ASSISTED LIVING FEDERATION OF AMERICA (ALFA).

Assisted Living: New Industry, New Millennium

When you look at the life experience of our residents, it is easy to understand how the assisted living movement developed. Most assisted living residents have lived through decades of phenomenal changes. They've gone from "hand-crank telephones"

to cellular phones in a few short decades. They have experienced years of expanding choices in almost every aspect of their lives. Long-term care is no exception. In less than 20 years, the assisted living movement has grown from a "cottage industry" to a leadership position in the continually evolving senior care market.

The Assisted Living Federation of America (ALFA) is celebrating its 10th anniversary next year with its more than 6,500 members. Recent mergers with the National Association of Residential Care Facilities and National Association of Senior Living Industry Executives are evidence of just how broad the assisted living base has become. Among highlights of the last few years:

* The assisted living "model" has continued to evolve, offering an ever-increasing number of options for care to meet individual needs and preferences. The various long-term care models--home health, skilled nursing, assisted living and retirement communities--are no longer "fixedpoints" on the long-term care continuum. Rather, they are often available in combinations.

* The means for offering consumers both protection and information--always an important focus of the assisted living industry--have become more uniform and available. ALFA has developed tools to help providers educate the consumer, including sample resident agreements, sample consumer information statements, consumer brochures, consumer videos, an online Careguide residence directory and Web site information. Efforts to make assisted living more accessible to consumers of all income levels have progressed rapidly. Currently 37 states offer limited Medicaid assistance, while at least 10 of the largest long-term care insurance carriers offer assisted living coverage.

* Providers have recognized that the recruitment and retention of qualified staff is critical to successful delivery of care. A national training program developed by ALFA helps providers empower their staff through quality training and defined career paths.

* ALFA and its membership have worked proactively to ensure that assisted living is recognized in state regulations as a viable care alternative. All 50 states have regulations, but now 27 include the term "assisted living," recognizing that the assisted living model has distinctive elements of care delivery.

The positive consumer response to the assisted living model has challenged healthcare providers across the entire spectrum to re-evaluate how care is delivered. Assisted living has pushed consumer needs and preferences to the forefront of the healthcare debate.

The new millennium brings many exciting initiatives, including:

* Voluntary Accreditation: A national voluntary assisted living accreditation process is being developed in conjunction with CARF, an independent accreditation commission. This will assure consumers that providers are adhering to a high standard of care that is responsive to residents' needs.

* Regulatory Standards: ALFA is working with state lawmakers to develop outcome-based rather than prescriptive regulations. This emphasis will help maintain quality of care without sacrificing the resident's ability to choose an assisted living model that suits personal needs and preferences.

* Affordability: ALFA will continue to support federal initiatives for long-term care insurance, tax breaks and other programs that help consumers retain control over their long-term care choices.

* Training: Best practices in care delivery, facility design and organizational management are better defined as the industry matures. ALFA is committed to making sure that quality training based on best practices is available for all providers in the industry.

The truly exciting aspect of the assisted living industry at the beginning of the new millennium is that it continues to evolve. Already it is apparent that there will be an opportunity to work more closely to integrate independent living services with assisted living, continuing to expand the range of choice for the consumer.

Just as no one could have envisioned the transition from "hand-crank" telephones to cellular phones, we can't predict exactly how assisted living will evolve in the new millennium. We do know that the assisted living movement will continue to be energized by its commitment to consumer needs and preferences. The original commitment to high-quality care delivered with maximum choice and dignity remains the cornerstone of our future plans. With a steadier rate of industry growth, ALFA and assisted living providers look forward to building an infrastructure that will continue to ensure the highest standards of customer satisfaction, protection and choice.

Karen Wayne is president/CEO of the Assisted Living Federation of America.