CAADS - California Association for Adult Day Services

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What’s at Stake in Current Federal Budget Proposals

Get the Fact Sheet for your district.

Adult Day Health Care: An Unbelievable Cost Containment Resource that Is Underfunded and Underutilized

For those who think Adult Day Health Care (ADHC) is just day care…think again! Yes, it’s a place for family members to drop-off their aging parents while they head off to work, run errands or simply use the time to get a little (and often much needed) respite from their 24/7 caregiving duties. But, ADHCs are so much more than a place to drop off Mom and Dad for part of a day. Read Russell D. Foster's featured article in MAZARS USA HEALTHCARE TRENDS,Sept 2017.

The Effect of Adult Day Program Attendance on Emergency Room Registrations, Hospital Admission and Days in Hospital: A Propensity-Matching Study

Research by Ronald Kelly, PhD finds a decreased reliance on costly health care services by seniors who attend adult day programs. Read Abstract and Full Article | JUN 2017 | The Gerontologist, Volume 57, Issue 3, Pages 552–562.

HELP II Loan Program -- Affordable Capital

The HELP II Loan Program, administered by the California Health Facilities Financing Authority (CHFFA) within the State Treasurer’s Office, offers low cost loans to assist eligible health facilities wanting to expand and improve services to their clients and the greater community. Learn more at

CAADS Next Webinar - JAN 18, 2:30 PM to 4:00 PM

Federal and State Environment Affecting Adult Day Services
CAADS MEMBER: Free, register on Members Only page)
NON-MEMBER: $199, registion form: Write-on :: Fill-in

Past webinar recordings / handouts order form: Write-On :: Fill-In

What's New . . . JANUARY 12, 2018

AB 1500 Passes Unanimously Out of Assembly Aging and Long-Term Care Committee, Heads to Assembly Appropriations Committee JAN 18

JAN 9, 2018 | CAADS

AB 1500, co-sponsored by CAADS and the Alzheimer's Association, would create a $200 million general obligation bond to be placed on the California election ballot in 2020 to stimulate construction and renovation of adult day health care, adult day programs and PACE centers with a focus on unserved or underserved areas of the state. With more than 134 closures of ADHC centers (56 of them just since January 2011) the need to rebuild infrastructure to meet the needs of an aging population has never been greater.

Dawn Myers Purkey, MSW Families need and want this option, as CAADS member Dawn Myers Purkey, Program Director for Yolo Adult Day Health Center, so eloquently expressed in her testimony at the Assembly Aging and Long-Term Care Committee hearing on January 9, in Sacramento. The bill passed unanimously out of Committee.

On January 18, the Assembly Appropriations Committee will meet to vote up or down on this two-year bill, and it could be a tough vote.

Letters of support are encouraged, before January 18, and should be sent to: The Honorable Lorena Gonzales Fletcher, Chair, Assembly Appropriations Committee, State Capitol, Room 2114, P.O. Box 942849, Sacramento, CA 94249-0080 or FAX to (916) 319-2180. To express your support by phone, call: (916) 319-2080.

If you live or work in any of the Appropriation Committee Members' districts, call their Capitol office or fax a letter of support for AB 1500.

Regardless, making your support for AB 1500 known is a way to share the message about the need for and value of adult day services.

Revised MSSP Transition Framework Released

JAN 10, 2018 | California Department of Health Care Services (DHCS)

The Department of Health Care Services (DHCS) has released a revised framework for transitioning the Multipurpose Senior Services Program (MSSP) to managed care, reflecting stakeholder feedback received during the public comment period in the fall of 2017.

As proposed in the Governor's January 2017 budget, the MSSP transition into managed care has been delayed to no sooner than January 1, 2020. This reflects the lengthened demonstration period for the Coordinated Care Initiative (CCI) and will give managed care plans, MSSP sites, stakeholders, and beneficiaries sufficient time to work together to plan for a smooth transition.

The framework outlines the steps and process moving forward in transitioning MSSP to a managed care benefit in the CCI counties, including plan-readiness reviews, consumer protections, and a stakeholder engagement process. DHCS released both redline (accessible) and clean (accessible) versions of the framework, showing the specific changes made in response to stakeholder feedback.

Click here to read more about the revisions and clarifications made to the framework in response to stakeholder feedback.

In response to the request for more detail regarding the model of care, DHCS and the California Department of Aging are convening a workgroup with MSSP sites and health plans to create a model of care proposal. This proposal will be released for public stakeholder comment in the spring of 2018.

Collabria Care and Partnership HealthPlan Team Up to Provide Medi-Cal Palliative Care Benefit

JAN 1, 2018 | Partnership HealthPlan of California

In the months near the end of life, what most people want is a last chance to be themselves, in their homes, with the people they love.

Palliative care is patient- and family-centered care that anticipates, prevents, and treats suffering during end of life. And beginning January 1, 2018, palliative care becomes a covered benefit for all eligible Medi-Cal beneficiaries. The benefit gives individuals, during the period before hospice care is necessary, an alternative to spending time in hospitals and emergency rooms.

Partnership HealthPlan of California (PHC), the Medi-Cal managed care plan for 14 Northern California counties, is pleased that its community-based palliative care pilot program, which launched in September 2015, is becoming a full-fledged benefit. READ MORE

Legitimate CMS Communications to Beneficiaries

JAN 2, 2018 | California Health Advocates, Senior Medicare Patrol

The Senior Medicare Patrol is sharing two very important announcements regarding CMS legitimate communication:

  1. Medicare is sending emails about new Medicare cards coming:

    It was brought to our attention by our Stanislaus SMP liaison, that Medicare is sending emails to beneficiaries with a subscription informing them about New Medicare cards coming in 2018 and asking everyone to update their address with Social Security. We have confirmed with our CMS contacts that these emails are legitimate. The email is from Medicare ( with Subject: New Medicare cards coming in 2018 and Subject: Update your information. Per CMS, they are trying to ramp up their Medicare email efforts in advance of the card mailings. This listserve currently has 300+K on it, and folks will be able to sign up from the homepage after December 20th.

  2. CMS is sending mail containing a survey:

    It was brought to our attention by the Alameda HICAP, about a letter being sent to beneficiaries informing them about a "Medicare Provider Experience Survey" they will be receiving in the mail. According to the letter, a beneficiary's response is voluntary; whether or not he/she take the survey has no effect on his/her Medicare benefits. The survey itself is being sent by nrc Health. For more information, you may visit

Cal Duals CCI Monthly Update: December 2017

PDF | Word

Congress: Protect Americans who need the most care.

DEC 11, 2017 | AARP

The National Adult Day Services Association (NADSA) was asked and agreed to be a signatory urging the House-Senate tax conference committee to retain the Medical Expense Deduction in any final tax restructuring bill. The ad appeared in Politico on Thursday of the past week and was sponsored by AARP on behalf of the signatories.

Politico is a daily publication “with a focus upon Congress and issues that make Washington tick.” It is delivered free to all Capitol offices and available to the public at several other locations in DC.

High Marks for CAADS 40th Anniversary
Annual Meeting and Fall Conference!

DEC 7, 2017 | CAADS

Thank you to all who attended CAADS 40th Anniversary Annual Meeting and Fall Conference. In case you missed it, attendees rated this conference and meeting among the best.

Highlights included a dynamic and entertaining keynote presentation by Greg Newton on marketing and his follow up session on how to turn tours into enrollment. His marketing presentations were eagerly embraced and we are now planning a series of webinars featuring more of Greg Newton and his “marketing magic.”

Kevin Prindiville, JD, Executive Director of Justice In Aging provided the audience with a preview of Congressional legislation that will affect low income seniors and others of moderate income by increasing the federal deficit by $1.5 trillion, triggering cuts to Medicare and Medicaid.

The closing session for ADHCs featured a managed care panel discussion with information about some exciting new initiatives including Plan and Center partnerships on reducing hospital readmissions, and designation of CAADS ADHC members as health homes under the state’s Section 2703 Pilot Project.

The closing session for ADPs featured important Community Care Licensing updates from Claire Matsushita, Assistant Program Administrator, Monterey Park Adult and Senior Care Program.

Attendees rated the education break out sessions uniformly high with requests for repeat sessions in 2018. We value and appreciate attendee feedback, and are pleased to announce Julia Saleh, Program Director for The Bedford Center for Adult Day Health Care in Antioch, is the winner of the drawing for a $50 CAADS Cash Certificate, randomly selected from those who completed the on-line Conference Evaluation.

CAADS staff drawing the winning name --Julia Saleh
CAADS staff -- Kathy Atkinson (standing), Coni Ricci (left), and Phyliss Regino (right) --
draw the winning name for $50 CAADS Cash Certificate. Congratulations Julia Saleh!

Be sure to mark your 2018 calendar now for May 1-3, so you don’t miss CAADS 2018 Spring Conference at the newly remodeled Doubletree Berkeley Marina Hotel!

CMS Temporarily Suspends Improvements in QMB Notices

DEC 8, 2017 | Justice in Aging | Fact Sheet

On October 2, 2017, the Centers for Medicare and Medicaid Services (CMS) initiated changes in the Provider Remittance Advice and the Medicare Summary Notice (MSN) to show more clearly that Qualified Medicare Beneficiaries (QMBs) may not be charged for Medicare deductibles and co-insurance. Unfortunately, CMS will be temporarily suspending these system changes as of December 8 because of significant unforeseen issues affecting provider payments. CMS is working to address the problem and reinstate the new systems sometime in 2018.

The temporary suspension of the system improvements does not affect the rights of QMBs. QMBs do not owe deductibles and co-insurance for any Medicare Part A or Part B services.

The suspension also does not affect another change, instituted in November, that enables providers to confirm QMB eligibility before serving individuals, using the same systems through which they check other insurance coverage.

To learn more about these developments, read our fact sheet.

For more information on QMB protections, see the CMS QMB Program webpage. For tools that advocates can use to assist QMB clients who have been improperly billed, go to Justice in Aging’s Improper Billing page.

Strengthening Medicaid Long-Term Services and Supports in an Evolving Policy Environment: A Toolkit for States

DEC 2017 | Center for Health Care Strategies, Inc. (CHCS) | Toolkit

Long-term services and supports (LTSS) enable more than 12 million Americans to meet their personal care needs and live with dignity and independence in a variety of community and institutional settings. With Medicaid LTSS expenditures of more than $140 billion annually and the aging population projected to grow 18 percent by 2020, the increasing demand for LTSS is putting more pressure on Medicaid at both the federal and state levels. As a result of these challenges, states are seeking to reform their Medicaid LTSS systems to both improve care quality and contain program costs.

A new toolkit, developed by CHCS and Manatt Health with support from The SCAN Foundation and the Milbank Memorial Fund, provides a targeted menu of LTSS reform strategies adopted by state innovators that may be replicated by other states. It identifies concrete policy strategies, operational steps, and federal and state authorities that states have used to advance their LTSS reforms. It also highlights opportunities and challenges that states faced in designing and implementing reforms.

Other stakeholders, such as federal and state legislators, health plans, and providers, may find the toolkit helpful to identify opportunities for collaboration with state Medicaid agencies on future LTSS reform efforts.

Long-Term Care in America:
Views on Who Should Bear the Responsibilities and Costs of Care

DEC 2017 | AP-NORC Center | Overview | Report [HTML :: PDF]

The AP-NORC Center’s fifth annual Long-Term Care Poll explores how older Americans feel about the services and support in their community, the country’s preparedness to meet the care needs of an aging population, and other attitudinal trends.

Results from the 2017 Long-Term Care trends poll find that two-thirds of Americans age 40 and older feel the country is not prepared for the rapid growth of the older adult population. The Associated Press-NORC Center for Public Affairs Research survey also finds that at the local level, less than half of older Americans say their community is doing a good job of meeting older adults’ needs for nursing homes, assisted living facilities, and home health care aides to provide long-term care. Additionally, a majority of older adults say they would like the federal government to devote a lot or a great deal of effort this year to helping people with the costs of ongoing living assistance. READ MORE

Millennials and Dementia Caregiving in the United States

DEC 4, 2017 | USC Roybal Institute | Issue Brief | Full Report

Today, the USC Edward R. Roybal Institute on Aging and UsAgainstAlzheimer’s released a issue brief that shows that one out of six millennial caregivers cares for someone with dementia. With the prevalence of Alzheimer’s disease and other dementias expected to reach nearly 16 million in the U.S. by 2050 from 5 million today, more millennials and young Americans are expected to face caregiving responsibilities in the future.

“Caregiving to family members with dementia can be a full-time job. Caring for the millennial caregiver is a societal investment with the potential of delaying family burdens and health care costs in the future,” said María Aranda, associate professor and interim executive director at the USC Edward R. Roybal Institute on Aging.

The Many Faces of Caregivers:
A Close-Up Look at Caregiving and Its Impacts
Regional Perspectives: California

NOV 2017 | Transamerica Institute | Survey Report

This national survey of 3,000+ non-professional caregivers examines their duties and the impact caregiving has on their personal health and well-being, employment, finances and retirement preparations. It also offers detailed findings about care recipients, including their health status and financial situation. The survey report comprises these chapters:

  • Primary vs. Non-Primary. This chapter contains a portrait of today’s caregivers based on 26 key indicators measuring caregiving’s impacts on both the caregiver and care recipient.
  • Influences of Demographics on Caregiving. These chapters are demographic segmentation analyses by voluntary status, employment status, gender, generations, household income, and ethnicity. Each chapter presents a concise set of 26 key measures for each demographic segment.
  • Regional Perspectives: California is supplemental report to The Many Faces of Caregivers that compares and contrasts California-based caregivers relative to the national population of caregivers.

2018 Open Enrollment for Medicare & Covered California

NOV 1, 2017 | Justice in Aging | California Fact Sheet | National Fact Sheet

Here’s what older adults need to know about this year’s Open Enrollment periods for both Medicare and Covered California.

Open Enrollment

Fall is open enrollment time for both Medicare beneficiaries and enrollees in Covered California purchasing coverage in 2018.

Justice in Aging’s California open enrollment fact sheet reveals who is impacted by fall open enrollment, covers critical dates for each group, and provides key information on actions to take to ensure continuous coverage.

Key Facts

  • Medicare Part C and Part D enrollees should review their coverage options each year as Medicare Advantage and Prescription Drug plans can change their cost-sharing, provider networks, and drug formularies.
  • Medicare’s open enrollment period is from October 15-December 7, 2017.
  • Covered California open enrollment is from November 1-January 31, 2018.
  • Open enrollment periods have been extended for victims of natural disasters like the California wildfires..

Key Issues in Long-Term Services and Supports Quality

OCT 27, 2017 | Charlene Harrington, Joshua M. Wiener, Leslie Ross, and MaryBeth Musumeci | Issue Brief

This issue brief discusses four key issues related to long-term services and supports (LTSS) including institutional and home and community-based services (HCBS) quality, highlighting major legislative and policy changes over the last 30 years. The Appendix Tables provide data about LTSS providers and consumers, summarize key federal laws and policies related to quality, and list selected federal quality measures.

What Are Adult Day Centers -- Besides The Basis For Political Insults?

OCT 11, 2017 | Forbes | Howard Gleckman

Adult day centers seem to have made it into the political debate in Washington, though not in a good way. In his nasty weekend back-and-forth with President Trump, Senator Bob Corker (R-TN) suggested the White House has become an “adult care center” and wondered if the staff had “missed a shift” when Trump launched his Sunday Twitter storm. Yesterday, Rep Diane Black (R-TN)—who wants to run for governor — replied that the Senate“ is an adult day care center” that can't get anything done.

Leaving aside this mature level of political discourse, the name-calling does raise an important question: What are adult day centers and how do they work?

Adult day centers can be an important service to frail seniors and other people with disabilities who are living at home. They provide companionship, social support, and sometimes therapy and medical services. For people who live alone or even with a caregiver, adult day programs are an opportunity to get out of the house and spend time with others. Many, though not all, provide transportation to and from their centers. READ FULL ARTICLE

What’s at Stake in Current Federal Budget Proposals:
Fact Sheets by Congressional District

OCT 2017 | California Budget & Policy Center
Get the Fact Sheet for your district

A number of current proposals at the federal level, put forth by the Trump Administration and congressional leaders, call for deep spending cuts to many important public services and systems that improve the lives of individuals and families across California.

Seniors & the Law: A Guide for Maturing Californians

SEPT 2017 | The State Bar of California

Seniors & the Law — A Guide for Maturing Californians is the third in a series of State Bar consumer education guides and is available in both English and Spanish. The guide addresses a number of issues confronting seniors, including:

  • Finances and debt
  • Social Security and insurance
  • Housing and caregiving
  • Employment
  • Healthcare
  • Elder abuse/elder fraud
  • Grandparents' rights
  • Divorce and remarriage
  • Estate planning and legal services

Your Donations Help!

Three (3) great opportunities to further support Adult Day Services:


Learn more and DONATE today -- thank you!


California Association for Adult Day Services, a 501 (c) 6 non-profit grassroots-driven organization, advocates for the growth and development of adult day services in California and nationally. Centers in membership with CAADS provide innovative day programs that support individuals with physical or mental disabilities and older adults with Alzheimer's disease and their families.
Learn more about CAADS


ALE logoThe Alliance for Leadership and Education (A.L.E.) is a non-profit 501(c)(3) public benefit arm of CAADS. Its mission is to advance innovation and quality in Adult Day Service through research and analysis, education and training, and leadership for the benefit of consumers and their caregivers.



CAADS is a proud member of the National Adult Day Services Association.

Three representatives from California currently serve on the NADSA Board of Directors:

Corinne Jan, RN, PHN (NADSA Treasurer)
CEO, Family Bridges / Hong Fook Centers

Lydia Missaelides, MHA
Executive Director, CAADS

Amanda Sillars, MSW, LCSW
CEO, Total ADHC Solutions, Inc.


For help, call the VA Caregiver Support Line (toll-free):


Mon - Fri 8 AM - 11 PM (EST) || Sat 10:30 AM - 6 PM (EST)


Call DHCS Medi-Cal Fraud Hotline:


The call is free and you can remain anonymous.


The California Senior Medicare Patrol offers free fraud prevention education throughout the state.
To schedule a presentation, call 855-613-7080

See the SMP/Medicare fraud section at, for more information on ways to protect yourself from healthcare fraud and how to detect it.

If you come across any suspicious activity,




California Association for Adult Day Services
1107 9th Street, Suite 701 || Sacramento, CA 95814–3610
T: (916) 552-7400 || F: (866) 725-3123

CAADS 40th Anniversary logo


Human Kindness--it just flows around here
[Download Real Player]

Click to view the clip from CAADS 25th anniversary video
Honoring Adult Day Services pioneers and those they serve.

Facebook Live: It’s ACA Sign Up Season. Here’s What you Need To Know This Year
NOV 2, 2017
California Healthline
Featuring Julie Appleby, KHN senior correspondent
[video starts ~ 1 min mark]

What is an Adult Day Health Care Center? One of San Diego's Best Kept Secrets...
APR 18, 2017
Featuring Kathryn Holt, Owner, Poway Adult Day Health Care Center, and her mother Lois Knowlton, the Center's Administrator

More Videos / Podcasts


Governor Brown’s Proposed Budget Has Only Modest Boost For Health Care
Kenny Goldberg | 1/10/18

What Are Adult Day Centers -- Besides The Basis For Political Insults?
Howard Gleckman | 10/11/17


For Elder Health, Trips To The ER Are Often A Tipping Point
JAN 11, 2018
California Healthline
Judith Graham
emergency room | nursing home | geriatric emergency medicine | caregivers | older adults

Alzheimer's 'Looks Like Me, It Looks Like You'
JAN 10, 2018
California Healthline
Ana B. Ibarra
early onset Alzheimer's | dementia | Alzheimer's Association | #IHaveAlz | 10 early warning signs of Alzheimer's

Governor Brown’s Proposed Budget Has Only Modest Boost For Health Care
JAN 10, 2018
Kenny Goldberg
heath care spending | Medi-Cal patients

Susan Crosby: Who will take care of us?
JAN 1, 2018
Lodi News-Sentinel /
Susan Crosby
AARP | caregiver | Adult Day Care | Hutchins Street Square Adult Day Care

Who’s taking care of California’s seniors? Probably a millennial, survey says
DEC 3, 2017
Sacramento Bee
Molly Sullivan
caregivers | health care | long term care

Fairfield HOST Lions Club makes Donation to Senior Day Care Program
NOV 16, 2017
Daily Republic
Leo Martin
Senior Day Care Program | Fairfield Senior Day Program

Eureka Seniors got Talent: Talent Show showcases importance of social interaction
NOV 15, 2017
seniors | Adult Day Health | Humboldt Senior Resource Center

Retirement planning should include long-term care costs
NOV 15, 2017
SF Gate
Alexandra Olson, Associated Press
long-term care | care for older adults | adult day health center | Medicare | Medicaid

Southern California soon will have a lot more old people, and that will change everything
NOV 15, 2017
The Orange County Register
David Whiting
HICAP | Southern California Council on Aging | California State Plan on Aging | Medicare | aging baby boomers | caregivers | caring for elderly parents

Adult Day Services Ease Isolation, But Aren’t Always Viable
FEB 8, 2017
Margaret Danilovich
adult day care services | community-based center offering comprehensive health and social services | older adults | long-term care | adult day services as a viable provider of post-hospitalization care | Medicaid | Medicare | Affordable Care Act (ACA) | scaling back important social services will endanger the lives of vulnerable older adults

California Makes Progress On Launching Medical Interpretation Study
OCT 30, 2017
Tarryn Mento
Adult day centers | important service to frail seniors and other people with disabilities | social model | medical model | National Adult Day Services Assn | Program of All-Inclusive Care for the Elderly (PACE)
| Medicaid

What Are Adult Day Centers -- Besides The Basis For Political Insults?
OCT 11, 2017
Howard Gleckman
Department of Health Care Services | interpretation services for Medi-Cal patients | health plans | Affordable Care Act | ACA

Why Medi-Cal Enrollees Gain Coverage But Not Broad Access To Doctors
OCT 1, 2017
Sacramento Bee
Cathie Anderson
Medi-Cal | Anthem | federally qualified health centers | Affordable Care Act | Medi-Cal enrollees | health plans serving adult Medi-Cal patients | government reimbursements are too low

More Media Coverage
Please Direct Questions and Comments to


Photo of Lydia Missaelides

Lydia Missaelides, MHA
Executive Director

Photo of Kathryn Atkinson

Kathryn Atkinson
Membership & Communications Director

Photo of Coni Segretto-Ricci

Coni Segretto-Ricci
Office Assistant

(not pictured)

Phyliss Regino
Office Assistant

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