ALE Supports Adult Day Services During COVID-19 Pandemic

When the COVID-19 pandemic hit California, Adult Day Services (ADS), which act as hubs to connect older adults to medical and social care, were forced to quickly transition to providing services remotely. And as a result of the economic devastation the pandemic caused, they also were threatened by severe state budget cuts.

A $50,000 COVID-19 Emergency Response Grant from Archstone Foundation allowed the Alliance for Leadership and Education (ALE) to provide guidance and support to ease the move to remote services, and also advocate for continued funding for ADS.

ADS programs serve more than 30,000 people in California, offering a safe, positive, caring alternative to nursing home care for those who do not need 24-hour skilled nursing. ADS programs, which include Community-Based Adult Services (CBAS), serve to promote both physical and mental health, reduce social isolation, and provide much-needed respite care to their caregivers in facilities known as Adult Day Health Centers (ADHC).

Although these centers serve as the primary location for older adults to receive support, the beginning stages of the COVID-19 crisis disrupted their work. As shelter-in-place orders grew more stringent, Gov. Gavin Newsom limited public gatherings to 100 people, then 50 people, and finally down to 10 people.

At that point, ADHCs across the state closed their doors, under guidance from the California Department of Aging (CDA). Although the crisis moved quickly, ALE partnered with state departments—including the CDA, Department of Health Care Services, and the Department of Public Health—to rapidly respond to the needs of ADS providers.

Within about two weeks, the partnership created guidance to help the centers figure out how to remotely provide their participants with health information, caregiver counseling, meal delivery, supplies, activity programs and nursing telehealth check-ups.

Helping ADS Providers Assess People Remotely

The Archstone Foundation grant enabled ALE to create technically supportive resources for ADS providers to help them navigate the transition to providing services remotely. ALE created a COVID-19 Participant Wellness Check and Risk Assessment to support ADS providers in delivering services to their participants and caregivers weekly by phone. The assessment helps to evaluate the current health and situation of participants, many of whom are experiencing more stress and anxiety as a result of the pandemic. It also helps identify resources that can help.

In addition to identifying necessary services, the wellness checks help facilitate conversations that build rapport and offer support with ADS clients despite the remote environment. ALE sees this as an opportunity to evaluate the effectiveness of the wellness check with an eye toward potentially expanding the use of telehealth communications in the future to help identify resources and support for both new and existing clients.

Additionally, funding from Archstone Foundation supports ALE in hosting weekly meetings with Medi-Cal Managed Care plan members and community members of the California Association for Adult Day Services (CAADS). Through these weekly Wednesday meetings, ALE hosts an hour conversation on a number of topics to help the community and plan members navigate this crisis.

Typically, ALE reviews the most recent guidance from the CDA with community members to increase clarity and awareness. The meetings have also been essential in providing counsel to providers on how to enroll new participants and create modified plans of care. The meetings help identify problems and provide support to members. As a result, the number of individuals streaming these discussions has continued to grow.

The Archstone Foundation grant also helps ALE create a series of weekly webinars that provide information related to the pandemic to guide ADS providers, MediCal managed care plans, and state personnel. An average of 250 members join the webinars each Monday.

In the early stages of the COVID-19 crisis, webinars focused on topics and resources such as infection control, COVID-19 screenings, and preparing for flu control. Now, ALE views the weekly webinars as an opportunity to highlight new insights and information regarding how to improve the ADS model through a greater focus on person-centered care.

Advocating for ADS

While ALE continues working to improve ADS, it also organized grassroot efforts to oppose proposed budget cuts that threatened the continuation of this model. In early May, Gov. Newsom announced a budget proposal that aimed to cut two California day programs: Multipurpose Senior Services Program (MSSP) and Community-Based Adult Services (CBAS). Both programs are instrumental in providing alternatives that help keep older adults out of unnecessary or unwanted institutionalization.

In response, ALE and CAADS organized grassroot efforts through social media. Response materials encouraging individuals to tell legislators that the budget was unacceptable were widely spread and flyers and hashtags opposing the budget cuts were circulated through social media to generate a greater public awareness of the importance of ADS services.

Through the collective effort from individuals, caregivers, and families all fighting to protect the two programs, the 2020-21 state budget rejected the proposed health and human services cuts, ultimately saving CBAS and MSSP. But the work to improve services is far from over, as ALE and CAADS continue to act as key advocates committed to educating and spreading awareness of the benefits of ADS.

Special thanks to Lydia Missaelides, Executive Director, Alliance for Leadership and Education