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Since 2024, Day Break Adult Day Health Care Center has helped San Benito County Medi-Cal recipients navigate their way to better health and well-being by offering individual counseling and coordinated access to support organizations.
Structured to assist seniors as well as adults with physical or mental disabilities, the center focuses on Enhanced Care Management, which addresses the clinical and non-critical aspects of people with complex medical and social needs. It offers comprehensive assessments and customized care management plans along with coordination of care services.
Other targeted members of the community include:
- Adults/families experiencing homelessness
- Adults at risk for avoidable hospital/ER utilization
- Adults with serious mental health and/or substance use disorder needs
- Individuals transitioning from incarceration
- Adults with intellectual or developmental disabilities
- Pregnant or postpartum adults
- Adults living in the community and at-risk for long-term care institutionalization
Day Break began in 2020 as a “leap of faith” when founder Michael Chai and Director of Programs Nancy Agosto moved from Los Angeles to revive a shuttered healthcare center in Atwater. This move eventually laid the foundation for the Hollister center, along with clinical programs in Merced and Mariposa counties.
The center’s Enhanced Care Management services are rooted in the California Advancing and Innovating Medi-Cal Act (CalAIM), passed in 2021. In addition to care management for qualifying applicants, it provides support for mental health services, housing and transitional services and asthma remediation, among other programs.
According to Agosto, the initiative began in the early 2000s, when health center administrators identified needs that were not being addressed.
“Under CalAIM,” she said, “care managers can identify medical needs and address them; people who have no doctors, or haven’t seen a doctor in years, people who have needs in dental care, medical care, specialist care, people who are at the end of their lives.”
The center’s care offerings extend from simple services such as medication reminder calls to more complex issues, including identifying needs for housing, food uncertainty, lack of community or social support, or clinical counseling with staff nurses.
Applicants are assessed in their homes, and their needs are incorporated into an individualized care plan. The process, Chai said, is like making somebody a tailored suit.
“The services are not homogeneous,” he said. “The different members have different levels of need. Some you call only to do a follow-up. Some are able to manage more, and we just need to nudge them along. Then there are people we need to check on several times a day.”
The center particularly focuses on creating a pathway for its members to stay independent in their homes for as long as possible.
“Our goal is to keep seniors where they are,” Chai said, “because we all know it’s a lot better than being in a care facility. We try our best to maintain their current level of functionality to keep them in the community for as long as possible.”
Albert Arevalo, who has been an enhanced care manager with the center for just over a year, describes himself to clients as “your personal assistant when it comes to your health.”
On any given day, he might find himself picking up and delivering medication to clients’ homes, arranging for a senior to receive fresh produce and fruit or prepared food through Project Food Box, helping with referrals to specialists or attending one gentleman’s doctor’s appointment.
“He asked me to be there,” Arevalo said, “and I will be there to help him interpret what he is told or ask questions that he might not remember to ask. Some doctors don’t know about the ECM program yet, but when we explain to them, they open up.”
Being in the room with a doctor, he said, has the side benefit of hearing more about the client’s medical condition and needs, which helps the center assess other ways it can offer support.
“You listen, and you learn,” Arevalo said. “We’ll say, ‘Okay. So, these are other things you have going on with you. Later on, we’ll have a conversation about it and let’s work on that too.’ We can find out they need help with something else, and go from there.”
Day Break’s Atwater facility is a model for what Chai hopes to bring to Hollister someday: a full-fledged adult day care center.
“We wish to expand on our current infrastructure,” he said, “and develop our reach in other areas that we’ve identified where the community is really asking for, indeed sometimes even crying for, the services that we provide.”
A full-fledged center, as described online as existing at the Atwater site, could allow the organization to eventually include services similar to those at Atwater on a drop-in basis, such as social activities and games, physical and occupational therapy, nutritional consultation, medication management, caregiver respite and on-site emergency treatment.
“A center like this,” Chai said, “the first of its kind in the county, will truly have a transformational effect on so many who live in the area and will provide them with services that they never had before. I just cannot be convinced that San Benito County doesn’t need this.”
Day Break Adult Day Health Care Center
321 5th Street, Hollister
For more information, contact Albert Arevalo at 831-313-3532
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