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California Culture Change Coalition

Contact Information

Darren Trisel, MSA, NHA, RCFE, MT
Board President

Jennifer Mangosong-Shankle, MS
Program Director


The California Culture Change Coalition (CCCC) began in June 2005, when four Californians attended the Pioneer Network's St. Louis Accord and came back with a plan. This was followed by the "Drive Improvements in Nursing Home Care" Caravan in August of 2005 engineered by Lumetra, California's then Medicare Quality Improvement Organization (QIO), partnering with Dr. Bill Thomas, founder of the Eden Alternative Green House Model. The Caravan attracted the interest of providers and other stakeholders. The group then formed a steering council that grew into the California Culture Change Coalition in August 2006 and incorporated as a 501(c)(3) non-profit in February 2007.


To provide support and expertise to California's nursing homes assisting them to become models for quality of care, quality of life and quality of work.

California's nursing homes will be great communities in which to live and work.

Organizational Structure
CCCC is incorporated as a 501(c) (3) nonprofit organization with a Board of Directors that is composed of representatives from all areas of the long-term care community including resident advocates, skilled nursing providers, labor unions, quality improvement organizations, and state and federal regulators.

CCCC is funded through in-kind donations from supporting individuals and organizations; CMP and other grant funding; and revenue from educational programs.

2014 Accomplishments


  • Received a Civil Monetary Penalty (CMP) grant of $500,000 over a two-year period of time for the program titled "California Partnership to Improve Dementia Care and Reduce Unnecessary Antipsychotic Medication Drug Use in Nursing Homes". This grant was approved March 2014 to facilitate the California Partnership to Improve Dementia Care (CA Partnership), and was converted to a Contract with the California Department of Public Health. Under the contract, CCCC:
  • Serves as the lead agency of the CA Partnership which includes various stakeholders such as the California Association of Health Facilities, California Advocates for Nursing Home Reform, California Long Term Care Ombudsman Association, California Association of Long Term Care Medicine, Health Services Advisory Group, and the California Medical Association
  • Convenes and facilitates the CA Partnership meetings as a whole, via phone and in-person at the Department of Public Health in Sacramento
  • Convenes and facilitates the CA Partnership workgroup meetings, including: Informed Consent, Enforcement, Education and Consumer Awareness workgroups
  • Convenes and facilitates the CA Partnership Executive Committee, including facilitators of the CA Partnership, the CCCC Program Director, with support from select CCCC Board members
  • Created the foundation for an online toolkit that includes train-the-trainer materials for implementing evidenced-based materials, such as the CMS Hand-in-Hand training. The toolkit can be found at
  • Partnered with the Alzheimer's Association to prepare presentations on least medicating approaches and best practices that identify effective strategies in dementia care that result in antipsychotic medication reduction
  • Developed a corrective action plan to promote training in geographic areas with facilities that have an antipsychotic medication rate of 30% or higher.
  • Partnered with Health Services Advisory Group (HSAG), California's Medicare QIO, to plan 2015 Learning and Action networks
  • Hired Administrative, Public Relations and Web Consultants to support the needs of the CA Partnership Education and Consumer Awareness arenas
  • Hired Program Director to facilitate the California Partnership deliverables stated under the CDPH Contract utilizing the CMP funds
  • 2015 will be devoted to facilitating the Consumer Awareness campaigns, and to carry out educational opportunities with various dementia care educators, physicians, pharmacists and CA Partnership partners
  • Received funding in the amount of $50,000 over an 18-month period to create and distribute a training webinar for all California skilled nursing home employees focusing on the implementation of day-to-day practices that result in consistent staffing assignments to reduce staff turnover and improve staff stability in order to improve the quality of life and quality of care of nursing home residents.
  • Received grant approved for the Eden Alternative Educational Project entitled, Leveraging Leadership to Drive Sustainable Change, for 2015 fully funded by the May and Stanley Smith Trust
  • Grant from HRET $60,000 being considered by CCCC for 2015/2016 to assist nursing homes in controlling infections.

Seminars/Conferences & Presentations

  • Under the CMP Grant, planned two statewide conferences entitled "Dementia Care California: Sustaining Momentum and Success" to be held in February 2015 in Pasadena and Sacramento highlighting keynote speaker, Dr. Allen Power, author of Dementia Beyond Disease

Pioneer Network

  • CCCC Board President attended the Pioneer Network Annual Conference.
  • Continues to participate in the quarterly Pioneer Network coalitions networking calls

Staffing and Consultants

  • CCCC was able to hire project-based staff and consultants, including: Program Director (CMS/CDPH Contract for the CA Partnership), Certified Public Accountant (CPA), Administrative Assistant, Public Relations and Web platform Consultants (CMS/CDPH Contract for the CA Partnership), and Graphic/Web Designer Consultant


  • Facilitated development of the CA Partnership to Improve Dementia Care toolkit, 2015 will be devoted to enhancing the toolkit resources
  • Continuation of updating the California Culture Change Coalition website Enhancements to be added in 2015.