County Closes its Adult Medical Day Care Facility

While Derry state representatives had varied reactions to the Rockingham County Commissioners’ decision to close the county Adult Medical Day Care facility, they agreed that New Hampshire’s frail elders need their – and their constituents’ – support.

The Adult Medical Day Care (AMDC) was scheduled to close Tuesday, Dec. 31. Two Commissioners, Chairman Katharin Pratt and Derry’s Kevin Coyle, voted to close the facility, while Commissioner Thomas Tombarello of Sandown did not. The two Commissioners cited declining enrollment and a deficit in the program.

Rep. John O’Connor, R-Derry, a member of the County Delegation, said the issue came to light last January, when the Commissioners began expressing concern about the value of the program. The Commissioners proposed closing the facility on Jan. 3, and voted to freeze admissions on Jan. 9. The Delegation formed a study committee to review the program, chaired by Rep. Debra DeSimone. On April 24 the freeze on admissions was lifted and an action plan agreed upon to improve the income of the Center.

But in December, the Commissioners voted 2-1 to close the program by Dec. 31. They wrote in a statement, “The commissioners along with Steve Woods, director of long-term care services, spent a great deal of time reviewing the program with the study committee. In April the board presented a plan to improve the program, enhance revenues and increase enrollment. The plan was reviewed regularly and despite the best efforts of all involved, enrollment goals were never achieved.”

The Executive Committee of the County Delegation voted unanimously to oppose the closing, and asked the Commissioners to reconsider their vote and keep the program open through 2014. The Commissioners refused the request, according to O’Connor.

A press conference Dec. 12 was held to educate the public on the closure and the effect on seniors in the area.

In the press conference, Rep. Norm Major, R-Plaistow, chairman of the County Delegation, said the program’s projected loss for this year would be approximately $45,000, but added that it ran at a deficit of $250,000 in previous years.

Opponents of the closure contend that the service was not properly marketed, or marketed at all. O’Connor said he did research in his own town, meeting with Derry Human Services Director Jill McLaughlin. “I asked her, ‘Did you receive posters, brochures or calls advertising this service?’ She said she did not.”

He met with Sarah Garvin, director of the Marion Gerrish Community Center, which sponsors or hosts several programs for seniors. Garvin told O’Connor, “We were not aware of this,” and went out and checked her bulletin board for good measure.

O’Connor met with a staff member at Derry Parks and Recreation, another source for senior programs. The staff member also said they were not aware of the AMDC, and added, “We had a phone call from someone looking for a service like that two days ago.”

While the Commissioners talked about marketing efforts in Exeter and with Lamprey Health Care in Newmarket, the outreach effort apparently didn’t get to Derry, and that bothered O’Connor. “We are the fourth-largest town in the state,” he said.

In O’Connor’s eyes, the Commissioners “didn’t do their due diligence. They wanted it closed, period.”

The Center was opened 33 years ago and its official name is the Helen F. Wilson Adult Medical Day Program. It was named after a State Representative known as an advocate for the elderly and needy, according to the program’s Web page. Payment may be private, through Medicaid or Choices for Independence, through veterans’ benefits or through certain forms of long-term care insurance policies.

According to the Web site, the cost of the program is less than a nursing home, less than an assisted living community and less than in-home care.

The Web site said the program could “help individuals remain in their own homes despite needing personal assistance;” prevent or delay costly long-term care alternatives; reduce unnecessary hospitalizations by providing nursing supervision and health monitoring; and relieve or prevent “caregiver burnout.”

Representative Jim Webb, R-Derry, agreed. Webb, a member of the Executive Committee, said, “I think the program itself was a meaningful one. It didn’t directly affect Derry – we didn’t have anyone in it. But it did affect Rockingham County.”

And it was available for Derry residents if they chose to use it. “Someone who worked in Portsmouth could drop Mom or Dad off on their way to work, and pick them up on the way back,” Webb said.

Closing the program will not save a lot of money, Webb added, as its total cost is $70,000 to $80,000. And it’s worth far more to the families who use it. “The adults who go there, sometimes it’s their only social event,” he said. “They look forward to it.

State Rep. Mary Till, D-Derry, a delegation member, said she was “torn” on the closure. “It think it’s really important to have a safety net for older people,” Till said.

But she was persuaded by the Commissioners’ argument that the committee had worked on this all year, and not been able to increase participation. Proponents of the closure argued that there were other adult day care facilities in the area, and that tipped the balance for Till.

“If others in the area are offering these services, why are we paying for it?” she asked. She pointed out that the state and county are still “financially strapped.”

There are other facilities in the area, O’Connor agreed. But those are private, for-profit, and not all provide the medical support the AMDC did. “It’s not just adult day care, it’s adult medical day care,” he emphasized. “The Nursing Home was right there if someone had a medical issue.”

O’Connor said he does not know what else the Representatives can do. “It looks like a done deal,” he said, adding that when the County begins budget hearings this month, the subject may come up again.

“The population is ‘graying,’” he said, and with the economy, “more seniors are sharing homes with their adult children.” A service like the AMDC would benefit both, he said.

“I understand we can’t keep spending and spending,” Webb said. “But we judge a society on how it treats its elders.”

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