91Ö±²¥

91Ö±²¥ Island Adult Care (HIAC) opened its doors as the first adult day care center in January 1976, and it is currently the only one on the island. Adult day care helps kupuna stay at home, slows down dementia and memory loss, lowers hospital visits, and costs much less than home care or nursing homes.

Even though adult day care has clear benefits, it is not used enough in 91Ö±²¥â€™s long-term care system. Studies show that adult day care is effective and cost-saving. Yet there is a misconception that it is not needed or too expensive.

For many families, there is no safety net. Without increased government support and fair reimbursement, adult day care programs cannot meet rising demand. Adult day care is essential, not optional.

On 91Ö±²¥ Island, where geographic isolation intensifies workforce shortages, adult day care provides structured care, medical supervision, nutritious meals, social engagement and respite for caregivers. This allows kupuna to age in place and enables working adults to remain in the labor force, supporting the local economy.

Even with all the good adult day care does for 91Ö±²¥ Island, day care programs are under financial pressure. Government payments are much lower than what it really costs to provide care. For instance, Medicaid pays only $80 to $110 per person each day for adult day care in 91Ö±²¥, which does not cover wages or the 40% rising costs over the last 10 years, which makes it hard to find and keep good staff.

Government contracts that cover the full costs of programs would not just keep current programs running. They would also:

• Allow providers to offer competitive wages and retain trained staff;

• Expand services to underserved rural communities;

• Reduce hospitalizations and emergency room visits through preventive care;

• Support family caregivers, reducing burnout and workforce dropouts;

• Keep healthcare dollars circulating locally on 91Ö±²¥ Island.

Supporting adult day care is both caring and fiscally responsible. Nasdaq reports that adult day care in 91Ö±²¥ costs about $20,800 a year, while nursing homes can cost over $180,000 — almost nine times more.

Adult day care is a kind, affordable choice that lets kupuna stay active and at home. Without HIAC’s services, many families would be forced to leave the workforce to care for aging loved ones. Kupuna would face isolation at home or be pushed prematurely into costly residential facilities, rather than aging safely and with dignity in their own communities.

Ensuring that government contracts cover the real cost of services would also help our economy grow. Adult day care centers help people build careers in healthcare and create steady jobs in healthcare, transportation, food service, and administration.

But without increased funding and updated payment policies, centers like HIAC cannot grow as more people need care. HIAC can serve up to 105 people if it maintains a 1 to 6 staff-to-participant ratio, but staff shortages and limited provider capacity have made it difficult to keep up with growing demand. According to a report from the 91Ö±²¥ Executive Office on Aging, vacancies and limited capacity have led to fewer assessments and case management services for the expanding senior population.

Our kupuna deserve dignity, care partners deserve competitive wages, families deserve meaningful support, and our island deserves an economy that reflects our values.

Policymakers need to see that adult day care is essential, not just a nice-to-have. With adequate contracts and updated payment rates, we can build a system that respects our elders, helps our workers, and makes 91Ö±²¥ Island stronger for the future.

Since what we invest in is a direct reflection of what we care about, it creates a ripple effect on what we invest in for the future.

Andrea Wernli is executive director of 91Ö±²¥ Island Adult Care Inc.