CDCAN REPORT #159-2011: Adult Day Health Care elimination as Medi-Cal benefit focus of Assembly Aging and Long-Term Care Committee hearing

ELIMINATION OF ADULT DAY HEALTH CARE MEDI-CAL BENEFIT  FOCUS OF OVERSIGHT HEARING THIS AFTERNOON 2 PM BY ASSEMBLY AGING & LONG TERM CARE COMMITTEE

Also Set For Hearing Today At 1:30 PM Is Joint Hearing of Senate and Assembly Human Services Committee on State's Draft 2012-2013 Community Services Block Grant To Federal Government  - Grant Funds Several Critical and Important Programs in the State for Low Income Communities Including Persons with Disabilities, Mental Health Needs, the Blind and Seniors

SACRAMENTO, CALIF (CDCAN)  [Last updated 08/16/2011 10:30 AM] - As reported last week, the Brown Administration's controversial implementation plan to eliminate by December 1, 2011, Adult Day Health Care as a Medi-Cal benefit impacting over 34,000 persons with disabilities and seniors and over 300 community providers and over 7,000 workers, will be the focus of an oversight  hearing this afternoon, August 16th, at 2 PM by the Assembly Aging and Long Term Care Committee, at the State Capitol, in Room 437 (note room change).  [CDCAN will provide full details on hearing later today - and also coverage of what happened last week at the public stakeholders meeting organized by the Department of Health Care Services].

The official title of the oversight hearing is "Costs and Consequences: Eliminating the Adult Day Health Care Optional Medi-Cal Benefits" and updates on the implementation plan and other information will be provided by officials from the Department of Health Care Services - the state agency that oversees California's Medi-Cal program, the California Department of Aging, and representatives from Adult Day Health Care centers, and various advocacy groups.  Public comments will follow.

This hearing is scheduled to be webcasted live from the California Channel website at www.calchannel.com (click under "LIVE webcast and scroll down to the 2:00 PM time).  The hearing may also be broadcast live on the Cal Channel cable channel - check your local listings

Brown Administration Under Strong Criticism From Many Disability and Senior Advocacy Groups

The Brown Administration has come under strong criticism by many disability and senior advocacy groups and individuals for its original proposal to eliminate Adult Day Health Care Medi-Cal funding - and for its subsequent implementation and transition plan, saying it failed to address the specific needs of thousands of people with disabilities and seniors who rely on those community-based services to remain safely in their own homes, saying it violated the 1999 US Supreme Court "Olmstead Decision" under the federal Americans with Disabilities Act.

They also criticized the Administration claiming that Department of Health Care Services officials and other State officials have not worked closely with stakeholders, including representatives of Adult Day Health Care centers and recipients and families of Adult Day Health Care services.

The Governor and senior Brown Administration officials in the Department of Health Care Services disagreed with those claims, insisting that the State's transition plan address or will address those needs and that it was moving forward in working with stakeholders, including conducting outreach and public stakeholder meetings.

Advocates have also been critical of the Brown Administration because its implementation and transition plans largely do not focus on next steps - after the Medi-Cal benefit is eliminated - for the over 300 community organizations and over 7,000 individuals who work to provide Adult Day Health Care services across the State and the impact of closure of hundreds of centers and loss of jobs for thousands of workers.

Adult Day Health Care Elimination As Medi-Cal Benefit Part of Sweeping Massive Budget Reductions Approved in March To Close Over $25 Billion On-going State Budget Shortfall

• Adult Day Health Care as a Medi-Cal "optional benefit" was proposed for elimination by Governor Brown in January as part of his package of sweeping and major permanent budget reductions to help close what was then still an over $25 billion on-going State budget shortfall.  The federal government requires each State to provide a certain level of benefits and services as part of their Medicaid program (called "Medi-Cal" in California)but allows the states to provide certain additional "optional benefits" - including Adult Day Health Care - that are not required.
• The Legislature in March approved the proposal, though with significant changes that would allocate 50% of its State general funding for the 2011-2012 State Budget year for transition and the development and creation of a new model of Adult Day Health Care through a proposal to the federal government.
• The Legislature, controlled by Democrats in both the State Senate and Assembly, however did not make that development and creation of a new model of Adult Day Health Care a requirement that the Brown Administration had to implement - but instead included it in the March budget package of bills, signed by Governor Brown on March 24th, as "intent language".   
• The Legislature later - in June - approved a new budget related bill, AB 96, that included a requirement for the Brown Administration to develop and submit a proposal to the federal government for a new model of Adult Day Health Care under a new federal Medicaid waiver or through some other new federal Medicaid funding.  The Governor however vetoed that bill on July 25th.
• On July 1st, the Obama Administration approved the State's request to eliminate the Adult Day Health Care Medi-Cal optional benefit, effective September 1, 2011.  That date was, at the State's request, delayed until December 1, 2011, which the federal government approved.   
• A federal lawsuit - part of an on-going lawsuit dealing with Adult Day Health Care -  that seeks to block, at least temporarily, the State from proceeding in the elimination of Adult Day Health Care as a danger to persons with disabilities and seniors health and safety and a violation under several federal laws, including the federal Americans with Disabilities Act -  was originally set to be heard in federal district court in Oakland in late July - but will now be heard in early November (because of the delay of the effective date for the elimination of Adult Day Health Care as a Medi-Cal benefit from September 1st to December 1st this year).

Assembly Aging  and Long Term Care Committee Members

The committee has 6 members - 4 Democrats and 2 Republicans.  There is no similar regular standing committee in the State Senate, though there is a 3 member Subcommittee on Aging and Long Term Care, chaired by Sen. Elaine Alquist (Democrat - Santa Clara, 13th State Senate District) under the Senate Health Committee.

The committee, chaired by Assemblymember Mariko Yamada (Democrat - Davis, 8th Assembly District), has jurisdiction in the Assembly on issues and bills dealing with seniors and long term care issues for that population, specifically those covering the Area Agencies on Aging (AAA), California Department of Aging, California Commission on Aging, the federal Older Americans Act, the Older Californians Act, the California Senior Legislature, senior citizens advocacy efforts,  services for seniors in residential and day settings.  Jurisdiction for several of these issues are also shared by other Assembly committees, including Assembly Health Committee and Assembly Human Services Committee.

MEMBERS - DEMOCRATS (4 members): Mariko Yamada - Chair, (Democrat - Davis, 8th Assembly District), Richard Pan (Democrat - Sacramento, 5th Assembly District), V. Manuel Perez (Democrat - Cathedral City, 80th Assembly District), and Norma Torres (Democrat - Pomona, 61st Assembly District)
MEMBERS - REPUBLICANS (2 members): Linda Halderman - Vice Chair (Republican - Clovis, 29th Assembly District), and Donald Wagner (Republican - Irvine, 70th Assembly District)
COMMITTEE OFFICE:  1020 N Street Room 360A, Sacramento, CA 95814
COMMITTEE PHONE:  (916) 319-3990
COMMITTEE STAFF:  Robert McLaughlin (committee staff consultant) and Sarah Loftin (committee secretary)

Also Today At 1:30 PM - Joint Hearing by State Senate & Assembly Human Services Committee on Federal Community Services Block Grant State Plan for 2012-2013

Also being heard today in a joint hearing by the Assembly and Senate Human Services Committee  at 1:30 PM, at the State Capitol in Room 3191, is an informational hearing on the Department of Community Services and Development (CSD)'s 2012-2013 proposed Community Services Block Grant (CSBG) State Plan application to the federal government.  A copy of the 49 page draft plan can be downloaded or viewed at www.csd.ca.gov

This hearing is scheduled to be webcasted live from the California Channel website at www.calchannel.com (click under "LIVE webcast and scroll down to the 1:30 PM time).  The hearing may also be broadcast live on the Cal Channel cable channel - check your local listings.

The federal block grant provides federal funding to California and the other states, the District of Columbia and US territories, and federally and State recognized Indian tribes and tribal organizations to provide assistance for communities in poverty, including persons with disabilities, seniors and others who are low-income.  The States (including California) funnel the federal money to various state agencies, including community action agencies, agencies dealing with migrant farmworkers.  Some of those agencies are non-profits and some are part of the county or city local government.

While advocates for some low income groups and communities do focus on this grant plan - and also the related federal LIHEAP (Low Income Heating and Energy Assistance Program) - and the administration of these federal programs in California by the Department of Community Services and Development, the issues attract often little or no attention from many disability, mental health, senior advocacy groups - though the purpose and mission of these programs cover those groups.