Massachusetts Begins to Regulate Adult Day Care

Kimberly Butler Rainen

March 20, 2015

Massachusetts recently enacted 105 CMR 158 which, for the first time, requires Adult Day Health Programs to be licensed. Approximately 150 Adult Day Health Programs in Massachusetts currently receive Medicaid funding, but due to the lack of regulation and oversight for these programs, it is unclear how many are operating in the Commonwealth.

The regulation does make a distinction between adult day health services and an adult day care that provides mere companionship or social activity for participants. The regulation covers providers that perform at least one skilled service or assistance with at least one activity of daily living, as described in the regulations.

A recent study conducted by a number of post-acute and long-term care provider associations, “Mapping the Future: Estimating Massachusetts Aging Services Needs 2010-2030,” predicts a dramatic rise in the need for Adult Day Health Services, including an increase of 70% in the number of people served by Adult Day Health Programs by 2030. With such a dramatic rise potentially forthcoming, it seems the regulations are both timely and necessary to protect and ensure the safety of those partaking in these services.

While Medicaid does have a certification process for the programs that it reimburses, it is expected that the new regulations will improve the overall quality of all such programs, as well as prevent hospitalization and extending the time program participants are in the community without need for institutionalization.

The regulation requires that Adult Day Health Programs be inspected every other year by the Department of Public Health, mandate minimum staffing requirements, institutes sanitary standards, implements participant rights policies, necessitates assessment and care planning and requires separate spaces to provide activities for participants with advanced dementia, among other requirements.