Elderday, adult day health care breathe easier

California is one of only a few states that covers adult day health care programs for Medicaid recipients. Adult day health care centers provide daytime supervision for people with cognitive, physical and social impairments. They also administer a variety of prescribed therapies. Since May, supporters of adult day health care have been rallying—first against a cut of all Medi-Cal funding. More recently, they rallied against a proposal to cap the number of days Medi-Cal recipients would be able to attend these programs. From Elderday, an adult day health care program in Santa Cruz, Christopher Connelly has this story.

Elderday is the only adult day health care program in Santa Cruz County. The center has about 150 regular paritipants over the age 50 with a variety of physical, cognitive and social impairments. A typical day begins at 8 or 9 in the morning, when the participants are picked up from their homes by bus and driven to the facility.

Elderday does everything that any adult daycare center does, providing seniors a chance to socialize with each other and with staff members, a variety of activities to keep them sharp and meals and supervision while their families and caretakers work during the day. But what separates adult daycare programs from adult day health care centers is the range of therapeutic and health services that are offered at programs like elderday. They provide physical and occupational therapy, case management, mental health services, excercize, transportation, podiatry and nursing.

Sheri Anselmi is the director of Elderday. She says that in California, there are over 33,000 participants at around 330 adult day health care facilities. While most participants are seniors, the facilities can serve adults of any age.

Starting last spring, anselmi and other adult day health care supporters have been fighting to keep Medi-Cal funding intact. She says that the battle began in may, when Governor Schwarzenegger proposed to cut all Medi-Cal funding of adult day health care to help balance the budget. Although a total cut didn’t gain traction, the idea was revised. In July, lawmakers and the governor passed the budget revision package that would scale back the number of days Medi-Cal would pay for—from five to three days per week.

Anselmi says although it was not a total cut, the effect of the cap on her facility would have been severe.

A law suit was filed in august on behalf of three women who attend adult day programs paid for by Medi-Cal five days a week. They argued that the cuts violated the Americans with Disabilities Act and federal Medicaid law because it failed to provide alternative care and was therefore a cut in medically necessary services. They said that the cap would lead to institutionalization in nursing homes in most cases.

The case was heard on September 9^th in federal district court in Oakland.

On September 10^th, Judge Sandra Armstrong ordered an indefinite suspension of the cap, saying that scaling back services would cause irreparable and immanent harm to the people who rely on them, and that the state was obligated to provide alternative services that would prevent insititutionalization.

The Health Effects of State Budget Cuts

September 2009 Health Dialogues

www.HealthDialogues.org

As Congress considers a major overhaul of the U.S. health care system, Health Dialogues examines how the new state budget will affect health care closer to home. Will kids in low income families be able to get basic services? What about drug treatment programs mandated by Proposition 36? And how may where you live affect the care you’ll get?

The Value of Community Health Clinics

Many unemployed Californians and the working poor often turn to the nearly 800 community health centers throughout the state when they need medical attention. Host Scott Shafer visits the Russian River Health Center in Guerneville, in rural Sonoma County, to see how the state budget cuts have affected staff and patients.

Proposition 36 Coping With Significant Cuts

California’s landmark Proposition 36 was intended to send drug users into treatment, rather than prison. The current budget slashed Prop. 36 funding almost in half. That complicates things for the Superior Court in Santa Clara County, where Judge Stephen Manley oversees Proposition 36 cases. Guest: Honorable Judge Stephen Manley, Santa Clara County Superior Court judge.

Map of Rural Health Clinics

For more information, visit www.HealthDialogues.org