State Delays Not-for-Profit Requirement for Adult Day Centers

The Department of Health Care Services extended the not-for-profit deadline for potential providers of the Community Based Adult Services program.

Organizations providing adult day health care services now have until Jan. 1, 2013 to become not-for-profit, a new stipulation by the state to be eligible to receive Medi-Cal funding. The previous deadline was July 1, 2012.

The six-month delay in establishing not-for-profit status was done, in part, because the state will need a substantial number of former Adult Day Health Care providers to become CBAS providers.

The department has granted eligibility to approximately 80% of former ADHC beneficiaries — roughly 28,000 frail and elderly Californians. Another 2,194 people have filed appeals of eligibility, according to the Department of Social Services.

With all of those people needing specialized care, DHCS will need a high percentage of former ADHC facilities to remain open and many have not been able to meet the earlier deadline for attaining not-for-profit status.

DHCS officials declined to comment on the deadline change, but did issue a  statement that said the change “allows for the CBAS transition to managed care to be complete, with a few months to demonstrate a ‘steady state’ population from which to judge access demands.”

Access demands could be exacerbated by the additional 2,000-plus appellants who seek eligibility to the CBAS program. So far, according to DSS, 89 cases have been heard by its administrative law judges and 36 of those have been sent to DHCS for approval. DHCS has 30 days to accept or reject those proposed decisions.

State officials said Tuesday that DHCS has ruled in five CBAS appeals hearings.