Switching Programs a Complicated Task

by David Gorn

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Norman Williams would like to start with a basic premise: Adult day health care is important to the state of California.

Williams is a deputy director at the state Department of Health Care Services. "We consider this a valuable program, a real benefit for the people who use it," Williams said.

That's why Gov. Jerry Brown (D) allocated $25 million in transition money, Williams said, to assess the individual needs of people currently in the program and see where else they could be placed.

A little background: The state wanted to save $169 million by cutting the adult day health care program. An idea was floated to take half of that money, $85 million, and create a new, slimmed-down version, called KAFI (Keeping Adults Free from Institutions). For legal reasons, it made sense to eliminate the original program, and then apply for a federal waiver for the new program.

The governor recently set aside $25 million for the transition toward elimination of the original program. The Senate then passed the budget trailer bill, which had that stipulation to establish the $85 million KAFI program in it, and the Assembly is expected to follow suit. Then it's up to the governor and his red pen.

Most advocates assumed that if the $85 million was appropriated by the Legislature and approved by the governor, that would preempt the governor's $25 million in transition money. Not so fast, Williams said.

"Our goal right now is to implement the governor's proposal," Williams said. "The transition process costs money itself. We have to do the individual assessments, and we want to make sure this is done correctly."

Williams said that the goal is to identify the needs of individuals in the current program first, and that is the first step toward transition -- whether that transition is wholly to other services currently within state government (such as In-Home Supportive Services) or in part to the new KAFI program.

So that $25 million is going to be spent in either case, Williams said.

"Right now, we're putting together a transition plan," he said, "coordinating with all of the agencies -- DHCS, mental health, aging, rehabilitation, all of those agencies touch adult day health care in some manner. We're assessing individuals and seeing what they need to stay out of the institutional setting."

Whether KAFI is created or not, Williams said, "the idea is that the savings we'll see will give us an opportunity to find the same level of care in a less costly setting. The adult day health care program was less costly than nursing homes. This takes another step in that direction."

Kathy Hilberg
I am constantly amazed at the thought process of those who are charged to develop plans to provide alternative care to keep those who are presently in ADHC out of institutions. When will they realize and accept that that is the very reason that ADHC was developed in the first place and that there are no other services that will keep these folks out of institutions! The research has been done and there are many years of experience that clearly proves that ADHC does just that, keep folks out of institutions and SAVES THE STATE MONEY! Perhaps what DHCS should be looking at is how to use that $25 million to add to the $85 million to enhance the KAFI program! Kathy Hilberg, ElderLife ADHC

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