As Cher is well-known in California’s disabilities and mental health communities as advocate and benefactor, it was not surprising that earlier this month she would send a tweet to her large
Twitter following regarding homeless services in Los Angeles:
“I understand helping struggling immigrants, but my city (Los Angeles) isn’t taking care of its own. What about the 50,000+ citizens who live on the streets. People who live below poverty line and hungry. If my state can’t take care of its own (many are vets) how can it take care of more?”
Despite Cher’s history, even her brief reference to immigration and the limits of social resources brought an outpouring of attacks directed at Cher, denouncing her callousness toward immigration, her alleged collaboration with President Trump, as well as her own personal wealth. It’s worth saying a word about Cher’s experience, for it says a lot about the difficulty today of starting any reasonable discussions of social services and immigration numbers, and the existence of any tradeoffs generally in government.
Two days after Cher issued her tweet, Capital Public Radio (CPR) in Sacramento profiled the closing of board and care homes for persons with severe mental illnesses in California. CPR reported that within the past five years, 1426 of these facilities have closed. These facilities provide 24-hour support to adults who cannot live independently. The director of Health and Human Services for Yolo County told CPR, “For us, losing even one bed is horrible.” Sacramento Mayor Darrell Steinberg, a state leader in mental health services, described the closing as “catastrophic”, adding, “They are not the perfect solution for everybody, but perspective here: It’s real shelter with care.”
Even with sizable government subsidies, the board and care homes are not able to make the numbers work. In San Francisco, the current state reimbursement rate to operators is $1058 per month per resident, when break-even for most homes is closer to $2000 per resident. More than a quarter of these residential homes in San Francisco have closed since 2012.
The breakdown in the board and care system for adults with mental health issues is only one of the many examples of the funding challenges facing the state’s mental health and disability programs. Employment is a top priority of advocates and practitioners in the disabilities and mental health field; and the job placement efforts have expanded and improved at the state Department of Rehabilitation (DOR), one of the two main agencies serving Californians with disabilities. But the job counseling system DOR continues to be overwhelmed, with counselor caseloads averaging over 100 clients.
The California Department of Developmental Services (DDS) is the other state agency serving individuals with disabilities, and it is focused on more severe disabilities. DDS now has over 330,000 Californians on its service rolls, and is growing by 17,000 clients each year. Even with an annual budget of over $7.2 billion, it has long waiting lists for services, pays service providers at minimum wage, and in the words of prominent advocate Rick Rollens is “a system in financial crisis”.
To be sure, no matter how much government money is spent on homeless, mental health and other social services, it will never be enough. This is where social capital comes in: an extensive network of volunteer, religious and community-based structures that complement and build on the government efforts. But the experience of the past four decades indicates that social capital too is not unlimited.
So is Cher wrong to ask about tradeoffs with current immigration levels? Does this make her “anti-immigrant”? To see the Twitter responses to Cher is to see once again the vitriol and polarization, especially around immigration. It is also see how widespread is the idea that if we just tax millionaires and billionaires, we can have enough money for everything: enough for education, homeless, mental health, disabilities.
One of the tweets that stood out for me came from David Simon, the (rightfully) acclaimed creator of The Wire. Simon seems to be very active on twitter, with a history of angry tweets at anyone who doesn’t agree with his views. He attacks Cher, and then asks “And we can be bigger than this.” But what is meant by ‘bigger’? What has Simon done for individuals with mental health or developmental challenges, and how much of his vast wealth does he give to the needy? Beyond his tweeting, Simon, and the other Twitter commentators, can’t hold a candle to Cher’s efforts in these areas.
Cher and her media people most likely regret her comments. They shouldn’t. It’s time that trade-offs among social services and immigration levels are more openly analyzed and debated. I’ve been part of employment and anti-poverty programs for nearly forty years in California and one thing I’ve learned: Even in our age of unparalleled affluence, there are limits to social resources– that cannot be overcome by the now-familiar trope of taxing millionaires and billionaires.
Originally published at Forbes.