Is Medi-Cal Coverage for Adult Day Health Care in our Future?

January 8, 2014 – The court settlement that preserved Medi-Cal coverage for Adult Day Health Care will expire on August 31, 2014. That settlement gave the benefit its new name – CBAS, for Community-Based Adult Services – and transitioned the benefit from Medi-Cal fee-for-service to a Medi-Cal Managed Care Plan benefit in Alameda and many other counties. The settlement thus gave CBAS the distinction of being the first LTSS to move into Medi-Cal Managed Care. It also bought time, enough to allow California’s Department of Health Care Services to change its opinion about eliminating the program.

In October 2013, DHCS acknowledged that “CBAS is a key component of LTSS under the Coordinated Care Initiative” and “an important Home and Community-Based Service that provides alternatives to institutional care.” More, DHCS and the California Department on Aging launched a CBAS Stakeholder Workgroup. Its purpose is to develop a future (post-settlement) direction for CBAS, and to prepare for amending the CBAS section of the federal 1115 Waiver (itself set to expire in August 2014).

This bodes well, as does the meaningful participation of an impressive and broad set of workgroup members. The Workgroup will meet three times (Jan. 9, Feb. 4 and March 6) before they must complete their deliverables in April. The door is open for the public and service providers to participate at the meetings (in person and by webinar), and to offer comments and recommendations in writing (by emailing or by phone (916-419-7545) through April 2014.

To sign up to receive email notices, and to view meeting materials, go to


Return to the CCI Policy Developments page.

Hello, is Anyone Listening? California Assembly’s Budget Blueprint Leaves Out Seniors!

January 8, 2014 – Have you ever felt ignored? In a proactive move, ahead of the Governor’s budget proposal scheduled for release this week, California’s Assembly Democrats recently released their 2014/15 Blueprint for a Responsible Budget (click here to check it out). The plan responds to the Legislative Analyst’s Office recommendations for keeping us on the path of fiscal stability now that we have a structurally balanced budget. It would build reserves and increase investments, and be smart about it. Unfortunately, the Blueprint makes no mention of seniors.

Over the past ten years, California has dismantled its safety net for seniors. While the population of seniors grew exponentially, state funding dropped by half (click here for the charts). State funding vanished for many programs, including cornerstones of the Older Californian’s Act. We are talking about services designed to help seniors successfully navigate the challenges of aging so that they can maintain a steady state. Food, caregiver respite, day care, foster grandparents, senior companion, case management, senior employment…the list of cuts and eliminations is stunningly long (click here to see it). Some programs are just barely holding on – at least in some counties – with local and federal funding. But nowhere is there capacity to serve the need.

Why is there no mention of restoring these services in any of the grand plans for California’s turn-around? It can’t be because they are too costly. Returning the Older Californian’s Act budget to its 2006 levels would only take $30 million, a small sum when we are looking at putting aside a $2 billion surplus for fiscal 2014/15. It can’t be because seniors don’t contribute to the Blueprint priorities of expanding opportunities for California’s families, investing in education, reducing poverty and investing in jobs…See foster grandparents, caregiver respite, day care and senior employment in the previous paragraph.

Certainly we’re in for a lively debate about how California can craft a final budget that reflects our priorities. Let’s just not forget that “our” priorities include those of seniors. I hope you will join me in attending state budget hearings and contacting your legislators to remind them.

Stay tuned.

Return to the State Budget page.

Policy Brief: UCLA Center for Health Policy Advocacy

July 2012 – Today, UCLA Center for Health Policy Advocacy released a Policy Brief: Nearly 4 Million Californians are Food Insecure. The report’s county-by-county data is available at California Food Policy Advocate’s web site.

While this report does not separate out seniors, we know from past UCLA studies that over 20% of Alameda County seniors were food insecure in 2007, before the Great Recession.


Return to the Food Insecurity page here.

Disability Rights California Court Motion

September 20, 2012  –  On September 15, Disability Rights California filed a court motion stating that California has violated the terms of the Settlement. The motion sets forth the problems experienced by class members throughout implementation of the settlement, and offers proposed solutions. Read the motion.

California Assembly Aging and Long-Term Care Committee Letter

August 20, 2012  – “The Legislature agreed to the difficult budget action in eliminating the optional ADHC benefit.  We did not agree with the dismantling of the services and neither did the courts.” This is the closing of an August 14 letter from the California Assembly Aging and Long Term Care Committee to Diana Dooley, California Secretary of Health and Human Services. The letter summarizes the multiple problems with the transition of Medi-Cal coverage for Adult Day Health Care (from optional benefit to a new program called CBAS) that are forcing centers out of business and frail participants into nursing homes. Read the Letter.

Proposition 30

September 20, 2012  –  The November Ballot Initiative, Proposition 30, is key to preserving what remains of long term services and supports after years of state cuts.  Why?  Isn’t this tax increase for California’s wealthy targeted at preserving public school funding, along with community colleges and universities?  Yes, but the revenue infusion would attack the state’s “structural deficit,” freeing up an estimated $5.6 billion General Fund dollars this year and more over the next seven years.

Prop 30 would also put the recent “Realignment” into the state constitution, an important safeguard for counties that are taking on funding and responsibility for public safety and social services programs that once belonged to the state.  For more information, read the California Budget Project’s Brief on Prop 30.