To cope with the state's $24 billion budget deficit, Governor Schwarzenegger is proposing to eliminate funding for a variety of programs. One of them provides skilled day care services to chronically ill seniors and disabled adults. Advocates say if these programs are shut down, thousands of people will suffer.
Casa Pacifica Adult Day Health Care Center sits in an office park in South San Diego. Inside, a group of older women sit around a long table.
"Qué día es hoy muchachas, se acuerdan? Hoy es Martes. Martes."
These women suffer from Alzheimer's disease and other forms of dementia. Some of them are in their '90s.
"En qué año estamos?" asks a staff member.
"No sé," says a client.
"En 2009," the staff member responds.
Casa Pacifica is the only skilled daycare program in San Diego County that works with Spanish speaking dementia patients.
In a different part of the building, some adults with other disabilities take a cooking class. Today, they're learning how to make mini-pizzas.
Beth Atkinson is an occupational therapist. She says Casa Pacific has a well-structured program.
"We make sure that they have a mixture of socialization, we provide a meal and a snack a day so they have some good nutrition," Atkinson says. "We provide learning opportunities, we do a variety of things. But it's not just baby sitting, it's actually helping them cope."
Casa Pacifica has about 280 clients. More than half of them come five days a week.
The clients are separated into four distinct groups: Alzheimer's, Spanish speaking elderly with chronic medical problems, developmentally disabled, and people with mental illnesses.
Mark Woodruff is Casa Pacifica's program director.
"This middle section here is a segment of society that has fallen through the cracks, and it is psychiatric," Woodruff points out. "And adult day healthcare centers provide a day program for these schizophrenics, for these bipolar, for these depressed 30-year-old adults, to come. And they have purpose."
Woodruff is afraid of what might happen to these clients if his program closes.
"Some of these people, no question, will be in the emergency room within a week," Woodruff warns. "Some of this population will end up in jail. I have some consumers here that I am worried that if adult day healthcare closes, a segment of society will get hurt, based on behaviors, based on the fact that you cannot monitor the medications."
So what's good about that?
"I can answer that question in one word: nothing," says H.D. Palmer. "This is not a proposal that the governor takes any pleasure in putting forward."
H.D. Palmer is deputy director for the state department of finance. He says cutting funding for adult day healthcare is something the governor wouldn't even have considered a few months ago.
But Palmer says in the current budget crisis, the state must cut spending wherever it can.
Otherwise he says, the state won't have money to pay its bills come July.
"So as difficult as these decisions are that are on the table, the alternative is basically for the state to go off the cliff," Palmer says.
Casa Pacific client Ramon Carillo is 83 years old.
"Sure, I understand," admits Carillo. "The economic situation is very tough, and we must accept that. But it's not our fault."
Nonetheless, if the governor has his way, Casa Pacifica and other programs like it in California will have to close.
If that happens, more than 30,000 chronically ill seniors and disabled adults will have to get home care. Or, they'll be forced to go into nursing homes, or skilled nursing centers.
One way or another, the taxpayers would have to pick up the tab.