How to Start a Special-Needs Adult Day Care

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Special-needs adults may suffer from a variety of chronic health problems, from cognitive conditions like Down syndrome or autism to debilitating physical disabilities like cystic fibrosis or Alzheimer's. Special-needs adults span the age spectrum from older teenagers to the aged and infirm.


Parents and other primary caregivers need competent professionals to care for their adult family member with special needs when they are away. Their goal is to find a facility where the special-needs loved one is safe, engaged through activities, and well fed and nourished while their primary caregiver is away. This is the role of a special-needs adult day care.

Opening a Special Needs Adult Day Care

  • Contact the local licensing office of your state's Department of Family and Protective Services office. Let the staff know you are interested in starting an adult day care business and request literature. In a few weeks you'll get a number of forms to complete, as well as information about registering for orientation sessions and training sources for CPR and first aid. Familiarize yourself with your state's minimum standard rules for center and home-based day care operations.

  • Familiar yourself with the various types of adult day care options and consider what is appropriate for you and your business. Some adult day care centers deal with young people who have special needs because of autism or birth defects. Others deal with the aged patient exclusively, while others serve a variety of clients with different needs. The type of facility you operate will determine the business's need for space, equipment and manpower.

  • Determine where you'll operate your adult special-needs day care business. This could be a home business with you as the sole worker. Many special-needs businesses are small companies with a few workers, each worker serving one special-needs client.

    If your plan is for a larger day care where a number of special-needs adults will be served, you'll need to find or build a facility. Contact your local municipal government to determine building codes and ordinances regarding zoning, fire safety, access and egress as well as food service permits and inspection requirements.

  • Make modifications or new installations to the physical space as required to provide ease of access by persons in wheelchairs or using walkers. Outside entrance ramps as well as other adaptive equipment for bathing, toilets and basins with nonstandard heights may be required. Depending on your facility, bed rails, mobile toilets and other safety and convenience items may need to be available for your client base.

  • Hire your staff. Most states require people who care for special-needs patients to obtain a state-licensed nursing assistant certificate. Evaluate the temperament of potential employee candidates. Patience is an excellent character trait to possess when working with special-needs adults.

    Providing transportation to and from your facility may be part of your business's service offering. If so, you'll need to have drivers with a commercial vehicle driver's license to drive a vehicle such as a van for transport of people in wheelchairs. Do a complete criminal history check and a review of their driving record. You might also insist upon drug tests and vision tests.

  • Contact the federal Center for Medicaid and Medicare Services to enroll as an approved non-physician provider to receive payments directly from the government under the Special Needs Plans that are part of the Medicare Modernization Act.

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