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Sara Clarenbach, director of community relations at Salud Para La Gente, makes the case for saving Santa Cruz County's only adult day health care program. "Without it, many participants will deteriorate and will have to move into a nursing home at four times the cost to the taxpayer."

By Sara Clarenbach

ON FRIDAY, May 29, Gov. Schwarzenegger announced another $3 billion in budget cuts that include eliminating adult day health-care centers (ADHCs) as a Medi-Cal benefit in California, thus displacing over 36,000 beneficiaries statewide. Given the frailty of the adult day health client population, institutional care will be the only option left for thousands, just as demographic trends and national policy are shifting toward home and community-based care.

Here in Santa Cruz, Salud Para La Gente operates the county's only ADHC, Elderday, located at 100 Pioneer St. in the city of Santa Cruz. Elderday currently has 133 enrolled participants, and averages 81 participants per day, five days a week. In calendar year 2008 Elderday had 19,300 participant visits.

Among Elderday's participants, the three top medical diagnoses are heart problems (50 percent of the participants), diabetes (34 percent) and cardiovascular problems (30 percent). Eighteen percent of the participants are diagnosed with dementia and an additional 8 percent with Alzheimer's. Twenty-two Elderday participants suffer "wandering" issues, 23 need medication management, 13 exhibit psychotic behaviors and 42 are "fall risks."

As is the case statewide, the overwhelming majority of Elderday's participants are entirely dependent on Medi-Cal support for that care. Participants are poor, frail and in ill-health. Without adult day health care, many participants will deteriorate and will have to move into a nursing home at four times the cost to the taxpayer. Elderday estimates that if the program closes, within 30 days of closure 13 participants will have gone to skilled nursing facilities; 18 will have gone to a hospital emergency room. Within six months of closure, an additional 27 elders will be in skilled nursing facilities, and an additional 31 will have gone to a hospital emergency room.

Closing Elderday will disastrously impact not only the participants themselves, but also their families and caregivers who depend on Elderday as their only affordable source of safe, secure, and reliable supervision for the elders. Working caregivers will be forced to give up paying jobs and face their own impoverishment to care for their elders. Elderday employees will also be impacted--they'll lose their jobs.

On Wednesday, June 3, the Legislature's Joint Budget Conference Committee took public testimony on the governor's proposal to eliminate Medi-Cal funding for adult day health centers. Representatives of adult day health centers testified in opposition to the governor's proposal. The Conference Committee is presently conferring in closed session and will shortly make its decision.

Salud urges all Santa Cruz Weekly readers to voice their support for ADHC funding by contacting our legislators and the governor and first lady.

Assembly: Bill Monning--831.425.1503, Anna Caballero--831.759.8676; Senate: Joe Simitian--831.425.0401, Abel Maldonado--831.657.6315; the governor and first lady--916.445.2841. For a list of contacts for conference committee heads and other legislative leaders, call Salud Para La Gente at 831.728.8250.

Sara Clarenbach is director of Advocacy, Community Engagement and Community Relations for Salud Para la Gente.

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