Some days are harder than others.

For some reason when the rain returns after a glimpse of sunlight it seems a little darker than if we just had a few rainy ones in a row.  You need that morning coffee to kick in a little harder those days.

Reading the headlines of the paper there doesn’t seem to be much in the way of uplifting news.  Budget cuts, another round of teacher pink slips, and an unrelenting concern for profit juxtaposed with a disappointing negligence toward our country’s everyday people.

As one can imagine, working in the fundraising department of a non-profit during these times is an emotional and logistical challenge.  It is my job, however, to keep faith.  And  I must say, I am in a pretty good place for that.  At St. Anthony’s I am surrounded by people keeping faith and having hope that it may be dark today, but there will be light.  Our staff, guests, supporters and neighborhood friends are all amazing reminders, and believers.

As so many know and have been touched by the gratitude expressed by our guests, I too am thankful that there is a mission and movement that I can be a part of to keep faith and remember the sunnier days ahead.

It is good to dream, but it is better to dream and work. Faith is mighty, but action with faith is mightier. Desiring is helpful, but work and desire are invincible.    –Thomas Robert Gaines

Attending a St. Anthony’s advocacy meeting for the first means being bombarded by acronyms: SSI, IHSS, Calworks. It means facing some disheartening news: increased muni prices for seniors and the disabled, increased co-pays for medi-cal, and grant reductions proposed in the Senate budget hearing. The list could go on.

But an advocacy meeting also means taking all the bad news while still seeing the good news. Here’s some good news: all the letters and emails opposing the IHSS (in-home senior service) cuts were presented in the Senate budget hearing. Here’s some more: St. Anthony guests are signing a petition opposing the increased muni fares and other guests may potentially find part-time work as 2010 census employees. Good news does not reduce bad news, but understanding that it’s not all bad news can help from becoming completely overwhelmed at all the work ahead. But good news does not mean relaxing, it means plowing ahead so that there’s more good news.

Following is a brief summary of the Governor’s proposed budget and its potential impact on health and social services.

The governor is proposing drastic cuts to the programs that our clients and guests depend on for their very survival. Programs affected include CalWORKs, In Home Support Services, SSI/SSP, CAPI (SSI program for immigrants), California Food Assistance Program, Healthy Families, Prop 63-funded mental health services, and Medi-Cal.

Two Types of Cuts
The Governor has proposed significant cuts affecting health and human services programs. Many of these cuts have been proposed to begin in March 2010. The Governor has also asked the legislature to approve “triggering” additional program cuts and revenue increases if the federal government gives California less than $7 billion in relief.

Overview of the spending reductions:
• Medi-Cal:
o Unspecified limits on services and increased cost sharing with benefit recipients (co-payments/premiums).
o Elimination of Medi-Cal services for certain immigrants (e.g. those living in the U.S. less than five years).
o Eliminating Adult Day Health benefits.
• Healthy Families:
o Limit eligibility to families with incomes less than 200% of the Federal Poverty Level. (Current threshold = 250% of poverty level. This change would leave 240,000 children without coverage.)
o Eliminate vision benefits for all Healthy Families participants
o Increase premiums and co-pays for the second year in a row.
• CalWORKs:
o Reduce grant level by 15.7%. This cut would reduce the maximum monthly grant for a family of three in high-cost counties from $694 to $585.
o Eliminate CalWORKs benefits for legal immigrants who have been in the US for less than five years.
• In Home Supportive Services (IHSS)
o Limit IHSS services to individuals with “functional index” scores of 4.0 and higher. This change would eliminate services for 87% of the IHSS caseload, reducing the number of recipients from 485,000 to 63,000.
o Cap the maximum amount up to which the state will share in the cost of wages and benefits for IHSS workers at the state’s minimum wage, currently $8.00 per hour . Currently, the state shares in combined wage and benefit payments of up to $12.10 per hour for IHSS workers.
• Reducing SSI/SSP grants for single individuals to the minimum level allowed by federal law. This would amount to a $15 per month reduction effective June 1, 2010, the fourth grant reduction for SSI/SSP in the past 12 months.
• Elimination of state-funded programs specifically for (legal) immigrants, including CAPI (SSI-like program for people ineligible for SSI due to immigrant status) and California Food Assistance Program (Food Stamp-like program for people ineligible for Food Stamps due to immigration status).
• Ballot proposals: transferring money for Prop 10 (First 5 program funding for young children) and Prop 63 (mental health funding) to the General Fund.

Triggered Expenditure Reductions, Revenue Options, Spending Shifts:
• Permanent elimination of CalWORKs, IHSS, and Healthy Families programs.
• Reduce Medi-Cal eligibility to the minimum allowed under current federal law and eliminate most remaining optional benefits.
• Eliminate funding for the Transitional Housing Placement for Foster Youth-Plus Program ($36 million).
• Delay last year’s corporate tax changes for 1 year.
• General Fund savings from an additional $873 million transfer from Prop 63 to General Fund.

Tax credits/Job Creation spending initiatives:
• Homebuyer tax credits of up to $10,000.
• Exemption from sales tax for “green-tech” manufacturing equipment.
• Borrow from Disability Insurance Fund to support training grants to employers and a $3,000 per job tax credit to employers for new employees retained for at least nine months.

Budget Reform Proposals for ballot:
• Majority vote budget.
• 2/3 vote for fee increases in certain circumstances.
• Granting Governor midyear expenditure reduction authority.
• Limiting use of one time funds for one time expenditures.
• Requiring Legislature to review performance of programs every 10 years.
• Give legislature extra 10 days to pass budget and prohibiting legislature from being paid for days during late-budget impasse.

Where does this information come from?

California Budget Project, “Governor’s Proposed Budget Includes Deep Cuts, Assumes More Federal Funds”. Available at: www.cbp.org/pdfs/2010/100108_Gov_Budget.pdf

California Legislative Analyst’s Office: “The 2010 Budget: Overview of The Governor’s Budget”. Available at http://www.lao.ca.gov/laoapp/PubDetails.aspx?id=2160

Information compiled by Colleen Rivecca, Advocacy Coordinator, St. Anthony Foundation.

On January 6, 7, and 8, 2010, advocates in cities across California rallied to send Governor Schwarzenegger this message: “California’s budget should put low income families first!” Low-income families, seniors, and people with disabilities were hit hard with budget cuts last year, and this year they are asking the Governor to invest in them with health and social services and opportunities for employment.

St. Anthony Foundation acts as the “hands below the safety net”. We are proud of the services that we provide to folks who have fallen through the cracks due to budget cuts and elimination of government-funded health and social service programs. But at St. Anthony’s, we also work hard to ensure that our government invests in society’s most vulnerable members so that, even if they may fall on hard times, they don’t have to hit rock bottom before assistance is available.

Our city and state budgets are not just financial documents; they are statements about our priorities and values. St. Anthony Foundation’s statement of values states that we promote the dignity and respect of all people, even those among us who have very little. We are working with advocates across California to ensure that our budget protects programs that help vulnerable community members to simply survive: programs like In Home Supportive Services, CalWORKs, Social Security Income, Medi-Cal, and Healthy Families.

As we analyze the Governor’s proposed budget, stay tuned for information about how to get involved in advocating for a budget that supports all Californians!

After a very long and difficult budget year there is some good news to report on the advocacy front. We just got the update from Colleen Rivecca, St. Anthony’s Advocacy Coordinator, that the legislature was able to put politics aside and save the Healthy Families program.

Healthy Families provides low- or no-cost medical insurance to low-income children. This news means that nearly 700,000 California kids will be able to keep their health insurance!

Thanks to all of you who have advocated for this program over the past year! Whether sending a quick email to your legislator, a phone call to their office, or posting your thoughts and concerns on Facebook or Twitter, expanding the dialogue on these critical issues DOES make a difference. Any one of the 700,000 children who this helps can attest to that.

Homelessness and substance abuse are linked, and are associated with alarmingly high mortality rates. Mortality, a very scientific and dissociative way of saying people are dying in the streets, literally, before finding help with addiction. The average age a homeless person in San Francisco dies is 41. Seventy-eight percent of those who die on the streets are intoxicated at the time they die.

That is dark, difficult to hear, and incredibly saddening. But somehow that has not been enough for the city of San Francisco to help to it’s residents who are dying on the streets by offering comprehensive drug and alcohol rehabilitation to those who most need it, and saving the programs that DO WORK from complete elimination during budget season.

According to the San Francisco City Fire Division intervention, and diversion programs work. As Chronicle  columnist C.W. Nevius has pointed out, repeat ambulance transport and emergency care spent on homeless users is very costly to the city. One of such intervention programs, McMillan Drop-In Center, created beds for emergency response calls dealing with intoxication to bring people to detox, sign-up for drug and alcohol recovery programs, and receive counseling and social services support to further stabilize themselves. In one year this program brought 300 people into detox and recovery programs, and 750 people case management linking them with critical supportive services such as housing.

Through this program “a number of high-profile homeless inebriates have been engaged and housed,” according to the San Francisco Medical Society’s study of the program. The SF Fire Department, St. Francis Hospital, SF General and other partners were thrilled by the success of the project, saving money and more importantly helping increase health and stability of at-risk San Franciscans.

But that was not enough to save the service, and McMillan Drop-In Center was cut. A similar program, Buster’s Place, was initiated in the same rite and same location. This program too, was cut.

Emergency visits are costly. Critical care is costly. Without the preventative care, supportive services and case management that help people become stable and seek help before it becomes an “emergency”, these costs will continue. To see that this is a problem in hindsight takes no special talent. But, to take action and create and support (especially in difficult times of budget crises) programs that comprehensively address the dangerous problem of drug and alcohol abuse, that takes determination and compassion. Criticizing those the system has failed has no productive ends, criticizing the failing system can bring about powerful change that makes a stronger city and citizenry.

No matter your stance on the health care debates being held country-wide, one thing is certain: insurance is expensive and far too many people are going without necessary care.

When deciding between immediate needs of shelter and food, or paying utilities and transportation costs to work, or for kids back and forth to school, paying the extra expense of health care can fall to the wayside.  This is especially dangerous for families and individuals who are on the brink of making ends meet, when one accident, one illness can mean the difference between paying bills or going into default, having electricity cut or even being put on the streets.  In 2007, 62% of bankruptcies were due to medical bills, a 49% increase since 2001, according to the American Journal of Medicine.  In 1981 only 8% of bankruptcies were attributed to medical bills.

At St. Anthony Free Medical Clinic, we care for 3,500 low-income or homeless patients who rely on our preventative and critical care.  In the coming year we anticipate this number vastly increasing, as state funding for Medi-Cal was cut by $323 million, and the Healthy Families program has stopped enrolling eligible children.  More than 12,000 children in San Francisco alone (942,000 state-wide) rely on Healthy Families for their regular check-ups, for emergency care, and medication.  In September disenrollment of these children will begin.

No matter our political stances, I hope we can all appreciate the need for change.  A system that perpetuates costly acute emergency care and puts affordable preventative medical care out of reach does not serve the individual, the family or the community as a whole.

When I first volunteered at St. Anthony’s in 1995, the Dining Room served an average of 1900 meals per day. When I began working here in 2000 the number had jumped a little to 2,000 meals per day and today we serve an average of 2600 meals per day. I reflect on the past nine years – 9/11, the dot com crash, the wars – and can see how the numbers have grown. As I read the news and the budget process updates every day what is happening now is greater than all of the events in the past nine years put together. I cringe to imagine all of the new people who are beginning to fall down the economic ladder. People like you and me who one day soon will find themselves finally accepting that they have joined the ranks of people who must eat at a soup kitchen. They will resign themselves and walk to Golden Gate Avenue and wait in line at St. Anthony’s. I also try to image how our Dining Room will be able to serve all of the new people who are left behind by the economic crisis.

In the midst of all of this pain and suffering I try to find a sense of hope. I keep flashing back to an incident during my first volunteer immersion experience at St. Anthony’s as a high school student. The Justice Education staff took us on a tour of the neighborhood. During the tour a neighborhood resident stopped us and began talking. He told us that it was nice that the nonprofits were in the neighborhood to take care of people because there are a lot of people here in need of care and support. However, they are also bad, because as long as they are here there will never be a revolution. What I have valued most working at St. Anthony’s is that we work at all levels form meeting people’s immediate needs to advocating for social change working “to create a society which all persons flourish.” It’s pretty unique to find an organization that works across that full spectrum. As I review the lists of programs and services that will be cut on the Federal, State and local level, I feel pain and despair for the people who will go without food, healthcare, mental health services, drug rehabilitation and so on. But, I also keep thinking back to the man’s words. And I think of Alina’s blog post on July 23rd. Will this time of crisis bring people together? Will it remind us that we have choices? Will it make us reexamine our priorities?

This is a time of crisis, but crisis can open the door to opportunity. This is where I am finding hope. Hope for a revolution in people’s hearts that leads to new priorities and making choices that move us towards becoming “a society in which all persons flourish.”

The Governor may have said his machete wielding twitter video was just a joke, but the budget he signed today makes very real, very deep cuts into services for those most in need.  Schwarzenegger signed an already brutal budget and added $656 million more in cuts.

“Schwarzenegger’s vetoes include $80 million from child welfare programs; $61 million in county funding to administer Medi-Cal, California’s version of Medicare; $52 million from AIDS prevention; $50 million to Healthy Families, the low-cost health insurance program for poor children; and $6.2 million more from state parks,” Reported the Associated Press.

In the days, and months ahead we will see just how devastating these cuts are.  It is already estimated that the cuts to Social Security Income will cause nearly 50,000 San Franciscans who are already living in poverty to survive on even less.  Our low-income seniors and people with disabilities will have to figure out how to live on even less, and will have to choose between rent, food, medicine and other essentials.  Our community will see an even greater number of SSI recipients in our already overtaxed food line, free clothing distribution lines, food pantry lines and emergency shelter lines. With the additional cuts to Medi-Cal community clinics, including St. Anthony Foundation’s Free Medical Clinic, will certainly see an increased need for our services

Perhaps when the Governor sees the fall out of this budet, he will put the knife away, stop playing with his camcorder and make a little more time to focus on the citizens of California.

Having enjoyed my new life working with the St. Anthony’s community for a little over a month, I got to experience a rite of passage bestowed on all hard working, diligent employees: the sick day. As I spent Friday, as well as a good part of my weekend, huddled on the couch in a pool of cold sweat, tissues, cough syrup and self-pity, friends urged me to go to the doctor as soon as possible as I “probably had swine flu”.

Well yes, I felt like death, had aches and pains, a fever, congestion, the whole 9 yards. Needless to say, I didn’t leave the house for 72 hours. But I did do some research on what I stubbornly maintain is an over-hyped virus…so, let’s talk about swine flu:

According to the CDC, the H1N1 influenza virus was first detected in the United States in April 2009. It’s spread from person-to-person in the same way any other “regular seasonal influenza virus” is spread. It earned the nickname “swine flu” because initial lab tests of the virus showed genetic similarity between the virus and viruses that typically occur in North American pigs. But just how dangerous is it? The CDC puts it best in this comparison of the dreaded swine flu versus our good’ol, plane-jane seasonal flu:

“Each year, in the United States, on average 36,000 people die from flu-related complications and more than 200,000 people are hospitalized from flu-related causes. Of those hospitalized, 20,000 are children younger than 5 years old. Over 90% of deaths and about 60 percent of hospitalization occur in people older than 65…So far, with H1N1 flu, the largest number of H1N1 flu confirmed and probable cases have occurred in people between the ages of 5 and 24-years-old. At this time, there are few cases and no deaths reported in people older than 64 years old, which is unusual when compared with seasonal flu.” (more…)