CAADS - California Association for Adult Day Services


COMMUNITY BASED ADULT SERVICES (CBAS)

Updated: December 11, 2013


CA Dept of Health Care Services (DHCS) Website (CBAS/ADHC Information) | Email (Comments/Questions)

Medi-Cal Managed Care Enrollment: Health Care Options Website
(General informing materials, enrollment forms, plan comparison charts, etc.)
Call Toll-Free 1-800-430-4263 or write to DHCS, Health Care Options, P.O. Box 989009, West Sacramento, CA 95798-9850

CA Dept of Aging (CDA) Website (CBAS Providers)


STATE'S NEXT CBAS STAKEHOLDER WORKGROUP MEETING
January 9, 2014 | 2 PM to 5 PM

The Department of Health Care Services (DHCS) and the California Department of Aging (CDA) have announced the schedule for the CBAS Stakeholder Workgroup meetings:

          January 9, 2014 | 2-5 PM - Stakeholder Workgroup Meeting
          February 4, 2014 | 2-5 PM - Stakeholder Workgroup Meeting
          March 6, 2014 | 2-5 PM - Stakeholder Workgroup Meeting
          April 10, 2014 | 3-5 PM - CBAS Stakeholder Process Summary Webinar

All meeting announcements, agendas, meeting materials, etc., will be shared through the CDA CBAS distribution list. You may register to receive notifications about the CBAS Stakeholder Process and Workgroup Meetings. Information regarding the CBAS Stakeholder Process can be found on the CDA website. Meeting summaries and action items will be posted to the CDA website:

    12/3/13 CBAS Stakeholder Workgroup Webinar Agenda | Members | Slides | Recording

Public comment will be allowed at each meeting and is encouraged in writing or by phone at any time through April 2014. Contact information for CDA is below.

       California Department of Aging
       1300 National Drive, Suite 200
       Sacramento, California 95834

       CDA CBAS Mail Box: CBAScda@aging.ca.gov
       CDA CBAS Website: www.aging.ca.gov
       CDA Phone Number: (916) 419-7545

 

STATE ANNOUNCES FIRST CBAS STAKEHOLDER WORKGROUP MEETING
December 3, 2013 | 2 PM to 5 PM

The Department of Health Care Services (DHCS) and the California Department of Aging (CDA) have announced that the first CBAS Stakeholder Workgroup meeting will take place at CDA on Tuesday, December 3, 2013, from 2 PM to 5 PM. This will be the first of four such meetings which will run through April 2014. Special thanks are extended to the Workgroup members for their commitment to participate and to the SCAN Foundation for supporting the CBAS Stakeholder Process.

 

CBAS STAKEHOLDER PROCESS KICKS-OFF
October 23, 2013 Presentation Slides Available

View PowerPoint Presentation

On October 23, 2013, the Department of Health Care Services (DHCS) and California Department of Aging (CDA) conducted the first in a series of meetings to obtain input from interested parties regarding the future direction of the CBAS program and the amending and renewing of the CBAS section of the California Bridge to Reform 1115 Demonstration Waiver, which expires August 2014.

Due to technical difficulties with the Webinar service provider, the meeting was conducted via teleconference and covered specifics on the CBAS Stakeholder Process that will run through April 2014. To subscribe to CDA’s distribution list for CBAS Stakeholder Process notifications go to www.aging.ca.gov. (Click on the CBAS icon, then click on “Sign Up or Unsubscribe for Notifications” link).

 

CDA CBAS Branch Issues All Center Letter #13-13 To Provide Fair Hearing Penalty Program Update

July 31, 2013 - The California Department of Aging (CDA) has issued an All Centers Letter to all Community Based Adult Services (CBAS) providers to update the information sent on July 9, 2013 via ACL #13-11, regarding fair hearing penalty payment checks that the California Department of Social Services (CDSS) is currently issuing to eligible CBAS participants.

ACL #13-13 (CBAS providers are asked to share the information with participants who receive penalty payment checks.)

 

State Notifies Providers RE: CBAS Benefit Termination Letter to Beneficiaries

October 25, 2012 - The California Department of Health Care Services will send a letter during the last week of October 2012 to CBAS beneficiaries who have opted to remain in Medi-Cal Fee-For-Service after November 1, 2012. The letter explains the process for enrolling in a Medi-Cal managed care plan if the beneficiary wants to receive CBAS after November 1, 2012. Read more.

 

State Announces "Easy Way Back" into CBAS Services

October 19, 2012 - The California Department of Aging has issued a notice to Community Based Adult Services (CBAS) providers currently in Phase II of the CBAS Transition to address Fee-For-Service (FFS) participant choice deadlines and an "easy way back" into CBAS services. Read more.

 

State Issues Clarification of CBAS Benefit Under Medi-Cal Managed Care

October 18, 2012 - The Department of Health Care Services (DHCS) and the California Department of Aging (CDA) are taking steps to provide clear information to physicians, hospitals, professional associations, and CBAS providers to help everyone understand the benefits of a coordinated system of care, to clarify that physicians can continue treating their Medicare patients who are CBAS participants if the participant enrolls in Medi-Cal Managed Care, and how the physician can go about doing that. Read more.

 

SEPT 24, 2012: CBAS Oversight Hearing by Assembly Committee on Aging and Long Term Care
"The Community Based Adult Services Transition: Impacts to Participants, Families, and Communities"

September 24, 2012 - The Assembly Aging and Long Term Care Committee, chaired by Mariko Yamada, held an oversight hearing on Community Based Adult Services. Toby Douglas, Director, Department of Health Care Services, reported on the CBAS transition, costs and savings, eligibility determination procedures, treatment authorization, appeals, quality assurance, and access. CBAS providers Debbie Toth, CEO, Rehabilitation Services of Northern California, Micheal Pope, Executive Director, Alzheimer's Services of the East Bay, and Nina M. Nolcox, RN, PHN and Administrator, Graceful Senescence ADHC, described recent experiences and challenges in the transition. Kevin Prindiville, Deputy Director, National Senior Citizens Law Center, Gary Passmore, Excutive Director, Congress of California Seniors, and Director Douglas offered guidance on lessons learned from the ADHC to CBAS transition, and how those lessons may be of value to future beneficiary transition planning. Public testimony followed.

Hearing (3 hr, 51 min) Click on the "Video on Demand" tab and select 2012 Archive.

 

CBAS Transition Stakeholder Update
MEDI-CAL MANAGED CARE FREQUENTLY ASKED QUESTIONS

September 10, 2012 - The Department of Health Care Services (DHCS) has prepared a fact sheet with frequently asked questions (FAQs) on the transition of the Community-Based Adult Services (CBAS) program into a Medi-Cal managed care benefit. If you are interested in learning more about CBAS and how this transition will impact CBAS beneficiaries, please use the following resources:

FAQs
CA Medical Assn: CBAS website (CMA and DHCS are partnering to promote greater understanding of CBAS Medi-Cal managed care among physicians.)
Department of Health Care Services (DHCS): CBAS website
Contact DHCS by email: CBAS@DHCS.ca.gov
California Department of Aging (CDA): CBAS website
Contact CDA by email: CBAScda@aging.ca.gov

 

Community Based Adult Services Information Now on LA Care Website

August 24, 2012 - Current and prospective Community Based Adult Services (CBAS) participants can now obtain information about CBAS, a Medi-Cal Managed Care plan benefit available to eligible individuals enrolled in LA Care, by visiting the LA Care website.

 

Medi-Cal Managed Care and Community Based Adult Services
FREQUENTLY ASKED QUESTIONS

August 16, 2012 - Medicare / Medi-Cal (dual) beneficiaries who are eligible for Community Based Adult Services (CBAS) have received letters from the California Department of Health Care Services instructing them on how to enroll in a Medi-Cal Managed Care (MCMC) plan to keep their CBAS (formerly ADHC) Medi-Cal benefit. As of October 1, 2012, CBAS will only be available as a Medi-Cal Managed Care benefit. This will not change the Medicare insurance benefit. The Medicare doctor and specialists will continue to serve the dually eligible CBAS patient.

Understandably, this transition to CBAS as a managed care benefit has been confusing. The FAQs will help you understand what is happening. Enrollment in Medi-Cal Managed Care must be done by September 18, 2012 to assure uninterrupted services at the CBAS center. If no choice is made, then the state will select and enroll you in a plan.

FAQs for Medi-Cal Managed Care and Community Based Adult Services (8/16/12, 6 pages)

 

CBAS Non-Profit Provider Requirement Postponed

June 8, 2012 - The California Department of Health Care Services (DHCS) is postponing implementation of the CBAS non-profit requirement from July 1, 2012 to January 1, 2013, to allow for the CBAS transition to Medi-Cal Managed Care to be complete, with a few months to demonstrate a "steady state" population from which to judge access demands. The six-month postponement also allows DHCS to work with providers and provider associations to obtain additional information to construct useful and effective criteria for subsequent exception processing. DHCS will issue advice and guidance to the provider community regarding criteria related to exceptions defined for this non-profit requirement in advance of the new implementation date.

CDA Notice 6/8/12: Postponement of CBAS Non-Profit Provider Requirement

 

DHCS Announces Plan to Phase CBAS Transition into Managed Care

May 17, 2012 - The California Department of Health Care Services announced that Community Based Adult Services (CBAS) will be transitioned into Medi-Cal Managed Care in two phases. The first phase, starting in July, involves transition of less than 10% of current CBAS participants, 31 CBAS providers, and 5 individual plan organizations serving 12 counties. The second phase will begin October 1, 2012, and represents the remaining CBAS participants, 222 CBAS providers, and 16 individual plan organizations serving 17 counties.

DHCS Notice 5/17/12: Plan for transitioning Community Based Adult Services (CBAS) into managed care

 

CMS Approves Waiver Amendment, CBAS Program is Effective April 1

March 30, 2012 - The Centers for Medicare & Medicaid Services (CMS) approved the State of California's request, submitted January 1, 2012, to amend its Demonstration project authorized under section 1115 of the Social Security Act (Act) entitled the "Bridge to Health Care Reform (Waiver number 11-W-00193/9)," to incorporate the Community Based Adult Services (CBAS) program effective April 1, 2012.

CMS Letter 3/30/12: Approval of amendment to "Bridge to Health Care Reform" to incorporate CBAS program

 

Court Hearing Postponed to April 27, so Parties Can Work to Resolve Allegations that DHCS Failed to Comply with Darling v. Douglas Settlement

March 29, 2012 - A hearing before a federal district court judge was taken off calendar (postponed), at the request of both parties to allow more time to try and reach a resolution. The hearing was rescheduled for April 27, 2012 at 9:00 AM. On March 22, 2012, Disability Rights California (DRC) filed documents with the court claiming the California Department of Health Care Services (DHCS) failed to fully comply with the court approved agreement that settled a lawsuit between the State of California and the class of plaintiffs who include frail seniors and persons with disabilities authorized to receive Adult Day Health Care services as a Medi-Cal benefit.

Civil Minute Order Filed 3/29/2012 (1 page)
Notice of Motion and Motion for Enforcement of Stipulated Judgment and for Civil Contempt Sanctions Filed 3/22/2012 (38 pages)
Proposed Order on Enforcement of Stipulated Judgment and Contempt Filed 3/22/2012 (10 pages)

 

State Conducts CBAS Updates Webinar for Providers

March 22, 2013 - The California Department of Health Care Services (DHCS) conducted a one-hour CBAS Providers Updates Webinar. The new CBAS Individual Plan of Care (IPC) form and Treatment Authorization Request (TAR) processing were highlighted.

DHCS webinar Powerpoint presentation (3/22/12)
DHCS Community-Based Adult Services (CBAS) / Adult Day Health Care (ADHC) Transition website
Individual Plan of Care (IPC) -- DHCS 0020 Form (Rev 01/2012)

 

CAADS Releases Issue Paper Critical of State's New Policy Requiring Non-Profit Status for CBAS Providers

March 13, 2013 - CAADS has published an analysis of the state’s new policy requiring CBAS providers to become non-profit entities, outlining the legal and logistical challenges that make implementation of this policy a maze of bureaucratic dead ends. CAADS recommends that the state take a different approach to avoid problems with reducing access to care and creating unnecessary state cost. The burdensome oversight of the exception process that the state proposes as a remedy to maintain access, merely adds to the uncertainty as the programs move into managed care. Penalizing two-thirds of existing providers based on their tax structure does not make sense when the vast majority of ADHC participants are found eligible for CBAS and require uninterrupted access to those very same for-profit centers. A better solution is one that relies on assuring compliance with the new Standards of Participation in the 1115 Waiver.

CAADS Issue Paper: New CDHCS Policy Requiring Current CBAS Providers to be Non-Profit Entities (3/13/2012, 9 pages).

 

Joint Oversight Hearing on Long-Term Care Integration and Medi-Cal Managed Care

March 7, 2012 - The Assembly Budget Subcommittee No. 1 on Health and Human Services and Assembly Committee on Aging and Long-Term Care held a joint oversight hearing on the Brown Administration’s proposal to expand the "Dual Eligible" demonstration project from four counties to as many as 10. Now referred to as the "Care Coordination Initiative," the project shifts seniors and persons with disabilities who are eligible for both Medicare and Medi-Cal from Medi-Cal fee-for-service to Medi-Cal managed care.

Video Part 1 (2h 52m) *Starts with CA's Clean Energy hearing; advance to 4m 32s mark and Video Part 2 (3h)

Handouts:
LAO Assessment of the Governor's Care Coordination Initiative (3/7/12)
Recent History of Adult Day Health Care and Transition of Seniors and Persons With Disabilities Into Managed Care (3/7/12)

 

California Department of Aging (CDA) Notice to All ADHC Providers

February 17, 2012 -- The CDA Notice to All ADHC Providers on ADHC Program Continuation, Community-Based Adult Services (CBAS) Program Implementation Delay, CBAS Provider Clarification, DHCS Press Release (2/17/2012), and Beneficiary Notice to be sent by DHCS.

CDA Notice 2/17/12: ADHC Program Continuation / Community-Based Adult Services (CBAS) Program Implementation Delay

 

STATE TO CONTINUE ADHC PROGRAM THROUGH MARCH

February 17, 2012 -- The California Department of Health Care Services issued a news release announcing that the ADHC program will be extended through March 31, 2012 to accommodate the federal government's request for additional time to process the proposal that will launch the Community-Based Adult Services (CBAS) program.

DHCS News Release 2/17/12: State to Continue ADHC Progam Through March

 

CDA PUBLISHES LIST OF APPROVED COMMUNITY-BASED ADULT SERVICES (CBAS) PROVIDERS

February 15, 2012 -- The California Department of Aging has approved 264 CBAS applications out of 275 submitted. Of the 275 applications submitted, 2 were denied, 4 were withdrawn, and 5 are pending completion. Of the 264 applications approved, 258 are centers that are currently open and operating. The list will be updated as pending applications are completed and processed.

CDA Notice 2/15/12: Approved CBAS Providers

 

CDA ISSUES CBAS PROVIDER UPDATES

February 13, 2012 -- The California Department of Aging issued CBAS Provider Updates to all ADHC Providers to announce that several documents have been posted to the DHCS website. Included are Frequently Asked Questions (February 2012), Medi-Cal Field Office Directory and Map, and revised PowerPoint slides from the CBAS Provider Webinar held February 10, 2012 to correct the telephone number individuals call to receive assistance regarding managed care enrollment.

CBAS Provider Updates (2/13/12)
Frequently Asked Questions (FAQ) (FEB 2012) Located under CBAS PROVIDER INFORMATION at: http://DHCS.ca.gov/ADHCtransition
Medi-Cal Field Office Directory and Map Located under CBAS BENEFICIARY INFORMATION at: http://DHCS.ca.gov/ADHCtransition
Corrected PowerPoint Slides for 2/10/12 CBAS Provider Webinar by DHCS Located under CBAS WEBINARS at: http://DHCS.ca.gov/ADHCtransition

 

PROVIDER BULLETIN ON CBAS POSTED ON MEDI-CAL NEWSROOM WEBSITE

February 3, 2013 - The California Department of Health Care Services has posted a Provider Bulletin on CBAS on the Medi-Cal Newsroom Website.

DHCS Notice 2/3/12: Provider Bulletin on CBAS Posted (http://files.medi-cal.ca.gov/pubsdoco/newsroom/newsroom_20285.asp)

 

LEGAL HELP FOR ADHC PROVIDERS SEEKING NONPROFIT STATUS

With the recent announcement by the California Department of Health Care Services that CBAS sites must be nonprofit organizations, many of the state's for-profit ADHC centers are facing significant financial implications and a tight timeframe to complete the process for obtaining nonprofit status. In response, CAADS has prepared a Preferred Attorney List which includes legal firms in membership with CAADS which have experience with establishing a nonprofit organization and have expressed interest in working with ADHC providers on this complex process.

Preferred Attorney List

 

FEDERAL COURT JUDGE APPROVES DARLING v. DOUGLAS SETTLEMENT

January 24, 2013 - Judge Saundra Brown Armstrong gave final approval to a settlement in the case of Darling v. Douglas. The settlement agreement between the seven plaintiffs who represent a class of 35,000 Adult Day Health Care (ADHC) patients throughout California and the California Department of Health Care Services will transition Medi-Cal patients out of ADHC and into a new Community-Based Adult Services (CBAS) program offered through Medi-Cal managed care plans on or after July 1, 2012. CBAS will offer center-based skilled health and nursing care, therapies, transportation and other services to eligible low income seniors and persons with disabilities.

 

COURT ORDER GRANTS PRELIMINARY APPROVAL OF DARLING v. DOUGLAS SETTLEMENT

December 14, 2011 - The United States District Court for the Northern District of California issued an order granting preliminary approval of the Darling v. Douglas settlement agreement, directing notice to the class, and setting a scheduling order and fairness hearing. Before final approval may be granted by the court, members of the class are to be notified and afforded an opportunity to object in writing, and/or appear at the Fairness Hearing which will take place on January 24, 2012. A copy of the notice to class members has been posted on the DHCS website at: http://www.dhcs.ca.gov/services/medi-cal/Pages/ADHCClassActionSettlement.aspx.

DHCS will mail the notice in English to all class members. Soon thereafter, notices in threshold languages will be mailed to participants and also posted to the DHCS website. Additionally, DHCS will fax copies of the class notice to all Adult Day Health Care Centers with instructions to post the notice in their centers.

Notice to Class Members (8 pages)
Court Order (70 pages).

 

DHCS PREPARES ADHC CENTERS FOR CBAS ELIGIBILITY ASSESSMENTS
Sacramento Region Training/Webinar DEC 13 | Los Angeles Region Training/Webinar DEC 14

December 2011 - The California Department of Health Care Services hosted trainings to prepare Adult Day Health Care (ADHC) center staff and State assessment teams for the face-to-face assessments that will get underway the week of December 19, 2011. The trainings were held in two areas of the state as well as by Webinar and provided an overview of ADHC / CBAS implementation, the ADHC model of care, and the eligibility assessment and CBAS eligibility level of care determination process.

 

ADHC SETTLEMENT AGREEMENT PROCESS MOVES FORWARD

December 1, 2011 - Disability Rights California filed the necessary legal documents to move forward with the settlement of the Darling v. Douglas case. On December 13, Plaintiffs and Defendants will jointly move for preliminary approval of the proposed Settlement Agreement. If the court approves the Class Notice, it will be sent to all ADHC participants on December 14.

On January 24, 2012, the court will conduct a Fairness Hearing as required for final approval of the settlement. In the meantime, Adult Day Health Care will continue as a Medi-Cal benfit under the State Plan Amendment to give the state and ADHC providers time to prepare for implementation of the new Community-Based Adult Services (CBAS) program which starts March 1, 2012.

Joint Notice of Motion and Motion for Preliminary Approval of Class Settlement Agreement and for an Order Directing Notice to the Class and Scheduling a Fairness Hearing; Memorandum of Points and Authorities in Support of Motion (Filed 12/1/2011)
Settlement Agreement (Filed 12/1/2011)
Proposed Notice to Class (Filed 12/1/2011).

 

CMS APPROVES CALIFORNIA'S REQUEST TO EXTEND ADHC BENEFIT TO MARCH 1, 2012

November 30, 2011 - The Centers for Medicare and Medicaid Services approved the state's request to extend the ADHC Medi-Cal benefit elimination from December 1, 2011 to March 1, 2012. This action allows the state the time needed to implement the new Community-Based Adult Services (CBAS) program.

CMS Approval Letter (11/30/2011).

 

SERVICES TO CONTINUE FOR ADHC PATIENTS AND FAMILIES!
Federal Court Settlement Reached in Darling v. Douglas Case

November 17, 2011 - Sacramento -- “Immense relief” and “joy” are the words that California Association for Adult Day Services Executive Director Lydia Missaelides uses to describe the sentiments of tens of thousands of elder, chronically ill and disabled patients after a major settlement was reached today in a lawsuit against the state brought on their behalf by Disabilities Rights California.

CAADS Media Statement (11/17/2011)
Disability Rights California Press Release (11/17/2011)
California Department of Health Care Services Press Release (11/17/2011)
Summary of Settlement Agreement (11/17/2011).

 

Hearing Postponed to Nov 17, in ADHC Elimination Case Darling v. Douglas

November 14, 2011 - Disability Rights California (DRC) and the California Department of Health Care Services (DHCS) have jointly requested that the preliminary injunction hearing, in the Darling v. Douglas ADHC benefit elimination case, be moved from November 15 to November 17, 2011. This brief court date postponement is necessary to enable the parties to finalize a settlement the details of which will be available on Thursday. For updates on the status of the hearing and any potential settlement, please check the following websites:

DRC: http://www.disabilityrightsca.org/advocacy/Darling-v-Douglas/index.html
CA DHCS: http://www.dhcs.ca.gov/services/medi-cal/Pages/ADHC/ADHC.aspx .

 

In Home Operations (IHO) Waiver

October 28, 2011 - Information on the level of care determination process for the IHO Waiver is now available under Webinars on the DHCS ADHC Transition website. ADHC providers are encouraged to carefully review the following materials and submit Initial Assessment Reports for patients likely to be eligible.

IHO Initial Assessment Report (16-pages, Rev 8/1/11) See DHCS website for fill-in version
Cover Sheet for ADHC Center Participant Initial Assessment Report (Rev 10/24/11) See DHCS website for fill-in version.
Presentation: LTC Division Eligibility Criteria for Nursing Facility B (NF-B) Level of Care (LOC) (Updated 10/25/11)
Excerpts from
Title 22. Social Security, Division 3. Health Care Services, Subdivision 1. California Medical Assistance Program (Refs & Annos), Chapter 3. Health Care Services, Article 2. Definitions, § 51124. Skilled Nursing Facility Level of Care and Article 4. Scope and Durantion of Benefits, § 51335. Skilled Nursing Facility Services.

 

How to Become a Home and Community-Based Waiver Service Provider

October 25, 2011 - CDA distribution of DHCS notice to All ADHC Centers (10/25/11).

 

Senate Committee Hearing on Administration's Transition Plan for ADHC -- Video Available

September 2, 2011 - The Senate Budget Subcommittee No. 3 on Health and Human Services, chaired by Mark DeSaulnier, pushed for details about the Administration's plan to transition ADHC patients into managed care health plans. Opening testimony by Health and Human Services Secretary Diana Dooley set the tone and confirmed ADHC patients, families and providers worst fears when she said, "We are not going to do more with less, we are going to do less with less."

DHCS Director Toby Douglas and other state department representatives testified about the transition plan and strategy, outreach plan, monitoring plan and alternate services, making it clear that managed care plans will not provide social services. Subcommittee members pushed for more details and answers about timeframes for key activities and expected cost overruns to the $85 million transition budget.

Testimony by ADHC providers challenged much of the information presented in testimony by state representatives and called into question why far more than $85 million is being spent to eliminate ADHC as a Medi-Cal benefit, when $85 million would have allowed for an "ADHC-like" waiver program matched with $85 million in federal funds. Cathy Davis, Executive Director of Bayview Hunters Point ADHC, summed it up in pointed and passionate testimony as she repeatedly said, "This just doesn't make any sense."

The hearing concluded with two major directives to the Administration, first to prepare a timeline with target dates for key activities, and second to develop a detailed projected budget for the ADHC transition, and provide both to the subcommittee for review.

Hearing Notes written by Adam Tavitian, Partners in Care Foundation

Video Part 1 and Video Part 2

Agenda
Part 1: Presentation of Administration's Transition Plan for Services
Testimony by:
Diana Dooley, California Health and Human Services Agency
Toby Douglas, Director, Department of Health Care Services
Eileen Carroll, Deputy Director of the Adult Programs Division, Department of Social Services
Ed Long, Deputy Director of Long-Term Care and Aging Services Division, Department of Aging

Part 2. Discussion and Comment on Administration's Transition Plan
Testimony by:
John F. Grgurina Jr., Chief Executive Officer, San Francisco Health Plan
Lydia Missaelides, Executive Director, California Association for Adult Day Services
Cathy Davis, Executive Director, Bayview Hunters Point Multipurpose Senior Services
David Friedman, Vice President State Health Programs, Health Net
Debbie Toth, Chief Program Officer, Rehabilitation Services of Northern California
Robert E. Edmonson, Chief Executive Officer, On Lok

Part 3. Public Testimony
Testimony by:
Judy Canterbury, MSN, CNP, RN
Maria Dodson, daughter and caregiver for her mother Beulah Perkins
Supervisor Provenza, Yolo County

 

If We Fail To Listen To The Population We Are Becoming

The following is a heartfelt letter by Jill Hanson, Assistant Social Worker, in response to a Fresno Bee article about the closure of St. Agnes Adult Day Health Care Center:

To whom it may concern,

I just wanted to write a note of thanks for writing the article on the closing of Saint Agnes Adult Day Care and the future closure of all other day cares in Fresno. I want to share my personal feelings on the closing of this institution. I and others have been proud employees of Saint Agnes Adult Day Care for 3 years, 5 years, 10 years, 19 years, and 22 years. I have loved wearing the badge and have felt comfort in what it represents. Read more.

 

CAADS Analyzes Inadequacies of ADHC "Transition Plan"

August 31, 2011 - Frail elders and their families across the state will soon feel the loss of Adult Day Health Care (ADHC) services in their communities. CAADS looked at the various alternatives referenced in the "Transition Plan," as well as the facts related to appropriateness, access and availability of these alternatives for current ADHC patients and their families, and issued An Analysis of the Inadequacies of the ADHC "Transition Plan."

An Analysis of the Inadequacies of the ADHC "Transition Plan" (15 pages)
A Brief of the Analysis (2 pages)

 

DHCS Webinar On Eligibility For In-Home Operations Waiver Will Include
Discussion of Beneficiary Notices, What Patients Are Asked To Do

August 31, 2011 - ADHC program directors will want to register for this Webinar now that the agenda includes a discussion of beneficiary notices and what patients are asked to do. Registered Nurses employed by Adult Day Health Care centers and Medi-Cal Home and Community-Based Services waiver providers are reminded to register to learn how individuals are assessed for Nursing Facility B Level of Care to assist ADHC participants meet eligibility for the In-Home Operations Waiver. View Webinar notice and materials at: http://DHCS.ca.gov/ADHCtransition.

 

DHCS Director Asked To Extend ADHC Medi-Cal Benefit to 3/31/2012

August 24, 2011 - In a letter from Assembly Member Mariko Yamada and other legislators, DHCS Director Toby Douglas was asked to exercise his authority to extend the Adult Day Health Care benefit to allow the Legislature to review the transition plan, assess proper notification compliance, ensure availability of replacement services and allow for uninterrupted delivery of those services.

Letter from Assembly Member Mariko Yamada and others (8/24/11)
Sign-on List

 

State Develops ADHC Transition Outreach and Monitoring Plans

August 23, 2011 - As directed by the Assembly Committee on Aging and Long-Term Care at its hearing on August 16, the Department of Health Care Services has develop and submitted two plans to the Legislature:

Outreach Plan for educational outreach to patients and ADHC providers (8/23/2011)
Monitoring Plan to track outcomes for ADHC patients and total costs (8/23/2011)

 

Hearing Conducted by Assembly Committee on Aging and Long-Term Care
Cost and Consequences: Elimination of the Adult Day Health Care Optional Benefit

8/18/2011
August 16, 2011 - The Assembly Committee on Aging and Long-Term Care, chaired by Mariko Yamada, probed for the truth about the cost and consequences of elimination of the ADHC optional benefit for 37,000 chronically ill and disabled adults. The testimony was revealing and alarming. Questions from Assembly members sought specifics about the DHCS ADHC Transition Plan, and how this medically fragile and linguistically diverse population would be able to understand the complexities of Managed Care Plans and their options. In addition, the committee was concerned about what happens to ADHC patients after their benefit ends on December 1, and the cost comparisons between ADHC services and "alternative" services. The committee directed Toby Douglas, DHCS Director, to develop a detailed plan for educational outreach to patients and ADHC providers, track outcomes for ADHC patients and total costs, and provide reports to the Legislature.

Video Part 1 and Video Part 2

Agenda
Part I: Overview of Adult Day Health Care (ADHC) in California
Background Information
Background, Issues, Other
AB 96 Veto/Chapter Summary
AB 96 Letter of Support from Norco Fire Department
Initial Input from Multipurpose Senior Services Program Site Directors
Adult Day Health Care (ADHC) Benefit Timeline (Updated August 5, 2011)
Testimony by:
Lydia Missaelides, Executive Director, California Association for Adult Day Services

Part II: California Department of Health Care Services, Director's Presentation
Testimony by:
Toby Douglas, Director, California Department of Health Care Services
California State Plan Amendment 11-026 Approval Letter from CMS (7/21/2011)
Department of Health Care Services Adult Day Health Care (ADHC) Transition Plan (8/5/2011)

Part III: Legal Update
Testimony by:
Elissa Gershon, Senior Attorney, Disability Rights California
Motion for Preliminary Injunction (6/9/2011)

Part IV: ADHC Stakeholders: Consumers and Administrators
Testimony by:
Dawn Myers Purkey, Yolo Adult Day Health Care Center
Paul Heyn, Consumer, Robertson's Adult Day Health Care Center
Tracy McCloud, Director of ADHC, Institute on Aging

Part V: Community Stakeholders
Testimony by:
Dr. Calvin Hirsch, MD, Professor of Clinical Internal Medicine, UCDHS
Anne Hinton, Executive Director, Department of Aging and Adult Services-San Francisco
Tony Anderson, Executive Director, The Arc of California
Kristie Hernandez, Policy Analyst, AltaMed Health Services
Marcelo (Nunie) Matta, Consumer, Yolo Adult Day Health Center

 


Photo Montage by Capitol Public Radio

 

DHCS Held Second ADHC Stakeholders Meeting August 9

August 9, 2011 - The California Department of Health Care Services held a second ADHC Stakeholders Meeting on Tuesday, August 9, 2011 from 1:30 to 3:30 PM, to present their strategy and plan for transitioning patients out of Medi-Cal ADHC and into managed care plans. Comments and questions from those attending in person and by telephone focused on the state's lack of knowledge abut the need for hands-on, eyes-on protective supervision and medical care for the poor elderly, chronically ill and disabled adults served by Medi-Cal ADHC, and references to meetings with certain stakeholder groups that had not occured. An audio recording of the meeting will be posted as soon as it is available.

DHCS Transition Strategy and Plan (Revised 8/5/2011)

 

"UNKINDEST CUTS: THE DE-FUNDING OF CALIFORNIA'S ADULT DAY CARE PROGRAM"

August 8, 2011 - City Visions Radio host Joseph Pace and his guests discussed the state's elimination of the Adult Day Health Care (ADHC) Medi-Cal benefit, and what that says about the future of community-based healthcare for California's poor, chronically ill and disabled adults. Featured guests: Assemblymember Mariko Yamada, Chair of the Assembly's Aging and Long-Term Care Committee; Micheal Pope, Executive Director of Alzheimer's Services of the East Bay; and Elizabeth Zirker, Staff Attorney with Disability Rights California.

Link to PodCast

 

Governor's Veto of AB 96 Seen As Insensitive and Fiscally Irresponsible

July 25, 2011 - Governor Brown vetoed AB 96, the bill that would have allowed roughly one-half of the 300 ADHC centers to continue providing services under a new federally approved replacement program called Keeping Adults Free from Institutions (KAFI). In response, CAADS executive director Lydia Missaelides issued a media statement calling it a sad day for the elderly and disabled patients and their families who rely on Adult Day Health Care (ADHC) to remain living at home and out of high-cost institutionalized care.

Governor Brown's veto message: AB 96
CAADS media statement (7/25/11)

 

Governor Signs SB 91 Allowing ADHCs To Do Business After Medi-Cal Benefit Expires

July 25, 2011 - In the same message in which Governor Brown vetoed AB 96, the Keeping Adults Free from Institutions (KAFI) program, he indicated he had signed SB 91, a separate bill allowing ADHC centers to continue operating after the Medi-Cal benefit and provider payments expire on December 1, 2011 by de-linking Medi-Cal certification from facility licensing.

Governor Brown's veto message: AB 96

 

What Did California's Legislative Leaders Intend for ADHC?

That Adult Day Health Care providers are not going to close their doors, instead, they will have a new way of operating -- sort of an ADHC-2.

March 31, 2011 - View the March 31, 2011 Budget Conference Committee proceedings as regards the future of ADHC.

Video: 3/31/11 Budget Conference Committee

 

ADHC Medi-Cal Elimination Date Extended to DEC 1, 2011

July 21, 2011 - The State of California received approval from CMS to extend the elimination date of the ADHC Medi-Cal benefit from SEP 1, 2011 to DEC 1, 2011. Concurrently, the state submitted a request to the court to postpone the hearing in the Darling v. Douglas case scheduled for July 26, 2011 in Oakland.

SPA Approval Letter from CMS to DHCS dated 7/21/2011
Toby Douglas, DHCS Letter to Members of the California State Legislature dated 7/14/2011

 

CMS Approves State Plan Amendment to Eliminate ADHC as a Medi-Cal Benefit Effective SEPT 1

July 1, 2011 - In a letter dated July 1, 2011, the Centers for Medicare & Medicaid Services (CMS) approved California's State Plan Amendment to eliminate ADHC as a Medi-Cal Benefit effective September 1, 2011.

SPA approval letter (7/1/11)

 

California Department of Health Care Services Issues Final ADHC Transition Plan and Draft Community Services Resource Guide

July 1, 2011 - The California Department of Health Care Services (DHCS) publicly released its final ADHC Transition Plan, and a draft Community Services Resource Guide for Los Angeles City.

ADHC Transition Plan (June 2011)
Draft Community Services Resource Guide for Los Angeles City (June 2011)

 

U.S. Senators Dianne Feinstein and Barbara Boxer Send Letter Expressing Support for ADHC Transition to U.S. Health and Human Services Secretary Kathleen Sebelius

June 29, 2011 - Letter of Support

 

DHCS Announces New ADHC Transition Website and Email Address

June 6, 2011 - The California Department of Health Care Services (DHCS) announced the launch of their ADHC Transition website and email address.

Transition information will be posted to http://www.dhcs.ca.gov/services/medi-cal/Pages/ADHC/ADHC.aspx as it is available.

Comments about the transition now may be emailed to: adhc-transition@dhcs.ca.gov.

 

Assembly Aging and Long Term Care Committee Held Oversight Hearing

May 17, 2011 - The Assembly Aging and Long Term Care Committee, chaired by Assembly Member Mariko Yamada, held an oversight hearing titled, "What is California's Plan for Home and Community Based Choices and What Are the Choices?" on May 17, 2011 at the State Capitol. The state's watchdog Little Hoover Commission provided an overview of their recently released report titled, "A Long Term Strategy for Long Term Care."

Oversight Hearing Video Part 1 and Video Part 2.

 

DHCS ADHC Stakeholders Meeting

May 13, 2011 - A 90 minute public stakeholders meeting was held in in Sacramento and via a webinar. The purpose of the meeting was to review high level service data, present an initial framework for elimination of Adult Day Health Care (ADHC) as a Medi-Cal Optional State Plan benefit, and outline the process for transitioning ADHC patients to other services. More than 290 individuals participated by webinar and approximately 50 attended in person. The somber audience applauded the emotional and articulate remarks made by long time respected providers who challenged the assumptions of the department and portrayed the true human consequences of eliminating ADHC without hope of a redesigned program under a federal waiver. Attendees were disappointed by the absence of a transition plan and the lack of timeframes.

Meeting Handout from May 13, 2011 DHCS Transition Planning Stakeholders Meeting in Sacramento and via webinar
Recording of May 13, 2011 DHCS Transition Planning Stakeholders Meeting in Sacramento and via webinar:

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

On June 6, 2011 the transcript of the 90 minute public stakeholders meeting held May 13, 2011 in Sacramento and via webinar was made available to CAADS.

Transcript of May 13, 2011 Meeting

On June 1, 2011 the California Department of Health Care Services (DHCS) issued responses to questions from the stakeholders meeting.

DHCS responses to attendee questions (Updated as questions are received)
DHCS answers to CAADS questions.

DHCS also announced that the State Plan Amendment (SPA) to eliminate ADHC as a Medi-Cal benefit had been sumitted to CMS on May 12, 2011.

State Plan Amendment (SPA) Documents:
May 12, 2011 DHCS Cover Letter
Limitations on Attachment 3 1-A page 19
Limitations on Attachment 3 1-B page 19
Attachment 4 19-B pg 6C - 6D
Attachment 4 19-B Supplement 6 page 2
HCFA-179 SPA 11-014
Final Notice to Indian Health Programs

 

CAADS Submits Letter to CMS Detailing Concerns About ADHC Elimination

May 11, 2011 - CAADS submitted a 7-page letter to CMS describing the serious consequences associated with elimination of the ADHC Medi-Cal benefit for 37,000 patients with medically complex disabling conditions. CAADS urged CMS to carefully consider the health and safety of the individuals currently in the care of ADHC centers, should the complete termination of the ADHC benefit occur without an orderly transition to other services or a redesigned ADHC program.

CAADS letter to CMS (5/11/11)

 

New Report on KAFI Program

May 10, 2011 - AARP released a new report outlining California’s policy options in designing the KAFI program described in AB 96, the health trailer bill enacted in March 2011, as the Legislature’s intent to recast the ADHC program under a federal waiver. Authored by Health Management Associates, the May 10, 2011 report describes the possible waivers, state plan amendments, and combinations of options that the state may wish to consider as the legislation authoring KAFI moves forward.

AARP Report (May 2011) Keeping Adults Free from Institutions (KAFI): Medicaid Options to Guide Program Design

 


 

 


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