CAADS - California Association for Adult Day Services

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PUBLICATIONS: Reports / Studies

Updated: April 9, 2014


April 2014 | Bipartisan Policy Center (BPC)

America's Long-Term Care Crisis: BPC Launches Initiative to Find a Politically and Fiscally Viable Path Forward to Improve the Financing and Delivery of Long-Term Care

In December 2013, the Bipartisan Policy Center (BPC) launched a Long-Term Care Initiative under the leadership of the BPC Health Project leaders, former U.S. Senate Majority Leaders Tom Daschle (D-SD) and Bill Frist (R-TN), as well as former Congressional Budget Office Director Alice Rivlin and former Wisconsin Governor and Secretary of the U.S. Department of Health and Human Services Tommy Thompson.

The Long-Term Care Initiative will propose a series of bipartisan policy options in late 2014 to assist in the effort to build consensus on how to finance and deliver long-term care—referred to in this paper as longterm services and supports (LTSS)—at a time of political discord and fiscal constraints. The initiative seeks to raise awareness about the importance of the issue, bringing it to the attention of the public, as well as to policymakers, and making a strong case for action.

This paper sets the stage for BPC’s recommendations by identifying the major challenges and key questions in the financing and delivery of LTSS for both seniors and individuals under age 65.


Executive Summary and Full Report | March 25, 2014

Over the past 11 years, Genworth has been able to recognize and identify trends across the long term care services landscape. Now availabe is the 2014 Genworth Cost of Care Executive Summary and Full Report, which looked at Homemaker Services, Home Health Aide Services, Adult Day Health Care (ADC), Assisted Living Facility (ALF) and Nursing Home Care.

Key findings for Adult Day Health Care (ADC) show:

  • INCREASE OVER 2013:    0%

*Percentage increase represents the compound annual growth rate for surveys conducted from 2009 to 2014.


April 1, 2014

The National Senior Citizens Law Center (NSCLC), committed to providing a voice for the millions of low-income seniors who struggle everyday to meet their basic needs, released the NSCLC 2013 Annual Report. Here are some of the highlights:

  • Worked with allies to preserve Medicaid-funded home and community-based services for 370,000 seniors and persons with disabilities in California, keeping them at home and out of institutions.
  • Partnered with advocates across the country to ensure strong beneficiary protections were included in new programs that will provide health care and long-term services and supports to over one million people with Medicare and Medicaid (dual eligibles).
  • Advanced Congressional legislation that would update the Supplemental Security Income program for millions of poor seniors.
  • Trained over 10,000 advocates and provided over 700 case consultations.


CHCF's California Health Care Almanac | March 2014

New reports feature physicians, nurses, and allied health professionals

An influx of new patients, a result of the Affordable Care Act (ACA), along with an aging population, is expected to increase demands on California's health care workforce. Will providers be ready?

A package of new publications from CHCF's California Health Care Almanac examines workforce issues from a variety of angles. As highlighted by an infographic, some regions, like the San Joaquin Valley, have a far smaller supply of both primary care physicians and specialists than some other regions, such as the Bay Area.

California Physicians: Surplus or Scarcity? finds the number of physicians increased by nearly 40% between 1993 and 2011 (outpacing growth in the general population). At the same time, close to one-third of California physicians are nearing retirement age.

California Nurses: Taking the Pulse provides an overview of nursing, which — with more than 300,000 actively licensed registered nurses (RNs) — comprises the largest health profession in the state. Over the past 15 years the number of RNs has steadily increased, although the ratio of RNs per capita has remained significantly lower than the national average. Five Quick Reference Guides share highlights on allied health professions including pharmacists, physician assistants, therapists, imaging technicians, and clinical lab scientists.



February 2014 -- ISSUE BRIEF | Robert Wood Johnson Foundation

The demand for long-term care services will explode as the population ages and more people live longer with chronic conditions. Who will pay for these services and how will they be delivered?



December 19, 2013 -- REPORT | California HealthCare Foundation

California's Uninsured: By the Numbers provides a look at California's uninsured population before full implementation of the ACA. Key findings in this annual update include:

  • While one in five Californians overall is uninsured, the rate among those who work is even higher: one in four.
  • Sixty-two percent of uninsured children in California are in families where the head of the household worked full-time during 2012.
  • Employees in businesses of all sizes are more likely to be uninsured in California than in the rest of the United States. In businesses with fewer than 10 employees, 40% of workers are likely to have no insurance.
  • Nearly one-third of the uninsured in California have annual family incomes of $50,000 or more.
  • Nearly 60% of the state's uninsured population is Latino.



December 18, 2013 -- REPORT | California HealthCare Foundation

This first public performance dashboard of Medi-Cal managed care shows areas of strength and opportunities for improvement. Among the key findings:

  • Medi-Cal managed care performs at or above the national Medicaid median on 17 of 19 quality indicators. On the two measures for which Medi-Cal lags behind the national median — postpartum care and timeliness of prenatal care — the gap has persisted over the last four years.
  • On most measures of consumer experience, the program performs below the national Medicaid median.
  • Across all measures of quality, access, and consumer satisfaction, there are considerable differences in performance among participating plans, including significant variation in plan performance within counties.
  • Most plans participating in Medi-Cal appear to be in sound financial health. Two plans, however, have had net losses in each of the last two years.



December 12, 2013 -- REPORT | National Center for Health Statistics (NCHS)

The National Center for Health Statistics released a 93-page report based on findings from the National Study of Long-Term Care Providers. The study considered long-term care services provided by adult day services centers, home health agencies, hospices, nursing homes, and assisted living and similar residential care communities. The key goals of the periodic study are to:

  • Estimate the supply of paid, regulated long-term care services providers
  • Estimate key policy-relevant characteristics of these providers
  • Estimate the number of long-term care services users
  • Estimate key policy-relevant characteristics of these users
  • Compare provider sectors
  • Produce national and state estimates, where feasible
  • Monitor trends over time



November 2013 -- ISSUE BRIEF | National Senior Citizens Law Center (NSCLC)

A new NSCLC issue brief provides an overview of new coverage options and how they impact low-income older adults and people with disabilities. The brief also explores how people receiving coverage under Medicaid expansion and exchanges will transition into Medicare coverage when they turn 65 or otherwise become eligible. While the issue brief focuses on how these issues play out in California, much of the information is relevant to advocates and policymakers in other states as well.



November 2013 -- REPORT | California HealthCare Foundation

This report shows interest continues to grow among Californians in using technology to support their health care needs, with 60% saying they would like online access to their health information. Similar percentages want the ability to schedule appointments online, receive appointment reminders, and email their medical professionals.



November 2013 -- ARTICLE | California HealthCare Foundation

This article asserts that as demand for adult health care services surges, the number of primary care physicians entering medicine continues to decrease, with shortages predicted to reach as high as 40,000 to 52,000 over the next decade. Recruiting new physicians is a logical solution, but one that won't close the care gap anytime soon.



October 2013 -- REPORT | California HealthCare Foundation

This report looks at the quality of care in California on a variety of measures, including childbirth, children's health, and management of patients with common chronic conditions. It also provides data on patient safety, nursing homes, home health, and end-of-life care.



September 2013 -- SCORECARD | The Commonwealth Fund

Of all the challenges we face in health care, variation in system performance and disparities in health outcomes are among the most persistent and troubling. The Commonwealth Fund's new Scorecard on State Health System Performance for Low-Income Populations, 2013 sheds light on these problems and identifies opportunities for states to improve their health systems for economically disadvantaged populations.

The report identifies benchmarks for state performance and shows that if all states reached the targets, an estimated 86,000 fewer people would die prematurely and tens of millions more adults and children would receive timely preventive care. The disparity in performance between the leading and lagging states, as much as four-fold, represents a critical opportunity to lessen the burden of chronic disease, avoid unnecessary and costly hospitalizations, and improve the overall health of the nation.



September 2013 -- REGULATORY ALERT | ORDER FORM | California Association for Adult Day Services

On September 23, ALL Adult Day Health Care / CBAS facilities that are subject to the HIPAA privacy and security rules must come into compliance with the “HIPAA Omnibus Rule” which implements changes required by the HITECH Act of 2009. Any facility engaging in electronic transmission of protected health information is included. Failure to have internal guidelines in place that comply with the new Rule can lead to fines and other sanctions after September 23, 2013.

A fully updated Privacy Policies and Procedures Manual, designed to be easily customizable to your center, is available from CAADS. This manual replaces the previous CAADS HIPAA Policy and Procedures Manual in its entirety.


HEALTH CARE COSTS 101 -- Slow Growth: A New Trend?

September 2013 -- REPORT | California HealthCare Foundation

Relying on the latest data available, Health Care Costs 101, part of CHCF's California Health Care Almanac, details how much is spent on health care in the US; which services are purchased; and what proportions are financed by households, government, and business. Key findings include:

  • In 2011, health care spending reached $2.7 trillion, an average of $8,680 per person.
  • Both health spending and the overall economy grew at similar rates, keeping health care's share of the gross domestic product (GDP) unchanged for the third straight year at 17.9%.
  • The slow rates of growth were seen across all spending categories in 2011, and no major categories exceeded 5% per year.
  • Prescription drugs spending increased 2.9% in 2011, a near-record low.
  • Public health insurance paid for the largest share of the nation's care at 39%; private health insurance paid for 33%.
  • Health care spending consumed 46% of federal government revenues and 6% of household income.

Infographic: US Health Care Spending 1960-2011: Who Pays?



August 2013 -- California HealthCare Foundation

The leading edge of the baby-boom generation is beginning to flood California's long term care system. And the population of residents 65 and older is projected to triple by 2060. Long Term Care in California: Ready for Tomorrow's Seniors? describes the state's supply and use of long term care services, including Medicare and Medicaid spending on services, and quality of care. The oversight and regulation of long term care services varies by provider, resulting in limited information — especially quality data — about assisted living facilities, personal care providers, and other home- and community-based services.

This report is published as part of CHCF's California Health Care Almanac, an online clearinghouse for key data and analysis examining California's health care marketplace. Find all Almanac reports at

*Correction: The graphic on page 49 of Long Term Care in California: Ready for Tomorrow's Seniors? mischaracterized the frequency of reviews for assisted living facilities. These facilities are subject to annual compliance reviews and investigations of serious complaints, but are not subject to annual site inspections.


August 13, 2013 -- AP/NORC Center for Public Affairs Research Poll

Langer Research Associates launched an in-depth analysis of the April 2013 AP/NORC Center for Public Affairs Research poll. Findings show that people who know where to get information on long-term care are more apt to prepare for those needs. Funded by The SCAN Foundation, the survey results detailed in Pathways to Progress in Planning for Long-Term Care, explore why this avoidance occurs – with useful conclusions for policymakers, practitioners and the public alike.


August 2013 -- PHI Data Center Web Tool

This unique state-by-state web tool now includes standards for home health, personal care, and nursing aides. View California's profile of Workforce Size, Employment Projections, Wages, Health Coverage, Public Assistance, Training, Legislation/Regulation, Best Practices and Resources.


May 20, 2013 -- The Gerontologist

In The Effects of Adult Day Services on Family Caregivers' Daily Stress, Affect, and Health: Outcomes From the Daily Stress and Health (DaSH) Study, we examine the effects of use of adult day service (ADS) by caregivers of individuals with dementia (IWD) on daily stressors, affect, and health symptoms. Participants were interviewed for 8 consecutive days. On some days, the IWD attended an ADS program and on the other days caregivers provide most or all of the care at home.

Methods: Participants were 173 family caregivers of IWDs using an ADS program. Daily telephone interviews assessed care-related stressors, noncare stressors, positive events, affect, and health symptoms. Multilevel models with data nested within persons were used to examine effects of ADS use on daily stressor exposure, affect, and health symptoms.

Results: Caregivers had lower exposure to care-related stressors on ADS days, more positive experiences, and more noncare stressors. ADS use lowered anger and reduced the impact of noncare stressors on depressive symptoms.

Implications: The findings demonstrate that stressors on caregivers are partly lowered, and affect is improved on ADS days, which may provide protection against the effects of chronic stress associated with caregiving.


APR 2013 Guide -- The California HealthCare Foundation

Tracking ACA Implementation in California

The California HealthCare Foundation (CHCF) has updated its Tracking ACA Implementation in California guide, which details California's progress toward meeting the Affordable Care Act's (ACA) four main objectives — expanding coverage in public programs; streamlining eligibility and enrollment; protecting health insurance consumers; and creating a user-friendly marketplace for consumers to shop for private health insurance.


APR 2013 Poll Findings -- Associated Press-NORC Center for Public Affairs Research

LONG-TERM CARE: Perceptions, and Attitudes among Americans 40 or Older

According to a new poll, Americans underestimate their chances of needing long-term care as they get older - and are taking few steps to get ready. Conducted by the Associated Press-NORC Center for Public Affairs Research, funded by The SCAN Foundation, the poll examined how people 40 and over are preparing for this difficult and often pricey reality of aging. Related articles:
Poll: Aging US in denial about long-term care need | AP Mobile | 4/24/2013
Americans Seriously Unprepared for Long-Term Care, Survey Finds | PBS NEWSHOUR | 4/24/2013


APR 2013 Fact Sheet -- The SCAN Foundation

Cal MediConnect Program

Cal MediConnect: A Summary of the Memorandum of Understanding Between California and the Centers for Medicare and Medicaid Services is a 13 page fact sheet issued by the SCAN Foundation. The fact sheet provides background information and summarizes key points of the MOU that formalized a federal-state partnership to implement the Dual Eligibles Integration Demonstration known as "Cal MediConnect."


APR 17, 2013 Report -- The California HealthCare Foundation

APR 17, 2013 -- California's Health Care Safety Net: A Complex Web

The health care safety net is a complicated web of programs and providers that serve low-income Californians without private health insurance. Changes in the economy, government budgets, and health care policy can influence how the safety-net population obtains medical care. An updated report by the California HealthCare Foundation, California's Health Care Safety Net: A Complex Web, provides a snapshot of California's safety net at a critical juncture ahead of the full implementation of the federal Affordable Care Act (ACA) in 2014. Stakeholders are preparing for important ACA deadlines, such as the expansion of Medi-Cal, the state's largest safety-net program, while legal and political battles wage on over the future of health care reform.


APR 17, 2013 Compendium -- The SCAN Foundation

Long Term Services and Supports Program Compendium

The Long Term Services and Support Program Compendium, issued by The SCAN Foundation, is a compendium of federal and state agencies and departments supporting Long-Term Services and Supports Systems (LTSS), including:

  • U.S. Department of Health and Human Services (DHHS)
  • Centers for Medicare and Medicaid Services (CMS)
  • Administration on Aging (AoA)
  • California Health and Human Services Agency Program Initiatives
  • California Department of Health Care Services (DHCS) Programs/Services
  • California Department of Aging (CDA) Programs/Services
  • California Department of Rehabilitation (DOR) LTC Programs/Services
  • California Department of Social Services (CDSS) Programs/Services
  • California Department of Public Health (CDPH) LTC Programs/Services
  • California Department of Developmental Services (DSS) Programs/Services


March 2013 -- NSCLC

President Obama recently appointed the final members of the Commission on Long Term Care. Over the next six months the Commission must accomplish one objective: develop a plan for the establishment, implementation and financing of a comprehensive, coordinated, and high-quality system that ensures the availability of long-term services and supports (LTSS) for individuals who need LTSS. Read The HCBS Opportunity: Recommendations for the Commission on Long-Term Care


Examining the Experiences of Beneficiaries

March 28, 2013 - The video and slides from the March 28, 2013 California HealthCare Foundation briefing, Transitioning the SPD Population to Medi-Cal Managed Care: Examining the Experiences of Beneficiaries, may be viewed on the State Health Policy page of the CHCF website.


MAR 22, 2013 Survey Findings -- Genworth

Genworth 2013 Cost of Care Survey

Home Care Providers, Adult Day Health Care Facilities, Assisted Living Facilities and Nursing Homes
For the 10th consecutive year, Genworth has examined the cost of long term care across the U.S. to help Americans plan for these expenses. The most comprehensive study of its kind, Genworth’s 2013 Cost of Care Survey (conducted by CareScout®) covers nearly 15,000 long term care providers across all 50 states and the District of Columbia, in 437 regions nationwide. This unique level of detail can help consumers plan for long term care costs in their preferred location and care setting. (96 pages)


FEB 2013 Health Policy Brief -- UCLA Center for Health Policy Research

Limited English Proficient HMO Enrollees Remain Vulnerable to Communication Barriers Despite Language Assistance Regulations

The policy brief, Limited English Proficient HMO Enrollees Remain Vulnerable to Communication Barriers Despite Language Assistance Regulations, reveals that HMO enrollees with limited English proficiency, and particularly those in fair to poor health, face communication barriers despite language assistance regulations. More than 1.3 million California HMO enrollees ages 18 to 64 do not speak English well enough to communicate with medical providers and may experience reduced access to high-quality health care if they do not receive appropriate language assistance services.

Based on analysis of the 2007 and 2009 California Health Interview Surveys (CHIS), commercial HMO enrollees with limited English proficiency (LEP) in poorer health are more likely to have difficulty understanding their doctors, placing this already vulnerable population at even greater risk. The analysis also uses CHIS to examine the potential impact of health plan monitoring starting in 2009 (due to a 2003 amendment to the Knox-Keene Health Care Services Act) requiring health plans to provide free qualified interpretation and translation services to HMO enrollees.

The authors recommend that California’s health plans continue to incorporate trained interpreters into their contracted networks and delivery systems, paying special attention to enrollees in poorer health. The results may serve as a planning tool for health plans, providing a detailed snapshot of enrollee characteristics that will help design effective programs now and prepare for a likely increase in insured LEP populations in the future, as full implementation of the Affordable Care Act takes place over the next decade.


JAN 2013 Fact Sheet -- The SCAN Foundation

California’s Proposed 2013-14 Budget: Impact on California’s Seniors and People with Disabilities

On January 10, 2013, California Edmund G. Brown, Jr. released his proposed budget, outlining his spending plan for fiscal year beginning on July 1, 2013 and ending June 30, 2014. This fact, California's Proposed 2013-14 Budget: Impact on California's Seniors and People with Disabilties, looks at the initiatives and program adjustments that would impact California's seniors and people with disabilities.


NOV 13, 2012 Study Findings -- MetLife Mature Market Institute®

2012 MetLife Mature Market Study of Long Term Care Costs

The MetLife Mature Market Institute® has released the 2012 MetLife Mature Market Study of Long Term Care Costs, its annual national survey of charges for adult day services, home care, nursing homes and assisted living. The study found that the national average daily rate for adult day services is $70, unchanged from 2011 after being $67 in 2009 and 2010. The median daily rate for adult day services rate nationally remained at $65.

Home health aide rates were unchanged at $21, although homemaker rates increased by 5.3% to $20 per hour from $19 per hour in 2011. National average rates for a private nursing home room increased 3.8% to $248 daily from $239 daily in 2011. Assisted living base rates rose by 2.1% to $3,550 monthly from $3,477 in 2011.


OCT 12, 2012 -- AARP Public Policy Institute

Across the States 2012: Profiles of Long-Term Services and Supports

From the AARP Public Policy Institute, Across the States 2012: Profiles of Long-Term Services and Supports presents comparable state-level and national data for more than 140 indicators, drawn together from a wide variety of sources into a single reference. The full report provides a comprehensive picture of long-term services and supports in each state.
[ In-Brief 2 pgs || Executive Summary 92 pgs || CA 8 pgs || Full Report 370 pgs ]


OCT 10, 2012 Report -- Center of Budget and Policy Priorities

Moving “Dual Eligibles” Into Mandatory Managed Care and Capping Their Federal Funding Would Risk Significant Harm to Poor Seniors and People With Disabilities

As policymakers seek to reduce federal budget deficits, they may face proposals to reduce spending on low-income Medicare beneficiaries who also are eligible for Medicaid (the “dual eligibles”) by 1) requiring them to receive both their Medicare- and Medicaid-covered services through a single managed care plan that would operate under a contract with their state, and 2) imposing a cap on the funding their state would receive for that purpose. Such proposals would be ill-advised at this time.

Experts agree that we should try to find ways to better coordinate care for these beneficiaries that would improve quality of care while producing savings. But, as the report Moving "Dual Eligibiles" Into Mandatory Managed Care and Capping Their Federal Funding Would Risk Significant Harm to Poor Seniors and People with Disabilities shows, we do not yet know how to do this.


MAY 2012 Policy Brief - Center for Health Care Strategies

Medicaid Rate-Setting Strategies to Promote Home- and Community-Based Services

In creating managed long-term services and supports approaches that foster home- and community-based services, states need to explore rate-setting strategies that reward health plans for promoting the use of such services. The brief, Medicaid Rate-Setting Strategies to Promote Home- and Community-Based Services, discusses strategies for structuring rates for managed long-term services and supports programs to encourage the use of home- and community-based services and details state experiences in setting rates for these programs.


MAY 24, 2012 Survey Findings - Jackson Healthcare

A Tough Time for Physicians: 2012 Medical Practice & Attitude Report

In A Tough Time for Physicians: 2012 Medical Practice & Attitude Report, Jackson's findings from a series of surveys conducted between May and June 2012 are summarized. Topics surveyed and included in this report:

  • Current practice environment (p 5)
  • Current retirement plans (p 7)
  • Current access for Medicaid and Medicare patients (p 10)
  • Current use of physician assistants and nurse practitioners (p 13)
  • Current participation in Accountable Care Organizations or Medical Homes (p 15)
  • Current attitudes on the Affordable Care Act (p 17)

FEB 17, 2012 Report - LAO

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

In a February 17, 2012 LAO report, The 2012-13 Budget: Integrating Care for Seniors and Persons With Disabilities, 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.


DEC 2011 Health Policy Brief -- UCLA Center for Health Policy Research

Independence at Risk: Older Californians with Disabilities Struggle to Remain at Home as Public Supports Shrink

Researchers spent a year following and documenting the lives of a typical group of seniors with disabilities who are enrolled in Medicare and Medi-Cal and receive in-home and community care in Los Angeles, San Diego, San Francisco and Santa Clara counties. The seniors depend on fragile networks of paid public programs and unpaid help to live safely and independently at home. In spite of these challenges, most display resilience and fortitude, and all share a common determination to maintain their independence at almost any cost. Read Independence at Risk: Older Californians with Disabilities Struggle to Remain at Home as Public Supports Shrink.


OCT 2011 Study -- Centers for Disease Control and Prevention National Center for Health Statistics

National Study of Long Term Care Providers

The National Study of Long-Term Care Providers (NSLTCP) is a new integrated initiative sponsored by the Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS). The NSLTCP will replace the NCHS’ National Nursing Home Survey, National Home and Hospice Care Survey, and National Survey of Residential Care Facilities.

NCHS plans to field the residential care and adult day care components of NSLTCP in late 2012. Participants will be selected randomly from among all residential care communities and adult day services centers in the United States. The main goals of NSLTCP are to:

  1. Estimate the U.S. national supply of paid, regulated LTC providers (i.e., nursing home, home health care, residential care, adult day care, and hospice).
  2. Estimate key policy-relevant characteristics and practices of these providers.
  3. Estimate the use of these providers.
  4. Estimate key policy-relevant characteristics of these users.
  5. Monitor national trends in these estimates of LTC supply and use, overall and by provider type.

NCHS plans to release the first NSLTCP overview report in late 2013, using a combination of survey and administrative data. This first report will include nursing homes, home health care agencies, hospices, residential care facilities, and adult day services centers. To learn more, visit or contact: Dr. Lauren Harris-Kojetin, Chief, Long-Term Care Statistics Branch,, 301-458-4369.


OCT 27, 2011 Chart -- Medi-Cal Provider Payment Reductions

Medi-Cal Provider Payment Reductions in SPAs Approved by CMS

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:

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


OCT 2011 Study Findings -- California Association for Adult Day Services

A Study of Patient Discharge Outcomes Resulting from California's Elimination of Adult Day Health Care on December 1, 2011CAADS Report on ADHC Patient Discharge Outcomes

CAADS surveyed ADHC providers for the purpose of analyzing overall services needed and services available for typical ADHC patients attending 4 or 5 days per week who will be involuntarily discharged from ADHC when Medi-Cal funding for the program ends December 1. Read A Study of Patient Discharge Outcomes Resulting from California's Elimination of Adult Day Health Care on December 1, 2011 - CAADS Report on ADHC Patient Discharge Outcomes. The findings focus on:

  • Post-ADHC Discharge Prognosis
  • Multi-Disciplinary Team Recommendation for Discharge
  • Patient Needs
  • Services Needed / Available
  • Significant Risk Factors

In compliance with HIPAA, the ADHC Involuntary Discharge Form was developed as an e-form which transmitted the data without patient identifying information.


SEP 21, 2011 Policy Brief -- UCLA Center for Health Policy Research

Stressed and strapped: Caregivers in California

Family members or friends caring for aging or disabled individuals in California are under both financial and emotional strain and are likely to face even greater burdens, given recent cuts in state support for programs and services that support in-home care, according to the authors of a new policy brief, Stressed and strapped: Caregivers in California, by the UCLA Center for Health Policy Research.


JUN 2011 Survey Findings - California Association for Adult Day Services

Elimination of ADHC as a Medi-Cal Optional Benefit

CAADS surveyed California's ADHC providers on the impact the elimination of ADHC as a Medi-Cal optional benefit would have on their center, patients and community. The survey findings focus on:

  • Adult Day Health Care Providers Ability To Stay Open Without Medi-Cal Reimbursement
  • Nursing Facility Placements and Access to Medi-Cal Nursing Home Beds
  • Psychiatric Facility Placements and Access to Medi-Cal Psychiatric Beds
  • Consequences For Patients With Developmental Disabilities
  • Cost Shift to Emergency Rooms and Emergency Room Visits Over One Year
  • Consequences for IHSS Caregivers and Consequences for Working Caregivers
  • Availability of Alternative Services


MAY 10, 2011 -- HMA / Health Management Associates

Keeping Adults Free from Institutions (KAFI): Medicaid Options to Guide Program Design

The 2010-2011 California Legislature enacted AB 97 eliminating Adult Day Health Care as a Medi-Cal covered service. The legislature is instead proposing to transition individuals no longer eligible for ADHC services to other service options including California’s In-Home Supportive Services program, (which provides personal care and related services) or to existing home and community-based services (HCBS) waivers. Read Keeping Adults Free from Institutions (KAFI): Medicaid Options to Guide Program Design.


MAR 2011 Policy Brief -- UCLA Center for Health Policy Research

The Health of Aging Lesbian, Gay and Bisexual Adults in California

Members of California's aging lesbian, gay and bisexual population are more likely to suffer from certain chronic conditions, even as they wrestle with the challenges of living alone in far higher numbers than the heterosexual population, according to a new policy brief from the UCLA Center for Health Policy Research.


2011 Survey Findings -- Genworth

Genworth 2011 Cost of Care Survey: Home Care Providers, Adult Day Health Care Facilities, Assisted Living Facilities and Nursing Homes

Across 437 regions, surveyors polled more than 34 percent of adult day health care facilities, resulting in more than 1,300 completed surveys. ADH is designed to meet the needs of adults who are functionally and/or severely cognitively impaired. Programs are intended to be structured and comprehensive, and to take place in a protective setting that promotes well-being through a variety of health, social and other support services.


JAN 2010 Report -- Case Western Reserve University

Evaluation of the Parma D.A.Y. (Designed Around You) Program

Facilitating the safe transition of persons from the acute care hospital to home is a priority issue, given the frequency with which individuals are readmitted and/or visit the emergency department within 30 days of discharge. Many of these individuals require rehabilitation services, but reimbursement policy currently limits available options for continuing care. Furthermore, families may need more comprehensive education about health care needs of their family member, and home environments may need to be modified to ensure safety once the person returns home. One strategy for meeting these needs of patients and family members is an expanded adult day services program.


DEC 9, 2010 Investigative Report -- National Public Radio

A New Nursing Home Population: The Young

There's one age group that's going into nursing homes at a higher rate. And it's not the elderly. Young people ages 31 to 64 now make up 14 percent of the nursing home population, an analysis of federal data from the Department of Health and Human Services by NPR's Investigative Unit found. That's up from 10 percent just 10 years ago.


MAY 18, 2010 Report -- The Lewin Group

Projected Economic Impact of Eliminating California's Medi-Cal Adult Day Health Care Program

Our analysis indicates that the savings associated with eliminating this program would be more than offset by cost-shifting to other services and reductions to State revenue resulting from the program elimination. In total, we estimate the State would lose $51 million in 2010-11 over and above the estimated savings that would come from eliminating the program (excluding the loss of federal matching funds). Annual losses to the State are projected to increase to $72 million in 2020-21, $198 million in 2030-31 and over $412 million in 2040-41.


FEB 2010 Policy Note -- UCLA Center for Health Policy Research

Budget Proposals Turn Back Clock 30 Years in Long-Term Care Services for California Seniors

The 2010-2011 California budget proposal released in January by Governor Arnold Schwarzenegger’s office proposes deep cuts in community-based services available to low-income seniors and low-income Californians of all ages with disabilities. The cuts will make it much more difficult for many older adults to continue to live safely in their own homes, create hardships for their families, lead to a loss of jobs and health insurance by direct service providers, and close many adult day care centers. Increased use of emergency rooms, hospital in-patient care and nursing facilities by affected older adults are likely to erode the financial savings of the reductions.


OCT 2009 Policy Brief -- UCLA Center for Health Policy Research

California Budget Cuts Fray the Long-Term Care Safety Net

The deep budget cuts enacted by California’s legislature in the summer of 2009 will be felt especially among the elderly and infirm. Disabled older adults with low incomes will find it harder to access services and, ultimately, harder to live safely at home.


JUL 2006 Report -- U.S. Department of Health and Human Services

Adult Day Services: A Key Community Service for Older Adults

Adult day health services are part of the continuum of both health and long-term care services. In the states we visited, ADS providers are furnishing preventive care, health monitoring, and skilled nursing services to individuals with chronic illnesses and physical and cognitive impairments. Some providers are also serving adults under age 65, depending on regulatory requirements and the funding streams for this population.


OCT 2003 County Data Book -- UCLA Center for Health Policy Research

Health of Older Californians: County Data Book

Data from the 2001 California Health Interview Survey and 2000 U.S. Census

This data book provides important information about the health behaviors, health status, and the use of health services by Older Californians. The first section contains a narrative summary about the health of the older people in California. The second section has maps that show the distribution of the older population along several of the basic demographic characteristics used in this report, including race/ethnicity, low-income, and limited-English proficiency. The third section provides a series of two-page tables with the rates of selected health behaviors, the health status, and the use of health services of older Californians. Each geographic area has columns with information for elders of different races and ethnicities, older women, older people with low-incomes, older people with limited-English abilities, and for Medi-Cal recipients age 65 and over. This section ends with a summry table that makes comparisons between counties easier for the total county populations of older adults. The fourth section has demographic data for the state, substate regions, and each of the 58 counties. The fifth section contains technical appendices and acknowledgments.



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