Quick Take
Raymon Cancino, CEO of Santa Cruz County nonprofit Community Bridges, points out a big failure in our community – our inability to connect needy people to the services they need. Here, he warns that Elderday, which serves about 140 vulnerable older adults in Watsonville, faces an unsustainable financial future unless enrollment grows to roughly 200 participants. Cancino says the need is out there, but argues that bureaucratic delays, weak referral systems and looming Medi-Cal changes threaten not only Elderday but the region's broader safety net for older adults and people with disabilities. He contends that failing to connect eligible families to available care will lead to more hospitalizations, institutional placements and caregiver burnout while driving up long-term healthcare costs.
Every day at Elderday, we see what is possible when care works.
We see older adults getting the care they need to stay safely at home. We see veterans finding friendship after years of isolation. We see family caregivers able to keep working because someone they love is safe, supported and connected.
But we also see a warning.
Watsonville’s Elderday serves approximately 140 of the county’s most vulnerable seniors, including those with dementia and disabilities. It provides meals, therapies and social interaction and keeps them from going into facilities.
It is also under serious financial stress. Elderday is not closing today, but the pressure is real, growing and unsustainable unless it attracts more eligible participants and connects them to care.
We estimate we need 200 total enrolled participants, so approximately 60 more people.
We know the need is out there.
In fact, the painful contradiction is that the need is growing, but too many families are not connected to Elderday in time. Some do not know it exists. Others are not referred soon enough. Many are already overwhelmed by the time they begin looking for help.
Elderday is a test case for whether our region can coordinate care fast enough to protect essential services in a more difficult Medi-Cal environment. If we do not improve referral, approval and connection systems, Elderday will not be the only provider at risk. It will be one of the first clear examples of what happens when the need exists, the service exists, but the pathway between them fails.
Consider Martha.
Like many working families on the Central Coast, Martha works two jobs to afford life in this region. Her mother has medically complex needs and requires coordinated care, medication support, therapy, transportation, meals and daily engagement. Without Elderday, Martha would face an impossible choice: leave the workforce, seek a much more expensive institutional placement or hope nothing goes wrong.
Elderday gives her family another option. Her mother receives professional care and connection. Martha receives peace of mind. The healthcare system avoids preventable crises and a working caregiver can keep working while her mother remains safely at home.
For John, a veteran who struggled with isolation and a fragmented healthcare system, Elderday became more than a healthcare program. It became a place where people knew his name, helped him navigate challenges and gave him a community where he belonged.
Stories like Martha’s and John’s happen every day. Yet the program that makes them possible is financially fragile and being pushed closer to the brink by federal policy changes and local responses.
That is unfortunate because Elderday offers huge benefits, including helping medically vulnerable adults avoid unnecessary hospitalization. It also offers assistance to worn-out families who can’t handle caregiving, and it prevents premature institutional placement. Also, it provides a social outlet for seniors and prevents feelings of isolation.
It provides affordable, coordinated care through nurses, therapists, social workers, transportation, meals, facilities, compliance and trained staff.
This is why Community Bridges took on Elderday and has fought to keep it open. Our mission is to deliver essential services, provide equitable access to resources and advocate for health and dignity at every stage of life. Elderday advances that mission by helping older adults, veterans, people with disabilities and family caregivers remain healthy, connected and at home.
But mission does not pay for that level of care. Enrollment and reimbursement do.
To remain viable, Elderday needs a consistent pipeline of about 200 participants across Santa Cruz, Monterey and San Benito counties. That level sustains fixed costs for nurses, therapists, transportation, meals, facilities and specialized staff. Each empty seat represents both an unmet community need and lost reimbursement that supports care for the current participants who depend on Elderday.
This challenge is becoming more urgent in light of H.R. 1 and its impacts on Medi-Cal. New eligibility rules, reporting requirements, more frequent renewals and administrative complexity could increase paperwork, disrupt coverage and make it harder for vulnerable people to stay connected to Medi-Cal-funded care.
And Elderday’s situation is not isolated. It is a microcosm of what will either work or fail across our region’s healthcare system in this new environment.
If hospitals, health plans, physicians, discharge planners, social workers, the Veterans Administration and community-based providers do not improve how we identify, refer, approve and connect people to care, other Medi-Cal-serving providers will face the same pressure Elderday is facing now.
Because if Elderday closes, the need will not disappear.
Families will become caregivers overnight. Hospitals and emergency rooms will absorb needs that could have been addressed earlier. More seniors and adults with disabilities will be pushed toward institutional care at far greater human and financial cost. Caregivers will leave the workforce. Our region will lose a critical part of its healthcare infrastructure.
This is not only a healthcare issue. It is a community issue, a workforce issue, a family caregiving issue and a test of whether we are willing to protect essential services before they disappear.
The solution is within reach, but it requires a coordinated regional response.
Hospitals and clinics must identify eligible patients earlier. Health plans must expedite approvals and reduce administrative barriers. Physicians, discharge planners and social workers must make warm referrals before crisis hits.
The VA and veteran-serving organizations must connect veterans to Elderday when daily care, structure, and community could improve their quality of life. Families must know Elderday exists before they face the difficult choice of placing a loved one in a skilled nursing facility outside their community.
Elderday is ready to serve. The infrastructure is here. The need is clear.
Now the systems around Elderday must align so older adults, veterans, people with disabilities and family caregivers can continue to thrive at home, in community, with dignity.
If Elderday closes, we all lose.
The time to act is now.
Raymon Cancino is the CEO of Community Bridges, Santa Cruz County’s leading human services nonprofit headquartered in Watsonville.
