On Friday, May 29, Gov. Schwarzenegger announced another $3 billion in budget cuts that include eliminating adult day health care centers (ADHCs) as a Medi-Cal benefit in California, thus displacing over 36,000 beneficiaries statewide. Given the frailty of the adult day health client population, institutional care will be the only option left for thousands, just as demographic trends and national policy are shifting towards home and community-based care.
Here in Santa Cruz, Salud Para La Gente operates the County’s only ADHC, Elderday, located at 100 Pioneer Street in the city of Santa Cruz. Elderday currently has 133 enrolled participants, and averages 81 participants per day, five days a week. In calendar year 2008 Elderday had 19,300 participant visits.
Amongst Elderday’s participants, the three top medical diagnoses are heart problems (50 percent of the participants), diabetes (34 percent) and cardiovascular problems (30 percent). Eighteen percent of the participants are diagnosed with dementia and an additional 8 percent with Alzheimers. Twenty-two Elderday participants suffer “wandering” issues, 23 need medication management, 13 exhibit psychotic behaviors and 42 are “fall risks.”
As is the case statewide, the overwhelming majority of Elderday’s participants are entirely dependent on Medi-Cal support for that care. Participants are poor, frail and in ill-health. Without adult day health care, many participants will deteriorate and will have to move into a nursing home at four times the cost to the taxpayer. Elderday estimates that if the program closes, within 30 days of closure 13 participants will have gone to skilled nursing facilities; 18 will have gone to a hospital emergency room. Within six months of closure, an additional 27 elders will be in skilled nursing facilities, and an additional 31 will have gone to a hospital emergency room.
Closing Elderday will disastrously impact not only the participants themselves, but also their families and caregivers who depend on Elderday as their only affordable source of safe, secure, and reliable supervision for the elders. Working caregivers will be forced to give up paying jobs and face their own impoverishment to care for their elders. Elderday employees will also be impacted—they’ll lose their jobs.
On Wednesday, June 3 the legislature’s Joint Budget Conference Committee took public testimony on the Governor’s proposal to eliminate Medi-Cal funding for adult day health centers. Representatives of adult day health centers testified in opposition to the Governor’s proposal. The Conference Committee is presently conferring in closed session and will shortly make its decision.
Salud urges all Santa Cruz Weekly readers to voice their support for ADHC funding by contacting our legislators and the Governor and First Lady.
Assembly: Bill Monning—831.425.1503; Anna Caballero—831.759.8676. Senate: Joe Simitian—831.425.0401; Abel Maldonado—831.657.6315. Governor and First Lady: 916.445.2841.
For a list of contacts for conference committee heads and other legislative leaders, call Salud Para La Gente at 831.728.8250
Sara Clarenbach is Director of Advocacy, Communitiy Engagement and Community Relations for Salud Para la Gente.
Comments (9)
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Kim Gilgenberg Thu, Jun 11, 2009 - 8:58 am
Cutting services for the most disabled and the least able to care for themselves not only shameful, it does not make financial sense. Adult Day Health services were created as a cost savings alternative to nursing homes and guess what. it works. Nursing home care costs Californians $59000 per year versus $15000 for Adult Day Health. In addition, for eery one dollar spent on Adult Day Health, we receive $1.64 in matching funds from the federal government. Yes, on paper, eliminating ADHC will save the state 117 million dollars, but we lose over 190 million. Add it this the loss of productivity and absenteeism as employees struggle to work and care for their elderly family members, these cuts don’t make sense.
Helga Wiench Sat, Jun 13, 2009 - 12:20 pm
Our newly elected president is going to cut matching funds for Medi-Cal, also cuts are going to be made to Medi-Care.
News, morning of June 13, 2009.
wayne lin Fri, Jun 12, 2009 - 10:42 am
i agree
Helga Wiench Sat, Jun 13, 2009 - 12:16 pm
Ms. Clarenbach please go to CafeMom to find out how to have a baby in CA without paying a penny. Medi-Cal picks up the tap. One of these young never married women is in my Health Club doing Yoga and Pilates. What I don’t understand is the “Salud Para La Gente”. Is the same “Health for the People” available for me in Mexico. I am so tired of whining and an entitlement attitude; everyone in this state knows we are bankrupt.In your law practice you would not even speak to a client unless they paid a $3,250.00 retainer, your hourly rate was $325.00. I am an emigrant and have provided for myself; Ms. Clarenbach, Teachers, Park Rangers, Firefighters, Police Personnel etc, etc are loosing their jobs, get real.
Sunil Asthana Sat, Jun 13, 2009 - 8:12 pm
Gov. Please donate all your money to the state as we have provide you a position to serve the state.
Then please go on Medi-cal Benefit.
Now feel the pain when these benefits are taken away.
Mr. Gov. you need to be show more passion and care please.
It is a shame to discontinue services for elderly.
Please look at other venues to cut cost and not at poor elderly people who have no other way out in life.
Also please do not use my Tax money to pay for expensive nursing or hospital care when it can be avoided by having Adult Day Health Care programs.
Vic Wed, Jun 24, 2009 - 2:10 pm
am the social worker who has been working in the ADHC for many years. I read your article and it’s seems to me that you are not familiar with this system at all.
Yes, you have said that all of those clients are Medical Recipients and probably you have to know who is eligible for this program. Those people may have diseases that are not curable….welfare recipients, and also the majority of them are elderly who recently entered the US because of their children who have been naturalized. These immigrants obtain medical benefits and SSI. Most of those people can function independently that are receiving IHSS hours as well and their children serving as their primary caregivers. In my opinion it’s a major scam that threatens the system.
I think that possibly 2-3% of those people may seek nursing home care, but the majority of them are sustainable elderly who never been working in the US and enjoying all the benefits.
The average American citizen who has worked in this country for their entire life is not eligible for those services because they don’t have a Medi-Cal, and their family member would have to quit their jobs at times or hire someone to take care of their older parents.
That why (we still talking about immigrants) some of the people who never contribute one penny to this country have to enjoy all privileges and the others who worked hard and paid taxes receive nothing? If a person decided to bring an older parent to this country it is the responsibility of that person to provide all required care for their relative. These individuals expect the government to take care of them. This is a form of discrimination that is going to be known to the public.
In many instances stories about nursing homes that mistreated people is created by people who would like to still have a privileged life and also by those who are afraid to lose their jobs because of significant state budget reductions.
Another consideration is that not every county in California have both ADHC and IHSS. Some rural counties don’t have those services at all and now the discussion about discrimination using a capital letters. I think this matter needs to be researched with great scrutiny in order to eliminate this kind of waste.
VicSc
view Sat, Jul 11, 2009 - 2:33 pm
The closure of programs and state parks, and home health care and day programs result in a grander loss than percieved..I creates new problems and expenses. These resources like the Library internet are needed and taking simple tools like this really save no money…It adds to job losses and more displacement of people. California doesn’t want to care for its special populations…and this allows the terrorism to proceed…Americans against Americans. A big boo to the Governor!
alexa Wed, Aug 12, 2009 - 12:15 pm
Community health Centers that receive federal funding through the Health Resources and Services Administration, HHS, are also called “Federally Qualified Health Centers.”
Irean San Diego Fri, Feb 12, 2010 - 9:18 am
As the Social Serv Dir at an ADHC I disagree with most have never worked in the U.S. all of our clients are cauc born and worked in the US. They don’t deserve the treatment the State and biased SW put them through and Yes they will be going into nursing homes when the state is finished supporting them in their homes. Think 1000 for day care or 3500 for nursing home.