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What are Adult Day Services in Washington State?

Adult day services are community-based daytime programs that have existed for nearly 70 years and consist of adult day care and adult day health. Yale Psychiatric Hospital developed the first adult day program in 1949 to serve primarily as a community resource for successful discharges from the psychiatric hospital. When Medicare and Medicaid were enacted in the 1960s, the model expanded to include a focus on health maintenance. In the early 2000s, the United States Department of Health and Human Services (DHHS) funded a study to identify the role of adult day centers under a long-term care model (see Historical Highlights). This is the model Washington state continues to use for adult day services.

Adult day programs provide family and caregivers with respite while meeting the medical and social needs of the participants through individually developed plans of care. Additionally, these services provide an opportunity for participants to remain in a community setting of their choice while providing safe and supportive activities to assist with maximum independence and quality of life.

Adult day care is a daytime program, typically consisting of four hours of services, providing the participant with an opportunity to socialize with peers, enjoy a meal and snack, engage in exercise programs, and receive periodic health monitoring by a nurse. Individuals who attend adult day care do not have a medical need requiring the skills or interventions of a skilled professional such as a therapist or nurse. Activities offered in adult day care centers may include evidence-based or evidence-informed exercise programs, memory stimulating group activities, Alzheimer’s and dementia care, reminiscence groups, personal care assistance, recreational activities, arts, crafts, gardening, cooking, and medication management while at the center.

Adult day health provides all the core services of adult day care with the addition of higher level support by a Registered or Licensed Practical Nurse (RN or LPN), Occupational or Physical Therapist, and a Master’s prepared social worker for participants who have been assessed with medical, therapeutic, and/or clinically social needs. The site offers transportation to and from the center for Medicaid clients and provides one-on-one nursing and therapy services. Services offered in adult day health may include medication administration, laboratory blood draws, wound and ostomy care, diabetic management and diabetic foot care, injections (subcutaneous and intramuscular), tube feedings, bowel and bladder training, care coordination, nutritional and health education, skilled rehabilitative services, and individualized exercise programs.

For more information

There are currently 25 Medicaid-contracted adult day care centers and 16 Medicaid-contracted adult day health centers in Washington state. Many of the centers operate both adult day care and adult day health. If you have questions regarding the programs or would like to request a tour, contact the facility directly for hours of operation and availability of tours.

For participants and family members who are interested in accessing services but are unsure if they are eligible under Medicaid or pre-Medicaid dollars, contact your local Home and Community Service (HCS) office for further coordination. Find my local HCS office.

For participants who wish to access services under resources other than Medicaid, contact the facility directly for more information on available funding sources. To find a full list of DSHS contracted adult day centers, visit Find a Adult Day Service Center or contact Susan Worthington, Program Manager for HCS Adult Day Service, Aging and Long-Term Support Administration at 360-725-2638 or”

Contributor Erika Parada, RN, BSN, manages Adult Day Services with Home and Community Services at the Washington State Department of Social and Health Services in Aging and Long-Term Support Administration.