Balancing the budget: Making the weak pay

Sylvia Mnuchen has spent her life fighting.

First it was cancer that attacked her skin, then her breast. More recently it has been an ailment that has kept her in a wheelchair, her feet swollen, her legs wrapped tight like a mummy.

But as a loyal Jewish Democrat and longtime advocate of social justice, she never thought she would find herself fighting Jerry Brown, a man she voted for three times for governor. Yet the 94-year-old is suddenly on the wrong side of Brown’s proposed budget cuts that would slash state spending by $12.5 billion, ripping a hole in numerous social service programs and eliminating others entirely.

Payouts for Medi-Cal, California’s version of Medicaid, would be reduced by $1.7 billion. The welfare-to-work program CalWORKs would be cut by $1.5 billion. Other programs assisting the elderly and disabled would be affected, too.

Legislators are working on a budget agreement with the governor and expect it to be ready for a vote early this month.

Brown has called it “a tough budget for tough times.” To Mnuchen and other social service advocates in the Jewish community, though, it would only make tough times tougher.

“It’s a terrible situation,” she said.

A former travel agent who lives in an apartment in Beverly Hills on $986 per month, she uses the state’s In-Home Supportive Services Program (IHSS), which pays for personal care assistance. She needs someone to help her get out of bed, wash herself, make her meals and prepare her many medications.

“What are they trying to do? Kill us all?” she asked. “I can’t manage. I can’t manage because I can’t be without a caretaker.”

Mnuchen’s concern is that cost-cutting measures — on top of a 3.6 percent reduction in IHSS hours enacted by the previous administration — would endanger her well-being as well as that of her caregiver, who makes only $9 an hour. Fewer hours will mean less money and tougher times for such providers.

“How can a person live on that kind of money? And then take more money from them?” Mnuchen said.

No one disagrees about the root of the controversy: a state budget gap that has spun out of control to more than $25 billion.

“I think everybody who does advocacy on their agency’s issues understands there is a shortage of dollars. It’s just that simple,” said Adine Forman, director of government affairs and special projects for Jewish Vocational Service (JVS). “The government’s short money, and it has to take it from somewhere.”

Somewhere, it turns out, could be far reaching. The governor’s proposed reductions to CalWORKs, for example, would add up to $450 million in Los Angeles County, causing tens of thousands of families to lose their benefits.

The program, known in the county as GAIN, or Greater Avenues for Independence, is administered by JVS at three sites: Palmdale, Chatsworth and Santa Clarita. It helps provide child care, case management, transportation, counseling and more, all with the goal of returning people — often single moms — to work and helping them regain self-sufficiency.

Anne Kagiri can testify to the importance of that. The mother of two moved here from Michigan to live with her sister after she lost her job and separated from her husband. Even though she had a master’s degree in human resources, she couldn’t find a job quickly and left one son in the care of her mother back in Kenya.

“I never thought I would be on welfare,” said Kagiri, 35.

But it worked. Now she has a full-time job as a case manager for JVS, has her own house, and she was able to bring her other child to live with her.

“I’m completely independent,” she said.

Brown’s budget would trim grants and cap participation in the program at four years instead of five over the course of a person’s lifetime.

JVS officials say it’s their job in this time of financial crisis to examine how the programs can be scaled back with the least damage to those they serve. Still, they worry about the stress the governor’s proposals would have on county resources as former CalWORKs participants end up on general relief. Other worries plague their minds, too.

“I think you have the potential to have a highly elevated homeless count because of it,” Forman said. “There are a lot of people that are hanging on by a thread that are on CalWORKs and living on bare bones to try and make it work.”

It may seem hard to think of number crunching and state budgets as a matter of life and death, but that’s how Paul Castro sees it. The chief executive officer of Jewish Family Service of Los Angeles (JFS) fears that some proposed reductions could leave frail elderly populations with a deadly choice: Stay at home and die or be institutionalized.

Consider the Multipurpose Senior Services Program (MSSP), operated locally by JFS and earmarked by the governor for elimination. It provides skilled health care professionals to give case management and supplemental services to poor, at-risk seniors who are living at home. If axed altogether, it would cost JFS $2.9 million and affect more than 650 of its clients who might otherwise be in nursing homes, Castro said.

While ending the program would trim $20 million from the budget, Castro said the state should consider the full implication of its actions. Not only are California’s dollars matched by federal contributions, the eventual cost to the state of at-risk seniors moving into nursing homes would be much greater, he said.

“The math doesn’t work,” he said. “The question becomes: Have they calculated the cost yet?”

And not just the cost in dollars. Castro said he’s concerned about people who would do anything to stay in their homes, even without the program. He sees them missing doctor appointments and meals, not taking their medications regularly and ending up in emergency rooms.

A January policy note by the UCLA Center for Health Policy Research supports his concerns about the impact of possible budget cuts to this and other initiatives, stating, “Recipients of these programs are already in precarious situations and … undermining their care networks will place them at risk of worsened health and institutionalization.”

Castro takes it a step further: “Some are just going to stay home and die because they won’t have any support system.”

It’s an argument that many lawmakers have found persuasive. Jewish State Sen. Alan Lowenthal (D-Long Beach) said he understands the role such programs play in keeping people alive.

“Somehow, we have to keep as much of the safety net in place as we can,” he said. “Right now, we’re trying to do the least amount of harm, but it’s still terrible.”

Lowenthal is a member of the State Senate’s Budget Committee and the conference committee charged with reconciling differences between the Assembly and Senate. Legislators in both chambers have indicated they will try to protect — partially or in full — various iniatives that serve the aging, poor and disabled, including MSSP.