Regulations that require specific qualifications for activities professionals in adult day care centers, while well-intentioned, are inadvertently creating significant challenges—both financial and operational—for providers in this sector. Regulation 22VAC40-61-330 D mandates that activities professionals hold certain certifications, degrees, or documented experience, which narrows the pool of eligible candidates and drives up staffing costs.

Financially, the burden of compliance can be substantial. Smaller or community-based adult day care centers operate on tight budgets, relying heavily on limited public funding or client fees. Hiring individuals with formal credentials—such as a degree in recreation therapy or certification from a national organization—means offering higher salaries and benefits to attract and retain those individuals. For centers like Generations Crossing, already struggling with rising costs of operations, this can strain resources or divert funds from other essential services, ultimately impacting the quality of care provided to participants.

In terms of staffing, the availability of qualified professionals is limited, especially in rural or underserved areas. Many talented and compassionate individuals with relevant experience—such as former caregivers, volunteers, or those with informal training—are excluded from consideration because they lack the formal qualifications now required by regulation. This leads to longer hiring times, increased workloads for existing staff, and sometimes unfilled positions that reduce the variety and consistency of activities offered..

Additionally, these regulations create staffing obstacles. The talent pool of individuals who meet the required qualifications is already small, and competition from other healthcare sectors only compounds the issue. This is especially problematic given that adult day care centers serve clients only during the day, unlike assisted living facilities where staff are responsible for resident engagement 24/7. Paradoxically, the facilities providing round-the-clock care have more flexibility in hiring activity staff, while adult day centers—designed to supplement family caregiving and provide community-based support—face stricter restrictions.

While the goal of these regulations is to improve care quality, the unintended consequences may include staff shortages, increased turnover, and decreased program accessibility. A more flexible approach that allows for equivalent experience or in-house training programs could help balance quality standards with real-world workforce and financial realities. 

Thanks for your consideration.

Laurie Deavers / Executive Director / Generations Crossing