The National Center of Excellence in Assisted Living began to advance the well-being of those who live and work in assisted living through research, practice, and policy. Last year, CEAL@UNC ushered in a new era for the organization, expanding its ability to do this work. Cheryl Zimmerman, MSW, PhD, executive director of the newly established CEAL@UNC, recently spent a few minutes with McKnight Senior Living Content Editor Kimberly Bonvisuto to discuss how the organization works to advance evidence and workforce support and advance evidence-based practices and policies in the field of assisted living.
Q: In 2023, the National Center of Excellence in Assisted Living expanded and moved to CEAL@UNC. What benefits have you seen in moving CEAL to UNC-Chapel Hill?
A: We have more capabilities. The Center of Excellence in Assisted Living began in 2003 as a result of the first recommendation in the landmark Assisted Living Task Force report, which was delivered to the Special Committee on Aging of the U.S. Senate. I wanted to know what was going on with assisted living and all these records. This still exists now in partnerships with the United Nations Command. We're bringing that extra capacity now. CEAL had a management company that was helping all of these volunteers implement all the initiatives they did. Now, with UNC and me as CEO, we have established broader oversight and expertise than just the volunteer efforts of all the people who are still part of CEAL.
Q: Can you highlight some of the work going on at CEAL@UNC right now?
A: There are three ongoing initiatives, one of which is a continuation of when CEAL@UNC was CEAL. CEAL has already begun compiling all state transition plans associated with the final rule for HCBS settings in a unified manner. CEAL@UNC has begun wrapping up this effort on the CEAL@UNC website. We'll make sure to spread its availability widely and probably write some synths around it.
Another effort that began before CEAL became CEAL@UNC: last year, recommendations on medical and mental health care were published in Gamma. Several organizations have formed a coalition to share recommendations beyond the scope of the published paper Gamma Giving people tools for them. They are very actionable recommendations. One of the things that CEAL@UNC is moving forward with is the Be Well in AL coalition, which is developing toolkits, and we're going to make them available to the public.
Initiative 3: I have been researching assisted living for 30 years, and there are thousands of articles available on assisted living, most of them behind a paywall. We have a component on our website. We have just started with calendar year 2022. We are publishing summaries and short synthesis. You can go to all summaries of sources published in the past year, for every paper published by researchers that has a help word living in its title. You go to our website – they're all there – and we write a short summary so that people who need the information really know what it's saying. These are very short translations that I hope will help providers, policy makers, advocates and people who need them.
We all know that researchers know research. We work to understand the regulations, talk to regulators and try to talk to consumers on a regular basis. But there is no organized way to do this.
At CEAL@UNC, we develop national cores. We have already started with research, and we are still building the provider core, the policy core, and the consumer core. These will be individuals and organizations who want to participate in or learn about these areas. In developing these cores, we expect that we will all work with each other to benefit the work people are already doing. We see ourselves as bringing constituencies together. We're just getting started, but it's going to be a great contribution to the whole assisted living space, serving as the infrastructure to help people do what they already do, but more efficiently, and benefit from each other's expertise and efforts.
Q: Is there a schedule for these cores, and how can people participate?
A: We have already built a research core, inviting more than 300 people to come to the meeting. We will soon be working on better ways to build other cores. Anyone interested in other centers can go to the website and contact us about getting involved. We are still in a formative stage at CEAL@UNC, but we may always be in a formative stage. We are here for the well-being of everyone involved in the entire assisted living project.
Q: Are there any research projects you are working on, whether related to your work with CEAL?
A: I am proud that the assisted living system has been designated as an important primary framework of care. Recently, the National Institute on Aging provided an $81 million grant to Michigan and California to conduct five years of national dementia care workforce surveys to understand the nature of the workforce, and what their needs are. This includes physicians, nursing homes, home care and assisted living. the living. Given my own background and affiliation with CEAL, I am an expert on the assisted living aspect. This can have a big impact.
Information has been requested for the first phase of surveys through December 15, but this is just the first wave. There will be four more waves.
We are always receptive to topics. This will have huge implications.
Q: CEAL was launched in 2003, the same year this happened McKnight Senior Living – which was then known as McKnight Assisted Living – Launched. What do you think are the main ways in which assisted living has changed over time?
A: Some changes come to mind. Affordable assisted living and public dollars — Medicaid — are changing.
Assisted living, or the way we think about assisted living, it was… the high-end site. There were other models of service, but we talk more about accessibility than we did.
The regulations weren't there, so this was a big change.
The third thing that comes to mind is how important the social model of care is, quality of life is important, but now we all realize that people who lived in supported living have always had health care needs. It is now moving away from simply being a social model of care, and recognizing the totality of care needs of people receiving supportive care in residential communities that are not nursing homes.
Q: What trends in assisted living do you see for 2024?
A: One thing is the Be Well In AL initiative. We must be more aware in a practical, practical and feasible way across the full spectrum of assisted living – small to large, private and non-private – about how we address care needs in practical and feasible ways. Recently, there have been cost issues that need to be addressed, which go back to accessibility.
Regulations evolve in a way that suits care needs and how settings are run.
And none of us can have a conversation without talking about the workforce. Some talked not only about training and ensuring training, but also about how we think about competencies and how to do this in a sustainable way.
One thing I love about this field is all the organizations that deal with it in one way or another. Large national organizations – such as PHI, the National Center for Assisted Living, and Argentum – and professional organizations and providers, such as AMDA – the Association for Long-Term and Post-Acute Care Medicine. What I love is that these organizations talk to each other a lot, which is what CEAL loves to see. There will be a greater need for that moving forward.
Assisted Living is the nation's largest provider of long-term residential care. When you look at long-term care and how nursing homes have evolved, assisted living is the largest provider of long-term residential care, including for people with dementia. We all just need to work together and talk about care needs, and make things move forward purposefully and not just by accident, which sometimes happens.
CEAL is still CEAL. CEAL@UNC means we have a well-established infrastructure to respond to needs and bring research into practice and policy. We welcome input. We welcome anyone who wants to be part of this broad mission.
This interview has been edited for clarity and other considerations. Listen to the podcast version of this interview here.
From the February 2024 issue of McKnight's Senior Living
