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JewishJournal.com

April 30, 2003

Care Programs Face State Funds Loss

http://www.jewishjournal.com/health/article/care_programs_face_state_funds_loss_20030501

Life was good for Bennett Bridge. He owned his own business, raked in more than $100,000 a year, had a good marriage and two healthy children.

Then, fate took an unexpected turn. In 1990, Bridge, then 50, had a massive stroke that nearly killed him. After surprising his doctors by surviving, he began a long and difficult rehabilitation. His right side paralyzed, speech slurred and his gait now regulated with a walker, Bridge had to painfully confront his limitations and reinvent himself along the way.

An optimist by nature, he successfully staved off depression. Still, feelings of uncertainty seeped in. What would he do? What could he do?

Bridge found answers to those and other questions one year later, when he began attending the Valley Storefront Adult Day Health Care Center in North Hollywood.

At the Jewish Family Service (JFS)-run facility, he developed an abiding love for and dexterity in needlepoint. Since learning how to sew and perform other tasks left-handed, Bridge has made 13 needlepoints for friends and family. He is now working on an autumnal scene of trees, with leaves of brilliant red, yellow, orange and blue.

For Bridge, coming to the center five days a week to needlepoint, eat kosher meals with friends and attend a stroke support group has given a purpose and meaning to his life that it might otherwise lack.

"This place has done more for me than anything I've done since my stroke," said Bridge, a tall, slender man with a soft gaze. "I would be devastated if it closed."

Like Bridge, Milton Knopoff has found an outlet for his artistic side at the Valley Storefront. Knopoff, a 68-year-old former L.A. county administrator who suffers from dementia, particularly enjoys drawing, painting with watercolors and spending time with contemporaries.

"If I stayed at home, I would just be there," he said. "It would be boring."

For Bridge, Knopoff and the 50 other men and women who drop by the center daily, the place is nothing less than a home away from home. And it offers their overtaxed loved ones a much-needed break -- for a few hours -- from the difficulties of caring for them.

But the state's budget crisis has cast a pall over Valley Storefront's very existence. Proposed major cuts to Medi-Cal, the state's health insurance for the poor, could force the center to close its doors permanently.

With a projected budget shortfall of at least $35 billion over the next 15 months, Gov. Gray Davis has proposed slashing $20 billion from the state budget and increasing taxes by $8.3 billion. Among the most painful suggested cuts is a 15 percent reduction in Medi-Cal reimbursements. That belt-tightening would save more than $1.4 billion in the 2003-2004 fiscal year, but might do so at the expense of the some of California's most vulnerable.

The governor also wants to tighten Medi-Cal eligibility rules by requiring people to apply for benefits quarterly, rather than just once a year. Experts believe such an action would shrink the number of beneficiaries and potentially save millions.

Medi-Cal underwrites a slew of programs that caters to a largely Jewish clientele, including the Valley Storefront, the Los Angeles Jewish Home for the Aging and the JFS-run Multipurpose Senior Services Program (MSSP), which provides indigent elderly men and women taxi vouchers, home meal preparation and other services to keep them out of nursing homes. Overall, an estimated 50,000 Southland Jews are Medi-Cal recipients, said Jessica Toledano, director of government relations for the Jewish Community Relations Committee, a department of The Jewish Federation.

Many lobbyists and advocates for the elderly hope that the proposed Medi-Cal cuts will prove so politically unpopular, that they will be scaled back significantly before the Legislature passes a final spending blueprint later this year. To ensure a more favorable outcome, they have recently ratcheted up the heat.

Los Angeles Federation members have written letters and called state politicians to voice their opposition. The group plans to dispatch a mission of 50 people to Sacramento in mid-May as part of its "strategic plan" to restore Medi-Cal funding, Toledano said.

"If those cuts go through, some people will lose their home health care, oxygen tanks, walkers, wheelchairs and dental services," she said.

A 15 percent reduction in reimbursements might lead to the closure of up to one-quarter of California's 307 adult day health-care centers, said Lydia Missaelides, executive director of the California Association for Adult Day Services. Such widespread closures could force many ailing seniors into nursing homes, because they have no one at home capable of caring for them, she said.

Taxpayers might suffer nearly as much as the displaced seniors. With round-the-clock care, nursing homes eat up more tax dollars than adult day care and other outpatient services. Nursing home living also increases the risk of depression among seniors, mental-health experts said.

Hilary McLean, spokeswoman for Davis, said the governor is concerned about the impact his proposed cuts could have on the elderly, students and other Californians. However, she continued, the state Constitution mandates a balanced budget, and he must make tough choices. Lower-than-expected tax collections might also force Davis to propose additional and deeper cuts in the revised budget he will submit in mid-May.

"Those hoping and crossing their fingers that the governor will undo the cuts he's proposed are frankly kidding themselves," McLean said. "There's no way to balance a budget of this size without affecting real lives. The effects are going to be felt everywhere."

That's bad news for the 800 residents at the Los Angeles Jewish Home for the Aging. The home, which features a beauty salon, gift shop and even an on-site post office at its two campuses, stands to lose $1.5 million a year. Such a "devastating loss," coupled with higher energy and insurance costs, could lead to cuts in nurses, social workers and such programs as exercise and knitting, said Molly Forrest, the home's chief executive.

With a waiting list of 325, the Jewish Home has won kudos for the quality of its facilities and social services. In January, a California Department of Health Services inspection found no safety and staffing deficiencies, a rarity among the state's nursing homes.

Forrest said the growing difficulty seniors face in getting needed assistance infuriates her.

"People in sheltered care can't go out and get a job or pull themselves up by their bootstraps, because they're frail and elderly," she said. "We have an obligation to them to make sure they are well cared for with dignity and respect."

Paul Castro, JFS director, shares Forrest's frustration. He said MSSP could no longer afford to serve 110 of its 734 monthly clients if the governor's Medi-Cal cuts go through. Many of those people would end up in nursing homes, he said.

"I haven't seen such a serious crisis in my 25 years in the nonprofit world," Castro said. "I'm hoping for a miracle."

Back at Valley Storefront, program director Devorah Teyer surveyed the activities room, where about 25 elderly men and women played bingo. Her face darkened with the realization that the 18-year-old center might soon be shuttered.

"I would like Gov. Davis to meet with these people and talk with them," she said. "I don't know how he couldn't be touched."

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