Frail and disabled program participants must be deemed too medically frail by a doctor to attend adult day health care centers through Medi-Cal, and often have multiple health disorders that require oversight.

Currently, the centers are almost completely reliant on Medi-Cal funding, with the state and federal governments splitting the bill. The program is not paid for by private insurance or Medicare, and few families pay for it out of pocket.

Last year, a study funded by the Congress of California Seniors found it would cost the state more money to get rid of the program than to keep it, with nearly $125 million in losses in the first two years. The cut would also result in the loss of 7,600 jobs, according to the study by the Lewin Group, a Virginia-based health consulting firm.

The program is taking a hit as part of a broad slate of social services cuts as the state tries to dig out of a budget deficit.

In March, the state reduced the program budget from about $210 million in state funds to $85 million. The May revision of the state budget dropped that sum to $25 million, and the money is transition funding toward elimination, not preserving the centers, said Missaelides.

Missaelides said her organization is working to restore funds through a legislative effort, with bills from State Sen. Mark Leno D-San Francisco and Assemblyman Bob Blumenfeld, D-San Fernando Valley.

The legislation would put the state back on track to fund the program with $85 million and convert to a waiver-funded program.

A waiver-funded system would mean more stringent participation standards and reduce the number of people the state would serve.

That would be better than nothing for families who rely on adult day care centers to care for their elderly and disabled relatives while they hold down jobs, said Missaelides.

The hardest hit county would be Los Angeles, where beneficiaries used the program 34,246 times in fiscal 2009. In all, the program's benefits were used more than 53,000 times by programs in 31 counties.

Residents of rural counties, like Sonora where Sierra LifeNet closed, feel a different sort of desperation because there are so few alternative services to rely on.

Sue Barnett, 58, went to the day care for physical therapy and other care as a result of a major stroke she suffered in 1998. But it's not herself that she's worried about.

"There are a lot of people that are worse than me that have real bad problems," said Barnett, her voice choked with emotion. "I worry about a lot of the ones with mental problems because they're just not going to be able to do anything."

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Shaya Tayefe Mohajer can be reached at http://twitter.com/APShaya.