Paying for Adult Day Care and Adult Day Health Care

Page Reviewed / Updated - Jun. 2016

Adult Day Care Background Information

Definitions: Adult Day Care vs. Adult Day Health Care

Adult day care (ADC) provides frail seniors and persons with Alzheimer's with supervision and care in a structured setting during daytime hours allowing their primary caregivers to work or take a break from their caregiving responsibilities. There are two primary types of adult day care programs.  Adult social day care offers basic health services, meals and activities while adult day health care (ADHC) provides intensive health services for individuals that might otherwise need to reside in a skilled nursing community. Some centers offer both types of care and there some centers that specialize in Alzheimer's or dementia care, referred to as Alzheimer's Day Care.  Many centers provide transportation to and from the center.

“Adult day care and adult day health care are the most economical approach to provide supervision and personal care for an elderly loved one on a daily basis.” 

Regulation of Adult Day Care

All adult day care centers are required to have state licenses or are regulated to a degree to provide certain types of services.  This is especially true of those centers that receive public funding.  Most staff members receive background checks and many are certified social workers. In addition, many states regulate the staff-to-patient ratio and the minimum staff available at any time.

  In adult day care, there is on average one care worker for every six participants.  State regulations vary with some as low as a 1:4 ratio and others as high as 1:10. 

 

How Adult Day Care Works

Once specific care requirements have been determined, the family will contact a center by phone for an initial conversation about matching needs with their services.  Most families then proceed to visit the center twice, first without the individual in need of care and then again later with their loved one.  At that point, if all parties feel comfortable with the center, it is common to conduct a week-long trial of their services before making any longer term contractual agreement with the center.

 

Paying For Adult Day Care

Medicare's Benefits

As most elderly Americans have Medicare, the question if Medicare will pay for adult day care is very common and should be addressed at the forefront of this discussion.  Medicare does not pay for any form of adult day care.  There is some confusion regarding this question partly because Medicare is often mixed up with Medicaid and partly because there are certain Medicare / Medicaid combination programs that cover adult day care. To be clear, a person will only Medicare coverage will not receive adult day care as a benefit.  

 

Medicaid

In all states, Medicaid pays for adult day care and / or adult day health care. This is especially true if an individual would otherwise require full-time nursing home care. Each state has several Home and Community Based Services (HCBS) Medicaid Waivers or 1915 Waivers that are offered as an alternative to nursing home care. These waivers help individuals remain living in their homes and communities by providing the necessary support services. Very often, this includes adult day care and transportation assistance to and from the community. Unfortunately, waivers are not entitlements and wait lists may exist.

Adult day care is also covered under many Medicaid State Plans (regular Medicaid programs). State Plan Medicaid is an entitlement; so eligible families may use this as a funding source while wait listed for a HCBS Waiver.

Our state-by-state guide to Medicaid programs and adult day care details which programs cover adult day care and their eligibility requirements. One can also read more about Medicaid's eligibility requirements or determine if you or your loved one will require assistance becoming eligible for Medicaid.

 

Veterans’ Programs

VHA Medical Benefits
The VA will pay for adult day health care but not adult day care.  Adult day health care is included in VHA Medical Benefits Package, however one cannot simply enroll in a program, they first must be assessed and found to have a clinical for the level of care and supervision provided in adult day health care centers.  While the VA will provide assistance, they may not necessarily pay for 100% of the cost.  Depending on the individual resources and level of need, a co-payment may be required.

Veterans’ Pensions
Specific pensions, such as Aid & Attendance, are intended to be used to provide care for ailing or disabled veterans. Both adult day care and adult day health care fall squarely within that definition and therefore can be used in that capacity.

Veterans Directed Care
As implied by the name, these VA Medical Center based programs give the veterans considerable latitude on how they can spend the funds allocated towards their care. Putting funds towards adult day care is well within the regulations. Read more.

 

Non-Medicaid State Assistance for Adult Day Care

Many states have non-Medicaid assistance programs; sometimes referred to as nursing home diversion programs. These programs are intended to prevent or delay the placement of elderly state residents in nursing homes. To that end, these programs will pay for or help with the cost of daytime supervision in a group environment. This is especially true for individuals with Alzheimer's or dementia. Our organization’s research found thirty-four states have state-funded, non-Medicaid programs that can be used for adult day care. However, a superb but not consumer-friendly report produced for the Office of the Assistant Secretary for Planning and Evaluation found just twenty-four states. It is strongly suggested the families undertaking research on adult day care review both our list below and this study.

 Did You Know? Free assistance is available to help families find adult day care which meets their care and financial needs. Get help here.

The links which follow contain each programs' eligibility requirements and the services they cover.

Non-Medicaid State Programs Covering Adult Day Care / Adult Day Health Care -Updated Apr. 2016

State

State Programs

 

Alaska

Adult Day Services

 

Arizona

NMHCBS

 

California

Alzheimer's Day Care

 

Connecticut

Home Care Program for Elders

Statewide Respite Care Program

 

Delaware

Adult Day Care & Alzheimer's Day Treatment

 

Florida

Alzheimer’s Disease Initiative

CCE Program

Local Services Program

 

Georgia

Home and Community Based Services

 

Hawaii

Kupuna Care

 

Indiana

Choice

 

Iowa

Case Management Program for Frail Elders

 

Kansas

Senior Care Act

 

Kentucky

Adult Day Care and Alzheimer's Respite

 

Maine

Caregiver Respite Program

 

Maryland

Senior Care Program

 

Massachusetts

HCP and ECOP Programs

 

Minnesota

Alternative Care Program

Essential Community Supports

 

Nebraska

 

Social Services for Aged and Disabled Adults

Disabled Persons and Family Support

Assistance to the Aged, Blind, or Disabled

 

Nevada

Community Options Program for the Elderly

 

New Jersey

 

Alzheimer's Adult Day Care

Statewide Respite Care

Assistance for Community Caregiving

 

New Mexico

Older Americans Act Services

 

New York

 

Community Services for the Elderly

Expanded EISEP Program

 

North Dakota

SPED and Ex-SPED

 

Ohio

Older American Act Services

Elderly Services Program

 

Oklahoma

Adult Day Care Services

 

Oregon

Project Independence

 

Pennsylvania

Options Program

 

Rhode Island

Home and Community Care Co-Pay Program

 

Tennessee

Homemaker & Adult Day Care

 

Texas

 

CCAD Program

DADS Services to Assist Independent Living

 

Utah

The Alternatives Program

 

Vermont

Dementia Care Respite

 

Virginia

Adult Services

 

Wisconsin

Alzheimer's Family & Caregiver Support

 

Wyoming

Home Services

 

Paying Out-of-Pocket for Adult Day Care

Should a family be unable to find financial assistance for adult day care, it is worth noting the cost of adult day care is almost always tax deductible.  It can be included as a Medical and Dental expense.  Alternatively, if your loved one is your dependent, the costs can be deductible under the Dependent Care Credit.

 

Costs of Adult Day Care

Adult day care and adult day health care are, without question, the most economical way to provide supervision and personal care for an elderly loved one on a daily basis.  When compared with home care for an equal number of hours, adult day care usually costs at least 50% less.  Nationwide in 2016, the average daily rate for adult day care is $68.  It is worth noting that most centers bill in half-day or 4 hour increments.

The table below contains the average daily cost for each specific state.  The information is sorted alphabetically and also from least to most expensive.  

 

2016 State-by-State Adult Day Care Costs
States In Alphabetical Order Adult Day Care Daily Average States From Least to Most Expensive Adult Day Care Daily Average
United States $68 United States $68
Alabama $20 Alabama $20
Alaska $100 Texas $24
Arizona $60 North Carolina $35
Arkansas $57 Ohio $39
California $55 South Carolina $39
Colorado $46 District of Columbia $41
Connecticut $58 Nebraska $41
Delaware $47 West Virginia $41
District of Columbia $41 Georgia $43
Florida $45 Oklahoma $43
Georgia $43 Pennsylvania $43
Hawaii $48 Tennessee $43
Idaho $70 Iowa $44
Illinois $51 Florida $45
Indiana $55 Colorado $46
Iowa $44 Virginia $46
Kansas $53 Delaware $47
Kentucky $49 Massachusetts $47
Louisiana $50 Hawaii $48
Maine $77 Mississippi $48
Maryland $56 Washington $48
Massachusetts $47 Wisconsin $48
Michigan $57 Kentucky $49
Minnesota $57 Louisiana $50
Mississippi $48 New Hampshire $50
Missouri $52 Wyoming $50
Montana $68 Illinois $51
Nebraska $41 Nevada $51
Nevada $51 Utah $51
New Hampshire $50 Missouri $52
New Jersey $61 Kansas $53
New Mexico $77 Rhode Island $53
New York $64 California $55
North Carolina $35 Indiana $55
North Dakota $55 North Dakota $55
Ohio $39 Maryland $56
Oklahoma $43 Arkansas $57
Oregon $67 Michigan $57
Pennsylvania $43 Minnesota $57
Rhode Island $53 South Dakota $57
South Carolina $39 Connecticut $58
South Dakota $57 Arizona $60
Tennessee $43 New Jersey $61
Texas $24 New York $64
Utah $51 Oregon $67
Vermont $88 Montana $68
Virginia $46 Idaho $70
Washington $48 Maine $77
West Virginia $41 New Mexico $77
Wisconsin $48 Vermont $88
Wyoming $50 Alaska $100
 

 

Affordable Adult Day Care

Did You Know?
Alzheimer's and dementia are the most common conditions among adult day care participants.


Our organization has partnered to help families locate affordable, high quality adult day care and adult day health care centers in their geographic area and in their price range.  Through this partnership, we are now able to provide this service free of charge.  Find affordable adult day care now.