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The Sacramento Bee

November 23, 2008

The Conversation: Proposed cuts would hit disabled people too hard

By Daniel Weintraub

State Finance Director Mike Genest stands by as Gov. Arnold Schwarzenegger calls for a special legislative session to address the state's revenue shortfall during a Nov. 6 news conference at the state Capitol. The governor's proposed budget cuts are sweeping – too much so for some. Photo: bbaer@sacbee.com

As Gov. Arnold Schwarzenegger and state legislators begin to grapple with a massive shortfall in the state budget, they will be inundated with desperate pleas from people who do not want their taxes raised or their services cut. Protesters have already begun their chants on the steps of the Capitol.

I don't know what the best mix of cuts and taxes might be, if there is such a thing. All the choices seem bad to me.

But after spending parts of two days last week with more than a dozen disabled people who depend on state aid to live on their own, outside of nursing homes, I do know this: They are the last ones whose services and support should be cut.

Almost every other part of state government serves people who, to one degree or another, can survive a budget cut. But those cuts should not fall on people like Dena Wright. Wright, 47, suffered brain damage in an automobile accident as a young woman. For a time after that, she lived with her parents, but when they could no longer care for her, she was moved to a nursing home. Now she lives independently with the help of her caretaker, Tony Vreeland.

While in nursing homes, Wright says, she "only existed" and felt as if she were among people who "were just waiting to die."

Now, she says, she feels alive.

"I finally have my freedom and independence," she told me in a written message.

When Wright and the other disabled people with whom I met speak of independence, they mean it in the sense of personal freedom, and especially a kind of psychological and emotional liberty. As Wright notes, life in an institution, for many, is really no life at all, only an existence. But the irony is that many people who are disabled are still utterly dependent on the rest of us for the independence they cherish. Without the support we give them through government, they would have to be institutionalized again.

If the proposals put forward by Schwarzenegger become law, we might not see the effects overnight. Few people would have the foundations of their support so utterly destroyed that they would immediately be forced to return to a nursing home. But I think it is safe to say that, over time, many of them would be. And in addition to the loss of human dignity, the slow erosion of independent living could cost all of us more money in the long run.

The governor's proposals would hit many of these people from several different directions. Almost all of them rely on SSI-SSP, the program that provides cash aid to the indigent aged, blind and disabled to pay for rent, food, clothing and transportation. A typical grant right now is $870 a month for a single person. That is scheduled to increase in January to help people keep up with the rise in the cost of living. Under the governor's plan, though, the grants would instead drop to $830 a month, the minimum allowed by federal law.

At the same time, the governor's proposal would cut Medi-Cal, the program that almost all severely disabled people rely upon for their health care. It would eliminate dental care for adults, as well as vision care, psychological counseling, speech therapy and even incontinence creams and washes. Schwarzenegger's proposal would also charge higher fees to disabled people who are able to earn some income on the side but still use Medi-Cal for their health care.

The governor's plan also includes a 3 percent reduction in the services coordinated by the regional centers that help people live independently.

But the proposed cuts that most alarm the disabled people with whom I spoke involve the In-Home Supportive Services program, which provides caregivers in the home that many credit for keeping them independent and out of an institution.

Schwarzenegger's plan would eliminate cleaning and cooking services for all but the most disabled recipients and charge others a fee even for basic care. He also proposes to limit the state's share of the cost of the program to the minimum wage, a change that could have profound effects.

Currently, most counties pay these workers more than the minimum wage. In Sacramento County, the pay is $10.40 an hour. If the state pulls back, the counties would either have to make up the difference themselves at a time when their own budgets also face deep cuts, or pass on the reduction to the workers. Recipients fear the cut would mean fewer and less- experienced people applying for those jobs, which would mean gaps in coverage.