By NINA NOLCOX

California’s governor and Legislature, facing an official “budget emergency,” are instituting a 10 percent budget cut. The cut will be coupled with deferred payments, delaying state payments by two weeks and, later, by another month. These two strategies will inflict pain and suffering on many, including local economies and businesses. But the damage will be most extraordinary for our most vulnerable citizens, our frail elderly.

Wholesale budget cuts at first glance appear to spread evenly the pain of our state’s inability to budget responsibly. That appearance is a lie. Universal budget cuts will do far more damage to some than to others, including seniors with limited incomes and chronic health challenges.

Even if we ignore the cruelty our seniors will suffer under the cuts (and it takes a cold heart, indeed, to do that), the proposed cuts still don’t make one lick of sense. As a matter of absolute fact, cuts and delayed payments will cost the state far more than any savings they will generate.

I know how painful cuts are. I operate an adult day health facility, one of some 300 such centers across the state serving seniors, most having some form of Alzheimer’s disease or other dementia, who have medical conditions that require constant attention and medication. Last summer, when the Legislature failed to pass a budget, our Medi-Cal funds stopped cold. Because the vast majority of those who use adult day services depend on California’s Medi-Cal program to fund their care, we faced two choices close our doors or borrow to stay open. At least two centers had to close immediately and a huge number of others borrowed money to continue services.

Adult day health centers are small businesses serving local communities. Forcing us to fund the state’s deficit from our own pockets was bad enough mostany of us are still paying down our loans. The anguishing thought of having to turn our seniors away was even worse. The stress literally caused my hair to fall out.

Intolerable cut

The 10 percent budget cut, combined with delayed payment, will make permanent the temporary horrors of last summer. In theory and in practice, that is intolerable.

There will be no savings when we force adult day health centers to close. It doesn’t take a Ph.D. in economics to see that the cost differential is substantial. In the weeks after the 10 percent cut is implemented, at least 13 centers will close, driving some 400 seniors to nursing homes. That shift will cost the state at least $15.7 million more than day care. That loss is just the beginning.

The parallel “savings” from deferred payments will force an additional 15 centers to close, most because their ability to borrow was exhausted last summer. Those closures will send nearly 800 more individuals into nursing homes; the added expense to the state will go from $15 to about $30 million.

Those who can’t get nursing home care will be left at home to fend for themselves, deprived of the medical services that day care delivers. They won’t stop having heart disease, diabetes or Alzheimer’s disease just because the state cuts their services, so they’ll go to emergency rooms where the cost to taxpayers will be dramatically higher.

Moreover, the state’s primary sources of revenue income tax and sales tax will go down, not up. Caregivers who work outside the home rely on adult day services in order to go to work. When the centers are forced to close, those wage earners at least 1,300 of them initially will give up or significantly alter their work. The minute that happens, the state’s income tax revenue drops and sales tax revenues generated by that wage earner practically vanish. Of course, everyone who works in adult day centers will stop earning, too, and so will our vendors.

Thus, in a matter of weeks, the 10 percent cut will generate additional costs and lost revenue that are staggeringly higher than any possible savings.

The fiscal impact is nothing compared to the human damage. For those we serve, the simplest acts preparing a meal, taking the right pill at the right time, getting to the bathroom will no longer be taken for granted. Their physical and mental health will suffer, the joy of life that remains for them will disappear, their families will feel guilty and stressed.

There is no doubt that we must thoughtfully and carefully address the budget crisis we face. There should be no doubt that we cannot address that crisis by cutting care to our most frail seniors. That’s not just bad policy, it’s just plain bad.

Nina Nolcox owns and operates Graceful Senescence in South Los Angeles, which serves 130 low-income seniors and their families.

LETTER

Roiling Real Estate

No wonder the real estate market is in shambles right now, as highlighted in Allen P. Roberts Jr.’s Feb. 26 article on the Business Journal Web site headlined “L.A. Real Estate Still Tumbling.” Amid all the issues, interest rates act like a daily roller coaster and consumers are screaming to get off the ride. One day the rates are down and look good (for a momentary sigh of relief); the next day, economic reports, speculation and media coverage of inflation surface (again), continuing to further undermine the entire market. Adding to the downward spiral are lenders “cutting” appraisals to offset future reductions in value, which can eliminate the possibility of refinancing or purchasing. This cutting tactic is used by lenders when a severe downturn trend in the real estate marketplace is well under way. Everyone better brace for the big drop.

Richard Maize

Los Angeles