Proposal Presented for the Master Plan for Aging (#41)
Disclaimer
Throughout the MPA process, more than 100 proposals were developed thanks in particular to thousands of hours of work by external stakeholders and members of the public. These proposals and the MPA Council commentary are being submitted to the Governor and shared with policymakers and the public to inform policymaking. These proposals represent a starting point for discussion. Further discussion is necessary between relevant state agencies and stakeholders to both refine these proposals and assess which may be appropriate to adopt and implement.
Summary
Increase and incentivize Adult Day Care programs through regulatory reforms that address reimbursement and financing, expanded staffing, innovative partnerships with other service providers including with transportation providers, and encourage pilot programs that integrate adult day services.
Justification
For older adults who require supervision during the day or those who would benefit from more social interactions outside of their homes, adult day care facilities and programs (including both Adult Day Health Care and Social Adult Day Care) offer a safe and secure environment. Local and regional collaborations with key organizations will help ensure that programs are accessible and inclusive for older adults with disabilities or with unique needs who are often left unaccommodated and unaccounted. Incentivizing the participating Adult Day Care programs with a program that directly reimburses the facility with up to 50% of the Medicaid rate will ensure these critical services will be sustainable for community members who greatly need them.
Full Proposal
For older adults who require supervision during the day or who would benefit from more social interaction outside of their homes, adult day care facilities and programs offer a safe and secure environment. Increase and incentivize adult day care programs as an alternative to provide respite and relief to family caregivers so they can work, run errands, or have time to recharge emotionally, psychologically, and physically.
Adult day programs serve a diverse, predominantly older clientele that is approximately one-third black, indigenous, or of color. Compared with other home-and community-based supports, adult day programs are among the most racially and ethnically diverse according to a study published by the National Institute of Health.
- Staff the program with nurses, social workers, health aides, activity professionals, and other health professionals such as occupational and/or physical therapists.
- Partner with local transportation organizations to provide transportation services to and from the program.
- Collaborate with organizations like the New York State Adult Day Services Association (NYSADSA) to ensure that the program is accessible and inclusive for seniors with disabilities or unique needs by providing necessary accommodations and equipment.
- Incentivize participating Adult Day Care programs by initiating a program that subsidizes the cost of Adult Day Care by directly reimbursing the facility with up to 50% of the Medicaid rate based on the client’s ability to private pay for these services.
- Remove MLTC requirements that participants accept mandatory home care services in order to attend Social Adult Day Care programs.
- Enhance New York's Medicaid Program by reimbursing Adult Day services on a fee-for-service basis under the Medicaid Community First Choice Option (CFCO) in New York State. Note that this would provide additional federal assistance via the 6% Federal Medical Assistance Percentage provided under CFCO.
- Initiate a pilot program for integrating adult day services under CFCO.
MPA Council Commentary
This proposal is categorized as long-term. Components of this proposal would require expanded availability and capacity of the workforce and of transportation systems. Other components may require statutory changes. State agency partners may continue to assess workforce challenges and opportunities for improvement regarding transportation challenges statewide. Additionally, decisions about the provision of Medicaid services happen in the context of the Medicaid Global Spending Cap and the annual budget process and must consider the availability of resources.