Proposed Slashes in Health Care Sound a Grim Note in County

Health-care programs for thousands of poor, disabled and elderly Orange County residents would be significantly curtailed if the $47.8-billion state budget proposed this week by Gov. George Deukmejian is enacted as written, county officials said Wednesday.

“It’s not a pretty picture from the standpoint of health care,” said Ronald R. Di Luigi, assistant director of the Orange County Health Care Agency.

Hardest hit by the governor’s blueprint to cut $485 million from health and welfare services in the state’s 1989-90 budget are county programs serving low-income families and the medically indigent.

For example, Deukmejian’s recommendation to withhold cost-of-living increases for recipients of Aid to Families With Dependent Children would affect 55,000 county residents, many of them single, unemployed women with children. The maximum grant the welfare program currently provides a family of three--a mother and two children--is $663 a month. The cost-of-living increase would have provided the family with another $32 a month.

“To the average individual, that may not seem like much, but to a single mother trying to cope with the county’s high cost of living, $32 is significant,” said Bob Griffith, chief deputy director of the county’s Social Services Agency.

Deukmejian’s budget proposals will go through months of legislative hearings before they are returned to his desk.

But initial reactions among county officials to the proposed health and welfare cuts unveiled on Tuesday were gloomy.

John Sibley, assistant county administrative officer, said the governor’s proposed budget would further strain the county’s health care system.

“It’s hardly good news in light of our situation,” Sibley said in referring to the county’s own budget troubles. In recent days, the Board of Supervisors reached funding agreements with the County Employees Retirement Board and county judges that are expected to bail it out of a budget crisis. But the picture still is not bright.

Unlike in past years, Sibley said, it would be difficult to absorb the proposed health and welfare spending cuts because of the county’s own fiscal problems. Yet by law, the county must provide a certain level of service for the poor and disadvantaged--something that the county has succeeded in doing by using large amounts of federal money. But this year, Sibley said, is a different story.

“Our opportunities to match funding shortfalls (are) very limited,” he said.

Sibley and other county officials said that the cuts were not altogether surprising. The passage of Proposition 98, approved by voters last year, required Deukmejian to provide additional money for education. To comply, Griffith said, health care and welfare programs were likely targets.

“We’ve been anticipating this,” Griffith said. “Welfare and health programs are big-ticket items. We knew we were going to get hit . . . but that doesn’t make it any easier.”

A key component of the Deukmejian package is a $63.9-million spending reduction for in-home nursing care services provided to low-income elderly and disabled people. About 4,500 county residents receive assistance under the program. It is designed to keep elderly and disabled people out of nursing homes and other such institutions.

Recipients are given help with such tasks as cleaning, cooking and shopping. The governor recommended that payment for such services be restricted to 70 hours a month; county residents are now receiving payments that cover care for an average of 79 hours a month.

Griffith estimated that the governor’s proposal would reduce payments under the program from $335 to $297 a month.

Proposed cuts in the state’s funding for programs for the medically indigent could affect 12,000 county residents who currently receive free or heavily subsidized hospital and health care.

Deukmejian proposed replacing some of that money with funds from a November ballot measure that enacted a 25-cent-a-pack increase in cigarette taxes. But Di Luigi said that using Proposition 99 revenue to offset spending cuts is “disappointing.” Many health-care providers had hoped that money would be used to expand medical care for the indigent.

“Proposition 99 revenues offered the first real sign of daylight in our attempts to provide adequate health care for those people,” Di Luigi said. “It was a rare chance to improve our level of service. The governor is simply suggesting we shuffle dollars around.”