Supportive Services Programs in Naturally Occurring Retirement Communities. APPENDIX 3. Comparison of the Conceptual Model by NORC Sites

COMPARISON OF THE CONCEPTUAL MODEL BY NORC SITES
  Baltimore's Senior Friendly Neighborhoods (SFN) Cleveland's Community Options Program Philadelphia's STAR NORC Program Pittsburgh's NORC Demonstration Program St. Louis's NORC Project
NORC Definition Residents 62 and older living in Baltimore's Upper Park Heights neighborhood and the Milbrook building. Services provided in 13 buildings with plans to expand to neighborhoods with row houses and single family homes. NORC program exists in 5 private apartment buildings east of the Cuyahoga River in Cleveland. NORC is comprised of 4 cooperative buildings and 1 condominium located in the Center City section of Philadelphia. Adults 60 and older living in Squirrel Hill, Point Breeze, Regent Square, Swisshelm Park, Oakland, and Greenfield neighborhoods. Used Census data to determine specific census tracts covering approximately 1 square mile in Creve Coeur, St. Louis, that contains a large proportion of older people and is the site of several Jewish community services.
Community Resources JCC, Myerberg Senior Center, Baltimore Hebrew University, synagogues and churches public library, shopping areas, public bus transportation, and a senior shuttle. Apartments are within walking distance of synagogues, shopping, and bus lines. Within walking distance of health care providers, access to public transportation, close proximity to Temple University and the University of Pennsylvania, museums, and restaurants. Social service organizations such as the JCC, JFCS, and JAA, 4 universities, libraries, a music hall, hospitals and mental health services, and public transportation. Service organizations such as JCC, JFCS, and a publicly funded senior congregate housing site (Covenant House/ CHAI), churches, grocery store, kosher restaurant, gas station, restaurant area with movie theater and gym.
NORC Formation
-  Internal Most residents have aged in place, living in their homes or apartments within the community for over 30 years. Long-term residents have aged in place, mostly widows. Most residents have aged in place. Most of the elderly have aged in place. Most have aged in place.
-  External Some older Russian immigrants who settled in the area in late 1980s. In migration of elderly residents in their 70s and 80s. Some in-migration of retirees moving from the suburbs into the city. In-migration of Soviet immigrant population in 1980s who are generally among the young elderly. Some older persons have moved to the neighborhood to be close to family, friends, or the JCC.
Organizational Structure
-  Internal SNF program developed an Advisory Council of resident member volunteers to facilitate resident involvement and empowerment. Resident advisory councils per building. Residents approached JFCS about need for a social worker in 1 building. In response, JFCS developed the STAR program.   Advisory committee of residents, members of community organizations, and state representatives to assist in development of NORC service program. Goal to have committee be the vehicle for communication with NORC residents.
-  External Coordinated by 4 Jewish community service organizations. Nurse and resident activities coordinator organize activities and events in NORC buildings. Began by Jewish Community Federation of Cleveland. A volunteer committee oversees the program. Resource coordinators organize activities and provide referrals to service providers. JFCS expanded the STAR program into STAR NORC. Social workers are key actors in program along with a nurse, community educator, and chaplain. Operated by three organizations under the United Jewish Federation. Three-member care teams comprised of one staff member from each sponsoring organization. Jewish Federation of St. Louis partnered with the Center for Aging at Washington University in St. Louis to conduct research on service program options and the community before designing its NORC service program.
Service Program
-  Internal Program has hired residents in buildings as on-site coordinators who seek input from residents, and help to publicize and organize activities. Two apartment buildings continue to have residence councils, floor captains, and phone trees that existed prior to SFN program. Outreach by resource coordinators to determine what seniors want from the program. Resident volunteers help publicize and organize events. Co-op board or condominium association hears from residents. Residents have monthly House Council meetings, part of which is open to all residents and the rest limited to floor representatives.   Conducting primary research to determine which NORC service programs will be most responsive to the elderly communities' needs.
-  External Case aides, nurse, and resident activity coordinator provide range of services including case management, information and referral to services, preventative health, recreational activities, and transportation. Social events, preventative health, and referrals to providers. Services social workers can arrange include in-home assessments and care plans, case management, home care, shopping, individual or family therapy, guidance on alternative living arrangements, support groups, outreach to Holocaust survivors, respite care, and spiritual counseling. Interdisciplinary care teams develop care plans based on in-home assessments. Provide information and referrals to community services.
Funding
-  Internal Small share of program's costs paid by resident member's annual $15 fee. Financial support from building management includes office space, use of party room, salary and benefits of resource coordinator, and program costs such as paper and copying. Residents pay for costs of activities. JFCS funding for the STAR NORC program comes from building fees ranging between $5,000 and $7,500 a year per building. Additional resident payments.    
-  External Combination of funding from the AoA grant, the Jewish Community Association of Baltimore, local foundations, and Baltimore County funding. HUD spend down grant covers overhead costs of main office. AoA grant used to replicate Community Options program in 4 other Ohio sites. JFCS used AoA grant money to expand the STAR program into STAR NORC. Addition funding includes grants from the Pew Charitable Trusts, and the Connelly, Tuttleman, and Clayman foundations. AoA grant and in-kind contributions from the 3 coordinating agencies. AoA grant used to fund research conducted by the Center for Aging at Washington University in St. Louis. Also received grant funding from State of Missouri and uses matching funds from sponsoring organizations.
Outcomes Collect information on the number of people attending programs and using the case aide service. Future plans include a survey of members and nonmembers with service users followed for 1 year and a process evaluation of the program's operations. Master database tracks participation in activities and houses a computerized referral list of providers. Database automatically alerts resource coordinators to follow up with residents referred to services. Staff remove service providers with a noted pattern of dissatisfaction from list. AoA grant money used to participate in Case Western Reserve University research project that will compare community-dwelling older people in Cleveland with residents in Community Options buildings. No formal outcome measures, but informal feedback has been obtained by program staff and from interviews with clients' families. Client fills out satisfaction form when a social worker closes a case. Program contracted with Unicentric, Inc., to create a virtual office with electronic formats and a client database that could be accessed by care teams and program staff who do not share a common office. No formal outcome measures, but informal feedback from clients has been positive. Program is considering implementation of a client satisfaction survey during the second grant year. No formal outcome measures developed at this time.

 

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