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New Health Cuts Plus Old Cuts Equals a Budget

The joint conference committee decided to eliminate adult day health care services in California — and then voted to reinstate about half of the program.

The Adult Day Health Care program was clearly something legislators want to retain, in part because it actually might save the state money by keeping seniors out of nursing homes. Drastic cuts, though, might have created legal problems by running afoul of the Americans with Disabilities Act.

The solution? The conference committee proposed elimination of the $165 million ADHC budget, and then reinstated about half of it for a revised program.

“They split the difference,”  said Anthony Wright of Health Access California. “They cut the progam and then instituted a new version funded with $85 million.”

One thing that Senate and Assembly subcommittees actually agreed upon — that they would not place Medi-Cal caps on visits to the doctor — was put back into the budget plan by the conference committee, in a different form.

“That just shows the severity of the budget crisis,” Wright said. “Both the Assembly and the Senate decided that caps on doctor visits went too far. But nothing is final till the ink is dry on the governor’s pen.”

The original budget proposal placed a hard cap of 10 visits a year to the doctor. Subcommittees rejected that idea, and the conference committee took the unusual step of reviving that plan, but changed it to a 7-visit soft cap limit. A hard cap means once the limit has been reached —  no more visits, no matter what. A  soft cap means that patients can exceed the limit if a clinical case can be made for more visits.

“The hope is that it will reduce doctor visits by 15%,” Wright said.

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Capitol Desk