On Wednesday, April 12, 2000 the New York Association of Realty Managers (NYARM) presented the second in a series of seminars scheduled for this year. Managing an Aging Population, moderated by Rochelle Captan, NYARM Executive Vice President and manager of Amalgamated Warbasse Houses in Brooklyn, was billed as "the new millennium issue."
For many years the NYARM newspaper has published articles about "aging in place" and the need for supportive services in developments that find themselves with an aging population. NORCs, as these sites came to be known, are Naturally Occurring Retirement Communities. When 50% of a building, or a development's population exceeds the age of 60 it can be labeled a NORC and thus apply for specific services and benefits. This seminar was assembled in order to bring to the audience the expertise and knowledge of a group of professionals ensconced in this field.
NORC SUPPORTIVE SERVICES
Ms. Captan serves on the Board of NORC Supportive Services, an organization founded in 1996 by a group of professionals in the fields of housing, medicine, social services, law, mental health, education and gerontology. Their major objective: to assist housing developments in responding to the special needs and problems of their senior citizen residents.
Ms. Captan is well familiar with NORCs and the problems of a senior tenancy. When she first took over as manager of Warbasse Houses 23 years ago she recognized the phenomenon that was taking place. Like many other moderately priced cooperative housing developments built in the early 1960s under the Mitchell-Lama law, Warbasse attracted people retiring from business, looking for affordable housing within the five boroughs. "By the late 70s," states Ms. Captan, "these people were becoming older and frailer. Many had lost their spouses and their children had moved away something had to be done for these people."
These aging residents needed the guidance of case workers, nurses and people trained to organize the well elderly as well as the frailer seniors. Currently, Warbasse has 1600 seniors participating in their NORC program, Warbasse Cares for Seniors. There is an on-site nurse who monitors blood pressure; a van to transport residents to the doctor; a psychiatrist and a chaplain to administer to mental health and "end of life" issues. Social workers do individual assessments and help forage community links with other providers. A respite program is available for people suffering from Alzheimer's and dementia.
Warbasse Cares for Seniors not only provides for the aging residents, they also work with Warbasse management, security and maintenance personnel who have been trained to recognize certain symptoms and manifestations that would indicate a resident needing supportive services.
Ms. Captan assembled the panel of speakers from those professionals that worked with her to develop Warbasse Cares for Seniors. Next to speak was Anita Altman, Deputy Managing Director of the Caring Commission for the UJA-Federation of New York, the largest local philanthropic organization in the world. The UJA is a network of more than 100 social service and health care organizations serving the New York metropolitan area. Ms. Captan introduced Ms. Altman as the "mother of NORC."
THE FIRST NORC PROGRAM
Ms. Altman informed the group that New York's population is aging, with seniors over 60 years of age comprising 18% of the population, more than the national average. The UJA is currently providing care for over 2 million New Yorkers. The UJA was contacted by the Board of Directors of Penn South in 1986. They described the "terrible problems that they, as a community, were facing as a majority of their residents were now senior citizens." Growing infirmities and mental health issues were beginning to take their toll and management was unable to provide the support services these individuals needed.
Thus, the Penn South Program for Seniors was born. A service program established on-site providing social, recreational, informational and referral, case management and community nursing services. The program helps link residents with community services: meals on wheels, home care, transportation, etc. It also provides an important nexus to attract other resources from the community. Penn South receives free psychiatric consultations since it's been selected as a training site for geropsychiatric fellows; two medical centers have opened geriatric practices on -site and the visiting Nurse Service is contributing a half-time nurse to perform non-reimbursable services. Volunteers are a major source of coverage and program extenders.
It was realized, from the Penn South experience, that the size and density of urban housing developments presented an opportunity to organize services for seniors efficiently and effectively. These on-site service programs enabled housing managers to get back to the business of maintaining and operating the buildings instead of handling the constant tenant crises that emerged as the aging population grew and the seniors became increasingly frail and infirm.
Financing the program was a challenge. The Board and the UJA did not want to turn the program into a reimbursement-based funding stream and the senior population was not comfortable with a fee for services structure. The challenge was to create a primarily communalized financing structure, one in which everyone participated through common carrying charges and government funding. In order to make government their partner they recognized the necessity to document the need for this program, to prove that Penn South was not an isolated case and a replicable model. In 1991, a study validated their theory, identified 250,000 households of moderate and low income seniors living in NORCs in New York City. Today, in New York City alone, ten moderate income co-ops and two public housing projects have UJA sponsored NORC programs on site.
AGING IN PLACE
Fredda Vladeck, Project Director for the United Hospital Fund's Aging In Place Initiative spoke next. Fredda was the founding director at Penn South, New York City's first comprehensive NORC program. A certified social worker for 25 years, Fredda has been an advocate for the needs of older people and vulnerable populations for many years.
According to Ms. Vladeck, in 30 years the senior population will double and 7% of the population (37 million people) will be 65 and over. It has been proven, through numerous surveys and polls, that the majority of people would rather age in their own homes, within their own communities and that Florida and Arizona retirements are more the exception than the rule. Ms. Vladeck predicts that taking care of the elderly will thus become a community effort and that Continuing Care Retirement Communities, adult homes and assisted living facilities will become part of the landscape of a neighborhood while the rest of the population remains in place.
STYLING THE PROGRAM
Next to address the audience was David Stern, the Executive Vice President of JASA, the Jewish Association for Services for the Aged. JASA is the largest community based geriatric social service agency in the country. In 1999, through programs of casework, counseling, housing, financial management, legal, group and homecare services JASA has helped more than 57,000 older adults in New York City and Long Island to function with dignity and autonomy in their homes and community.
According to Mr. Stern each NORC is unique as to its makeup and requirements and the program should be styled to the needs of the community. When entering into an agreement with any form of social services, a manager should hold the agencies to the same standards as they would a contractor. Clear expectations should be stated with an outline of specifications defined before any decision is rendered. A structure of governance needs to be determined as to who the NORC staff reports to. Will the manager be in charge, a committee, an individual board member? This decision is imperative to insure a smooth flow of communication between the program staff, volunteers, participants and the building staff and residents.
NORCs SAVE MONEY
Ed Yaker, Vice President of NORC Supportive Services and President of the Board at Amalgamated Houses in the Bronx had a great deal of personal experience to relate to the seminar attendees. He warned the group, "Don't isolate your senior program from the rest of the community. Seniors enjoy programs that include the non-seniors."
Seniors are the most effective lobbying group in the nation. For the most part they are well informed, conscious of social programs and have a lot of time on their hands. They have been successful in making government understand that by giving money to NORCs they save money. Making social services available on-site, in the long run, is a tremendous savings for all involved.
MANAGERS ARE IMPORTANT
Nat Yalowitz was introduced as the "father of NORCs." Nat is the President and CEO of NORC Supportive Services. He is the founding father of the Penn South Program for Seniors and a tireless advocate for the senior population of this city.
The NORC program at Penn South succeeded because, according to Nat, "the board and management were determined to see this project through. Without their understanding and support it would not have succeeded; and the co-op was determined to succeed." Nat suggests that the "NORC program at Warbasse Houses would never have gotten off the ground but for its General Manager, Rochelle Captan," thus his insistence that management is imperative to a successful NORC program.
There are certain risks that are involved in developing these programs and it requires a manager to have a special kind of understanding beyond an education based on the physical plant and local law compliance. Managers, in the normal course of a day's work, come across some of the human problems that senior residents pose: loss of keys; forgetfulness in paying maintenance charges, taking out the garbage, turning off a stove or faucet; locking themselves out of their apartments; etc. When managers recognize and embrace the trained professionals that can help seniors, they therefore help the entire development.
Managers benefit as well resulting in better tenant relations and use of housing company personnel; reduction of risk; resolution of complex social and individual resident problems; housing staff training; financial matters; handling of building crises; community relations the list goes on.
NORC supportive service programs depend on many organizations and people to be successful. Volunteers from the housing company and the Board of Directors become partners in the NORC program. "However, in no case can there be a successful program without the leadership of the manager and his/her involvement in the program," emphasized Mr. Yalowitz.
NORC Supportive Services is "enlightened social policy." New York City and State are the pioneers in on-site, government assisted programs for seniors. This success lays the groundwork for national growth and support from the federal government through HUD (Housing and Urban Development). According to Mr. Yalowitz, "Housing management professionals can rightfully feel proud of their place in it."