State of California--Health and Human Services Agency Department of Health Care Services
Medi-Cal Program
September 10, 2009
Update on the Medi-Cal Adult Day Health Care Benefit
Dear ADHC Center:
The Department of Health Care Services (DHCS) previously provided notice to you about changes in State law (Welfare and Institutions (W&I) Code sections 14132, 14522.4, 14525.1, 14526.1, 14526.2, and 14550.6) regarding the Medi-Cal Adult Day Health Care (ADHC) benefit. As a result of these changes, the ADHC benefit was to be reduced to a maximum of three days of ADHC per week effective September 7, 2009.
Due to a federal court ruling September 10, 2009 in the matter of Brantley v. Maxwell Jolly (Case No. 4:09-cv-03798-SBA), this reduction will not take place at this time.
If your ADHC center currently has participants attending the ADHC center more than three days per week pursuant to a currently approved Treatment Authorization Request (TAR), those participants may continue to receive ADHC services at their approved level. For those TARs that were reduced to a maximum of three days a week as a result of the benefit reduction, please provide a list of the beneficiary names and TAR numbers to the Field Office Administrator of the local Medi-Cal Field Office. These TARs will be modified to reflect the previously approved days of attendance.
You can find the State law that authorizes the reduction of ADHC on the California Legislative Information website at www.leginfo.ca.gov. Copies of all notices released regarding ADHC benefit changes are provided on the DHCS website at http://www.dhcs.ca.gov and on the
Medi-Cal website at http://www.medi-cal.ca.gov. You may print, post, and/or distribute these notices to your ADHC participants.
If you have additional questions, please contact your local Medi-Cal field office. You may also contact the Medi-Cal Benefits Analysis, Waiver Analysis and Rates Division at (916) 552-9797 or the California Department of Aging at (916) 419-7545.