More crime committed by addicts. More people with intellectual disabilities and mental illnesses in institutions. Higher unemployment costs as nonprofits that serve needy populations lay off workers.
Those were just a few of the outcomes predicted by social services providers who testified Tuesday before Philadelphia City Council about the potential impact of Gov. Corbett's proposed budget cuts.
Previous discussions have focused on Philadelphia, but the lengthy hearing before the Council Committee on Public Health and Human Services made it clear that people across Pennsylvania would feel the budget's effects.
"This is an issue for every county across the state," said Joanne Kline, executive director of Montgomery County's Aging and Adult Services. "Throughout my county and the region as a whole, we will see an increased cost in emergency services, jail days, physical health services, demands on shelters, stress in urban areas, and agency unemployment. These are costs that may very well equal the reduction."
Douglas Hill, executive director of the County Commissioners Association of Pennsylvania, said that his members "understand the Commonwealth's fiscal constraints," but that they were "distressed at another round of significant cuts contained in the proposal, cuts that will dramatically alter our social services safety net and touch other program areas as well."
This year's budget is the 10th year of decreases for substance-abuse services, despite rising need in many counties, he said.
Corbett has proposed combining into a single block grant state dollars that help pay for services to the homeless, people with mental health and substance-abuse problems, HIV patients needing hospice care, children aging out of foster care, people with intellectual disabilities, and those in the city-run nursing home. Then, the budget would reduce total payments to those programs 20 percent.
In Philadelphia, that would mean a loss of $41 million.
In addition, the budget would eliminate about $65 million in general assistance money to Philadelphia residents that helps the disabled and sick, domestic-violence survivors, adults in alcohol- and drug-treatment programs, and others. Statewide, about $300 million would be eliminated. Advocates for those groups say they believe some general assistance recipients would also lose medical care.
Anne Bale, a spokesperson for the Pennsylvania Department of Public Welfare, said people who lose general assistance should be able to retain their medical benefits.
The cuts are necessary, she said, to balance the state budget.
About 80 percent of the DPW's budget can't be trimmed because of federal or other mandates, she said, leaving these programs as the only savings targets.
"This is the only thing that we have left to make changes to," she said. "There are still many millions of people that DPW will continue to serve, and our core programs will remain in place."
But advocates for affected groups told Council on Tuesday that the cuts put too many people at risk. Several who testified said Pennsylvania should instead boost revenue, possibly by slowing down reductions in the state's capital stock tax, which is scheduled to be eliminated by 2014.
Donald F. Schwarz, Philadelphia's deputy mayor for Health and Opportunity, called the proposed cuts "unprecedented."
They will likely leave more people in institutions, as funds that had helped people remain in their communities dry up, he said.
"Families who depend on a modest amount of funds to keep a child with intellectual disabilities living at home, rather than in an institution, will lose this support," he said.
The Corbett administration has said the block grants were designed to improve flexibility in care, but Schwarz said that, for many affected groups, alternatives were not obvious. As an example, he described a schizophrenic patient who lived at home and benefited from funding that ensured that someone checked to make sure he had taken his medication.
Many social services providers said they had laid off people during previous budget cuts and would now have to let more go.
Dyann Roth, director of corporate operations for Resources for Human Development, a nonprofit human services provider, estimated that her organization, which employs 1,400 people, might have to lay off more than 80.
Paul Sachs, executive director of NHS Human Services, told the Council committee that the changes would drive costs higher, not lower.
"We will see an increase in medical hospitalizations for the types of problems that frequently coexist with behavioral-health problems, such as diabetes, pulmonary, and cardiac conditions, not to mention sensitivity to extremes of cold or hot weather. And, I am sorry to say, we will see more people die whose deaths could have been avoided," he said. "The governor's budget cuts will not save money. Rather, it is an elaborate cost shift to emergency medical care and criminal justice systems, neither of which is designed to address the core problems facing these vulnerable individuals."
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