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Welfare recipients would see smaller monthly checks and low-income residents would pay more for medical care, local officials said Monday in evaluating Gov. Jerry Brown's plan to plug a $25.4 billion state deficit.

Two of the biggest spending cuts in the governor's plan hit Medi-Cal, the public health insurance program ($1.7 billion next fiscal year), and CalWORKS, the cash aid program for needy families ($1.5 billion).

The average CalWORKS family payment in Sonoma County would be pared to $449 a month, down from $516, under the budget's proposed 13 percent cutback, said Jo Weber, county Human Services Department director.

There were 3,728 families covered by CalWORKS in November, with a total of 8,391 people enrolled, three-quarters of them children, officials said.

CalWORKS payments overall totaled $1.91 million in November; a 13 percent cut would take $248,300 from the local economy.

The governor's plan would also cut CalWORKS eligibility from five years to four years, Weber said.

A proposed 12 percent cut to In-Home Supportive Services would reduce the average home assistance in Sonoma County from 100 hours to 88 hours a month, she said.

About 5,200 elderly and disabled county residents receive in-home services, which are intended to keep them out of nursing homes.

A 50 percent funding cut in transitional housing for 18- and 19-year-olds leaving the foster care system would reduce the number of beds available in Sonoma County from 13 to seven, and Weber said there is a "long waiting list" for the beds.

"Those are painful cuts, no doubt about it," county Supervisor Shirlee Zane said. But, she added, "how do you cut a budget without cutting programs?"

State Sen. Noreen Evans, D-Santa Rosa, said spending cuts were needed "to restore fiscal health to the state. The course we were on has never been sustainable."

Evans, who lambasted Arnold Schwarzenegger's moves to cut health and human services, said the former governor "attempted to shut down programs." Brown is making big cuts to some of the same programs, "but he is not trying to destroy them," she said.

Pedro Toledo, spokesman for the Redwood Community Health Coalition, said Brown's proposal to set mandatory co-payments — $5 for a doctor's office visit and $50 for emergency room services — could curtail health care for low-income Medi-Cal beneficiaries.

The eight Sonoma County community clinics in the coalition are required by law to treat Medi-Cal patients and generally do not charge the current $1 optional payment for office visits.

"We don't want that to be a barrier to care," Toledo said, noting that most Medi-Cal beneficiaries are "extremely poor."

Co-payments might require some to choose between food and medical care, a choice "people shouldn't have to make," Toledo said.

There are about 60,000 Medi-Cal beneficiaries in the county, officials said.

A proposed 10 percent cut in Medi-Cal reimbursements to health care providers would cost the community clinics about $6 million in annual revenue, Toledo said.

That loss would not curtail clinic staffing but likely would curb the expansion of clinics in Santa Rosa, Petaluma and West County, he said.

To patients, that would ultimately mean less access to care and longer waiting times in the clinics. But the cuts in Brown's plan are not new.

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