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Will California Keep Adult Day Health?

Senior advocates are hoping a hearing at the end of last week was a turning point for the Adult Day Health Care program. It is slated to be eliminated as part of Governor Brown’s proposed budget — but since one committee recommended keeping it while another committee urged its elimination, the fate of the ADHC program has come down to the joint conference committee.

The committee is scheduled to meet every day this week to work out all budget discrepancies, including a decision on what to do with the ADHC program. But it was the meeting at the end of last week that gave a flare of hope to advocates.

“By the time I went home that day, I had the first sense of some hope,” Lydia Missaelides of the California Association for Adult Day Services said. “And that’s all I can ask for right now.”

The tone of committee members toward most of the discrepancies was one of weary acceptance — and acknowledgement of the budget realities forcing so many of the cuts and decisions.

But when it came to ADHC, that tone shifted.

“It’s important to note that, compared to other states, we have a lower number of people in nursing homes in California,” committee member Nancy Skinner (D-East Bay) said, adding that it’s the ADHC program that helps keep people out of nursing homes, which benefits the state, she said.

“Because nursing home care costs more. A lot of the reason that we moved toward these programs is that they save that cost,” Skinner said. “So I have to ask: What good are we doing here?”

Assembly member Diane Harkey (R-Dana Point) agreed.

“I would like to echo the sentiments of Miss Skinner,” Harkey said. “We need to look at other areas of the budget because the return on investment is good here.”

That bipartisan support was music to Missaelides’ ears.

“That conversation, to me, was heartening,” Missaelides said. “It showed that all the grassroots efforts so many people have made had finally broken through. It was clear that members were intently and intelligently looking for some kind of alternative. I did definitely sense a shift.”

Missaelides said her organization is poring over its budget looking for more savings beyond the $28 million cut it earlier proposed. “We are working on some kind of cost saving we can do for the conference committee,” she said.

Last week, the federal Health and Human Services department announced the availability of $3.7 billion for Community First Choice Option, a program that promotes long-term care options.

“Our country recognized in the Americans with Disabilities Act that everyone who can live at home or community-based setting should be allowed to do so,” Secretary Kathleen Sebelius said. “The Affordable Care Act provides states critical new dollars toward achieving that goal.”

That money would not necessarily be available to the ADHC program, but the sentiment echoes the state program’s intent, Missaelides said.

“[California legislative] action so far has been the Assembly wanting to retain, and the Senate to eliminate,” she said, “and the sense I have is they’re still searching for something in between. I do feel we moved the needle a little bit, so we’ll see this week.”

If the conference committee decides in favor of ADHC, any victory party would still be pretty muted, Missaelides said, and not just because of the cuts that still would need to be made.

“It won’t be so much of a celebration. There’s still the sobering reality of the June ballot initiative,” she said. If the initiative fails to make the ballot or fails a vote, that would also spell the end of the ADHC program. “Should we survive this part of the process,” Missaelides said, “it’s really just living to fight another day.”

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