sr-112211-13c13 -C
November 22, 2011
CITY CLERK'S OFFICE - MEMORANDUM
To: City Council
From: Mayor Bloom, Councilmember O'Connor and Councilmember McKeown
Date: November 22, 2011
13 -C: Request from Mayor Bloom, Councilmembers Pam O'Connor and Kevin
McKeown that the City Council oppose state budget cuts to physical,
mental health therapeutic care and social services for frail seniors and
adults and other Medi -Cal recipients including the elimination of the Adult
Day Health Care (ADHC) program and advocate that the State legislature
continue to explore alternatives to eliminating the ADHC program,
including the California Association for Adult Day Services' (CAADS)
proposal to reduce ADHC without having to eliminate the program.
13 -C
November 22, 2011
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P-00 v si. A, i- l
RES0I UT ION ��.
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WHEREAS, any official position of the City of Los Angeles with respect to legislation,
rules, regulations or policies proposed to or, pending before a local state: or federal governmental
body or, agency must have first been adopted in the 'form of a Resolution by the City Cojjiiujj with
the conounenco of the Mayor; and
WHEREAS, the State of California's legislature is currently determining the necessary
budget cuts to lessen the State's $28 billion deficit; and
WHEREAS, the governor has proposed to save $500 mullion by reducing and /or
eliminating programs %r low - income seniors, disabled people mud other Medl -Cal rocipieats;
filduding the e1lmhzatiou of the Adult Day Health Care (ADI-IC!) program; and
WHE.REAS,.Medl -Claps ADHC Program is a licensed. community- basod:day care
programproviding,a varietyofhealth, therapeutic, and social seivices to those'at -risk of being:
placed in a nursing home; and
WHEREAS, the ADHC program is used by approximately 37,000 elderly State residents
who, ifhospitalized, could create a larger burden on the State's taxpayers; and
WHEREAS, it has been reported that Los Angeles County ADHC centers, which
received over 30,000 visits in 2009, will be, the most affected county in the State; and
WHEUAS, the City's families will be greatly affected if the ADHC programs are
eliminated and their loved ones must. survive with less care and assistance; and
WilEREAS,the State legislature should continue tea explore alternatives to e1tmrnat4ng
the ADTIC progra n, 'including the California Association for Adult Day Services" (CAADS)
proposal to reduce ADKC without having to eliminate the program;
NOW, TtILRFFORB, BE IT RESOLVED, that by the adoption of this Resolution, the
City of Loos Angeles, hereby includes in its 2011-2012 State Legislative Program OPPOSITION
to any reductions in the State's, Adult Day Health Care (ADHC:) program and /or any other''State
prograin,5:that would negatively' ffeet the elderly population,
PRESENTED Y:
Counciinerdber, 14 11e District
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S,ECONUEU:BX; 144
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WESTSIDE CITIES
' BEVERLY HILLS
' CULVER CITY
' LOS ANGELES
' SANTA MONICA
' WEST HOLLYWOOD
' COUNTY OF LOS ANGELES
DATE: NOVEMBER 17, 2011
TO: WESTSIDE CITIES COUNCIL OF GOVERNMENTS BOARD
FROM: MARIA RYCHLICKI, EXECUTIVE DIRECTOR
SUBJECT: ADULT DAY HEALTH CARE FUNDING CUTS UPDATE
PROPOSED ACTION: CONSIDER REPORT AND POSSIBLY TAKE
RELATED ACTIONS
INTRODUCTION
Adult Day Health Care ( "ADHC ") is a licensed, community -based day care program
providing a variety of activities and physical and mental health therapeutic care and
social services to frail seniors and adults — some of whom have disabilities - who are at
risk of being placed in nursing homes or other institutional facilities. The Fiscal Year
2011 -12 State Budget will eliminate the ADHC as a Medi -Cal plan optional benefit as of
December 1, 2011.
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BACKGROUND
Currently over 300 centers exist throughout the State of California and, in Los Angeles
County alone, there are 166 licensed centers caring for 23,000 participants. In the
County's Third District (Supervisor Yaroslaysky) there are 62 centers.
At the COG's Homelessness and Social Services Issues October 20, 2011 meeting,
information on this important issue was provided by Lorenza Sanchez, Assistant
Director of Los Angeles County Aging and Adult Services /Area Agency on Aging, and
Nina Nolcox, R.N., Vice President of the California Association of Adult Day Care
Services and Administrator of an Adult Day Care Center.
The primary objectives of the ADHC program are to: a) restore or maintain optimal
capacity for self -care to frail, elderly and /or disabled persons; and, b) delay or prevent
inappropriate or personally undesirable institutionalization. Without these ADHC
services, participants would need other, more expensive alternatives such as skilled
nursing, in- patient mental health and emergency facilities. The ADHC centers have
been providing these services for 30 years, on an interdisciplinary team basis,
connecting seniors and disabled clients with other essential services. The cost is $76
per day, half of which is paid for by Medi -Cal and the other by federal funds. Each
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participant has a specialized care program. approved by the State and attends the
centers from two to five times a week.
Participants in the In -Home Supportive Services have been notified of the above
funding cuts and will be provided with needs assessments: What is unknown is when
and if the remaining ADHC participants will be notified and whether they will receive any
alternate care. To date, the County has received very few calls from centers or
participants on this issue.
It is anticipated that the gap in services for ADHC participants and families will have a
local impact resulting in increased 9 -1 -1 calls, increased emergency room. visits,
increased placement of older adults and persons with disabilities in nursing homes,
increased Adult Protective Services investigations, increased demand for In -Home
Supportive Services and an increase in need for health and mental health services.
Unemployment will also rise as ADHC employees are laid -off and family caregivers are
forced to provide direct care and supervision for their family members.
Los Angeles County and City Area Agency on Aging have formed an ADHC taskforce,
comprised of several County departments, to obtain data on the ADHC population,
evaluate their needs and services, identify the most vulnerable and develop outreach
and education plans to ensure ADHC participants' smooth transition into the County's
network of services.
In June 2011,. legal documents were filed requesting that a federal district court in
Oakland stop the State of California from eliminating Adult Day Health Care as a Medi-
Cal service because it would be a violation of the Americans with Disabilities Act (ADA)
and other federal laws unless the State can prove that the elimination will not cause
those impacted to be harmed or unnecessarily placed in nursing facilities or hospitals.
The hearing scheduled for November 8, 2011 was moved to November 15, 2011.
NEXT STEPS
Staff will continue to monitor the issue. It has been suggested that, should the COG
wish to contact any legislators about this issue, they should contact Senators Yamada
and Ted Lew rather than Governor Brown.
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