One year after an emergency room doctor noticed a disturbing spot on Deborah Davis' kidney, the recovering alcoholic who has been homeless for years is finally trying to find out if she has cancer.
But if she needs a kidney removed, she may be one year too late to get help from Utah.
This January, the state stopped enrolling poor, disabled clients for short-term monthly cash payments known as General Assistance, intended to keep them afloat until they receive federal disability benefits. Being enrolled in GA also allowed people to apply for state money for one-time medical procedures.
Fixing a hernia or carpal tunnel syndrome -- more typical procedures than Davis' kidney surgery -- allows a recipient to go back to work, stop relying on public benefits and prevent a long-term disability.
Fewer and fewer Utahns have access to that support. In the past few years, state budget cuts reduced GA by millions of dollars and shortened the amount of time clients receive aid, resulting in hundreds of people losing benefits.
As of January, slightly more than 1,000 poor, mentally or physically disabled Utahns received the monthly $261 stipend. Client numbers are down by about 39 percent compared to last year's high in June.
Without money for medication co-payments, some former GA clients are now dropping their limited state insurance through the Primary Care Network (PCN). Without it, they may be eligible to get prescriptions filled for free at Fourth Street Clinic, which provides medical care to the homeless.
"The system is putting more pressure on us in order to provide the services that before were getting covered through state-funded programs," said Jenn Hyvonen, a spokeswoman for Fourth Street. "So now we have to pick up the slack; otherwise, people will go without."
Like last year, the state has $120,000 to spend on health fixes for GA clients during this fiscal year. Over the past seven months, 20 people have used up about $35,000 -- although some bills may still be in the pipeline.
Fourth Street Clinic understands that expensive cancer treatment probably would not be covered, but they would have liked to apply for help with Davis' kidney surgery. For now, they don't know whether she has cancer, but the surgery is likely necessary to find out.
To pay for it, they'll need donated medical care and money. The procedure could be delayed by weeks or months, potentially putting Davis at risk.
After she got out of jail in December, Davis spent her days panhandling, walking to a liquor store and buying vodka. Now she wants to stay clean, healthy and go back to work, perhaps at a law firm, the kind of job she had many years ago.
"I'm just living each day as it comes," she said.
Her health care dilemma is not unique. At 40, Kimarie Montoya is exhausted and anemic from the constant bleeding from her uterus. "I always know when I'm short on blood," she said. "I get really dizzy."
She would love to work, but her health prevents it. Montoya guesses she's been to the emergency room about seven times in the past year. Doctors are recommending a hysterectomy.
"I don't think I've ever had insurance," she said.
Had the GA program remained open to new clients, Fourth Street Clinic would have signed her up and applied for the medical funding. Instead, they're now looking for donations, or hopeful that she will receive Medicaid disability benefits, which could take six months or more.
Corie McDermaid Theel, 57, is among the former GA recipients who have dropped PCN coverage. After getting laid off from her customer service job and being diagnosed with diabetes, Theel, 57, ended up homeless.
The shelter helped her find transitional housing, but without GA, she couldn't afford her eight monthly prescriptions and looked for help at Fourth Street. Theel has gone to the ER twice since quitting her insurance.
"The legislators don't understand any of this," said the former teacher, who is also struggling with lupus. "What they need to realize is these people are not a bank account, they're not numbers ... they're not faceless just to be left in the gutter to die."