State Budget Ax Devastates S.D. County

SAN DIEGO — San Diego County feared the worst from Sacramento on Wednesday and still ended up devastated.

From libraries to flood control projects, fire protection to mental health programs, the state Legislature’s $57.6-billion spending plan trimmed $44.4 million from San Diego County’s budget and $19 million more from its special districts.

The long-expected drop in property tax revenues to California counties hit San Diego County hard and forced the Board of Supervisors to open dozens of its projects and programs up to new scrutiny.

“We’ve got to review damn near everything because of the property tax situation,” said George Bailey, the board chairman. “I guess we have to see which things can be cut some more.”

The cutbacks hit San Diego County particularly hard because officials had already trimmed $26 million from this fiscal year’s budget when it ran into severe cash-flow problems.

The state budget approved Wednesday means a $27.4-million reduction in general revenue--the money that elected officials control--and a $17 million cut in health and social service programs that the state pays for but makes the county operate.

Talk surfaced immediately about county layoffs, shorter work weeks, and cuts in the Sheriff’s Department, stopgap measures that could be put into place right away.

But reductions in state-paid programs may never be resolved. As a general policy, county supervisors have decided not to use any county money to make up what the state has cut, arguing that it has precious little money for its own use.

In the social services area, a state-funded program that sends nurses, doctors and therapists to the homes of people partly or totally disabled is losing $7.5 million, or 12% of its budget. Called In-Home Supportive Services, it serves 30,000 to 40,000 county residents.

“If the care is not provided in the homes, then nursing homes have to take these people, and the state ends up paying more,” said David Janssen, the county’s chief administrative officer. “These cuts will trigger more expensive care.”

Early projections from Sacramento show a $2-million cut in indigent health care, a $5.3-million reduction in mental health treatment and a $500,000 decrease in alcohol- and drug-treatment programs. The money for all three programs come from state tobacco tax revenues, which are being sharply curtailed.

Jim Lott, president of the Hospital Council of San Diego and Imperial Counties, called the new budget “calamitous” and said the wave of cuts would “destroy the infrastructure of the indigent health care system of San Diego County.”

“It’s gotten to the point where we won’t be able to recover when the recession ends and more money becomes available,” Lott said.

Lott said the diversion of money from the county’s general fund “to education and other state priorities leaves our county--which already went through severe budget reductions last year in the health area--to have to come back, again, with even more Draconian cuts.

“The system will never survive,” Lott said. “We just won’t have a system for indigent care in San Diego County.”

Lott fears the transfer of patients from community clinics to increasingly overburdened hospital emergency rooms, “which are far more costly. We’re talking about some 225,000 people who receive some 660,000 medical visits a year through the community clinic system now being at risk.”

Such patients suffer from epilepsy, hypertension, heart disease and diabetes, and, Lott said, “require constant monitoring and medication to keep their diseases from leaving them disabled or dead. If they can’t get the care they need, they’ll have to show up at hospital emergency rooms, which aren’t really prepared to take them, at least not in the numbers I envision.”

The county funds 39% of the total budgets of 22 community clinics located in 39 sites throughout San Diego County, Lott said, adding that the clinics soon will be nearing collapse.

He fears an “especially big hit” to the county psychiatric hospital, which last year suffered a $3-million cut that forced drastic cutbacks in the number of beds and services it provides.

“What that unit does is take the dangerously mentally ill off the street--people who are dangerous to themselves and others,” Lott said. “If these centers take another huge hit--and at this point, it appears unavoidable--you’ll see dangerously mentally ill people out in the streets or winding up in hospital emergency rooms, which are not equipped to handle them by any means. These are the kinds of things we’ll be increasingly confronted with.”

Lott expects a 25% reduction in services to the county’s medical services program, which “will be downsized to the point that it’s totally inadequate to meet the needs of 23,000 San Diegans who rely on that system for care. It’s the beginning of the end of an organizational approach to meeting the needs of poor people in San Diego County.”

The intrusion of 100,000 new patients converging on the hospital emergency rooms of the county may mean the health care of all San Diegans is affected, Lott said, “regardless of their financial or insurance status. The domino effect is probably months away, but it’s certainly something we ought to be frightened about.”

Lott said California should follow the lead of Texas, which, faced with drastic budgetary problems during the oil crisis several years ago, instigated a policy of thoroughly reviewing every governmental program to deem its worthiness.

“They gave every program a so-called ‘sunset provision,’ where it’s re-evaluated and rejustified every two to three years,” Lott said.

Mental health care will also suffer, officials said.

“We have to cut,” said Patrick Stalnaker, spokesman for County Mental Health Services. “It’s a simple matter of cutting treatment programs in a county that’s terribly underfunded in the first place.”

Although the county won’t be expected to shore up cuts to Medi-Cal, the state is slashing that allocation by $152 million.

Portia Bibb is a mother anxiously awaiting the fate of her son--Stacy, 18, a quadriplegic--and that of the Mountain Shadows home where he resides in Escondido.

Bibb says Mountain Shadows, which houses 105 residents ranging in age from 6 to 62 and is managed by the parents of its patients, is totally dependent on Medi-Cal funding. She said 50% of the resident patients have no living relatives, and the 25% who do have living relatives are unable to depend on them for care. The relatives are not physically able.

Of the fate of the residents, Bibb said, “There’s nowhere for them to go. We’re talking people in wheelchairs being homeless. We don’t know what to do (if, indeed, the funding is lost). We can’t even formulate a plan.”

Bibb said her son would move home with her, and that, somehow, she would manage.

“But physically and emotionally, it would be so hard,” she said. “I work full-time, and I’m a single mother. It wouldn’t be a good situation.”

With cuts in state-paid health and social service programs so severe, including an automatic 4.5% drop in welfare payments, elected officials must decide if they will make up the difference. At the same time, they must cope with a $27.4-million deficit in their own general revenues, more than half of which go to public safety.

General revenues come from property taxes, cigarette taxes, sales taxes, vehicle license fees, the county’s interest earnings and its lease revenues.

Faced with having to lay off deputies from the Sheriff’s Department, further delay the opening of a new jail, eliminate social workers or reduce its contribution to health care, county supervisors face a tough choice.

“You wind up having to choose between helping old people and sick people or providing police service,” said John Sweeten, the county’s director of intergovernmental affairs. “What you’re going to see is counties being sued for not providing enough in the health care area.”

Dan Greenblat, a special assistant to Sheriff Jim Roache, said the department does not want to further delay the opening of the new 1,500-bed jail, but “if it means decimating the department with layoffs to maintain a level of protection, we’d have to defer it.”

Holding back on opening the new jail would be a last resort, he said.

Perhaps the biggest blow came late Wednesday when county officials learned that Gov. Wilson had used a line-item veto on the state’s $135 million trial court funding program. San Diego County’s share is $9.5 million.

In 1991, San Diego County got $40.7 million from the state for courtroom operations, which made up about half of its budget.

“Last year, we had to bail out the superior and municipal courts because they overspent their budgets,” Janssen said. “They couldn’t live within their means, and now you take 12% more without taking any judicial positions. That’s a major problem.”

The veto of trial court funding so rattled Janssen that he called a Times reporter to change an earlier, more optimistic assessment of the county’s financial picture late in the day to one with a bleaker outlook.

“There’s a big difference between a $35-million shortfall and a $44-million shortfall,” he said.

Janssen is reviewing a list of possible solutions to the budget crisis, including shortening the work week of county employees, reducing salaries, and temporary or permanent layoffs.

Unlike city government, which has given recent raises, the county has not given increased salaries to executive employees since December, 1990, and other county employees have not had raises since July, 1991, he said.

A reduction in property tax revenue, which was at the root of all the budget reductions, hit hard on San Diego County’s special districts, which are set up to provide special services, like fire protection, water and sewer service and libraries.

The cut appeared to be $19 million, Sweeten said, including a $7.6 million decrease in money for 21 independent districts that provide firefighting services. Another $2.1 million was to come from flood control and library districts over which the board of supervisors have some control.

“Our special districts are taking a big hit,” said Bailey, the board’s chairman. “We may need to close one or two libraries.”

If the districts providing fire protection are cut, Sweeten said, the county will probably be asked to step in and help out, especially in the midst of a drought.