Adult Day Health Care Center forges on
By Emily Sorensen
It’s been six months since the Poway Adult Day Health Care Center rallied to protest state budget cuts, and their long struggle is not over.
The center, the brainchild of owner and founder Kathryn Holt, focuses on providing restorative and/or maintenance care for elderly adults who require assistance with movement or otherwise need nursing supervision. The center also provides physical, occupational and speech therapy. The center not only provides a break for those giving elderly relatives or friends 24-hour home care, but also gives seniors the opportunity to socialize and enjoy social activities, as well as the chance to live at home with loved ones, instead of in a nursing facility.
Six months ago, a group of nearly 150 seniors who attended the Poway center, and similar centers around the county, rallied to protest the state’s decision to eliminate Medi-Cal funding, which adult day health centers relied on to provide seniors with care.
“A 10 percent reduction to payments to providers went into effect the last week in December,” said Holt. “We’re providing the same services, but at the rates of 10 years ago.” Holt is hoping to receive a reprieve from the 10 percent cut in funding. “Gas and food cost more now than 10 years ago,” said Holt.
“Why are we having to fight so hard to provide good services to frail, elderly citizens in our community?” Holt asked last week. Despite the increase in costs for the center, Holt says she isn’t in a position to cut any of the services her center provides. “They’re mandated by the state,” said Holt. “We have to have an RN, a social worker.”
In addition to the cut in funding, Holt and the Poway Adult Day Health Care Center are also struggling with the state’s mandate that all centers transition to nonprofit, with a deadline of July 1. Seventy percent of adult day health care centers in the state are for-profit. “We’re actually in a better position, because we had already been thinking about transitioning from for-profit to nonprofit,” said Holt.
Still, the working toward that transition on a deadline hasn’t been easy. Though Holt managed to pay off one of the center’s Small Business Administration (SBA) loans, more remain on the building — and nonprofit organizations are not eligible for SBA loans. “We have to figure out how, or if, we can convert to a nonprofit [with these loans],” said Holt.
The state is allowing the ADHC centers to remain open and operational under the new Community-Based Adult Services (CBAS) program. As part of this, all attendees of ADHC centers had to be assessed by nurses of the state, to try and weed out those using the service unnecessarily.
“The state thought that only 50 percent of attendees had health issues that required these services,” said Holt. “But the results showed that about 85 percent need services.”
Out of the Poway ADHC Center’s attendees, 25 out of 110 were found to not qualify for CBAS services, though Holt notes that they’re appealing all these cases. Holt stated that between 7,000 and 8,000 attendees statewide were found ineligible for CBAS services, though all are allowed to appeal this determination.
“The state has wasted a huge amount of money on sending these nurses out to do these face-to-face assessments,” said Holt.
A further complication is the holdup on finalizing contracts between the state and managed care companies. July 1 is the date when centers can no longer bill the state for services, but according to Holt, the state and the managed care companies who will need to be billed instead are still negotiating. A worst-case scenario if contracts are not finalized by July 1 is centers having to shoulder all the costs of care themselves. “There’s no way we could survive that,” said Holt.
“The managed care companies are feeling just as much pain as we are” said Holt. “We all feel the state is moving way too fast. I hope the state will slow down implementation.”
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