Brown Vetoes Adult Day Health Bill; Future of Program Unknown
Settlement Called 'Less Harmful' for In-Home Support Recipients
State Accused of Denying Seniors Day Care Access
Meet the New Costs, Same as the Old Costs
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Future of Program Unknown","publishDate":1412190781,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_6652\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/OldPersonCaneGeneric-e1402507272914.jpg\">\u003cimg class=\"size-large wp-image-6652\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/OldPersonCaneGeneric-620x413.jpg\" alt=\"There is a 45% increased risk of death in people who are lonely compared to not lonely, according to a UCSF study.\" width=\"620\" height=\"413\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The state has tried to eliminate adult day health care in the past. (Photo: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong>\u003ca title=\"http://www.californiahealthline.org/capitol-desk/2014/10/governor-rejects-adult-day-health-bill-future-of-senior-program-now-up-in-air\" href=\"http://www.californiahealthline.org/capitol-desk/2014/10/governor-rejects-adult-day-health-bill-future-of-senior-program-now-up-in-air\" target=\"_blank\"> California Healthline\u003c/a>\u003c/p>\n\u003cp>On Monday, Gov. Jerry Brown vetoed a bill to codify Community Based Adult Services as a Medi-Cal benefit and continue offering it as a benefit into the future.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"It puts everything up for grabs. It's a real step backward.\" \u003c/aside>\n\u003cp>The state \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/10/25/state-accused-of-denying-seniors-disabled-access-to-day-care/\" href=\"http://ww2.kqed.org/stateofhealth/2012/10/25/state-accused-of-denying-seniors-disabled-access-to-day-care/\" target=\"_blank\">has attempted to eliminate adult day health care\u003c/a> in the past. The CBAS program, serving some of the oldest, most frail Californians on Medi-Cal, is the result of a 2011 settlement of a lawsuit challenging the state the last time the state tried to cut the program.\u003c/p>\n\u003cp>The veto Monday of \u003ca title=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1552\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1552\" target=\"_blank\">AB1552\u003c/a> by Assemblywoman Bonnie Lowenthal (D-Long Beach) leaves an uncertain future for CBAS. The agreement in the 2011 settlement expired at the end of August, but CBAS is included as a Medi-Cal benefit in a proposed amendment of the state's Medicaid waiver and is included in the Coordinated Care Intitiative. CMS is expected to approve the amendment by the end of this month.\u003c!--more-->\u003c/p>\n\u003cp>\"It seems like the governor is picking at a scab,\" said Gary Passmore, vice president at the California Congress of Seniors. \"CBAS exists as a settlement, and we tried to establish that in law. And here we are again. … Without it existing in statute, it puts everything up for grabs. It's a real step backward.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Coincidentally yesterday, hundreds of senior care stakeholders, including Passmore, gathered in Sacramento for the annual SCAN Foundation conference on long-term care and services.\u003c/p>\n\u003cp>Lydia Missaelides, executive director of the California Association of Adult Day Services, also attended the conference and said the veto was troubling but does not spell elimination for the program.\u003c/p>\n\u003cp>\"It doesn't mean the demise or defeat of CBAS as a [Medi-Cal] benefit,\" Missaelides said. \"But it is a signal that the future of the benefit will be a deal between the state and CMS.\"\u003c/p>\n\u003cp>The veto raises questions, Missaelides said, such as whether the state and CMS might decide to change the benefit, or whether adult day health providers in counties not included in the Coordinated Care Initiative might be affected. Codifying current policy, she said, is not a big leap for the state to take.\u003c/p>\n\u003cp>\"It seemed like a simple thing to ask for,\" Missaelides said.\u003c/p>\n\u003cp>In the long run, said Passmore, it leaves the door open for amending the benefit -- by CMS or by Medi-Cal managed care health insurers.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I guess we're going to leave it up to the managed care plans,\" Passmore said. \"What's going to happen is, plan by plan, those entities will decide what role CBAS plays in their range of services.\"\u003c/p>\n\n","blocks":[],"excerpt":"The program serves some of the oldest, most frail Californians on Medi-Cal. ","status":"publish","parent":0,"modified":1412211274,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":14,"wordCount":459},"headData":{"title":"Brown Vetoes Adult Day Health Bill; Future of Program Unknown | KQED","description":"The program serves some of the oldest, most frail Californians on Medi-Cal. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Brown Vetoes Adult Day Health Bill; Future of Program Unknown","datePublished":"2014-10-01T19:13:01.000Z","dateModified":"2014-10-02T00:54:34.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"21874 http://blogs.kqed.org/stateofhealth/?p=21874","disqusUrl":"https://ww2.kqed.org/stateofhealth/2014/10/01/brown-vetoes-adult-day-health-bill-future-of-program-unknown/","disqusTitle":"Brown Vetoes Adult Day Health Bill; Future of Program Unknown","path":"/stateofhealth/21874/brown-vetoes-adult-day-health-bill-future-of-program-unknown","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_6652\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/OldPersonCaneGeneric-e1402507272914.jpg\">\u003cimg class=\"size-large wp-image-6652\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/OldPersonCaneGeneric-620x413.jpg\" alt=\"There is a 45% increased risk of death in people who are lonely compared to not lonely, according to a UCSF study.\" width=\"620\" height=\"413\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The state has tried to eliminate adult day health care in the past. (Photo: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong>\u003ca title=\"http://www.californiahealthline.org/capitol-desk/2014/10/governor-rejects-adult-day-health-bill-future-of-senior-program-now-up-in-air\" href=\"http://www.californiahealthline.org/capitol-desk/2014/10/governor-rejects-adult-day-health-bill-future-of-senior-program-now-up-in-air\" target=\"_blank\"> California Healthline\u003c/a>\u003c/p>\n\u003cp>On Monday, Gov. Jerry Brown vetoed a bill to codify Community Based Adult Services as a Medi-Cal benefit and continue offering it as a benefit into the future.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"It puts everything up for grabs. It's a real step backward.\" \u003c/aside>\n\u003cp>The state \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/10/25/state-accused-of-denying-seniors-disabled-access-to-day-care/\" href=\"http://ww2.kqed.org/stateofhealth/2012/10/25/state-accused-of-denying-seniors-disabled-access-to-day-care/\" target=\"_blank\">has attempted to eliminate adult day health care\u003c/a> in the past. The CBAS program, serving some of the oldest, most frail Californians on Medi-Cal, is the result of a 2011 settlement of a lawsuit challenging the state the last time the state tried to cut the program.\u003c/p>\n\u003cp>The veto Monday of \u003ca title=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1552\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1552\" target=\"_blank\">AB1552\u003c/a> by Assemblywoman Bonnie Lowenthal (D-Long Beach) leaves an uncertain future for CBAS. The agreement in the 2011 settlement expired at the end of August, but CBAS is included as a Medi-Cal benefit in a proposed amendment of the state's Medicaid waiver and is included in the Coordinated Care Intitiative. CMS is expected to approve the amendment by the end of this month.\u003c!--more-->\u003c/p>\n\u003cp>\"It seems like the governor is picking at a scab,\" said Gary Passmore, vice president at the California Congress of Seniors. \"CBAS exists as a settlement, and we tried to establish that in law. And here we are again. … Without it existing in statute, it puts everything up for grabs. It's a real step backward.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Coincidentally yesterday, hundreds of senior care stakeholders, including Passmore, gathered in Sacramento for the annual SCAN Foundation conference on long-term care and services.\u003c/p>\n\u003cp>Lydia Missaelides, executive director of the California Association of Adult Day Services, also attended the conference and said the veto was troubling but does not spell elimination for the program.\u003c/p>\n\u003cp>\"It doesn't mean the demise or defeat of CBAS as a [Medi-Cal] benefit,\" Missaelides said. \"But it is a signal that the future of the benefit will be a deal between the state and CMS.\"\u003c/p>\n\u003cp>The veto raises questions, Missaelides said, such as whether the state and CMS might decide to change the benefit, or whether adult day health providers in counties not included in the Coordinated Care Initiative might be affected. Codifying current policy, she said, is not a big leap for the state to take.\u003c/p>\n\u003cp>\"It seemed like a simple thing to ask for,\" Missaelides said.\u003c/p>\n\u003cp>In the long run, said Passmore, it leaves the door open for amending the benefit -- by CMS or by Medi-Cal managed care health insurers.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I guess we're going to leave it up to the managed care plans,\" Passmore said. \"What's going to happen is, plan by plan, those entities will decide what role CBAS plays in their range of services.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/21874/brown-vetoes-adult-day-health-bill-future-of-program-unknown","authors":["8344"],"categories":["stateofhealth_11","stateofhealth_14"],"tags":["stateofhealth_275"],"featImg":"stateofhealth_6652","label":"stateofhealth"},"stateofhealth_11517":{"type":"posts","id":"stateofhealth_11517","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"11517","score":null,"sort":[1363807905000]},"guestAuthors":[],"slug":"settlement-called-less-harmful-for-in-home-support-recipients","title":"Settlement Called 'Less Harmful' for In-Home Support Recipients","publishDate":1363807905,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>By David Gorn, \u003ca href=\"http://www.californiahealthline.org/capitol-desk/2013/3/state-settles-suit-over-inhome-service-cuts.aspx\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>California officials and disability rights advocates yesterday announced a settlement of a lawsuit challenging a 20 percent budget trigger cut in In-Home Supportive Services care.\u003c/p>\n\u003cp>The settlement allows an 8 percent reduction this year and a 7 percent reduction in 2014. It also changes the cuts from permanent to temporary.\u003c/p>\n\u003cp>The size and timing of the cuts are based, in part, on a current 3.6 percent IHSS cut established in 2009. That reduction will remain in effect, and an additional 4.4 percent cut will be added onto that this year followed by a 3.4 percent additional cut next year, bringing the totals to 8 percent this year and 7 percent next year.\u003c!--more-->\u003c/p>\n\u003cp>\"As a package deal, it's not as simple as saying it's 20 percent down to 8 percent,\" said Elissa Gershon, attorney for one of the plaintiffs, Disability Rights California. \"What we're looking at is small cuts this year and the following year, and hopefully full restoration of benefits in 2015.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Michael Weston, spokesperson for the Department of Social Services, which was named in the suit along with the Department of Health Care Services, said the budget included the 20 percent cut over only seven months, so the 8 percent cut over the full 12 months actually achieves budgeted savings, while helping beneficiaries and eliminating a costly lawsuit.\u003c/p>\n\u003cp>\"The agreement still captures budgeted savings, that's really the gist of it,\" Weston said. \"And we're creating stability for IHSS recipients, ensuring that these individuals remain safely in the community.\"\u003c/p>\n\u003cp>IHSS aid allows some recipients to avoid hospitalization or nursing home care, which \"would be far more costly than the current IHSS program,\" according to Weston.\u003c/p>\n\u003cp>In addition to settling the issue of the 20 percent trigger cuts, the settlement covers several other key points:\u003c/p>\n\u003cul>\n\u003cli>The agreement resolves earlier cuts based on beneficiaries' functional index score;\u003c/li>\n\u003cli>It ensures IHSS beneficiaries will have the right to request a reassessment based on a change in circumstances. Now they won't need a medical certification, as is currently required;\u003c/li>\n\u003cli>The agreement not only resolves the Oster v. Lightbourne lawsuit (formerly known as V.L. v. Wagner), but it also settles another IHSS case, Dominguez v. Schwarzenegger; and\u003c/li>\n\u003cli>The agreement restores the hours lost from the 7% cut as early as the spring of 2015, as long as California is able to obtain federal approval of a provider fee to bring new federal revenue to California, according to advocates.\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\n\u003cp>\"The gradual nature of the cuts is less harmful,\" Gershon said. \"It means the uncertainty of the past four years is gone, and there is hope for full restoration of hours in 2015. People depend on these services to remain in their home. We don't want to minimize the impact [of these cuts], but under the circumstances, we're doing it in the hopes that the stability outweighs the harm for the next two years.\"\u003c/p>\n\n","blocks":[],"excerpt":"California officials and disability rights advocates yesterday announced a settlement of a lawsuit challenging a 20 percent budget trigger cut in In-Home Supportive Services care.\r\n\r\nThe settlement allows an 8 percent reduction this year and a 7 percent reduction in 2014. It also changes the cuts from permanent to temporary.","status":"publish","parent":0,"modified":1363807929,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":12,"wordCount":496},"headData":{"title":"Settlement Called 'Less Harmful' for In-Home Support Recipients | KQED","description":"California officials and disability rights advocates yesterday announced a settlement of a lawsuit challenging a 20 percent budget trigger cut in In-Home Supportive Services care.\r\n\r\nThe settlement allows an 8 percent reduction this year and a 7 percent reduction in 2014. It also changes the cuts from permanent to temporary.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Settlement Called 'Less Harmful' for In-Home Support Recipients","datePublished":"2013-03-20T19:31:45.000Z","dateModified":"2013-03-20T19:32:09.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"11517 http://blogs.kqed.org/stateofhealth/?p=11517","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/03/20/settlement-called-less-harmful-for-in-home-support-recipients/","disqusTitle":"Settlement Called 'Less Harmful' for In-Home Support Recipients","path":"/stateofhealth/11517/settlement-called-less-harmful-for-in-home-support-recipients","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>By David Gorn, \u003ca href=\"http://www.californiahealthline.org/capitol-desk/2013/3/state-settles-suit-over-inhome-service-cuts.aspx\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>California officials and disability rights advocates yesterday announced a settlement of a lawsuit challenging a 20 percent budget trigger cut in In-Home Supportive Services care.\u003c/p>\n\u003cp>The settlement allows an 8 percent reduction this year and a 7 percent reduction in 2014. It also changes the cuts from permanent to temporary.\u003c/p>\n\u003cp>The size and timing of the cuts are based, in part, on a current 3.6 percent IHSS cut established in 2009. That reduction will remain in effect, and an additional 4.4 percent cut will be added onto that this year followed by a 3.4 percent additional cut next year, bringing the totals to 8 percent this year and 7 percent next year.\u003c!--more-->\u003c/p>\n\u003cp>\"As a package deal, it's not as simple as saying it's 20 percent down to 8 percent,\" said Elissa Gershon, attorney for one of the plaintiffs, Disability Rights California. \"What we're looking at is small cuts this year and the following year, and hopefully full restoration of benefits in 2015.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Michael Weston, spokesperson for the Department of Social Services, which was named in the suit along with the Department of Health Care Services, said the budget included the 20 percent cut over only seven months, so the 8 percent cut over the full 12 months actually achieves budgeted savings, while helping beneficiaries and eliminating a costly lawsuit.\u003c/p>\n\u003cp>\"The agreement still captures budgeted savings, that's really the gist of it,\" Weston said. \"And we're creating stability for IHSS recipients, ensuring that these individuals remain safely in the community.\"\u003c/p>\n\u003cp>IHSS aid allows some recipients to avoid hospitalization or nursing home care, which \"would be far more costly than the current IHSS program,\" according to Weston.\u003c/p>\n\u003cp>In addition to settling the issue of the 20 percent trigger cuts, the settlement covers several other key points:\u003c/p>\n\u003cul>\n\u003cli>The agreement resolves earlier cuts based on beneficiaries' functional index score;\u003c/li>\n\u003cli>It ensures IHSS beneficiaries will have the right to request a reassessment based on a change in circumstances. Now they won't need a medical certification, as is currently required;\u003c/li>\n\u003cli>The agreement not only resolves the Oster v. Lightbourne lawsuit (formerly known as V.L. v. Wagner), but it also settles another IHSS case, Dominguez v. Schwarzenegger; and\u003c/li>\n\u003cli>The agreement restores the hours lost from the 7% cut as early as the spring of 2015, as long as California is able to obtain federal approval of a provider fee to bring new federal revenue to California, according to advocates.\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\n\u003cp>\"The gradual nature of the cuts is less harmful,\" Gershon said. \"It means the uncertainty of the past four years is gone, and there is hope for full restoration of hours in 2015. People depend on these services to remain in their home. We don't want to minimize the impact [of these cuts], but under the circumstances, we're doing it in the hopes that the stability outweighs the harm for the next two years.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/11517/settlement-called-less-harmful-for-in-home-support-recipients","authors":["8344"],"categories":["stateofhealth_166","stateofhealth_14"],"tags":["stateofhealth_275","stateofhealth_474"],"label":"stateofhealth"},"stateofhealth_8698":{"type":"posts","id":"stateofhealth_8698","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"8698","score":null,"sort":[1351184665000]},"guestAuthors":[],"slug":"state-accused-of-denying-seniors-disabled-access-to-day-care","title":"State Accused of Denying Seniors Day Care Access","publishDate":1351184665,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>\u003cem>By Mina Kim\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_8703\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/10/Esfandiar_MinaKim_10252012.jpg\">\u003cimg class=\"size-medium wp-image-8703\" title=\"66-year-old Esfandiar Asbagh is waiting to learn if he is eligible for state adult day care services. (Mina Kim: KQED)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/10/Esfandiar_MinaKim_10252012-e1351184417392-300x276.jpg\" alt=\"66-year-old Esfandiar Asbagh is waiting to learn if he is eligible for state adult day care services. (Mina Kim: KQED)\" width=\"300\" height=\"276\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">66-year-old Esfandiar Asbagh is waiting to learn if he is eligible for state adult day care services. (Mina Kim: KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Golden State Adult Day Health Care in San Francisco serves seniors primarily from Russia, Ukraine and other Eastern European countries. As I walked in, I saw immediately that I was underdressed. All around were seniors pushing walkers, and they were wearing glittering sweaters, fur hats or chiffon skirts.\u003c/p>\n\u003cp>“This is mostly clothes from fifty years ago,” Center Director Katya Hope says. “But you look like you’re going to the opera because in fact, this is the major chance to socialize.”\u003c/p>\n\u003cp>Socializing is why 83-year-old Berta Vekhman says she loves it here.\u003c/p>\n\u003cp>“We cannot stay alone. When we are alone, we are dead,\" Vekhman says. “because we stay alone and nobody at home you cannot talk to somebody. You forget how to talk.”\u003c/p>\n\u003caside class=\"pullquote alignright\">The prospect of being home alone is hard on her. “I cry all day, all day.\"\u003c/aside>\n\u003cp>Vekhman suffers from diabetes, Parkinson’s Disease and needs help using the bathroom. She is prone to depression which she says has worsened since January. That's when state officials deemed her -- and 2,000 other seniors -- ineligible for services.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Vekhman was receiving care through the Adult Day Health Care program. Through the program, independent centers, like Golden State, provided physical therapy, mental health treatment and a chance to socialize.\u003c!--more-->\u003c/p>\n\u003cp>In a budget balancing move last year, Gov. Jerry Brown tried to eliminate Adult Day Health Care entirely. \u003ca title=\"http://ww2.kqed.org/stateofhealth/2011/12/14/how-lawsuits-can-stymie-some-budget-cuts/\" href=\"http://ww2.kqed.org/stateofhealth/2011/12/14/how-lawsuits-can-stymie-some-budget-cuts/\" target=\"_blank\">But advocates for the disabled sued\u003c/a>, and the result was a legal settlement that created Community Based Adult Services. It's a smaller program and has stricter eligibility requirements.\u003c/p>\n\u003cp>Vekhman has appealed her ineligibility. She feels lucky that Golden State is letting her continue to come for free. But the prospect of being home alone is hard on her. “I cry all day, all day,\" she says.\u003c/p>\n\u003cp>According to attorney Alice Ho the state is rejecting people who clearly qualify for the program. Ho and her colleagues at the law firm Ropes & Gray have handled the appeals of 14 of the seniors at Golden State Adult Day Health Care.\u003c/p>\n\u003cp>“These seniors had either Alzheimer’s or another form of dementia, issues like Parkinson’s disease, coronary artery disease, spinal meningiomas, other tumors,” Ho says. “Imagine older grandparents who’ve actually gotten really sick.”\u003c/p>\n\u003cp>What frustrates Ho is that all 14 seniors had initially been deemed eligible after face-to-face evaluations with state nurses last year. Officials with the Department of Healthcare Services overturned the nurses’ assessments, creating a lengthy appeals process -- that has resulted in all the seniors getting reinstated.\u003c/p>\n\u003cp>Golden State Adult Day Health Care has managed to keep providing services to seniors, even though the state is not reimbursing centers during the appeals process. But that's been the exception, not the rule.\u003c/p>\n\u003cp>At Grace Adult Day Health Care in Sunnyvale, an occupational therapist leads seniors through stretching exercises, giving instructions in both English and Farsi. At this center which serves seniors -- mostly from Iran and Afghanistan -- the state deemed nearly 80 of them ineligible for Community Based Adult Services.\u003c/p>\n\u003cp>“That's almost half the center,” Grace Adult Day's director Manooch Pouransari says. “And we think all of them are a mistake.”\u003c/p>\n\u003cp>The seniors here filed appeals earlier this year, but the state hasn't yet decided any of them. Pouransari says he tried to swallow the costs of caring for these seniors, but after three months, it became too much.\u003c/p>\n\u003cp>“It was a big blow financially to keep them here without the pay.” Pouransari says. “But with the state not responding, no news about hearings, we had to let them go.”\u003c/p>\n\u003cp>Pouransari says the seniors have suffered strokes, falls and broken hips.\u003c/p>\n\u003cp>Esfandiar Asbagh, 66, says he's had several falls while he's been home alone. Asbagh was stricken with polio as an infant and can't control the left side of his body.\u003c/p>\n\u003cp>“I have dizziness,” Asbagh struggles to say. “I'm very deep depression when I am alone.”\u003c/p>\n\u003cp>Asbagh says what keeps him going is the belief that the state will allow him back in to the program. “I believe 95 to 95 percent I'll win.”\u003c/p>\n\u003cp>State officials say delays in the appeals process stem from the program's legal battles and that the agency is now moving through the cases much faster. They say hearings are expected to be completed next month. Jane Ogle, Department of Health Care Services Deputy Director, says she stands behind the agency's eligibility determinations, including the ones that have overruled nurses' earlier assessments.\u003c/p>\n\u003cp>“With such a highly scrutinized program, we need to make sure that our decisions are fair and accurate and correct for each of the participants,” Ogle says. “That's why we put in a quality assurance review for each of these decisions”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>On November 8, state officials are expected to explain this in federal court. Advocates for the disabled say the state's eligibility reversals are illegal and are asking a judge to order that all seniors awaiting hearing decisions be reinstated.\u003c/p>\n\n","blocks":[],"excerpt":null,"status":"publish","parent":0,"modified":1351783780,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":26,"wordCount":901},"headData":{"title":"State Accused of Denying Seniors Day Care Access | KQED","description":"By Mina Kim Golden State Adult Day Health Care in San Francisco serves seniors primarily from Russia, Ukraine and other Eastern European countries. As I walked in, I saw immediately that I was underdressed. All around were seniors pushing walkers, and they were wearing glittering sweaters, fur hats or chiffon skirts. “This is mostly clothes","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"State Accused of Denying Seniors Day Care Access","datePublished":"2012-10-25T17:04:25.000Z","dateModified":"2012-11-01T15:29:40.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"8698 http://blogs.kqed.org/stateofhealth/?p=8698","disqusUrl":"https://ww2.kqed.org/stateofhealth/2012/10/25/state-accused-of-denying-seniors-disabled-access-to-day-care/","disqusTitle":"State Accused of Denying Seniors Day Care Access","path":"/stateofhealth/8698/state-accused-of-denying-seniors-disabled-access-to-day-care","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>By Mina Kim\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_8703\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/10/Esfandiar_MinaKim_10252012.jpg\">\u003cimg class=\"size-medium wp-image-8703\" title=\"66-year-old Esfandiar Asbagh is waiting to learn if he is eligible for state adult day care services. (Mina Kim: KQED)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/10/Esfandiar_MinaKim_10252012-e1351184417392-300x276.jpg\" alt=\"66-year-old Esfandiar Asbagh is waiting to learn if he is eligible for state adult day care services. (Mina Kim: KQED)\" width=\"300\" height=\"276\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">66-year-old Esfandiar Asbagh is waiting to learn if he is eligible for state adult day care services. (Mina Kim: KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Golden State Adult Day Health Care in San Francisco serves seniors primarily from Russia, Ukraine and other Eastern European countries. As I walked in, I saw immediately that I was underdressed. All around were seniors pushing walkers, and they were wearing glittering sweaters, fur hats or chiffon skirts.\u003c/p>\n\u003cp>“This is mostly clothes from fifty years ago,” Center Director Katya Hope says. “But you look like you’re going to the opera because in fact, this is the major chance to socialize.”\u003c/p>\n\u003cp>Socializing is why 83-year-old Berta Vekhman says she loves it here.\u003c/p>\n\u003cp>“We cannot stay alone. When we are alone, we are dead,\" Vekhman says. “because we stay alone and nobody at home you cannot talk to somebody. You forget how to talk.”\u003c/p>\n\u003caside class=\"pullquote alignright\">The prospect of being home alone is hard on her. “I cry all day, all day.\"\u003c/aside>\n\u003cp>Vekhman suffers from diabetes, Parkinson’s Disease and needs help using the bathroom. She is prone to depression which she says has worsened since January. That's when state officials deemed her -- and 2,000 other seniors -- ineligible for services.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Vekhman was receiving care through the Adult Day Health Care program. Through the program, independent centers, like Golden State, provided physical therapy, mental health treatment and a chance to socialize.\u003c!--more-->\u003c/p>\n\u003cp>In a budget balancing move last year, Gov. Jerry Brown tried to eliminate Adult Day Health Care entirely. \u003ca title=\"http://ww2.kqed.org/stateofhealth/2011/12/14/how-lawsuits-can-stymie-some-budget-cuts/\" href=\"http://ww2.kqed.org/stateofhealth/2011/12/14/how-lawsuits-can-stymie-some-budget-cuts/\" target=\"_blank\">But advocates for the disabled sued\u003c/a>, and the result was a legal settlement that created Community Based Adult Services. It's a smaller program and has stricter eligibility requirements.\u003c/p>\n\u003cp>Vekhman has appealed her ineligibility. She feels lucky that Golden State is letting her continue to come for free. But the prospect of being home alone is hard on her. “I cry all day, all day,\" she says.\u003c/p>\n\u003cp>According to attorney Alice Ho the state is rejecting people who clearly qualify for the program. Ho and her colleagues at the law firm Ropes & Gray have handled the appeals of 14 of the seniors at Golden State Adult Day Health Care.\u003c/p>\n\u003cp>“These seniors had either Alzheimer’s or another form of dementia, issues like Parkinson’s disease, coronary artery disease, spinal meningiomas, other tumors,” Ho says. “Imagine older grandparents who’ve actually gotten really sick.”\u003c/p>\n\u003cp>What frustrates Ho is that all 14 seniors had initially been deemed eligible after face-to-face evaluations with state nurses last year. Officials with the Department of Healthcare Services overturned the nurses’ assessments, creating a lengthy appeals process -- that has resulted in all the seniors getting reinstated.\u003c/p>\n\u003cp>Golden State Adult Day Health Care has managed to keep providing services to seniors, even though the state is not reimbursing centers during the appeals process. But that's been the exception, not the rule.\u003c/p>\n\u003cp>At Grace Adult Day Health Care in Sunnyvale, an occupational therapist leads seniors through stretching exercises, giving instructions in both English and Farsi. At this center which serves seniors -- mostly from Iran and Afghanistan -- the state deemed nearly 80 of them ineligible for Community Based Adult Services.\u003c/p>\n\u003cp>“That's almost half the center,” Grace Adult Day's director Manooch Pouransari says. “And we think all of them are a mistake.”\u003c/p>\n\u003cp>The seniors here filed appeals earlier this year, but the state hasn't yet decided any of them. Pouransari says he tried to swallow the costs of caring for these seniors, but after three months, it became too much.\u003c/p>\n\u003cp>“It was a big blow financially to keep them here without the pay.” Pouransari says. “But with the state not responding, no news about hearings, we had to let them go.”\u003c/p>\n\u003cp>Pouransari says the seniors have suffered strokes, falls and broken hips.\u003c/p>\n\u003cp>Esfandiar Asbagh, 66, says he's had several falls while he's been home alone. Asbagh was stricken with polio as an infant and can't control the left side of his body.\u003c/p>\n\u003cp>“I have dizziness,” Asbagh struggles to say. “I'm very deep depression when I am alone.”\u003c/p>\n\u003cp>Asbagh says what keeps him going is the belief that the state will allow him back in to the program. “I believe 95 to 95 percent I'll win.”\u003c/p>\n\u003cp>State officials say delays in the appeals process stem from the program's legal battles and that the agency is now moving through the cases much faster. They say hearings are expected to be completed next month. Jane Ogle, Department of Health Care Services Deputy Director, says she stands behind the agency's eligibility determinations, including the ones that have overruled nurses' earlier assessments.\u003c/p>\n\u003cp>“With such a highly scrutinized program, we need to make sure that our decisions are fair and accurate and correct for each of the participants,” Ogle says. “That's why we put in a quality assurance review for each of these decisions”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>On November 8, state officials are expected to explain this in federal court. Advocates for the disabled say the state's eligibility reversals are illegal and are asking a judge to order that all seniors awaiting hearing decisions be reinstated.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/8698/state-accused-of-denying-seniors-disabled-access-to-day-care","authors":["240"],"categories":["stateofhealth_14"],"tags":["stateofhealth_275"],"featImg":"stateofhealth_8703","label":"stateofhealth"},"stateofhealth_6079":{"type":"posts","id":"stateofhealth_6079","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"6079","score":null,"sort":[1337899677000]},"guestAuthors":[],"slug":"meet-the-new-costs-same-as-the-old-costs","title":"Meet the New Costs, Same as the Old Costs","publishDate":1337899677,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>By David Gorn, \u003ca title=\"http://www.californiahealthline.org/features/2012/costs-in-new-adult-day-program-almost-same-as-old-one.aspx#\" href=\"http://www.californiahealthline.org/features/2012/costs-in-new-adult-day-program-almost-same-as-old-one.aspx#\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_6090\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/SeniorWalking_KaiserHealthNews.jpg\">\u003cimg class=\"size-full wp-image-6090\" title=\"(Photo: Kaiser Health News)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/SeniorWalking_KaiserHealthNews.jpg\" alt=\"(Photo: Kaiser Health News)\" width=\"300\" height=\"215\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: Kaiser Health News)\u003c/figcaption>\u003c/figure>\n\u003cp>After more than a year of battling over eliminating and then restructuring adult day health care coverage for Medi-Cal beneficiaries, California's budget for delivering that care is similar to what it was before all the haggling started.\u003c/p>\n\u003cp>The \u003ca title=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/ADHC/ADHC.aspx\" href=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/ADHC/ADHC.aspx\" target=\"_blank\">Community-Based Adult Services\u003c/a> program grew out of a lawsuit challenging the state's proposal and replaces the \u003ca title=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/ADHC/ADHC.aspx\" href=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/ADHC/ADHC.aspx\" target=\"_blank\">Adult Day Health Care\u003c/a> program. CBAS will provide services to 80 percent of previous ADHC beneficiaries and is funded at a similar level to the original program.\u003c/p>\n\u003cp>\"The original budget for ADHC was $170 million, and the current CBAS budget is\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"I guess I just don't understand why we had to go through all of this.\"\u003c/aside>\n\u003cp>$155 million,\" said Lydia Missaelides, executive director of the \u003ca title=\"http://www.caads.org/index.html\" href=\"http://www.caads.org/index.html\" target=\"_blank\">California Association of Adult Day Services\u003c/a>. \"That means you're looking at roughly the same cost to provide the same services to 80% of the beneficiaries.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Of course, that doesn't count the expense of legal battles, or the daunting number of man hours spent designing and implementing a new system, not to mention the constant arguing and debating over more than a year, she said. Missaelides sighed at the idea of it.\u003c!--more-->\u003c/p>\n\u003cp>\"I guess I just don't understand,\" she said, \"why we had to go through all of this.\"\u003c/p>\n\u003cp>The ADHC-to-CBAS metamorphosis -- which began in budget proposals more than a year ago -- sparked legislation, multiple hearings at the Capitol and a lengthy lawsuit.\u003c/p>\n\u003cp>\"We are in the process of implementing a legal settlement of substantial scope, and we are starting an entirely new program -- two very costly activities,\" said Norman Williams, deputy director of public affairs at the \u003ca title=\"http://www.dhcs.ca.gov/Pages/default.aspx\" href=\"http://www.dhcs.ca.gov/Pages/default.aspx\" target=\"_blank\">Department of Health Care Services\u003c/a>. \"Because of this, in subsequent years we expect additional savings to be realized.\"\u003c/p>\n\u003cp>The state's costs related to the lawsuit and settlement are separate from CBAS expenditures.\u003c/p>\n\u003cp>\u003cstrong>Process Slowing Down\u003c/strong>\u003c/p>\n\u003cp>DHCS recently announced it would phase in its new adult day health program, rather than implement it all at once on July 1. The shift involves several complicated steps: determining eligibility for 40,000 frail and elderly patients across the state, moving 80 percent of them to managed care plans and converting existing centers to not-for-profit status. The state recently adjusted its timetable and built in a three-month cushion to ease the transition.\u003c/p>\n\u003cp>State officials said 31 of the 253 adult day health care centers in California will make the switch in July, while the bulk of the centers now are eyeing an Oct. 1 deadline.\u003c/p>\n\u003cp>The extra time was necessary, health officials said, to work out a number of crucial details. For instance, the state requires any for-profit adult day health care center to switch to not-for-profit status to qualify as a Community-Based Adult Services center. But here we are -- just about a month to the July 1 deadline and the state has not yet issued guidelines for that requirement.\u003c/p>\n\u003cp>In addition:\u003c/p>\n\u003cul>\n\u003cli>Rates still need to be worked out for health plans\u003c/li>\n\u003cli>Questions remain about what will happen if the for-profits can't make the switch\u003c/li>\n\u003cli>And what about patient eligibility denials?\u003c/li>\n\u003c/ul>\n\u003cp>Appeals to denials will be heard starting next week. The Adult Day Health Care Association recently announced that it will file an appeal to reverse the state's 10 percent provider rate cut. Meanwhile, two more ADHC centers recently closed.\u003c/p>\n\u003cp>The good news for adult day health care beneficiaries is that state officials agreed to spend more on the new program. In the May budget revision, the CBAS budget was raised to $156 million for the next year.\u003c/p>\n\u003cp>Missaelides said state officials clearly have been listening to stakeholders' concerns these days, as evidenced by the decision to delay implementation for most of the centers, with the new phase-in approach.\u003c/p>\n\u003cp>The relative handful of CBAS centers that will lead the way with a July 1 implementation date were selected because they are all \u003ca title=\"http://www.chcf.org/publications/2000/03/medical-managed-care\" href=\"http://www.chcf.org/publications/2000/03/medical-managed-care\" target=\"_blank\">County Organized Health Systems\u003c/a>, according to Jane Ogle, deputy director of the Department of Health Care Services.\u003c/p>\n\u003cp>\"We picked the COHS counties first because the beneficiaries are already members of the plan and don't have to make a plan selection,\" Ogle said. \"This eliminates one step in the process.\"\u003c/p>\n\u003cp>In the rest of the counties, a big step in the process will be enrollment into Medi-Cal managed care plans. Medi-Cal is California's Medicaid program.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"In those counties where beneficiaries have to make a choice,\" Ogle said, \"we will wait until October, to give them plenty of time to make that selection.\"\u003c/p>\n\n","blocks":[],"excerpt":"After more than a year of battling over eliminating and then restructuring adult day health care coverage for Medi-Cal beneficiaries, California's budget for delivering that care is similar to what it was before all the haggling started.\r\n\r\nThe Community-Based Adult Services program grew out of a lawsuit challenging the state's proposal and replaces the Adult Day Health Care program. CBAS will provide services to 80 percent of previous ADHC beneficiaries and is funded at a similar level to the original program.\r\n\r\n\"The original budget for ADHC was $170 million, and the current CBAS budget is $155 million,\" said Lydia Missaelides, executive director of the California Association of Adult Day Services. \"That means you're looking at roughly the same cost to provide the same services to 80% of the beneficiaries.\"","status":"publish","parent":0,"modified":1337899677,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":772},"headData":{"title":"Meet the New Costs, Same as the Old Costs | KQED","description":"After more than a year of battling over eliminating and then restructuring adult day health care coverage for Medi-Cal beneficiaries, California's budget for delivering that care is similar to what it was before all the haggling started.\r\n\r\nThe Community-Based Adult Services program grew out of a lawsuit challenging the state's proposal and replaces the Adult Day Health Care program. CBAS will provide services to 80 percent of previous ADHC beneficiaries and is funded at a similar level to the original program.\r\n\r\n"The original budget for ADHC was $170 million, and the current CBAS budget is $155 million," said Lydia Missaelides, executive director of the California Association of Adult Day Services. "That means you're looking at roughly the same cost to provide the same services to 80% of the beneficiaries."","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Meet the New Costs, Same as the Old Costs","datePublished":"2012-05-24T22:47:57.000Z","dateModified":"2012-05-24T22:47:57.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"6079 http://blogs.kqed.org/stateofhealth/?p=6079","disqusUrl":"https://ww2.kqed.org/stateofhealth/2012/05/24/meet-the-new-costs-same-as-the-old-costs/","disqusTitle":"Meet the New Costs, Same as the Old Costs","path":"/stateofhealth/6079/meet-the-new-costs-same-as-the-old-costs","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>By David Gorn, \u003ca title=\"http://www.californiahealthline.org/features/2012/costs-in-new-adult-day-program-almost-same-as-old-one.aspx#\" href=\"http://www.californiahealthline.org/features/2012/costs-in-new-adult-day-program-almost-same-as-old-one.aspx#\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_6090\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/SeniorWalking_KaiserHealthNews.jpg\">\u003cimg class=\"size-full wp-image-6090\" title=\"(Photo: Kaiser Health News)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/SeniorWalking_KaiserHealthNews.jpg\" alt=\"(Photo: Kaiser Health News)\" width=\"300\" height=\"215\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: Kaiser Health News)\u003c/figcaption>\u003c/figure>\n\u003cp>After more than a year of battling over eliminating and then restructuring adult day health care coverage for Medi-Cal beneficiaries, California's budget for delivering that care is similar to what it was before all the haggling started.\u003c/p>\n\u003cp>The \u003ca title=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/ADHC/ADHC.aspx\" href=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/ADHC/ADHC.aspx\" target=\"_blank\">Community-Based Adult Services\u003c/a> program grew out of a lawsuit challenging the state's proposal and replaces the \u003ca title=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/ADHC/ADHC.aspx\" href=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/ADHC/ADHC.aspx\" target=\"_blank\">Adult Day Health Care\u003c/a> program. CBAS will provide services to 80 percent of previous ADHC beneficiaries and is funded at a similar level to the original program.\u003c/p>\n\u003cp>\"The original budget for ADHC was $170 million, and the current CBAS budget is\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"I guess I just don't understand why we had to go through all of this.\"\u003c/aside>\n\u003cp>$155 million,\" said Lydia Missaelides, executive director of the \u003ca title=\"http://www.caads.org/index.html\" href=\"http://www.caads.org/index.html\" target=\"_blank\">California Association of Adult Day Services\u003c/a>. \"That means you're looking at roughly the same cost to provide the same services to 80% of the beneficiaries.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Of course, that doesn't count the expense of legal battles, or the daunting number of man hours spent designing and implementing a new system, not to mention the constant arguing and debating over more than a year, she said. Missaelides sighed at the idea of it.\u003c!--more-->\u003c/p>\n\u003cp>\"I guess I just don't understand,\" she said, \"why we had to go through all of this.\"\u003c/p>\n\u003cp>The ADHC-to-CBAS metamorphosis -- which began in budget proposals more than a year ago -- sparked legislation, multiple hearings at the Capitol and a lengthy lawsuit.\u003c/p>\n\u003cp>\"We are in the process of implementing a legal settlement of substantial scope, and we are starting an entirely new program -- two very costly activities,\" said Norman Williams, deputy director of public affairs at the \u003ca title=\"http://www.dhcs.ca.gov/Pages/default.aspx\" href=\"http://www.dhcs.ca.gov/Pages/default.aspx\" target=\"_blank\">Department of Health Care Services\u003c/a>. \"Because of this, in subsequent years we expect additional savings to be realized.\"\u003c/p>\n\u003cp>The state's costs related to the lawsuit and settlement are separate from CBAS expenditures.\u003c/p>\n\u003cp>\u003cstrong>Process Slowing Down\u003c/strong>\u003c/p>\n\u003cp>DHCS recently announced it would phase in its new adult day health program, rather than implement it all at once on July 1. The shift involves several complicated steps: determining eligibility for 40,000 frail and elderly patients across the state, moving 80 percent of them to managed care plans and converting existing centers to not-for-profit status. The state recently adjusted its timetable and built in a three-month cushion to ease the transition.\u003c/p>\n\u003cp>State officials said 31 of the 253 adult day health care centers in California will make the switch in July, while the bulk of the centers now are eyeing an Oct. 1 deadline.\u003c/p>\n\u003cp>The extra time was necessary, health officials said, to work out a number of crucial details. For instance, the state requires any for-profit adult day health care center to switch to not-for-profit status to qualify as a Community-Based Adult Services center. But here we are -- just about a month to the July 1 deadline and the state has not yet issued guidelines for that requirement.\u003c/p>\n\u003cp>In addition:\u003c/p>\n\u003cul>\n\u003cli>Rates still need to be worked out for health plans\u003c/li>\n\u003cli>Questions remain about what will happen if the for-profits can't make the switch\u003c/li>\n\u003cli>And what about patient eligibility denials?\u003c/li>\n\u003c/ul>\n\u003cp>Appeals to denials will be heard starting next week. The Adult Day Health Care Association recently announced that it will file an appeal to reverse the state's 10 percent provider rate cut. Meanwhile, two more ADHC centers recently closed.\u003c/p>\n\u003cp>The good news for adult day health care beneficiaries is that state officials agreed to spend more on the new program. In the May budget revision, the CBAS budget was raised to $156 million for the next year.\u003c/p>\n\u003cp>Missaelides said state officials clearly have been listening to stakeholders' concerns these days, as evidenced by the decision to delay implementation for most of the centers, with the new phase-in approach.\u003c/p>\n\u003cp>The relative handful of CBAS centers that will lead the way with a July 1 implementation date were selected because they are all \u003ca title=\"http://www.chcf.org/publications/2000/03/medical-managed-care\" href=\"http://www.chcf.org/publications/2000/03/medical-managed-care\" target=\"_blank\">County Organized Health Systems\u003c/a>, according to Jane Ogle, deputy director of the Department of Health Care Services.\u003c/p>\n\u003cp>\"We picked the COHS counties first because the beneficiaries are already members of the plan and don't have to make a plan selection,\" Ogle said. \"This eliminates one step in the process.\"\u003c/p>\n\u003cp>In the rest of the counties, a big step in the process will be enrollment into Medi-Cal managed care plans. Medi-Cal is California's Medicaid program.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"In those counties where beneficiaries have to make a choice,\" Ogle said, \"we will wait until October, to give them plenty of time to make that selection.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/6079/meet-the-new-costs-same-as-the-old-costs","authors":["8344"],"categories":["stateofhealth_14","stateofhealth_13"],"tags":["stateofhealth_275","stateofhealth_99"],"featImg":"stateofhealth_6090","label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. Michel Martin hosts on the weekends.","airtime":"MON-FRI 1pm-2pm, 4:30pm-6:30pm\u003cbr />SAT-SUN 5pm-6pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/All-Things-Considered-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/all-things-considered/","meta":{"site":"news","source":"npr"},"link":"/radio/program/all-things-considered"},"american-suburb-podcast":{"id":"american-suburb-podcast","title":"American Suburb: The Podcast","tagline":"The flip side of gentrification, told through one town","info":"Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. 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You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. 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On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. 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