Anita Friedman is waiting for the other shoe to drop.
The good news is that on Nov. 17 the state announced a reprieve for 275 Adult Day Health Care centers, which were slated to endure severe budget cuts — and possible closure — on Dec. 1. The cuts would have taken a huge toll on the L’Chaim Adult Day Health Center, run by S.F.-based Jewish Family and Children’s Services, for which Friedman serves as executive director.
But the bad news, Friedman noted, is that the reprieve expires Feb. 29, 2012. Between now and then, the state will review eligibility requirements for those who receive adult day health care, including L’Chaim clients. Friedman expects up to 50 percent might be disqualified.
Adult Day Health Care is a program that provides services that help keep about 35,000 low-income California seniors out of nursing homes. Gov. Jerry Brown, seeking to ease the state’s $3.7 billion revenue shortfall by reducing Medi-Cal spending, had targeted the ADHC program as a way to save the state about $170 million a year.
Senior advocates sued the state to prevent ADHC from being eliminated, and a compromise was reached Nov. 17 that avoids “across-the-board budget cuts or closures,” Friedman said, but does institute a system to determine eligibility. Many participants in the ADHC program will be transitioned into a new program, Community-Based Adult Services.
“It will probably be based on how sick people are,” Friedman said. “We don’t know which will qualify for continued treatment and which will be rejected.”
She noted that the average age of seniors served by the program is 85, and many are very frail. They have average monthly incomes of less than $900 and qualify for L’Chaim through Medi-Cal, the state’s health insurance program, according to JFCS.
The L’Chaim center in San Francisco’s Sunset District serves approximately 400 elderly Jews, most of them Russian-speaking and many of whom would be housebound or in a nursing home without the center. The list of supports provided by L’Chaim includes medical supplies, hot meals, nursing care, physical therapy, social work and simple human contact.
In October, San Francisco Mayor Ed Lee announced a one-time $3.4 million grant to the city’s ADHC centers, including $600,000 for L’Chaim. Friedman said that amount doesn’t come close to making up the $2.4 million hole left in the center’s budget following state government cuts announced last March.
Friedman said JFCS is actively fundraising to make up the shortfall. Meanwhile, she predicted the state would determine those new eligibility protocols by the spring of 2012. Once in place, she said, they are not likely to change.
“Government cutbacks will not be reversed in the foreseeable future,” Friedman said. “It’s a restructuring of how we care for the old, the sick and the poor. It’s not just a temporary departure, but part of a trend that’s been going on for several decades and has accelerated.”
She added that she feels optimistic as her agency plans for the new reality.
“That’s a healthy process,” she said. “It’s important that this community assess current conditions, then plan how to respond. We have a growing number of poor in the Jewish community that need to be taken care of. That’s the point of the entire Jewish endeavor: to figure out how to care for those people.”