Assisted Living Disclosure Collaborative (ALDC)

The goal of AHRQ's Assisted Living (AL) initiative is to increase the value of health care for consumers by developing tools that help consumers and consumer intermediaries make better choices based on improved information on AL costs and services. Currently, differences in State requirements and a wide variety of services and amenities provided by individual AL providers make it difficult for consumers to access uniform information to determine which AL providers best meet their priorities and needs.

Known now as the Assisted Living Disclosure Collaborative (ALDC), this project is an outgrowth of a 2006 Technical Expert Panel that recommended that AHRQ develop tool(s) to help AL consumers differentiate between individual facilities on the "domains" of: services available; pricing information; admission and discharge criteria; and staffing information (RN staffing, 24/7 staffing, staff training, and turnover). Subsequently, the domains were expanded to include resident rights, house rules, and life safety.

To advance these recommendations, AHRQ has been partnering with the Center for Excellence in Assisted Living (CEAL). The collaboration between AHRQ and CEAL, has gradually expanded to include other key AL stakeholders (providers, consumers, clinicians, and policy experts) to work collaboratively through a voluntary consensus process to develop uniform consensus information (data items and definitions) that can be used to describe the services and characteristics of individual AL residences.

The ALDC is now engaged in the voluntary consensus process.¹ Four workgroups have been established:

• AL Services and Costs of Care.
• AL Staffing, Staff Training, and Turnover.
• Move-in/Move-out Criteria and Residents Rights, House Rules, and Life Safety.
• Dementia-specific Services.

Workgroup participants (approximately 100 individuals) meet monthly to develop uniform data items and definitions. These are then subject to formal ALDC consensus voting and will subsequently be developed into an instrument and associated materials. ALDC efforts are supported by a team from Abt Associates & University of North Carolina Chapel Hill that provides measurement expertise and logistical assistance. Current participating ALDC organizations are listed below.

Phase II of the project (planned for FY 09 funding) will include small-scale testing with consumers and providers and medium- and large-scale testing with providers. Based upon the testing results, the instrument and associated materials developed in Phase I will be finalized.  Phase III of the project (planned for FY 10 funding) will include dissemination activities for the materials developed (scheduled to begin in late 2010).

ALDC efforts also support AHRQ's Strategic Effectiveness Goal "by encouraging the use of evidence based (AL) information in the making of informed treatment decisions and choices." Similarly, efforts support AHRQ's Value Portfolio goals by increasing the number of people who are served by community collaboratives that are using evidence-based measures and data... to increase health care efficiency... (Value Portfolio Goal 1); increasing the number of new reports and tools... available for Chartered Value Exchanges (CVEs), States and other decisionmakers (Value Portfolio Goal 5); and increasing the number of AHRQ measures available for public reporting (Value Portfolio Goal 6).

Organizations Participating in the ALDC²

Voting Organizations

• AARP
• Agency for Healthcare Research and Quality
• Alzheimer's Association
• American Association of Homes and Services for the Aging
• American College of Health Care Administrators
• American Seniors Housing Association
• Assisted Living Federation of America
• Commission on Accreditation of Rehabilitation Facilities-Continuing Care Accreditation Commission
• Consumer Consortium on Assisted Living
• Gerontological Society of America Assisted Living-Special Interest Group
• National Association of State Ombudsman Programs
• National Association of State Units on Aging
• National Association of Social Workers
• National Association of Professional Geriatric Managers
• National Center for Assisted Living
• NCB Capital Impact
• Paralyzed Veterans of America
• Pioneer Network

Ex-Officio Organizations (non-voting)

• U.S. Administration on Aging
• Office of Disability, Aging, and Long-Term Care Policy, U.S. HHS, Office of the Secretary
• U.S. National Center for Health Statistics
• National Conference of State Legislatures

Other Key Non-Voting Participants

• Center for Excellence in Assisted Living
• Abt/UNC Support Team

¹ The voluntary consensus process follows the consensus requirements specified in OMB Circular A-119.
² Participants as of September 22, 2008.