Adult Day Health (ADH) Programs make the critical difference for seniors, adults with disabilities, and family members seeking lower cost community-based services, rather than institutional care, or more costly home health care services. ADH programs are extremely cost effective, providing a six-hour day, with daily registered nursing care, health care management and prevention, social services, personal care, therapeutic activities, respite and family/caregiver support, and two meals all for the state base rate of $79.94 per day (State complex care rate: $102.80).
Who Benefits From Adult Day Health Services?
• 10,500 seniors and adults with disabilities currently participate in Massachusetts’ ADH programs each year. Medicaid and other state funders are the payors for approximately 70% of participants.
• More than half of ADH participants have behavioral health needs or require memory care. Without these services, many ADH participants would be at risk in the community and would require more expensive health care or institutional services.
• ADH services provide major support for working caregivers and elderly spouses who are committed to helping their family members remain at home for as long as possible, resulting in considerable savings to the state.
Eligibility
Individuals eligible for Adult Day Health Services must:
- Be age 18, or over.
- Have insurance coverage or other types of funding (MassHealth, Senior Care Options (SCO), One Care (ICO), ASAP/Home Care, or private pay).
- Have a physician’s approval and confirmation of medical necessity, if seeking MassHealth or other types of insurance or state sponsored funding.
Adult Day Health (ADH) Programs improve health care and save the state, insurance providers, and families money. Because licensed nurses provide daily on-sight health care services and have regular communication with physicians, these programs can serve as gatekeepers to more expensive health care services, such as emergency room care and hospitalizations. ADH Programs are extremely cost-effective, helping individuals avoid expensive premature nursing facility or institutional care.
The average cost to MassHealth for a full year of ADH Services is only $19,170/per person, compared to about $102,200 for nursing home care. ADH Programs save the State approximately $83,030 per person each year, compared to nursing home care. Adult Day Health services are far less expensive, on average, than home health care as well.
What Services Do Adult Day Health Programs Provide?
Each ADH program is unique, but all of these vital community-based health care programs provide a wide array of services including:
• Chronic Disease Management, Health Oversight/Care Coordination
• Skilled Services including nursing assessments, physician-ordered treatments, medication administration and management, and lab work
• Physical, Occupational and Speech Stabilization Therapy
• Direct Care/Assistance with Activities of Daily Living and Hygiene
• Nutritional and Dietary Services: Two meals and snacks
• Rehabilitative and Preventive Care
• Therapeutic Recreation designed to enhance cognitive ability and build physical strength
• Respite, Support, and Education for participants, families, and caregivers
What is the Massachusetts Adult Day Services Association (MADSA)
MADSA is a well-respected and influential non-profit membership organization with a 40-year history of outstanding representation of Adult Day Health (ADH) programs all across the Commonwealth. Our mission is to promote and support the development of high quality ADH services. MADSA is the trusted leader in the field of ADH services and we currently represent 105 of the 134 programs in the state. MADSA has been highly successful in advocating on behalf of ADH programs, participants, and families, and for adequate reimbursement and fair regulatory policies. We provide members timely and vital information, technical assistance, knowledge, and training opportunities to help them meet their day-to-day challenges and fulfill their long-term goals. MADSA works to continually enhance ADH services by promoting and supporting best practices and is affiliated with the National Adult Day Services Association.