A partnership of the Indiana FSSA Division of Aging & the University of Indianapolis Center for Aging & Communit

1. 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

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 FreddaVladeck, 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. 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. 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. 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. 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. 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

10. Introduction to the AdvantAge Initiative

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

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

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:

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

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.

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. 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.

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.

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

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

23. Using the NORC Blueprint to Inform NNORC Process Flowchart

24. Using the NORC Blueprint to Inform NNORC Process Flowchart

25. Indiana’s Use of The AdvantAge Survey Flu Shot in the Past 12 Months Among People Aged 65 and Older Martindale/ Brightwood NNORC2,5 National1 Indiana2,3 Area 82,4 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 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.

26. Indiana’s Use of The AdvantAge Survey Diabetes1 Among People Aged 65 and Older Martindale/ Brightwood NNORC3,6 National2 Indiana3,4 Area 83,5 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). 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. 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.

27. Indiana’s Use of The AdvantAge Survey Mammogram1 Among Women Aged 65 and Older Huntington NNORC3,6 National2 Indiana3,4 Area 33,5 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). 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. 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.

28. 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

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

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

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

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

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

34. 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.

35. 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

36. 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

37. Gary Midtown NNORCGary, 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

38. Huntington NNORCHuntington, 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 senior-friendly website with a link from the HCCOA’s website • Train senior volunteers as resource information guides

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

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

41. 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