Success Through a Unified Vision: The Fight to Preserve Alzheimer's Care in California

California Association for Adult Day Services

Sacramento, CA

https://caads.org/

Success Through a Unified Vision: the Fight to Preserve Alzheimer’s Care in California saved Adult Day Health Care (ADHC) from elimination as a Medi-Cal benefit through a concentrated effort utilizing public interest litigation, grassroots advocacy and persuasive media stories. As a result of decisions made by the Governor and Legislature to eliminate ADHC as a State Plan Benefit in 2011, 252 centers made plans to discharge 37,000 frail elders including an estimated 15,000 persons with dementia and their families by November 30, 2011. No other state has ever proposed wholesale elimination of the ADHC benefit. Due to the severity of the state’s actions, CAADS’ advocacy prevent significant harm to beneficiaries and the families had to follow an innovative course. Key collaborators included attorneys, Disability Rights of California, AARP, California Hospital Association, and the Alzheimer’s Policy Council. A legal settlement with the state stopped the discharges on December 1, 2011. In addition to reopening the doors to ADHCs across the state, the campaign evidenced other successes: changes in ADHC eligibility requirements, grassroots mobilization, an extensive media campaign resulting in extensive coverage of “impact” stories; and application of the principles of the Americans with Disabilities Act to obtain a temporary injunction based on immediate harm and ultimately a federal court settlement creating the Community Based Adult Services Medi-Cal benefit under managed care. Even so, by mid-2012, 52 ADHCs permanently had closed their doors. The campaign’s key elements and lessons learned could be replicated or adapted in other states.