• The Health Perils of Aging: Lonely and Sick | HealthyCal.org, 5/13/12
• Keeping Up With DHCS Lawsuits | California Healthline, 4/10/12
• Medi-Cal Coverage for Adult Day Care | AARP Bulletin, 4/5/12
• State launches smaller program for adult day health care | HealthCal.org, 4/3/12
• Advocates File Contempt Motion Against State | California Healthline, 3/26/12
• Program's transition mired in confusion | HealthyCal.org, 3/8/12

View Media Archives

Four Counties Selected for Project to Improve Health of Beneficiaries Insured by both Medicare and Medi-Cal, DHCS Awaits Approval by CMS

The State of California Department of Health Care Services recently announced that it will seek approval from the Centers for Medicare and Medicaid Services (CMS) to initiate demonstration projects in four counties that seek to improve health outcomes through better care coordination of Medicare and Medi-Cal services for beneficiaries who are eligible for both insurance programs. The four counties selected are: Los Angeles, Orange, San Diego, and San Mateo. Los Angeles County proposes to utilize Community Based Adult Services (CBAS) as an innovative health home model for individuals requiring complex care in the community. Click here to access County Fact Sheets and to read the full proposal, which is available for public comment now through 5:00 PM May 4, 2012.

The Governor proposes to expand this project to six additional counties through his Coordinated Care Initiative currently before the Legislature as part of the 2012-13 budget package. For more information visit the DHCS website.

CMS Approves Waiver Amendment, CBAS Program is Effective April 1

On March 30, 2012 the Centers for Medicare & Medicaid Services (CMS) approved the State of California's request, submitted January 1, 2012, to amend its Demonstration project authorized under section 1115 of the Social Security Act (Act) entitled the "Bridge to Health Care Reform (Waiver number 11-W-00193/9)," to incorporate the Community Based Adult Services (CBAS) program effective April 1, 2012. Read approval letter.

Court Hearing Postponed to April 27, so Parties Can Work to Resolve Allegations that DHCS Failed to Comply with Darling v. Douglas Settlement

A March 29, 2012 hearing before a federal district court judge was taken off calendar (postponed), at the request of both parties to allow more time to try and reach a resolution. The hearing was rescheduled for April 27, 2012 at 9:00 AM. On March 22, 2012, Disability Rights California (DRC) filed documents with the court claiming the California Department of Health Care Services (DHCS) failed to fully comply with the court approved agreement that settled a lawsuit between the State of California and the class of plaintiffs who include frail seniors and persons with disabilities authorized to receive Adult Day Health Care services as a Medi-Cal benefit.

• Civil Minute Order Filed 3/29/2012 (1 page)
• Notice of Motion and Motion for Enforcement of Stipulated Judgment and for Civil Contempt Sanctions Filed 3/22/2012 (38 pages)
• Proposed Order on Enforcement of Stipulated Judgment and Contempt Filed 3/22/2012 (10 pages)

CAADS Releases Issue Paper Critical of State's New Policy Requiring Non-Profit Status for CBAS Providers

CAADS has published an analysis of the state’s new policy requiring CBAS providers to become non-profit entities, outlining the legal and logistical challenges that make implementation of this policy a maze of bureaucratic dead ends. CAADS recommends that the state take a different approach to avoid problems with reducing access to care and creating unnecessary state cost. The burdensome oversight of the exception process that the state proposes as a remedy to maintain access merely adds to the uncertainty as the programs move into managed care. Penalizing two-thirds of existing providers based on their tax structure does not make sense when the vast majority of ADHC participants are found eligible for CBAS and require uninterrupted access to those very same for-profit centers. A better solution is one that relies on assuring compliance with the new Standards of Participation in the 1115 Waiver.

• CAADS Issue Paper: New CDHCS Policy Requiring Current CBAS Providers to be Non-Profit Entities (3/13/2012, 9 pages)

Joint Oversight Hearing Conducted on Long-Term Care Integration and Medi-Cal Managed Care

On March 7, 2012, the Assembly Budget Subcommittee No. 1 on Health and Human Services and Assembly Committee on Aging and Long-Term Care held a joint oversight hearing on the Brown Administration’s proposal to expand the "Dual Eligible" demonstration project from four counties to as many as 10. Now referred to as the "Care Coordination Initiative," the project shifts seniors and persons with disabilities who are eligible for both Medicare and Medi-Cal from Medi-Cal fee-for-service to Medi-Cal managed care.

• Video: Part 1 | Part 2 | Part 3 (Allow ample time, each part runs 2 hours)
• Handouts: LAO Assessment of the Governor's Care Coordination Initiative |
  Recent History of Adult Day Health Care and Transition of Seniors and Persons With Disabilities Into Managed Care

State Conducts CBAS Updates Webinar for Providers

On March 22, the California Department of Health Care Services (DHCS) conducted a one-hour CBAS Providers Updates Webinar. The new CBAS Individual Plan of Care (IPC) form and Treatment Authorization Request (TAR) processing were highlighted. View DHCS webinar Powerpoint presentation. View DHCS Community-Based Adult Services (CBAS) / Adult Day Health Care (ADHC) Transition website.

CDA Publishes List of Approved Community-Based Adult Services (CBAS) Providers

February 15, 2012 -- The California Department of Aging has approved 264 CBAS applications out of 275 submitted. Of the 275 applications submitted, 2 were denied, 4 were withdrawn, and 5 are pending completion. Of the 264 applications approved, 258 are centers that are currently open and operating. The list will be updated as pending applications are completed and processed.

• CDA Notice (Issued 2/15/12)
• Approved CBAS Providers List (Issued 2/15/12)

CDA Issues FEB 13, 2012 CBAS Provider Updates

February 13, 2012 -- The California Department of Aging issued CBAS Provider Updates to all ADHC Providers to announce that several documents have been posted to the DHCS website. Included are Frequently Asked Questions (February 2012), Medi-Cal Field Office Directory and Map, and revised PowerPoint slides from the CBAS Provider Webinar held FEB 10, 2012 to correct the telephone number individuals call to receive assistance regarding managed care enrollment.

• Frequently Asked Questions (FAQ) - February 2012
  Under CBAS Provider Information at: http://DHCS.ca.gov/ADHCtransition


• Medi-Cal Field Office Directory and Map
  Under CBAS Beneficiary Information at: http://DHCS.ca.gov/ADHCtransition


• Corrected PowerPoint Slides - February 10, 2012 CBAS Provider Webinar by DHCS
  Under CBAS Webinars at: http://DHCS.ca.gov/ADHCtransition

Legal Help for ADHC Providers Seeking Nonprofit Status

With the recent announcement by the California Department of Health Care Services that CBAS sites must be nonprofit organizations, many of the state's for-profit ADHC centers are facing significant financial implications and a tight timeframe to complete the process for obtaining nonprofit status. In response, CAADS has prepared a Preferred Attorney List which includes legal firms in membership with CAADS which have experience with establishing a nonprofit organization and have expressed interest in working with ADHC providers on this complex process.

For more information on ADHC Transition to CBAS, click here.

LAO Issues Report -- The 2012-13 Budget: Integrating Care for Seniors and Persons With Disabilities

In a February 17, 2012 LAO report, the Legislative Analyst found that it is premature to expand the Care Coordination Initiative demonstration statewide and make LTSS managed care benefits, since the demonstration has not yet been implemented—much less evaluated—and many key implementation details remain to be determined. The report recommends the Legislature reject the Governor’s proposal to expand the demonstration statewide before the results from the demonstration have been properly evaluated, but proceed instead with the four-county demonstration. Additional recommendations are made with the intent to help the state move toward a more integrated system of care delivery for SPDs. Read more.

Medi-Cal Provider Rate Reductions

On October 27, 2011 the Centers for Medicare and Medicaid Services approved California’s request to reduce Medi-Cal reimbursement rates for providers of health care services. To view documents related to approval of the State Plan Amendment (SPA), visit: www.dhcs.ca.gov.

Additional details about implementation of the retroactive 5% and 10% rate reductions for ADHC providers in urban areas of the state are not yet available from the state. The 5% rate reduction is currently enjoined by federal court order, but the new 10% rate reduction was approved by the California Legislature in March 2011 to be retroactive to June 1, 2011 and, therefore, is not currently part of any litigation proceedings.

• October 27, 2011 CAADS Industry Alert
• State of California Medi-Cal Provider Rate Reductions Chart

SCAN Foundation Fact Sheet -- No. 21 -- July 2011

Summary of the California 2011-12 Enacted Budget: Impact on Older Adults and People with Disabilities

On June 30, 2011, California Governor Jerry Brown signed the 2011-12 budget. The enacted budget includes significant cuts and prepares the framework for additional cuts in the following 2012-13 budget year that negatively impact health and human services programs serving older adults and people with disabilities.

California Association for Adult Day Services, a 501 (c) 6 non-profit grassroots-driven organization, advocates for the growth and development of adult day services in California and nationally. CAADS was the first state association formed in the United States for the purpose of advancing adult day services. CAADS member-centers provide innovative day programs that support individuals with physical or mental disabilities and older adults with Alzheimer's disease and their families.

A nationally recognized leader in the field of aging, the Association is governed by the CAADS Board of Directors and provides advocacy, timely information, analysis, technical assistance, education, and networking opportunities for member organizations. CAADS members agree to abide by the Association's Bylaws and Code of Ethics. For more information on CAADS Membership click here!

The 2010 CAADS Annual Report highlights the Associations efforts to build state relationships, pursue legislation, and provide education, training and public awareness.

CAADS Members-Only Online Benefits

Available to CAADS members on the Members-Only page:

• State Budget Analysis
• CBAS / Medi-Cal Managed Care Plans Information
• Medi-Cal Updates
• Licensing Updates
• Laws & Regulations for ADHC/CBAS and ADP Facilities
• Advocacy & Legislative Alerts
• Funding Sources
• Technical Assistance
• Education / Training Materials
• Member Roster
  
  

The Alliance for Leadership and Education (A.L.E.) is a non-profit 501(c)(3) public benefit arm of CAADS. The A.L.E. mission is to advance innovation and quality in Adult Day Service through research and analysis, education and training, and leadership for the benefit of consumers and their caregivers. The organization is governed by the 7-member A.L.E. Board of Directors.

The 2010 A.L.E. Annual Report summarizes the year's grant activities and initiatives focused on Quality of Care, Public Education and Information.

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Lydia Missaelides, MHA
Executive Director

Pamela Amundsen
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Kathryn Atkinson
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Office Assistant