Watsonville, CA - On Friday, May 29, 2009, Governor Schwarzenegger announced another $3 billion in budget cuts that include eliminating all adult day health care centers (ADHCs) as a Medi-Cal benefit in California, displacing over 36,000 beneficiaries. 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, at 100 Pioneer St., in the City of Santa Cruz. Elderday has 133 enrolled participants, and averages 81 participants per day, 5 days a week. In 2008 Elderday had 19,300 participant visits. Amongst Elderday’s participants the three top medical diagnoses are heart problems (50% of the participants), diabetes (34%), and cardiovascular problems (30%). 18% of the participants are diagnosed with dementia and an additional 8% with Alzheimers. 22 of Elderday’s participants suffer “wandering” issues; 23 need medication management; 13 exhibit psychotic behaviors; 42 are “fall risks.”
According the California Association of Adult Day Services (CAADS), statewide 36,000 Californians participate in state funded day health programs; their average age is 78 years, and they take six or more medications a day, for which nearly two- thirds require supervision or assistance. More than two-thirds also face at least three serious medical challenges including cardiovascular disease (39%) dementia (13%) and diabetes (10%). The overwhelming majority of those cared for in these programs (92%) are entirely dependent on Medi-Cal support for that care. Without adult day health care, many would deteriorate and 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 would go to skilled nursing facilities; 18 will have gone to a hospital emergency room. Within 6 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.
“Participants in Elderday are poor, frail and in ill-health. Families and caregivers rely on Medi-Cal funded adult day health care to provide a level of community-based care. These families and caregivers rely on the state support and they are being abandoned,” says Sr. Julie Hyer, O.P., President and CEO of Salud Para La Gente.
Closing these facilities is nothing less than a disaster for every California community, including Santa Cruz County. The loss of vital health care services is inhumane for the participants. The impact on families who depend on these centers as their only affordable source of safe, secure, and reliable supervision is equally devastating. Working caregivers will be forced to give up paying jobs and face their own impoverishment. In addition, over 6,500 adult day health employees will be laid off statewide. Families throughout the state are going to face economic hardships while
those they love and care for face harsh medical, mental and psychological consequences. “Eliminating adult day health services will result in institutionalization of those who are medically frail, cognitively impaired, or have a chronic conditions which make independent living virtually impossible. ADHCs such as Elderday minimize emergency room visits, hospital stays and nursing home placement. We urge the legislature to oppose the elimination of adult day health centers,” said Hyer.
The Joint Budget Conference Committee will take public testimony on Wednesday, June 3 at 9:30 a.m. on the Governor’s proposal to eliminate Medi-Cal funding for adult day health centers. To voice your support for ADHCs contact members of the Conference Committee and legislative leadership listed below, along with your legislators: Assembly: Bill Monning (831) 425-1503, Anna Caballero (831) 759-8676; Senate: Joe Simitian (831) 425-0401, Abel Maldonado (831) 657-6315, and the Governor and First Lady (916) 445-2841.