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.

Incompetence At The State Level. Again.

Here's Arnie trying hard to not burst a blood vessel. He has threatened to veto the state budget because he said the long overdue spending plan that lawmakers have approved lacked long-term fiscal reforms and would burden taxpayers.

He said, "I think nothing is more important than getting our fiscal house in order, and I promise the people of California that I will not stop until the job is done."
However, our illustrious and irresponsible lawmakers are saying that they're not going to back down. They're prepared to override the veto. The bill is going to land on Arnie's desk tomorrow morning, and because he's channeling Conan the Barbarian, the only response he was able to come up with for this sticky situation was to proclaim that his plan was: "To crush your enemies, see them driven before you, and to hear the lamentation of the women." Nevermind that billions of dollars in payments to schools, medical clinics, daycare centers, adult and otherwise, as well as payments to state vendors continue to be in limbo. What's wrong with this picture?

Senate Minority Leader Dave Cogdill said said that no one has the stomach to keep going down this path. He says, "It is a mistake, and I will vote to override the governor's veto, as should every other legislator who approved this budget."

It has been 78 days since the start of the fiscal year. They finally passed a $143 billion budget shortly after 2 a.m. this morning. As you can see by Abel Maldonado, he's truly riveted and interested in the process. One of these days I'll figure out why he's there.

Meanwhile, Arnie said that the reforms that our duly elected lawmakers added to the budget were flawed and would do nothing to halt the state's persistent imbalance between spending and the amount of money it takes in. What is the deal with these people? Why can't they do anything right by the people that voted them in?

As it stands now, the budget's main feature requires that the screws be applied to their constituents. How? Well, we get to pay our income taxes sooner. This is their brilliant idea to help close a $15.2 billion deficit without borrowing or imposing new taxes. Here's another idea? How about if these knuckleheads go without their pay for a while? Might that light a fire under them? If nothing else it might wake them up.

Even lawmakers who voted for the plan agreed that it merely delayed the toughest fiscal decisions until next year.

If they cannot get it together to pass a decent budget that makes sense now, what's going to change by next year? Do you suppose that they think they'll be smarter in another year?

Saying that the current budget would require a major tax increase or massive cuts to education Arnie said, "If lawmakers think that's what the people of California deserve, then I don't know what their thinking is of the people of California. I think the people of California deserve better."

Yeah, as a matter of fact we do. However, enough knuckleheads voted for you Arnie, so in essence, at least THEY are getting exactly what they deserve. The rest of us however are feeling the pinch in a variety of ways.

Arnie went further with his threats. He said that if lawmakers override his budget veto, he'll not be kind to their legislation, potentially wiping away a year's worth of work. He said, "Hundreds of bills will be vetoed."

Yeah, that's just all kinds of helpful.