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Regulatory Review of Adult Day Services: Final Report - Section 2
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Regulatory Review of Adult Day Services: Final Report
SECTION 2. STATE REGULATORY PROFILES
The following profiles summarize states' approaches to regulating adult day services. While state regulations cover a multitude of areas, a primary purpose of this study is to understand the role that ADS plays in the health care and long-term care systems. Therefore, in addition to identifying each state's general approach to regulating adult day services, we focused primarily on those provisions related to the target population and services.
Consequently, our regulatory review does not include a summary of all regulatory provisions. The following are not included in the state profiles:
- Advisory board and governing body requirements.
- Enrollment procedures.
- Facility, equipment, and physical plant requirements.
- General health and safety requirements, such as infection control, fire safety, and emergency operations.
- Program activities requirements.
- Record keeping requirements.
- Participants' rights.
- Personnel policies not related to staffing and training, such as conducting criminal background checks.
- Meal and food requirements related to food handling, preparation, and storage.
- Medication storage policies.
All of these areas, while important, are not directly related to the provisions of health and long-term care services.
The regulatory profiles have several sections:
Overview. The overview contains a brief description of the state's general approach to regulating ADS providers, indicating whether the state uses licensure, certification, or some other approach. The overview also indicates whether the state's Medicaid program has additional requirements for ADS providers who serve Medicaid beneficiaries. Because the focus of this review is on services for elderly persons, the profiles do not include regulatory or Medicaid information for ADS providers who exclusively serve individuals with mental retardation or other developmental disabilities.
Licensing, Certification, or Other Requirements. This section specifies whether a state requires licensure, certification, both, or neither or uses some other regulatory approach such as contracts with public funders of adult day services.
Definitions of Adult Day Services. This section provides the regulatory definitions for each type of adult day service that the state regulates (i.e., adult day care and adult day health care).
Parameters for Who Can Be Served. This section includes provisions that specify the health and functional needs of the population that may be served. These provisions are generally not specifically stated in regulation. The information in this section was obtained from a combination of sources: discharge criteria, definitions of adult day services, lists of required services, and Medicaid eligibility criteria for ADS services.
Inspection and Monitoring. This section contains basic information about the type and frequency of oversight activities.
Required and Optional Services. This section lists required and optional services in a table format. Although states may specify a service as optional, some also specify that providers are required to cover any services specified in a participant's care plan.
Provisions Regarding Medications. This section contains information pertaining to self-administration of medications and the administration of medications to ADS participants, including what types of staff (e.g., licensed personnel) may administer medications to ADS participants.
Provisions for Groups with Special Needs. This section indicates whether a state has regulatory provisions for serving populations with special needs such as dementia. While states may not have a section of their regulations addressing the needs of groups with special needs (e.g., dementia), many have specific provisions for dementia participants in the regulatory sections dealing with staffing and training.
Staffing Requirements. This section includes information about the type of staff required in addition to required staff-to-participant ratios.
Training Requirements. This section includes information about staff training requirements, including orientation training and annual training.
Relevant Medicaid Contracting Requirements. This section includes additional contracting requirements for ADS providers serving Medicaid beneficiaries in waiver programs or under the State Plan.
Each profile ends with citations for information sources and the URL addresses for on-line information sources when available.
The profiles are intended to provide basic information for how states regulate providers of ADS for elderly persons. They do not include information about specific programs or sources of public funding other than Medicaid (e.g., Older Americans Act and Veterans Administration funding).
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Alabama
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Alaska
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Arizona
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Arkansas
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California
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Colorado
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Connecticut
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Delaware
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District of Columbia
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Florida
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Georgia
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Hawaii
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Idaho
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Illinois
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Indiana
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Iowa
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Kansas
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Kentucky
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Louisiana
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Maine
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Maryland
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Massachusetts
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Michigan
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Minnesota
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Mississippi
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Missouri
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Montana
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Nebraska
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Nevada
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New Hampshire
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New Jersey
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New Mexico
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New York
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North Carolina
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North Dakota
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Ohio
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Oklahoma
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Oregon
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Pennsylvania
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Rhode Island
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South Carolina
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South Dakota
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Tennessee
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Texas
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Utah
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Vermont
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Virginia
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Washington
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West Virginia
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Wisconsin
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Wyoming
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