It was another afternoon of bad news and grim testimony Tuesday before the Sacramento County Board of Supervisors, who are staring at a $122 million budget deficit for the fiscal year that begins July 1.
Department heads outlined dramatic cuts proposed for health and human services programs serving the county's most vulnerable citizens, including seriously mentally ill people, medically indigent residents and those at risk of abuse and neglect.
Program administrators and members of the public warned that the consequences would be dire. "We're being reduced to Third World standards of care," said Scott Seamons of the Hospital Council of Northern and Central California.
Ann Edwards-Buckley, director of the Department of Health and Human Services, told the supervisors that her proposed budget "is our best possible plan given the resources available."
"None of these proposals came without a tremendous amount of thought, awareness and angst," she said.
Here are some of the programs and services facing the budget ax, and some possible consequences:
-- Dental care: Patients would no longer be able to get routine dental care, such as cavity fillings, at the county clinic and the waiting time for "urgent" treatments for problems such as abscesses would increase from three weeks to six weeks.
-- Primary health care: The Del Paso and South City health centers would close, and hours at the Primary Care clinic would be reduced. Staffing and hours would be cut at the public health laboratory, and fewer chest X-rays would be given to tuberculosis patients. Fewer low-income people and high-risk patients would get immunizations against the flu and other illnesses.
-- Children's services: Fewer public health nurses and social workers would be available to visit the homes of at-risk families, and services to children with disabilities would be delayed. Children with such conditions as cerebral palsy and muscular dystrophy who need therapy may have to be placed on waiting lists for up to a year.
-- Mental health: The county's outpatient treatment program for children would lose counselors and other staffers, resulting in longer waiting times for youngsters to get care. The Mental Health Treatment Center no longer would be open around the clock to provide crisis services to young people. The adult outpatient program would be revamped into a "hybrid" model in which county workers and contractors would work together to provide psychiatric services.
-- Homeless services: The proposed budget provides enough money from the general fund to support homeless programs for two months. After that, unless money is found elsewhere, more than 3,000 beds for homeless people could disappear, resulting in more men, women and children living on the streets.
The county's public health officer, Glennah Trochet, told the board that cuts to her programs could translate into a crisis for the community.
"We will do our best," Trochet said. "However, if we had a TB outbreak, we would not be able to control it" with the resources provided in the projected budget.
"I have heard that the economy will recover in two years, so we might get away with this," she said. "If not, I will be back before you" to request more funding.
"We are taking a risk, and we all have to understand that," Trochet said.
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