Lawsuit filed to block budget cut

June 10, 2011

Defenders of a program that provides health care to keep low-income people with disabilities from being hospitalized or placed in nursing homes sued today to block the state from eliminating the program.

The Adult Day Health Care program serves 35,000 people, including many older adults. It is a benefit provided through Medi-Cal, the subsidized health program financed by a combination of state and federal money.

The plaintiffs in the lawsuit, known as Darling et al v. Douglas, contend that the planned, Sept. 1 elimination of the program would put tens of thousands of people at risk of institutionalization, hospitalization, injury or death.

“Elimination of this program as a Medi-Cal benefit will not only cause irreparable harm to the tens of thousands of people affected by the cuts, but will also result in increased costs to the State and counties in hospitalization, nursing facility placements, Adult Protective Services, and emergency services,” Elissa Gershon, an attorney with Disability Rights California, said in statement.

The lawsuit contends that the Legislature’s decision in March to eliminate the program was illegal because the state has not assured that the people who now get those services can receive the care needed to avoid hospitalization or being placed in nursing homes.

The litigation follows on a case first filed in August 2009. A federal court stopped the state from cutting the program in September 2009 and February 2010.

The state had tried to reduce the maximum number of days a person could receive services from five days to three, regardless of need. The state later tried to restrict eligibility in a way that would have ended services to as many as 15,000 clients.

Those rulings, ironically, led the state to try to eliminate the entire program. The state is not required to provide the service under the terms of its relationship with the federal government to receive funding for Medi-Cal. But if it does provide it, the state must meet certain standards. State officials reason that eliminating the entire program will free them from that legal burden.

But supporters of the program say otherwise.

“The State cannot shirk its obligation to provide medically necessary services to each and every Medi-Cal participant who qualifies. If the State chooses to cut ADHC services across the board, it still must, according to federal law, continue to provide skilled nursing and therapy services to people who need them” said Anna Rich, attorney with the National Senior Citizens Law Center.

The plaintiffs in the case say that clients in the program average 78 years old and take six or more medications a day, for which nearly two-thirds require supervision or assistance. More than two-thirds also face at least three serious medical challenges including cardiovascular disease, dementia, and diabetes. The overwhelming majority are entirely dependent on Medi-Cal funding for their care at the adult day health centers.

-Daniel Weintraub

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