<Back

Governor's Proposed Budget Threatens Elderday, A Program of Salud Para La Gente
Written by: Sara Clarenbach, J.D., Director Advocacy, Community Engagement & Media Relations, Salud Para La Gente

Elderday, a program of Salud Para La Gente, is an adult day health center (ADHC) located in the City of Santa Cruz, which provides health and therapeutic services to adults with physical, emotional, social and cognitive impairments.  With 136 participants currently enrolled and over 80 attending daily, Elderday is the only adult day health care center on the Central Coast from Half Moon Bay to Santa Maria.   Average age is 77; of the 136 participants, 63% are Latino, 40% are monolingual Spanish-speakers, 61% live in Watsonville.  Diagnoses include 42% with diabetes, 50% with some form of heart condition, 25% some form of dementia, including Alzheimer’s. 

All participants need help with daily living tasks.  The Elderday program helps participants reach and maintain their maximum level of physical, mental, emotional and social functioning by providing an opportunity for companionship, activities and professional supervised therapies.  Elderday’s objective is to help participants maintain or improve their current level of functioning.

In his January state budget message, ostensibly to “close” the over $20 billion budget shortfall facing the State, Governor Schwarzenegger proposed to completely eliminate state Medi-Cal reimbursement for ADHCs, claiming that elimination would save the State $135 million.  At Elderday, 92% of the participants rely on Medi-Cal to pay for their participation.  The Medi-Cal day rate per participant to attend Elderday is $106.52; the State pays $41.54 and the Federal government pays $64.98. 

If the Legislature agrees with the Governor’s proposal, 328 ADHCs throughout California would close, affecting over 37,000 participants statewide. Closure would not in fact result in a “cost savings,” and the ripple effect of ADHC closure is pervasive and disastrous. 

Closing ADHCs would cause California to lose over $200 million in Federal match dollars.  Participant caregivers and family members will be impacted, as they will need to find alternate care for the participant, which will likely mean the caregiver will need to quit work to stay home to care for the participant.  Elderday estimates that within 6 months of its closing, nearly 16% of its participants will require skilled nursing facilities; however, there are no Medi-Cal beds presently available in Santa Cruz County, so finding a spot for these individuals will be difficult.  Further, loss of preventive care, such as diabetes treatment and physical therapy provided at Elderday, will drive participants to seek treatment in expensive Emergency Rooms, increasing the overall cost.  Closure of ADHCs statewide will lead to the loss of an estimated 7,600 jobs at ADHCs alone, which does not even begin to count the impact on vendors and other providers which serve and support ADHCs.
 
The Governor’s present attempt to defund ADHCs follows passage of a “trailer bill” at the end of the 2009 legislative session which reduced the “allowable Medi-Cal reimbursable days” per week at ADHCs from 5 to 3.  The bill also raised eligibility criteria for Medi-Cal reimbursement, making it very difficult for participants to qualify for Medi-Cal coverage, notwithstanding their frail and infirm conditions.  The reduction in reimbursable days was tentatively halted by a federal court injunction, but the stricter eligibility criteria are set to begin on March 1, 2010.  The effects of the “trailer bill” legislation would be moot if the entire program is defunded, as the Governor wants.

Salud is working diligently, along with other groups statewide, to inform the Legislature of the impact of defunding ADHCs.

************************************************************************

For further information on Elderday, and to learn how you can help preserve the program, contact Elderday Program Manager Sheri Anselmi, Ph.D. at (831) 458-3481.   For further information on Salud Para La Gente and its overall services and programs, visit Salud’s web site at www.splg.org, or contact Sara Clarenbach, J.D. at (831) 728-8250 ext. 1005.

About the author:
Sara Clarenbach is the Director of Advocacy, Community Engagement and Media Relations for Salud Para La Gente, a Federally Qualified Health Center, with sites in Watsonville and Santa Cruz, in Santa Cruz County.  It provides comprehensive primary care through its medical, dental, and optometric departments and Elderday, its adult day health center.

Comments or feedback? Email us at advocate@csrha.org.

3720 Folsom Boulevard Suite B | Sacramento CA 95816
Phone: 916-453-0780 Fax: 916-453-0783 Email: advocate@csrha.org Web: www.csrha.org