Adult Day Health Care Centers Struggle With Financial Challenges

Adult day health care centers across California are struggling financially, prompting officials to consider changes to operations and services, Capital Public Radio's "KXJZ News" reports (Bartolone, "KXJZ News," Capital Public Radio, 7/3).

Background

The Community-Based Adult Services program has replaced the state’s Adult Day Health Care program. It will provide services to 80% of previous ADHC beneficiaries and is funded at a similar level to the original program (Gorn, "Capitol Desk," California Healthline, 5/24).

Funding Challenges

Lydia Missaelides -- executive director of the California Association of Adult Day Services -- called the fiscal situations at 260 centers in California "dire."

She said, "Some centers have already reduced hours of operation, some have already reduced their staff, laid off some staff." She added, "Some are preparing plans for temporarily closing. Others are having a very difficult time finding lines of credit."

Responding to a CAADS survey, the centers said that if they do not receive state reimbursements soon, they likely will have to close or implement changes, such as:

• Laying off staff; or
• Stopping treatment for beneficiaries who are deemed ineligible for the program ("KXJZ News," Capital Public Radio, 7/3).

Determining Eligibility

When the state launched the CBAS program and started assessments to determine eligibility, some beneficiaries were grouped as categorically eligible or presumptively eligible.

The state estimates there are more than 9,000 residents in those two groups, which generally are comprised of the sickest and most frail of the adult day health care population.

The roughly 5,900 categorically eligible beneficiaries automatically get into the CBAS program. The remaining 3,500 presumptively eligible beneficiaries still need to be assessed (Gorn, "Capitol Desk," California Healthline, 6/14).

In recent months, state-employed nurses have been determining which patients at adult day health care centers still qualify for services.

According to the California Department of Health Care Services, about 1,800 patients have been determined ineligible for services and have appealed the decision.

Many patients will have to wait months for a hearing.

Sergey Ionov -- director of the Altamedix adult day health care center in North Sacramento -- said the center still is taking care of the patients while they wait for appeal hearings but is not being reimbursed ("KXJZ News," Capital Public Radio, 7/3).