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Adult Day Health Care on Track?

Adult day health care is like the Polly Purebred of the California budget process — always in calamity, always one sinister flick of the mustache away from disaster.

Well, for the moment anyway, it looks like ADHC actually might be untied and lifted off the budget train tracks.

“We’re going to focus all our attention now on the governor,” Lydia Missaelides of the California Association of Adult Day Services said. “So he understands what’s at stake here.”

Missaelides can push for gubernatorial support because it appears that both political houses in California are firmly behind establishment of a new, half-sized adult day health care program.

The state Senate and Assembly budget committees are expected to meet today to finalize details of the budget. A committee vote is expected in the next day or two, and that would send the budget for a floor vote which could happen as early as tomorrow, but more likely next week.

The news for adult day health care is — there doesn’t seem to be any legislative opposition to appropriating $85 million to fund the scaled-back ADHC program.

In fact, it’s possible that trailer bill budget language could include direction to the Department of Health Care Services to apply for a federal waiver to kick-start the program — a detail that could make the push to pass AB 96 a moot point.

In an earlier saga, to salvage any adult day services, the original ADHC program had to be eliminated and then reborn at half the size through a new federal waiver. AB 96 is Assembly member Bob Blumenfield’s (D-Woodland Hills) bill to establish that new ADHC program.

“It should take the next few weeks to button things up,” Missaelides said, “assuming everything goes the way we hope it will.”

That hope hinges on Gov. Jerry Brown. He earlier set aside $25 million in his May revise budget for the transitional elimination of ADHC. The Legislature has budgeted its own $85 million plan to keep ADHC going, and it has basically ignored the transitional money in favor of keeping the larger, operational money.

Meanwhile, the uncertain funding has prompted a number of adult day health care centers to close, and other closures could follow.

“The government is spending a lot of federal dollars, and state dollars for that matter, to keep people out of [more-expensive] nursing homes,” Missaelides said, “and at the same time now involuntarily forcing people into that residential setting. I just don’t see how that makes sense. It doesn’t make sense from a policy or a financial or a human point of view.”

The big remaining question, she said, is how eligibility criteria for the new program will be determined.

All of this budget negotiation is based on the idea that tax extensions will eventually be passed by voters. If that doesn’t happen, ADHC will be back on the railroad tracks, and probably with quite a lot of company.

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