National Resource Center on Supportive Housing and Home Modification

I. INTRODUCTION

SLIDE ONE:

PLEASURE TO BE HERE TODAY,

NAME IS JULIE OVERTON.

SLIDE TWO:

I WORK FOR THE NATIONAL RESOURCE CENTER ON SUPPORTIVE HOUSING AND HOME MODIFICATION, HEADQUARTERED AT THE USC ANDRUS GERONTOLOGY CENTER

FUNDED BY THE ARCHSTONE FOUNDATION AND THE CALIFORNIA ENDOWMENT

THE CENTER’S MISSION IS TO MAKE SUPPORTIVE HOUSING AND HOME MODIFICATION A MORE INTEGRAL COMPONENT OF SUCCESSFUL AGING, LONG-TERM CARE, PREVENTIVE HEALTH, AND THE DEVELOPMENT OF ELDER-FRIENDLY COMMUNITIES.

WHAT WE DO:

APPLIED RESEARCH, EVALUATION AND POLICY ANALYSIS

TRAINING AND EDUCATION

TECHNICAL ASSISTANCE

INFORMATION CLEARING HOUSE

SINCE PART OF OUR MISSION IS TO DEVELOP ELDER-FRIENDLY COMMUNITIES ACROSS THE US, ONE KEY PART OF THIS IS OUR CREATION OF LOCAL COMMUNITY COALITIONS TO INCREASE HOME MODIFICATION AWARENESS AND AVAILABILITY.

WE HAVE BEEN WORKING WITH THE CALIFORNIA DEPARTMENT OF AGING, SENIOR HOUSING INFORMATION AND SUPPORT CENTER TO CREATE LOCAL COALITIONS IN CALIFORNIA. SHERI PEIFER IS GOING TO SHARE MORE WITH YOU ABOUT THAT. .

TODAY, I WILL DESCRIBE THE FUNCTION OF COALITIONS AND COALITION BUILDING,

WHY COALITIONS ARE IMPORTANT IN PROMOTING HOME MODIFICATION AVAILABILITY.

WE WILL GO THROUGH THE STEPS OF ACTUALLY CREATING A HOME MODIFICATION ACTION COALITION, INCLUDING WHO SHOULD INITIATE AND BE INVOLVED IN HOME MODIFICATION COALITIONS.

I’LL GIVE YOU AN OVERVIEW OF OUR EFFORTS TO SELECT AND IMPLEMENT HOME MODIFICATION COALITION SITES IN THE UNITED STATES.

MAXINE CULP, FROM THE VENTURA HOME MOD COALITION IS GOING TO TALK ABOUT HOW THEY “LAID THE GROUNDWORK” FOR THE COALITION: NEEDS ASSESSMENTS, DEVELOPING MISSION, GOALS AND OBJECTIVES, AND SETTING UP THE STRUCTURE, GOVERNANCE AND ADMINISTRATION.

THE FUN PART IS TALKING ABOUT THE THINGS A HOME MODIFICATION COALITION CAN ACCOMPLISH: THE ACTIVITIES! MARVIN SCHACTHER IS GOING TO GIVE YOU EXAMPLES OF PUBLICITY AND PROMOTION AND ADVOCACY AND SHARE A MAJOR HOME MODIFICATION COALITION ACTIVITY IN SOUTHERN CALIFORNIA, AN INTERACTIVE HOME MODIFICATION EXHIBIT, THAT WAS VERY SUCCESSFUL. YOU CAN DO IT TOO!

WE’LL END WITH “LESSONS LEARNED” AND CHALLENGES FOR THE FUTURE FOR HOME MODIFICATION COALITIONS

SLIDE THREE:

REAL QUICKLY, HERE IS HOW WE ARE DEFINING HOME MODIFICATIONS TODAY

HOME MODS: ADAPTATIONS TO THE HOME ENVIRONMENT THAT MAKE LIVING EASIER, SAFER, AND MORE COMFORTABLE

MAJOR: RAMPS, ROLL-IN SHOWERS, ELEVATORS

MINOR: GRAB BARS, WIDENED DOORS, LEVER HANDLES

SLIDE FOUR: “WHERE DO OLDER PEOPLE LIVE?” PIE CHART

AS MANY OF YOU MAY KNOW, MORE THAN 70% OF OLDER PERSONS LIVE IN THEIR OWN HOMES - PRIMARILY SINGLE FAMILY DWELLINGS.

THESE RESIDENTS EXPRESS A VERY STRONG PREFERENCE TO AGE IN PLACE - AARP STUDY FINDS THAT OVER 80% INDICATE THAT THEY WOULD LIKE TO STAY IN THEIR CURRENT DWELLINGS AND NEVER MOVE

UNFORTUNATELY, THEIR HOMES LACK THE SUPPORTIVE FEATURES AND PRESENT BARRIERS. HOWEVER, THEY MAY BE UNAWARE OF THE PROBLEMS AND DANGERS THEIR HOME PRESENTS BECAUSE THEY HAVE GRADUALLY ADAPTED THEIR ACTIVITIES AND LIVING PATTERNS TO ACCOMMODATE THEIR INCREASING LIMITATIONS. A SIGNIFICANT NUMBER OF ELDERS LIVE IN HOUSING THAT HAS DETERIORATED, LACKS SUPPORTIVE FEATURES OR PRESENTS BARRIERS TO MOBILITY.

SLIDE FIVE: SENIORS NEEDS FOR ASSISTANCE RISE WITH AGE

UNFORTUNATELY, MOST OF OUR CURRENT DWELLING UNITS CAN BE TERMED "PETER PAN HOUSING", DESIGNED FOR PERSONS WHO NEVER AGE. THEY WERE BUILT FOR YOUNG PERSONS AND THEIR FAMILIES WITH LITTLE RECOGNITION THAT THEIR RESIDENTS WOULD "AGE IN PLACE". CONSEQUENTLY, A HOUSE THAT MET A PERSON’’S NEEDS WHEN THEY WERE YOUNGER MAY BECOME INACCESSIBLE, UNSUPPORTIVE AND EVEN HAZARDOUS WITH AGING.

SLIDE 6: ONLY HALF OF THE DISABLED SENIORS HAVE THE HOME MODIFICATIONS THEY NEED.

ACCORDING TO THE 1995 AMERICAN HOUSING SURVEY (AHS), ONLY ABOUT HALF OF THE ELDERLY DISABLED HOUSEHOLDS HAVE THE HOME MODIFICATIONS THEY NEED.

THIS LEAVES HUNDREDS OF THOUSANDS OF SENIORS WITHOUT THE STRUCTURAL MODIFICATIONS THAT WOULD HELP THEM FUNCTION MORE EASILY AT HOME.

SLIDES 7, 8, AND 9: THE THREE MOST COMMON AREAS OF THE HOME THAT PRESENT CHALLENGES TO OLDER PERSONS ARE: 1) ACCESS IN AND OUT OF THE HOME; 2) THE BATHROOM; AND 3) STAIRS INSIDE THE HOME.

THE MOST COMMON AREAS OF THE HOME THAT PRESENT CHALLENGES TO OLDER PERSONS:

1.ACCESS IN AND OUT OF THE HOME

THE MOST COMMON AREAS OF THE HOME THAT PRESENT CHALLENGES TO OLDER PERSONS:

BATHROOM

THE MOST COMMON AREAS OF THE HOME THAT PRESENT CHALLENGES TO OLDER PERSONS:

STAIRS

2. IN 1970, ALMOST 3/4 OF HOMES BUILT WERE ONE-STORY

3. IN 1993, MORE THAN HALF OF THE NEW HOMES BUILT HAD STAIRS

SLIDE 10:

MY COLLEAGUES AT ANDRUS AND I ARGUE THAT THE FAILURE TO INCLUDE HOME MODIFICATIONS AS AN INTEGRAL COMPONENT OF LONG TERM CARE IS ONE OF THE SINGLE LARGEST IMPEDIMENTS TO DEVELOPING A COMPREHENSIVE COMMUNITY-BASED CARE SYSTEM.

THE CHALLENGE IS “HOW CAN WE INCREASE THE LEVEL OF HOME MODIFICATION ACTIVITY AND AWARENESS AT THE LOCAL LEVEL TO ENSURE THAT IT IS INTEGRATED WITH OTHER PROGRAMS, POLICIES AND FUNDING?”

OR RATHER:

HOW CAN COMMUNITIES CAN INCREASE HOME MODIFICATION AWARENESS AND ACTIVITIES THROUGH COALITION BUILDING

SLIDE 11:

SO WHAT IS THE FUNCTION OF COALITIONS AND COALITION BUILDING?

I. THE FUNCTION OF COALITIONS AND COALITION BUILDING

WHILE FEDERAL AND STATE OFFICIALS GRAPPLE WITH THE ISSUES OF AN AGING AMERICA, AT THE LOCAL LEVEL IT IS INCREASINGLY IMPORTANT THAT INDIVIDUALS WITH VARIOUS TYPES OF EXPERTISE COME TOGETHER TO SOLVE ISSUES THAT IMPACT THEIR COMMUNITY.

THE BENEFITS OF CURRENT HOME MODIFICATION INFORMATION AND SERVICES REMAIN INACCESSIBLE TO THE MAJORITY OF THE ELDERLY AND PERSONS WITH DISABILITIES, PARTLY DUE TO POOR COORDINATION AMONG THE AGING, DISABILITY, AND HOUSING COMMUNITIES.

WHY LOCAL COALITIONS?

IN LAYMAN TERMS, COALITIONS ARE A WAY TO GET THINGS DONE THAT ARE NOT BEING DONE, OR NOT BEING DONE WELL ENOUGH, BY OUR EXISTING PUBLIC, PRIVATE OR NONPROFIT ORGANIZATIONS. WITH RESOURCES STRETCHED AND NON PROFIT AND PRIVATE SECTOR ORGANIZATIONS STRUGGLING TO RESPOND TO AN AGING SOCIETY, COMMUNITY BASED COALITIONS CAN HELP SOLVE PROBLEMS.

SLIDE 12:

WHAT ARE THE BENEFITS OF COALITIONS?

1) CONSENSUS: DECISION MAKERS MORE LIKELY TO SUPPORT AN ISSUE IF BROAD CONSENSUS IS DEMONSTRATED;

2) EDUCATION: OPPORTUNITY TO EDUCATE THE COMMUNITY AND INCREASE AWARENESS

3) STRATEGIC PLANNING: DEVELOP MORE COMPREHENSIVE NEEDS ASSESSMENT AND SERVICE PLANNING INFORMATION; CRITICAL ISSUES CAN BE PRIORITIZED UNITED FRONT ON A GOAL; RATHER THAN HAVING A NATIONAL OR STATE ORGANIZATION PICK AN ISSUE AND TELL THE COMMUNITY WHAT TO DO, THE IDEA HERE IS TO LET THE COMMUNITY DECIDE WHICH ISSUES ARE MOST IMPORTANT;

4) MAXIMIZE RESOURCES: COORDINATING EXISTING AND POTENTIAL RESOURCES CAN EXPAND THE EFFECTIVENESS OF THE RESOURCES. RESOURCES WHICH CAN BE SHARED INCLUDE STAFF SKILLS, PUBLICATIONS, MEDIA CONTACTS, PROVIDER NETWORKS, EQUIPMENT AND FACILITIES, SERVICES, KNOWLEDGE, AND EXPERIENCE. IN ADDITION, NEW RESOURCES THAT COULD SUPPORT THE ISSUE MAY BE IDENTIFIED.

5) CONNECTIONS: CREATES NEW RELATIONSHIPS AND ENABLES EXISTING GROUPS AND PROFESSIONALS TO RECOGNIZE EACH OTHER AS STAKEHOLDERS IN A COMMON PURPOSE

6) COLLABORATION: DECREASES FRAGMENTATION AND MISCONCEPTIONS AMONG POLARIZED INTEREST GROUPS, EACH WITH SEPARATE DEMANDS ON SERVICES AND RESOURCE; THE COMMUNITY CAN BE THE LOSER IF VARIOUS PLAYERS PURSUE RESPECTIVE INTERESTS SEPARATELY (E.G., GOVERNMENT FUNDING)

7) PROFESSIONAL DEVELOPMENT: COALITION MEMBERS’ KNOWLEDGE BASE IS EXPANDED AND THEN BROUGHT BACK TO THEIR AGENCY OR AFFILIATION AND WORK IN THE COMMUNITY

THE USE OF STRUCTURED GROUPS SUCH AS TASK FORCES AND COALITIONS TO ENHANCE COLLABORATION AND CONSENSUS BUILDING IS NOT A NEW APPROACH. HOWEVER, COALITIONS FOCUSED ON HOUSING HAVE HISTORICALLY CONCENTRATED ON AFFORDABILITY, ZONING, REGULATIONS, COMMUNITY DEVELOPMENT, AND BUILDING CODES CONCERNING HEALTH AND SAFETY.

SLIDE 14:

WHY COALITIONS ARE IMPORTANT IN HOME MODIFICATION

HOME MODIFICATION COALITIONS ARE IMPORTANT FOR SEVERAL REASONS:

$ WHILE A LOT OF POLICIES AND PROGRAMS ARE INSTIGATED AT THE STATE AND NATIONAL LEVELS, WHERE IMPLEMENTATION IS CARRIED OUT IS IN COMMUNITIES. SOME EXAMPLES THAT RELATE TO HOME MODIFICATIONS IS THE AMERICANS WITH DISABILITIES ACT (ADA) AND THE FAIR HOUSING AMENDMENTS ACT (FHAA). THESE WERE PASSED AS FEDERAL LEGISLATION BUT THE IMPLEMENTATION AND OVERSIGHT IS LEFT UP TO LOCAL COMMUNITIES.

A HOME MODIFICATION ACTION COALITION HELPS A COMMUNITY TO TAKE “OWNERSHIP” OF THE ISSUE. THIS IS ESPECIALLY IMPORTANT WITH HOME MODIFICATIONS, SINCE IT TENDS TO FALL THROUGH THE CRACKS OF HOUSING, DISABILITY AND HEALTH PROGRAMS.

$ HOME MODIFICATIONS IS MULTIDISCIPLINARY. IT RELATES TO HOUSING ISSUES, DISABILITY ISSUES AND AGING ISSUES. YET MOST TASK FORCES OR GROUPS THAT ARE SET UP FOCUS ON ONE OR THE OTHER WITHOUT BRINGING IN PROFESSIONALS AND DISCUSSIONS FROM ALL SIDES.

HOME MODIFICATION COALITIONS ENCOURAGE THE INVOLVEMENT OF INDIVIDUALS WITH DIFFERENT BACKGROUNDS IN SOCIAL CHANGE. THE MANY DIFFERENT TYPES OF PROFESSIONALS INVOLVED IN HOME MODS BECOME PART OF THE BIG PICTURE OF PLANNING HOME MODIFICATIONS FOR THEIR COMMUNITY, RATHER THAN THEIR ISOLATED PROFESSIONAL WORK. SINCE THE WORK IS DONE IN A GROUP, THERE IS MUCH OPPORTUNITY TO BUILD ON EACH OTHER’S IDEAS.

$ EXPAND FUNDING. HOME MODIFICATION COALITIONS HELP PUT THE ISSUE ON THE AGENDA OF FUNDERS AND DECISION MAKERS. FOR EXAMPLE, IN OUR STUDY OF HOME MODIFICATION FUNDING SOURCES, WE FOUND THAT COMMUNITY DEVELOPMENT BLOCK GRANTS (CDBGS) ARE THE MOST COMMON SOURCE OF PUBLIC FUNDING FOR HOME MODIFICATIONS. HOWEVER, MANY COMMUNITIES HAVE NOT EVEN TAPPED INTO CDBG MONEY FOR HOME MODIFICATIONS.

.UNLESS A UNITED VOICE IS HEARD FOR HOME MODIFICATION FUNDING, CDBG FUNDS WILL CONTINUE TO FALL TO OTHER INTERESTS. THIS IS JUST ONE EXAMPLE OF HOW A COALITION CAN IMPACT AGENDA SETTING AND RESULT IN TANGIBLE OUTCOMES.

$ SOCIAL SERVICE SYSTEM INTEGRATION. COALITIONS CAN HELP IMPROVE THE WAY A LOCAL SYSTEM OF CARE IS ORGANIZED AND ENSURE THAT HOME MODIFICATIONS ARE INTEGRATED INTO THE HOME AND COMMUNITY BASED CARE SYSTEM.

$ PREPARE FOR THE FUTURE. COALITIONS PREPARE THE COMMUNITY TO ADAPT TO MEET THE LIFESTYLES AND NEEDS OF THE GROWING NUMBERS OF OLDER PEOPLE, WHILE AT THE SAME TIME PREPARING FOR AGING BABY BOOMERS. HOME MODIFICATIONS HELP SUPPORT CONTINUITY OF LIFESTYLE FOR ITS RESIDENTS AND THE COALITION MAY ALSO ADDRESS UNIVERSAL DESIGN WHICH WILL IMPACT THE HOUSING STOCK LONG TERM.

SLIDE 15:

$ STIMULATE DEMAND THE INCREASE OF MOST PRODUCTS AND SERVICES DEPENDS ON DEMAND FROM CONSUMERS. THE TRADITIONAL SUPPLY AND DEMAND SCENARIO BREAKS DOWN SOMEWHAT WITH HOME MODIFICATIONS. IN TERMS OF DEMAND, CONSUMERS ARE ACCUSTOMED TO MAKING DO WITH WHAT THEY HAVE AND DON’T REALIZE ALTERNATE PRODUCTS AND ENVIRONMENTAL DESIGNS THAT MAY BE MORE CONVENIENT AND SAFER TO USE. THERE ARE FEW ADVERTISEMENTS, IF ANY, ON TELEVISION OR IN GENERAL CONSUMER PRINT PUBLICATIONS THAT TOUT THE DESIRABILITY, BEAUTY AND BENEFITS OF ACCESSIBLE MODIFICATIONS. DEMAND IS LOW BECAUSE RECOGNITION IS LOW. THUS, THE SUPPLY OF QUALIFIED PROVIDERS, FUNDING SOURCES, AND PRODUCTS COALITIONS HELP STIMULATE DEMAND FOR HOME MODIFICATIONS BY EDUCATING THE CONSUMER AS WELL AS THE PROFESSIONAL IN THE COMMUNITY

SLIDE 16:

IIA. WHAT IS A HOME MODIFICATION ACTION COALITION?

SO...WHAT IS A “HOME MODIFICATION ACTION COALITION?” OUR NATIONAL RESOURCE CENTER ON SUPPORTIVE HOUSING AND HOME MODIFICATION CREATED A FORMAL DEFINITION OF A HOME MODIFICATION ACTION COALITION:

A HOME MODIFICATION ACTION COALITION INVOLVES THE ORGANIZED PARTICIPATION OF PROFESSIONALS AND CONSTITUENCIES THAT ARE EITHER DIRECTLY OR INDIRECTLY INVOLVED WITH HOME MODIFICATIONS.

THE COALITION MEMBERS HAVE A FORMAL SUSTAINED COMMITMENT TO ACHIEVE A CLEARLY DEFINED MISSION OR PURPOSE.

LOCAL LEADERSHIP IS DEVELOPED TO MOBILIZE RESOURCES AND ORGANIZE SUPPORT ON BEHALF OF THE HOME MODIFICATION NEEDS OF THE COMMUNITY.

THE COALITION INCREASES AWARENESS ABOUT HOME MODIFICATION NEEDS IN THE COMMUNITY AND WORKS TO INCREASE THE NUMBER OF ACTIVITIES UNDERTAKEN THAT FOCUS ON DEVELOPING HOME MODIFICATIONS.

WE INCLUDE THE WORD “ACTION” BECAUSE TANGIBLE OUTCOMES AND SUCCESSES RESULT FROM THE COALITION=S ACTIVITIES - THE COALITION IS NOT DESIGNED SIMPLY FOR NETWORKING AND PROFESSIONAL DEVELOPMENT BUT RATHER TO INSTIGATE CHANGE.

SLIDE 17:

IIC. IMPORTANCE OF LEAD COORDINATOR: WHO SHOULD INITIATE LOCAL COALITIONS?

A HOME MODIFICATION COALITION SHOULD NOT BE ASSOCIATED OR DOMINATED BY ANY ONE GROUP OR PROFESSIONAL.

AT THE SAME TIME, COALITIONS BY THERE VERY NATURE ARE INHERENTLY UNSTABLE. A GROUP OF INDIVIDUALS COMING TOGETHER FOR A COMMON PURPOSE ARE LIKELY TO DRIFT BACK TOWARD THEIR INDEPENDENT ROLES RATHER THAN REMAIN IN THE COALITION.

A LEAD COORDINATOR OF A HOME MODIFICATION ACTION COALITION MAKES A COMMITMENT TO ENSURE THAT THE COALITION FOCUSES ON THE COMMUNITY, NOT INDIVIDUAL GOALS OF COALITION MEMBERS.

WHAT SPECIFIC RESPONSIBILITIES DOES THE LEAD COORDINATOR PLAY IN THE HOME MODIFICATION ACTION COALITION?

$ ASSEMBLES COALITION

$ COORDINATES MEETINGS, LEADS MEETING DISCUSSIONS AND KEEPS PARTICIPANTS ON TRACK

$ KEEPS COALITION FOCUSED ON PRIORITIES AND GOALS

$ CONTINUALLY REINFORCES IN COALITION MEMBER’S MINDS WHY THEY WERE BROUGHT TOGETHER IN THE FIRST PLACE

$ ENSURES COALITION IS WELL ORGANIZED

$ INTERVENES WITH TURF ISSUES AND CONFLICTS

$ ENCOURAGES COOPERATION AND INTERPERSONAL RELATIONS AMONG COALITION MEMBERS

$ PROVIDES OVERSIGHT OF ACTIVITIES AND CONDUCTS FOLLOW UP

$ INITIATES EVALUATIONS AND PROVIDES UNBIASED FEEDBACK

WHO SHOULD INITIATE COALITIONS AND ACT AS THE LEAD COORDINATOR?

THERE IS NO ONE CORRECT ANSWER TO THIS QUESTION. WHETHER OR NOT A LEAD COORDINATOR IS APPROPRIATE DEPENDS ON THE SPECIFIC CULTURE OF THE COMMUNITY, THE STATURE AND POSITION OF THE LEAD COORDINATOR IN THE COMMUNITY, HOW RESPECTED AND ENTRENCHED THEY ARE IN THE COMMUNITY, THE HISTORY OF HOME MODIFICATION ACTIVITY, AND THE RESOURCES AT HAND.

WE CAN THINK ABOUT THIS IN TERMS OF THE SECTORS THAT ARE DIRECTLY OR INDIRECTLY INVOLVED WITH HOME MODIFICATIONS: HOUSING, AGING, DISABILITY, AND HEALTH. THERE ARE PROS AND CONS TO EACH OF THESE GROUPS SERVING AS LEAD COORDINATOR FOR A HOME MODIFICATION ACTION COALITION.

FROM THE AGING ARENA,

$ AREA AGENCIES ON AGING

$ CITY’S SENIOR COMMISSION

$ SENIOR CENTER

$ LOCAL NONPROFIT ASSOCIATIONS: THE ARTHRITIS FOUNDATION, AARP

FROM THE HOUSING ARENA,

$ CITY OR COUNTY HOUSING AND COMMUNITY DEVELOPMENT DEPARTMENT.

$ LOCAL HOUSING FINANCE AGENCY

$ REGIONAL HUD OFFICE

$ LOCAL NONPROFIT HOUSING ASSOCIATIONS: CHRISTMAS IN APRIL, HABITAT FOR HUMANITY

FROM THE DISABILITY ARENA,

$ AMERICANS WITH DISABILITIES ACT ADVISORY BOARDS

$ CENTERS FOR INDEPENDENT LIVING

$ ASSISTIVE TECHNOLOGY CENTERS

FROM THE HEALTH ARENA,

$ LOCAL COMMUNITY HOSPITAL

$ CITY OR COUNTY HEALTH DEPARTMENT

$ VISITING NURSES ASSOCIATION

IID. IDENTIFICATION OF COALITION MEMBERS AND ROLES

ONE OF THE MOST IMPORTANT STEPS IN CREATING A SUCCESSFUL HOME MODIFICATION ACTION COALITION IS IDENTIFYING INDIVIDUALS TO SERVE AS MEMBERS OF THE COALITION. SELECTING THE MEMBERS COULD BE A “TRAP IN STARTING” (SCHINDLER-TRAINMAN, ET. AL., 1980) AND ULTIMATELY, COULD BE A TRAP IN HAMPERING THE COALITION’S ENDURANCE. A CORE GROUP THAT IS COMMITTED AND ENTHUSIASTIC IS NEEDED TO GET THE COALITION OFF THE GROUND.

THE CHALLENGE IS TWO-FOLD: FIRST, TO ASSURE THERE IS BROAD-BASED REPRESENTATION ON THE COALITION OF THE VARIOUS CONSTITUENT GROUPS AFFECTED, SO THAT THERE IS BROAD-BASED SUPPORT;

AT THE SAME TIME, THE CHALLENGE IS TO SELECT MEMBERS WHO WILL WORK WELL TOGETHER IN A COALITION THAT IS MANAGEABLE, COOPERATIVE AND NOT UNWIELDY.

THROUGHOUT OUR HOME MODIFICATION ACTION COALITION EXPERIENCE, I HAVE REALIZED THAT AT THE CORE OF THE COALITION IS SHARED VALUES, SUCH AS INDEPENDENCE, DIGNITY, CONSUMER CHOICE...AND AT THE CORE OF THOSE VALUES IS PASSION.

SLIDE 18:

WHO?

WHEN SELECTING HOME MODIFICATION ACTION COALITION MEMBERS, TAKE A GLOBAL VIEW OF THE RESOURCES IN YOUR AREA. NO OUTSIDE AGENCIES, NONPROFITS, OR BUSINESSES SHOULD REMAIN UNTAPPED AS POSSIBLE MEMBERS.

IT IS CRUCIAL THAT COALITION MEMBERSHIP INCLUDES THE PEOPLE WHOM THE PLANS AND DECISIONS OF THE COALITION DIRECTLY AFFECT (E.G., OLDER CONSUMERS, CAREGIVERS, INDIVIDUALS WITH DISABILITIES).

IN ADDITION, ONE KEY TO THE COALITIONS’ SUCCESS WAS THE IDENTIFICATION AND INVOLVEMENT OF WELL-POSITIONED AND VISIBLE COMMUNITY AND STATE LEADERS. THIS INCLUDED CITY COUNCIL MEMBERS, WELL KNOWN CIVIC MEMBERS, REPRESENTATIVES OF THE “FUNCTIONAL SECTORS” OF THE COMMUNITY (CITY OFFICES) AND KEY LEGISLATIVE OFFICIALS SUCH AS STATE ASSEMBLY AND STATE SENATORS.

OTHER EXAMPLES OF COALITION MEMBERS INCLUDE ALL SECTORS RELATED TO HOME MODIFICATION: HEALTH, HOUSING, AGING, AND DISABILITY.

ARCHITECTS

AREA AGENCY ON AGING,

ASSISTIVE TECHNOLOGY CENTERS, PROFESSIONALS, GROUPS

BUILDING SUPPLIERS/HARDWARE STORES

CAREGIVERS AND HOME MODIFICATION USERS/CONSUMERS

CENTERS FOR INDEPENDENT LIVING,

CHAMBER OF COMMERCE

CITY DISABILITY ACCESS COMMISSION AND/OR ADA IMP. DEPARTMENT

CITY OR COUNTY HEALTH DEPARTMENTS

CITY OR COUNTY HOUSING AND COMMUNITY DEVELOPMENT DEPARTMENT

CITY SENIOR COMMISSION

CONTRACTORS

FOUNDATIONS

HMOS AND HOSPITALS

HOME MODIFICATION PROGRAMS

INTERIOR DESIGNERS

LOCAL CIVIC ASSOCIATIONS

MAYOR’S OFFICE

OCCUPATIONAL THERAPISTS

PHYSICAL THERAPISTS

PHYSICIANS AND NURSES

REALTORS

REGIONAL HUD OFFICE

RELIGIOUS ORGANIZATIONS

REMODELERS

REPRESENTATIVES FROM AREA COMMUNITY COLLEGES OR UNIVERSITIES

SENIOR CENTERS

SOCIAL SERVICE AND HOME HEALTH CARE AGENCIES

STATE ASSEMBLY AND SENATE REPRESENTATIVES

STATE AND LOCAL ASSOCIATIONS OF GROUPS AFFILIATED WITH HOME MODIFICATIONS

SLIDE 19:

ROLES OF COALITION

STEERING COMMITTEE MEMBERS (NAAAA, 1992)

1. PROVIDE TECHNICAL ASSISTANCE REGARDING DEVELOPMENT OF COALITION ACTIVITIES

2. SERVE AS AN INTERMEDIARY TO INTRODUCE COALITION TO OTHER INFLUENTIAL LEADERS IN THE COMMUNITY

3. PARTICIPATE ON A WORKING GROUP SUBCOMMITTEE

4. ATTEND STEERING COMMITTEE MEETINGS EVERY OTHER MONTH

5. PROVIDE THE COALITION ACCESS TO INFORMATION ABOUT SERVICES, GAPS, AND CURRENT PROGRAMS AND VOLUNTEER ORGANIZATIONS

6. HELP THE COALITION GAIN VISIBILITY AND RECOGNITION THROUGH EXISTING COMMUNICATION CHANNELS AND MEDIA CONTACTS ALREADY ESTABLISHED BY THEIR ORGANIZATION

7. LET THE COALITION KNOW OF PAST SPONSORS AND COLLABORATING ORGANIZATIONS WHO SUPPORTED PREVIOUS COMMUNITY PROGRAMS

8. ASSIST THE COALITION IN RESOURCE DEVELOPMENT (FOR EXAMPLE, HOLDING SPECIAL FUNDRAISING EVENTS, DEVELOPING A VOLUNTEER PROMOTION PROGRAM)

9. ADVOCATE ON BEHALF OF THE COALITION THROUGH SUCH ACTIVITIES AS: A) TESTIFYING OR MAKING PRESENTATIONS AT LOCAL AND STATE LEGISLATIVE HEARINGS OR MEETINGS; OR B) MEET WITH ELECTED OFFICIALS TO ACQUAINT THEM WITH THE NEEDS IN THEIR JURISDICTION

SLIDE 20:

B. NEEDS ASSESSMENT AND PROBLEM IDENTIFICATION : ESTABLISHING THE BASELINE

“ESTABLISHING THE BASELINE” FOR THE COALITION AND ITS ACTIVITIES INCLUDES: NEEDS ASSESSMENT AND PROBLEM IDENTIFICATION

1. WHAT IS THE GEOGRAPHIC FOCUS?

IT IS IMPORTANT TO DEFINE A COMMUNITY OF APPROPRIATE AND MANAGEABLE SIZE FOR COALITION-BUILDING ENDEAVORS.

IS IT THE NEIGHBORHOOD? A VILLAGE OF THE CITY? THE ENTIRE CITY? THE COUNTY? DOES IT CROSS CROSS POLITICAL BOUNDARIES?

IT MIGHT BE TEMPTING TO TARGET AN ENTIRE CITY, BUT KEEP IN MIND: “ONE SIZE DOES NOT FIT ALL.” IF YOUR CITY HAS A LARGE POPULATION, IT MIGHT BE MORE DIFFICULT TO MAKE A NOTICEABLE IMPACT.

2. IDENTIFICATION OF TARGET POPULATION: BEYOND THE GEOGRAPHIC FOCUS, THE COALITION SHOULD AGREE ON THE TARGET POPULATION. NOTE THAT YOU MAY START OUT WITH A SPECIFIC TARGET POPULATION (OLDER INDIVIDUALS) AND EVENTUALLY MOVE TO A LARGER POPULATION (UNIVERSAL DESIGN NEEDS OF ALL RESIDENTS).

3. WHAT ARE THE UNMET NEEDS FOR HOME MODIFICATION IN THE COMMUNITY?

THE PURPOSE IS TO CLARIFY UNMET NEEDS FOR HOME MODIFICATIONS IN THE COMMUNITY, THE PROBLEMS AND BARRIERS THAT MIGHT INHIBIT HOME MODIFICATION AWARENESS AND ACTIVITY, AND TIE THESE FACTORS IN TO THE COALITION MISSION, GOALS AND OBJECTIVES.

SLIDE 21:

SET MISSION, GOALS AND OBJECTIVES

AFTER THE INITIAL INTRODUCTION AND GATHERING OF THE COALITION MEMBERS, THE NEXT STEP FOR THE COALITION IS TO JOINTLY DETERMINE THE MISSION, GOALS OBJECTIVES, AND ANTICIPATED SHORT AND LONG TERM ACTIVITIES.

WHILE INCREASING HOME MODIFICATION ACTIVITY AND AWARENESS MAY BE THE OVERALL PURPOSE OF THE COALITION, THE COALITION NEEDS TO CONCENTRATE ON SPECIFIC GOALS THAT ARE TIED TO MEETING CURRENT NEEDS, FILLING GAPS, AND ADDRESSING PROBLEMS RELATED TO HOME MODIFICATION IN THE COMMUNITY.

SLIDE 26:

VIII. LESSONS LEARNED AND CHALLENGES FOR THE FUTURE

WE HAVE REFERRED TO THE MANY CHALLENGES AND OPPORTUNITIES OF BUILDING HOME MODIFICATION ACTION COALITIONS. HOPEFULLY, WE HAVE STIMULATED YOUR INTEREST IN PERHAPS FORMING OR AT LEAST SERVING ON SUCH A COALITION. THE FOLLOWING LIST CONTAINS SOME “LESSONS LEARNED” FROM OUR EXPERIENCE WITH HOME MODIFICATION ACTION COALITIONS ACROSS THE COUNTRY.

1. THE KEY TO THE COALITIONS SUCCESS IS COALITION MEMBER COMMITMENT. PEOPLE START OFF EAGER BUT UNLESS THEY SEE THAT THEY WILL GET SOMETHING OUT OF THEIR COALITION MEMBERSHIP AND THAT THE COALITION IS ORGANIZED AND DIRECTED, THIS IS A VOLUNTARY EFFORT AND THEIR INTEREST WILL WANE.

2. TIMING OF EVENTS: WHILE THE COALITION SHOULD IDENTIFY SOME IMPORTANT IMMEDIATE ACTIVITIES, IT IS IMPORTANT TO HAVE A LONG TERM PERSPECTIVE. ACTIVITIES TAKE TIME TO PLAN AND OPPORTUNITIES NEED TO BE ANTICIPATED DOWN THE ROAD. A 1-YEAR, 3-YEAR AND 5-YEAR PLAN IS HELPFUL. THE FIRST ACTIVITY SELECTED SHOULD BE SOMETHING THAT HAS A REASONABLE CHANCE OF SUCCESS AND HAS GREAT CONSENSUS. SUCCESS IS A WONDERFUL MOTIVATOR FOR CONTINUED ACTION AND INTEREST.

3. FOLLOW-THROUGH AND GUIDANCE IS A MUST FROM A LEAD COORDINATOR AND/OR A LEAD AGENCY. AT THE SAME TIME, BROAD EXPERTISE IS NECESSARY SO THAT THE LEAD COORDINATOR’S AGENDA OR EXPERTISE DOES NOT DOMINATE THE COALITION. THE OVERALL PURPOSE OF THE HOME MODIFICATION ACTION COALITION IS TO INCREASE AND PROMOTE HOME MODIFICATION AWARENESS AND AVAILABILITY IN THE COMMUNITY AND NOT JUST TO PROMOTE ONE PROGRAM OR AGENDA.

4. INCREASING SUPPLY AND DEMAND GOES HAND-IN-HAND. WHEN YOU ORGANIZE ACTIVITIES THAT WILL ULTIMATELY INCREASE THE DEMAND FOR HOME MODIFICATION (E.G., EDUCATION, PROMOTION), YOU NEED TO INCREASE THE SUPPLY (E.G., SERVICES, FUNDING) AT THE SAME TIME.

5. A HOME MODIFICATION COALITION WILL INEVITABLY HAVE TO FOCUS ON UNIVERSAL DESIGN ISSUES. THE COALITION SHOULD CONSIDER ENVIRONMENTAL ISSUES RELATED TO BOTH NEW CONSTRUCTION AND EXISTING HOUSING AT THE SAME TIME

6. HOME MODIFICATION ACTION COALITIONS MUST TAKE ADVANTAGE OF EXISTING RESOURCES AND EFFORTS OF ORGANIZATIONS. EVEN THOUGH THE COALITION IS LOCAL, YOU CANNOT DO IT ALL ON YOUR OWN. –BENEFIT FROM THE EFFORTS OF NATIONAL ORGANIZATIONS AND BRING THEIR RESOURCES TO THE COMMUNITY LEVEL. FOR EXAMPLE, NATIONAL ASSOCIATIONS SUCH AS AARP, THE NATIONAL RESOURCE CENTER ON SUPPORTIVE HOUSING AND HOME MODIFICATION (US!) AND THE AMERICAN OCCUPATIONAL THERAPY ASSOCIATION HAVE EDUCATIONAL MATERIALS THAT CAN BE REPRODUCED OR ORDERED IN BULK. ORGANIZATIONS SUCH AS CHRISTMAS IN APRIL AND THE NATIONAL ASSOCIATION OF HOME BUILDERS HAVE REGIONAL TRAINING CONFERENCES THAT THE COALITION AND COMMUNITY MEMBERS COULD ATTEND.

7.DIALOGUE FOR THE SAKE OF DIALOGUE. WHILE GUIDELINES FOR DISCUSSION AND DECISION MAKING ARE IMPORTANT, ALLOWING THE GROUP TO “BRAINSTORM” STIMULATES CREATIVITY. MANY TIMES, HMAP WOULD PLAN AN AGENDA AND THE MEMBERS WERE EAGER TO DISCUSS A TIMELY COMMUNITY ISSUE. THE SIDE EFFECT OF THE COALITION IS JUST HAVING A FORUM FOR VARIED INTERESTS TO COME TOGETHER AND “VENT” ABOUT HOME MODIFICATION. SOME OF OUR BEST ACTIVITIES RESULTED FROM OFF-HAND CONVERSATIONS. THE COALITION CAN PROVIDE A NONJUDGMENTAL, FREE ATMOSPHERE FOR GENERATING NEW IDEAS AND STRATEGIES TO INCREASE HOME MODIFICATION AWARENESS AND ACTIVITY.

1. GOVERNANCE AND ADMINISTRATION IS IMPORTANT EVEN IN AN INFORMAL HOME MODIFICATION ACTION COALITION. DETERMINE WHO IS GOING TO SEND OUT NOTICES, RECORD AND DISSEMINATE MEETING MINUTES AND COORDINATE COMMITTEES. HOW WILL MEMBERS HAVE INPUT AS TO WHAT IS ON THE MEETING AGENDAS? ALLOW FOR GENERAL DISCUSSION ABOUT THE TOPIC AT MEETINGS. REVIEW MISSION STATEMENT AND GOALS PERIODICALLY .

ALTHOUGH OFTEN OVERLOOKED IN CURRENT LONG TERM CARE DISCUSSIONS, HOME MODIFICATIONS IS A CRITICAL COMPONENT THAT SIGNIFICANTLY AFFECTS HOW HOME AND COMMUNITY BASED SERVICES ARE DELIVERED AND FINANCED.

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WE SHAPE OUR DWELLINGS AND DWELLINGS SHAPE US...