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whos-eligible-state-advocates
They're poor. They're elderly. They're disabled. But are they eligible? Advocates and state officials are struggling to determine just who among hundreds will be allowed to continue in the program that replaces Medi-Cal's Adult Day Health Care (ADHC) system. Cash-starved California slashed the optional ADHC benefit last fall and replaced it with a leaner program called Community-Based Adult Services (CBAS).
The state-wide centers continue to serve about 80 percent of the original 40,000 or so participants, some of California’s frailest individuals, people who suffer from multiple disabilities including Alzheimer's, paralysis and traumatic brain injury. Advocates say the evaluation process for new participants was flawed and left many needy people without care. The state contends that the process worked and that only the most medically fragile individuals qualified, as intended.
- Grizzley-1
Grizzley-1 on September 07, 2012 21:04
The State, particularly in the San Francisco area, is excluding people from eligibility based on incomplete profiles provided by unqualified reviewers. For example, the RN who reviewed a number of cases in our area had two years' operating room experience and several years working as a bureaucrat. She described one of the partciipants she interviewed as "alert and oriented," the fact that, with some of his social skills intact, he has advanced Alzheimer's disease. Nice lady, but has never worked with patients who were awake when she dealt with them. I blame the Department for sending her into a situation for which she was not qualified. Another problem is overrulling of decisions that participants are eligible by bureaucrats who have never seen them and who have reviewed only a limited summary document. The review sysem is broken, and the State is not meeting its agreed-upon deadlines for eligibility hearings, which greatly compounds the problem.
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