June 14, 2011; Source: Orange County Register | Both nonprofit and for-profit providers of adult day care are likely to be cut – some will close – as a result of planned cuts in California’s state budget. Who often goes to these state-funded centers? One in Los Angeles highlighted in this Orange County Register article services primarily elderly African Americans and Latinos, often suffering from Alzheimer’s, diabetes, high blood pressure, and other chronic illnesses.

The projected state cuts will deprive 35,000 people of adult day care services, though some will probably be “transitioned” to other kinds of help, albeit not adult day care (the plan is to shift the “worse cases” to a yet-to-be-approved program called Keeping Adults Free From Institutions).

It’s a little counterintuitive. Adult day care is an alternative to more expensive nursing homes and hospitals, so this move of budget-cutting may end up as cost-exacerbating. How do legislators justify such an ass-backwards budget move? They claim that adult day care is “vulnerable to fraud,” though the article indicates that that is a pretty rare excuse. What’s really at issue?

Adult day care is an optional benefit under federal Medicaid rules, so if your state is parceling out what it is able to pay for through Medicaid, optional services lose out. Closing adult day care centers means depriving poor seniors of a “socially rich environment where they can receive a number of health-related services – such as physical, occupational and speech therapy, dietary information, and blood pressure and blood sugar monitoring…[and] group activities also provide social interaction and physical exercise…[for] healthier emotional lives,” according to the Register.

Adult day care is a well-regarded alternative to the warehousing of the chronically ill in nursing homes and the isolation of people in their own homes. The likely impacts are pretty dire. According to the program manager of the nonprofit Yolo Adult Day Health Center in Woodland, "We could bear at most several months worth of support as we slowly work toward completely closing our doors. There's no pretending for us that we're going to survive.”

According to the director of the Congress of California Seniors, "It is ironic and tragic that in the face of [the] projected demand [due to a huge projected increase in the elderly population], the State of California is actually cutting back. We have…put our heads in the sand, and (are) in denial that millions of people are going to need services and care."—Rick Cohen