Hospice day care standards development in Michigan.

Adult daycareis arelativelyunderdevelopedalternativein thecontinuum of healthcaredeliverybutisbecoming increasingly important. By 2020 the CensusBureaupredicts that almost one-thirdoftheU.S.populationwill be at least55 yearsof age. Alreadydaycarecentersfor adults exist in nearly everystate. Nationwide,accordingto the National Institute on Adult Day Care,therewerea meredozencenters in 1970andmorethan1,200 now.1 The term day care is actually generic. Although the servicecomponentswhich comprise a day care programarenot new, day careis consideredto beanewwaytodelivercertain medical,healthand/orhealth-related social servicesfor older and/or disabledadults.Thepurpose, organization, kinds of participants,settings, programcontent, and structuremay differ markedly ranging from active rehabilitationto theprovisionofoneor morehealth-relatedsocialservices. When developinga day care program,emphasishouldbeplacedon meetinghigh quality of careandadequatebuilding safetystandardswhich confonnto stateandlocal codesand regulations. Although somestates haveattemptedto createguidelinesfor the operationof day care programs, there areno uniformly appliedstandards. In a studyby Issacs,thirty-four of the fifty states(plus the District of ColumbiaandPuertoRico)hadestablished state-levelstandardsfor both funding and licensure,twelve had standardsfor funding only, and only eighthadstandardsfor licensure.2