This opinion piece, by UNH Executive Director Nancy Wackstein and Policy Analyst Carin Tinney, was originally printed in the May 9, 2013 issue of the New York Nonprofit Press. Read the original piece here.
Until very recently, most New Yorkers hadn't heard of something called social adult day care. If they did, perhaps it conjured up images of frail seniors on small plastic chairs, drinking from ½ pint milk cartons while having a story read to them by a teacher. That is why the attention now being paid to this program - due to the recent scandal involving two Bronx Assembly Members and the resulting articles in the New York Times about alleged abuses by “pop up” social day care providers- is bittersweet.
The unfortunate impression is that this program is at best unnecessary and at worst riddled with fraud, political kickbacks and unscrupulous operators. But the attention, however negative, does give us a chance to highlight the benefits of this program, which when done the right way by credible and professional providers, has helped thousands of genuinely frail seniors remain independent in their communities and has given their family caregivers essential support and respite.
The social adult day care model has been around for decades. In many cases, there is a dual focus on providing supervised care and support to seniors while allowing family caregivers a few hours of relief. Social adult day care specifically supports seniors who would have a difficult time adapting to a bustling environment of a traditional senior center because of their frailty or dementia. These seniors are dependent on continuous care and need extra supervision, usually with eating, using the bathroom, or walking. The benefit of the social adult day care model is that it allows otherwise homebound older adults to get out and socialize with their peers through art, shared meals, exercise and music.
The challenge to the model, as it was designed, began about a year ago. Many senior center operators located primarily in immigrant communities began noticing a decrease in daily attendance. As a general rule, the number of seniors served varies on a daily basis, but this was not normal fluctuation. Seniors were being lured out of senior centers and into “adult day care programs” with cash and other incentives. This was alarming on many levels. First, the seniors leaving for adult day programs were not physically or cognitively frail, which is the main eligibility criterion of social adult day care. Second, this exodus jeopardized funding for traditional senior centers because reimbursement partially depends on the number of meals served daily. Third, it was clear that these new “social adult day care” programs were unregulated and were not using precious Medicaid dollars in the way it had been intended: to help frail seniors remain in their communities. The new centers called into question the integrity of the entire model and cast a shadow on the longstanding history of many quality-driven programs
United Neighborhood Houses, the federation of the city’s settlement houses and community centers, has within our membership some of the finest and most experienced providers of social adult day care. UNH members helped pioneer the concept and some of their adult day care programs have been operating for over a decade. It would be a horrible shame for these legitimate and important programs to be swept up in an enforcement reaction meant to shut down the Medicaid cheats.
Legitimate social adult day care programs are one of the components of a comprehensive continuum of care for older adults in their neighborhoods. They greatly benefit a population in need of specialized and supervised care, and contribute to a better quality of life for both seniors and their caregivers through constant emotional support. This program deserves not only to continue but to expand in order to accommodate the dramatic increase in the number of older adults who are projected to need this kind of care. Let’s not allow a vulnerable population to become the victims of a few dishonest program operators. Don’t throw the good out with the bad.
Nancy Wackstein in Executive Director of United Neighborhood Houses. Carin Tinney is a Policy Analyst with UNH.
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News and Resources
January 30th, 2013
This week on Business Matters, we talk about what it means for businesses to go beyond profits. What can happen when businesses decide to give back to the community? What benefits do companies perceive may arise from philanthropic work? How can “doing good” affect employee retention rates? In what ways do philanthropies themselves benefit from corporate involvement? What are the preferred ways for companies to be involved in community organizations?
We discover some surprising statistics about the amount of money, investment in volunteerism, and the number of corporations involved in giving back to their communities, and the reasons “giving back” is important to business. We hear the interesting story of a philanthropic project offered by Hewlett Packard to economically depressed areas, noting the many benefits and some pitfalls of this corporate-community collaborative project. Then we discuss the benefits to communities and businesses when corporations offer support to local not-for-profit organizations, including employee retention, community resiliency, and long-term interactions with consumers. We also hear suggestions for business leaders who are interested in offering such support.
UNH Executive Director Nancy Wackstein spoke to Business Matters Radio about corporate responsibility from the perspective of non-profit organizations.
Listen to her 13 minute interview here! (bottom of the page)
"While an increase in the state minimum wage represents welcome progress for the millions of low-wage workers across the state, we want to be certain that the value of the state's investment in [SYEP] is not diminished," said Kevin Douglas, a co-chair of the Campaign for Summer Jobs. "Since the vast majority of SYEP funding goes directly to participant wages, any increase in the minimum wage must be met with a commensurate increase in funding for the program, or ultimately we will be able to serve fewer youth."
Over 300 young people from across New York City traveled to Albany yesterday for the Campaign for Summer Jobs’ 14th Annual Youth Action Day. Their message to top state lawmakers was straight forward. The Summer Youth Employment Program (SYEP) has tremendous positive impact the program has on the lives of young people. However, every year huge numbers of youth are denied access to the program due to inadequate funding. And, this year, even fewer youth will be able to participate unless new funds are added to Governor Cuomo's budget proposals.
And, on the ground, EarlyLearn providers are continuing to express concerns about the inadequacy of funding to support the new program model. “It is a huge issue,” says Gregory Brender, Early Childhood and Education Policy Analyst at United Neighborhood Houses.
One aspect of the problem was the need for EarlyLearn provider agencies to pick up the costs of providing health insurance and other benefits for program staff – an expense which had traditionally been paid directly by the City itself. Even after additional funding was added, providers found the resources to be insufficient to purchase benefit plans that did not require significant increases in employee contributions.
And, providers continue to anticipate significant operating losses on the programs themselves. “The rate still isn’t adequate to cover the cost of care,” says Brender. “Providers are having a hard time covering their costs while providing services that meet their own standards and those of the EarlyLearn model.”
Read the whole article here>>
Please visit our Volunteer and Donation Needs page for updated information about what UNH's member agencies need at this time.
WNYC: On the Lower East Side, A Woman Emerges From a Dark High Rise for the First Time
UNH member Henry Street Settlement delivered meals and cooked food from their headquarters that would have otherwise gone bad to serve the residents of the Lower East Side during the week-long power outage.
NY1: Supplies Arrive for Chelsea Residents
UNH member Hudson Guild partnered with The National Guard, Salvation Army, and NYPD to distribute vital resources to community residents.
WNET: Serving Seniors During Hurricane Sandy
Staff members from UNH member Queens Community House worked through the storm to ensure that seniors who depends on delivered meals were not left hungry.
NY Daily News: Readers Sound Off on Hurricane Sandy and its Aftermath
Executive Director of UNH member Sunnyside Community Services, Judy Zangwill, wrote a letter to the editor detailing the barriers staff overcame to ensure the safety of homebound seniors who use SCS services.
Wall Street Journal: Feeling Forgotten After the Storm
UNH member Henry Street Settlement continues to help the battered Lower East Side neighborhood of Manhattan.
Sheepshead Bay Blog: The Doctor is in at Shorefront Y
UNH member Shorefront Y, located in Coney Island, has a doctor on hand to see children who need medical attention during this time when many residents do not have power.
R.A. Dickey stood about 15 feet from a group of kids, giving each a chance to catch his famous knuckleball. Judging on how most of them dropped it, maybe it is as hard to catch as they say it is.
Dickey and several members of the Stony Brook University baseball team joined up on Wednesday morning at the Jacob A. Riis Neighborhood Settlement House in Long Island City to address 100 kids from United Neighborhood houses, as part of the Mets' Citi Field Kids program. Following a short speech, Dickey and the Stony Brook players held a baseball clinic at a nearby park.
"They want to play baseball now, or they want to go to Stony Brook or they want to become a New York Met, whatever it is," Josh Barry, a left-handed pitcher for Stony Brook, said of the youngsters at the clinic. "It's good to breathe stuff like this in."
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The city hopes EarlyLearn will make for higher-quality city-funded daycare. Despite funding shortages and doubts about the way contracts were awarded, some agencies and advocates believe the program has promise.
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