WCCEAL is a group of dedicated people organized to improve the outcomes of individuals living in Wisconsin assisted living communities (ALCs). The state of Wisconsin recognized the importance of addressing quality in Assisted Living. In 2009, the Wisconsin Coalition for Collaborative Excellence in Assisted Living (WCCEAL) was formed to redesign the way quality is ensured and improved for individuals residing in ALCs. This public/private coalition utilizes a collective impact model approach that brings together the state, the industry, the consumer, and academia to identify and implement agreed upon approaches designed to improve the outcomes of individuals living in Wisconsin ALCs.

Awards/Recognition
What is WCCEAL?

Benefits of WCCEAL-+

Core benefits of WCCEAL for Assisted Living Communities (ALC)

  • Membership in a statewide coalition that represents providers, regulators, payers, residents, and quality improvement experts.
  • Access to a secure data-driven platform to assess their quality improvement structures, processes, and outcomes using measures co-designed by statewide stakeholders.
  • Regular feedback through data-driven reports that they can customize to compare themselves to ALC peer groups of their choice.
  • Targeted support to adapt their quality improvement efforts, including expert coaching, peer mentoring, and active engagement in a state-approved quality improvement program.
  • Free access to the Clinical Resource Center including the AMDA clinical practice guidelines for assisted living.
  • Access to promotional media resources.

Additional benefits of WCCEAL for ALCs in good standing

  • Public recognition on the WCCEAL website.
  • Regulatory flexibility: If an assisted living community that qualifies for the abbreviated survey is a member of WCCEAL in good standing, that assisted living community is surveyed later than assisted living communities in the same situation that are not members of WCCEAL in good standing.
  • Eligibility for premium discounts for liability insurance.

How to Join WCCEAL-+

Assisted Living Communities (ALCs) Interested in Joining WCCEAL

ALCs interested in joining WCCEAL must first be part of an approved quality improvement program. ALCs should contact their member Association for further information about joining WCCEAL.

LeadingAge Wisconsin
204 S. Hamilton St.
Madison, WI 53703
Phone: (608)255-7060
Email: info@leadingagewi.org
WI Assisted Living Association
PO Box 7730
Madison, WI 53707-7730
Phone: (608) 288-0246
Email: info@ewala.org
WHCA/WiCAL
121 E. Wilson St., L200
Madison, WI 53703
Phone: (608) 257-0125
Email: info@whca.com
Disability Service Provider Network
16 N Carroll St., Suite 300
Madison, WI 53703
Phone: (608) 244-5310
Email: support@dspn.org

To remain in good standing and be listed in the ALC membership section of this website all ALCs must abide by the WCCEAL membership rules.

Associations interested in joining WCCEAL

WCCEAL is a public/private collaboration between the a) Wisconsin Department of Health Services, b) Wisconsin’s assisted living provider associations that include LeadingAge Wisconsin, Wisconsin Assisted Living Association (WALA), Wisconsin Center for Assisted Living (WiCal), and Disability Service Provider Network (DSPN), c) Wisconsin’s consumer advocacy agency and ombudsman program, and d) the University of Wisconsin-Madison. All WCCEAL Associations must abide by the Association Guiding Values for Participation in WCCEAL. To receive more information about the Collaborative please contact the WCCEAL Helpdesk (wcceal@qid.wisc.edu).

Approved Quality Programs-+

When assisted living communities and health care facilities implement internal quality assurance and quality improvement throughout their systems, they will have better outcomes. The core of WCCEAL is the implementation of an association developed, department approved comprehensive quality assurance, quality improvement program.

LeadingAge Wisconsin Echelon

Echelon – A Quality Improvement Program for Those Who Strive for Excellence in Assisted Living

The LeadingAge Wisconsin Echelon is a systematic and all-encompassing program to serve assisted living professionals who strive for excellence in the care and services they offer.

Developed by assisted living professionals for assisted living professionals, Echelon is an unparalleled forum offering peer networking and sharing, a series of quality improvement initiatives, quality improvement modules, staff training modules, educational programs, workforce development tools, leadership development, policy and procedure resources, regulatory guidance and support, and certification courses for assisted living professionals.

Echelon provides collaborative guidance and support for each participating assisted living community as the community pursues its individual journey of quality improvement. Through Echelon, assisted living professionals become better by working together.

This program was reviewed by DHS and UW Madison - CHSRA staff and approval was granted as follows:

The LeadingAge Wisconsin CBRF and RCAC Quality Improvement Network (Now Echelon) Approved 11/16/2010

The WALA Diamond Accreditation Program is a voluntary, cost-effective, and self-directed quality management program that is available to WALA provider members.

The purpose of this program is to improve and maintain high standards of quality care and services for residents of Wisconsin's assisted living communities where individual needs are met in safe, healthy, respectful and dignified environments.

The Diamond Accreditation Program is an invaluable resource to help improve the quality of your assisted living operations and increase the quality of care you provide to your residents.

This program was reviewed by DHS and UW Madison - CHSRA staff and approval was granted as follows:

WALA’s Diamond Accreditation Program Approved 01/19/2012
WiCAL PEAL Program

PEAL is a voluntary program open to all WiCAL members, regardless of their licensure or certification, or whether they are currently qualified for the abbreviated survey process. Participation is voluntary, but all members are strongly encouraged to participate. Participating facilities receive training in recognized performance excellence criteria and quality improvement processes. Specifically, the PEAL program will rely heavily on the Baldrige Excellence Framework (Health Care) as the foundation of the program.

This program was reviewed by DHS and UW Madison - CHSRA staff and approval was granted as follows:

WiCAL’s Performance Excellence in Assisted Living (PEAL) Program Approved 04/06/2012
DSPN Star Quality Accreditation Program

The mission of the Disability Service Provider Network (DSPN) is to exist as a resource to foster a community for advocacy and education for excellence in community residential and non-residential support services. It is the goal of DSPN to positively impact residential and non-residential support services throughout Wisconsin by supporting providers in the fields of Disabilities, Mental Health, and Community Corrections so that they can achieve the highest level of service to individuals with these challenges throughout Wisconsin. It is for this reason that the STAR Quality Accreditation Program was developed.

This program was reviewed by DHS and UW Madison - CHSRA staff and approval was granted as follows:

RSA Star Quality Accreditation Approved 12/20/2011
DSPN Star Quality Accreditation Approved 2019

Partners & Collaborators-+

Department of Health Services

Division of Medicaid Services (DMS): DMS provides leadership and funding support for the Coalition including funding for design and maintenance of the WCCEAL website and information system.

Board on Aging and Long Term Care

The Board on Aging and Long Term Care, operates the Long Term Care Ombudsman, Volunteer Ombudsman, and Medigap Helpline Programs. It is the premier resource for information and advocacy.

Department of Health Services

Division of Quality Assurance (DQA): DQA provides regulator and licensing information for ALCs in Wisconsin and the Coalition, as well as providing survey relief to WCCEAL members.

University of Wisconsin - Madison

University of Wisconsin-Madison is the academic partner, providing website and database design and management. Also providing academic and evidence based research expertise and collaboration.

To become a member of WCCEAL, ALCs must first be part of an approved quality improvement program. Those interested in joining WCCEAL should first contact one of the following Associations to become an active member of their quality improvement program. All WCCEAL Association must abide by the Association Guiding Values for Participation in WCCEAL.

LeadingAge Wisconsin

LeadingAge Wisconsin, a statewide membership organization, is dedicated to the work of long-term care and assisted living organizations who principally serve seniors and persons with a disability. Through the core services of advocacy, education, and networking and guided by member-driven strategies, LeadingAge Wisconsin supports the efforts and mission of those who care for others. Together, LeadingAge Wisconsin and its members pursue better services for better aging.

Wisconsin Assisted Living Association

The Wisconsin Assisted Living Association (WALA) promotes standards of quality care and provides valuable member services to organizations providing assisted living services. WALA’s mission is to support providers in enhancing the best quality of life for residents in assisted living in Wisconsin through advocacy, education, communication, and quality initiatives.

Wisconsin Center for Assisted Living

PEAL is a voluntary program open to all WiCAL members, regardless of their licensure or certification, or whether they are currently qualified for the abbreviated survey process. Participation is voluntary, but all members are strongly encouraged to participate. Participating facilities will be trained in recognized performance excellence criteria and quality improvement processes. Specifically, the PEAL program will rely heavily on the Baldrige 2011-2012 Healthcare Criteria for Performance Excellence as the foundational of the program.

Disability Service Provider Network

The mission of the Disability Service Provider Network (DSPN) is to exist as a resource to foster a community for advocacy and education for excellence in community residential and non-residential support services. It is the goal of DSPN to positively impact residential and non-residential support services throughout Wisconsin by supporting providers in the fields of Disabilities, Mental Health, and Community Corrections so that they can achieve the highest level of service to individuals with these challenges throughout Wisconsin. It is for this reason that the STAR Quality Accreditation Program was developed.

Collaborators

M3 Insurance

The complicated and the simple. We do our best to never confuse the two. Risk management, business insurance, employee benefits – these are increasingly complex. But that’s why we’re here. We advise you on these complicated areas and partner with you to improve your operation, help keep you protected, and save you money. How we make that happen comes from a simple idea: Hire great talent and allow them to thrive. And that means you benefit.

Center for Excellence in Assisted Living

The Center for Excellence in Assisted Living (CEAL) is a non-profit collaborative of 9 national organizations. The organizations represent a unique blend of key stakeholders in assisted living. CEAL promotes high-quality assisted living, serves as a convener to bring together diverse stakeholders to discuss and examine issues related to assisted living, helps bridge research, practice and policies that foster quality and affordability, and maintains an objective national clearinghouse of information and resources about assisted living.

Argentum

Argentum member companies operate senior living communities offering assisted living, independent living, and memory care services to older adults and their families. Argentum is the largest national association exclusively dedicated to supporting companies operating professionally managed, resident-centered senior living communities and the older adults and families they serve. Since 1990, Argentum has advocated for choice, accessibility, independence, dignity, and quality of life for all older adults. Argentum expands senior living through industry-leading events, publications, education, and research.

National Center for Assisted Living

The National Center for Assisted Living (NCAL) is the assisted living voice of the American Health Care Association (AHCA). NCAL is dedicated to serving the needs of the assisted living community through national advocacy, education, networking, professional development, and quality initiatives. NCAL's proactive, national focus on assisted living legislation is backed by the strongest and most influential long term care advocacy team in the country. NCAL members know that their voices will be heard by the national policymakers and regulators who continually seek to influence the future of assisted living.

LeadingAge

The LeadingAge community includes 6,000 not-for-profit organizations in the United States, 39 state partners, hundreds of businesses, research partners, consumer organizations, foundations and a broad global network of aging services organizations that reach over 30 countries. The work of LeadingAge is focused on advocacy, education, and applied research. We promote adult day services, home health, hospice, community-based services, PACE, senior housing, assisted living residences, continuing care communities, nursing homes as well as technology solutions and person-centered practices that support the overall health and wellbeing of seniors, children, and those with special needs.

Advisory Group

This is a list of the members of the Coalition Advisory group. The WCCEAL Advisory group meets monthly to discuss, build and improve the WCCEAL program, project and infrastructure in order to increase quality of care for all those residing in Wisconsin ALCs.





  • Erin Boutan, WALA
  • Jasmine Bowen, DHS
  • Pat Boyer, WiCAL
  • Heather Bruemmer, BOALTC
  • Linc Burr, DSPN
  • Kevin Coughlin, DHS
  • Christopher Crnich, UW Madison
  • Kate Dickson, WiCAL
  • Jay Ford, UW Madison
  • Alfred Johnson, DHS
  • Jeff Kaphengst, DSPN
  • Chris Kenyon, M3 Insurance
  • Angie Kieffer, DSPN
  • Kim Marheine, BOALTC
  • Janice Mashak, LeadingAge Wisconsin
  • Susan Nordman Oliveira, UW Madison
  • Mike Pochowski, WALA
  • Brian Purtell, WiCAL
  • Edmond Ramly, UW Madison
  • John Sauer, LeadingAge Wisconsin
  • Matthew Sorenson, DQA
  • Judith Stych, DHS
  • Jim Williams, LeadingAge Wisconsin
  • Otis Woods, DHS
  • David Zimmerman, UW Madison

Financial Support of WCCEAL-+

Wisconsin Department of Health Services (DHS) has provides funding support for WCCEAL for the initial and ongoing infrastructure development. Activities include but are not limited to ongoing support for the monthly WCCEAL collaborative meetings; creation and ongoing maintenance of the WCCEAL website; and development, testing and implementation of the reporting infrastructure for the resident satisfaction and quality improvement measures as well as benchmark reports. DHS funding also supports UW Madison - CHSRA research activities, evaluation and analysis of WCCEAL data.

2015 Wisconsin Partnership Program Community Impact Grant. DHS and UW Madison - CHSRA awarded a $1,000,000, 5 year grant to expand the statewide impact of WCCEAL.

Grant Aims:

  1. Ensure that residents of Wisconsin ALCs have access to quality care by expanding the reach of the collaborative to engage more ALCs
  2. Improve ALCs ability to report and compare their progress and quality improvement by updating the WCCEAL data infrastructure
  3. Address health disparities in ALCs by assessing and targeting underserved communities and resident groups
  4. Reach more publically-funded and underserved residents through integrating WCCEAL into the Family Care Quality Strategy
  5. Improve specific quality targets for ALCs by developing processes for ALCs to work together with their peers
  6. Produce and disseminate evidence to sustain positive systems change through this collaborative

Initial funding for development and implementation of the WCCEAL project was provided by a 2011 ICTR Community Collaboration Grant. On May 9, 2011 UW Madison - CHSRA and DHS were awarded a $200,000 two-year ICTR Community Collaboration Grant be used to help build the infrastructure for the collaborative and to study the effectiveness of WCCEAL.

The Wisconsin Coalition for Collaborative Excellence in Assisted Living was supported by the Clinical and Translational Science Award (CTSA) program, through the NIH National Center for Advancing Translational Sciences (NCATS), grant UL1TR000427. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Funding for this project was also provided by the UW School of Medicine and Public Health from the Wisconsin Partnership Program, within the Institute for Clinical and Translational Research.

Associated Research Grants:

2014 ICTR Dissemination and Implementation Award. UW Madison - CHSRA awarded $150,000 grand to investigate falls prevention programs among WCCEAL members.

Park Family Foundation Grant. $10,000 Music & memory grant to pilot-test the Music and Memory program with iPads in ALCs.

Assisted Living in Wisconsin-+

The past 20 years have seen a dramatic shift in residential long term care, as medically frail older adults with complex health conditions who previously received care in nursing homes and hospitals are now residing in Assisted Living Communities (ALCs). In 2003, Wisconsin had 43,052 nursing home resident beds compared to 30,411 Assisted Living resident beds. By 2015, nursing home resident beds decreased by approximately 8,600 (total = 34,463 beds) versus an increase in Assisted Living resident beds of 23,972 (total=54,383 beds) (Johnson, 2016). As the number of individuals living in ALCs increases so does the need to provide, ensure, and improve quality in these communities.

Unlike nursing homes, ALCs do not have federal regulations and oversight.

Similar to nursing home facilities, ALCs offer a range of services, from home-like settings with minimal care to multiple skilled services. The minimum age requirement for residing in an ALC is 18 years. The state of Wisconsin has 3 types of residential ALCs that are licensed by the Wisconsin Department of Health Services Department of Quality Assurance:

  1. Adult Family Home (AFH): 3-4 bed residential home, where adults who are not related to the operator reside and receive care, they provide treatment or services above the level of room and board and may include up to seven hours per week of nursing care per resident.
  2. Community Based Residential Facility (CBRF): 5-257 bed residential home, where five or more unrelated people live together in a community setting. CBRFs provide services to people of advanced age, persons with dementia, developmental disabilities, mental health problems, physical disabilities, traumatic brain injury, AIDS, Alcohol and Other Drug Abuse, correctional clients, pregnant women needing counseling and/or the terminally ill.
  3. Residential Care Apartment Complex (RCAC): 5-109 individual apartments, where five or more adults reside in an independent apartment complex (sometimes referred to as independent living). Apartments must each have a lockable entrance and exit; a kitchen, including a stove (or microwave oven); and individual bathroom, sleeping and living areas.

For further information and consumer assistance about Assisted Living in Wisconsin please contact The State of Wisconsin Board on Aging and Long Term Care. The state of Wisconsin Department of Health Services has a great deal of information about ALCs and Finding and Choosing an Assisted Living Facility.

Background

  • Wisconsin has a rich history of community based programs, including licensure of the first Community Based Residential Facility (CBRF) in 1979. As a public funding agency, the Department of Health Services (DHS) has honored consumer choice providing supports for people to live in the least restrictive, most integrated setting possible. Beginning with the enactment of the Community Option Program (COP) in 1981 and through the creation of Family Care in 1999, Wisconsin has been a national leader in relocation efforts from institutions to community settings.
  • In 1980 Wisconsin ranked 2nd nationally in the number of nursing homes beds per capita with 87 nursing home beds per 1,000 residents 65 years of age and over. Thirty years later that ranking moved to 20th nationally with 46 nursing home beds per 1,000 residents 65 years of age and over, an increase of 47%. In 2008 Wisconsin Assisted Living beds surpassed nursing home beds with the gap widening each year since.
  • Since 1979 Assisted Living licensed beds have increased 34 consecutive years while the regulatory agency resources has not kept up with the increasing workload.
  • Wisconsin’s innovative regulatory approaches have improved overall quality in Assisted Living while also receiving national recognition.
  • Wisconsin has four strong Assisted Living provider associations supporting their members to improve the care and services they provide to the residents/tenants in their communities.
  • Wisconsin’s ombudsman program is a national leader with committed resources to the advocacy of residents in Assisted Living Communities (ALCs).

Website Information-+

The password protected section of the WCCEAL website is available only to members of WCCEAL. It consists of an annual resident satisfaction survey, an instrument to collect information about each member ALC’s quality improvement structure, processes, and outcomes, webpages for ALCs and associations to monitor their data benchmarked against other participating ALCs, and quality improvement tools and resources for ALCs and associations.

The resident satisfaction survey is administered at the ALC level once per year between January and April. ALCs and their associations can compare their performance with other providers in the state, in seven areas: staff, resident rights, environment, activities, meals and dining, health management/care, and overall ratings. The quality improvement data is collected from ALC members once per quarter providing information about the ALCs quality improvement structure, processes and outcomes.

The output of the system is a series of web-based reports on the results of the satisfaction measures, the quality improvement variables, and the ALCs’ rate of participation in the data collection. These reports permit the participating communities to review their performance and compare themselves to their counterparts in the program. More extensive information on individual ALC performance and participation is available to the Associations, since they are integral to the feedback and quality improvement functions of WCCEAL.

Below is a WCCEAL activity timeline:

One page, printable PDF of the WCCEAL Timeline
One page, printable PDF of the specific ALC tasks that need to be completed each year

Text For Susan :)-+

Pioneer Institute Better Government Competition 2017
WCCEAL is a special recognition awardee in the Pioneer Institute's 26th annual Better Government Competition. This year's topic was "Aging in America."
WCCEAL is a 2016 winner of the Association of Health Facility Survey Agencies (AHFSA) Promising Practice Award in the Category of Quality Improvement in the Regulatory Process.
Bright Ideas is an initiative that recognizes creative and promising government programs and partnerships, through the Innovations in Government Program, a program of the Ash Center for Democratic Governance and Innovation at Harvard Kennedy School.

Project Goals

  • Create a Public/Private collaboration with DHS Division of Quality Assurance and Division of Long Term Care, Wisconsin’s four provider associations that include LeadingAge Wisconsin, Wisconsin Assisted Living Association (WALA), Wisconsin Center for Assisted Living (WiCAL), and Residential Services Association of Wisconsin (RSA-WI), Wisconsin’s advocacy agency, the ombudsman program, and the University of Wisconsin-Madison’s Center for Health Systems Research & Analysis (CHSRA)
  • Incentivize Assisted Living Communities to strive for excellence through internal quality improvement
  • Collaborate with provider associations to develop a comprehensive QI & QA program and to help their members to be successful.
  • Collaborate with the UW Madison - CHSRA to improve long-term care and health systems by creating performance measures and developing information and decision support systems.
  • Provide regulatory relief for high performing Assisted Living Communities.
  • Define the level of excellence that will be recognized by public funding agencies, insurance companies, Assisted Living Communities, advocates, legislators, general public and other key stakeholders.

Project Activities

  • Implement the WCCEAL infrastructure using a grant secured by UW Madison - CHSRA;
  • DHS approves provider association Quality Improvement and Quality Assurance programs;
  • Develop a website and password-protected web-based information system for members of WCCEAL;
  • Develop a standardized Resident Satisfaction Survey for WCCEAL members;
  • Develop performance measures of quality improvement structures, processes, and outcomes for WCCEAL members;
  • Create a firewall preventing the DHS from accessing Assisted Living Community specific WCCEAL data.; and
  • Provide feedback to provider associations and Assisted Living Communities on their resident satisfaction and quality improvement performance with trend information and comparisons to peers and other cohorts.

Deliverables

  • 11/30/2009 - WCCEAL established
  • 09/17/2010 - DQA updated database to capture WCCEAL members
  • 05/09/2011 - UW Madison - CHSRA awarded $200,000 to develop and pilot-test WCCEAL from the 2011 ICTR Community Collaboration Grant
  • 04/06/2012 - All four provider Association’s QA/QI programs approved
  • 06/12/2012 – Resident Satisfaction Survey finalized and approved
  • 11/02/2012 - UW Madison - CHSRA launched WCCEAL Website https://wcceal.chsra.wisc.edu/
  • 11/12/2012 - WCCEAL Satisfaction Survey process launched
  • 02/25/2013 - WCCEAL Quality Improvement Data Submission process launched
  • 06/18/2014 - UW Madison - CHSRA awarded $150,000 to investigate falls prevention programs among WCCEAL members, from the 2014 ICTR Dissemination and Implementation Award
  • 01/01/2015 – WCCEAL introduced new Falls Prevention questions
  • 09/15/2015 – WCCEAL Membership Rules implemented
  • 10/21/2015 – DHS and UW Madison - CHSRA awarded a $1,000,000 grant to scale-up the statewide impact of WCCEAL from the 2015 Wisconsin Partnership Program Community Impact Grant
  • 10/26/2015 – Music & MemorySM awarded $10,292 to pilot-test the Music and Memory program with iPads in ALCs, from the Park Family Foundation

Dissemination

  • 30+ Presentations about WCCEAL to various stakeholder groups including CMS, the Center for Excellence in Assisted Living (CEAL), Assisted Living Federation of America (ALFA), national Ombudsman group and at the different state Assisted Living conferences.
  • WCCEAL benchmark data on resident satisfaction and quality improvement currently covers 24% of Wisconsin Assisted Living Communities licensed beds.

Research and Evaluation

  • 7/1/2010 to Present: Wisconsin Department of Health Services (DHS) - WCCEAL Infrastructure and Research
  • 09/01/2011 – University of Wisconsin Institute for Clinical and Translational Research Community Collaboration Grant
  • 09/01/2014 – University of Wisconsin Institute for Clinical and Translational Research Falls Prevention grant
  • 11/01/2015 – Park Family Foundation Music and Memory grant
  • 03/01/2016 – Wisconsin Partnership Program Community Impact grant

Honors

  • 2015 – WCCEAL recognized as a Bright Ideas through the Harvard Innovations in Government Program, a program of the Ash Center for Democratic Governance and Innovation at the Kennedy School of Government at Harvard University.