The Marin Adult Day Health Center in Novato — the county’s solely such website — is shutting down, leaving 36 purchasers with no various program.

Jacquie Phelan of Fairfax mentioned she acquired the information not too long ago after making an attempt to rearrange for her husband Charlie Cunningham, 74, to get care there. He suffered a traumatic mind harm in a motorcycle accident in 2018.

Phelan, 67, and her husband visited the middle in October and crammed out paperwork. But they heard nothing again from LifeLong Medical Care, a federally certified well being middle in Berkeley, which took over the middle in 2008.

“I would routinely call every couple of weeks to ask if there were any hurdles,” Phelan mentioned. “I didn’t get any feedback.”

In the meantime, she positioned her husband at a long-term care middle in San Anselmo.

“He’s always happy to see me and hoping to come home, which I don’t think is realistic because I can’t do that kind of care,” Phelan mentioned. “It’s been a long, hard eight years. I burned out.”

Adult day providers present an alternative choice to nursing house take care of individuals who don’t want 24-hour expert nursing. They give caregivers, typically members of the family, a while to relaxation or do different duties whereas permitting their family members to stay at house. The Marin Adult Day Health Center picks up members within the morning after which transports them house within the mid-afternoon.

Kari Beuerman, an assistant director with the Marin County Health and Human Services Department, mentioned LifeLong didn’t notify the county of its plans to shut the middle.

Sylvia Hacaj, the corporate’s director of growth and communications, disagreed.

“We informed the county shortly after we talked to our staff and participants,” she mentioned. “I would not think it would have come as a surprise, as we did reach out to them a year ago to let them know we were struggling to continue supporting this site. Unfortunately, they had no funds available to assist.”

David Vliet, LifeLong’s chief govt officer, mentioned the board of administrators made the choice to shut the middle on Feb. 28. Clients and their households have been notified of the closure plans on March 21.

An electronic mail LifeLong despatched to “community partners, neighbors and friends” acknowledged, “This heartbreaking decision was made because financial sustainability of the center is no longer viable for LifeLong. This comes after years of rising costs and loss of funding that historically supported the Center.”

“We did carry the center for as long as we possibly could,” Vliet mentioned. “This was not a decision that was made lightly.”

Beuerman mentioned that for six years, from fiscal yr 2011-12 to 2017-18, Marin County transferred $125,000 yearly that it acquired from Partnership HealthPlan of California to LifeLong to assist help operation of the middle. Partnership HealthPlan of California, primarily based in Fairfield, manages the well being care of Marin residents who qualify for Medi-Cal.

Johnathan Logan, a Marin Community Foundation vice chairman, mentioned the muse supplied the middle with grants from 2012 by way of 2018. Logan mentioned the help amounted to about $40,000 a yr from 2015 to 2018. He declined to say what stage of help the muse was offering previous to that.

As to why the muse stopped funding the middle in 2018, Logan mentioned, “The foundation periodically makes changes to its strategic plan and direction. Different initiatives have different life cycles and so for this particular initiative the cycle ended.”

LifeLong, which was based by the Gray Panthers in 1976 as a well being middle for folks over 60, operates 14 main care well being facilities, 4 dental facilities, 4 school-based well being facilities, a supportive housing program, psychological well being providers and pressing care facilities.

LifeLong’s 2022 annual report acknowledged that it expects to open a brand new well being middle in Berkeley this spring and to interrupt floor on a brand new well being middle in East Oakland someday this yr. According to the annual report, LifeLong had over $122 million in income in 2021, together with almost $45 million in grants, and ended the yr with income exceeding bills by $4 million.

But Vliet mentioned LifeLong’s monetary well being is just not as rosy as that report may point out.

“COVID had an impact on us,” Vliet mentioned. “Costs have risen. Volumes have not been what they have traditionally been in the past. We’re currently running a significant structural deficit.”

LifeLong served 56,612 sufferers in 2022, an amazing majority of whom have been low-income folks of coloration. Before the COVID-19 pandemic started, Lifelong served 66,681 sufferers.

Vliet added that LifeLong’s labor prices have elevated considerably. He mentioned most sufferers obtain Medi-Cal and authorities reimbursements are inadequate. The East Oakland well being middle venture has been placed on maintain.

Vliet mentioned the Marin Adult Day Health Center has been working at a considerable deficit for plenty of years. Losses over the past 5 years have totaled greater than $2 million, and a lack of $600,000 is projected for subsequent yr.

“ADHC is an expensive program to operate,” Vliet wrote in an electronic mail. “Medi-Cal reimbursement doesn’t cover costs; we are a small center, so don’t have economies of scale; enrollment dropped precipitously during the pandemic; and we have not been as successful in securing grants as in the past.”

Debbie Toth, the chief govt officer of Choice in Aging, a nonprofit that operates grownup day well being facilities in Pleasanton and Antioch, mentioned Marin’s middle is one in all many across the state which can be closing.

“The infrastructure in our industry is crumbling because we do not have funding that meets the regulatory requirements of service delivery,” Toth mentioned. “That is the bottom line.”

Toth mentioned state staffing necessities for grownup day well being facilities mirror these for expert nursing websites.

“We have to have the same medical director, pharmacy consult, psyche consult, nurses, social workers, physical occupational speech therapy, registered dietician, and then we have activity coordinators, professional activity staff, and professional care providers,” Toth mentioned.

Vliet mentioned the Marin middle has 20 workers.

Most sufferers at grownup day care well being facilities qualify for Medi-Cal. But Toth mentioned Medi-Cal managed care plans, corresponding to Partnership HealthPlan of California, can principally dictate the charges they pay for offering grownup day care since it’s thought of an non-obligatory profit and there’s no legislated minimal cost.

Vliet mentioned Partnership HealthPlan has authorized a Medi-Cal reimbursement price of $100 per day for purchasers on the Marin middle whereas the present value is $345 per day. He mentioned the Veterans Administration, which is meant to be paying for 3 members within the Marin program, has paid for under someday of care since 2020.

Dustin Lyda, a spokesman for Partnership HealthPlan, mentioned it’s “saddened by the closure of LifeLong Marin Adult Day Health Center.

“Partnership will not speculate on the specific factors leading to the decision made by MADHC,” Lyda mentioned.

Toth mentioned, “We prioritize institutional care over community-based care in our policies and our funding. It’s a broken system.”