Cynde Soto dreads the arrival of yet another benefit notice.
Her cash assistance has been cut four times in two years. State medical coverage is getting more expensive and no longer includes dental care or podiatry. And the in-home help she needs to take care of basics has been cut by about 20 minutes a day.
For The Record
Los Angeles Times Friday, August 19, 2011 Home Edition Main News Part A Page 4 News Desk 1 inches; 55 words Type of Material: Correction
Safety net: An article in the July 31 California section about cuts to health and social services said Medi-Cal beneficiaries are being charged co-payments of $5 for prescriptions, $50 for emergency room visits and up to $200 for hospital stays. No co-payment is currently required; the state is waiting for federal approval to begin charging.
For The Record
Los Angeles Times Sunday, August 21, 2011 Home Edition Main News Part A Page 4 News Desk 1 inches; 56 words Type of Material: Correction
Safety net: An article in the July 31 California section about cuts to health and social services said that Medi-Cal beneficiaries are being charged co-payments of $5 for prescriptions, $50 for emergency room visits and up to $200 for hospital stays. No co-payment is currently required; the state is waiting for federal approval to begin charging.
"That doesn't sound like a lot to people but ... I'm a quadriplegic," said the 54-year-old Long Beach resident. "I can't even scratch my own nose."
Faced with years of recession-driven budget shortfalls, state lawmakers have made deep cuts to health and social services. The reductions, including a round that took effect this month, translate into sizable state savings but are sharply scaling back the safety net for California's most vulnerable residents: the elderly, the disabled and the poor.
Since mid-2008, more than $3 billion has been sliced from CalWorks, the state's welfare program for nearly 600,000 families with children, according to an analysis by the California Budget Project, a nonpartisan think tank. Another $3 billion has been cut from Medi-Cal, which provides health coverage to about 7.5 million Californians. And $4.6 billion has been cut from the Supplemental Security Income program, which supports nearly 1.3 million elderly and disabled people with little or no other income.
The cuts are reversing longstanding policy priorities and eroding the ability of public agencies to cope with a growing and aging population, advocates for low-income families say.
More than a billion dollars has been slashed for childcare, job training and other services that have helped hundreds of thousands of unemployed Californians reenter the workforce since a Clinton-era overhaul of the national welfare system imposed strict limits on benefits in 1996.
"We've gone back on the social compact of welfare reform," said Jean Ross, the California Budget Project's executive director.
Because those programs are stretched, welfare recipients with small children have not been required to participate in workforce preparation activities since 2009, increasing the number of exempt families by about 60,000, according to the County Welfare Directors Assn. of California.
"We have a lot of people we're telling to sit at home," said Michael Herald, a lobbyist for the Western Center on Law & Poverty. "We have fundamentally distorted the program in recent years because of the budget crisis."
Programs that help the poor, the elderly and the disabled stay healthy and independent have also been hit, undercutting local, state and federal efforts to keep the needy away from high-cost emergency rooms and institutionalized care.
"You've got the most vulnerable people in society getting hit with multiple cuts," said Frank Mecca, who heads the welfare directors association. "The same person gets hit over and over."
Soto is paralyzed from the shoulders down but does not let that keep her from doing advocacy work for people with disabilities at a Los Angeles independent living center. Using her mouth, she can operate a computer trackball and type numbers into a phone with a Popsicle stick. Several times a week, an aide helps her into an electric wheelchair so she can take the train to work.
Most of the $800 she earns a month goes toward work expenses, including paying someone to feed her lunch. She has relied on $723 a month in SSI to cover rent and utilities. In July, the state reduced its portion of the grant for single beneficiaries like Soto to the federal minimum, shaving $15 from her income.
The same month, the state began charging Medi-Cal beneficiaries copayments of $5 for prescriptions, $50 for emergency room visits and up to $200 for hospital stays. Soto has five prescriptions and went to the hospital four times last year. "That can really add up," she said.
But the cuts that worry her most are those to the In-Home Supportive Services program, which is paying for about nine hours of care a day. The two women who have been assisting Soto for more than a decade have told her they will have to look for other jobs if their hours are cut again. Without them, she fears she would have to go into a nursing home.
"Oh, my gosh. That's no way to live," she said. "I wouldn't be able to continue working. I would lose my quality of life.... I think I would rather just die."
State lawmakers said tough choices had to be made because of the size of the budget shortfalls, which totaled tens of billions of dollars. Health and human services account for about a quarter of state spending.
Last month, Gov. Jerry Brown signed another "painful budget" with deep cuts to services after losing a bid to win enough Republican votes to extend temporary taxes. Republicans said the taxes were a drag on the struggling state economy.
