Communities for Life:
Neighborhood Naturally Occurring Retirement Communities
A partnership of the Indiana FSSA Division of Aging &
the University of Indianapolis Center for Aging & Community
1
One State’s Approach to the
Development of NORC Program
Public Policy
Presented by:
Jennifer Bachman, MEd, Senior Projects Director,
University of Indianapolis Center for Aging & Community
LaNita Garmany, MS, Project Director, University of Indianapolis Center for Aging & Community
Mia Oberlink, MA, Senior Research Associate, Center for Care Policy & Research, New York
Fredda Vladeck, LMSW, Director, Aging in Place Initiative, United Hospital Fund, New York
Learning Objectives
1) Learn how two national resources, NORC Blueprint and
the AdvantAge Initiative, were used in Indiana to develop
and provide community-based services to their aging
population.
2) Understand the need for a systematic and
comprehensive planning approach to developing
community-based programs through the Communities
for Life project.
3) Review key lessons learned through the process.
3
What is a NORC?
Naturally Occurring Retirement Community
(NORC) – a demographic term used to
describe a community:
• Not originally built for seniors
• Significant proportion of its residents are
seniors
4
Definition of a NORC Program
NORC Programs are public-private partnerships
of:
• Housing/neighborhood organizations
• Residents
• Health and social service providers
• Community stakeholders
• Government agencies
NORC Programs organize and develop services
and programs to advance successful aging in
place.
5
A Community Change Model
NORC programs are dynamic and aim to be
responsive to their communities by:
• Empowering seniors to take on new roles in
the community
• Fostering connections within the community
• Maximizing the health and well being of all
older adults in the community
6
Elements of Developing Effective
NORC Programs
• Understanding the community
•
Partnering with the community
•
Designing and implementing a NORC program
•
Evaluating projects of a NORC program
•
Strategic planning for sustainability
7
United Hospital Fund
• New York City public charity, policy, and research center
• Shapes positive change in the delivery of health services
in New York City
• Established the Aging in Place Initiative in 1999
• Works with multiple partners
 Programs
 Funders
 Researchers
8
9
Introduction to the AdvantAge Initiative
10
Promotes Social
and Civic Engagement
Addresses
Basic Needs
•Fosters meaningful connections
with family, neighbors, and
friends
•Promotes active engagement in
community life
•Provides opportunities for
meaningful paid and voluntary
work
•Makes aging issues a
community-wide priority
•Provides appropriate and affordable
housing
•Promotes safety at home and in the
neighborhood
•Assures no one goes hungry
•Provides useful information
about available services
Optimizes
Physical and Mental
Health and Well Being
•Promotes healthy behaviors
•Supports community activities
that enhance well being
•Provides ready access to
preventive health services
•Provides access to medical,
social, and palliative services
An Elder Friendly
Community
Maximizes
Independence
• Mobilizes resources to facilitate
“living at home”
• Provides accessible
transportation
• Supports family and other
caregivers
11
The AdvantAge Initiative Planning Process:
Data Driven, Participatory Community Development
DATA
INFORMATION
ACTION
EVALUATION
12
AdvantAge Initiative Survey Conducted in:
•
National Survey
•
States
– Indiana
•
Counties
– California
• Contra Costa &
Santa Clarita Counties
– El Paso County, TX
– Indiana
• Elkhart, Kosciusko,
LaPorte, Marshall, &
St. Joseph Counties
– Maricopa County, AZ
– Newaygo County, MI
– Orange County, FL
•
Cities, towns, & neighborhoods
– Six neighborhoods of
Chicago, IL
– Grand Rapids, MI
– Indianapolis, IN
•
Cities, towns, & neighborhoods
(cont’d)
– Jacksonville, FL
– Parsippany, NJ
– Puyallup, WA
– New York
• Upper West Side
• Yonkers
– NORCs
– Indiana
• Gary Midtown, Huntington,
Martindale/Brightwood
(Indianapolis), Linton, &
LaSalle Park
– New York
• Brownsville, Chinatown,
Harlem, & Lincoln Square
13
Indiana’s Aging Dilemma
Several years ago, Indiana had only 2 choices
for its seniors – either receive home health care
services (if you qualified) or enter a long term
care facility.
– 45th among states for distribution of Long
Term Care dollars versus community-based
dollars
– Long waiting lists for the CHOICE program
14
SHIFT IN RELATIVE INVESTMENT
Phase IV
7/1/09
-Preventative Care Program for Seniors
-Long Term Care Insurance Partnership Program
-INShape Indiana (Health Program)
-Golden Hoosier Card
Individual
Individual
Phase III
7/1/08
Community
-Communities for Life (NORC)
-Hoosier Youth Providing for Elders (HYPE)
-Aging and Disability Resource Center (ADRC)
-Adult Guardianship Program
Community
Phase II
7/1/07
Support Services
-Transportation
-Affordable and Accessible Housing
-Nutrition Services
-Service Access (211)
Support
Services
Phase I
7/1/06
Institution Based Healthcare
Delivery
-OPTIONS
-Assisted Living
-Adult Foster Care
-Adult Day Services
Community
Dashboard
Institution
Based
Healthcare
Delivery



Project
Completion
Cost
Savings
Healthcare
Outcomes
15
Comprehensive Planning Process
Concerted effort to build the community-based service side
to allow people to age in place and have more choices
about where and how they do so
– Redistribution of dollars in a more strategic way
– Strengthen Information & Referral departments of the
16 Area Agencies on Aging to create a one-stop for
information
– Implement state-wide AdvantAge survey to ascertain
“elder-friendliness” of communities and establish
baseline data to use in state program plan.
16
Implementing the Strategy
NORC model explored - New York NORC’s and
Elder Friendly Community (Indianapolis)
Aging Director was intrigued by this model. Could
this be adapted and applied in both urban and rural
settings to provide a network of community-based
services locally?
– Shift monies to grassroots level to allow for communitybased expansion
– Ask communities to take personal responsibility
– Engage a broad range of stakeholders, including senior
residents themselves, to help seniors age in place
17
Implementing the Strategy
Statewide NNORCs
• Philosophy of NORC model fit with the concept of multiple
geographic and demographic community-based sites
• Communities for Life: 18-month planning grant concept
conceived to explore feasibility of developing 5
“horizontal” sites simultaneously in both urban and rural
settings
• Multi-layered evaluation of planning grant process by
independent evaluator incorporated as well as extensive
technical assistance.
18
Communities for Life Planning Grant
In June 2007, the Family and Social Services
Administration Indiana Division of Aging
contracted with the University of Indianapolis
Center for Aging & Community to develop and
implement Communities for Life to:
• maintain neutrality and
• maximize efficiency
• provide timely and comprehensive technical
assistance.
19
Importance of Partnerships
• University reached out to national NORC
experts for information, advice, and support:
Fredda Vladeck, United Hospital Fund
• University linked with Indiana University’s
Center on Aging and Community, Phil
Stafford, to dovetail with state-wide
AdvantAge Initiative with the NNORC data
collection, and Mia Oberlink, Center for Home
Care Policy & Research
20
Communities for Life NNORC Development
Purpose of CFL Project:
 Develop a model of an “elder friendly” community
 Develop a method to measure community “elderfriendliness”
 Help communities interpret and use this information to
create action plans to support older residents’ health,
well-being, and independence as well as their social and
civic engagement
Communities for Life Planning Grant
CFL Program Objectives
• Identifying and assembling community stakeholders
• Identifying neighborhood assets and resources as
well as the needs of older adults
• Analyzing, evaluating and interpreting the data
• Developing a program plan for supportive services
for older adults
• Developing a sustainability plan for implementation
and growth
22
Using the NORC Blueprint to Inform
NNORC Process Flowchart
23
Using the NORC Blueprint to Inform
NNORC Process Flowchart
24
Indiana’s Use of The AdvantAge Survey
Flu Shot in the Past 12 Months Among People Aged 65 and Older
80%
73%
78%
64%
56%
40%
0%
National1
Indiana2,3
Area 82,4
Martindale/
Brightwood NNORC2,5
1
Federal Interagency Forum on Aging-Related Statistics. Older Americans 2008: Key Indicators of Well-Being. Federal Interagency Forum on AgingRelated Statistics. Washington, DC: U.S. Government Printing Office. March 2008. Data for 2006.
2
AdvantAge Initiative Community Survey in Indiana, 2008
3
Excludes Area 2 (Elkhart, Kosciusko, LaPorte, Marshall & St. Joseph Counties) which was surveyed in 2006 (Unweighted N=3,337; Weighted N=734,461).
4
Area 8 includes Boone, Hamilton, Hancock, Hendricks, Johnson, Marion, Morgan, and Shelby Counties (Unweighted N=227; Weighted N=182,961).
5
Unweighted N=85; Weighted N=1,533.
25
Indiana’s Use of The AdvantAge Survey
Diabetes1 Among People Aged 65 and Older
31%
32%
22%
23%
18%
16%
0%
National2
Indiana3,4
Area 83,5
Martindale/
Brightwood NNORC3,6
The AdvantAge Initiative survey asked, “In the past five years, has a doctor told you that you have … Diabetes.” National data are based on a 2-year
average (2005-2006).
2 Federal Interagency Forum on Aging-Related Statistics. Older Americans 2008: Key Indicators of Well-Being. Federal Interagency Forum on AgingRelated Statistics. Washington, DC: U.S. Government Printing Office. March 2008.
1
3
AdvantAge Initiative Community Survey in Indiana, 2008
4
Excludes Area 2 (Elkhart, Kosciusko, LaPorte, Marshall & St. Joseph Counties) which was surveyed in 2006 (Unweighted N=3,337; Weighted N=734,461).
5
Area 8 includes Boone, Hamilton, Hancock, Hendricks, Johnson, Marion, Morgan, and Shelby Counties (Unweighted N=227; Weighted N=182,961).
6
Unweighted N=85; Weighted N=1,533.
26
Indiana’s Use of The AdvantAge Survey
Mammogram1 Among Women Aged 65 and Older
66%
64%
60%
56%
50%
33%
0%
National2
Indiana3,4
Area 33,5
Huntington NNORC3,6
1
The AdvantAge Initiative survey refers to mammogram in the past 12 months. National figure refers to mammogram in the past 2 years (data for 2005).
Federal Interagency Forum on Aging-Related Statistics. Older Americans 2008: Key Indicators of Well-Being. Federal Interagency Forum on AgingRelated Statistics. Washington, DC: U.S. Government Printing Office. March 2008.
2
3
AdvantAge Initiative Community Survey in Indiana, 2008
4
Excludes Area 2 (Elkhart, Kosciusko, LaPorte, Marshall & St. Joseph Counties) which was surveyed in 2006 (Unweighted N=1,786; Weighted N=423,327).
5
Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, and Whitley Counties (Unweighted N=109; Weighted N=43,306).
6
Unweighted N=45; Weighted N=297.
27
Communities for Life NNORC Development
Planning Phase Accomplishments:






Successfully initiated community asset mapping
Participated in the state-wide AdvantAge Initiative Survey
Developed relationships
Developed a structure of governance
Organized community-wide advisory committees
Launched resident education and community awareness
campaigns
 Coordinated other localized data collection activities
 Partnered with local universities/colleges to provide evaluation
and analysis of the data collected
 Assisted their steering committees in the development of
NNORC work plans and time lines
28
Shepherd Communities NNORC, Linton
Empowering seniors to
take action through
community organizing
29
Huntington NNORC
Providing opportunities
for greater
socialization,
education and
awareness
30
Martindale/Brightwood NNORC
Seniors
speaking out
and voicing
their concerns
and perceptions
31
Gary Midtown NNORC
Engaging residents
through focus groups
and broad-based
community-wide
forums
32
LaSalle Park NNORC, South Bend
Collaborating with existing
community partners to create a
forum for informing senior
residents of the programs and
services already available in their
local community
33
Communities for Life NNORC Development
NNORC Supportive Services
Program Implementation
CFL NNORC programs have received an additional
$75,000 to design and implement projects that
address a “banner issue” or concern expressed by
area seniors.
34
Shepherd Communities NNORC
Linton, IN
Banner Issue: Improved mobility through physical
wellness, transportation, and home safety assessment
 Removing and/or modifying existing safety hazards
within and around resident’s homes
 Establish a walking program
 Provide healthy living seminar and EnhanceFitness®
class
 Provide elder-friendly training to current transportation
providers
 Provide transportation vouchers for seniors in need
 Partner with faith-based organizations to provide
additional transportation for seniors
35
LaSalle Park NNORC
South Bend, IN
Banner Issue: Senior Resource Information and
Referral and Home Modification
 Develop an information distribution system utilizing
direct mail, educational seminars and area business
displays
 Implement “Neighbors with Neighbors” volunteer
neighborhood beautification clean-up program
 Establish on-site NNORC Case Management services
 Provide home modification services to four NNORC
residents
36
Gary Midtown NNORC
Gary, IN
Banner Issue: Neighborhood and Personal Safety
 Establish a 24-Hour NNORC Crisis Hotline for
emergency intervention assistance
 Partner with Gary Police Department to operate a
Community Oriented Policing (COP) Program
 Implement the “Tree of Three” Network to provide a
core support team to monitor senior wellness
 Organize a Fix-Up-Clean-Up team of community
volunteers to promote beautification initiatives, a safe
neighborhood environment and stimulate neighborhood
entrepreneurship
37
Huntington NNORC
Huntington, IN
Banner Issue: Senior Resource Information and
Referral
 Provide home safety assessments to seniors to identify
and remedy safety hazards within the home
 Establish/stock a Senior Resource Display in the
Huntington City Library
 Utilize the Huntington County Council on Aging
(HCCOA) newsletter to promote senior resources
 Partner with Huntington University to develop a seniorfriendly website with a link from the HCCOA’s website
 Train senior volunteers as resource information guides
38
Martindale/Brightwood
Golden Ages NNORC
Banner Issue: Home modification related to
accessibility in and around the home
 Provide Home Safety Education and Awareness
 Partner with MCHD, CICOA, and MBCDC to perform 30
home safety assessments
 Establish a home safety products pantry to provide 50
seniors with smoke detectors, night lights, grab bars,
outdoor motion-sensor lighting, raised toilet seats, etc.
 Conduct four fall-prevention educational seminars
 Enhance communication and involvement through a
quarterly senior newsletter
39
Future NORC Development
Lessons Learned
•Technical Assistance
• Factors that Impact Success
• Long Range Sustainability Strategy
• What’s the Right Way to Grow this Model
40
Communities for Life NNORC Development
For more information, contact:
Jennifer Bachman, MEd
Senior Projects Director
University of Indianapolis
Center for Aging & Community
317-791-5936
bachmanj@uindy.edu
LaNita Garmany, MS
Project Director
University of Indianapolis
Center for Aging & Community
317-791-5941
garmanyl@uindy.edu
Mia Oberlink, MA
Senior Research Associate
Center for Care Policy &
Research, New York
212-609-1537
mia.oberlink@vnsny.org
Fredda Vladeck, LMSW
Director
Aging in Place Initiative, United
Hospital Fund, New York
219-494-0750
fvladeck@uhfnyc.org
41