The Bridge Center 3

Jo Jo is settling into The Bridge Center, but something isn’t right. He hesitates before getting on the van, comes home tense, and even has a small unexplained bruise. His mother, Rosa, senses something is wrong—and she’s right. A newly hired staff member, Jamie Peterson, lacks the experience and training needed to work with individuals with disabilities, and it’s affecting Jo Jo and others at the center. In this episode, we explore the underfunded and underregulated world of adult day programs, why so many operate with underqualified staff and high turnover, and what caregivers can do to hold programs accountable.

Because finding the right program isn’t just about getting in—it’s about making sure it’s safe, supportive, and truly the right fit.

Transcript

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Welcome back to Take Care of Time, the Tales at Exhales of Caregivers. I'm your host, Beverly Nance and this is episode three of the Bridge Center. Our series Exploring Adult Day programs and the families who rely on them. In our last episode, we followed Jojo's first days at the Bridge Center. His moments of adjustment, Rosa's unease with her new reality and Georgia's quiet encouragement for her to rediscover a piece of herself. But as we all know, transitions aren't always smooth. For many families, finding the right program is only half the battle. The real challenge begins once their loved ones are inside navigating new environments, new routines, and new people. This episode is about trust, how quickly it can be given, how easily it can be broken, and the uneasy feelings when something just isn't right, because today something isn't right at the Bridge Center and Rosa knows it. Rosa stands by the front window. Arms crossed watching as the bridge center's van pulls up. It's been nearly two weeks since jojo started, and until now things have gone as well as she could have hoped. He doesn't seem thrilled to leave in the morning, but he doesn't resist either a neutral reaction, which for jojo is a win. But today is different. As Lisa, the transportation aide slides open the van door. Jojo hesitates. He stays in his seat, gripping the edge of his hoodie sleeve tightly rubbing the fabric between his fingers, his go-to soothing motion. Hey buddy, we're home. Hey, jojo. We're home. Lisa coax is gently You okay? Jojo Finally moves. But there's no hum under his breath. Like usual, no rocking, just a slow, deliberate step off the Van Rosa notices immediately. His whole body is tense. Lisa steps down behind him and hands rosa the clipboard with the daily notes. She lowers her voice. He seemed off today. Didn't wanna go to the rec room. He didn't eat lunch either. Rosa's stomach tightens. Did. Did something happen? Rosa shrugs. Lisa Shrugs. Not that I know of, might just be adjusting, but Rosa isn't convinced. She thinks Lisa takes Jojo's backpack and leads him inside. He heads straight to his usual spot by the window. No humming. No contented rocking, just staring Something's wrong. She just doesn't know what. The next morning at the Bridge Center staff members gather in the break room at the center of attention is their new hire. Jamie Peterson. Jamie is a 20-year-old junior college student. She took the job because it seemed easy, a way to make money while she figured out her next steps. But to the seasoned staff, something is already clear. Jamie doesn't understand the population she's working with. Unlike teachers or therapists who spend many years studying autism and intellectual disabilities, many day program employees receive little to no formal training before stepping into the role. The pay is low. Barely above minimum wage, and the turnover rate is extremely high. Jamie received a one day orientation, a PowerPoint presentation on basic safety, a tour of the facility, and a few shadow shifts with experienced staff. That was it. Yes, that was it. No in-depth training on communication strategies, behavioral supports, or how to handle sensory overload. Daniel, the staffer who is assigned to jojo watches as Jamie scrolls through her phone, between conversations clearly disengaged. when another staff asks how her first week has been, she laughs. It's fine. Just gotta get used to these weird behaviors. She says casually Daniel Stiffens. They're not weird. Their communication. Jamie Shrugs. You know what I mean? But Daniel doesn't like it, and soon neither will Rosa. Over the next few days, Rosa starts noticing patterns. Jojo once neutral about drop offs, now hesitates before getting on the van, his clothes come home wrinkled in a way that suggests that he's been holding onto them tightly throughout the day. Then there's the unexpected bruise on his forearm. It's small, barely noticeable, but Rosa notices everything. Jo Jo, she says softly sitting beside him. Did something happened today? He doesn't respond, but his hand moves to his sleeve rubbing anxiously that night. Rosa can't sleep. Something is wrong, and she's going to find out what. The next morning, Rosa drops Jojo off instead of his using the van service. She parks outside the bridge center and watches as he walks in. Then she waits. 15 minutes later, she sees her. Jamie Peterson steps outside standing near the entrance, scrolling through her phone. A few minutes later, she heads back inside, swinging the door carelessly, letting it slam behind her. Rosa feels her pulse Quicken. If Jamie is this disengaged in the parking lot, what's she like inside? Rosa doesn't wait. She marches inside and asks to speak to the program director. She lays out her concerns. Jojo's change in behavior, the bruises, the hesitancy to go inside. I want to know who's working with my son. Rosa says her voice even, but firm. I want to know what's going on. The director listens carefully nodding, then she sigh. You're not the first parent to say something about Jamie. That's all Rosa needs to hear by the end of the week. Jamie is no longer employed at the Bridge Center. Finding the right day program isn't just about picking a place with good reviews. It's about ongoing vigilance, about paying attention to the details that others might miss. Jamie was a bad fit, but the real danger was in what might have happened if no one spoke up. Rosa knew something was wrong and she acted. Because being a caregiver doesn't stop when your loved one enters a program. Advocacy is forever. So you might be interested in why day programs are understaffed and underpaid. The situation with Jamie isn't unique across the country. Adult day programs struggle with staffing issues, not because they aren't good dedicated workers, but because the system itself isn't built to support and retain them. Low pay and high overturn. Most day programs rely on Medicaid funding, which set strict reimbursement rates. As a result, staff wages are often just above minimum wage, making it hard to attract and retain skilled professionals. Many leave for better paying jobs in retail or food service leading to a constant cycle of turnover. Minimal training. Unlike teachers or therapists day program, staff don't require certifications. Many receive only a one day or a one week crash course covering safety procedures, but not in depth education on working with people with disabilities. Lack of oversight. Regulations exist, but enforcement varies. Some programs barely meet the compliance requirements, and without strong parental advocacy problems often go unnoticed, high demand and limited funding. Thousands of individuals with disabilities rely on day programs, but funding hasn't kept pace with the need. That means centers are often short staffed with a high staff to client ratio, which makes quality support difficult. So you're wondering what can parents and caregivers do? The system won't change overnight, but caregivers do have power. Here are a few things that parents can push for, for better standards. Ask questions before enrolling your loved one in a program. Ask about the staff training, the turnover rates and pay. A good program should be transparent about these issues. Advocacy for policy changes. Join parent advocacy groups which push for better Medicaid reimbursement rates, which would allow programs to pay staff more and improve training. File complaints when necessary. If you suspect neglect or poor treatment, report it to your state's Medicaid oversight office. Many states have online portals for filing concerns, support legislations for higher wages. Some states have introduced bills to increase wages for direct care workers. Caregivers can contact their legislators to support these efforts. Stay involved even after choosing a program regularly. Check in on your loved one's. Experience. pop-in visits, reviewing daily reports and building relationships with staff can help ensure quality care. Finally, day programs can be a lifeline or a liability and the difference often comes down to who's running them and who's advocating for change. Caregivers like Rosa aren't just fighting for their own child. They're pushing for a system that works for everyone. Until that happens, stay informed. Speaking up and holding programs accountable is the best way to ensure that the right people are caring for our most valuable loved ones. In our next episode, we'll explore what happens after trust is broken. How does the Bridge Center regain Rosa's confidence? How does jojo adjust after a shakeup to his routine? And what can other parents learn from this experience? Stay tuned for episode four of the Bridge Center. If you've ever faced challenges with the day program, I'd love to hear your story. Reach out and contact us at podcast@takecaretime.com. We'd love to hear from you. Being a caregiver isn't just a role, it's a full-time responsibility. And while you're constantly looking out for your loved one who's looking out for you, that's where the take care of time and respite box comes in designed specifically for caregivers. This box is filled with thoroughly curated self-care essentials to help you recharge. Inside, you'll find relaxation tools. Comforting treats self-care activities to help you unwind during your well earned break because you deserve care too. Give yourself permission to pause. Visit takecaretime.com to order your respite box today. Taking care of yourself isn't selfish is essential. Please note that this episode features reenactments and dramatized details. While in most cases the exact verbatim dialogue may not be known. All dramatizations are grounded in thorough research and crafted to honor the stories shared to respect the privacy and confidentiality of the individuals involved names, and some identifying details have been changed. Until next week, take care.