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NMSU researchers examine adult day services in New Mexico

Donna Wagner, dean of the College of Health and Social Services and Joe Tomaka, associate dean and director of the New Mexico State University Survey Research and Program Evaluation Center, conducted a study of adult day services in New Mexico for the Aging and Long-Term Services Department of New Mexico. Their study found that many of the 27 licensed adult day programs in the state were begun in response to community demand and were providing important support for older adults in the community as a result.

Adult day services provide a critical piece of the long-term services and support available to adults in need of assistance because of physical or mental conditions. They are an important component to the array of home and community-based services that assist older adults to remain living in the community.

“The Department of Aging and Long-Term Services commissioned the study in order to examine options that would strengthen this important component of the home and community based services available to New Mexican elders,” Wagner said.

More than 5,000 adult day service programs exist in the nation but only 27 licensed adult day programs exist in New Mexico, as identified by the New Mexico Aging and Long-Term Services Department.

The study was conducted in fall 2014 and spring 2015 and included personal interviews with adult program administrators, aging network representatives and adult protective services representatives. NMSU received a 74 percent response rate from adult program administrators with 20 of 27 agreeing to participate in the study. Additionally, 19 adult protective services respondents, eight tribal staff members and eight area agency members on aging personnel were interviewed.

“The purpose of the study was to develop a comprehensive overview of regulatory environment, types of programs and funding options. The data collected will guide the development of recommendations designed to strengthen the network of adult day service programs, their funding adequacy, and accessibility for potential participants,” according to the report.

The report found that New Mexico spends about $7.9 million annually on adult day services through a variety of funding sources.

“The most surprising finding for me is that few of the programs relied upon Medicaid funding for their support,” Wagner said. “In other states, the Medicaid waiver, which is designed to provide services to those who qualify for this program, is an essential source of revenue for many, if not most adult day programs. The Medicaid waiver provides funding for the home and community-based services needed by those who might otherwise have to rely upon an expensive nursing home option for care. Most professionals agree that alternatives to an institution is important for the well-being of older adults and living at home while getting necessary supports and services offers a higher quality of life to elders with care needs.”

Challenges to expanding services in New Mexico are heightened by the state’s rural geography. Albuquerque, the state’s largest city, has the majority of the programs, while in Las Cruces, the second-largest city, the one freestanding adult day program has been closed.

Tomaka noted the importance of “an expansion of training and technical assistance opportunities for both center directors and staff to ensure that programs are relying upon evidence-based information to improve and maintain a high quality experience for participants and access to a variety of resources needed to fundraise for the programs.”

In addition, language barriers can pose a challenge because more than a third of the population in New Mexico is non-English speaking.

“There is a need for this service in other communities in the state and it is a challenge to make this service cost-effective in rural areas,” Wagner said. “If there was a higher level of awareness about adult day programs and their importance to older adults and their family members who are providing them with regular assistance, we might see a higher level of demand.”

The study found that adult day centers had an average of 28.42 participants, who range in age from 49 to 91, with an average daily attendance of 17 participants. The report also indicated that participants’ average number of days a week they attended a center were about four and a half days.

“The Department now has some data and information upon which they can act to ensure that people who need adult day services know about the service and have access to it in their community (if possible) and hopefully more options for paying for this service if it is needed,” Wagner added.

The report stated, “Adult centers provide an important lifeline of support for their participants with 83.5 percent described as being unable to stay home alone, and must rely upon the center to remain in a community living situation.”