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Too poor to be sick
By KATHRYN WEXLER
© St. Petersburg Times, TAMPA -- On most days, nausea from dialysis keeps Martha Walker in bed. Medication for her waning health -- 26 pills a day -- helps keep her alive. If it weren't for Hillsborough County, which picks up most of the monthly $319 tab for her medication, Walker would have to choose between her medicine and her mortgage. When Hillsborough County commissioners meet today, they will likely decide whether to slash funding for the program that grants Walker, 69, access to the county's indigent health care plan. If they decide to do so, Walker is one of the people who may be dumped from the plan. She has no bank account because she has no extra money. Her kidneys went bad six years ago, and in January she suffered a stroke when her husband of 34 years died, so she needs more medications now than ever before. The prospect of losing prescription benefits is a dismal one for a woman who worked all her life and always struggled, toiling at dry-cleaning shops and cleaning South Tampa's big houses until she got sick. "Well, I just don't know what we poor people's to do," said Walker, sitting in her darkened living room, masking tape on the ceiling because sodden plaster falls through when it rains. With rising prescription costs and slumping sales-tax revenue, the indigent health care plan is getting more expensive for the county to operate and, according to projections, may outspend itself in the next several years unless something is done. The county's entire proposed budget for fiscal year 2002-2003 approaches $1-billion. Cutting funding for the plan Walker is on, known as the catastrophic health care benefit, will save taxpayers $3.2-million. For those savings, about 1,000 county residents with dire illnesses and incomes marginally above the poverty level will be left to fend for themselves when it comes to health care. Also on the chopping block today is a special fund for emergencies known as the General Assistance Fund. That program catches people teetering on the brink of poverty when a personal disaster occurs and helps with rent, food or utilities, generally on a onetime basis. Commissioners will decide whether to cut that fund by 50 percent over the next two years, saving a total of about $2-million. But the cost to those eligible for the General Assistance Fund could be devastating, say those in the social services sector. Cretta Johnson, director of the county's Health and Social Services Department, said that would mean more than 4,400 people who qualify for emergency funding under the current standards would be bumped from the program. "That would hurt the working poor and anyone on fixed income," Johnson said. Wanda Bolen is one of those people. In January 2000, she bought her first house for $68,500. By November, she was having her breast removed because of cancer. Between rounds of chemotherapy, she held on to her job at a liquor wholesale shop, but her working hours slipped to about 16 hours a week. Supporting two teenagers, Bolen, 47, faced losing her house. The county stepped in, paying $370 a month toward her mortgage for six months. Bolen had to show receipts every month to prove she was still working and paying for her utilities, her car bills and putting $82 toward her home. It was a rare arrangement for the county, which generally helps any one resident only once a year. Bolen's case was different because she was temporarily disabled, Johnson said. Bolen is now back on her feet. "I hope they don't stop that program," Bolen said. "I was really, really, really struggling." The General Assistance Fund came under fire in 1997, when commissioners criticized how it was being spent. An independent audit found no major problems with the program. Commissioners voted to tighten qualifications anyway, citing generous spending guidelines that allowed recipients to receive checks for years. County commissioners appear divided. Commissioner Jim Norman thinks the funding should be cut, telling commissioners during a budget review Tuesday night, "They're not stripping it down to zero." Commissioner Ronda Storms suggested it was the responsibility of churches more than government to help the poor. The Salvation Army gets money from the Federal Emergency Management Agency to fund rents or utilities during emergencies, said spokeswoman Catherine Hammer. But with the downturn in the economy, there already is not enough to go around, she said. "They typically cut the check in March, and we have used up most of that money already for this year, our need has been so great," Hammer said. If the commission votes in favor of reducing the health care program, Walker will be one of the people considered too rich to qualify for county health care. County administrator Dan Kleman has suggested to commissioners that if they want to reduce spending, they should phase out health care recipients such as Walker who take in more than poverty-level income. Walker gets $9,588 a year from the federal government from Social Security disability. That puts her almost $1,000 over the poverty line. She also gets Medicare, which does not cover prescriptions. If she were to add her prescription costs to her $545 monthly mortgage, she would already be $65 over her disability checks. That's without paying for utilities, phone service, food or clothing. "It's a mess," Walker said. "I've got no savings. How could I, with all these bills?" - Times researcher John Martin contributed to this report. Kathryn Wexler can be reached at (813) 226-3383.
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