Despite state compromise, some seniors no longer eligible for adult day healthcare

Workers at some Adult Day Healthcare Centers in Alameda County were initially relieved to hear that their state funding would not be entirely cut, thanks to a settlement reached in November between disability rights activists and the State Department of Health Care Services. But at LifeLong Medical Care in East Oakland, more patients have been found ineligible for the new Medi-Cal subsidized program set to replace adult day healthcare than LifeLong staffers expected.

Adult Day Healthcare is one of Medi-Cal’s largest general fund expenditures. These centers provide medical care and socialization for about 35,000 elderly or disabled people in the state. Talks about cutting the service, against the backdrop of the state’s budget crises, have been ongoing for the past few years. Advocates say that the service saves the state money because it keep frail patients stable and out of nursing homes and hospitals.

In November, after being sued by a legal advocacy group called Disability Rights California, the California Department of Health Care Services announced a compromise measure that would maintain a smaller program. State officials estimated the new scaled-back program called C-BAS, or Community-Based Adult Services, would allow about half of the current 35,000 Adult Day Health Care patients to remain eligible for services. Patients found ineligible would receive enhanced case management to help them transition to other services.

“I was really pleased with the settlement,” said Kathryn Stambaugh, geriatric services director at LifeLong. “I thought this was a great compromise to reach the patients out there who are the most vulnerable and are at high risk for institutional placement. And what’s ended up happening is that far more of our patients have ended up ineligible than we ever thought possible.”

Angela Fazio-Landrum, a social worker at LifeLong Medical Care, is working to appeal the decisions that found nearly 20 of the center’s patients ineligible for C-BAS. She’s concerned about what will happen to them without Adult Day Healthcare. “Enhanced case management doesn’t provide services–it coordinates them. So without this service I’m not sure where they would refer our participants to. We’re the only program of our type,” said Fazio-Landrum. “It’s really sad to see this service being taken away from them. It just seems to show a real lack of respect and lack of regard for our elders.”

Read more about Adult Day Healthcare Center’s transition to C-BAS in our article, “Adult daycare center, facing cutbacks, saved from total funding cutoff.”