Best Practices


Mayor Michael A. Traficante

Adult Day Care and Continuum of Care

Since a grant from the City of Cranston's Community Development Block Grant (CDBG) fund was used in 1977 to provide start-up money for the Cranston Adult Day Care program, it made sense to look to this fund in 1993 for monies to construct a new facility to provide day treatment for victims in the middle to advanced stages of Alzheimer's disease -- the Louis Feinstein Alzheimer's Day Care Unit. The Adult Day Care division of the City's Department of Senior Services had come to the realization that treatment of middle to advanced Alzheimer' s victims could not take place in a standard geriatric day care setting.

Cranston Adult Day Care statistics had shown an alarming escalation of clients afflicted with Alzheimer's disease -- a direct correlation with the national data on this. At present, there are an estimated four million Americans suffering from Alzheimer's. In Rhode Island alone, there are approximately 25,000 Alzheimer's patients. It is estimated that by 2050, 14 million people over the age of 65 will suffer from this disease -- over 75,000 of them in Rhode Island.

The present Adult Day Care facility, which provides services to 55 physically and/or cognitively impaired participants, was not equipped to meet the unique needs of the middle to advanced stage Alzheimer's victim. Therefore, it was necessary to expand our Adult Day Care and construct a satellite unit that would provide services and programs only to participants in the middle to advanced stages of Dementia/Alzheimer's disease.

While the Mayor supported such a facility, he made it clear that the city's financial situation made it impossible for the municipal government to undertake financial support for the construction of the building from such traditional sources as general obligation bonds.

After some discussion about other options, including state supported revenue bonds, the city decided that the most feasible way to build such a facility would be to devote funds from its annual CDBG entitlement. Public facilities are eligible under 24CFR570.201 and the use for a limited population -- that is, persons who are handicapped by illness and are over 65 -- enhanced the eligibility. Thus, the city made $600,000 available in two of the CDBG program years to create a $1,200,000 pool for the building. Costs were kept down when the state donated a site for the facility. The building was completed in late 1994 on budget and accepted its first clients four months later.

In another innovation, the city assisted in the creation of a private, non-profit company to operate the facility. Through this new facility, comprehensive services and a continuum of care is available to our elder population. This continuum of care will keep individuals with middle to advanced stages of Alzheimer's in the community longer through participation in specialized programming, thus avoiding the high cost and often unnecessary hospitalization or premature nursing home placement.

Contact: Office of the Mayor, (401) 461-1000

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