Kenny Burton, 61, slowly picks out the yellow plastic jewelry beads and puts them in his clenched left hand until he gets to a green one. He stops, looks at the colored beads spread out on the tray before him and begins sorting the blues.
When he was 19, Burton was in a serious motorcycle accident that cost him a 3-square-inch portion of his brain. He has no short-term memory, can't speak, is prone to seizures and for most of his life has needed someone to care for him — a task that fell primarily to his mother and twin brother before they died.
Today, that help comes from a team of occupational and physical therapists, nurses and nursing assistants at Sonoma County's only adult day health center. In the company of other seniors, some of them with Alzheimer's or stroke victims, Burton has found a place of his own.
"When he walks in the door, I get so emotional about it," said Burton's sister Hazel Bishop, 63, of Fulton. "Those are his friends, the people that relate to him, and I'm only a visitor. I'm in his community; he's not in my community and that gives him a sense of worth that he's not had for a long time."
This week, Bishop was told the adult day health program, located for decades at the Friends House campus in Santa Rosa's Rincon Valley, will be closing in mid-July because of state budget cuts. The news has sent her and other clients' family members into a panic about what to do since there is no other adult day center in the county that offers health care services.
State funding for such programs has been threatened for years, and in March 2011 the state Legislature voted to eliminate Adult Day Health Care, or ADHC, as an optional benefit under Medi-Cal, the state's Medicaid program. The community-based program is aimed at keeping low-income, frail seniors and disabled adults from being put into skilled nursing homes or other residential institutions.
Two months later, about a half dozen adult day health clients asked for a preliminary injunction in federal court to stop the elimination of the program. Attorneys for the adult day health clients argued that the state's move violated the due process clause of the 14th Amendment of the U.S. Constitution, the Social Security and Americans with Disabilities acts, as well as other federal and state laws.
Elimination of the program, which serves 35,000 people across the state, without replacing it with adequate services would put many at risk of being placed in an institution, they argued.
Before the case reached a court hearing late last year, the parties reached a settlement. Under the agreement, adult day health clients would be switched from Medi-Cal to a new program called Community Based Adult Services.
But there was one catch. Adult day health programs that were operated by federally qualified health centers would no longer get the enhanced Medi-Cal reimbursement on which they relied so heavily.
The Rincon Valley program is operated by one of them, the Santa Rosa Community Health Centers. Its daily reimbursement before the settlement was between $150 to $170 per person, said Naomi Fuchs, executive director of the health centers.
Under community-based services, the reimbursement is $78. The loss was more than the health centers could cover.