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Health & Fitness

Supervisor Wilma Chan's Blog: An Update on Adult Day Health Care Services

An update on Adult Day Health Care, a program that helps seniors and disabled adults to live independently in their communities.

As you may recall, just a few weeks ago, hundreds of seniors and advocates for Adult Day Health Care in Alameda County gathered on the plaza at the County offices. Together, we called upon the Governor and the State of California to stop the elimination of ADHC that would have taken effect Dec. 1.  We called for more time, or a new and innovative solution, to help the nearly 1,000 Alameda County residents who rely on these services to live independently.

It was an emotional day as one resident described how ADHC services allow her to go to work and ensure her mom is under great care while another senior described how ADHC was essential to her receiving the care and companionship she needs. Assemblywoman Nancy Skinner described the short-sightedness of the cuts when placed against the long-term cost implications of other options for senior health care.

Last week we learned about a settlement between advocates and the State of California to delay implementation of these cuts and provide an alternative for those impacted. We are still waiting to hear about final details of the settlement, but here’s what we know so far: 

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First, ADHC in its current format will continue through Feb. 29, 2012. That means the state will have additional time to ensure a smooth transition, which is especially critical in a county like ours where many of our ADHC participants face language, mobility and economic barriers to receive the care they are entitled to.

Second, in 2012, ADHC will be replaced by a program called CBAS offering center-based services to a range of elderly and disabled adults. I will monitor the development of CBAS closely and advocate strongly for this program to provide seniors and people with disabilities with the services they need.

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Eliminating ADHC on Dec. 1 would have been devastating, both for the 7,000 people who work in this field and the tens of the thousands of people who depend on these services. Statewide, 17,184 nursing home placements would have been needed as a result. There are nowhere near that many beds available. Instead, many seniors and disabled adults would have been forced to seek long-term care in hospitals.  

Many thanks to all of the providers, clients, caregivers and doctors who have demonstrated their support of Adult Day Health Care. Their hard work and perseverance made all the difference in this fight. 

I will share more details as they emerge, and, over the coming months, I will continue to advocate for our area’s seniors and people with disabilities.   

 

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For greater detail, I’ve attached an excerpt from the Disability Rights Coalition news release.

Adult Day Health Care Settlement:  New Program for People at Risk of Institutionalization, December 1 Elimination Date Postponed

Oakland, CA:  Today, seven plaintiffs who represent a class of 35,000 low-income people with disabilities, including older adults, and the California Department of Health Care Services (DHCS) reached a settlement in a federal lawsuit that challenged the State’s planned elimination of Adult Day Health Care (ADHC) as a Medi-Cal benefit on December 1, 2011 (Darling et al. v Douglas C:09-03798 SBA ). The settlement ensures that even in these challenging economic times, critical community based services will be preserved and low income seniors and people with disabilities will avoid unnecessary hospitalization or institutionalization.

After extensive negotiations, the Parties reached a compromise which preserves ADHC-like services for people who are at risk of institutionalization, in a new program called Community-Based Adult Services (CBAS).  Similar to ADHC, CBAS will offer center-based skilled health and nursing care, therapies, transportation and other services, to eligible low income seniors and people with disabilities.  Under the settlement, the planned December 1, 2011 ADHC elimination date will be moved to February 29, 2012 to ensure a seamless transition for eligible ADHC participants to the CBAS program, and provide time for the Court to review the settlement and give final approval of the Agreement.

“There are a lot of people who really need this program; I have fought to stay out of a nursing home and have been able to with ADHC,” said Esther Darling, lead plaintiff in the case, age 74, who lives alone with the help of ADHC, and will transition to the CBAS program.  Under the terms of the settlement, CBAS will be offered through Medi-Cal managed care plans in most parts of the State. CBAS will be part of the State’s 1115 Medicaid waiver, and will not cap enrollment, ensuring that all eligible beneficiaries are able to receive these vital services.  Current ADHC recipients who are not eligible for CBAS will receive enhanced case management to assist them to transition smoothly to other long-term care services in the community.  Many of the current ADHC providers will be able to provide CBAS services, thus ensuring continuity of care. 

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