Shay Stevens does not harp about state regulations on adult day care, but the rule on pill dispensers does puzzle her.
Adult day care attendants, you see, are not authorized to dispense medicine, and dementia patients often have shaky hands. “If the dispenser has more than one top (to denote different doses or times of day), we can’t close those lids because that would be considered administering medication,” said Stevens, who has two Millennium Adult Day Care locations in Little Rock, as well as an affiliated home care company.
The rule is just one example of the level of detail the state applies to overseeing a small but growing slice of the elder care industry.
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All in all, though, Stevens has high praise for the state’s Medicaid waiver programs, including ARChoices, which reimburses the cost of care for many of Millennium’s patients. “At this point, I’m top-heavy with ARChoices clients, but other times I’m top-heavy with Medicaid or private-pay.”
ARChoices in Homecare, as the program is known in full, covers a number of community-based services through Medicaid, including attendant care, respite care, adult day care, home-delivered meals, personal emergency response systems and environmental modifications, according to Marci Manley of the Arkansas Department of Human Services.
The state differentiates between adult day care and what it calls adult day health care, which emphasizes rehabilitation, therapy and supportive health and social services, said Craig Cloud, director of the DHS Division of Provider Services & Quality Assurance. Adult day health care “is differentiated from adult day care or community centers by the strong emphasis on holistic health care,” Cloud said, noting that adult day health care’s interdisciplinary teams consist of nursing, social work, medicine, rehabilitation, therapy and coordinated activities.
While doctors, social workers and law enforcement officials do make presentations at adult day care centers, those specialties are not a routine presence.
The state provided a county-by-county breakdown that showed that 22 adult day care centers are operating in 12 counties. Pulaski County has the most, with eight serving up to 130 clients. Crittenden County is next with four centers, including three in West Memphis. The other 10 counties have one center each.