March 2007

Grant Results

SUMMARY

Staff of the National Adult Day Services Association, a Washington-based nonprofit organization supplying educational services and products to the adult day services industry, worked to reorganize the association, raise its profile nationally and make it self-sustaining.

Previously, the association had been a constituent unit of the National Council on Aging, a nonprofit national network of organizations, also Washington based.

Key Results

  • Staff achieved self-sustaining status for the association during the grant period, with operating funds from:
    • Membership dues.
    • The profit from annual educational conferences for members. Staff organized two such conferences in 2003 and 2004.
    • Development and sale of new and existing training products, resources and services.
    • An expanded drive for donor contributions.
  • Staff hired a full-time director of training and education to manage educational, training and technical assistance requests of association members.
  • According to former association Executive Director Lisa Gables, association staff played a role in securing the first regulatory review of the adult day care industry in the United States. The Department of Health and Human Services (HHS) Office of the Assistant Secretary for Planning and Evaluation conducted the review, which HHS released in August 2005.
  • Staff established a technical assistance hotline for members.

Funding
The Robert Wood Johnson Foundation (RWJF) supported this work from February 2002 through December 2004 with a grant of $398,535.

 See Grant Detail & Contact Information
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THE PROBLEM

Across the United States, staff at more than 3,500 adult day centers care for 150,000 older Americans daily. Such adult day services allow aging and disabled individuals to continue living in the community while receiving health care and social services that improve their quality of life.

Since the late 1980s, research conducted by two RWJF national programs (the Dementia Care and Respite Services Program, 1988–1992; and Partners in Caregiving: The Dementia Services Program, 1992–1996) has demonstrated that:

  • Adult day centers can become financially viable, especially by focusing on the private pay market.
  • Organizations that provide adult day services desperately need continuing education, training and technical assistance.
  • Technical assistance to supply these needs can be as effective as funding in helping adult day centers replicate best practices models of care-and become financially viable at the same time.

Until January 2002, when it became an independent membership organization, the National Adult Day Services Association, the trade organization for adult day services in the United States, operated as a constituent unit of the National Council on Aging, with extremely limited staff capacity.

As a result, the association had difficulty providing the educational, training and technical assistance needed to foster the growth of adult day services in this country, including the support of quality care and the promotion of sound business practices. In addition, its visibility was not as great as that of other national membership organizations, and it offered only limited member benefits.

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RWJF STRATEGY

In the 1980s, when RWJF began to foster adult day services — by funding two national programs, the Dementia Care and Respite Services Program (1982–87) and Partners in Caregiving (established in 1987) — the field was still in its infancy. These two national programs played a critical role in the generation of knowledge and best practices in the areas of program design/operation, financing and marketing. The programs were also active in disseminating lessons learned through a national newsletter, training products, toll-free hotline and regional workshops.

These two successive national programs filled an important gap and were adopted by the field as the national adult day services resource center. Partners in Caregiving has continued this work and become a self-sufficient resource center for the field. See Lessons Learned: The Sustainability of Partners in Caregiving: Adult Day Services Program.

When the National Adult Day Services Association decided in 2001 to become an independent entity — in order to increase its visibility with member organizations and to offer a full range of educational, training and technical assistance to members as well as to the entire field of adult day services — RWJF wanted to help build the association into a strong membership organization providing adequate services to sustain and further the adult day services field.

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THE PROJECT

Staff of the National Adult Day Services Association initiated a reorganization and growth of the association, building on its new status as an independent membership organization (achieved in January 2002). With the aim of raising its profile nationally and making the association self-sustaining, it:

  • Hired new staff.
  • Sought increased donor support.
  • Expanded the association's base of dues-paying member organizations.
  • Offered fee-for-service training, educational products, services and events to members.
  • Recruited a four-member advisory committee (see the Appendix for a list of its six 2006 members). The committee, consisting of experts in adult day care issues, many with hands-on experience in adult day care, provided active guidance and input during the reorganization.

In 2002, the association contracted with the Association Management Group, a Tysons Corner, Va., corporation dedicated exclusively to staffing and managing tax-exempt organizations, to support its operations and membership development. In 2003, association staff terminated the agreement due to its cost and took over operations.

Staff of Partners in Caregiving assisted the association's launch in a number of ways, especially in the project's first two years. They consulted frequently with association leadership, provided expertise, and taught association staff how to train others thus helping to assure the association's capacity to offer technical assistance and training resources to the field from the time of its launch.

Additional support for this project came from the Chicago-based Retirement Research Foundation ($390,000) and from the Margaret T. Morris Foundation, a Prescott, Ariz., philanthropic organization ($20,000).

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RESULTS

Staff of the National Adult Day Services Association:

  • Brought the association to the status of an independent, self-sustaining national membership organization for the adult day services industry. Staff achieved the necessary income through emphasis on:
    • Dues-paying membership
    • Donor support
    • Annual educational conferences for members
    • The sale of new and existing educational material (see the Bibliography for details).
  • Hired a director of training and education in April 2002 to manage educational, training and technical assistance requests of association members. As a result, the association could supply technical assistance to the field almost from its first day in operation, and it allowed the association's executive management staff to focus exclusively on startup issues.
  • Hosted two annual conferences focused on education of adult day center providers.
    • The association sponsored its first conference in January 2003 in Miami. Josefina Carbonell, assistant secretary for aging, U.S. Department of Health and Human Services, delivered the keynote address. The conference attracted 250 participants.
    • The association's second annual conference, in January 2004 in New Orleans, featured three keynote panels and 30 educational sessions. Claude Allen, deputy secretary of Health and Human Services, spoke at the conference, attended by 275 people.
  • Helped assemble the first national regulatory review of the industry, according to former Executive Director Lisa Gables. HSS's Office of the Assistant Secretary for Planning and Evaluation commissioned the review, which it released in August 2005. The review examines state approaches to regulating adult day services to understand better states' roles in health care and long-term care systems. It cites the contribution of Gables, among other professionals who shared their knowledge and expertise with the review's authors.
  • Developed training products that included:
    • A revised educational manual published in 2005, Training the Program Assistant in Adult Day Services. The manual is available for purchase online.
    • A public awareness campaign toolkit for the adult day services field to help state associations market the services of the industry during National Adult Day Services Week, celebrated each year in mid-September.
  • Established a technical assistance hotline for members. According to former Executive Director Gables, service over the hotline, which began in 2003, grew during the grant period (which ended in December 2004) to an average of 75 calls each week from members asking for information. It is one of the most utilized resources provided by the association.
  • Strengthened the association's relationship with state associations of adult day services providers, and worked with state associations to foster their growth. Staff invited state association presidents to bimonthly conference calls to foster state associations' growth.
    • On average, one-third of state association presidents participated.
    • By 2005, two-thirds of the 44 state associations had become members of the association.
  • Continued to publish a quarterly newsletter, The Voice, for the field. In 2002, staff began distributing a printed version of the newsletter in addition to its ongoing electronic version. In 2005, distribution of the quarterly newsletter totaled approximately 2,000 copies.
  • Added additional resources for members to the association Web site. These included:
    • An interactive map that allows users to access information on adult day services for each state.
    • Licensing and certification requirements for each state.
    • A monthly update on happenings in the field.
    • Fact sheets.
    • A list of available resources.

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LESSONS LEARNED

  1. Management firms are expensive. "The decision to use a management firm turned out to be a costly mistake," according to former Executive Director Gables. "If you have a lot of dues revenue, you can afford this type of service. However, we did not have the resources to continue a long-term contract with the management firm." (Project Director/Gables)
  2. "Grants can't sustain you." Gables continues: "We needed to offer products, services and activities to generate revenues to offset the limited dues amounts we could ask from our members." (Project Director/Gables)
  3. Generate member and public awareness of what your new role will be as a stand-alone organization. In a transition of this magnitude, your members see, mainly, a lot of change and turmoil. It is critical to maintain a core group of member organizations who are willing to stick with you. You need to get the word out about your role and usefulness to them in order to be successful in this type of transition. (Project Director/Gables)
  4. Consider strategic alliances as you become independent. You can collaborate with another organization and achieve economies of scale but still maintain your independence. (Project Director/Gables)
  5. The composition of the advisory committee is critical as a membership organization transitions to stand-alone status. Make sure you have committee members who will support the transition and provide essential expertise. (Project Director/Gables)

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AFTER THE GRANT

A Strategic Alliance

In early 2005, the National Adult Day Services Association formed an alliance with the American Association of Homes and Services for the Aging, a Washington-based nonprofit membership organization, and moved its headquarters to Washington, home of its alliance partner.

According to former Executive Director Gables, the alliance benefits both organizations and expands advocacy, education and research to the adult day community.

Under the strategic alliance:

  • The National Adult Day Services Association retained its own identity and legal status.
  • The American Association of Homes and Services for the Aging assumed the operational functions of the National Adult Day Services Association.
  • The National Adult Day Services Association combined its educational conferences with those of the American Association of Homes and Services for the Aging, thus increasing its conference audience from less than 300 to more than 6,000 annually.

In 2006, the National Adult Day Services Association's membership base stood at 241 members, representing just over 300 adult day services sites.

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GRANT DETAILS & CONTACT INFORMATION

Project

Providing Training and Technical Assistance for Adult Day Services

Grantee

National Adult Day Services Association Foundation (Washington,  DC)

  • Amount: $ 398,535
    Dates: February 2002 to December 2004
    ID#:  040623

Contact

Lisa Gables
(703) 739-1316 (ext. 107)
lgables@ascp.com

Web Site

http://www.nadsa.org

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APPENDICES


Appendix 1

(Current as of the time of the grant; provided by the grantee organization; not verified by RWJF.)

Advisory Committee of the National Adult Day Services Association

Membership as of December 2006

Mary Brugger Murphy, M.L.A.
Consultant
Bethesda, Md.

Marilyn Hartle, M.S.W., L.C.S.W.
Jentle Harts Consulting
Indianapolis, Ind.

Kathy Montague
Quality Perceptions
Council Bluffs, Iowa

Judy Bellome, R.N., M.S.
South View Home Care
Kansas City, Kan.

LaDonna Jensen, R.N.
Jentle Harts Consulting
Indianapolis, Ind.

Joyce McIntosh
Minnesota Masonic Home
New Hope, Minn.

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BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Books

Brugger M. A Manual for Training the Program Assistant in Adult Day Services. Washington: National Adult Day Services Association, 2005.

World Wide Web Sites

www.nadsa.org. This Web site provides information on adult day services, advocacy and policy as well as current events and news relevant to adult day services. Association publications and other resources are available for ordering at the site, including several publications of interest to the field that are downloadable without charge. Washington: National Adult Day Services Association.

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Report prepared by: Karin Gillespie
Reviewed by: James Wood
Reviewed by: Molly McKaughan
Program Officer: Rona Smyth Henry