1. 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 1

2. 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

3. 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

4. 4 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

5. 5 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.

6. 6 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

7. 7 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

8. 8 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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10. Introduction to the AdvantAge Initiative 10

11. 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 Community 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 Maximizes Independence Mobilizes resources to facilitate “living at home” Provides accessible transportation Supports family and other caregivers 11

12. ACTION EVALUATION INFORMATION DATA The AdvantAge Initiative Planning Process: Data Driven, Participatory Community Development 12

13. 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: 13

14. 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. –45 th among states for distribution of Long Term Care dollars versus community-based dollars –Long waiting lists for the CHOICE program 14

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16. 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

17. 17 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

18. 18 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.

19. 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

20. 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

21. 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

22. 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

23. 23 Using the NORC Blueprint to Inform NNORC Process Flowchart

24. 24 Using the NORC Blueprint to Inform NNORC Process Flowchart

25. 25 Flu Shot in the Past 12 Months Among People Aged 65 and Older Martindale/ Brightwood NNORC 2,5 Area 8 2,4 Indiana 2,3 National 1 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

26. 26 Diabetes 1 Among People Aged 65 and Older 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 NNORC 3,6 Area 8 3,5 Indiana 3,4 National 2 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

27. 27 Mammogram 1 Among Women Aged 65 and Older Huntington NNORC 3,6 Area 3 3,5 Indiana 3,4 National 2 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

28. 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 28

29. Shepherd Communities NNORC, Linton Empowering seniors to take action through community organizing 29

30. Huntington NNORC Providing opportunities for greater socialization, education and awareness 30

31. Martindale/Brightwood NNORC Seniors speaking out and voicing their concerns and perceptions 31

32. Engaging residents through focus groups and broad-based community-wide forums Gary Midtown NNORC 32

33. 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

34. 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 34

35. 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 35

36. 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 36

37. 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 NNORC Gary, IN 37

38. 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 NNORC Huntington, IN 38

39. 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

40. 40 Future NORC Development Technical Assistance Factors that Impact Success Long Range Sustainability Strategy What’s the Right Way to Grow this Model Lessons Learned

41. 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 Communities for Life NNORC Development 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 For more information, contact: 41