and in the process advanced a new interpretation of
the Social Security Act: “to help needy individuals through assistance and other welfare
services to remain in and maintain their own homes.” BPA provided hypothetical cases,
such as a brother and sister with muscular dystrophy, an aged couple—the husband with
a heart condition and wife in a wheelchair—and an elderly woman with cancer, to
suggest the need for long-term care. It further justified payment because “the
homemakers are staff members of the department of public welfare” and their “training is
focused, not upon housekeeping duties, but upon the principle of maintaining the home.”
Eighteen months later the Social Security Administration approved federal participation
in the administrative costs of long-term homemaker service in the categorical programs,
encouraging public provision of such service. 45
The clients of old age support and those of ADC became more tightly linked
when administrators of New York’s Homemaking Center called for continued expansion
of homemaker service as a more cost-efficient and humane alternative to
institutionalization. Proponents simultaneously invoked the language of independence
and protection, arguing that “[t]he homemaker’s supportive role has been found to have