Last February 21-year-old Tatiana Cheeks took her one-week-old baby, Shannell, to the outpatient clinic of the New York Methodist Hospital in Brooklyn for a scheduled checkup. When she arrived clinic personnel told Tatiana that since her baby did not have a Medicaid number she would have to pay $25 before a doctor could examine her. Ms. Cheeks, an unemployed welfare recipient, did not have the money.
The hospital staff referred the young mother to a city Medicaid office a few blocks away where she could apply for a temporary letter of eligibility for the baby. Tatiana knew this was easier said than done. She had been through nearly a year of bureaucratic rules and regulations, and was still unable to get a Medicaid number for her first-born child, Davaughn, who suffered from asthma.
Five weeks later, Shannell, whom Tatiana was breast-feeding, died of malnutrition.
Authorities immediately blamed the victim for this tragedy. Tatiana Cheeks was jailed on charges of criminally negligent homicide and second-degree manslaughter last May. Her young son was taken and put in foster care and Tatiana was only allowed to visit the toddler for two hours every two weeks.
The case was only dropped in July after an outpouring of protest and testimony from lactation experts and pediatricians that the health of a breast-fed infant can only be determined through weigh-ins and examinations during regular doctor visits. Tatiana, who lives in a non-profit shelter and has completed training as a bank teller, is awaiting a December 8 Child Services hearing on whether Devaughn will be returned to her.
The New York State Department of Health has since concluded that the hospital was at fault. State authorities said the hospital violated regulations that all patients 'receive treatment without discrimination as to their source of payment.' Moreover, it found that Tatiana's Medicaid coverage did entitle her baby to checkups until she was one-year-old. The department decided not to impose any monetary fine, and instead ordered the hospital to carry out a 60-day program of staff re-education.
This incident is symptomatic of a more general situation involving New York City's welfare policy. In July Mayor Rudolph Giuliani reaffirmed his goal to 'end welfare' by the year 2000. In his rush to reduce the number of people on public assistance, the Mayor, along with President Clinton, Congress and Governor George Patacki, have introduced a series of obstacles aimed at making it more difficult for poor people to qualify for welfare, food stamps and Medicaid, the chief health insurance for low-income families.
New York City's welfare centers are being transformed into 'job centers.' Two of them, in Jamaica, Queens and Boerum Hill, Brooklyn, have reduced approval rates for welfare applicants from 54 percent to 24 percent. There are now eight job centers, and according to the Mayor all 40 welfare centers will be converted by March 1999.
Currently there are 745,800 New York residents on welfare; 407,800 or about 55 percent of them, are children. Since 1994 the number of people on public assistance has fallen by 400,000. Many of those who have been kicked off the welfare rolls have been disqualified for the slightest infractions from the city's Work Experience Program (WEP). WEP has been widely criticized for compelling welfare recipients to work in menial, dangerous and dirty jobs for their welfare benefits, as well as for using welfare recipients as a cheap alternative to municipal employees.
When a needy person enters a welfare job center, he or she is confronted with the following hurdles before qualifying for benefits of roughly $100 a week:
1. Complete an employment profile and application (this sometimes takes two separate visits).
2. Meet several times with a financial planner.
3. Provide all identification cards and documents.
4. Participate in a 30-day job search program, monitored by an employment counselor.
5. Show up on time for all on site and off site job appointments.
6. Submit to home inspection by a fraud investigator.
7. Submit to electronic fingerprinting.
If an applicant is accepted, they will be placed on the WEP program and work for 20 hours for their welfare check. In addition, they must spend 15 hours a week looking for a job. However, the effort does not stop there. Those applicants applying for Medicaid and food stamps are 53 percent successful if they go to a 'welfare center,' but only 25 percent successful if they go to a 'job center.'
Federal law requires municipalities to allow a person to apply for Medicaid and food stamps on the first day he walks into a welfare office, but the city does not give these applications until the person returns a second day. The city administration's zealousness in denying applicants their benefits has raised protests from federal officials. A regional administrator for the Federal Department of the Health and Human Services, Sue Kelly, wrote that she was 'concerned that many eligible low-income children and adults are being exposed to additional barriers to Medicaid.'
However, Giuliani has essentially followed the lead of the federal government. The sweeping changes in welfare law passed by Clinton and Congress in 1996 authorizes states and municipalities to discourage people from applying for welfare. Since 1996 the federal government has reduced the number of people receiving food stamps nationally by 21 percent.
The reduction in the welfare rolls has not coincided with a fall in poverty. On the contrary, many indices show an increase in the number of the city's hungry and homeless. The Board of Education distributed 631,000 free or reduced-price meals last year, up 31,000 from the year before. The amount of food the city distributed to soup kitchens rose by 52 percent over the previous year. Nevertheless, 421 out of 1,100 kitchens turned away an estimated 59,000 people due to a lack of food.
The result of welfare 'reform' is a return to levels of suffering associated with Charles Dickens' 19th century London. It appears that Tatiana Cheek's daughter, Shannell, is only New York City's youngest victim thus far.
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