Public Policy Agenda

The following issues affect adult day services and are either currently being considered by Congress or on the verge of introduction. Supporting National Adult Day Services’ policy priorities will help assure that the full range of long-term care options is available to the individuals and families you serve.

Protecting Medicaid Adult Day Services

There is much focus on reforming Medicaid to help ease the fiscal crisis and relieve stretched state budgets.  While there are positive changes that can be made to Medicaid that are also fiscally responsible, like rebalancing the system to provide more home and community-based services such as adult day services, many of the propsals currently being considered would be harmful to beneficiaries.  Among the issues being discussed is a blended matching rate to states, block granting Medicaid, imposing per capita caps on spending by states and more.  We are concerned that these  proposals by the President and members of would have a negative impact on providing services to elders with chronic diseases and persons with disabilities. We believe that the Congress and President should continue to concentrate on reducing waste, fraud, and abuse in Medicaid. We also believe that Adult Day Services can be part of the solution to reducing costs.

Protect Medicaid funding, encourage innovation by providers and eliminate waste, fraud and abuse.

 

Facilitate Access to Adult Day Services.

Adult day centers service more than 260,000 participants and their family caregivers in more than 5,000 centers across the United States, and are leaders in community-based care for individuals with Alzheimer’s disease and other dementias (Dabelko-Schoeny & Anderson, 2010).  People living with chronic conditions and diseases such as hypertension, physical disability, cardiovascular disease, diabetes, mental illness and developmental disability need better access to adult day centers so they can receive the care they want and need while living in their own homes and communities.  Nearly 80% of adult day centers have a nursing professional on staff, nearly 50% have a social work professional on staff, and approximately 60% offer case management services.  NADSA is particularly concerned with developing policies that ensure effective and accessible long term services and supports for older adults and individuals with disabilities.

Ensure access to Adult Day Services is included in long term care services and supports.

 

Reauthorize the Older Americans Act Programs

Senate Bill 3562, introduced September 2012, combines Older Americans Act proposals from 10 Senate bills and a number of information recommendations.  Originally enacted in 1965 along with Medicare and Medicaid, the Older Americans Act was the first initiative by the federal government to provide comprehensive assistance to seniors. With 10,000 Baby Boomers turning 65 every day and with the worst economic downturn since the 1930s, help for seniors is needed now more than ever. States depend on these funds, and services provided through Adult Day Services are essential to help caregivers and elders remain in their own homes.

Reauthorize the Older American’s Act to prevent more expensive hospitalizations and unnecessary nursing home placements.

bullet-blueMaximize Medicare Coverage with Adult Day Services

It shouldn’t matter where a Medicare beneficiary receives nursing services, physical therapy, occupational therapy and social work services. It should matter that these services are quality, cost-effective services that the Medicare beneficiary can choose. NADSA encourages the Centers for Medicare & Medicaid Services (CMS) to infuse health care funding with the cost-effective community-based services provided through Adult Day Centers for persons with chronic diseases.  Ensure adult day services inclusion in Medicare Advantage, care transitions, care coordination, dual eligible projects and other innovations.

Ensure Adult Day Services is included in Medicare options.

 Respond to Affordable Care Act

Implications of the Affordable Care Act (ACA) are still being revealed.   How the ACA is implemented makes a real difference and the future of healthcare for people served in adult day centers can be dramatically impacted.  NADSA will track the implementation of the ACA which could impact policies such as hospital readmissions, accountable care organizations and state Medicaid policies.

Explore implications of Affordable Care Act for Adult Day Center participants and their families.