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The Importance of Care Options in South Carolina

By: Glenn F. McConnell: Lieutenant Governor
web posted March 7, 2013

GUEST OPINION - Across South Carolina, options for care for senior citizens and persons with disabilities are dwindling, while our escalating population continues to place a greater reliance on our state's available resources.

Helping to fill part of this void is adult day care, which gives family members who care for a loved one the ability to have a break in their caregiving responsibilities in order to maintain their normal work schedule while a dependent family member receives valuable services at a day care center.  Participants at these centers, including seniors and persons with disabilities, may require some assistance with the activities associated with daily living (such as bathing, eating, and dressing), but generally, they are not in need of advanced forms of care.

Adult day care centers are vital community resources that serve as life-savers for countless family members and individuals in our state.  First and foremost, adult day cares provide a much-needed benefit for working family members, who, without these facilities, would be forced to choose between their job and taking care of a loved one.  These facilities allow a family member to continue to support themselves, keep the family unit together, and prevent their loved one from becoming a ward of the state.  Secondly, these centers serve as an outlet during the day for similarly challenged individuals so that they are able to associate with one another, receive nursing support, and benefit from mental and physical stimulation.  Thirdly, these centers prevent the migration of its participants to more costly forms of care, such as an assisted living facility or a nursing home.  In essence, these centers not only provide a benefit for the families and individuals who rely on their services, but they also save taxpayers money.

Some families are able to pay privately for services at adult day care centers.  But for participants who qualify for assistance, adult day programs in South Carolina are reimbursed $43.75 per person per day for services.  Nationally, the average rate for adult day care centers is $61 per person per day, which often includes eight to ten hours of care.  Recent state Medicaid rate reductions have made providing day care increasingly challenging, and furthermore, South Carolina’s Medicaid reimbursement rates are among the lowest in the nation.  Compared to a Medicaid nursing home bed, which costs approximately $52,000 per year, the savings to taxpayers is over $40,000 annually.

In addition, adult day care continues to be plagued by government’s regulatory environment.  In one particular facility I visited, there was a strong interest shown by the participants, family, and staff for the center to open on Saturdays.  However, for that to occur in the same center where they operate Monday through Friday with identical services, the center was required to jump through more bureaucratic hoops via a recertification process in order to receive special permission.  Therefore, it just wasn't worth it to them in time, energy, and money.

Care options, such as adult day cares, are the answers to many of our residents' prayers.  They allow loved ones to live at home with their family close by, while creating social opportunities with fellow peers.  They provide flexible nursing care, as needed, throughout the day, while monitoring and supervising the distribution of medication.  Many of them offer transportation and are designed for adults of any age, including seniors, with intellectual or developmental disabilities.

I have toured similar facilities state-wide, and I have observed first-hand the severe need for care options, such as adult day care centers.  We should be doing everything in our power to promote additional care options in our state.  Yet, our state has created a regulatory road so bumpy that the effort required to offer additional services is barely outweighed by the advantages.  Options for care, such as adult day care centers, should be encouraged instead of hindered.

Sadly, an increasing number of these facilities are struggling to remain open.  Money is not the only roadblock that these centers must overcome, and the desire for additional care options will only continue to grow as South Carolina's senior population doubles over the next 20 years.  This is a trend that must be reversed, but it will take a more common sense approach from policymakers across our state.

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