L.A. Times

June 29, 2010

Sacramento County budget cuts trigger lawsuits

Sacramento County supervisors should be happy they didn't cut too much from the county counsel's office last week when they passed a fiscal year 2010-11 budget.

That's because they keep getting sued for the cuts they did make.

On Tuesday, two indigent residents and Loaves & Fishes in Sacramento filed a lawsuit against the county to block cuts to medical care for the poor. That same day several nonprofit mental health providers sued to stop cuts to their programs.

"It means that the state of California and the county of Sacramento have constitutional obligations to serve the very poor and homeless," said Sister Libby Fernandez, Loaves & Fishes' executive director, adding that the governments are failing to fulfill those obligations.

These are the third and fourth lawsuits against the county over budget cuts. Mental health advocates and the Sacramento County Probation Association filed lawsuits before budget hearings even began.

The Loaves & Fishes lawsuit is an attempt to stop the closure of two of three county clinics and the halving of service at the one remaining clinic. Those clinics provide medical care to poor residents who don't qualify for other health coverage such as Medi-Cal.

"Absent injunctive relief from the court, the county will fail to provide medically necessary care in a timely and humane manner to some indigent residents and will fail to provide any care whatsoever to other indigent residents," according to the lawsuit.

The Primary Care Center – the one remaining clinic after the closure of the Del Paso and South City clinics – will go from 48,000 patient visits a year to 21,000 annually, the suit says. Advocates said wait times for those lucky enough to get an appointment could be more than six months.

A plaintiff in the Loaves & Fishes lawsuit is Rhonda Poole, 46, who has colon cancer and lives at a Salvation Army shelter.

Poole was diagnosed with cancer in June 2009 and then waited more than a year for a referral to see a specialist, according to the complaint.

"I was in pain. I couldn't eat. I was throwing up blood," Poole said, describing her year of waiting. "They haven't really done anything for me – nothing but make me suffer."

The new cuts will lead to more suffering and some will die waiting for care, advocates said.

The other lawsuit filed Tuesday was over the county's decision to cut four Regional Support Teams for adult mental health. Nonprofits El Hogar Community Services Inc., Human Resource Consultants, Turning Point Community Programs and Visions Unlimited have run the teams and are suing to stop the cuts, which take effect after July 1.

The suit alleges the county is placing its own strict civil service rules – which protect county workers at the expense of contractors during budget cuts – ahead of state laws mandating social services for residents.

The county is moving forward with a reorganized adult mental health program. The new system will use four county-run wellness centers partially staffed with contractors.

"I don't believe anyone won't get treatment under the new system," said Ann Edwards-Buckley, Health and Human Services Department director.

So far, Sacramento County appears to be the only county in the state to face such lawsuits this fiscal year, said Jennifer Henning, executive director of the County Counsel's Association of California. The state has faced numerous suits in the past few years from groups trying to block budget cuts, but local lawsuits are more rare, she added.

What's unclear is if the lawsuits against Sacramento County are a sign of things to come for local governments statewide or if they are merely a sign of just how bad things are in Sacramento County, which has had three years of $100 million-plus deficits and is laying off more than 700 workers in a few weeks.

"The state has tried to make certain cuts, and the courts have come back and said, 'No,' " Henning said. "Maybe courts are what people turn to when the decisions get so difficult. And maybe we'll see more of these."

Orange County faced a similar lawsuit last year from the Western Center on Law and Poverty. The center sued after cuts to welfare administration delayed many from getting aid such as food stamps.

The parties settled the suit a couple of weeks ago, and Orange County has agreed to provide aid in a more timely manner, said Michael Herald, legislative advocate for the center.

The center is working on the Loaves & Fishes case as well as the case mental health advocates filed against the county in early May.

"This is definitely not a pick on Sacramento County strategy," Herald said. "We are in the process of looking at a number of counties."

The center just sent a demand letter to San Joaquin County – prelude to a possible lawsuit – and could do the same with other counties

"I think you're going to see more cases like that be filed statewide," Herald said.

Henning, the county counsel association chief, said it's unclear where these suits will end. The courts can't appropriate money, and many of the counties like Sacramento have few if any other options.

The courts could potentially stop some cuts, but that might mean deeper reductions to other departments and possibly more lawsuits, she said.

"It will be curious to me to see what remedies the courts fashion because they can't print more money," Henning said.

Robert Ryan, Sacramento County counsel, said his office is reviewing the lawsuits and will defend against the actions. He declined further comment.