By Israel Bayer, Amanda Waldroupe and Joanne Zuhl, Staff Writers
Only weeks after Gov. Ted Kulongoski released his budget — the leveling off a $577 million deficit — the Dear John letters went in the mail: Thousands of letters informing the elderly, disabled, the sick and the poor that the state can no longer support the assistance they receive for basic needs.
The state Department of Human Services, which oversees assistance to the state’s most vulnerable populations, is absorbing well over $158 million dollars of this budget gap. Calling them cuts seems inadequate to describe the damage done. The governor’s reductions, which by law have to be across the board, also mean a reduction in the amount of federal funds leveraged because of state spending. In the end, what is cut at the state level is often only the tip of the iceberg in what is lost to the program.
In this edition, Street Roots is highlighting 15 state programs affected, and in some cases completely dismantled — most of them within the Department of Human Services, but housing as well. The programs include alcohol and drug treatment, homeless assistance programs, and an entire system working with seniors and people with disabilities. The cuts are also completely turning what’s left of a mental health system upside down, not to mention the slashing of the state’s HIV, sexually transmitted disease and tuberculosis programs.
What we’re charting here is only a portion of the cuts affecting Oregon’s poor. There are many others, but this gives an overview of the catastrophic impact these decisions will have on our neighbors and neighborhoods. The information on the programs and the impact are taken directly from the state’s matrix on the budget cuts, and unless specifically noted, include both the cuts from the state General Fund as well as the losses in federal and “other” funding for this fiscal year. Agencies are operating under these cuts now as the majority of these budgets went into effect July 1.
As tough as these current economic challenges are, analysts project a $2.5 billion dollar gap in the coming fiscal year. It is hoped that with the information presented on pages 8 and 9, you will better understand what this is costing us, and what will be at stake next year when we can expect even more reductions in services to those in need, barring intervention.
In addition to the programs we’ve highlighted here, there are many more, not the least of which are reduced support for educating our children and our corrections network.
By year’s end, more than 60,000 people in Oregon will have exhausted their unemployment benefits. Without the prospect of gainful employment, many will be forced into the safety net of the programs listed above. They may be family, friends or neighbors to you. They may be you.
Seniors and People with Disabilities Division
Medicaid Personal Care Program, $2,375,705 cut: This and other in-home assistance are getting relief from $17 million in emergency funding from the state through June, 2011.
Nearly 1,200 Oregonians (882 aged and physically disabled clients and 292 developmentally disabled clients) receive this service at an average cost of $250 monthly. Effective Aug. 1.
Impact: Reduction would eliminate in-home personal care services that help maintain independence and dignity, such as bathing, eating, dressing and mobility.
In Home Care Program, $25,708,247 cut: Provides seniors with personal assistance, such as food preparation, housekeeping, shopping, etc. Effective Oct. 1: This and other in-home assistance programs are getting relief from $17 million in emergency funding from the state through June, 2011.
Impact: The program will be reduced by 75 percent. An estimated 10,500 seniors will lose personal assistance services, and may no longer be able to live independently and need to move to nursing facilities or other care settings.
“Regarding Oregon Project Independence, if you have a client who is in their 80s who needs help with housekeeping a few hours a month — people who live independent, want to and need a little bit of help. If you take away that help, at some point soon they’re going to end up in a nursing home. It costs taxpayers a lot less to pay for the couple of hundred a month to pay for in home than it does the $5,000 to $7,000 a month in a nursing home.
I hope taxpayers and the public understand. The scary thing about it is we all know somebody who is a senior citizen. And we probably all have tangential connections with someone with a disability, or a child with autism. These cuts are going to hit home in a way that really everybody is going to feel.”
— Dave Austin, Multnomah County Department of Human Services
Developmentally Disabled Family Support, $1.8 million cut: Provides financial assistance to families raising children with developmental disabilities to alleviate the financial and emotional burden associated with supporting a child with developmental disabilities and caretaking. Examples include family respite, equipment and in-home care. Effective Aug. 1.
Impact: Services will be eliminated for 1,140 families with children who have developmental disabilities.
In-Home supports for Children with Developmental Disabilities, $2,105,515 cut Services maintain the child in, or return the child to, the family home from community placement resulting from a crisis. This program has funded 311 children to have in-home supports. To be eligible for the program the family must have been in crisis in supporting their child.
Impact: Without this program families may have to consider placing children within the Child Welfare system or in residential care (e.g., foster care or residential care). The typical profile of families receiving these services are single parents or grandparents caring for multiple children where one or more child in the home has a developmental disability.
“When the state cuts come down, we anticipate having a severe impact on some of the vulnerable residents we serve in those areas. And right now everybody knows that times are tight for everybody. People are losing jobs and houses. Vulnerable people get hit particularly hard by these kinds of things because they don’t have supplemental incomes. They rely on a set amount and what we try to do with our services. An important thing is to allow families and individuals to live as independently as possible.
“There is in-home support for people who have children with developmental disabilities. We provide respite care, cleaning in the house, watching a child to allow a parent to take a break. That costs about $600 to $700 a month. The next step in this equation, if a parent can’t continue without a break is foster care. Then you’re getting into the thousands per month. People need to understand the pay me know or pay me later of this.”
— Dave Austin, Multnomah County Department of Human Services
Mental Health Programs
Community Mental Health Program, $4,249,016 cut. Funds county contracts for mental health services for children and their families without access to treatment, and for adults who do not have coverage for Medicaid. Effective Aug. 1.
Impact: This reduction will affect 1,462 Oregonians with mental illness. Access to crisis services, psychiatric treatment, medications and access to case management will be greatly reduced. Reduces the 24/7 crisis response services in local communities. The ability of the counties to use state resources to pay for acute treatment for adults unable to pay, and for people unable to pay who are a possible danger to themselves or others will be reduced.
Development and Investment in Mental Health Programs and Services, $10,275,757 cut. The reduction means no additional state delivered secure residential treatment capacity will be developed, 12 secure residential beds will close, collaboration with State Housing and Community Services to fund housing for homeless people will not occur, and one time investments to train, staff, develop and build capacity for pilots for the adult mental health system will not be made. Effective July 1
Impact: Increasing capacity of secure residential treatments will not occur. Approximately 44 fewer secured residential beds will be available than planned. Fewer patients will be discharged from the Oregon State Hospital and placed in community settings. Fewer homeless people suffering from mental disorders will be able to find permanent housing.
“Fragile persons with disabilities are targeted to bear the burden of poor budget management on the part of the Governor and the state legislature. Other Western states are not having these problems understanding the fiscal value of early and worthy intervention; Washington, Arizona, Colorado, Hawaii, Alaska. Some of the burden will be carried by private hospital emergency rooms, who will bill the state for primary care services in lieu of psychiatric care, and on Oregon families. Expect more persons with mental illness and addiction entering the service system through jails and courts – the most expensive, least effective intervention we have yet concocted.”
— Jason Renaud, Mental Health Association of Portland
Community Mental Health Program, $2,140,427 cut. Elimination of the Personal Care 20 Program. Effective Aug. 1
Impact: The program will be eliminated. 800 people possibly could mentally decompensate and no longer be able to live in a community setting, instead needing hospitalization or institutionalization. 700 people care providers will lose their jobs.
“This cut sabotages a key tool case managers have to convince private landlords to rent to persons with a diagnosis of severe and persistent mental illness. Our friend Michael Hopcroft, writer for Street Roots, will be in jeopardy of losing his housing without this support, and finding new housing for him will be unlikely. This service cut will increase homelessness for persons with a mental illness.”
— Jason Renaud, Mental Health Association of Portland
Homeless Assistance Program, $382,179 cut from state general fund. Funds emergency shelters and related services. Those services may include meals, hygiene and referrals to housing agencies. Effective July 1
Impact: According to the budget assessment, an estimated 3,158 people will not receive services. Rural areas that do not have shelters, as well as communities with limited shelter space, rely on motel vouchers to provide housing for homeless people. The amount of motel vouchers will be reduced, with the direct result of fewer beds for the homeless.
“The cuts to the homeless, the cuts to senior citizens, the cuts to working parents who need child care. All of these are cuts that we cannot afford to see happen in Oregon. I do think the cuts that people are making, particularly in child care and in senior services, will result in a great deal of suffering. Certainly cuts to the programs for homeless will result in more suffering since the state homeless assistance programs help shelters stay open. If homeless shelters can’t stay open then homeless people are going to suffer even more.”
— Jean DeMaster, Executive Director, Human Solutions
HIV/Sexually Transmitted Disease/Tuberculosis Program, $478,040 cut. Provides funding for tuberculosis research, HIV/AIDS medication, testing, counseling, case management and support services to HIV/AIDS centers throughout the state. Effective Aug. 1.
Impact: Reduces state support for TB investigation, case management and medications, which could result in new cases. 5,747 patients would not receive medication for STDs, and approximately 345 clients with STDs would not be interviewed or notified of potential exposure. Reduction in HIV testing at counseling and testing centers statewide, which would mean approximately 1,143 clients would not be counseled or tested for HIV; reduction in distribution to counties for HIV case management and support services; 144 clients would not receive case-management services and 71 clients will not receive support services; could delay care, leading to disease progression and additional unnecessary transmission of HIV to others; reductions in all of these program areas would likely contribute to job losses at the local level.s
“Any cut is worrisome, particularly reductions in case finding as that simply ignores the problem. Worse yet, Oregon already lags behind other states in early testing outcomes, thus allowing HIV to spread unchecked, and to let those living with HIV fail to get proper care, resulting in greater and more expensive demands for care further down the road. These cuts play right into the idea of penny smart, pound foolish. Eliminating critical services at the front end for those impacted by STDs will only result in even greater demand for such services down the road, and progression of disease that will be more costly to treat.”
— Michael Kaplan, Executive Director Cascade AIDS Project
Oregon State Hospital, $4,807,020 cut. The Oregon State Hospital is Oregon’s only state-run mental institution. It provides care to up to 612 people with the severest of mental disorders. This cut will be a combination of administrative restrictions, including contact services and targeted delays in filing positions. Effective July 1.
Impact: The Oregon State Hospital will be reducing staff and services by approximately $100,000 a month, and aligning hiring of selected positions. This will impact 20 positions. Only those positions not considered critical for patient care and safety will be affected. This action would delay implementation of the new treatment model created by the state. Only the first units of the new facility will be opened 2009-11 in order to move clients from older facilities.
“Olmstead v. L.C.: Since 1999, this ruling requires states to provide institutional services in the least restrictive setting possible. Oregon has never been in compliance with Olmstead, and is on notice by the Department of Justice to comply or lose legal control over its state hospitals. Expect litigation from several sources.”
— Jason Renaud, Mental Health Association of Portland
Employment Related Day Care Program, $17,346,182 cut, all from Oregon’s general fund. The program serves day care services to working parents earning less than 185 percent of the Federal Poverty Level ($40,793) who are no longer receiving cash assistance from the Temporary Assistance to Needy Families program. The program will be eliminated. Effective Oct. 1.
Impact: Possible repercussions could include families losing their jobs and children possibly being cared for in less safe, lower quality child care settings.
“This program is the most viable of all programs the Department of Human Services has, specifically geared toward helping families toward self-sufficiency.
“Every budget cycle this program seems to be the first to be looked at, debated, discussed, and otherwise ‘thrown around’ for it is proposed to be too lenient, too generous and too liable for fraud. This is somewhat true. The department does not have enough stringent rules in place and the results are an increase in fraud.
“If the program is cut, this will do everything against the department’s objective of keeping people independent, healthy and safe. It is linked to jobs, which in turn, when cut, prevents single parents to participate in a healthy society because they cannot afford day care. If a parent cannot work, for lack of affordable day care, then the parent will quit, likely to be penalized because the TANF program is becoming more policy based.”
— Gina Santacroce, Progam Accuracy Reviewer, Human Service Specialist, State of Oregon
JOBS program, $5,000,000 cut. The JOBS program is Oregon’s employment training program for people on public assistance. It provides assessments, job training, and work-search assistance. The program’s goal is help people become self-sufficient so they do not need to rely on cash assistance from the Temporary Assistance for Needy Families (TANF) program. T
Impact: Services will be reduced for 25,000 people on TANF, meaning that they will have to wait longer for services or remain on TANF longer. Meanwhile, TANF recipients are also facing cuts to their monthly grants, and could mean difficult decisions in making rent, buying food or paying bills.
“It means that there will be some clients that will be able to access the employment and training services, and others that may have to wait.
And families will have less TANF income to meet their basic needs. For a family of three it’s about $22 a month, and that is significant to a family with no other income. This may mean people will have a harder time paying a bill or their rent.
— Xochitl Esparza, TANF Program Manager with the Oregon Division of Children, Adults and Families
Alcohol and Drug Treatment Program, $2,607,953 cut. Increases in federal Substance Abuse Prevention and Treatment revenue and unallocated Beer and Wine revenues were planned for program enhancement at the May Financial Update. However, these revenues will now be used to offset General Fund.
Impact: Increases in access to alcohol and drug treatment will not occur. 1,867 people in need will go untreated and risk their children due to untreated substance abuse.
Drug Courts, $248,312 cut. Drug courts act as diversion programs for people committing misdemeanors and other non-violent crimes who are experiencing drug addiction and substance abuse. Rather than going to jail, offenders enter a drug treatment program lasting from 12 to 14 months. Their criminal records are cleared upon successfully finishing the program. The hope is that, by entering treatment and becoming sober, offenders are less likely to commit crimes in the future.Effective July 1.
General Food Fund Program, $95,169 cut. The General Food Fund Program purchases food and distributes it to the Oregon Food Bank. Effective July 1.
Impact: The program will not be able to purchase 275,000 of bulk foods (such as beans, rice, oatmeal.)
“What it means is that families across Oregon are going to get less staple food in a food box. These staple foods are foods that are healthy, nutritious foods that can be prepared in different ways, around which a can of stew can be added and a nutritious meal can be served.
OFB and its statewide network continue to see record level need for emergency food. And we do not expect that to change in the coming year. So hunger is an income issue and as people are unemployed and underemployed, we will continue to see very high need for emergency food.”
— Jon Stubenvoll, director of advocacy