Licensing, Certification, and Other Requirements
The majority of states require licensure, certification, or both. According to the Department of Health and Human Services:
26 states require licensure only;10 states require certification only;4 states require both licensure and certification; and11 states do not require licensure or certification.
“Certification” means that the individual adult day services program has been evaluated and approved relative to standards set by the state government. These standards vary depending upon whether the program is an adult day health service or a social ADS program.
Licensing procedures vary from state to state, with different requirements based on the type of services provided. For example, a day care program that serves adults with dementia will have to meet specific guidelines, as must a program that operates both day and night.
States that neither license nor certify generally require publicly funded ADS providers to enter into official agreements with a state agency, specifying that they will comply with mandated requirements.
With the growth of the aging population, specific standards will continue to evolve.
Definitions of Adult Day Services
States vary considerably in the terms they use for ADS. Adult day health care is defined as a supervised daytime program providing skilled nursing and rehabilitative therapy services in addition to core services provided in adult day care.
Definitions of adult day services generally incorporate a statement about their purpose, the number of people who can be served, and limits on the number of hours a person may be served.
Staffing Requirements
States vary with regard to the number of staff required. All states require specific types of staff for ADS programs. The major difference in requirements between adult day care and adult day health care is the latter must have licensed nurses available in some capacity. The National Adult Day Services Association offers a full list of state-by-state requirements.
