CASE STUDY
KBH Advocacy and CAADS Secure $61.4 Million for Seniors, Adults with Disabilities
In a nutshell
After decades of state under investment in critical services for vulnerable senior and adults with disabilities, and after two years of pandemic upheaval, in 2022 the California Association for Adult Day Services (CAADS) partnered with experienced lobbyist and state budget expert Kristina Bas Hamilton to begin a new chapter of public investment. Together, CAADS and KBH Advocacy developed a winning campaign strategy that secured $61.4 million in new, one-time funds for adult day services – more than double their original goal.
Thanks to the success of this advocacy team, California’s adult day health centers (ADHCs) and adult day service providers will soon be eligible for grants to address significant needs caused by the pandemic. ADHCs and adult day service providers will use these grants for COVID mitigation and resilience, infrastructure improvements, and workforce recruitment and retention.
Together, CAADS and KBH Advocacy developed a winning campaign strategy that secured $61.4 million in new, one-time funds for adult day services – more than double their original goal.
“Kristina was an excellent fit with the CAADS team in every way, but strengths that really stood out were her expertise, persistence, and connections. She provided masterful leadership and guidance at every step, from identifying and educating key players, to timing communications, to elevating our members’ voices. We’re grateful for her guidance through each of these complex paths.”
Lydia Missaelides, Executive Director, California Association for Adult Day Services
The story of CAADS
CAADS represents hundreds of Community Based Adult Services (CBAS) and adult day service providers that serve over 40,000 Californians with chronic physical, mental, and developmental conditions and disabilities. In operation for nearly fifty years, CAADS is the oldest, largest state association representing ADHCs and adult day service providers in the country.
ADHCs and adult day service providers ensure that vulnerable seniors and disabled adult participants get the services and healthcare they need while allowing them to enjoy life in their communities and with their families.
For adults who have significant physical and/or mental needs but don’t need 24/7 care, ADHCs and adult day service providers offer invaluable daytime programming, tools, and services that help maintain a high quality of life for participants and their families.
Without ADHCs and adult day services, thousands of seniors and disabled adults would have no choice but to leave comfortable loving homes and give up their independence to go live at nursing homes or mental health facilities. ADHCs and adult day services help keep people out of expensive, crowded institutions and save taxpayers money. ADHCs and adult day service providers, represented by CAADS, are and will remain a crucially important part of California’s spectrum of healthcare and social services as the state’s aging population grows in the coming years.
Challenges Post-Covid
Even though participants and their families laud CBAS and adult day services as indispensable and central parts of their independent lives, many lawmakers have poorly understood the purpose of these programs and have therefore historically undervalued and underfunded them.
The pandemic forced ADHCs and adult day service providers to develop alternative care models to congregate settings. Providers pivoted to remote or drop-off care so that participants would continue to receive some services.
Over time, as Covid impacts improved for most Californians thanks to vaccinations and advances in medical treatment, ADHC and adult day service participants continued to remain vulnerable to complications from infection due to their age, immunocompromised status, disabilities and/or chronic conditions.
CAADS quickly recognized post-reopening needs for ADHCs and adult day service providers to invest in upgrades to ventilation, air filtration, sanitation, and staff training to limit the spread of Covid and other dangerous diseases amongst participants and staff. CAADS also noted that ADHCs and adult service providers lost skilled workers during pandemic closures and now needed to prioritize staff recruitment and retention.
To implement these necessary, protective measures, service providers needed much more than a reinstatement of prior funds lost to past rounds of budget cuts; CAADS would need to convince lawmakers, already overwhelmed by numerous urgent requests, to provide ADHCs and adult service providers with millions of dollars in new funding.
Why CAADS chose KBH Advocacy
CAADS needed an advocate who would help them leverage their considerable subject matter expertise and people power in meaningful, successful ways. They needed guidance to craft an effective budget and legislative strategy, to navigate a notoriously complicated and opaque budget process, and to connect them with influential policymakers in the Legislature and Newsom Administration. They also needed advice on shaping the most effective messages at each crucial point of the legislative and budgeting processes. In short, they needed a sharp, experienced Capitol insider.
CAADS partnered with KBH Advocacy and, together, success was dramatic.
Hired in December 2021, Kristina quickly helped CAADS shift away from years of defending funding from cuts and toward an assertive pitch for investment in ADHC care and adult day services. In developing a plan to secure new Covid mitigation and resiliency funds for facility upgrades and staffing increases, Kristina modeled how advocacy efforts could look to the future of ADHCs and adult day services.
Two-Pronged Strategy:
1 - Sponsor legislation to highlight the policy need for new investment in ADHC and adult day services.
2 - Sponsor budget funding request, working with Budget Committees in both houses to win state funding for the grant program.
At weekly meetings and in written updates, Kristina provided multifaceted guidance and helped CAADS advance through each step in the process. She made sure that CAADS advocates understood the stakes, the decision makers, and the deadlines – and where CAADS could best deploy its extensive network of centers and supporters on the ground. She worked with the CAADS communications team to develop media outreach plans and assisted with crafting messaging that resonated with the Capitol audience. These efforts were more complex than usual in an election year when legislators’ district boundaries were changing as the result of once-in-a-decade redistricting.
With her combined expertise in both the legislative and budgeting processes, Kristina worked with CAADS to pursue a two-pronged approach: 1 - sponsoring legislation to highlight the policy need for ADHC and adult day services investments through a grant program; 2 - working directly with Budget Committee legislators, committee staff, and Administration officials to ensure that the grant program proposed in the legislation would be funded in the 2022-23 state budget.
On the legislative side, Kristina positioned CAADS’ sponsored bill, AB 2331, for maximum positive exposure: for the bill’s lead author, she recruited Assembly Human Services Committee Chair Lisa Calderon, joined by former Chair Assemblymember Mark Stone and Senate Human Services Committee Chair Melissa Hurtado as bill coauthors.
Kristina and CAADS lobbied hard to build a broad coalition of supporters that included local governments, aging and disability advocacy organizations, social workers, and health insurers. The bill received all “AYE” (yes) votes - in multiple committee and floor votes - illustrating strong bipartisan support. Further, the introduction of the bill improved legislators’ and legislative staff understanding of ADHCs.
On the budget side, Kristina advised that CAADS would need to make a compelling case backed by strong evidence to budget committee members, staff, and Administration officials for new funds. As a result, CAADS developed and sent out a survey to California ADHCs and ADS and collected precise data to estimate funding needs and detailed explanations for how centers would use requested funds to protect and serve participants. The survey revealed that the original request of $30 million wasn’t sufficient; as a result, Kristina and CAADS doubled the request to $61.4 million, secure in the knowledge that they could provide proof of the need for the larger amount.
After years of cuts and setbacks, it was both exciting and relieving for Kristina and CAADS advocates to learn on June 27, 2022 that they had secured an agreement between the Senate and the Assembly to fund the entirety of their bold grant program and funding request in the FY 22-23 state budget. The Governor soon signed the agreement into law.
“Kristina brings a wealth of expertise, knowledge, and passion in legislative and budget advocacy. She also brings an educative approach that helped mobilize our association into action with specific planning to realize tangible results every step of the way.
With Kristina’s guidance, CAADS took a more proactive, strategic approach with the legislature and the Governor’s office, asserting the value of its good work and the profound benefits afforded to the older adult and adults with disabilities population the association serves.
Kristina Bas Hamilton is a true professional evidenced by her integrity, preparedness, and dedication to accomplish positive outcomes.”
– Daniel Gallagher, Board President, California Association for Adult Day Services
Outstanding Results
The two-pronged strategy accomplished everything that KBH Advocacy and CAADS set out to do and more.
ADHCs will soon receive $61.4 million in new grants.
The new grant program “the Bridge to Recovery for Adult Day Services” is being administered by the California Department of Aging. As early as second quarter 2023, ADHCs can apply for grants to upgrade facilities for COVID mitigation and retain staff during this historic workforce shortage.
CAADS is empowered for the future.
Through AB 2331, policymakers gained a stronger, more positive understanding of ADHCs. Legislators and staff learned about how their constituents value ADHCs – as community partners, as healthcare providers, as small business job creators, and as lower-cost alternatives to institutional care. Kristina helped CAADS grow its exposure, influence, and connections in and around the Capitol.
CAADS maximized the legislative and budget processes.
California’s state budget process and state legislative policy process have different rules, deadlines, and power centers that can be difficult for even experienced insiders to fully understand and navigate. Kristina and CAADS advocates maximized both processes to help ADHCs acquire the funding they need now and to develop the long-term relationships they will need in the future.