Social services for the poor and disadvantaged are being slashed across the country as states try desperately to shore up growing budget deficits. Many of the cuts have already been made, affecting tens of thousands of people. Many more cuts are in the works, as states continue to see declining revenues.
Arizona, which faced a $1.6 billion budget gap this year, has been among the hardest hit. Funding was trimmed for food banks, community health centers and home health care for the elderly. Monthly payments for foster care parents were reduced, and more than 1,100 children with chronic or disabling conditions were dropped from the state Children's Rehabilitative Services program.
One of those children is 14-year-old Jessica Dunn of Phoenix, who has cerebral palsy. Until last month, the state helped her parents pay her medical bills. Now, the Dunns will have to shell out about $1,000 more a month for medications and doctors' visits. Jessica's mother, Pam, says she's not sure what they'll do.
"She'll get them [her medications], but I'll have to figure out how to come up with the finances for them," she says. "I can't not let her get her medical. Her medical keeps her comfortable and keeps her able to function in our world."
Arizona Gov. Jan Brewer has asked state agencies to find an additional $1 billion in cuts for next year.
Similar reductions in social services are being felt across the country. California has also had to make cuts to deal with a multibillion-dollar budget gap.
That's going to hit Jeffrey Mende, who has been getting dental work done free at the University of Southern California's dental clinic in Los Angeles. He's one of 3 million low-income Californians who will have their dental benefits eliminated July 1 under the state Medicaid program.
"That's the end of my teeth work," says Mende, who is HIV-positive and worries about the impact on his health. "I'm a disabled individual on a limited income and I don't have the monies to continue with my dental care."
In Rhode Island, about 1,000 low-income adults have been dropped from the state health insurance program. Linda Katz of the Poverty Institute at Rhode Island College says 3,000 more needy families are losing cash assistance, and many of them have no job prospects in the current economy.
"So we're very fearful that these are parents who will show up in the homeless shelters, which are already overwhelmed," she says. "They're people that will really swamp the social safety net in the community."
But states don't have a lot of options, says Nicholas Johnson, director of the state fiscal project at the Center for Budget and Policy Priorities in Washington. He says states spend a large part of their budgets on things such as health care, education and human services.
"We're seeing a lot of social services cuts because, to a large extent, that's what states do," he says. "These are very large budget gaps states are facing — $350 billion or so over 2 1/2 years that states have to address. It's hard for states to do that simply by cutting things that people won't notice."
Johnson thinks states could do more to increase revenues, but many are already raising taxes and fees as they try to deal with the current crisis.
The only relief, it seems, is the federal economic stimulus package. Johnson estimates that stimulus funds should cover about 40 percent of the budget shortfall states would otherwise face. For example, Arizona is using stimulus funds to reverse cuts in child care subsidies. Virginia, Maryland, Florida and Iowa are relying on federal aid to avoid trimming education and health care.
Still, social service providers know they're in an era of drastic cutbacks, and they worry about the long-term impact. Joel Potts is director of the Ohio Job and Family Services Directors Association. He says Ohio counties are already finding it much tougher to investigate child abuse cases because of cutbacks. The laying off of thousands of government workers has left too few to help all the needy people showing up at social service agencies, he says.
"When they can't get assistance through us, they then have to turn to other avenues to be able to provide that assistance for their families," he says. "They're showing up in the emergency room and costing taxpayers far more money than it would have cost had we been able to get them simply onto the Medicaid program."
Emergency room bills might not be the worst of it. Potts says the failure to help people now with a range of social services could put much more strain on state budgets in the not-too-distant future.