A state Senate committee this week unanimously approved a measure to extend the end date of the adult day health care program as a Medi-Cal benefit in California.
Adult day care is offered through the Community Based Adult Services program as a Medi-Cal benefit. Created as part of a settlement of a lawsuit, the CBAS program was included in a Medicaid waiver granted California by CMS. The bill approved this week by the Senate Committee on Health would permanently extend that “Bridge to Reform” Section 1115 Medicaid demonstration waiver.
AB 1552 by Assembly member Bonnie Lowenthal (D-Long Beach) keeps adult day health care going, which keeps seniors and the disabled from expensive institutional care, according to Lowenthal.
“Thousands depend on adult day services every day,” she said. “The multidisciplinary services they receive keep them in the community and out of nursing homes.”
The adult day health care program was targeted for elimination in 2011 despite bipartisan support in the Legislature. It was cut to make way for a less expensive proposal — Keeping Adults Free from Institutions. But later that year Governor Brown vetoed the bill, effectively ending the adult day program. Settlement of a lawsuit prompted creation of the CBAS program in 2012.
“For years we’ve struggled to maintain adult day health care in California,” Lowenthal said. The CBAS program is estimated to cost $150 million general fund dollars, with federal funds matching that.
Dawn Myers Purkey, program manager of Woodland Healthcare, an adult day health care center in Yolo County, said the patients she sees have varied disabilities and maladies, but one thing in common.
“I can tell you, they all have the same goal,” Myers Purkey said. “Stay out of the ER. Stay out of the hospital. Stay out of nursing homes. And I think that’s what we all want.”
She said the $300 million overall cost is minor compared to what it would cost to institutionalize the people in the program.
“This isn’t just an issue of dignity, independence and choice,” she said. “It’s also a financial issue. For every 14 people we’re able to keep out of nursing homes in a year, we’re able to save the state $1.1 million.”
Quality of care, she said, is the main reason to keep adult day centers open.
“You should have the opportunity to live at home,” she said, “and not have a one-way ticket to a nursing home.”