Palm Trees

Proposed Cuts to California's Health Care Programs Put Most Needy at Risk

California Governor Schwarzenegger is proposing drastic changes to the state’s health care programs that cater to low-income households and individuals most at risk in order to help close the state’s $19.1 billion deficit. The $83.4 billion budget plan would significantly affect substance abuse treatment and mental health programs for individuals struggling with addiction and mental illness, low-income adults, seniors, families, and children.

Announced on May 14, Schwarzenegger’s proposal includes a $1.2 billion budget cut to state prison systems for the 2010–2011 fiscal year that includes an $811 million cut to prison health care expenses including medical, psychological, and behavioral health. This shift includes moving the state’s 33 adult prisons’ health care system from patients’ current on-site medical care to medicinal consultations performed by off-site practitioners. According to the Union of American Physicians and Dentists, the proposal that the Schwarzenegger administration is calling a “wholesale reform of the prison healthcare system” is more likely to result in an annual savings of only $17-35 million, but is also likely to cause an influx of lawsuit settlements over the prisons’ failure to provide standard health care. In addition, county jails would also receive low-level felons - as many as 15,000 prisoners who would normally be sent to state prison - and would need to supervise state juvenile parolees. At state prison, it costs about $25,000 to house an offender per year. Under the proposal, counties would receive $11,000-$15,000 per offender to help pay for the shift, including costs for probation, alternative forms of custody such as house arrest, drug court, and rehabilitation programs. The transfer of responsibility to county level is proposed to save the state $248 million. Previously when Governor Schwarzenegger made the same pitch on inmate transfer but without county funding in his January proposal, local law enforcement across the state overwhelming opposed the idea. Even with partial state funding, the financial burden still falls on the counties to provide necessary services to inmates; with the addition of other proposed county financial responsibilities, local law enforcement will experience a ripple effect.

Drug courts and prison drug treatment and education programs have shown to be effective in state and federal prisons across the nation. Inmates are more likely to become repeat offenders after their release if not rehabilitated. According to the U.S. Department of Justice’s Federal Bureau of Prisons, drug education programs, non-residential and residential drug abuse treatment programs, and community transition drug abuse treatment programs in prisons reduce recidivism, relapse, criminal behavior, mental illness, and behavioral health disorders, while increasing the offender’s chances of becoming a functioning member of society with family, education, and employment opportunities. By providing offenders with the knowledge and resources to become self-sufficient, they are more likely to overcome their addictions and seek treatment. By reducing recidivism, states are effectively reducing the cost to house inmates and increasing their economies when ex-offenders successfully re-enter employment.

Sending nonviolent drug offenders to county jail will qualify them for drug monitoring and rehabilitation programs once released, but it will not be as effective in preventing them from becoming repeat offenders as would an in-prison rehabilitation or education program. County jails will predictably have to send inmates to less crowded jails throughout the state to compensate for this new incursion as county jails are already experiencing overcrowding and granting early releases. Without proper penalization and treatment, offenders are denied the opportunity to reform. Without drug treatment programs, the tax-payers end up paying more for drug-related crimes and law enforcement. According to Columbia University’s National Center on Addiction and Substance Abuse, $467.7 billion is spent annually by local, state, and federal governments for substance abuse-related criminal activity, including police staff, criminal investigation, incarceration, foster care, and health care. Only 1.9% of this amount is spent on prevention and treatment programming.

For the fiscal year beginning July 1, Governor Schwarzenegger’s plan would also eliminate 60% of state funding for local mental health care programs, including psychiatric emergency services. This would force counties to cover the $435 million expense on their own. Narcotic treatment programs and their provider networks would be dismantled, ending services for approximately 160,000 Medi-Cal patients who struggle with addiction. These patients, both adolescents and adults, would no longer receive outpatient therapeutic treatment and residential services. This closure of narcotics treatment programs is proposed to save the state $53.4 million. Cuts to in-home services would cause approximately two-thirds of the In-Home Supportive Services program budget to become counties’ financial burden. The state’s welfare program that provides financial support to unemployed individuals while they search for work, CalWORKS, would be eliminated completely by October, leaving 1.4 million people without support. The proposed elimination of the cash-aid program would save $1.6 billion from the state general fund, but would also cause $3.7 billion in federal block grant funds to be lost. California would become the only state not to have a welfare-to-work program. Because of this, counties would again find themselves responsible for filling in the financial gap by having to fund county-operated General Assistance programs for the unemployed. With the elimination of so many substance abuse and mental health treatment resources, addiction and mental illnesses are likely to go untreated for the most vulnerable groups.

References

http://www.mercurynews.com/breaking-news/ci_15089306?nclick_check=1

http://www.prnewswire.com/news-releases/uc-regents-to-discuss-proposed-role-in-prison-health-care-93924474.html

http://www.modernhealthcare.com/article/20100514/NEWS/305149975#

http://www.cprinc.org/facilities_pgm.aspx

http://www.denverda.org/prosecution_units/Drug_Court/Drug_Court.htm

http://www.9news.com/news/article.aspx?storyid=137833&catid=188

http://www.latimes.com/news/local/la-me-state-budget-20100515,0,877220.story?page=2

http://www.turlockjournal.com/news/article/4134/

http://www.pressdemocrat.com/article/20100514/ARTICLES/100519644/1349?Title=Critics-assail-welfare-cuts

http://www.casacolumbia.org/articlefiles/380-ShovelingUpII.pdf