California Healthline: Long-Term Care

Humboldt County Senior Group Nabs Settlement Funds

Wed, 30 May 2012 08:00:00 GMT

The Area 1 Agency on Aging in Humboldt County will receive $198,078 under a 2010 settlement in a class-action lawsuit against nursing home chain Skilled Healthcare for allegedly failing to provide sufficient staffing levels for patients at 22 facilities, including five in Humboldt County. A1AA Programs Director Todd Metcalf said the funds will help expand the agency's caregiver training sessions, senior information and assistance counseling and volunteer driver transportation assistance to medical appointments. Eureka Times-Standard.

CalPERS Must Offer Long-Term Care to Same-Sex Couples, Judge Rules

Tue, 29 May 2012 08:00:00 GMT

A federal judge has ruled that CalPERS must give state workers' same-sex spouses or domestic partners access to a long-term care insurance plan. Experts say that more than 2,900 state workers in same-sex relationships have sought such coverage. Sacramento Bee et al.

Costs in New Adult Day Program Almost Same as Old One

Thu, 24 May 2012 08:00:00 GMT

The state's rallying cry when it first wanted to eliminate adult day health care as a Medi-Cal benefit was that it would save money. Now, after more than a year of battles at the Capitol and in court, the budget for the new Community-Based Adult Services program looks pretty similar to the ADHC budget that it replaced.

Calif. Veterans Express Frustration Over Claims Processing Backlog

Tue, 22 May 2012 08:00:00 GMT

At a recent forum, veterans highlighted claims processing problems at the Department of Veterans Affairs' Oakland office. It takes the office an average of 320 days to process disability claims, and nearly 40% of disability claims were processed incorrectly, according to an audit. Los Angeles Times.

Slower, Phase-In Approach for CBAS

Mon, 21 May 2012 08:00:00 GMT

The Department of Health Care Services has announced the conversion of adult day health care centers to a managed care system has been divided into a two-part process.

About 12% of the centers, which serve about 8% of the state's ADHC population, will still make the conversion to managed care by July 1. That leaves the bulk of the centers -- including Los Angeles County centers which serve two-thirds of the state's Medi-Cal beneficiariens receiving ADHC care -- to make the transition three months later, on Oct. 1.

"It was really welcome news," said Lydia Missaelides, executive director of the California Association of Adult Day Services. "It was clear nobody was ready yet. I think the Department [of Health Care Services] has been listening to stakeholders. I was really relieved. Not that October is so far away, but this is definitely good news."

Calif.'s Nursing Homes Face Deep Medicare Payment Cuts

Thu, 17 May 2012 08:00:00 GMT

In early 2013, California's skilled nursing facilities could face Medicare payment cuts totaling $75.9 million -- the largest amount of cuts among all states -- if Congress fails to overcome an ongoing budget stalemate, according to a recent study commissioned by the Alliance for Quality Nursing Home Care. Those cuts would come on top of a state proposal to rescind a recent payment hike to close California's $16 billion budget deficit. Payers & Providers.

Obama Administration Unveils Plan To Combat Alzheimer's Disease

Tue, 15 May 2012 08:00:00 GMT

The Obama administration has announced a plan aimed at finding an effective way to treat and prevent Alzheimer's disease by 2025. Officials also launched a website offering information for families and caregivers of people with Alzheimer's disease. AP/San Francisco Chronicle et al.

Disability Rights Withdraws Contempt Filing -- For Now

Wed, 09 May 2012 08:00:00 GMT

A contempt-of-court motion filed against the Department of Health Care Services was recently withdrawn by Disability Rights California, though adult day health care advocates said they might re-file later.

"We still think we're right and the department is wrong," said Elissa Gershon, a senior attorney at Disability Rights California. "But once we began having discussions, it became clear it wasn't something that was as appropriate to bring before a federal judge."

There were two main sticking points in the contempt filing, one of which has been worked out, Gershon said.

Will FQHCs Get Lower Adult Health Rate?

Tue, 08 May 2012 08:00:00 GMT

A federal judge last week heard arguments for and against issuing a temporary restraining order against the state's plan to reduce payments for adult day health services. The California Primary Care Association filed suit on behalf of federally qualified health centers.

U.S. District Court judge James Ware heard the case last week. He has 30 days to issue a ruling.

In a similar case last month filed by the Adult Day Health Care Association, a federal judge declined to issue a preliminary injunction against the state and upheld the Department of Health Care Services' plan to set new rates for day service providers in the recently launched Community Based Adult Services program.

Risks, Rewards Higher for Managing Dual Eligibles

Mon, 07 May 2012 08:00:00 GMT

California health plan officials say the experience of shifting seniors and persons with disabilities into Medi-Cal managed care plans over the past year will help as the state moves dual eligibles -- beneficiaries of both Medicare and Medi-Cal -- into managed care this year.

Opposition to Ombudsman Bill Evaporates

Fri, 04 May 2012 08:00:00 GMT

Joe Rodrigues, the State Long-Term Care Ombudsman, has removed his opposition to SB 345 by Lois Wolk (D-Davis), a Senate bill designed to reform the ombudsman's office.

Rodrigues said the bill authors made a number of amendments to the measure. He now supports the bill presented at a legislative committee hearing earlier this week.

"We were able to work with them on coming to some agreements that will benefit the program and strengthen the [ombudsman's] office," Rodrigues said. "It made some of the good things to do in the bill less burdensome, such as the advisory council and the annual report. The bill looks very different today than it was a year and a half ago when it was first introduced."

Bill for New Nursing Home Model Advances in Senate

Tue, 01 May 2012 08:00:00 GMT

The Senate Appropriations Committee will consider a bill, by Sen. Elaine Alquist, that would establish a licensing category for a new nursing home model, known as the "Green House Project." The model focuses on creating smaller, home-like facilities with a maximum of 10 residents. The Senate Health Committee approved the measure last week. KPCC's "KPCC News."

Successful Program for Seniors Shifting to Managed Care

Thu, 26 Apr 2012 08:00:00 GMT

The Multipurpose Senior Services Program, considered an important component of the state's safety net for some of California's most frail seniors, is about to be folded into the larger managed care system. Some beneficiaries and advocates are concerned about what the shift will mean for services.

Senate Committee Approves New Type of Nursing Home

Thu, 26 Apr 2012 08:00:00 GMT

A new idea elbowed its way into the familiar pile of health care legislation in the Senate Committee on Health yesterday. A nursing home model -- the "Green House Project" -- bucks the cold, institutional feel of many long-term care facilities.

"SB 1228 is a transformative bill that will eliminate red tape and save money. It is a revolutionary model of care," Senate member Elaine Alquist (D-San Jose) said, presenting her bill to the committee yesterday.

"It puts the 'home' back into nursing home," Alquist said.

Three Bills Aim To Change Nursing Home Care

Mon, 23 Apr 2012 08:00:00 GMT

The Assembly Committee on Health last week approved two bills to alter nursing home care in California and it will hear a third one this week.

AB 1752 by Mariko Yamada (D-Davis), expected to be heard in tomorrow's health committee hearing, is called the Nursing Facility Bed Hold Protection Act of 2012. It would require the Department of Health Care Services to penalize facilities for refusal to readmit a patient on appeal.

The Assembly health committee passed two other nursing home-related bills last week, also authored by Yamada.

Many Medi-Cal Caregivers Are Low-Income, Report Finds

Tue, 17 Apr 2012 08:00:00 GMT

More than 50% of California's long-term caregivers who are paid by Medi-Cal to aid low-income seniors and residents with disabilities are living in poverty or close to living in poverty, according to a new report by the UCLA Center for Health Policy Research. Capitol Public Radio's "KXJZ News."

HHS OIG Report Finds Gaps in Nursing Home Disaster Plans

Tue, 17 Apr 2012 08:00:00 GMT

Nursing homes across the country are not adequately prepared to protect residents and provide continuing care during a natural disaster, according to a report from the HHS Office of the Inspector General. The report recommends that Medicare and Medicaid add specific emergency planning and training requirements to federal regulations on disaster preparedness for nursing homes. U-T San Diego.

State Wins Case to Cut Adult Day Provider Rates

Tue, 17 Apr 2012 08:00:00 GMT

After four similar cases went against the state in the past few months, the Department of Health Care Services won in court late Friday, when a federal judge refused to issue a preliminary injunction against Medi-Cal cutbacks.

The lawsuit, brought by the Adult Day Health Care Association, challenged the department's plan to cut Medi-Cal provider rates by 10%. Judges in four other cases issued preliminary injunctions halting those cuts, including suits brought by the California Medical Association and the California Hospital Association.

The difference in this case, according to DHCS spokesman Norman Williams, lies in a previous settlement of another case over the state's adult day health services. That settlement prompted the creation of a replacement program, Community-Based Adult Services, and included an agreement that covered the lower rates.

Lawmakers To Hold Slew of Hearings on Expiring Health Care Policies

Mon, 16 Apr 2012 08:00:00 GMT

Today, Congress returned from recess to a series of hearings aimed at addressing expiring health care policies. Lawmakers will examine an update to prescription drug and medical device user fees, medical malpractice legislation and other issues. The Hill's "Healthwatch."

Brown's Proposed Cuts to IHSS Would Affect 254K Residents

Wed, 11 Apr 2012 08:00:00 GMT

Gov. Brown's proposal to cut state spending on In-Home Supportive Services by $207 million would affect about 254,000 beneficiaries statewide and would result in a loss of $424 million in county and federal funding, for a total reduction of $631 million, according to a new California Budget Project report. Sacramento Business Journal.

Medi-Cal Cuts Face Another Preliminary Injunction

Mon, 09 Apr 2012 08:00:00 GMT

The Department of Health Care Services has been on the losing end so far of four court cases over the 10% cut in Medi-Cal provider rates. In each of the four cases, preliminary injunctions were granted to halt the cuts from specific provider groups, such as emergency transport, hospitals, pharmacies, physicians and dentists.

Now it's adult day service providers' turn for a judicial ruling.

A decision is expected today from federal judge Christina Snyder on a request for another preliminary injunction. This one is from adult day health providers who worked under the Adult Day Health Care program before it was terminated and replaced by the Community Based Adult Services program, or CBAS.

San Diego Seeks Ways To Manage Frequent Users of Emergency Services

Wed, 04 Apr 2012 08:00:00 GMT

San Diego officials are working to address the frequent use of emergency services by a largely homeless population. According to experts, frequent emergency service users need access to better coordinated health care and more permanent housing options. U-T San Diego.

New Adult Program Launches With a Few Issues Still To Be Resolved

Tue, 03 Apr 2012 08:00:00 GMT

It was January 2011 when the governor first red-lined the Adult Day Health Care program for elimination as a Medi-Cal benefit. Since then, it has been rescued, cut in half, eliminated altogether, reinstated and replaced.

Yesterday the replacement program, Community Based Adult Services, went into effect. For about 32,000 former beneficiaries of ADHC, the changeover will go relatively unnoticed. Most of the currently open centers are expected to remain open, and CBAS benefits are similar to those in the now extinct ADHC program.

"It's a culmination of months of hard work, developing a program that's appropriate and useful for former ADHC participants," Norman Williams of the Department of Health Care Services said. "We had a goal of a program that would allow people to remain independent and living in the community."

Out With ADHC, In With CBAS

Mon, 02 Apr 2012 08:00:00 GMT

The CBAS era has officially begun.

Late Friday night, CMS approved implementation of the Community Based Adult Services program. That means the state has successfully eliminated adult day health care as a Medi-Cal benefit, and is replacing it with CBAS, starting today.

According to officials from the Department of Health Care Services, almost 32,000 of the nearly 40,000 ADHC beneficiaries have been deemed eligible for CBAS. That's more than 80% of the ADHC population.

State: DHCS Contempt Motion Won't Delay New Program Launch

Fri, 30 Mar 2012 08:00:00 GMT

Attorneys gathered in U.S. District Court yesterday morning to argue whether or not the state Department of Health Care Services should be found in contempt of court for its handling of the adult day health transition.

That argument will wait a week, at least. After meeting two hours yesterday, the two sides agreed to delay court proceedings.

"At this point the parties have been working on a possible solution. We hope to have a decision by next Friday," Disability Rights California attorney Elissa Gershon told the federal magistrate hearing the case.

Merced VA Clinic Seeks To Treat More Area Veterans

Wed, 28 Mar 2012 08:00:00 GMT

Officials with the Veterans Affairs Central California Health Care System's Merced Outpatient Clinic are trying to encourage more veterans in Merced County to seek health care at the clinic. An estimated 12,000 veterans live in the county, but the clinic serves only about 2,800 veterans. Merced Sun-Star.

Advocates File Contempt Motion Against State

Mon, 26 Mar 2012 08:00:00 GMT

The settlement now is officially unsettled.

Disability Rights California, which filed and then settled a lawsuit challenging the transition of adult day health care by the Department of Health Care Services, now has filed a contempt motion saying that DHCS officials have not been following the terms of the agreement.

That settlement prompted the state's creation of the Community Based Adult Services program, due to launch Sunday, the day after ADHC is eliminated as a Medi-Cal benefit.

Report: Many Californians With Dementia Live Alone

Tue, 20 Mar 2012 08:00:00 GMT

According to a recent Alzheimer's Association report, more than 800,000 U.S. residents with dementia live alone, including about 72,000 in California. Experts say those numbers are expected to increase dramatically as the baby boom generation ages. Sacramento Bee.

LAO Notes Possible Challenges for Gov. Brown's Proposed IHSS Cuts

Tue, 20 Mar 2012 08:00:00 GMT

The Legislative Analyst's Office says cuts proposed by Gov. Brown for In-Home Supportive Services could face legal challenges and be difficult to implement. LAO is offering alternative cost-saving proposals. HealthyCal, Sacramento Bee's "Capitol Alert."

Institute of Aging Hotline Aids Seniors With Mental Issues

Tue, 20 Mar 2012 08:00:00 GMT

In 2011, California's Friendship Line -- a 24-hour telephone hotline run by the Institute of Aging -- received about 18,000 phone calls and made 40,000 calls to assist seniors. Operators make calls to remind seniors to take their medications or offer support for those with mental health issues. The hotline, which also aims to reduce the rate of suicide among seniors, recently secured funding from the California Mental Health Services Authority to expand its presence in the state. HealthyCal.

Who Cares for the Caregivers?

Wed, 14 Mar 2012 08:00:00 GMT

Caregivers make up a sizable volunteer workforce in California -- people who put in about 1.7 billion hours of care last year and didn't get paid for it. If they did, all of that work is valued at more than $20 billion. In California, where more than 10,000 people turn 65 every day, the need for that workforce will only grow.

That's according to a raft of testimony yesterday at the Capitol Building in Sacramento, before a joint hearing of two committees: Human Services and Aging and Long-Term Care.

The state doesn't do much for this vast and contributing population, and is about to do even less, according to Michelle Pope, executive director for Alzheimer's Services of the East Bay, who testified yesterday before the joint committee.

Proposed Budget Cuts Could Affect 12,000 Caregivers Statewide

Tue, 13 Mar 2012 08:00:00 GMT

Nearly 12,000 caregivers could be affected by Gov. Brown's proposed budget, which would cut $2.9 million in state funds from caregiver resource centers. If the cuts are enacted, some of the centers might have to close or reduce services, according to caregiver advocates. HealthyCal.

Opinion Piece Slams Cuts to Services for Elderly, Disabled

Mon, 12 Mar 2012 08:00:00 GMT

In an opinion piece, Jonathan Glidden -- a retired attorney who was an aide to former state Sens. Rebecca Morgan and Tom Campbell -- and Nicki Pecchenino -- a former campaign consultant and chief of staff to Santa Cruz County Supervisor Robley Levy -- criticize Gov. Brown's proposed cuts to In-Home Supportive Services. They write, "The proposed savings of $1 billion may soon appear to be a poor bargain," adding, "The taxpayers of California will merely put money back into one pocket and take even more out of another, and everyone will then be the worse off for the bargain." Santa Cruz Sentinel.

More People May Be Eligible for Adult Day Services

Thu, 08 Mar 2012 08:00:00 GMT

There was a glimmer of good news for the 35,000 adult day health care Medi-Cal patients in California. It looks like a much higher percentage of them than previously estimated will be eligible to receive the new benefit called Community Based Adult Services.

Department of Health Care Services Director Toby Douglas originally said he expected about 50% of current ADHC patients to qualify for the new program. ADHC will be eliminated as a Medi-Cal benefit on Mar. 31 and the CBAS program starts Apr. 1.

Now it looks like 70% to 80% of those receiving the ADHC benefit will qualify for CBAS, according to Catherine Blakemore, executive director of Disability Rights California, which is monitoring the state's assessment and placement of ADHC patients.

Concerns Raised Over Adult Day Health Care Transition, Assessments

Tue, 28 Feb 2012 08:00:00 GMT

It has been a long, bumpy road in the state's effort to eliminate adult day health care services as a Medi-Cal benefit. Now, on the brink of launching a new program to provide similar services, there are fresh concerns about how the state is deciding eligibility.

From Supreme Court to Appeals Court

Thu, 23 Feb 2012 08:00:00 GMT

Yesterday's decision by the U.S. Supreme Court had a ripple effect in California, influencing a number of lawsuits in the state over health care cuts.

Four lawsuits have been filed over the 10% Medi-Cal provider rate cuts, and in all four cases, a federal judge has issued a temporary injunction blocking those cuts. In another court case, an injunction halted 20% trigger cuts to Californians receiving In-Home Supportive Services.

All of those cases were waiting to see what the Supreme Court would decide in Douglas v. Independent Living Center of Southern California. Yesterday's decision to send that case back to the Ninth Circuit Court of Appeals was a huge victory for patient rights' groups, according to Melinda Bird, a Disability Rights California attorney.

Calif. Fines Three Nursing Homes After Patient Deaths

Wed, 22 Feb 2012 08:00:00 GMT

On Tuesday, the California Department of Public Health announced that it has fined three Los Angeles County nursing homes after finding that inadequate care led to patient deaths. Fountain View Subacute and Nursing Center in Los Angeles received a $75,000 fine, while Downey Care Center and the Motion Picture & Television Hospital in Woodland Hills each received an $80,000 fine. Los Angeles Times' "L.A. Now" et al.

Adult Day Care Transition Gets Another Month

Tue, 21 Feb 2012 08:00:00 GMT

The state's move on Friday to shift the transition date for Adult Day Health Care elimination by a month was borne of a request by CMS, according to officials from the Department of Health Care Services.

Advocates say the delay may be due to the scattered nature of the state's transition so far.

"It's been a royal mess," Corinne Jan of the Family Bridges ADHC in Oakland said. "Lots of duplications on the lists. Some people got a notice they were eligible [for the alternate program], then another saying they're not. Lots of confusion."

San Mateo Board OKs Closure of Long-Term Care Center

Wed, 15 Feb 2012 08:00:00 GMT

The San Mateo County Board of Supervisors on Tuesday voted 5-0 not to renew a five-year lease for the Burlingame Long-Term Care Center. Board members said the county could not afford to keep the facility open because of $9 million in looming state budget cuts and the aging infrastructure of the nearly 50-year-old facility. Contra Costa Times, San Francisco Chronicle.

Survey: Patients, Physicians Not Discussing End-of-Life Care

Tue, 14 Feb 2012 08:00:00 GMT

A California HealthCare Foundation survey finds that about 80% of residents would want to talk to their physicians about end-of-life care if they became seriously ill. However, only 7% of residents have done so. Contra Costa Times, San Francisco Chronicle.

Study: Women Retirees More at Risk for Economic Hardship

Mon, 13 Feb 2012 08:00:00 GMT

A study by the UC-Berkeley Center for Labor Research and Education suggests that women retirees in California are more at risk for economic hardships than men because they tend to live longer and earn less over their lifetime. HealthyCal.

Seniors Improperly Denied Home Care Payments, Lawsuit Says

Thu, 09 Feb 2012 08:00:00 GMT

A new lawsuit alleges that Senior Health Insurance Company of Pennsylvania avoided reimbursing California seniors for in-home care costs. SHIP has about 10,000 policyholders in California. AP/San Francisco Chronicle, KPCC's "KPCC News."

Study IDs Factors Affecting Nursing Home Care Quality

Wed, 08 Feb 2012 08:00:00 GMT

Staff-to-patient ratios and ownership are important factors influencing the quality of care provided at nursing homes, according to a new UC-San Francisco study. The study compared care quality at the 10 largest for-profit nursing home chains from 2003 to 2008, with the care provided at other for-profit, not-for-profit and government-run facilities. Contra Costa Times.

Do Long-Term Care Patients Need a Stronger Advocate?

Mon, 06 Feb 2012 08:00:00 GMT

Change may be coming to the state ombudsman's office for long-term care, whether it likes it or not. Proposed legislation to strengthen advocacy and increase the independence of that agency has been greeted with stern resistance from the agency itself.

House Passes Repeal of CLASS Act; Legislation Unlikely To Pass Senate

Thu, 02 Feb 2012 08:00:00 GMT

Last night, 28 Democrats joined all House Republicans in approving legislation to repeal the federal health reform law's Community Living Assistance Services and Supports Act. The bill now goes to the Senate, where Democrats are expected to resist its passage. Roll Call et al.

Seton Hospital Hit With $100K Fine for Patient Death

Thu, 02 Feb 2012 08:00:00 GMT

On Tuesday, the California Department of Public Health announced that it has levied an "AA" citation and $100,000 fine -- the maximum penalties under state law -- against Seton Medical Center after an investigation determined that a hospital error led to the death of a patient in the long-term nursing unit. Seton is appealing the citation and fine. Bay Citizen, San Jose Mercury News.

Adult Day Health Services Budget Looks Familiar

Thu, 02 Feb 2012 08:00:00 GMT

The recent state budget proposal includes the expected cost of the Community-Based Adult Services program for next year: roughly $83 million.

That number is eerily close to last year's budget estimate for the Keeping Adults Free from Institutions program, which was an alternative adult day services plan that the Legislature passed in June. The Legislature approved $85 million for the KAFI program, which was designed as a half-price replacement for the adult day health care program.

Gov. Jerry Brown (D) vetoed KAFI.

Editorial: Calif. Must Resolve Issue of Aging Prison Inmates

Thu, 02 Feb 2012 08:00:00 GMT

Although California has made strides to reduce overcrowding in prisons, it also must address the cost of holding a growing number of geriatric prisoners, according to a Sacramento Bee editorial that highlights a new Human Rights Watch report. The editorial states, "Dealing with geriatric populations behind bars is costly, especially since prisoners are not eligible for federal health insurance programs for the elderly." It adds, "In addition to normal prison security costs, the state has to deal with the ailments of the old -- mobility impairments, hearing and vision loss, dementia, illnesses that are chronic, disabling and terminal." Sacramento Bee.

State Officials Seek To Educate Residents With Long-Term Care Website

Wed, 01 Feb 2012 08:00:00 GMT

California officials are directing residents to a website that explains the benefits of long-term care plans and provides details on available policies. Many adults do not purchase long-term care insurance because of the cost or because they do not think they need it. HealthyCal.

House Poised To Repeal Federal Health Reform Law's CLASS Program

Wed, 01 Feb 2012 08:00:00 GMT

Today, the House is expected to pass legislation to repeal the Community Living Assistance Services and Supports program created by the federal health reform law. However, the bill is unlikely to secure enough support to pass in the Senate. The Hill's "Healthwatch," National Journal.

Motion Picture Fund To Keep Nursing Home Facility Open

Thu, 26 Jan 2012 08:00:00 GMT

On Wednesday, the Motion Picture & Television Fund announced that it is reversing a decision to close its long-term health care facility in Woodland Hills. The facility was set to close after board members in 2009 announced a $10 million-a-year budget shortfall, but MPTF said the facility's finances have improved and it immediately will start admitting new and former residents. Los Angeles Times' "Company Town," Los Angeles Daily News.

L.A. Senior Advocates Stand Up to Budget Cuts

Thu, 26 Jan 2012 08:00:00 GMT

Advocates for senior health programs in Los Angeles are working on remedies to situations many thought couldn't get any worse -- until now. The governor's proposed budget prescribes more cuts for state-supported programs for low-income, vulnerable elderly residents.

Elderly Health Program Viewed as Model To Cut Costs, Improve Care

Thu, 26 Jan 2012 08:00:00 GMT

State and federal policymakers are looking to the Program of All-Inclusive Care for the Elderly as a potential model to save money and improve health care for the elderly and individuals with disabilities. California has five PACE organizations that operate 18 centers. San Francisco Chronicle.

Settlement in Adult Day Health Care Case OK'd

Wed, 25 Jan 2012 08:00:00 GMT

On Tuesday, a federal judge granted final approval to a recent settlement in a lawsuit challenging the state's plan to eliminate the adult day health care program. Under the settlement, about half of the 35,000 participants in the ADHC program beginning in March will be eligible to join the new Community-Based Adult Services program, while the rest of the participants will receive case management services that allow them to continue living at home. Los Angeles Times' "PolitiCal."

Judge Calls ADHC Settlement a Win-Win

Wed, 25 Jan 2012 08:00:00 GMT

A federal judge yesterday gave her official stamp of approval to last month's settlement of a lawsuit challenging the state's transition plan for adult day health care services.

"It's a good result in a challenging time," according to attorney Elissa Gerson of Disability Rights California, which brought the lawsuit.

During yesterday's hearing, U.S. District Judge Saundra Brown Armstrong said the settlement outcome was actually better than it would have been if the case went to trial and DRC eventually won it.

Senate Sends Ombudsman Bill to Assembly

Tue, 24 Jan 2012 08:00:00 GMT

The state Senate yesterday passed SB 345 by Lois Wolk (D-Davis), a bill designed to give more independence and power to the Long-Term Care Ombudsman program. It now heads to the Assembly for committee and floor approval.

"Most of the provisions in this law simply clarify state and federal law," bill author Wolk said. "What has happened in this ombudsman program is the office is not effectively being an advocate for people in long-term care and local [ombudsman] offices."

State ombudsman Joseph Rodrigues begs to differ, and has testified against the bill in committee hearings, saying that the proposed law is duplicative and establishes additional requirements without additional funding.

Federal Judge Continues To Block In-Home Supportive Services Cuts

Fri, 20 Jan 2012 08:00:00 GMT

On Thursday, U.S. District Judge Claudia Wilken issued a preliminary injunction to continue to prevent the state from implementing cuts to the In-Home Supportive Services program. The state plans to challenge the order. San Francisco Chronicle et al.

Calif. Long-Term Care Ombudsmen Concerned With Medical Parole Law

Fri, 20 Jan 2012 08:00:00 GMT

Long-term care ombudsmen in California are expressing concern that a state law allowing parolees to receive care at nursing homes could put other residents' safety at risk. However, one lawyer contends that the parolees do not pose threats to others. Bay Citizen/New York Times.

Trigger Cuts to IHSS Care Put on Hold

Fri, 20 Jan 2012 08:00:00 GMT

Federal judge Claudia Wilken did not mince words yesterday when an attorney representing California asked her if she would issue a stay, to grant the state the right to start implementation of a proposed 20% cut in In-Home Supportive Services.

"No, I won't stay it," Wilken said of the temporary restraining order she issued last month. "The TRO is now the permanent injunction, ... but it will be modified. It is appealable, as of now. But no, I'm not going to lift it."

The injunction means that 370,000 Californians, mostly seniors, will continue to receive IHSS care, while the state appeals the decision.

Financial Flexibility Could Be Key to Helping Seniors

Thu, 19 Jan 2012 08:00:00 GMT

California health officials have struggled with how to handle the state's burgeoning and expensive elder population -- the largest in the nation and growing quickly. One program in San Mateo County wants to take an unusual approach by launching a different financial structure that could benefit seniors and save money.

State Moving Toward Licensing Home Health Workers

Tue, 17 Jan 2012 08:00:00 GMT

Two bills have been proposed to regulate an estimated one million unlicensed home health workers in California. The big questions are, how much regulation is needed, and how much that type of program will cost. One of the bills, AB 899 by Mariko Yamada (D-Davis), has looser requirements and is currently stuck in the Assembly appropriations committee.

The one more likely to make it to the floor is SB 411 by Curren Price (D-Inglewood), which would require background checks and care instruction for all home health care workers. It is expected to be taken up for a floor vote as soon as the end of January.

SB 411 is the one up for debate and possible amendment, according to Jordan Lindsey, director of policy and public affairs for CAHSAH, the California Association for Health Services at Home.

Controversy Surfaces Over Ombudsman Plan

Wed, 11 Jan 2012 08:00:00 GMT

Legislative committees started back up with a bang yesterday, when a seemingly benign measure to beef up the state's Long-Term Care Ombudsman Program was almost scuttled by its director.

Yesterday, during the first meeting in months of the Senate Committee on Human Services, Senate member Lois Wolk (D-Davis) introduced SB 345, which is designed to increase the advocacy power of the long-term care ombudsman's office.

"The idea is to strengthen the ability to advocate residents' rights," Wolk said. "There is warranted concern that the ombudsman's office has not been adequately representing residents. The ultimate goal is that the ombudsman's office will aggressively pursue advocacy for the residents of long-term care facilities."

Opinion: Protect Funds for IHSS Anti-Fraud Initiatives

Tue, 10 Jan 2012 08:00:00 GMT

"Gov. Jerry Brown's plan to save money by cutting state funding to combat In-Home Supportive Services fraud is penny-wise and pound-foolish" because it "will create an open season for criminals to bilk taxpayers out of the very dollars he wants to save," Sacramento County District Attorney Jan Scully writes in a Sacramento Bee opinion piece. "For the past two fiscal years, the state budget included $10 million for IHSS fraud investigations," which "made California eligible to receive $10 million in additional federal funds, totaling $20 million each fiscal year for distribution to any county willing to implement an IHSS fraud investigation plan," she notes. "The governor should protect IHSS fraud prevention funds because ... [f]ailing to do so will be a disservice to IHSS participants, taxpayers and communities throughout California," Scully concludes. Sacramento Bee.

Could New Not-for-Profit Requirement Limit Patient Access?

Mon, 09 Jan 2012 08:00:00 GMT

State health officials recently outlined new requirements for the transition of adult day health care centers into the nascent Community Based Adult Services program. They include the stipulation that centers must be not-for-profit to qualify for Medi-Cal funding.

Many centers are for-profit, particularly in Los Angeles County where the bulk of day care beneficiaries live. Advocates worry the change could decrease access to care if for-profits are unwilling or unable to make the conversion to not-for-profit status.

Elissa Gershon, a senior attorney for Disability Rights California, said the new not-for-profit requirement could make it difficult for some beneficiaries to find care.

San Mateo Long-Term Health Care Center Faces Closure

Fri, 06 Jan 2012 08:00:00 GMT

On Thursday, San Mateo County health service officials said they plan to recommend that the county Board of Supervisors close the Burlingame Long-Term Care Center because of the nearly 49-year-old facility's age and because the county faces $9 million in state budget cuts. County Health System Chief Jean Fraser said that state and federal funding covered the cost of operating the 230-patient facility last year and that the recommendation is "a policy decision," adding, "The state doesn't support our type of nursing." The Board of Supervisors is expected to reach a final decision by Feb. 14. If the board accepts the recommendation, the facility would close within the next 16 months. San Jose Mercury News.

Nurses Assessing Residents for Scaled-Down ADHC Program

Thu, 22 Dec 2011 08:00:00 GMT

Nurses across the state are conducting evaluations to determine which residents will qualify for a scaled-down version of the adult day health care program. Although California initially planned to eliminate the program to reduce state spending, a recent legal settlement means that the state will continue offering certain ADHC services. KQED's "The California Report."

State Says IHSS Court Order Kept Counties in Dark

Thu, 22 Dec 2011 08:00:00 GMT

There are three levels of exemption for some Californians from the 20% trigger cuts to In-Home Supportive Services, according to officials from the Department of Social Services.

Counties, which administer IHSS programs through county welfare departments, haven't heard about any of these exemptions because a federal temporary restraining order halted the implementation of those cuts, according to Michael Weston of DSS.

Basically, he said, implementation of changes and communication about IHSS with the counties halted when the court issued its temporary restraining order. Meanwhile, the exemption process continued to be developed within the department, Weston said.

Disability Case Takes Unusual Turn

Wed, 21 Dec 2011 08:00:00 GMT

A federal judge temporarily halted automatic "trigger cuts" to the state's budget that would reduce In-Home Supportive Services by 20%. A hearing on the issue, originally scheduled this month, is now scheduled Jan. 19.

In the meantime, a state declaration filed in the case said 66,000 Californians would be exempt from the cuts -- including all children younger than age 21.

"In total, approximately 66,000 IHSS recipients will be completely exempt from the 20% reduction, which is roughly 15% of all IHSS recipients," according to a declaration by Eileen Carroll, deputy director of the Adult Programs Division at the Department of Social Services.

Washington State Case Could Carry Implications for California IHSS Cuts

Tue, 20 Dec 2011 08:00:00 GMT

An appeals court has ruled in a Washington state case that states cannot cut in-home services for the elderly and residents with disabilities if there is serious risk they could be institutionalized. An attorney says the ruling has implications for California. San Francisco Chronicle.

Two California Nursing Homes Fined in Patient Deaths

Tue, 20 Dec 2011 08:00:00 GMT

On Monday, the California Department of Public Health announced that it has fined two Orange County nursing homes in the deaths of patients who received "inadequate care." Newport Nursing and Rehabilitation Center in Newport Beach was fined $100,000 after a patient fell while using the bathroom unsupervised. Emeritus at Yorba Linda was fined $90,000 after an unintended patient choked on a piece of meat. The facilities received the most serious citations possible. Orange County Register.

Obama Proposes Plan To Extend Labor Protections to Home Care Workers

Fri, 16 Dec 2011 08:00:00 GMT

Yesterday, President Obama proposed new regulations that would extend minimum wage and overtime protections to the 1.8 million U.S. home health care workers. GOP lawmakers criticized the proposal, saying it would increase health care costs. AP/San Francisco Chronicle et al.

House GOP To Resume Efforts To Repeal CLASS Act in 2012

Thu, 15 Dec 2011 08:00:00 GMT

On Tuesday, House Republicans acknowledged that they will not be able to repeal the Community Living Assistance Services and Supports Act before the end of the year, but they pledged to revive repeal efforts in 2012. The CLASS Act -- created by the federal health reform law -- was intended to provide coverage to workers if they become unable to care for themselves because of injury or illness. According to House GOP members, the House Ways and Means Committee will begin markup on a CLASS repeal proposal early next year. The Hill's "Healthwatch."

Low Revenue Triggers $980M in Deeper State Spending Reductions

Wed, 14 Dec 2011 08:00:00 GMT

Gov. Brown has announced that there will be $980 million in deeper spending cuts because of lower-than-expected state revenue. The cuts will begin to take effect next year and will affect health and human services programs. Sacramento Bee et al.

Reform Law Program for Early Retirees To Close Earlier Than Expected

Mon, 12 Dec 2011 08:00:00 GMT

According to CMS, the health reform law's Early Retiree Reinsurance Program will close at the end of the year because it is nearly out of funding. ERRP aimed to help cover health costs for retirees older than age 55 who do not yet qualify for Medicare. Wall Street Journal et al.

Officials Prepare for Possibility of Trigger Cuts Under State Budget

Mon, 12 Dec 2011 08:00:00 GMT

California lawmakers and interest groups are preparing for possible deeper spending cuts triggered through the state's budget plan. The decision on whether to implement the cuts will be affected by a fiscal outlook to be released by finance officials this week. Wall Street Journal et al.

Opinion Piece Warns Against More Service Program Cuts

Fri, 09 Dec 2011 08:00:00 GMT

Under the automatic cuts included in the state budget package, the "$100 million, first tier trigger cut slated for the Department of Developmental Services will compound the impact of multiple, ongoing cuts to social services for Californians with developmental disabilities," Christopher Rice -- executive director of the California Disability Services Association -- writes in a Capitol Weekly opinion piece. According to Rice, a "decade of rate freezes, program closures and devastating budget cuts have destroyed many community-based service programs, leaving the more than 240,000 Californians with developmental disabilities at serious risk," adding, "The trigger cuts will make this problem even worse." Rice concludes, "Meaningful reforms to California's developmental services system are necessary to manage costs," such as "a careful examination of where California's service delivery system can be optimized and modernized." Capitol Weekly.

New Evidence of Seniors' Vulnerability

Thu, 08 Dec 2011 08:00:00 GMT

Kathryn Kietzman and other researchers from the UCLA Center for Health Policy Research conducted a series of interviews with California seniors and their families over a one-year period. Their ongoing monitoring yielded worrisome results, Kietzman said -- particularly seeing the effect on those seniors of a number of seemingly small budget cuts.

"Even those seniors with low-level needs were strongly affected by these cuts," Kietzman said, referring primarily to a 3.6% reduction in In-Home Supportive Services and also to a cutback in monthly Supplemental Security Income and State Supplementary Payments. "What we saw was a culmination of sometimes little cuts, sometimes bigger cuts," she said. "Many times we follow these things at the policy level, but [here] we've seen changes at the individual level, particularly for people with chronic care conditions."

Those cutbacks don't begin to compare with the state's trigger cut of 20% of IHSS care, and a state-estimated halving of service to people currently receiving adult day health care services, Kietzman said.

Opinion: New Type of Homes Can Change Long-Term Care

Mon, 05 Dec 2011 08:00:00 GMT

"'Green House' homes -- the first of their kind in California -- will provide seniors with quality care [and] could revolutionize the way California cares for seniors who can no longer live independently," Risa Lavizzo-Mourey -- president and CEO of the Robert Wood Johnson Foundation, and a former member of the federal Task Force on Aging -- writes in a Sacramento Bee opinion piece. Lavizzo-Mourey notes that the homes, which provide private rooms and bathrooms for up to 12 seniors, "look and feel like real homes" but also are fully equipped with "all the medical equipment and clinical apparatus" found in traditional nursing homes. She discusses construction under way in Pomona to build two Green House homes, adding that the Green House model "shows that it is possible to deliver the highest level of skilled to the most vulnerable members of society in a practical, affordable way." Sacramento Bee.

Judge Stops State From Planning for In-Home Supportive Services Cuts

Mon, 05 Dec 2011 08:00:00 GMT

A judge has issued a temporary restraining order blocking the state from notifying In-Home Supportive Services beneficiaries that the program could face automatic cuts if state revenue projections fail to meet budget estimates. Sacramento Business Journal, AP/Santa Cruz Sentinel.

Judge Temporarily Stops IHSS Cuts

Mon, 05 Dec 2011 08:00:00 GMT

A federal judge in Oakland issued a temporary restraining order last week, suspending the state's planned reduction of 20% to In-Home Supportive Services to 370,000 Californians.

Judge Claudia Wilken scheduled a hearing Dec. 15 to decide whether a preliminary injunction should be granted. The state has the option to move that court date, if it desires.

The judicial action came right before the state was set to send notices to IHSS participants -- most of whom are seniors -- notifying them of the reduction in services. The so-called trigger cuts were ordered by the Legislature back in June, to go into effect Jan. 1, if fiscal targets weren't met in December. Those targets are unlikely to be met.

House Committee OKs Bill To Repeal Reform Law's CLASS Program

Thu, 01 Dec 2011 08:00:00 GMT

Yesterday, a House committee approved a measure that would repeal the Community Living Assistance Services and Supports Act, a long-term care program created by the health reform law. The legislation could reach the House floor before the end of the year. The Hill's "Healthwatch" et al.

Editorial: ADHC Settlement Is a 'Win' for State and Elderly

Thu, 01 Dec 2011 08:00:00 GMT

The recent adult day health care settlement between state officials and advocates for the elderly and individuals with disabilities to establish a "similar community-based program" was "an 11th-hour reprieve," according to a Modesto Bee editorial. According to the Bee, the "threatened closures" of ADHC centers "made no sense either on fiscal or humanitarian grounds." The editorial notes, "While reimbursement will switch from a fee for service to a managed care model, the services for most of the elderly, low-income adults will endure." The editorial concludes that the settlement is "a rare win for both sides but mostly for frail, elderly Californians and their families." Modesto Bee.

Lyle Hurst of the Encore Fellowships Network Talks About Supporting Social-Purpose Groups

Wed, 30 Nov 2011 08:00:00 GMT

Lyle Hurst, network developer for the Encore Fellowships Network, spoke with California Healthline about a program that matches mid-career workers from the private sector with social-purpose organizations, including community clinics.

Ruling To Prompt New ADHC Transition

Wed, 30 Nov 2011 08:00:00 GMT

It's too early to know some details of the newest transition plan for adult day health care services, according to state officials. The final settlement of a lawsuit challenging the state's first transition plan will be released tomorrow, and the federal judge in the case will issue a ruling on the settlement in two weeks.

But that doesn't stop people from raising questions.

"Which [current ADHC] centers will be eligible to become CBAS (Community Based Adult Services) centers?" Lydia Missaelides of the California Association of Adult Day Services asked. The CBAS program is created in the settlement as a partial replacement for Medi-Cal benficiaries. To save money, state officials eliminated the ADHC program as a Medi-Cal benefit.

Website Offers Calif. Seniors Long-Term Care Information

Tue, 29 Nov 2011 08:00:00 GMT

The state Department of Health Care Services' California Partnership for Long-Term Care has launched a new website -- RUReadyCA.org -- to help California residents prepare for their individual long-term health care needs. The website comes in response to new research showing that two-thirds of California seniors will need long-term care, but few have prepared for it. The site provides users with various situations and options to address their needs. Sacramento Business Journal.

Settlement Sets New Course for Adult Day Health Care

Mon, 21 Nov 2011 08:00:00 GMT

The settlement of a lawsuit over adult day health care essentially reinstitutes many benefits for some of the state's most vulnerable residents in a new program, but many of the details -- such as who will be eligible and how many centers will remain open -- have yet to be worked out.

State Reaches Settlement To Establish New Version of ADHC

Fri, 18 Nov 2011 08:00:00 GMT

State officials and patient advocates have settled a lawsuit challenging the elimination of the adult day health care program as a Medi-Cal benefit. The settlement creates a new program for beneficiaries who need the most care. Contra Costa Times et al.

Lawsuit Settlement Ends Fight Over ADHC

Fri, 18 Nov 2011 08:00:00 GMT

Really, it's all about Esther Darling.

The 74-year-old is the poster child for adult day health care services. She had a stroke, deals with diabetes and congestive heart failure, takes multiple medications and receives care and treatment at a day center in Yolo County.

"If it wasn’t for the [ADHC] therapy, I wouldn’t be able to walk today," Darling said. "They said I wouldn't walk anymore, but I was determined to prove them wrong."

Physicians Back Palliative Care To Boost Quality of Life

Thu, 17 Nov 2011 08:00:00 GMT

A poll conducted by the Regence Foundation for National Journal found that nearly all physicians said they support medical care services that focus on quality of life for dying patients over efforts to extend patients' lives for as long as possible. The poll, which surveyed 500 board-certified physicians, found that 96% of respondents emphasize quality of life over length of life and that a similar majority said the U.S. health system should prioritize palliative care services. Eighty-two percent of respondents cited reimbursement as an issue hindering better palliative care. The Hill's "Healthwatch."

Closed ADHC Centers Make State's Exempt List

Wed, 16 Nov 2011 08:00:00 GMT

The state Department of Health Care Services recently released a list of 64 adult day health care centers among roughly 300 in the state that will be exempt from the recently approved 10% reduction in Medi-Cal reimbursements. Those centers will be not be charged retroactively to June as other proividers will be, nor will they be subject to the 10% cut going forward because they serve a mostly rural population that the federal government wants to make sure gets access to care.

"These are the centers that the state feels are critical to maintaining access, in order to follow federal law," according to Norman Williams of DHCS.

But 13 of the 64 centers on the exempt list have already closed, some of them last year.

Settlement Expected in ADHC Lawsuit

Tue, 15 Nov 2011 08:00:00 GMT

Disability Rights California is close to settling its adult day health care lawsuit against the California Department of Health Care Services, according to a joint release from the two parties.

Today's scheduled federal court date has been moved to Thursday, by mutual agreement. But according to the joint statement, the court date may not be necessary.

"This brief court date postponement is necessary to enable the parties to finalize a settlement, the details of which will be available on Thursday," the release said.

Judge About To Rule on ADHC Issues

Mon, 14 Nov 2011 08:00:00 GMT

Tomorrow, a federal judge is scheduled to hear the long-delayed court case challenging the state's adult day health care transition plan.

Both sides are trying to hash out a compromise settlement. Representatives from Disability Rights California, which filed the suit, and the state Department of Health Care Services met four days last week and may talk again today in an attempt to avoid the all-or-nothing judicial decision.

The state is due to eliminate ADHC as a Medi-Cal benefit on Dec. 1. The lawsuit challenges the efficacy of the transition plan proposed by DHCS to provide necessary care for 35,000 ADHC beneficiaries.

Senate Committee Takes Aim at Long-Term Care

Fri, 11 Nov 2011 08:00:00 GMT

The numbers are scary, according to policy experts and legislators at a Senate Subcommittee on Aging and Long-Term Care meeting yesterday:

• The cost of care in a nursing home in California is approximately $6,000 a month, and the cost of part-time, in-home care is roughly $1,700 a month, according to state officials.

• Both those numbers are expected to double in less than 20 years to $12,000 a month for nursing home care and $3,400 a month for in-home help, according to committee Chair Elaine Alquist (D-Santa Clara).

• California has more than four million seniors right now. That figure is expected to more than double to 8.8 million by 2030, according to Steven Wallace of the UCLA Center for Health Policy Research.

• About one-third of the respondents in a UCLA survey say they couldn't afford one month of nursing home care, Wallace said.

Access Issues Behind ADHC Exemptions

Mon, 07 Nov 2011 08:00:00 GMT

The Department of Health Care Services recently exempted 69 adult day health care centers from the 10% reimbursement cut. Because the cutback is retroactive to June 2011, it spared payback of a large amount of retroactive money for those mostly rural ADHCs.

"That is really good news for Contra Costa County," Debbie Toth -- executive director of the Mt. Diablo Center for Adult Day Health Care in Pleasant Hill -- said. "We would have had to pay back a lot of money through June. And we've already gone through our reserves, so we wouldn't have been able to do that."

The 10% cut would've put centers in Contra Costa County over the edge, Toth said. "Our direct care staff is required by regulation, so there's no way … I couldn't reduce my cost by 10%."

Legislation Aims To Repeal Reform Law's CLASS Program

Fri, 04 Nov 2011 08:00:00 GMT

On Wednesday, Sen. John Thune introduced a bill to repeal the Community Living Assistance Services and Supports Act created by the federal health reform law. Thune said the long-term health care program is "destined to fail" and Congress "ought to repeal it." In a letter sent to Thune on Monday, the Congressional Budget Office stated that repealing the CLASS Act would have no effect on the federal deficit. Also on Wednesday, AARP and more than 50 disability rights groups, unions and other advocacy organizations sent a letter to lawmakers urging them not to repeal the CLASS Act, reiterating the need for a long-term health care program. The Hill's "Healthwatch."

More Elderly Residents Seeking Medication Advice at No-Cost Events

Wed, 02 Nov 2011 08:00:00 GMT

A growing number of California's elderly residents are attending no-cost "Meet the Pharmacist" consultation clinics to receive drug and health advice. Organizers say the demand for the meetings has increased in recent years because of budget cuts and the economic downturn. HealthyCal.

Health Reform Retiree Plan's Budget Drying Up, GAO Says

Wed, 02 Nov 2011 08:00:00 GMT

In a report released on Monday, the Government Accountability Office warned that the $5 billion in funding that the federal health reform law allotted for the Early Retiree Reinsurance Program will be depleted by September 2012. GAO said HHS already has spent about $2.9 billion of the funds for the program, which helps cover the health costs for retirees older than age 55 who do not yet qualify for Medicare. The program also is intended to help prevent employers from dropping retiree health coverage before reform law provisions that prohibit insurers from denying coverage based on pre-existing conditions take effect in 2014. In a statement released on Monday, Sen. Mike Enzi criticized HHS for its funding distribution methods. However, federal officials said the accelerated pace of the program was an indicator of the program's success. Wall Street Journal, The Hill's "Healthwatch."

Grass Valley Nursing Home Cited, Fined for Patient Death

Wed, 02 Nov 2011 08:00:00 GMT

On Monday, the California Department of Public Health issued a Class AA citation to the former Meadow View Manor nursing home in Grass Valley over the death of a patient. The citation is the most severe penalty under state law, with a fine of $75,000. In February, a nursing assistant used a mechanical chair lift to remove the patient from a bathtub, a task that should have been handled by two staffers, investigators said. The patient sustained serious head and neck injuries after falling forward and died four days later. An official at the nursing home -- which was purchased in June by San Marcos-based Plum HealthCare Group and renamed Crystal Ridge Care Center -- said staff have been provided with advanced clinical training and support to ensure they are able to prevent and respond to falls. It is unclear whether the facility will appeal the fine. AP/San Francisco Chronicle, Grass Valley Union.

Advocates, Health Plans, State Eyeing ADHC Hearing

Tue, 01 Nov 2011 08:00:00 GMT

The state is moving forward with its plans to move 35,000 people who had been receiving adult day health care through Medi-Cal to other programs. However, the transition could be derailed on Nov. 8 when a judge will consider whether the state's plan adequately cares for patients.

Effort for Settlement of ADHC Lawsuit

Tue, 01 Nov 2011 08:00:00 GMT

State officials and advocates for seniors and the disabled are meeting today trying to work out a settlement of a lawsuit over adult day health care.

Today's settlement conference comes exactly one week before a federal hearing of the suit brought by Disability Rights California, scheduled Nov. 8. The court is asked to determine whether the state's transition plan is adequate to handle the needs of roughly 35,000 frail, elderly and disabled patients. The state's ADHC program ceases to be a Medi-Cal benefit on Dec. 1.

Yesterday, advocates took to the sidewalk outside of the Ronald Reagan State Office Building in Los Angeles, marching up and down in front of the government center with "Stop Elimination" signs.