a partnership of the indiana fssa division of aging & the university of indianapolis center for...
TRANSCRIPT
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A partnership of the Indiana FSSA Division of Aging &the University of Indianapolis Center for Aging & Community
Communities for Life:Neighborhood Naturally Occurring Retirement Communities
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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
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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.
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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
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Definition of a NORC ProgramNORC 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.
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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
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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
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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
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Introduction to the AdvantAge Initiative
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Promotes Social and Civic Engagement
•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
Addresses Basic Needs
•Provides appropriate and affordable housing
•Promotes safety at home and in the neighborhood
•Assures no one goes hungry
•Provides useful information about available services
An Elder -Friendly
CommunityOptimizes 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
Maximizes Independence
• Mobilizes resources to facilitate “living at home”
• Provides accessible transportation
• Supports family and other caregivers
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ACTIONACTION
EVALUATIONEVALUATION
INFORMATIONINFORMATION
DATADATA
The AdvantAge Initiative Planning Process: Data Driven, Participatory Community Development
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• 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
AdvantAge Initiative Survey Conducted in:
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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
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Individual
Community
Support Services
Institution Based
Healthcare Delivery
Individual
Community
Support Services
Institution Based Healthcare Delivery
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
Phase III 7/1/08 -Communities for Life (NORC) -Hoosier Youth Providing for Elders (HYPE) -Aging and Disability Resource Center (ADRC) -Adult Guardianship Program Phase II 7/1/07 -Transportation -Affordable and Accessible Housing -Nutrition Services -Service Access (211) Phase I 7/1/06 -OPTIONS
-Assisted Living -Adult Foster Care -Adult Day Services
Community Dashboard
Project Completion
Cost Savings
Healthcare Outcomes
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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.
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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 community-based expansion
– Ask communities to take personal responsibility– Engage a broad range of stakeholders, including senior
residents themselves, to help seniors age in place
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Implementing the StrategyStatewide 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.
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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.
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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
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Communities for Life NNORC Development
Purpose of CFL Project:
Develop a model of an “elder friendly” community
Develop a method to measure community “elder-friendliness”
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
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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
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Using the NORC Blueprint to Inform NNORC Process Flowchart
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Using the NORC Blueprint to Inform NNORC Process Flowchart
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Flu Shot in the Past 12 Months Among People Aged 65 and Older
64%
73%78%
56%
0%
40%
80%
Martindale/Brightwood NNORC2,5
Area 82,4Indiana2,3National1
4 Area 8 includes Boone, Hamilton, Hancock, Hendricks, Johnson, Marion, Morgan, and Shelby Counties (Unweighted N=227; Weighted N=182,961).
3 Excludes Area 2 (Elkhart, Kosciusko, LaPorte, Marshall & St. Joseph Counties) which was surveyed in 2006 (Unweighted N=3,337; Weighted N=734,461).
5 Unweighted N=85; Weighted N=1,533.
1 Federal Interagency Forum on Aging-Related Statistics. Older Americans 2008: Key Indicators of Well-Being. Federal Interagency Forum on Aging-Related Statistics. Washington, DC: U.S. Government Printing Office. March 2008. Data for 2006.
2 AdvantAge Initiative Community Survey in Indiana, 2008
Indiana’s Use of The AdvantAge Survey
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Diabetes1 Among People Aged 65 and Older
18%
22% 23%
31%
0%
16%
32%
1 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).
Martindale/Brightwood NNORC3,6
Area 83,5Indiana3,4National2
6 Unweighted N=85; Weighted N=1,533.
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).
2 Federal Interagency Forum on Aging-Related Statistics. Older Americans 2008: Key Indicators of Well-Being. Federal Interagency Forum on Aging-Related Statistics. Washington, DC: U.S. Government Printing Office. March 2008.
Indiana’s Use of The AdvantAge Survey
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Mammogram1 Among Women Aged 65 and Older
64%60%
56%50%
0%
33%
66%
Huntington NNORC3,6Area 33,5Indiana3,4National2
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).
4 Excludes Area 2 (Elkhart, Kosciusko, LaPorte, Marshall & St. Joseph Counties) which was surveyed in 2006 (Unweighted N=1,786; Weighted N=423,327).
2 Federal Interagency Forum on Aging-Related Statistics. Older Americans 2008: Key Indicators of Well-Being. Federal Interagency Forum on Aging-Related Statistics. Washington, DC: U.S. Government Printing Office. March 2008.
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.
3 AdvantAge Initiative Community Survey in Indiana, 2008
Indiana’s Use of The AdvantAge Survey
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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
Communities for Life NNORC Development
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Shepherd Communities NNORC, Linton
Empowering seniors to take action through
community organizing
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Huntington NNORC
Providing opportunities for greater socialization, education and awareness
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Martindale/Brightwood NNORC
Seniors speaking out and voicing
their concerns and perceptions
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Engaging residents through focus groups and broad-based community-wide forums
Gary Midtown NNORC
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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
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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.
Communities for Life NNORC Development
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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
Shepherd Communities NNORC Linton, IN
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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
LaSalle Park NNORC South Bend, IN
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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
Gary Midtown NNORCGary, IN
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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 senior-friendly website with a link from the HCCOA’s website
Train senior volunteers as resource information guides
Huntington NNORCHuntington, IN
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Martindale/Brightwood Golden Ages NNORC
Banner Issue: Home modification related to accessibility in and around the home
Provide Home Safety Education and AwarenessPartner with MCHD, CICOA, and MBCDC to perform 30 home safety assessmentsEstablish 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 seminarsEnhance communication and involvement through a quarterly senior newsletter
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Future NORC Development
•Technical Assistance
• Factors that Impact Success
• Long Range Sustainability Strategy
• What’s the Right Way to Grow this Model
Lessons Learned
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Jennifer Bachman, MEdSenior Projects Director University of Indianapolis Center for Aging & [email protected]
LaNita Garmany, MSProject Director University of Indianapolis Center for Aging & [email protected]
Communities for Life NNORC Development
Mia Oberlink, MASenior Research Associate Center for Care Policy & Research, New [email protected]
Fredda Vladeck, LMSWDirector Aging in Place Initiative, United Hospital Fund, New [email protected]
For more information, contact:
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