Supportive Services Programs in Naturally Occurring Retirement Communities. What Services are Typically Available in NORC Services Programs?

The 1997 report on the Naturally Occurring Retirement Community Supportive Services Program (NORC-SSP) from the New York City Department for the Aging is one of only a few published studies on service programs in NORCs that lists the categories of services provided.38 The categories are case management, emergency or general home care, meals, transportation, mental health and bereavement services, and informal supports. The NORC-SSP staff developed this complement of services by surveying residents about their needs.

Some information on available services can be gleaned from information on which services residents use. A survey of Penn South residents (no date provided) lists case management, information and referral, nursing services, classes and lectures, and health screenings as frequently used services.39 A survey of residents of Penn South and two other NORCs in 1996 found cultural events, exercise and dance classes, and health events among the most popular services.40 Such lists, however, do not represent a complete picture of services offered.

According to the subject matter experts, most NORC services programs provide transportation, housekeeping, and social activities or meals. These activities may be chosen because the lack of required licensed oversight makes them easier to provide. Casework and health care are often two core components of services programs, and program staff have found that health care education and preventive services such as blood pressure checks can be a good outreach technique for residents who may be more likely to get their blood pressure checked by a nurse than approach a social worker about health-related problems. Experts also noted that, in communities with no senior center or other such recreational organization, activities and recreation might become a central part of the program.

More literature is available on the range of services available in publicly funded housing for seniors, and these findings could apply to NORCs. The Service Coordinator Program (SCP), administered by HUD, is designed to meet the needs of older people and people with disabilities living in HUD-assisted housing. Under this program, service coordinators determine the needs of eligible residents, identify available community services including public programs for which residents might be eligible, link residents with needed services, monitor and evaluate service provision, and serve other functions as needed. An evaluation of the SCP found that transportation and housekeeping were the most frequently provided services.41 Other services included health screenings, exercise programs, and budget assistance.

A survey of HUD Section 202 housing residents found that services such as group dining, social work and counseling, and social and recreational activities were most likely to be provided by on-site staff.42 More personalized services, such as housekeeping, personal care, care management, medication management, and religious services, were usually provided by external agencies or contractors. Transportation and money management services were usually provided by family and friends.

Information from these studies shows that the most common services appear to be service coordination, transportation, group meals, and opportunities for socializing. Other health and personal care services appear less available. An agency may provide the services directly, it may facilitate delivery of services, or it may only provide residents with information and referral to service providers.

In general, these studies described the services offered or provided, not those that residents say they need. An agency may choose to offer those services residents have expressed an interest in, or that the agency knows from previous experience will be acceptable. It is also possible that an agency provides services it has provided in the past that it has found useful to the elderly, regardless of whether these services are the ones residents most need. In addition, the services needed may change over time. The literature did not discuss how agencies determine resident needs or if and how they adjust their offerings to resident preferences and changing needs.

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