Adult Day Services Plus—The Future of Adult Day Services?

In a 2006 article, Gitlin and Reever describe an enhanced model of Adult Day Services in their article “Enhancing Quality of Life of Families Who Use Adult Day Services: Short- and Long-Term Effects of the Adult Day Services Plus Program.” In short, the paper describes a model whereby the adult day services employs a social worker to work diligently with families during the first month and throughout the first year of attendance to address the individual’s needs and caregiver stress and burdens. The results of their research show that families receiving additional social services utilize adult day more and for a longer period of time while reporting reduced stress levels.

In a recent twist of the model, The California Adult Day Services Association in cooperation with the Scan Foundation conducted a study that they presented at the National Adult Day Services (NADSA) conference this past year. The goal of the study was to develop an expanded model that could additional revenue sources as the CAADS members moved to managed care. In the study the centers added an additional RN or nurse practioner to provide intense service to dual eligible seniors with significant chronic care needs. The nurse worked with the individual and their families, if present, to tackle the health challenges of the affected individual. The case management included efforts at disease education, attending medical appointments, identifying community resources, getting the individual to the emergency room when needed, and other interventions. The hope post study is that the centers would be able to contract with managed care organizations for additional services already being provided in other settings.

From a business perspective, many centers need to diversify their revenue sources whether a non-profit or for-profit entity in the face of steady or declining government payment programs. With the intentional and intensive social services (or perhaps nursing services?), the center potentially has the opportunity to sell the care management services in a geriatric care management model or other traditional care management models. At the very least there is the opportunity to increase utilization of the center by delaying discharge and increasing attendance days at the center. This in itself may pay for the increased social or nursing services inherent to the model.

Some variation of the model seems to hold significant promise to the center’s programming and the center’s business operations.

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