José is not a poster person. He’s not a starving doe-eyed child. He isn’t a struggling single mother. He isn’t bravely fighting cancer. He hasn’t risen to national prominence despite humble beginnings and devastating misfortune. He’s 45. He is Mexican. His face is weathered from too much time in the sun. He is obese from too much of a gringo diet. He has bipolar disorder, and does not really understand his disease. He speaks very little English. His hands are large and roughened from so much real work. And he is undocumented.

José is fortunate because, years ago, some forward-looking leaders realized this: people like José, when healthy, can give to our community far more than it costs us to treat their mental illnesses. For several years, José has been receiving care from a county-contracted facility. The actual cost for providing this care has been less than $400 per year. (Though the county agency involved charges the taxpayers some twenty times that amount, making José a profitable commodity when budgets are flush.) For one dollar a day, this quiet man has been given the strength and dignity to live a productive, fulfilling life. His presence in our community is so small that he is nearly invisible. Yet the money spent on his care has paid dividends that, in every imaginable way, exceed the investment.

Today I had the privilege of meeting José. I was able to help him obtain the medications that have saved his life. It also fell on me to tell José that, after today, he would no longer have access to these life-saving medications. The citizens of Sacramento County do not consider his life and contributions worth the $0.0003 per citizen per year to keep him alive and working. This when just two employees of the Department of Behavioral Health Services have a combined annual income of over one million dollars — enough to provide care to 2,500 Josés and have money left over.

Today, José became the first referral to the free clinic I hope to open in September. At best, the clinic will be able to provide care for 100 or so patients and, for that, it will require the faith and dedication of dozens in our community. Nobody wants to have to do it this way, but when “government for the people” turns its back, what choice do we have?

José is not poster material, but José is my hope and my inspiration.

Ron – Jun 2009