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NEXT CAADS WEBINAR | AUG 24 | 2:30 PM - 3:30 PM
ACA Repeal / Replace / Recraft – It’s not over!
CAADS Member Fee: None -- Register on Members Only page
Non-member Fee: $199 - Use Write-on or Fill-in Registration Form
Past webinar recordings / handouts order form: Write-on :: Fill-in
NEXT CAADS CONFERENCE | Southern California | NOV 6-8
Transforming the Continuum of Care | DoubleTree Anaheim—Orange County
Invitation to Exhibit & Contract | Sponsorship Opportunities
Registration information coming soon!
HELP II Loan Program -- Affordable Capital
The HELP II Loan Program, administered by the California Health Facilities Financing Authority (CHFFA) within the State Treasurer’s Office, offers low cost loans to assist eligible health facilities wanting to expand and improve services to their clients and the greater community. Learn more at www.treasurer.ca.gov/chffa/programs/help.
Block Grants
Fact Sheet: California
Changing Medicaid to a Block Grant or Per Capita Cap Could Hurt Californians
AARP Public Policy Institute | Fact Sheet 404 | Brendan Flinn | MAR 2017
What's New . . . AUGUST 18, 2017
IN MEMORY OF
ESTHER DARLING
Ester Darling, lead plaintiff in the Darling v Douglas lawsuit of 2011, shown here signing the Darling v Douglas legal settlement, died peacefully in her sleep July 18, 2017, at age 80, in Woodland, CA.
Esther faced many challenges during her life but none were as life changing as the stroke she suffered in 1996. With her left side paralyzed, this once independent woman found herself unable to manage her own care.
Determined to be discharged from the post-acute nursing home despite no family to depend on, she was referred to Yolo Adult Day Health Center.
There, with additional support from In-Home Supportive Services, Esther was able to move back to her apartment. At the ADHC center she continued her therapies, received timely nursing and social work support and thrived in the company of fellow participants.
Early in 2011, during an emergency budget session of the Legislature, adult day health care was eliminated as an optional Medi-Cal benefit. Esther and 35,000 other low-income Californians feared the worst. When she was approached by Disability Rights California to serve as a plaintiff for the class action suit being filed, Esther, along with seven other plaintiffs, was more than willing to share her personal story in hopes of saving her center and the 300 other centers throughout the State.
As the ADHC case made its way through federal court, first one and then a second lead plaintiff passed away. Esther agreed to become the lead plaintiff. The case was settled in December 2011 and Esther beamed with pride as she signed the settlement agreement that meant adult day health care was saved as a Medi-Cal benefit for her and tens of thousands of others like her.
Rarely does a poor small town girl from Oklahoma get a chance to truly shape the lives of many thousands for many years to come. Esther Darling's name will forever be memorialized in the settlement and she will lovingly be remembered for her role in saving ADHC for future generations. She is resting in peace at Monument Hill in Woodland, California.
Kelley v Kent
Spousal Impoverishment
CALIFORNIA LAWSUIT HELPS SPOUSES CARE FOR LOVED ONES AT HOME
AUG 10, 2017 | Justice in Aging
Pat Kelley, a 67-year-old veteran and former Los Angeles radio announcer, needs 24-hour care as a result of primary progressive multiple sclerosis. He desperately wants to remain at home, but he and his wife have exhausted almost all of their savings paying for supplementary in-home care. They were facing a draconian choice: either impoverish themselves or move Pat into a nursing home, where Medicaid would help pay for his care. But they shouldn’t have had to.
Since 2014, a federal law has required the spouse of someone who needs Medicaid-funded in-home care to keep some additional income and assets so that they can pay the rent, buy food, and meet their other needs, while their spouse qualifies for Medicaid. This law was intended to help people like Mr. Kelley avoid unnecessary institutionalization. But California failed to implement the law.
On July 7, 2017, working with partners, we filed a lawsuit against the state of California to compel the state to implement the law.
Already, as a result of the lawsuit, on July 19, California’s Department of Health Care Services instructed counties to apply spousal impoverishment provisions to married individuals who apply for Home and Community-Based Services (HCBS). We’ll keep you updated as the case progresses.
Read more about the case.
Class Certified for Medicare Patients in "Observation Status" Case
AUG 8, 2017 | Justice in Aging
Nancy Niemi was hospitalized for 39 days after a visit to an emergency room. She’s 84-years-old and eligible for Medicare. The hospital, however, categorized her as an outpatient receiving “observation services” for her entire stay. Medicare covers hospital care through an inclusive payment under Part A if the stay is classified as inpatient, but patients may incur unexpected cost sharing if the stay is classified as “outpatient” observation covered under Part B. Ms. Niemi was now in debt for thousands of dollars for her entire 39-day stay, and, in addition, Medicare does not permit beneficiaries to appeal when they are classified as receiving observation services when they are in the hospital, so she had no way to challenge the lack of coverage.
Due to a federal court decision issued last week, Nancy Neimi is now a member of a nationwide class of hospital patients who may gain the right to appeal their placement on observation. Hospitals commonly classify patients under observation, and, until March of this year, often without their knowledge. This practice has left many older adults and others with thousands of dollars in surprise bills not just for the hospital stay, but also medicine and other services received while classified as under observation. Class members could number in the hundreds of thousands. One study found that, in 2009 alone, 918,180 Medicare beneficiaries experienced observation stays.
Justice in Aging filed the original lawsuit (now named Alexander v. Price) along with the Center for Medicare Advocacy in 2011. The case was initially dismissed, but plaintiffs appealed to the 2nd Circuit and prevailed. The case is now going forward on the Due Process claim. Specifically, the plaintiffs allege that Medicare must allow beneficiaries to challenge the decision they are only receiving observation services. The class certification order was issued on July 31, 2017 and can be read here.
If you have a client who you think may be a member of the class, you can submit their story here. Otherwise, no action is required at this time. We’ll keep you updated on the case as it moves forward.
CAADS Next Webinar
ACA Repeal / Replace / Recraft – It’s not over!
Thursday, August 24, 2017 | 2:30 PM – 3:30 PM
Advance registration required by 5 PM, August 23
Join your webinar host CAADS Executive Director Lydia Missaelides and Senator Roy Afflerbach, Ret., Public Policy Advisor for the National Adult Day Services Association (NADSA), to hear the latest political news from Washington DC. With Congress on summer recess and only a few months remaining in the first half of the legislative session what are the chances that a deal to repeal, replace or amend the Affordable Care Act could happen? What are the political forces behind the historic drive to cut Medicaid funding by 33% over the next decade? Can these forces be stopped?
CAADS Member Fee: None -- More Information / Registration on Members Only page
Non-member Fee: $199 -- More Information / Registration: Write-on form:: Fill-in form
Cal Duals Coordinated Care Initiative Monthly Update
JULY 2017
PDF | Word
CAADS FALL CONFERENCE & ANNUAL MEMBERSHIP MEETING
Transforming the Continuum of Care
NOV 6-8, 2017
DoubleTree Anaheim—Orange County
Invitation to Exhibit & Contract || Sponsorship Opportunities || Event Brochure Coming Soon!
• Potential Changes to Medicare and Medi-Cal Financing
• Operationalizing the New IPC with CDA Guidance
• Implementation of Person Centered Care
• A Deeper Dive into Best Practices for CBAS and ADP Providers
• New Research Affecting Brain Health
Support National Level Advocacy!
AUG 8, 2017 | National Adult Day Services Association (NADSA)
NADSA has launched an Advocacy / Public Policy Initiative to raise funds needed to increase our visibility in Congress and the Executive Branch, strengthen our voice on national policy issues, and support Adult Day Services providers in serving clients and families. The most important thing we can do together is to support advocacy that none of us can do alone.
NADSA’s Advocacy / Public Policy initiative has five main objectives:
- Support NADSA’s legislative presence with Congress and the Executive Branch to fight deep Medicaid funding cuts and advance the expansion of Adult Day Services as a Medicare benefit;
- Ensure that NADSA has strong visibility on the national stage with organizations that impact ADS and participants and families;
- Help NADSA work with state associations to strengthen ADS advocacy in communities across the United States;
- Support the creation and dissemination of ADS advocacy materials and tools for NADSA members and to strengthen ongoing communications on policy issues; and
- Strengthen and enhance NADSA’s annual Policy Event in Washington D.C.
While it is an uncertain time for health-related issues, there are also opportunities to make a difference. Nearly 50 advocates joined us for our annual Public Policy Event in Washington D.C. this May and were well-received by members of Congress. Our work on gaining support for Veteran’s services is realizing success. We have momentum in our favor but the threat of deep funding cuts are all too real.
There has never been a greater need for NADSA to invest in building its public policy and advocacy capacity.
To do this, we need your financial support. We need resources beyond what dues provide to ensure that current Medicaid funding is protected from deep cuts, and, also to achieve our goal of ADS as a Medicare benefit. Any donation amount is appreciated.
Please go to http://www.nadsa.org/donate/ to make your donation. We will acknowledge your contribution on the NADSA website and continue to keep you apprised of our work protecting and championing ADS.
Governor and lawmakers reach final deal on new state budget
JUN 13, 2017 | Los Angeles Times | Melanie Mason and John Myers
With a deadline looming, there's a deal between Gov. Jerry Brown and lawmakers on a new state budget
Your Donations Help!
Three (3) great opportunities to further support Adult Day Services:
- CAADS STATE ADVOCACY FUND
- CAADS MANAGED CARE CONSULTING FUND
- ALE NINA M. NOLCOX SCHOLARSHIP FUND
Learn more and DONATE today -- thank you!
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. Centers in membership with CAADS 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 timely information, analysis, advocacy, technical assistance, education, and networking opportunities for its members. CAADS members agree to abide by the Association's Bylaws, Code of Ethics, and Anti-trust Policy.
VIEW:
CAADS Board of Directors: 2017
CAADS Annual Report: 2016 | 2015
Bylaws | Code of Ethics | Anti-trust Policy
The CAADS Members Only page features information and technical assistance specific to Adult Day Services, as highlighted below. For membership information, click here.
- State Budget Proposals, Legislative Alerts & Advocacy
- CBAS Waiver
- Medi-Cal Issues
- Medicare and Medi-Cal Dual Beneficiaries News & CCI / CalDuals Updates
- Managed Care Health Plans & CA Dept of Managed Health Care Updates
- ADHC / CBAS Licensing & Regulations (DPH, DHCS, CDA)
- Adult Day Program (ADP) Licensing & Regulations (DSS, CCLD)
- Funding Sources
- Education & Training Materials / Webinar Recordings
- Membership Roster
 The Alliance for Leadership and Education (A.L.E.) is a non-profit 501(c)(3) public benefit arm of CAADS. Its 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.
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NATIONAL ADULT DAY SERVICES ASSOCIATION (NADSA)
CAADS is a proud member of the National Adult Day Services Association.
Three representatives from California currently serve on the NADSA Board of Directors:
Corinne Jan, RN, PHN (NADSA Treasurer)
CEO, Family Bridges / Hong Fook Centers
Lydia Missaelides, MHA
Executive Director, CAADS
Amanda Sillars, MSW, LCSW
CEO, Total ADHC Solutions, Inc.
CARING FOR A VETERAN?
For help, call the VA Caregiver Support Line (toll-free):
1-855-260-3274
Mon - Fri 8 AM - 11 PM (EST) || Sat 10:30 AM - 6 PM (EST)
TO REPORT FRAUD AND ABUSE
Call DHCS Medi-Cal Fraud Hotline:
1-800-822-6222
The call is free and you can remain anonymous.
FREE FRAUD PREVENTION EDUCATION
The California Senior Medicare Patrol offers free fraud prevention education throughout the state.
To schedule a presentation, call 855-613-7080
See the SMP/Medicare fraud section at www.cahealthadvocates.org, for more information on ways to protect yourself from healthcare fraud and how to detect it.
If you come across any suspicious activity,
PLEASE REPORT IT AT
855-613-7080
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California Association for Adult Day Services
1107 9th Street, Suite 701 || Sacramento, CA 95814–3610
T: (916) 552-7400 || F: (866) 725-3123
E: caads@caads.org |
