New York State Implements Innovative Model to Deliver Adult Day Services
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New York State Implements Innovative Model to Deliver Adult Day Services
Under new regulations governing adult day health care ( ADHC ) providers , managed long term care ( MLTC ) plans now have the flexibility to purchase adult day services according to the specific needs of plan members .
Adult day health care programs , all certified by the New York State Department of Health ( DOH ), provide skilled nursing services , physical , occupational and speech therapy ( restorative and maintenance ), clinical and case management , personal care , medication management , nutrition and health education , socialization and therapeutic activities . Until recently , the complete bundle of services was delivered under one inclusive rate , making the program inflexible for both providers and plans .
Now , MLTC plans can purchase adult day services in three levels that fall into basic , standard and intensive categories ; plans will negotiate a price for each level of service . ADHC providers also have the ability to create custom packages that draw on the strengths or capabilities of the program , such as home delivered meals , caregiver or participant support groups , palliative care , locating affordable housing , language and literacy or other social determinants of health .
Appealing to the MLTC plan , individuals won ’ t need to move between different levels of care or split time between a social adult day care program and a medical adult day health care program during the course of the week . As an individual ages and requires even more services , they can stay in the program and delay nursing home placement . With one team of individuals caring for the participant , one care plan and one contract , the administrative burden on plans will likely decrease .
In 1969 , New York State was the first in the nation to enact legislation governing medical model adult day health care programs . Unbundling the services and rate for ADHC services is voluntary for ADHC providers .
For more information on adult day services in New York State , contact the Adult Day Health Care Council at 518-867-8383 or visit www . adhcc . org .
39 Adviser a publication of LeadingAge New York | Spring 2017