State money for program to help poor, disabled people may be in trouble Glendening reportedly cut it from budget

January 20, 1995|By Diana K. Sugg | Diana K. Sugg,Sun Staff Writer

When Gov. Parris N. Glendening presents his first state budget today, a program that provides emergency cash and medical care to poor, disabled people may be among the missing.

Known as the Disability Assistance and Loan Program, or DALP, the program gives roughly 20,000 adults a monthly stipend of $157, which costs Maryland about $34 million a year. With that check comes a clearinghouse of services. Soon, many recipients find themselves with medical care, a place to live and counseling.

Joe Johnson, 45, got a place to live. Frederica Height, 32, started working toward her high school diploma. And Robert Whitehurst, 60, says the help saved his life.

Homeless advocates said the governor told them Wednesday that he eliminated the program, which also gives about half the recipients medical care at an annual cost of $13.5 million. The rest receive medical care through Medicaid, the federal-state program for the poor.

Mr. Glendening's office refused to comment.

"We explained these people are depending on him," said Jeff Singer, spokesman for Health Care for the Homeless, a Baltimore group that provides health care, counseling and other services. "He said, 'I have received the many letters that you sent, and I expect to receive more. We have eliminated this program, but we will try to do something for the truly handicapped.'"

State figures show that more than half of DALP recipients have a substance-abuse problem, along with medical conditions. About half the participants are women. Diane Rowland, executive director of the Kaiser Commission on the Future of Medicaid, calls this group "the poorest of the poor and the sickest of the sick."

Roughly 60 percent will eventually qualify for federal disability, but that often takes more than a year. Until then, the program serves as a bridge that keeps recipients from homelessness or holds them over until they are able to work.

"It was like heaven. It was wonderful," said Mr. Whitehurst, a Baltimorean who lived on the streets for two years after health problems cut short a 30-year career working on fishing boats. In four months, DALP helped him get shoes, an apartment and the insulin he needs to control his diabetes and its numbing effects. He even started to get some of the feeling back in his feet.

Shane Thornton Jr., a 42-year-old Baltimore man, described it this way: "It's helping me maintain my sanity and livable conditions."

The budget cut would make morethan 5,000 people homeless, advocates say. And roughly 10,000 recipients would lose their access to medical care.

"There won't be any safety net," said Jim Mayhew, a staff attorney in the Baltimore County office of the Legal Aid Bureau.

Other experts said the change would affect everyone.

"We, as citizens of Maryland, will pay for it in many indirect ways," said Stanley Herr, associate professor of law at the University of Maryland Clinical Law Office, which represents DALP recipients.

Many of them have chronic diseases such as high blood pressure and mental illness that, without treatment, could easily put them in the hospital. And many of those hospitalizations would start in the emergency room -- where care is most expensive.

That also means hospitals would have to treat more people without getting paid. And that could translate into increased health costs for those who have insurance, said Robert Murray, executive director of the Health Services Cost Review Commission, which sets hospital rates.

Last year, the cost of uncompensated health care dropped from $440 million to $400 million, and Mr. Murray believes the disability program contributed to the decrease.

LTC What's not clear is how much of a dent the disability program made -- or how much rates might increase without it.

Rick Mosley of the Downtown Partnership of Baltimore Inc. worries that more homeless people downtown will hurt business. The coalition sponsors job training for the homeless, and he said he believes the state should do its part.

Across the country, states are struggling with how to afford care for the poor.

Between 1988 and 1992, state expenditures for Medicaid, the federal-state health program for the poor, increased at an average annual rate of 21 percent, according to a new study from the Urban Institute. Since that program mostly covers single women with children and those who are permanently disabled, many states also provide some cash assistance and health coverage -- such as DALP.

In lean budget years, these programs are vulnerable because they aren't mandated by the federal government, and the state doesn't get matching federal funds for them.

But Jacquelyn Gaines, president and CEO of Health Care for the Homeless, says these cuts exacerbate a troubling trend.

"More and more we are seeing the division between the haves and the have nots," Ms. Gaines said, "and it seems to me that this decision would push that wedge even further."

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