In a flash, the hope I had upon reading a recent article in the New York Times (“Vast Gene Study Offers New Insights into Alzheimer’s”) was dashed as California’s budget actions took a hard-hitting ax to a lifeline for many people with Alzheimer’s. That lifeline is Adult Day Health Care.
Lest you be reminded of Chicken Little, painting a reactionary doomsday, I do believe the sky really is falling. Just 2 weeks ago, our worst fears were realized when we learned that Governor Brown signed a bill into law eliminating Medi-Cal funding for Adult Day Health programs. In less than 2 months, on June 1, 2010, this funding elimination will become effective.
Obviously, the programs that are most vulnerable are those that receive most of their funding through Medi-Cal. When your funding stops, there are few choices but to close your doors. The most affected could be people with Alzheimer’s, as these folks often require the most intense services, constant supervision, and often have multiple medical complications.
It’s really all about the money. As Bill Fisher, CEO of the Alzheimer’s Association, Northern California and Northern Nevada Chapter always says, “no money, no mission.” So, those programs that can restructure are planning to do so. Some will change from a “medical” model to a “social” model which means such services as nursing, physical, occupational and speech therapy, will not be offered. More to the point, unless there is some type of long-term care insurance available or another form of available reimbursement, only those who can pay out of pocket will be able to attend the “social” day care program.
In some cases, programs may be able to refer Medi-Cal recipients to other programs so necessary services that help keep them at home and in the community can continue. But, there is no doubt that disruption will occur.
One of the most disturbing things about this law and its quick implementation time is that advocates expected the law to be accompanied by a “waiver” program that would provide Federal matching dollars for Adult Day Health. This program is not in place yet so programs are forced to make decisions while viewing an uncertain future. At least in the short-term, devastating effects will occur to program recipients as well as staff members.
Even more budget cuts will no doubt be considered, especially if the California legislature remains as dysfunctional as it is today.
If any of you have further information about actions an Adult Day Health Care program in your community is taking, we’d like to hear from you. It’s going to be critically important for all of us to keep our ears to the ground, as facts and figures will be needed to strengthen our story about the fallout.