One of Mountain View's few safety nets for older adults with serious medical needs says it is staring down a financial squeeze that could hit families hard. Staff at Avenidas Rose Kleiner Center, a longtime adult day health program, warn that looming federal policy changes could drive up out-of-pocket costs for families and, in the worst case, force the center to cut back enrollment or turn people away.
The nonprofit Avenidas runs the Rose Kleiner Center, which offers nursing oversight, physical therapy, meals, transportation and structured daily activities for people living with dementia and other complex health conditions. The center, which reopened in July 2021 after a pandemic shutdown, now serves dozens of local families, as detailed by Palo Alto Online.
More than half of the Rose Kleiner Center’s participants rely on Medi-Cal to help cover the cost of those services. Program director Nancy Keegan told the Mountain View Voice that she expects Medi-Cal to start seeing reductions at the start of next year as the state adjusts its budget in response to federal shifts. Because adult day health is an optional benefit for states, cuts could make the program more expensive or harder to access for people who rely on it.
Federal Changes Reshaping Medicaid Funding
The massive budget reconciliation package passed this year, often described in coverage as the "One Big Beautiful Bill," includes substantial cuts to Medicaid and SNAP along with new work or paperwork requirements. Analysts say those changes will strain state programs and could send shockwaves down to community-level providers, as reported by CNBC.
Older Americans Act Adds Uncertainty
The Older Americans Act, a key federal law that helps subsidize community services such as adult day care and caregiver support, expired in September 2024 and has been limping along on short-term funding extensions while Congress debates a longer-term deal. Reauthorization would restore more predictable funding for local programs that rely on those grants, according to KFF.
How Avenidas Is Responding
Avenidas President and CEO Kristina Lugo told the Mountain View Voice that the nonprofit is ramping up fundraising and growing its scholarship fund in an effort to shield families from the brunt of any cuts. "Even with all of this, the cuts could leave some families with less coverage than they need," Lugo wrote, adding that the "worst case would be turning someone away" if new dollars do not come through.
For caregivers, the stakes are intensely personal. Cole Cross, who became her grandmother's full-time caretaker during the pandemic and later brought her back to the Rose Kleiner Center, told the Voice that Avenidas "is the difference between a miserable life spent in isolation and a happy one" and said she is deeply worried about losing that support.
Local elected officials are paying attention. U.S. Rep. Sam Liccardo visited the center on Dec. 8 and said that reauthorizing the Older Americans Act is "imperative" so programs like Avenidas can keep offering an alternative to more expensive in-home nursing. For now, Avenidas says it will continue leaning on philanthropy and health partners while watching state and federal moves closely. More information about the organization is available on the Avenidas website.
