Lawmakers seeking to surgically repair California’s ailing budget delivered a debilitating blow last week to agencies that aid seniors, including S.F.-based Jewish Family and Children’s Services.
In moving forward Gov. Jerry Brown’s plan to narrow the state’s $25.4 billion deficit, the state Senate and Assembly approved roughly $12 billion in cuts to welfare, medical programs for the poor and in-home care for the elderly and frail.
Among the hardest hit were Adult Day Health Care and In-Home Support Services — two programs that help seniors live on their own rather than enter a nursing home. In order to save more than $500 million, legislators voted to eliminate the ADHC program and to reduce funding for IHSS.
“This affects large numbers of the poorest and the sickest Jewish elderly in our community,” said Anita Friedman, JFCS executive director. “It’s hurtful to the community at-large, as well, because it further disassembles the safety net for the poorest and the most alone. And it’s not a good solution because it will ultimately increase costs.”
Seniors who live on their own can use ADHC programs — such as JFCS’ L’Chaim Adult Day Health Center, which annually serves 300 seniors in San Francisco who have monthly incomes of less than $900 — for physical therapy, exercise, mental care, medicine assistance and other services.
Statewide, ADHC programs serve 37,000 people annually. Upon the elimination of such programs, JFCS estimates that 72 percent of those people will need to enter nursing facilities within six months.
“Living in a hospital for months is the most expensive alternative, not the least expensive,” Friedman said. “People wonder why we have increased health costs, and this is one of the reasons — elderly with nowhere to go but a hospital.”
Lawmakers did not approve an official 2011-12 budget with last week’s votes, but signed off on legislation necessary to enact the cuts. Moreover, the approved cuts would attack only a portion of the state’s huge deficit. Brown spent this week trying to advance the other half of his plan: a June 7 special election asking voters to extend tax increases (sales, personal income and vehicle) enacted two years ago.
If lawmakers don’t approve the special election, Brown will likely want to expand the agreed-upon cuts in order to further chip away at the $25.4 billion deficit.
“At this point, the best-case scenario is major cuts,” Friedman said. “But things could be even worse if voters don’t extend the taxes.”
Two of the cuts approved last week are expected to save the state nearly $740 million: 10 percent reductions in what the state pays for Medi-Cal patients at long-term care facilities and to physicians who see patients on Medi-Cal.
“We have a huge challenge to meet federal guidelines for staffing levels while [having our revenues reduced by] hundreds of thousands of dollars a year,” noted Janice Corran, executive director at Danville’s Reutlinger Community for Jewish Living, where the cuts will affect the center’s skilled-nursing facility. Reutlinger also offers assisted living.
Reutlinger will continue to house people on Medi-Cal (and/or Medicare) in its skilled-nursing facility, Corran said. “We must therefore look for ways to meet this challenge and continue to provide the highest quality care,” she added.
Friedman did her best to keep a positive outlook, as well, noting that — due in part to JFCS lobbying efforts in Sacramento — an $80 million program called Keep Aging Free of Institutionalization has been proposed as a substitute for ADHC, a $180 million program.
“Gov. Brown proposed a total elimination of ADHC and got a partial elimination,” Friedman said, “because the legislators [by proposing KAFI] said they were not ready to abandon old and frail people.”
However, the rules and regulations of the KAFI program — essentially an emergency program for people in acute need — are unclear at this point. Moreover, Brown could move to get it eliminated from the final version of the budget.
“It’s a sad state of affairs,” Friedman said. “But we’re not yet at the end of the story.”