Working Together To Provide Quality Service
BENEFITS OF MEMBERSHIP
A voice in Springfield IADSA members interact regularly with state legislators to advocate on behalf of the clients we serve and the programs we operate.
Relationship with IDOA IADSA fosters a working relationship with the Department on Aging.
Educational programs discounted rates at IADSA trainings and conferences
Representation IADSA members serve as members of the Illinois Coalition on Aging, NADSA, AARP and various committees to represent adult day service issues to the aging network
Networking Opportunities to network with other members at the regional, state or local level about best practices or to get help with operational questions
Pilot projects Members can apply for inclusion in cutting edge pilots such as Person-Centered Care & Dementia Care Mapping
Newsletter and web site Members have access to shared ideas and information
AFFIRM YOUR SUPPORT OF THE
ILLINOIS ADULT DAY SERVICE ASSOCIATION (IADSA)
(Your membership in IADSA entitles you to a special membership rate at NADSA)
RENEW YOUR MEMBERSHIP OR JOIN TODAY
Annual Dues…………..……….$250.00
You will be a member until June 30, 2012.
Add $30.00 per location for each satellite site.
Please complete copy and submit a separate demographics sheet for each location with appropriate contact information. This information will then be published on the website.
Individual memberships ($150.00) are available to interested individuals who are not affiliated with an operational adult day service center.
EXTENDED RENEWAL OFFER (after January 1, 2011)
Payment of $350.00 will extend membership to June 30, 2011)
Make check payable to:
Illinois Adult Day Service Association
Mail demographic data and checks to
Membership IADSA
c/o Angela Cope
6141 N. Cicero Ave.
Chicago, IL 60646
Illinois Adult Day Service Assoc.
Membership application form
Center name ___________________________________________
Center address _________________________________________
City _______________Zip _____________County ___________
Phone _______________Fax _____________________________
Contact Person _______________________________________
e-mail ______________________________________________
Please take a few minutes to complete the following information about your center. This information will be used to create a consolidated profile of Adult Day Service in Illinois. The demographics provided will be used as the Association advocates with the State, the Department on Aging, NADSA or other entities on our behalf.
1. How long has your center been in operation?____ still in the planning stages, ____ I am joining as an individual, ___less than one year, ___1-5 years ___more than 5 years ____more that 10 years
2. Is your center operated by a parent corporation? ____yes ____no
3. Does your parent corporation operate more than one adult day service center? ____yes ____no How many? _______
4. What is your daily rate (average if you have multiple rates) for private pay clients? ____________
5. What is your unit cost? (Total annual operating cost divided by number of client days provided annually)
___________
Example: $340,000 annual operating expenses for ADS
250 days of operation X 25 clients per day = 6250 units per year
UNIT COST = $54.40
Does this unit cost include rent? ____yes ____no
6. Does your center currently have contracts with the following reimbursement sources:
IDOA __yes ___no ; Veteran’s Admin ___yes ___no ;
DORS ___yes ___no ; USDA ___yes __no
7. During the most recent completed fiscal year did your center ___break even ___experience a loss ___have more revenue than direct expenses?
8. During the most recent completed fiscal year was your center filled to capacity? __yes ___no
9. What is your capacity? ______ What is your average daily attendance? ________
10. Have members of your staff attended IADSA sponsored trainings? ____yes ____no
11. Would you be willing/able to serve on IADSA committees or projects ___yes ___no ____only if work is local ___
once in a while ___call me to discuss further
FOR ASSOCIATION USE ONLY
Date application/dues received _________ Amt received ______
check # ______________Date certificate sent _____________________
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