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Jerry Brown vetoes bill to help elderly, disabled
Kaiser Health News
Sacramento -- Time is running out for the tens of thousands of frail, elderly and disabled Californians who currently depend on centers around the state for medical care and other support, after Gov. Jerry Brown refused to support a smaller incarnation of the decades-old program.
Brown vetoed a bill Monday that would have offered an alternative to Adult Day Health Care, which was eliminated under the budget signed last month. Now, funding for the approximately 300 existing centers that offer 37,000 adults medical care, physical therapy, exercise, counseling, socialization and other support will be cut off on Dec. 1.
"Providers, patients and families are scared and angry, and they feel abandoned and marginalized," said Lydia Missaelides, executive director of the California Association for Adult Day Services, who noted that the community-based model that defines Adult Day Health Care is exactly what the federal health care reform envisions.
The measure Brown vetoed would have replaced the $169 million Adult Day Health Care program with an $85 million alternative that served only the neediest patients. The bill was authored by Assemblyman Bob Blumenfield, D-Woodland Hills (Los Angeles County).
In his veto message, Brown said the proposed new program was "ill-defined" and that "creating a new ADHC look-alike program at this juncture is unnecessary and untimely." He said the state is working with existing centers to transition day care recipients into other programs and keep them out of institutions such as nursing homes. And, Brown wrote that his administration is working with the centers to identify alternatives, something Missaelides said was "news to me."
The governor said he has directed state officials to "ensure that ADHC beneficiaries will have a smooth transition to appropriate services, and those who are most at risk of institutionalization have access to services that will help them remain in the community."
But supporters of the program warned that its demise will end up costing the state up to five times as much, as those who were served by the program end up in emergency rooms, mental institutions and nursing homes. Until now, the state paid about $169 million a year for Adult Day Health Care - about $36 a day, per patient - and the federal government matched that funding.
Costs could go up
Missaelides said a survey conducted by her organization found that up to one-fourth of current patients would end up in nursing homes within a month of Adult Day Health Care ending, and two-thirds would be institutionalized within six months. Additionally, two-thirds of the centers said that nursing beds are simply not available in their areas, including San Francisco, where there is a waiting list.
Democratic lawmakers, who had worked for months to at least save portions of the program through Blumenfield's bill, reacted angrily. Assemblywoman Mariko Yamada, D-Davis, taking a personal jab, called Brown's veto "disappointing and incomprehensible, especially from someone who is himself a member of the senior community."
What's next for clients
And Blumenfield said he is "very worried about what's next for all the folks" currently served by Adult Day Health Care. He noted that once the infrastructure of "community-based care" disappears, it will be much harder and more expensive to start up again.
Under the budget approved in June, Adult Day Health Care funding was slated to dry up on Sept. 1. But last month, Toby Douglas, director of the Department of Health Care Services, announced that the state would allow the centers to stay open into the fall in order to give the agency more time to identify alternative care options. Douglas said he would evaluate the timing on a month-to-month basis, but Brown wrote Monday that it would expire on Dec. 1.
Supporters are still holding out hope that they will succeed in blocking the elimination of Adult Day Health Care in court.
E-mail Marisa Lagos at firstname.lastname@example.org.