Transition Money Designed To End ADHC

It’s a little complicated, when the governor sets aside $25 million for your program, and it’s a death knell for that program.

But that’s what has happened in the past week with the Adult Day Health Care (ADHC) program. The $25 million allocated by the state is to be used to help with a transition into program elimination.

That was the take-home message at a stakeholder meeting last Friday, and it was not exactly a vote of confidence from the governor’s office.

“We already have centers closing,” Lydia Missaelides of the California Association of Adult Day Services said. “And … there will be more.”

The quick version goes like this: ADHC was on the budget chopping block in March. The Legislature rescued it by making a deal — its budget would be cut in half and, for legal reasons, the program would have to be eliminated, then reborn through a new federal waiver. It would need about $85 million to fund that new program. The smaller dollar amount — $25 million — only would cover the cost of helping people move out of the centers before they close.

But there is still hope for the program, according to Assembly Budget Committee Chair Bob Blumenfield (D-Woodland Hills). It’s possible that the $25 million elimination money is a technical, legal decision — a necessary part of the initial elimination, before the new program can be created.

At least, that’s the hope. 

“We are committed to creating a new community-based program on a quick timeline that serves seniors with the greatest health care needs as ADHC ends,” Blumenfield said, adding, “Our plan has not changed. We look forward to the governor’s support.”

Blumenfield has authored a bill (AB 96) that maps out the policy end of the plan, and that bill is expected to move through committee in the next few weeks. The money end of it is supposed to come from the budget, which has not yet been submitted to Gov. Jerry Brown (D).

Missaelides holds out hope that funding will come, but she has not been encouraged so far by the tone and direction of the Department of Health Care Services.

“The department has publicly stated many times, including [at] last Friday’s stakeholder meeting, that they have no authority, nor intention, to apply for a waiver,” she said. “So it’s up to the Legislature to pass a bill directing them to do so and putting in more funding so a new program can be sustained, albeit with a smaller footprint.”

Without a federal waiver and without funding, Missaelides said, the ADHC program would shut down 60 days after CMS approves elimination.