After 31 years of providing day care for elderly people as an alternative to a nursing home, Vintage Senior Services in East Liberty is phasing out that service through June. It will continue to operate as a senior center.
The cost of adult day care has outpaced the flat funding levels of recent years, executive director Ann Truxell said.
Staff at the center at 401 N. Highland Ave. recently held a fair for families to meet other day care providers. Seven providers had 130 slots, enough to absorb all of Vintage's 65 day care clients, most of whom are on Medicaid, she said.
The day care staff will be laid off, she said, adding that Vintage is trying to help place the employees at other centers.
Located in a former Giant Eagle, Vintage will seek a tenant for the 7,000 square feet the day care occupies, she said, "hoping for a mission match, a nonprofit that does human service." The senior center occupies 18,000 square feet.
The agency began as a senior center in 1973 and expanded into adult day care in 1981. At the time, "the clients in day care looked more like the frailer people who are in the senior center currently, but people are living longer and want to live in their homes instead of nursing homes."
Today, the costs and needs are more complex, she said.
Day care clients are not independent like their counterparts on the other side of the building, and their care is highly regulated. A nurse must be on duty at all times, and there must be one staffer for every five clients and 11 hours of service daily. The day care side of the building has a staff of 20, while the senior center has four.
The door that separates the two groups must be opened and closed with a pass code to keep in clients who may be prone to wandering out.
Vintage operates on about $1.5 million a year -- $1 million of that for day care and $500,000 for the senior center, which will now be the focus, she said. With a daily average of 115 people, the senior center provides independent clients a daily lunch; a fitness and recreation room; social areas for playing cards; a billiards room; classes; field trips to the theater, zoo and other cultural institutions; and equipment for people to check their blood pressure. The clients pay for some expenses, such as theater tickets.
In adult day care, Ms. Truxell said, "you have very few opportunities to bump your cost down or keep them from escalating. As important as I think day care is -- because it does keep people in their homes longer -- we have hard decisions to make."
About 14 adult day care providers in the county have contracts to serve clients who have a Medicaid waiver or who qualify for assistance through the Options program that is funded by the state lottery, she said. Three or four other centers serve clients who pay privately.
Mildred Morrison, administrator of the Area Agency on Aging in the Allegheny County Human Services Department, said of the 519 adult day care slots available to clients in the county based on September figures, "we were using 181, so there is a ton of capacity."
She said adult day care is "on an hour-by-hour average cost cheaper" than out-of-pocket in-home care, "but at $1,600 a month, it seems to be not affordable. I'm saying affordable compared to what? If a family decided an elderly loved one needed to be in assisted living or a nursing home, it could run $3,000-$6,000 a month."
Heather Sedlacko, a board member of the state Adult Day Services Association and executive director of Valley Care in Ambridge, said the high cost of the medical model for day care "is a tremendous challenge we all face."
She said reimbursement doesn't come anywhere near her unit costs.
"We have been fortunate to have a supporting organization, the Valley Care Endowment Corp.," she said, adding that cost is a future worry because endowments can't carry the burden forever.
"When Vintage announced the closure of its adult day, we all kind of went 'whoa.' Vintage is held up as one of the most successful day care programs and the most high-profile. If they couldn't make it work financially at that number of clients, what the heck are we going to do averaging 18 per day?"
That nursing home care is an entitlement to eligible people while adult day care is not "is a big systems problem," she said, "because people want to stay in their home, and adult day services can help them do that with better economy of scale."
Ms. Truxell said public funding for elder services has been flat while funding for services for the disabled has been cut, "but flat funding is like a paycheck never going up while expenses all do."