CDCAN REPORT #151-2011: Text of letter from Department of Health Care Services announcing Adult Day Health Care Medi-Cal optional benefit extended beyond September 1, 2011

TEXT OF LETTER FROM DEPARTMENT OF HEALTH CARE SERVICES ANNOUNCING THAT ADULT DAY HEALTH CARE MEDI-CAL BENEFIT EXTENDED BEYOND SEPTEMBER 1, 2011

SACRAMENTO, CALIF (CDCAN)  [Last updated 07/14/2011 04:30 PM] -  Here is the text of the letter that Toby Douglas, Director of the Department of Health Care Services - the State agency that ovesees Ca;ifornia's Medi-Cal program - sent to the Legislature today regarding extending the Adult Day Health Care Medi-Cal benefit beyond the September 1, 2011 for what is likely  to be at least 30 days, meaning at least until October 1st. Further extensions of the benefit are possible, according to Douglas in his letter, depending on the progress of the transition and will be assessed on a "month-to-month" basis.

The news was a welcome reprieve to over 34,000 people with disabilities and seniors who participate in the program provided by over 300 community-based organizations and over 7,000 workers across the State - many who faced  until the announcement was made today, imminent closure of their programs, facilities and jobs in a matter of weeks.

[CDCAN Note: A copy of the 1 page letter is attached to this CDCAN Report as a pdf file titled "20110714-ADHC Extension Letter.pdf"  The letter however was not saved as a document, but instead as an image, which means that persons who are blind or sight impaired will likely not be able to read it using their screen reading device.  I reproduced the entire letter word for word however in this report below - Marty Omoto]

Douglas wrote that the extension of the Adult Day Health Care benefit - or delay of the elimination of that benefit beyond September 1, 2011 is for a "...time-limited basis" and based on the State's expectation that it will continue to receive federal matching funds.  He indicated - a point that Sen. Leno that was critical - that he would "continue to assess the need to exctend [delay the elimination] the benefit on a month-to-month basis as the transition progresses."

The main parts of the brief letter was read on the State Senate floor this afternoon by Sen. Mark Leno (Democrat - San Francisco), chair of the Senate Budget and Fiscal Review Committee, when he was bringing up for a vote a budget trailer bill dealing with Adult Day Health Care centers, AB 91.

Major Questions Remain

As welcome as the news is however, many critical questions remain.including: 

• It is not certain if the progress of transition that the Brown Administration is referring to also includes the development, submission and then implementation of a new model of Adult Day Health Care under a State plan amendment to California's Medicaid State Plan or through a new federal Medicaid waiver. 
• Among the over 34,000 seniors and persons with disabilities in the Adult Day Health Care program (the numbers have been cited as high as over 37,000) include thousands of adults with developmental disabilities who were referred to the program through the 21 non-profit regional centers under the State's Lanterman Developmental Disabilities Services Act.  It is not clear how the elimination of the Medi-Cal optional benefit impacts those persons since they were placed in those programs through regional centers - not through the Medi-Cal program.
• The $85 million in State general funds allocated by the Legislature in June restored only half the State general funding the Adult Day Health Care program received in the 2010-2011 State budget year that ended June 30th. It is not clear how many of the over 300 centers, 7,000 employees and over 34,000 recipients will be able to continue in a new model of Adult Day Health Care with State general funding cut by 50%.
• If people can be referred to other Medi-Cal services - a process that does not require changes in State or Federal law - why is there a need to eliminate the optional benefit  (policymakers who favored elimination of the program argued that trying to reform it was too difficult - and would be easier if it was a new model under a waiver - advocates and some other policymakers however don't agree.

TEXT OF LETTER

State of California - Health and Human Services Agency
Department of Healthcare Services

Edmund G.Brown Jr.
GOVERNOR

DHCS
Toby Douglas                                                                                                
DIRECTOR

July 14, 2011

To the Members of the California State Legislature:

I am writing about the elimination of the Adult Day Health Care (ADHC) benefit pursuant to AB 97 (Chapter 3, Statutes of 2011) and our on-going planning to transition ADHC participants to other meaningful services and supports that avoid a potential risk of institutionalization.

California has a longstanding and strong commitment to help seniors and persons with disabilities and extensive medical needs remain independent, vital members of the community without the need for institutionalization.  Based on the elimination of this benefit, we have already begun to transition these individuals to other services in a manner that is reflective of this commitment.

Pursuant to existing administrative authority, the Department of Health Care Servicecs has the flexibility to extend the ADHC benefit to ensure a smooth, seamless, and successful transition of former ADHC beneficiaries to other services.

Accordingly, I am extending the ADHC benefit beyond September 1, 2011, for a time-limited basis and based on anticipated federal financial participation, to allow the beneficiaries to continue to live independently, avoid a potential risk of institutionalization, and ensure a smooth tranistion to other services when the benefit is eliminated.  I will continue to assess the eneed to extend the benefit on a month-to-month basis as the transition progresses.  I will keep the legislature informed on our continuing progress.

Sincerely
[signed]
Toby Douglas
Director