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
Comments
The webinars throughout the pandemic have been of extreme high caliber and critical for our industry. I can’t thank Archstone enough for sponsoring this critical project.
Dear Mrs. Devaney
I’m working in an adult day care center and I’m looking for activities that we can do remotely to help mental or maybe physical health of our seniors. Because, as you know, elderly can’t get used to technology easily.
I would be grateful if you let me know about the list of activities we could do.
Sincerely,
Elahe Zare
Hello Elahe,
Some of the Adult Day Service programs we work with provide weekly activity packets, frequent wellness phone check-ins, video exercise classes, food drop offs, connections to other social services, and support groups for caregivers.
Also, some have provided drive-by opportunities to their Adult Day Care center so that participants can see familiar faces that they used to see daily.
I would also suggest visiting the California Association for Adult Day Services website at https://caads.org/covid-19.html for additional information, and reaching out to other local Adult Day Care centers in your area to see what might be working for them.
Kind regards,
Jasmine Lacsamana
jlacsamana@archstone.org
Hi Melissa. How do the most recent colors and tiers for reopening in San Diego affect in person services for those at United Cerebral Palsy Adult Day Care? We are anxious for our sons program to open back up. He lives at home and his education, socialization and community integration rely on his attendance to UCP. These are essential to his best life. He was a social distance king before it was cool. He loves a bubble around him and also likes social interaction. He is in great health and his staff and peers would be safe around him also. Any information about Adult Day Programs for us would be greatly appreciated. Our number one choice is to go back to UCP as before the shut down March 17.
@Dana L Schoonover
Dana, thank you for sharing how your son thrived as a result of his participation in Adult Day Programs. Currently, some Adult Day Programs continue to provide modified services telephonically or through teleconferencing apps. A number of factors are taken into account as to whether a program can offer services and what services they can provide. Some of these include staff to attendee ratio, space availability, and authorization by licensing boards. The program you are referencing provides primarily adult day social programs which is licensed by the California Department of Social Services.
I am not certain as to which category (orange or yellow) would be considered safe for Adult Day Programs to reopen so I would suggest contacting your program to see what modifications they have made in order to provide services and what preparations they are putting into place for when they are allowed to reopen their facilities.
To find the latest information on your specific county’s risk level, rate of new cases, and positivity rate, visit https://covid19.ca.gov/safer-economy/.
I wish you and your family good health.
Kind regards,
Jasmine Lacsamana