Only four states both license and certify providers. Kentucky licenses Medicaid providers of adult day health care but certifies facilities for the Adult Day Care and Alzheimer's Respite program. Nevada requires all facilities offering adult day or adult day health care to be licensed (including Medicaid waiver and State Plan providers) and requires Medicaid State Plan providers to meet adult day health care certification standards. Maryland licenses two types of adult day services--Day Care and Medical Day Care--but also offers a small social adult day care program called Senior Center Plus. Senior Center Plus providers do not have to be licensed but must meet Maryland Department of Aging certification requirements. California licenses two types of facilities: adult day programs and adult day health care centers. Adult day health care centers must also be certified. In addition, each local area Agency on Aging designates at least one Alzheimer's day care resource center (ADCRC) in its Planning and Service Area to provide specialized Alzheimer's care and community outreach and education. Until recently, the law permitted ADCRCs to function without a facility license, although the majority of ADCRCs are located in licensed ADPs or ADHC centers.