Hard choices for Pa.'s needy

The call comes at 11 a.m. "I am bleeding again," Mr. Jones says.

Since he developed colon cancer a year ago, Mr. Jones (not his real name) has had many physical complaints. The surgery was hard and traumatic. Six months of chemotherapy kept him nauseated and fatigued, symptoms that have not entirely gone away. He has lost significant weight, he gets short of breath when he walks, and his hands hurt.

His doctors caution him not to lift more than a few pounds at a time. After 25 years of working, he can't support himself anymore. And now, due to state welfare cuts as of the end of last month, he has no income assistance from the government at all.

When he calls and says he's bleeding, he's panicked. I think he's worried about the bleeding, which he is, but he has even more important concerns.

A Social Security hearing to determine whether he was too sick to work is scheduled for that day. Because Social Security's evaluators thought his disability would not last more than a year, they had rejected his claim. Now that a year has passed, maybe we can demonstrate that the residual effects of his cancer will indeed keep him from working in the long term.

A week before, Mr. Jones had gotten a notice in the mail about Pennsylvania's welfare cuts. The state had been providing a meager $205 a month in general assistance to him and other people with disabilities. The program was being canceled.

"I use that money for my electric and gas," he told a student who helps me represent low-income clients. "What will I do now?" The student and I weren't sure what to say. We told him that if we could get his Social Security disability benefits approved, he might start getting money in a few months. We hoped he could hold on until then.

Then the call comes. "I am bleeding again," he says. "I have to go to the hospital, but my hearing is at 3. What should I do?"

He and I both know he should go to the hospital. He knows he can't. Surely the judge would postpone his hearing without penalty to give him a chance to get treated; in fact, when I call the judge's clerk, he confirms that. But a postponement would mean he wouldn't get another hearing for three months. There would be no welfare benefits during those three months, which could mean no electricity or gas in the house.

"I must go to the hearing," he says. "You must check out why you are bleeding," I say. He says he has no choice. We go to the hearing.

With luck, he will have Social Security benefits in a few months. With luck, he will make it through the next few months with no money.

He'll get federal food assistance. He'll get health care - at least until the state develops new forms to evaluate his medical needs, forms his doctor may or may not fill out correctly or quickly enough to keep those benefits going. He may be able to keep the utilities from cutting him off. He'll hope he won't need new clothes or face housing expenses.

Mr. Jones' situation is not unique. Many Philadelphians are now making nearly impossible choices as they try to live without even the smallest amount of government income assistance. Our state government made that choice. We made that choice.