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Vetoed funds for adult care centers could leave seniors with few options


Marcia Shields/FlickrAdvocates for the elderly worry that seniors will be forced into institutions.

Gov. Jerry Brown's veto of services designed to keep senior citizens in their homes could force elderly Californians to seek help in nursing homes, mental health facilities or hospital emergency rooms, advocates predicted yesterday.

On Monday, Brown vetoed a bill [PDF] that would have provided $85 million of in-home and community services for the elderly. The new funding was designed as a partial replacement to the $169 million Adult Day Health Care program that was cut from the state budget this year.

An estimated 35,000 senior citizens use the services. Home-based services tend to mean a lot to seniors; 89 percent of AARP members reported in a 2005 survey [PDF] that they would prefer to remain in their home as they age.

Nina Nolcox, program director of Graceful Senescence Adult Day Health Care in Los Angeles, said her staff has sought alternative placements, only to encounter waiting lists, discontinued programs and disconnected phone lines.

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“I anticipate increased use of emergency rooms, nursing homes where available, mental health facility services and an increase in Adult Protective Services reports for abuse,” Nolcox said.

In his veto message, Brown said the state’s Medi-Cal agency is working to ensure that services are available so “beneficiaries do not face the risk of unnecessary institutionalization.” Norman Williams, a spokesman for the Department of Health Care Services, said staff are reaching out to a number of organizations to ensure that seniors get the care they need.

“The transition plan is considering a lot of alternatives; we believe the types of services will be adequate, and will be the appropriate and the meaningful care these recipients deserve,” he said.

But operators of Adult day health centers that are now closing said they are having a difficult time finding replacement services.

Tracy McCloud, director of a center in San Francisco, said her program closed June 30 and staff have had an uphill battle finding ways to replace the medical care, companionship and respite to families the program offered.

She said staff turned to the PACE program, which has 10 sites in the state, but found that only four of 72 former Adult Day Health Care participants were eligible or willing to join the program meant to give seniors the support they need to avoid 24-hour out-of-home care.

McCloud said many could not participate in PACE because of age, a psychiatric condition or other criteria. McCloud said 30 other seniors opted to stay home, including one who already has been hospitalized for psychiatric reasons.

The remaining 34 enrolled in other adult day health center programs, 95 percent which are expected to close down within two months, according to Lydia Missaelides, executive director of the California Association for Adult Day Services.

“I’m not sure what’s going to happen at this point,” McCloud said.

A coalition that includes the AARP California and Disability Rights California, which has sued to stop the adult day health center cuts, described the state’s transition plan as a “bridge to nowhere.”

The state offers an In-Home Supportive Services program meant to replace nursing home care, but it has a 700-person wait list that’s expected to last 19 months, the filing says.

An expert for the advocates estimates that the savings accrued by eliminating adult day health centers will be wiped out if 6,800 seniors go to nursing homes, which cost Medi-Cal far more each month.

Missaelides’ group estimates that about 2,000 more – about 8,750 seniors – will enter nursing homes within 30 days of the centers’ closing.

Assemblywoman Mariko Yamada, D-Vacaville, who has been a vocal champion of the program, said she will hold a hearing on the plans Aug. 16 at the Capitol. She already has invited a school janitor who relies on the program to help care for his adult children, who have complex medical needs.

Yamada said the man acknowledged that it will be difficult to make it to the hearing, considering his work and caregiving duties, but pledged that he would testify. “If there was a way for me to set up a temporary adult day care center in the Capitol, I’d do it,” Yamada said.

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