Hundreds of adult day healthcare centers across California may close as early as Nov. 1 if the courts allow a bill that cuts funding to the centers to proceed.
Governor Brown signed AB 97 in March, a bill that will remove these centers from the list of benefits covered by Medi-Cal on Dec. 1, saving the state $170 million annually.
The bill will appropriate $85 million to build a replacement program for approximately 37,000 elderly and disabled adults who would be affected by the closures. Officials say the program will include fee-for-service healthcare, including transportation to and from the doctor's office as well as in-home supportive services.
Audrey Larson, a certified psychiatric nurse at the San Fernando Valley Adult Day Health Center for the past 11 and a half years, says the state has no plan to transition out people who depend of adult day centers, especially those with disabilities.
"[Policymakers] say they have these programs, but they are literally non-existent," said Larson, "there is absolutely nothing for the mentally ill."
Advocates for Californians with developmental disabilities filed a lawsuit in September in an attempt to block the state's elimination of adult care centers, alleging that it is a violation of disabilities rights. The court hearing is set for Nov. 8, and will determine whether the state is able to proceed with the budget cut or not.
The San Fernando Valley Adult Day Health Center specializes in patients with physical and mental disabilities and the state funds each patient's stay based on the severity of their case. The center provides a van to pick up and drop off its patients. "They spend about 5 hours at the center, learning all kinds of really good things to take care of themselves," Larson said.
As one example, she told the story of one patient who was a diabetic with schizophrenia, HIV, and major lung problems. "He couldn't take care of himself," said Larson, "and he was living at a boarding house where the staff had no idea how to feed him."
Larson said he would have lost his leg to an ulcer if it were not for the doctors at San Fernando who advocated to get him the vaccines that Medi-Cal patients aren't usually eligible to receive. Now, Larson says his blood sugar levels are normal, "he's compliant, and his life was saved."
Larson says it is centers like San Fernando that keep adults out of nursing homes and hospitals, places that cost more to maintain than funding an adult day center.
Still, with California's projected $28 billion shortfall in 2012, the question comes down to what the state can actually afford.
"It's a very tough decision," California Department of Health Care Services spokesman Norman Williams told The Modesto Bee. "But it's one of the few ways in which the state can address its spending."