Federal Court Gives Final Approval of Medi-Cal Adult Day Health Care Lawsuit Settlement

Implementation of New Replacement "Community-Based Adult Services" Program As A Medi-Cal Managed Care Benefit To Take Effect March 1, 2012 Underway

SACRAMENTO, CA (CDCAN)  [Last updated 01/24/2012 03:00 PM] - A

US district court judge gave final approval of a settlement of a federal lawsuit that requires the Brown Administration to create a new version of adult day health care, called "Community-Based Adult Services"  under Medi-Cal managed health care that will replace the existing Adult Day Health Care Medi-Cal benefit effective March 1, 2012.  The existing Adult Day Health Care Medi-Cal benefit will be eliminated effective February 29, 2012.   

The settlement was reached  and originally announced on November 17, 2011 with those filing the lawsuit (seven persons with disabilities and seniors representing over 35,000 people with disabilities and seniors currently receiving the Medi-Cal benefit provided by over 300 Adult Day Health Care Centers across the State) and the Department of Health Care Services, the state agency that oversees the Medicaid (called "Medi-Cal") program.  US District Court Judge Saundra Brown gave preliminary approval of the settlement on December 14th and final approval today and said the settlement was "fair, adequate and reasonable" and a "win-win" for both sides    

Both the Department of Health Care Services and advocates for people with disabilities and seniors praised the settlement, though some advocates and stakeholders remain concerned and worried because the new replacement program will only cover an estimated 15,000 of the 35,000 persons currently receiving services under the Adult Day Health Care Medi-Cal and uncertainity still exists on what other services those persons will end up receiving.  Steps have been taken over the past two months to implement the settlement including the new replacement program and other transition efforts, including In-Home Supportive Services, once the Adult Day Health Care Medi-Cal benefit is eliminated...more  

Stay informed! Go to the Advocacy Corner for frequent updates!  

Do you have Medical & Medicare? If so, Please complete this survey

Do you have both Medicare and Medi-Cal? If so, the State of California wants to learn more about your needs, concerns and priorities as it works to improve care coordination for people in your situation, who commonly are called “dual eligibles” or “Medi-Medis.”  Please take 10 minutes to complete an electronic survey developed by Harbage Consulting as part of its work supporting the State's efforts to collect consumer input.

Access the survey through this link: www.surveymonkey.com/s/CalDuals

This survey collects information from people who have BOTH Medicare and Medi-Cal about their health care experiences. Your answers will inform California's planning. Family members and caregivers are encouraged to complete this survey based on the experience of their relative/friend/client. Responses will be collected through December 20, 2011. 

For more information about this project, you can visit the website www.CalDuals.org. Stay updated by following the group on Twitter @CalDuals.



Elimination of Adult Day Health Care is Delayed

A report from the California Disability Community Action Network:

DETAILS OF ADULT DAY HEALTH CARE MEDI-CAL BENEFIT SETTLEMENT AGREEMENT

Agreement Reached November 17th Delays Elimination of Medi-Cal Benefit Until February 29, 2012 - New Medi-Cal Program To Be Created

SACRAMENTO, CA (CDCAN)  [Last updated 11/18/2011 06:55 AM] -  As reported yesterday, the scheduled elimination date of Adult Day Health Care as a Medi-Cal "optional" benefit will be delayed from December 1, 2011 to February 29, 2012 under a settlement announced Thursday (November 17) of a federal lawsuit between recipients in the program and the California Department of Health Care Services under the Brown Administration.   The settlement agreement was hailed as a major victory by advocates for people with disabilities and seniors across the State, with the legal team headed by Disability Rights California (DRC) being widely praised for its work.

Still, some advocates and Adult Day Health Care program providers, while strongly praising the settlement note that many providers have been forced to close, laying off hundreds of workers - and it is not clear yet how many of the existing program providers - and their workers - will be able to survive under the new program that will be established under the settlement agreement. Others still fear the impact of State Budget "trigger cuts" on critical services and supports and a new round of State Budget cuts still to come when Governor Brown releases his new 2012-2013 State Budget in January - with massive spending cuts likely in order to close what is now projected to be a nearly $13 billion budget shortfall.   But almost all advocates, providers and program participants and policymakers welcomed the settlement agreement as an end to the uncertainty and confusion and turmoil that began since last March when the Legislature approved Governor Brown's proposal to eliminate Adult Day Health Care as a Medi-Cal benefit...more

Stay informed! Go to the Advocacy Corner for frequent updates!