OAKLAND — A federal judge Thursday ordered California to halt its cuts to the Adult Day Health Care program, unless and until the poor, elderly, disabled clients it serves are provided other MediCal services to prevent their institutionalization.

U.S. District Judge Saundra Brown Armstrong issued the 24-page ruling Thursday afternoon, one day after a 21/2 hour hearing in which a lawyer for the state Department of Health Care Services argued that it is up to the individual nonprofits and for-profit businesses operating the more than 300 ADHC centers across California to find alternative services for the clients.

Armstrong's ruling hinged on her finding that the named plaintiffs — three elderly women — would be put at high risk of requiring hospitalization or placement in nursing homes should their ADHC access be cut back from a maximum of five four-hour visits per week to a maximum of three four-hour visits. Such a risk could violate the plaintiffs' rights under the Americans with Disabilities Act.

"The harm in this instance is particularly irreparable and imminent," the judge wrote, noting the ADHC cuts — scheduled to take effect this week — would cause an immediate and significant reduction in services.


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The centers provide skilled nursing care, psychiatric and social services, meals and other services to thousands of disabled, low-income seniors up to five days a week with the goal of letting them continue living at home.

"As discussed, these services are necessary and critical to Plaintiffs' physical and mental well-being," the judge wrote. "Given the tenuousness and complexities of their conditions, an interruption in their care, even if temporary, will have serious consequences for Plaintiffs."

The cutback is part of the budget agreement reached by the Legislature and Gov. Arnold Schwarzenegger and could be rescinded after the state finishes reviewing eligibility requirements, but Deputy Attorney General Susan Carson acknowledged Wednesday that some clients' services might be permanently reduced.

Rachel Cameron, a spokeswoman for Schwarzenegger, said the administration is reviewing its legal options.

"The Governor understands how difficult these cuts are and sees the real Californians and the real consequences behind them, but had to make the difficult and necessary decisions to cut spending and close the state's multibillion dollar deficit," she said.

The plaintiffs' attorney, Elizabeth Zirker of Oakland-based Disability Rights California, said Thursday that her clients "have been very concerned about what's going to happen to them "... and they're incredibly relieved and happy."

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