Saturday, July 30, 2011

Adult Day Health Care Programs

Things aren't looking too good for adult day health care (ADHC) programs in the state. Unfortunately, this includes the Santa Maria Wisdom Center.
In his infinite wisdom, Jerry "the guv" Brown vetoed legislation that would have provided funds to allow adult day health care programs to continue to operate. In his world, other services will be available for the 35,000 medically frail or disabled clients. Naturally, he's dreaming. There are no alternatives for many of the clients.
According to him, the benefit would be available to Medi-Cal recipients until December 1, allowing enough time for a smooth transition to in-home care or other community-based support services.
Currently, so many programs are already so understaffed and overloaded that even if the former ADHC clients qualify for them the waiting lists would be incredibly long. Before they began to receive these community-based services, these people would end up in the emergency rooms suffering a myriad of problems due to being left alone while their children work, if they're lucky enough to have children to live with.
Apparently he seems to think that the Department of Health Care Services will ensure that "those who are most at risk of institutionalization have access to services that will help them remain in the community."
Then there's Lydia Missaelides, the executive director of the California Association for Adult Day Services. She says that nearly a quarter of ADHC clients will end up in a nursing facility within 30 days of losing daycare services. She also says that within 90 days, as many as 87% would need emergency room care for preventable falls, medication mismanagement and other complications.
Considering that ADHC services pays around $77 per person per day, and emergency room visits cost triple that or more, I'm rather curious where the savings will be.
Alas, "the guv" has an answer for that. He says that adult day care services will remain an option for Medi-Cal recipients, but will be provided to them through managed care programs.
Apparently managed care programs will suddenly crop up when needed.
He said, "The principle here is that California does not have enough money to do all the things it has been doing. We’re looking at each of these individual people, their cases, and we’re going to handle them in the most humane way we can."
Brown signed a separate bill that will allow the more than 300 adult daycare centers in California to continue operating without Medi-Cal licensing for participants who pay for their own care or are covered by private insurance.
Guess what? The only insurance that would cover these services would be a long-term care policy. How many seniors have that coverage? Since the ADHC is a Medi-Cal program, how many private pay clients does he believe there are that might be able to pay $77 each day?
Since the the majority of ADHC clients are covered by Medi-Cal, 95% of the centers would close within two months without those funds.
But hey, Jerry "the guv" Brown thinks he's got a handle on the situation.