Alhambra Source , News Feature, Daniela Gerson, Posted: Oct 30, 2011

Editor’s Note: The CHFC Center for Health Reporting partnered with New American Media and NAM’s LA Beez, a collaborative of Los Angeles ethnic-media outlets, to produce a multimedia news package chronicling the effects of California’s pending elimination of the state-funded Adult Day Health Care centers (ADHC). The LA Beez partners include Asian Journal, CaribPress, Eastern Group Publications, Impulso, India Journal, Latino California, and Media Central. The following article is from the Alhambra Source.

LOS ANGELES -- Hui is terrified that she may soon have to go to the bathroom on her own.

For more than a decade, the 80-year-old woman, who is debilitated from a stroke, has spent part of her weekdays at an adult day health care center in Alhambra, Calif. There, Hui converses with other elderly immigrants, is fed a hot meal from a local restaurant and depends on social workers, who use a coarse brown woven belt to support her as she walks.

“I need the center,” Hui said in Cantonese, as tears began to flow. It will likely be forced to close at the end of November, a casualty of state budget cuts.

Easy to miss in an area of strip-mall Chinese restaurants, the M&T Adult Day Health Care Center has provided a daily refuge for roughly 100 elders and severely disabled men and women for the past 11 years.

The centers offer basic health care and, through classes and activities, a version of group therapy where participants socialize with others who share their experiences -- as well as their ailments and fears.

“They Get Very Depressed”

But recently, Hui and her fellow center participants, who are from China, Vietnam, Hong Kong, Macao and Taiwan -- and almost all of whom are ethnically Chinese -- received a letter from the California Department of Health Care Services announcing that the state was eliminating the MediCal Adult Day Health Care (ADHC) benefit.

“With this kind of prospect, of course they get very depressed,” said Raymond Chu, one of the center’s administrators. “These people, they worry about everything, even really minor things. Most of them have insomnia.”

M&T is only one of the state’s adult day health care centers, 60 percent of which are in Los Angeles County, that fear the worst. At least two-dozen of the state’s centers have already closed this year, leaving 311, among them the only other facility located in Alhambra.

The center calculates that 25 staff members would lose their jobs, 200 participants would be stuck at home, and nearly as many families would face taking care of ailing loved ones themselves, enabling many to continue working.

Over the last 10 years, M&T’s presence has meant that Susan, the mother of one participant, was relieved from caring for her six hours a day, so she could work at an elementary school.

Susan is reeling at the prospect of not having the limited freedom the center provides her. “We already knew the government had no money, but this left us feeling unsettled,” said Susan, in Mandarin.

Chu said a private-pay model is being considered, with patients’ families providing around $30 a day for the adult day program. Some, including Susan, could afford that, but Chu does not believe there will be sufficient enrollment to make it a viable option. Almost all of the state’s 38,000 adult day health center clients are on MediCal, the program for those with low incomes.

He remains hopeful that the program won’t die. “Even at this time I don’t believe that they can shut it down,” he said. “This is a government program. If they are going to eliminate this program they have to do it in a responsible way.”

On a recent morning, Hui, neatly dressed in a purple vest, sits at the Cantonese-speaking table of M&T’s main room, which is decorated with red streamers and birthday greetings in Chinese and English. (The center’s management, concerned about the mental capacity of its participants, requested that only first names be used for this article. Many who benefit from the centers have Alzheimer’s disease or other forms of reduced cognitive ability.)

At the table next to Hui sit those with severe disabilities, a few lost in their own worlds, eyes roaming as arms flail. Across the room in the Mandarin corner, Ter, 87, chats with others who have shared this white plastic table for years.

Without Center He’d “Want to Die”

The scene might not look like much, but without the option to spend part of his days at this adult day-heath care center, Ter said he would “sit at home and wait to die.” Although his friends chuckle at his dark comment, they agree it’s a truth they share.

With its own version of cliques — mostly dictated by language and background —and group activities, the institutional room vaguely resembles a high school cafeteria. In the front, some gesture slowly and hit their arms in a version of Chinese martial arts targeted for elderly residents. In a far corner, others play a spirited game of mah jong underneath Xeroxed signs warning “No Gambling,” while chips click and bang against the table.

Removed from the commotion of the main room are small classrooms for activities like calligraphy, English and art. From one of them comes the tune of a heartfelt, if sometimes wrong, rendition of “O’Susannah.”

A spry man of 90 is practicing the American folk song on the piano, preparing for a singing class he will lead. Julio, a Hong Kong native, who picked up a Spanish name doing business in Honduras, can grasp only basic English, but center staff has translated for him American folk and patriotic songs.

Moments later he leads a half dozen elderly Chinese women in a rousing “O’Susannah”, as well as “America the Beautiful” and “God Bless America.” Next to him lies his bag, on which he has taped a Disabled American Veterans logo, a gift when he provided a donation.

“I’m an American citizen,” explains Julio, who said he moved to the United States at the age of 78. “I’m supposed to know American songs.”

The mood is joyful until Julio thinks about the fact that this center, where he has spent his mornings for most of his years in the United States, may cease to exist in less than a month.

Without warning, tears cascade down his wrinkled cheeks. “With this, we’re really happy,” Julio says in Cantonese. “Without it, we don’t know what we’ll do.”

Albert Lu and Stephanie Lee, community contributors to Alhambra Source, assisted with photography, reporting and translating.