Day care for grown-ups is growing Almost Family expanding fast

June 06, 1993|By Patricia Meisol | Patricia Meisol,Staff Writer

After her mom suffered another stroke two years ago, Lind Bond faced a dilemma: quit her job or send her mother to a nursing home. She couldn't afford the first option and didn't like the second. "I was at wit's end," she recalled.

A social worker offered a solution: a day care center for adults. Mrs. Bond was skeptical about the center, whose brochure featured a smiling, white-haired woman. But, curious, she went unannounced to an Almost Family center in Timonium.

What she saw changed her mind -- and pleased her mother, Edith Freeman, who has lived with her for more than a decade.

"It's allowed me and my husband and my son to continue our family life and afforded my mother an opportunity to meet people and develop new interests," said Mrs. Bond, 46, an office supervisor for the city of Baltimore.

When the Almost Family van returned her mother from the center that first day, Mrs. Bond said, "we couldn't wait to talk to each other. It was like she was a new person. She had found a life, and it was good for me seeing her that happy."

Those teal-and-white vans, which transport about 600 people to adult day care centers each day, are becoming as common as the yellow school buses that travel through Maryland's suburbs. And Timonium-based Almost Family, part of a publicly held company, plans to take those vans nationwide.

Almost Family, which has seven day care centers ringing the Beltway, is moving aggressively into a market long dominated by nonprofit centers run by churches and local government agencies. It has won a toehold in the huge California market, but is using Maryland, one of the few other states that pays adult day care costs for Medicaid recipients, as its main testing ground.

Adult day care is an increasingly popular option for 40-something working couples who seek help with aging parents. Today, it's a $490 million-a-year business and could grow to $29 billion by 2030 as the elderly population grows and working couples become more common, the company estimates.

Almost Family, with seven centers in Maryland and two in Connecticut, is the largest fish in a small pond. It posted revenues of about $5 million in the fiscal year that ended in March, 61 percent more than in the previous year.

Chief Executive Officer John Sneath anticipates revenues approaching $100 million. The company, which envisions 70 to 100 centers in the next five years, hopes its vans will become as ubiquitous as U.S. Postal Service trucks and as dependable as United Parcel Service vehicles.

"What gets us so excited is that it works from almost every angle: It keeps people in the community, it's less expensive, it's easier to manage, it's a very positive service . . . and it saves the government money," Mr. Sneath said.

The company bases its hopes on the fact that its centers, and others like them, cost one-third to one-half as much as a semiprivate room in a nursing home. And they are increasingly needed by families with two working spouses. By the end of the decade, an estimated 69 percent of women between 45 and 55 years old will be in the work force.

"Middle-aged women are now saying, 'I shouldn't ask for help.' But the baby boomers will have a different attitude," said Jane Wessley, coordinator for adult day care for the state health department. "Our generation is going to be a lot more comfortable in saying there are things I need to lead my life."

Almost Family is a subsidiary of Caretenders HealthCorp Inc., which offers a host of health services. Caretenders, which had revenues of $36.5 million and $1 million in operating profits in the most recent fiscal year, is shedding three small subsidiaries to concentrate on adult day care and home health care.

Meshing with state's plans

Caretenders' plan meshes well with Maryland's moves to expand such care.

Maryland is more involved in adult day care and reimbursement than most states, having built a pioneering system of community-based day programs for the mentally ill. In fact, two of Almost Family's local centers still focus almost exclusively on the mentally ill.

Today, Maryland spends $19 million in Medicaid money for adult day care and an extra $2.5 million in state funds buys the service for those who narrowly miss qualifying for Medicaid.

"The thinking is, this is really an alternative to nursing homes for the functionally impaired," said Jane Wessley, coordinator for adult day care for the health department. "The state really looks at it as a cost saving, because it avoids or postpones nursing homes and also [improves] the quality of life."

Ms. Wessley, who sets industry standards, says adult day care is primarily used by older people with some degree of physical or mental impairment. Younger adults with developmental disabilities, multiple sclerosis or brain trauma also use it.

Untapped market

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