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If the recent budget proposals from Gov. Gray Davis had gone into effect last winter, Kristine doesn’t know where she’d be today.

The Santa Cruz woman says she and her two children fled an abusive husband more times than she could count. If it weren’t for the emergency cash and food stamps she received from the county welfare department, Kristine might have been forced to return to him. That, or she and her children would have become homeless.

"I would have had no other means of survival," said Kristine, who asked that her real name not be used.

County social workers say Kristine and thousands of others will suffer if the governor’s plan to solve a $23.6 billion budget deficit goes through. Taking aim at health and human services, his cuts take away an estimated $1.2 billion from county programs statewide — including money for emergency cash programs like the one Kristine used. The cuts would be compounded by loss of the federal matching funds that come with most social services.

Ironically, the reductions could make it difficult, and in some cases impossible, for counties to carry out services they’re mandated to provide by the state. And in the long run, the cuts will only cost the state more as more people are locked up, hospitalized, or rendered homeless because the support services they relied on disappeared, county officials say.

Low-income families and advocates throughout the state have already started descending on the Capitol steps to rally against the governor’s plan. County officials are writing legislators nonstop, and the California State Association of Counties is recommending things like pension obligation bonds and state lease-backs of buildings as alternative ways to save money.

The governor’s recommendations come on top of this year’s decreases to county clinics as well as next year’s loss of revenue from voters’ repeal of the county’s 7 percent utility tax in March.

The $11 million loss in revenue is forcing health and human services departments to cut almost 75 positions, though many of them are currently vacant. A handful of programs and a career center will close, and more people will be turned away from county clinics, detox programs, mental health treatment and welfare-to-work programs. And that’s not counting the governor’s recomendations.

"It’s kind of a crescendo of just incredible bad luck," said health director Rama Khalsa, who also has to deal with steep increases to medical equipment and pharmaceutical prices. "A bunch of us said this must have shown in the star charts — there’s just too many bad things happening. You couldn’t ever think this up."

The proposals made by the governor three weeks ago would hit the county human services department hard. Most significantly, Davis wants to cut money used to administer welfare programs by 20 percent. That would translate to a loss of $10 million and 80 staff positions for county social services. The governor’s plan also reduces care for home-bound elderly and protection for seniors who are scammed.

If the cuts are approved, it would take county workers much longer to see to welfare, food stamps, Medi-Cal, foster care and in-home care participants’ needs, said Cecilia Espinola, human services director. That means participants would get paid later and people trying to apply for a program would have to wait months for approval — which could jeopardize the health and welfare of people in serious need, she said.

The cuts to adult protective services put the county’s new financial abuse team at risk, said Sandy Skezas, APS supervisor.

The governor’s proposed cuts to health services run equally deep, with treatment for at-risk and mentally and physically disabled children particularly hard hit. One of the most severe losses would be the elimination of the "Systems of Care" program, which helps keep abused or neglected children and at-risk youth out of group homes or juvenile hall.

Overall, 40 staff would go if Systems of Care is eliminated, said Khalsa. Each caseworker manages treatment for about 40 children, Khalsa said.

"These youth are at risk of going to out-of-home placement or the youth authority if we don’t get treatment to them," she said.

Systems of Care also provides core money for the county’s special education program. Khalsa estimates at least five classrooms for 300 mentally and physically disabled students would go under the governor’s plan.

The cuts to Medi-Cal funding affects Kahlsa’s department, too. If the human services department takes months to get people insured, the health department won’t be able to function, she said.

"Every program we have is built on Medi-Cal," she said.

The governor’s recommendation to re-institute quarterly reporting requirements for Medi-Cal recipients would only exacerbate the situation, Khalsa said. Done in the name of reducing fraud, the action is really just an effort to get people off the rolls by increasing bureaucratic red tape, she said.

The governor also has recommended taking back increases in Medi-Cal reimbursement rates that went into effect in 2000. Before that, rates hadn’t been raised for 15 years and California had the worst rates in the nation.

Alan McKay, executive director of Central Coast Alliance, the county’s managed Medi-Cal program, is afraid lower rates will force area doctors to stop taking Medi-Cal patients. alliance enrollment has decreased county ER use by 35 percent, but if doctors stop seeing alliance members, patients will turn once again to the ER, he said.

Bridgitte McMinn, spokeswoman for Watsonville Community Hospital, agreed.

"It could have a potentially crippling effect on an emergency care system already in distress," she said. "If larger sources of people have no access to health care, they won’t seek service until they are in a crisis health care mode. Then they’re going to come to our ER."

Watsonville hospital would also lose extra reimbursement it now receives for uninsured patients if the governor’s cuts go through, she said.

"These things are cumulatively big enough that Watsonville’s fiscal solvency is at risk," she said.

Even staunch Republicans like Tim Morgan, a Santa Cruz attorney who specializes in local government, say the governor’s cuts are as bad as counties make them out to be. Morgan said gubernatorial candidate Bill Simon, a Republican, has proposed a budget that is more "strategic and comprehensive" and leaves counties in better shape.

Bob Suhr, who led the effort to repeal the county’s utility tax, said it’s too early to start worrying about the governor’s proposals. Nothing’s been decided yet, he said.

"The Legislature still has to weigh in on what they’re going to do," Suhr said. "I don’t know what point there is now in addressing the thing. ... None of it is a fait accompli at the moment."

The county also has more money to fall back on than it makes out, he said. County employees have "excessive" retirement packages, and supervisors approved an increase in plans last year, he said. There are currently about 280 vacant positions as well — if the county doesn’t fill those vacancies, it’ll save millions of dollars, he said.

Khalsa and Espinola insist, however, the governor’s cuts run too deep for the county to handle.

"This is a direct attack on health and human services," Espinola said. "The reductions were not spread evenly at all. It’s easy to attack the poor because they have no paid lobbyists in Sacramento."

Contact Jeanene Harlick at jharlick@santa-cruz.com.

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