Your guide to NYC's public proceedings.
Q&A
Enrollment requirements and changes in adult day health center models
0:50:32
ยท
4 min
Dr. Mitch Katz provides a detailed explanation of the changes in adult day health center models over time and the challenges faced by these facilities.
- Dr. Katz explains that adult day health centers have declined in number due to changing healthcare models
- He outlines the specific criteria for enrollment, including the need for skilled nursing care
- The discussion covers the limitations of the adult day health center model and why it has become less popular
- Dr. Katz compares the adult day health center model to more flexible options like senior centers and home services
Selvena Brooks-Powers
0:50:32
Health and hospital has cited low enrollment as a key concern for closing the facility.
0:50:38
How many patients would the facility need to to serve in order to keep it open?
0:50:44
I will say this was a very contentious question last night.
0:50:47
We did not get, I think, a a good answer, and so I would like to hear from you.
Dr. Mitch Katz
0:50:56
Well, I don't know that it's as straightforward as how many people.
0:51:01
Maybe we could take a step back and talk about the program.
0:51:07
Twenty years ago there were many adult day health centers in New York City.
0:51:13
There aren't many now.
0:51:16
Why is that?
0:51:17
Because healthcare models change and what people think are the best ways to care for people change over time.
0:51:27
And that is what's happened in the adult day health center world.
0:51:32
When the programs were created, the criteria include that somebody must be sick enough to need skilled nursing care.
0:51:44
So these are not programs for, older seniors who need more socialization, who need a place to go, who need a hot meal, who need help with activities of daily living.
0:51:58
Those are not skilled nursing needs.
0:52:01
So you have to have a skilled nursing need.
0:52:03
On the other hand you have to be well enough to get on a van or have somebody transport you to it.
0:52:11
And so I think over time the reason these programs have so declined in number is that most people have decided that they would prefer to be, to get the care that they need at home.
0:52:24
There is a, you know, and it's true of Neponset, There is a group of people for whom this is a great option and they love it.
0:52:34
And nobody nobody is questioning, you know, the fact that there is a number of people for whom this is the right option.
0:52:44
And I know that it's also for the people who work there.
0:52:48
It is for the people who for whom it's right.
0:52:50
It works very well.
0:52:52
But in general, because of the level of state regulations about it, the requirement, for example, unlike our senior centers, are wonderful in the city, on a senior center, if you're a senior, if you wanna go Monday and Thursday, you go Monday and Thursday.
0:53:09
You don't make any commitment that you're going a minimum of days whether you want to or not.
0:53:16
And you don't, it doesn't have the segregation of you must have the skilled nursing need.
0:53:22
And it doesn't have the expense of the skill.
0:53:26
I mean, again, we love our nurses.
0:53:28
They are highly skilled.
0:53:29
They are the people you want assessing you for shortness of breath.
0:53:33
They are the people they want for, if you need your vital signs checked on a frequent basis if you have wounds.
0:53:43
But what I think the world has decided and someone who took care of his hundred year old father to his death in an apartment near mine is that most people wanna stay at home and what they want is their custodial needs met.
0:53:58
And again, I don't wanna in any way discount the people who love the center and for whom it is the right thing.
0:54:07
But as broad strategy, adult day centers are just not as flexible as senior centers focusing on socialization or home services.
0:54:21
And I feel that's the reason why there used to be a lot of these and there are not a lot of these now.
0:54:28
And this particular one does have challenges including that we don't own the building.
0:54:34
There are there have just been a number of challenges.
0:54:37
So, you know, like a lot of complex issues, I can see many sides of it.
0:54:42
I see the people who love it.
0:54:44
I see the people who like working there.
0:54:46
But I also see, you know, the change that's occurred over time in how people view the right levels of service.
0:54:55
So I don't know if that jives or doesn't jive with with some of the things you've heard, but that that's my big picture view of it.