The L’Chaim Adult Day Health Center, which serves mostly elderly, low-income Russian Jews in San Francisco, will close Dec. 1 — the latest victim of state budget cuts.
Jewish Family and Children’s Services, which runs the center with the help of $3 million in state aid, will send letters to its 400 clients informing them of the news, according to JFCS Executive Director Anita Friedman.
The state budget passed in March eliminated funding for 300 adult day health care centers around California. On July 25, Gov. Jerry Brown vetoed legislation that would have funded a scaled-down version of the program.
“This is a real crisis for us,” Friedman said. “We already lost $3 million in funding for early childhood, mental health, legal services and food programs. This is an additional $3 million. At the same time, our [number of clients] increased 40 percent because of families who have lost work. These are perfect-storm conditions for us.”
Opened in 1999 and located on Judah Street in the Sunset District, the L’Chaim Center offers medical and social services to otherwise housebound elderly Jews. They can eat nutritious meals, have their medication regimen supervised and shmooze. The center also allows family members a respite from constant care. The state funded up to three visits a week for clients, with a van to give them a lift.
Come December, said Friedman, it will be time for Plan B. JFCS owns the building, but the board has not yet decided what to do with it.
The closure “means caring for [clients] in their own homes,” she said, “which means we take a look at every individual, see what their condition is. It means we have to identify the people who are the most in trouble. It’s essentially an emergency room triage approach.”
The task is made more challenging because many clients suffer from dementia, and either live alone or have no nearby family members to help.
Friedman calls the cuts a “bad business decision” because many of the elderly now served by adult day health care centers throughout the state will be forced into far more expensive nursing homes or hospitals.
“The only other option,” she said, “is they end up on the street or they just die sooner or live unsafely in their own homes. It’s a sad story.”
One nursing home that the most infirm L’Chaim clients will not enter, at least for now, is the Jewish Home of San Francisco. Currently, the facility is not accepting long-term nursing care patients, in part for budgetary reasons, and also because of a space shortage.
A 1923 wing of the Home not only is old and outmoded, Executive Director Daniel Ruth said, it is not up to code. Bringing it into full compliance would cost $1 million, more than the building is worth.
“By federal regulation all nursing homes must be fully sprinklered by August of 2013,” said Ruth. “The building is not sprinklered, so we determined it will not be part of our future. It makes no sense to pour good money after bad.”
As a result, its current residents are being moved to other parts of the campus. The resulting bed shortage means the Home for now will only accept short-term care patients. In March, Ruth told j. that the expected budget cuts left him with “no choice but to accept fewer patients.”
Ruth said he and his colleagues have seen these changes coming, and have planned for them. Still, he admitted that state cuts, totaling a quarter of the operating budget, have devastated the Home’s operations.
“So we’ve done reductions in [staff] and changes in our operations to try and withstand some of this,” he said. “[The state budget cuts] equal $11.1 million annually. You cannot cut your way to solve that.”
Because of what he views as an ongoing assault on the social safety net, Ruth worries about the health and well-being of Jewish older adults.
“I see [governments] abdicating their responsibility in meeting the needs of the most frail,” Ruth added. “I’m very concerned where the country is going, where society is going.”
Carol Singer feels the same way. The director of clinical services for JFCS of the East Bay said that though her agency does not receive state funds directly, it has felt an impact from the cuts.
She cited as an example counseling services that JFCS provides at local women’s emergency shelters and safe houses for domestic violence.
“They also have had severe budget cuts,” Singer said. “They are in more need of our services than ever, yet we have less money than before. So we may have to cut out one of the shelters we serve.”
Her agency has been redoubling fundraising efforts, but JFCS clinicians have had to take on larger caseloads. Singer said the staff is overwhelmed but willing to do what it takes to serve needy Jews and others.
And the situation may worsen. Looming cutbacks in Medi-Cal may result in more people needing JFCS services. “It means more stress for families, and fewer services available,” she said.
Like Friedman, Singer believes state cuts to programs that serve at-risk populations — such as the school readiness program First 5 Alameda County–Every Child Counts — make no sense.
“By investing in early intervention, it’s been proven that we can help prevent preschool expulsion,” she said, noting that the rate is three times higher than for middle school or high school students. “It’s proven you need social and emotional stability first before attending school. It impacts peer relationships, and their ability to be cognitively present.”
So far such arguments have fallen on deaf ears in Sacramento. Friedman said she remains hopeful. She reports more volunteers and donors stepping up to help, and she has launched a drive to raise $500,000 in new funds for threatened JFCS programs that assist the frail and elderly.
“The Jewish tradition says, ‘Do not abandon me in my old age; when my health fails, do not leave me,’ ” she noted. “How will we do that? This is the largest blow we’ve ever experienced. It calls into question what a society will do to take care of its most vulnerable. We don’t want to look like Bangladesh.”