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HOME > ABOUT > PRESS > STATE BUDGET WOULD ELIMINATE ADULT DAY SERVICES
Article published - January 31, 2010
Credit: PRESS DEMOCRAT
State budget would eliminate funding for adult day services
by Martin Espinoza
Harry Gilmore, 82, has no children. The Arkansas native's wife died eight years ago and he's outlived all his relatives, except a niece he hasn't seen in 30 years.
But Gilmore, who's lived in Santa Rosa since 1969, is not alone.
At an adult day services program in Rincon Valley, Gilmore is among friends three times a week, scooting about with the aid of a walker. He has lunch there, bounces on an exercise ball, stretches his limbs with the aid of parallel bars and, most importantly, socializes.
His efforts often draw encouragement from other program participants: “Go, Harry.”
The day program at the Friends House campus on Benicia Drive is operated by the Santa Rosa Community Health Centers, until recently known as Southwest Community Health Centers. It is the only one of its kind in Sonoma County, and one of 327 in the state that would be eliminated under the budget proposal Governor Arnold Schwarzenegger submitted to legislators in January.
The proposal seeks to close a $19.9 billion gap with a series of cuts and budget maneuvers, including $2.9 billion in cuts to health and human services. An additional cut of $3.5 billion in health and human services would be “triggered” if the state fails to receive a $6.9 billion infusion of federal funds.
The Schwarzenegger administration says the state would save $135 million by eliminating Adult Day Health Care benefits, which provide health, therapeutic and social services to seniors at risk of being placed in a nursing home. Program advocates argue that killing adult day services would push thousands into more costly skilled nursing facilities.
This means we're going to back to the 1970s in terms of how we care for our elderly when the only option was a nursing home,” said Lydia Missaelides, executive director of the California Association for Adult Day Services.
“Not only do we know that (the program) prevents overuse of costly services such as 911 calls, hospital emergency departments and nursing homes, it is a way for elders to maintain their dignity and independence by getting the ongoing medical care they need during the day and going home to their own beds at night,” she said.
Among many proposed cuts are:
-- $750 million in Medi-Cal cost-containment measures, including increasing cost sharing by beneficiaries and “utilization controls.”
-- $118 million from Medi-Cal by eliminating coverage for legal immigrants who have been in the country less than five years, except emergency services and pregnancy-related services. Those who have been in the country longer are covered be federal Medicaid spending.
-- $74.4 million ($10.5 million in the current fiscal year and $63.9 million in 2010-11) by reducing eligibility for low-cost Healthy Families health insurance for children.
According to a Sacramento-based advocacy group called Health Access, the governor's proposed cuts that would be triggered if insufficient funds are received from the federal government include the elimination of $1 billion from CalWORKS and $495 million from in-home supportive services.
Sonoma County officials are assessing the impact of the the proposed state cuts.
“The most dramatic that we've identified to date are reductions to alcohol and other drug services,” said Rita Scardaci, the county health services director.
At a hearing last week of the Senate Budget and Fiscal Review Committee, state officials acknowledged that some of the cuts would increase the burden on hospital emergency rooms.
Vanessa Baird, deputy director of health care policy for the Department of Health Care Services, said 56 percent of legal immigrants affected would probably shift to emergency care. Such care would be delivered either in an emergency room or billed as emergency services in a doctor's office, state officials said.
“Once they are emergency services, we could collect federal funds,” Baird testified.
Naomi Fuchs, executive director of Santa Rosa Community Health Centers, which serves thousands of local immigrants, said such calculations are “appalling.”
“It's bad medical care if they don't need to be in an emergency room — and everybody pays in increased expenses. It raises insurance premiums and puts a burden on hospitals,” she said.
Fuchs said Santa Rosa Community Health Care Centers receives $850,000 a year to run the adult day services program at Friends House, a Quaker-sponsored retirement facility. The program has been around since 1984. It currently serves about 45 senior citizens and gets about 7,000 client visits a year, said Susan Beer, a registered nurse and director of Santa Rosa Community Health Centers' adult day services program.
At that participation level, the program costs about $121 a day for each participant.
Missaelides said eliminating the state's adult day programs would be a blow to a network of support for 37,000 seniors and would eliminate the jobs of 7,600 people, including social workers, physical therapists, speech therapists, registered nurses, activity directors, aids and drivers.
That support network, she said, keeps seniors from deteriorating and becoming a financial burden that would shift to hospital emergency rooms and nursing facilities.
At Friends House, the elderly come to play cards, paint, garden, exercise, have their limbs massaged and, most importantly, keep each other company.
Harry Gilmore, who worked in construction, manufacturing and maintenance before he stopped working at 55, said that in the years before joining the adult day services program, “I didn't do much of anything.”
He has a number of illnesses, including emphysema, arthritis and an enlarged prostate. He is on an oxygen tube that's connected to a small tank secured to his walker.
“This place is a godsend to us people who have a condition like me, who need assistance getting around,” he said.
“I used to work at a nursing home as a janitor,” Gilmore said. “They didn't have enough people to take care of everyone.”
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