Historical Highlights


Adult day services begin in psychiatric hospitals, such as the Yale Psychiatric Clinic (1949), primarily to assist patients following release from mental institutions.


Dr. Lionel Cousin’s geriatric day hospital programs in sites in England inspire interest in the United States.


Day service concept shifts from a single psychiatric focus to other health maintenance; centers begin operation in states across the country.

Medicare and Medicaid were enacted and the care of the aged was focused on acute care.

Dr. Cosin transplanted his model to Cherry State Hospital in Goldsboro, North Carolina in the late 1960’s


Byberry State Hospital in PA closes and adult day care program is established in 1970.

HCFA publishes a directory of nearly 300 adult day services centers.

The National Institute on Adult Day Care (NIAD) is formally organized as an NCOA unit. 400 NCOA members join.


The first National Adult Day Care Center Week is recognized by Congress and proclaimed by the President. • NCOA publishes the 1st edition of national voluntary Standards for Adult Day Care.

NCOA/NIAD conducts a nationwide survey of 1,400 adult day centers; the findings are submitted to HCFA.

Robert Wood Johnson Foundation (RWJF) launches the Dementia Care and Respite Services Program to demonstrate the benefits of adult day care.


NCOA/NIAD receives a Vira L. Heinz endowment, an AT&T Family Care Development Fund scholarship, and support from the IBM Fund for Dependent Care, Active Services Corporation, Bell Atlantic, Grotta Foundation, Met Life, Ross Labs, and US West.

National standards and guidelines are updated and published, training materials for adult day staff, including a certification program for program assistants and directors, are developed.

NIAD releases the first national educational video on adult day care: “Sharing the Caring: Adult Day Care” and a personal care training video for program assistants.

NIAD becomes NADSA, the National Adult Day Services Association (1996).

National adult day service program accreditation standards are developed and implemented through CARF, The Rehabilitation Accreditation Commission.


RWJF, Partners in Caregiving conducts a nationwide survey and reports 3,400 existing adult day programs, with a need for 5,400 additional centers.

A major start-up grant is secured from the Retirement Research Foundation to establish NADSA as an independent adult day services industry association.

NADSA achieves independent association status, while maintaining a long-term collaborative relationship with NCOA.

Congress authorizes a 5-year Medicare demonstration project to provide adult day services as a substitute for home health care services.

US Department of Health and Human Services funds a study to identify the role of adult day in long term care, and provide a basis for future research.

NADSA enters into a formal Strategic Alliance with the American Association of Homes and Services for the Aging (AAHSA) to collaboratively represent and advance adult day services.

NADSA completes a project with N4A and CMS to provide widespread Medicare Part D education and enrollment services to beneficiaries working through nine state adult day associations. 99 local programs were hosted in conjunction with adult day service providers.

NADSA begins pilot of the state alignment concept with Arizona, Florida, Iowa, Minnesota, and Wisconsin allowing service providers to become members of NADSA and their state association at the same time by writing one check.

NADSA joins the Leadership Council of Aging Organizations (LCAO), a prestigious coalition of national nonprofit organizations concerned with aging and representing aging issues in the public arena.

NADSA begins a dialogue with the Veteran’s Administration to improve funding to adult day providers.


NADSA discontinues strategic alliance with AAHSA, maintaining AAHSA staff person on board.

NADSA formally merges NADSA Foundation with NADSA and becomes a 50lc3 named National Adult Day Services Association.

NADSA begins management agreement with Washington State Adult Day Services Association for management of operations of NADSA.

NADSA joins advisory group of a nationally funded project of Easter Seals and National Hospice Association, looking at protocols for end of life care in adult day services.

Veterans Administration dialogue results in revised VA Guidelines for Adult Day Services and new partnership on Polytrauma Rehabilitation Services for Veterans.

NADSA begins offering quarterly audio conferences through Health Resources Publishing, focusing on education on issues and trends in ADS.

NADSA board of directors has strategic planning retreat to develop Areas of Focus to work on Critical Issues.

NADSA website becomes useful resource for members through timely updates and development of membership list serve.

Weekly email blasts used to communicate with members.

Reception held at GSA Conference, for researchers interested in ADS.

State Association survey completed and training offered at national conference, to strengthen state associations.

Task Force organized to look at endorsement of accreditation of ADS.

National conference held in partnership with Adult Day Care Association of Texas.

Scholarships provided for national conference through generous grant from MetLife Mature Market Institute.


NADSA receives funding from Met Life Mature Market Institute for Phase One of Census Project 2010. Ohio State University, under the direction of Holly Dabelko, PhD and Keith Anderson, PhD, will be gathering census demographics, outcome data and information on best practices, from random sample from 4700 center data base.

Rep. Sanchez, CA, introduced the Medicare Adult Day Care Services Bill of 2009. (HR3043). Bill will be seeking authority for adult day centers to become Medicare providers. This bill will give consumers an adult day center option, to receive their Medicare post acute care benefits such as rehabilitation, nursing care, enteral feedings, and wound care.

Weekly email blasts continue to communicate with members.

NADSA sponsored 2 state leadership conference calls for networking and problem solving.

Dialogue continues with the Veterans Administration. NADSA to participate on VA conference planning committee. VA staff person joins NADSA board.

NADSA to assist with dissemination of Easter Seals Hospice/End of Life Care project.

Creation of State Association Toolkit distributed to State Association Partners.

4 more state associations join with membership project status.

30th Anniversary of NADSA celebrated at conference.

30th Anniversary logo provided to state associations, centers and poster and updated ADS week materials made available to members.

Awards Nominations very successful, with new category added: Innovator Award.


Standards and Guidelines revised and published.

Communication is enhanced among members through quarterly teleconferences of VA Task Force, quarterly calls for state association leaders, monthly calls of Public Policy Committee.

Strengthened relationship with VA through quarterly teleconferences with VA Task Force and presentation by NADSA members at VA Employee Conference.

Webinars feature educational topics targeted for adult day center workers.

Creation of Advocacy Toolkit distributed to State Association Partners.

Revitalized website featuring integrated database and sales.

Continued promotion of National Adult Day Services Week through sale of poster and updated ADS week materials on website.

Next Steps Think Tank held for Adult Day Services, at University of Wisconsin, at Milwaukee, Oct 27-29, 2010.

Census 2010 completed by Ohio State.

Awards nominations added new category, Volunteer Award.

Annual conference held in Raleigh, NC, over 350 attendees and almost 30 exhibitors.

Medicare ADS bill rewritten to be reintroduced in 2011 Congress.


Transition to new management.

Relocation of national office to North Carolina.

Designed and launched new website.

Communication continued to be enhanced among members through quarterly teleconferences of VA Task Force and quarterly calls for state association leaders

National advocacy effort has continued through monthly calls with the Public Policy Committee.

Supported the Adult Day Achievement Center Act initiated by the National Multiple Sclerosis Society, to establish a grant program and fund research on developing specialized adult day service programs for younger adults with neurological diseases or conditions such as MS, Parkinson’s disease or TBI.

Created new Research Task Force committee to facilitate the development, utilization and dissemination of research to approve the delivery of adult day services and the quality of life of adult day participants and their caregivers.

Created new Business Task Force committee to focus on identifying and promoting professional business practices among providers of adult day services.

Invited to participate with the National Center for Health Statistics, a branch of the Centers for Disease Control and Prevention, to prepare the new biennial National Survey of Long Term Care Providers.

Initiated follow up with the office of the Inspector General on the report on Medicaid Services in Adult Day Health Care.

Despite the attempts of the Governor of California to eliminate the adult day health care program, NADSA provided support and collaborative efforts to CAADS in their ongoing fight to maintain the adult day health model for the participants and families in California.

Supported the national study of the use and implementation of electronic health records in adult day services.

Partnered with Lockton Affinity to provide members with an insurance program offering the coverage needed to protect their business.

Targeted efforts to increase NADSA membership through promotion of member benefits and state association partnerships has increased NADSA membership significantly in the past six months.  At the end of 2010 membership was 432 members including 25 state associations.  Currently membership is at 700 members including 35 state associations and corporate partners.

Targeted solicitation (The Giving Tree) was created by the development committee for board members to demonstrate their commitment to NADSA.

Development committee created an extensive sponsorship package to attract diverse sponsors/exhibitors/advertisers to the annual conference resulting in sold out exhibitor space for the 2011 conference.


Promoted participation in the National Study of Long Term Care Providers through e-alerts, Voice articles, presentations at state association gatherings, webinars, postcard mailings, phone calls to centers

Provided frame for the National Study of Long Term Care Providers in cooperation with the National Center for Health Statistics

Webinars featured educational topics targeted for adult day center workers

Supported introduction of a revised Medicare Adult Day Services Act by Rep. Linda Sanchez

Hosted first Public Policy Conference in Washington, DC in March 2012

Paid for part-time support staff to NADSA’s Managing Director

Explored possibility of hiring a lobbyist

Paid off LeadingAge for previous management debt

Hired accountant in North Carolina to establish continuity in filing corporate taxes

Presented two Beth Meyer-Arnold Dissertation Fellowships to doctoral candidates studying adult day services

Facilitated calls and meetings with state association leaders to survey members about issues among the states

Created new NADSA Marketing Committee

Supported CARF Financial Indicators Study


Worked closely with Easter Seals to sponsor Public Policy Conference in Washington, DC in April 2013

Implemented strategic marketing plan developed by consultant Lyn Geboy

Supported CARF Financial Indicators Study

Began reciprocating with LeadingAge to extend invitations for association-sponsored webinars to members

Refreshed the NADSA website to include a new homepage and searchable Locator which features NADSA members

Implemented rate increase in membership to better align the costs of providing benefits and services to NADSA members

Conducted strategic membership campaign including new NADSA brochure and invoice to all non-member centers in database

Selected the Afflerbach Group to lobby for NADSA

Annual conference held in Kentucky, over 350 attendees and almost 30 exhibitors.

2014 (in progress)

Provided 2014 frame for the National Study of Long Term Care Providers in cooperation with the National Center for Health Statistics

Worked closely with the Afflerbach Group to sponsor Public Policy Conference in Washington, DC in April 2014

Issued a new Code of Ethics April 2014





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