2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 Mayor's Disability Council
Budget Hearing Report And Recommendations
Adopted: March 21, 2003
Introduction
February 21, 2003, the Mayor's Disability Council held a Budget Hearing on the impacts of potential local and state budget cuts on persons with disabilities. The Council received testimony from five City departments, community organization, and many individuals. Representatives from the City Departments of Public Health, Human Services, Aging and Adult Services, the Mayor's Budget Office and MUNI were invited to present information on proposed budget cuts and to hear comments from Commissioners, the public, and representatives of community organizations. A representative from Planning for Elders in the Central City gave a report on the cumulative impact of these cuts on both seniors and persons with disabilities.
The Mayor's Disability Council (MDC) is the public input body to the Mayor on matters of concern specific to people with disabilities. Although individuals with disabilities and their representatives have testified before other City bodies during this current budget process, the February 21 MDC hearing represented the only opportunity for the impacts on individuals with disabilities to be considered overall and in their entirety. Attached to this report are summaries of testimony made by departments and the statements of individual presenters.
The session was introduced by the Director of the Mayor's Office on Disability, who pointed out that the budget crisis this year is unprecedented in recent history in its severity. The crisis reflects the economic recession, which is deeper and more persistent than most predicted a year ago or two years ago. Overall, local revenues have fallen by about $315 million dollars, which is about one-quarter of discretionary local revenue. This will have devastating impacts on local services, even with the best of budget planning.
Summary of Testimony
Several main themes emerged from the afternoon's proceedings:
1. Cuts Will Have Significant Negative Impacts on People with Disabilities
First and foremost, although departmental cuts are being made piecemeal, when taken cumulatively, and in conjunction with proposed state and Federal budget cuts, the impact on persons with disabilities will be drastic, and in many cases life-threatening. Because people with disabilities have historically little employment, they are particularly dependent on public benefits and services, and will bear a disproportionate share of the reduction in those services. The cuts under discussion will increase poverty, homelessness, morbidity, and mortality.
Throughout the MDC hearing, the public repeatedly expressed the opinion that, for whatever reasons, the deepest cuts are in the direct services needed by individuals with physical and psychiatric disabilities, and other most vulnerable and needy populations in our community. Speaker after speaker said that the concomitant impacts on all San Franciscans will be drastic, both socially and economically.
"It really is about people losing access to the housing
and the
fine, very thin network of social services
that keep people with psychiatric disabilities from being on our streets."
2. Unfunded Mandate Puts Seniors and Non-elderly People with Disabilities in Competition for the same (reduced) dollars
Testifiers from the Department and the public noted that under State law, the newly-configured Department of Aging and Adult Services has been given a mandate to expand its service from seniors alone to non-elders persons with disabilities - at the same time that its funding is being cut. This unfunded mandate to serve adults with disabilities has been passed along to the community agencies that actually provide the direct services. These agencies have historically served seniors only, and are now being asked to provide services to non-elderly adults with disabilities (people who were previously locked out of the system), with less funding. As a result, agencies testified they are being asked to reduce services to existing clients in order to serve new clients, whom they are not yet equipped to serve.
3. Community Care Funding Equity
Some stated their opinion that the issue of equity between funding for institutional care and community services is critical. Namely, that the level of funding for community-based services should have parity or should increase in relation to funding for institutional care, following the Olmstead principles. Some testified that proposed cuts would reverse this formula, and that this runs counter to societal goals, as well as Olmstead.
At the same time there was strong testimony by some opposing converting MHRF into a residential facility.
4. Cascading State Budget Issues
Impacts of proposed City cuts need to be assessed in light of proposed State cuts, which would decrease SSI checks from $758 to $708 per month; eliminate nearly a dozen Medi-Cal "Optional" benefits, including critically-needed physical therapy, medical supplies, etc; and would eliminate ten other medically necessary Medi-Cal benefits, including durable medical equipment, hospice care, hearing aids, etc.
Compounding this, the State is proposing to cut the California Aged and Disabled 133% of Poverty Program, which for many people has been a literal lifeline to paid health and long term care benefits. Persons newly ineligible for that program will no longer have access to the IHSS Program and Medi-Cal. As a consequence, people will become responsible for co-payments and deductibles for Medicare, averaging more than $200 per month -- an impossibility for people with an income of only $967 per month. It was estimated that these state health cuts will affect over a thousand low-income persons with disabilities, resulting in increased demand for City-funded emergency care.
The State's plan to cut funding for Adult Day Health Centers by 15% may lead to closure of centers, eliminating the Brown Bag programs that provide food to supplement shrinking income.
"Please tell our Mayor, we want to help people,
and this proposed budget is nothing but hurt
to those who have little or nothing."
5. Public Health
The Department of Health is continuing to invest more money in housing with support services, so that people with disabilities will have an alternative to institutionalization. A number of other programs, however, that have enabled people to live independently in the community, including Day Treatment Programs and Mental Health Programs, are being drastically cut.
One testifier stated that the level of financial and policy support of institutional care when compared with community-based long-term care services is not equitable. Efforts to aggressively draw down state and federal funding for Laguna Honda have not been matched with a similar commitment to draw down Medi-Cal funds for community-based services.
"I know you guys have priorities,
I don't understand how you set those priorities,
when you don't have health services at the top of your list."
6. Aging and Adult Services
The AAS Commission approved the reduction in budget to be shared 55% by the contract agencies and 45% by the Department for cuts in General Fund and Parking Tax revenues. Functionally these cuts mean that many people with disabilities will lose contracted services of case managers, neighborhood meal sites, home delivered meals, and emergency homecare.
7. Transit
It is anticipated that there will be no reductions in fixed route or paratransit services. However, it is proposed that taxi scrip costs will increase from $3.00 per book to $4.00 per book, lift van fares will increase from $.40 to $1.00 per trip, and group van fares will be increased.
Recommendations:
1. Create a Dedicated Funding Stream Serving People with Disabilities
Unlike other protected groups and interests in the City, including transit, the public library system, children's and seniors' services, there is no dedicated funding stream for programs serving people with disabilities. A number of disability advocates have discussed the need for some benchmark in the system so that the City assures a baseline of equitable funding for direct services for persons with disabilities, as it does for families with children or seniors who have disabilities.
"Mental health and substance abuse has been cut year after year,
-- the mental health system as we know it has been in crisis for years.
We can't provide basic services and support for people with psychiatric disabilities now."
2. Eliminate cuts to program with MediCaid or MediCal funding in which a $1 cut in local funding would result in a $4 to $5 in state and Federal match.
Such cuts will increase local costs.
3. At DHS, use General Fund savings retained from increased state payments for IHSS salaries for services to the same disabled population.
The City expects to receive $4.4 million from the State earmarked for minimum salaries of IHSS workers already being paid. These funds, retained at DHS should be used to benefit the disabled population for which they were originally intended.