INDIANAPOLIS – Jade Jeffries doesn’t know what she’d do without SarahCare — an adult day program that her father, James, attends every day. Jeffries works two jobs to pay the bills and is the sole caretaker of her father, who is in his late 80s and has dementia.
Jeffries feels lucky to have secured a place for her father where he can get socialization and specialized programming in addition to nursing services. After the toll of COVID-19, only 40 or so such adult day programs exist in Indiana — each serving 10 to 15 members.
“I struggled for a while before I could find them,” Jeffries continued. “I’m not sure how I was making it.”
With SarahCare, her dad has an activities calendar, music and movement programs, nurses, and nutritionally balanced meals.
But, like the rest of Indiana’s Medicaid landscape, adult day services face a monumental change this summer when the state transitions to managed care. For providers, that means a Managed Care Entity will handle their claims and payments rather than the state.
“We’re really kind of at a crisis right now,” said Laura Altenbaumer, president of the Indiana Association of Adult Day Services. “And I’m concerned … that when we transition to Indiana PathWays, we will lose additional day programs. (The small centers) are not going to be able to withstand this transition.”
Current struggles with low referrals — down 42% from last year even before the state implemented a waitlist — were pushed to a breaking point when the state briefly interrupted reimbursements for transportation services in April, a crucial service for families like the Jeffries.
Altenbaumer, who runs her own Indiana center in Merrillville, said adult day service providers were abruptly told that transportation service would no longer be reimbursed through their referral sources, Area Agencies on Aging (AAAs).
One center, she said, would have lost $6,500 monthly in transportation revenue alone, not including the loss from members who could no longer attend. Jeffries said she wouldn’t be able to work without the transportation service for her father.
Altenbaumer and others appealed and the state has since paused implementation, though Altenbaumer said some AAAs still hadn’t changed course — further sidelining an underutilized program with an uncertain future.
“We are still getting denied. The majority of the centers continue to provide free transportation in the hopes that we will get reimbursed. But it’s just not a sustainable model,” Altenbaumer said. “If we lose those transportations for adult day providers, more adult days will close.”
Click here to read the rest of the Whitney Downard story for the Indiana Capital Chronicle.
