October Start for New Adult Day Program Could Be Halted

Disability Rights California on Saturday filed a motion in U.S. District Court to stop the Department of Health Care Services’ implementation of portions of the Community Based Adult Services program, saying the department violated terms of a previous settlement agreement.

The motion noted that a federal court twice prohibited cutbacks to Adult Day Health Care benefits because “the loss or interruption of necessary ADHC services would irreparably harm ADHC recipients and place them at serious risk of institutionalization.”

That led to a December lawsuit settlement agreement that established the CBAS program to replace ADHC services.

“Yet, less than eight months after settlement approval,” the latest motion said, “[DHCS] defendants have repeatedly violated both the settlement and applicable laws in multiple ways that defeat the primary purpose of the settlement: to ensure that class members transition from ADHC to CBAS without interruption.”

The motion asks the court to intervene in 11 specific areas of the CBAS program, including several that would halt DHCS plans to convert CBAS to a Medi-Cal managed care benefit in some counties on Oct. 1.

“CBAS providers and managed care plans have raised significant concerns about readiness for the managed care conversion on October 1, 2012,” the motion said. Concerns have been raised about basic operational questions such as as how to transfer patient authorizations to health plans and how to submit claims, according to the motion.

“Moreover, requisite elements are not yet in place in some counties,” the motion said, “such as contracts between managed care plans and CBAS providers.”

Related Topics

Capitol Desk