California Gov. Gavin Newsom's plan to cover a $54.3 billion budget deficit includes slashing $119 million in spending that keep more than 45,000 people out of nursing homes — some of a series of cuts targeting older adults who are among the most at risk for the new coronavirus.
The proposed cuts have angered state lawmakers from both major political parties who say it's irresponsible in light of the coronavirus pandemic that has spread through nursing homes across the state. It's one of many conflicts emerging this week as lawmakers hold public hearings examining Newsom's proposal before they must vote on a spending plan by June 15.
Newsom, a Democrat, was the first governor to issue a mandatory stay-at-home order in mid-March. While widely credited with slowing the spread of the new coronavirus, it has caused state tax collections to plummet by forcing many businesses to close for more than two months and putting 4.7 million people out of work.
Newsom's plan to cover that deficit includes painful cuts across most government programs, including public education, environmental protections and state worker salaries. But the cuts targeting programs for older adults have alarmed advocates who have likened them to “a death sentence."
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Statewide, residents in skilled nursing facilities accounted for 6.4% of coronavirus cases but 27.2% of deaths reported by the state as of last week. Nationwide, outbreaks in nursing homes and long-term care facilities have killed more than 33,800 people, or more than a third of all coronavirus deaths in the U.S., according to a tally by The Associated Press.
“We don't care about elders or the disabled and they are going to be the primary victims of this budget,” said Pat McGinnis, executive director of California Advocates for Nursing Home Reform.
Newsom’s plan doesn’t cut everything. It includes a temporary 10% rate increase for skilled nursing facilities that treat Medicaid patients, or about $114 million in total. The state is waiting for the federal government to approve the increase.
But the spending proposal would eliminate two alternatives to nursing homes for older adults. Both programs pay for people to care for older adults in their own homes. The Community-Based Adult Services program had more than 36,000 clients as of February while the Multipurpose Senior Services Program has space for more than 9,200 people, according to the Department of Finance.
Cutting both programs saves $119 million. Those cuts would be eliminated if Congress OKs more aid for state and local governments — a prospect many state lawmakers believe is unlikely.
“The idea that we are going to eliminate (these programs) at a time when it's clear that it's not really safe to be in a nursing home, or not as safe as we would like it to be, is really troubling,” said Assemblyman Jim Wood, a Democrat from Santa Rosa and a member of the budget subcommittee that oversees health care spending. “That seems to be what we do in times of crisis. We hammer those who can least afford it, who can least protect themselves, and have the smallest voices in our society.”
Other cuts include $205 million from a program that gives in-home assistance to older, blind and disabled adults. The cut will reduce hours available for care by 7% for the more than 600,500 people in the program.
While Newsom has partnered with the federal government to pay local restaurants to make meals for low-income older adults during the pandemic, his budget would eliminate $8.4 million from a nutrition program that offers meals to older adults in group settings.
And $135 million in proposed cuts mean fewer older adults will be eligible for Medicaid, the joint federal and state health insurance program.
“Quite frankly, I feel like we should tell the governor he can kick rocks with his budget,” said Assemblyman Devon Mathis, a Republican from Visalia and a member of the budget subcommittee that oversees health care spending. “During a health pandemic you are going to cut health? That makes zero sense.”
Tuesday, representatives from the Newsom administration did not dig in their heels to defend the cuts, but told lawmakers they are “committed to work with the Legislature and stakeholders on alternatives and ideas,” according to Michelle Baas, undersecretary at the California Health and Human Services Agency.
“We think about COVID as a way to accelerate our creative thinking on other ways to do business and address the needs of our seniors and older Californians,” she said.
For most people, the new coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia and death.
