LOCAL

San Francisco Budget Passes

The Supevisors and the Mayor finally agreed to the budget. Here is an article about it. 44 Million add backs, including everything for DAAS
including the MHA Hoarding and Cluttering services!
http://www.beyondchron.org/news/index.php?itemid=8343

Updates at the following links:

Coalition of Agencies Serving the Elderly (CASE) www.sfseniors.org/
Human Services Network http://www.sfhsn.org

*Click Here to Find your local legislators!

STATE

BUDGET
________________________________________

Expectations are for a long drawn out budget battle again this summer, echoing the summer of 2008, which set a record for the longest budget delay in California history. That year the budget was signed on September 23rd. Last year the budget was signed on July 28, 2009. This year, the budget battle could again extend into September.

The conference committee must close a $19 billion budget gap with cuts and revenues solutions that the Governor and the Republicans will accept. With California's 2/3 vote requirement, at least six Republicans must join with all Democrats to vote for a budget. The Governor and Republicans will not vote for general tax increases. The Democrats will not balance the budget with cuts alone. This produces a stalemate that is not easily resolved.

The ADHC elimination proposal put forth by the Governor was rejected by the Legislature and is currently not up for discussion in the 10-member Budget Conference Committee. The conference committee continues to meet sporadically in an attempt to close out issues that are being negotiated among members of the Legislature and various staff and stakeholders.

Next steps:

The Assembly and Senate are not taking a recess, but they have been given permission to work in the district, but must remain "on call" and able to report to the Capitol within 24 hours for a floor vote.

We must remain vigilant because at some point in the process, negotiations will occur behind closed doors and any program, large or small, could be put back on the table for discussion.

Attached is CAADS' most recent budget fact sheet that includes information from the industry-wide survey conducted in January.

If you are interested in joining CAADS in the fight to protect adult day services in California, visit www.caads.org or call 916.552.7400.

Further details, contact LaNay at leastman@sfadultday.org

5/27/2010 LONG BEACH, Calif. - The SCAN Foundation releaseda fact sheet outlining the senior-related program reductions contained in the May Revision of the 2010-2011 California state budget.

The May Revision, released by Governor Arnold Schwarzenegger on Friday, May 14, proposes significant cuts to health and human services programs that would impact low-income older adults across the state.
Faced with a $19.1 billion budget shortfall for the 2010-2011 fiscal year, the governor seeks to fill the gap through a combination of expenditure cuts ($12.4 billion), federal funds ($3.4 billion), alternative funding ($1.3 billion) and fund shifts and loans ($2.1 billion).

"These are difficult times and cuts are inevitable," said Bruce Chernof, M.D., president and CEO of The SCAN Foundation. "Nevertheless, the availability of health and human service programs are absolutely essential for vulnerable seniors to remain independent and in the community. If this population is forced into nursing homes or ends up seeking long-term care treatment in acute care hospitals, it could end up costing the state much more in the long run."

The fact sheet, available on The SCAN Foundation Web site, highlights proposed program reductions that would impact seniors and their caregivers. Major proposals to cut Health and Human Service programs serving older adults include:

> $750 Million In-Home Supportive Services (IHSS) Cuts: IHSS provides in-home assistance to approximately half a million children and low-income adults who are blind or disabled. The May Revision calls for $750 million in reductions or cost containment measures.
> Adult Day Health Care (ADHC) Elimination: ADHC is a community-based day care program that provides health, therapeutic and social services to persons at-risk of nursing home placement. Its elimination would impact approximately 45,000 Medi-Cal beneficiaries at a savings of $104 million.
> Payment Reductions to the Supplemental Security Income/State Supplementary Payment (SSI/SSP) program: SSI/SSP is a federal/state income program that provides a monthly cash benefit to low-income, aged, blind and disabled individuals and couples. Approximately 1 million recipients' monthly payments would be reduced from $845 to $830 per month, beginning on October 1st.
> $750 Million in Medi-Cal Cost Containment: Program reductions proposed include limiting prescriptions to six per month (except for life-saving drugs) and physician or clinic visits to 10 per year; eliminating certain over-the-counter drugs; and putting dollar limits on hearing aids, durable medical equipment and other supplies. Increased co-pays and other cost-cutting program changes have also been proposed.

The May Revision removed a "federal trigger" included in the January budget that would have implemented additional program cuts if less than $6.9 billion in federal funds were received. In place of the trigger cuts, the governor proposed among other things, to scale back County Mental Health Services by approximately 60 percent at a savings of $602 million.

As the California Legislature considers ways to resolve the budget crisis, The SCAN Foundation developed the May Revision fact sheet to help the public better understand the proposed budget changes and specifically what programs would be affected that serve seniors.

To review the fact sheet, visit www.thescanfoundation.org.

The Department of Health Care Services (DHCS) has begun issuing payments for the 10% rate reduction that providers experienced between July 2008 and August 18, 2008. As some of you may recall, CAADS, along with other health provider plaintiffs, sued the State of California and succeeded in obtaining a preliminary injunction in federal court, effective August 18, 2008, to stop the 10% rate reduction approved by the Legislature and Governor in the 2008-09 state budget. This injunction was later upheld by the U.S. Ninth Circuit Court of Appeals. Subsequently, the plaintiffs argued that the injunction should have been effective retroactively to July 1, 2008. The federal courts agreed with us and ordered the State to restore the 10% reimbursement that had been withheld for that period.

FEDERAL

May 14, 2010, 11:27 am
New Funding Proposed for Adult Day Centers H.R. 3043
By PAULA SPAN

See full article at http://newoldage.blogs.nytimes.com/2010/05/14/new-funding-proposed-for-adult-day-centers/?ref=health

So federal legislation that would permit Medicare funds now designated for home visits or rehab centers also to be used for adult day programs seems a sensible move. Yet it’s been stalled in Congress, despite having attracted 80 co-sponsors from 30 states in the House of Representatives, for nearly a year.

Here’s how the Medicare Adult Day Services Act would work:

After a Medicare participant has spent three days in a hospital, she’s eligible to receive “post-acute care,” meaning that Medicare will reimburse either for a stay in a rehab facility or nursing home, or for home care visits. This care doesn’t last long — no more than 100 days a year — but it’s crucial for someone who’s well enough to leave a hospital but not recovered enough to resume her prehospital routine.

“We want to provide a third option,” said Morgan Gable, a policy analyst at the American Association of Homes and Services for the Aging, which has been spearheading the effort to pass this bill. It would reimburse a properly certified adult day health center to care for these post-acute folks, including transporting them from their homes to the center and providing physical and occupational therapy and access to social workers. Not everyone just out of a hospital would opt for this approach, but many might.

Who would benefit?

Seniors who would otherwise be isolated at home, even if a home health aide stopped by once a day for an hour or so, or who would have to spend time in nursing homes.
Family members who’d worry about either of those possibilities but are also trying to hang on to their jobs.

The federal budget, because the bill sets reimbursement at 98 percent of the Medicare home health rate. “That’s a 2 percent savings right off the top,” said Ms. Gable — and of course participants get more hours of care than home health aides provide and avoid the expense of nursing homes.
Struggling adult day programs, which would acquire a new revenue stream. Possibly, Medicare reimbursement would even help new centers ones open.

Virtually every advocacy group for caregivers, including the National Adult Day Services Association, supports this plan, which could help reduce costly hospital readmissions. Even home health agencies and nursing homes, which might be expected to object to competitors for Medicare dollars, favor its passage, Ms. Gable said. Agencies could become subcontractors to adult day programs, and nursing homes are branching out and have begun to offer adult day programs themselves.

However, the act, introduced in the House by Representative Linda Sanchez, Democrat of California, may not come up for a vote this session. With Capitol Hill preoccupied for months by health care reform, H.R. 3043 still hasn’t been “scored” by the Congressional Budget Office, which will determine whether the legislation would cost or save money or is budget-neutral. And the Senate currently is grappling with financial reform legislation and, now, a Supreme Court nomination.

But Ms. Gable has the sort of optimism that’s probably necessary to get anything passed by Congress. Though variants of this bill have been around for 10 long years, “it’s never had this much support,” she said. “So we’re still pushing.”

Its backers hope that families who use adult day will nudge their Congressional representatives to move H.R. 3043 along. Nothing it proposes is particularly revolutionary, but advocates for the elderly believe it’s the sort of common-sense shift that could help a lot of older people and their families through stressful times and, as a bonus, help keep adult day centers solvent and functioning.