Arguing that confusion and problems abound, advocates are seeking to postpone state plans to transition thousands of frail seniors into a new day program.
The controversy surrounds the state's decision to eliminate Medi-Cal funding for adult day health care programs serving nearly 35,000 seniors, shifting many of them to the new program.
But the upheaval and a bogged-down state response to seniors appealing to be found eligible for the new program has thrown the plan into disarray, critics say.
The delays and confusion are taking a toll on families, said Debbie Toth, CEO of Rehabilitation Services of Northern California, which operates the Mt. Diablo Center in Pleasant Hill and the Bedford Center in Antioch.
"People are stressed," Toth said. "They're scared. This has been a really brutal time for them."
A state legislator has set a hearing to consider the complaints Monday in Sacramento.
Eliminating funding for adult day health care was a painful 2011 budget decision made with the understanding that some service would continue for the most vulnerable seniors, said Assemblywoman Mariko Yamada, D-Davis.
"Despite a legal agreement establishing a standard for these replacement services, many of our constituents report continued problems in timely adjudication of appeals and access to care," Yamada said in a statement this week.
The hearing will begin at 1 p.m. in room 126 of the state Capitol.
The adult day health care program was meant to help keep people out of nursing homes. Seniors attended several days a week for lunch and social activities when they might otherwise be staying home alone. The programs also typically had nurses and physical, occupational and speech therapists available.
The decision to eliminate Medi-Cal funding for the program upset seniors and many of their caregivers, who relied on the centers to enable them to work or for respite from caring for their frail elders.
After advocates sued, the state agreed to set up a scaled-back program, known as Community Based Adult Services or CBAS, that would serve only those with the most serious health problems.
But the transition has not gone smoothly, advocates say.
To be eligible for the new program, seniors must switch to a Medi-Cal-managed program by Oct. 1.
But Toth said some doctors have been confusing and scaring patients by telling them they will no longer see them if they switch, and people will have to make large co-payments when they find a new doctor. Some physicians mistakenly believe they will be paid the lesser Medi-Cal fees, instead of Medicare payments.
State officials have noted that most participants are dually eligible for Medicare and Medi-Cal, and that primary care doctors and many specialists will continue to be paid through Medicare, as they are now.
Last week, Disability Rights California went to court seeking to postpone the transition, arguing that the state is violating the settlement of a lawsuit filed by the group that led to the CBAS plan.
The two sides are trying to resolve the dispute, said Anthony Cava, state health care services department spokesman. He argued that the state remains in full compliance with the settlement agreement.
"California is committed to ensuring important health care services are provided to our most vulnerable individuals so they can remain independent in their communities," Cava said Friday.