UPDATE: Deal In Adult Day Health Care Lawsuit Could Be Announced Thursday

By Gloria Alvarez, EGP News Editor

NEWS UPDATE (Posted 11/17/11): A settlement agreement has been reached in Darling et al v Toby Douglas, Director of California Dept. Health Care Services, which will postpone elimination of the Adult Day Health Care benefit until Feb. 29, 2012.

An estimated 35,000 frail elderly and disabled adults would have been impacted by the elimination of the program that was scheduled to end on Dec. 1 of this year.

As part of the settlement deal reached after  “after extensive negotiations,”  ADHC like services will be provided to people at risk of institutionalization in skilled nursing/convalescent  homes through a new program called Community-Based Adult Services (CBAS), according to  Disability Rights California.

Under the agreement, the CBAS benefit will be offered through Medi-Cal managed care plans and will provide “center-based skilled health and nursing care, therapies, transportation and other services, to eligible low income seniors and people with disabilities.”

According to the Disability Rights California statement, many of the centers now offering Adult Day Health Care will be able to provide the new CBAS services, “thus ensuring continuity of care.”

“There are a lot of people who really need this program; I have fought to stay out of a nursing home and have been able to with ADHC,” said Esther Darling, lead plaintiff in the case, age 74, who lives alone with the help of ADHC, and will transition to the CBAS program.

ABOVE NEWS UPDATE (Posted 11/17/11):

A hearing on a lawsuit seeking an injunction to stop the state from eliminating funding to Adult Day Health Care Centers was postponed until Thursday to give parties to the case, Disability Rights California (DRC) and the California Department of Health Care Services (DHCS), more time to iron out details of a possible settlement agreement, according to information posted on the California Association of Adult Day Services website.

Disability Rights wanted the Court to order the injunction until state health officials can show they have a plan in place that will provide “adequate, appropriate, and uninterrupted services” to the elderly and disabled who would be impacted by the cuts, which includes the closing of hundreds of Adult Day Health Care Centers that provide services to thousands of Californians.

The U.S. Department of Justice on Oct. 31 filed a “Supplemental Statement of Interest” in support of the plaintiffs in Darling v Davis, a lawsuit brought when state health officials “substantially shifted course” on how it would transition patients participating in the Medi-Cal funded Adult Day Health Care program, essentially speeding up the process.

The lawsuit contends that the state compressed the timeline they would have to evaluate patient conditions in order to refer them to other services if available. In addition, the Dept. of Justice, in its statement of interest, said the state’s plan to “encourage and assist enrollment of a majority of individuals currently receiving ADHC services into Medi-Cal Managed care plans,” which included the “rollout of a highly compressed timeline” to inform patients of the elimination of the ADHC benefit and the impact of enrolling in a managed care plan versus staying in fee-for-service Medi-Cal, is “well below the required threshold to ensure that” there are not gaps in service to the plaintiffs.

Providers of the service, such as AltaMed, the state’s largest adult day care provider, say trying to reduce the state’s multi-billion dollar budget deficit by eliminating the optional Medi-Cal benefit, which helps many the state’s frailest elderly and disabled adults to remain at home, could end up costing the state more in the long run.

Adult Day Health Care Centers provide supportive health and social services and supervision to patients who go to the centers for several hours, several days a week.

In many cases the patients have no other care options. Some live alone, others live with family members who must work in order to make ends meet. In other cases, the centers provide much needed respite to caregivers who are on call 24-hours a day, seven days a week for family members whose conditions can include Alzheimer, stroke, diabetes, heart disease, to name a few.

Without the service, many patients could wind up in more expensive full-time skilled nursing homes, say opponents the state’s planned elimination of the service.

To read more about the state’s plan to eliminate Adult Day Health Care, read EGPNews’ Special Report: Adult Health Care Center Cuts Devastate Elderly, Disabled, a collaboration between the LA Beez news network and The CHCF Center for Health Reporting at USC Annenberg to produce a multi-story, multi-media news package chronicling the effects on ethnic communities of the pending elimination.

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November 17, 2011  Copyright © 2012 Eastern Group Publications, Inc.


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