A powerful voice for the elderly in San Diego County is facing the same budget threats already dismantling similar programs in other counties this fall.

"It really is going to be devastating," said Chris O'Connell, coordinator of San Diego County's long-term care ombudsman program for Aging and Independence Services, or AIS.

"Right now we're in limbo," O'Connell said about the future of the program that hears complaints ranging from quality of care to elder abuse in the county's hundreds of long-term care facilities.

Earlier this fall, Gov. Arnold Schwarzenegger, with a line item veto, eliminated the $3.8 million in state funding for the program that trains and oversees volunteer ombudsmen who advocate for the rights of seniors living in long-term care facilities.

The concern is that inspections by other agencies only happen once a year or once every five years, O'Connell said, making the ombudsman the only regular "outsider" to hear and relay concerns.

If the program is cut, "the bottom line is, the residents will suffer," she said. "The majority of residents don't have family or friends to regularly visit."

O'Connell said San Diego County's program, consisting of nine staff members who train and supervise 125 volunteers, remains intact because of continuing county funding to offset the difference.

"If we don't have some sort of restoration (of state funding) by the end of the next fiscal year, we could be cut in half," she said.

Pat McGinnis, executive director of the California Advocates for Nursing Home Reform, said San Diego County "is one of the few counties that didn't have to do immediate layoffs."

Because eliminating state funding for the program came in the form of a last-minute line item veto, McGinnis said, there wasn't the usual scrutiny that comes with the traditional debates over legislative budget cuts.

Plus, in this case, the elimination of funds as of September was made retroactive to July 1-- the start of the state's fiscal year. Hence, the immediate layoffs in some counties suddenly finding themselves retroactively over their budgets, McGinnis explained.

"It's really horrible in some of the counties," McGinnis said.

The state funding accounted for half or more of the budgets of the programs, which also receive a mix of federal and local-level support.

McGinnis cited 17 layoffs in two programs covering Los Angeles County, the elimination of 14 positions in Orange County, and seven layoffs in Sacramento County in recent weeks.

McGinnis said it's difficult to get a total tally because each program is run by a different agency.

In San Diego County, the long-term care ombudsman program is under the umbrella of the AIS, a division of the county's Health and Human Services Agency.

The veto of state funding for the program followed a federal survey released earlier in September reporting that 99.1 percent of nursing homes in California had been cited for health and safety violations in 2007 -- up from 98.2 percent in 2006.

Nationally, 91 percent of all nursing homes fit that category in 2007, with two in 10 incidents involving neglect or abuse, according to the report by the U.S. Department of Health and Human Services.

In California, McGinnis said the cutbacks are happening just months before a new California law becomes effective Jan. 1 requiring additional reporting responsibilities by the volunteer ombudsmen in cases of elder abuse.

This is on top of a California law requiring that long-term care ombudsmen be present for advanced directives involving health care and "end of life" decisions, she added.

"There are a lot of mandates, but where's the funding?" she asked.

McGinnis is urging the public to contact local legislators, the California Office on Aging and governor's office to demand emergency action to restore the state funds.

Even though the ombudsmen are volunteers, eliminating staff positions creates a domino effect, since the staff is responsible for training and supervising the volunteers. Staff members also act as ombudsmen when the volunteers are not available, and handle incoming calls from family members and facilities.

O'Connell, of San Diego County's program, said the county's 125 volunteers go through 40 hours of preliminary training, 10 hours of supervised training in the field and then another 12 hours of ongoing training each year. She said additional costs are incurred in doing mandatory background checks and fingerprinting.

Volunteers then are asked to visit a long-term care facility once a week, she said.

"We figure there are at least 25,000 licensed beds just in San Diego County," she added. "That's why we're always trying to grow the program."

In addition to being present for some 500 advanced directives each year, the advocates hear hundreds of complaints each month.

"We get several thousand complaints a year as small as not getting the right kind of food -- although that's not small if you're on a prescribed diet -- to major issues of abuse and neglect," O'Connell said.

 "Our eyes and ears are just that -- our presence -- asking, 'Is everything okay?'" she said.