May 2003
Volume 1, Issue 2

From the Director, Jon Pynoos
Welcome back to the Home Modification News, a quarterly newsletter from the National Resource Center on Supportive Housing and Home Modification. In this issue, we are proud to highlight the work of the Center's research assistants. From reading about them, we are sure you will agree that they represent the brightest and best in preparing to serve the senior population.
On a less happy note, the budget crisis facing California has already resulted in the elimination of the Senior Housing Informationand Support Center (SHISC), a program of the California Department of Aging (CDA). SHISC represented the state's commitment to providing seniors and the disabled population with information about home modifications. With the elimination of the SHISC, there is now no central group in California actively working to raise awareness and disseminate information about the important role of home modification.
The Center remains committed to continuing the efforts of the CDA in promoting aging in place for seniors and independent living for persons of all ages. Along these lines, the Center is involved in several new complementary areas including falls prevention and technology and aging.

For more information about the Resource Center, visit our website at www.homemods.org where you will find a wealth of information related to supportive housing and home modification.

Planning for An Aging California-
Adequacy and Accesibility

Center staff Jon Pynoos, Ph.D. and Christy Nishita, along with Marvin Schachter and Carla Hett Smith from the California Commission on Aging, produced a policy report on the housing needs of older adults in California. The report, entitled "Statement of Findings - Senior Related Housing Issues," will aid in the creation of a long- range strategic plan for older Californians, as required by California Senate Bill 910 (Vasconcellos). Other policy reports prepared under SB 910 were related to health, transportation, and planning /systems design. The reports were presented at the California Commission on Aging's (CCOA) Statewide Invitational Forum on April 1-2, 2003 which was held in Sacramento.

Invitees to the forum included representatives of state agencies and organizations such as the California Department of Aging, California Department of Health and Human Services, the California Housing Finance Agency, the California Association of Homes and Services for the Aging, and Housing California.

The report on housing addressed, among other things, issues of adequacy and accessibility. In order to improve the adequacy of housing, some of the recommendations looked at problems associated with electricity, plumbing, or heating. One recommendation looked at expanding current state funding sources for home improvements, such as the State Community Development Block Grant Program and the California Self-Help Housing Program.

On the issue of accessibility, it was recommended that comprehensive home assessments be conducted in home and community-based services programs to facilitate aging in place. Examples of such programs are the Multipurpose Senior Services Program (MSSP) and the state's LINKAGES program. The assessments would result in home modifications that increase accessibility to all parts of the home. Another recommendation advocated increased funding for home modification by developing accessibility loan and grant programs under the California Housing Finance Agency.

A California Blueprint For Fall Prevention - A Step Forward

Center Director Jon Pynoos attended and presented at a two-day invitational conference organized by the Archstone Foundation, February 5-6, in Sacramento, California. He focused on the role of home and environmental modifications in his presentation "Prevention of Falls at Home and in the Community," and described the benefits of home hazard reduction and the use of supportive features in falls reduction efforts. The conference was co-sponsored by the California Wellness Foundation, the VA Greater Los Angeles Healthcare System/Geriatric Research Education Clinical Center (GRECC), and the California Geriatric Education Center. Other topics covered at the conference included consumer education, public policy, and service issues related to older adults and falls.

A copy of the White Paper prepared for this conference can be found at the Archstone Foundation's website: http://www.archstone.org Click on the link "Fall Prevention Conference White Paper."

International Conference on Aging, Disability and Independence

The Resource Center is proud to be a co-sponsor of the International Conference on Aging, Disability and Independence that will take place December 4-6, 2003 in Washington, DC. This conference is organized into six tracks: Assistive Technology, High-Technology Applications, Home Modification and Universal Design, Transportation, Injury Prevention, and Business Perspective and Issues. The Home Modification and Universal Design track will focus on buildings and objects in those buildings that support independence for people as they age. For more information, visit the conference website at http://www.asaging.org/icadi/ or contact Gwendolyn P. Mann at (352) 273-6451 or email gjpmann@hp.ufl.edu

Center's Research Assistants Contribute to the Field of Home Modification

Dawn Alley

Dawn Alley joined the Resource Center as an undergraduate in the spring of 2002. That fall she was admitted into the Ph.D. program in Gerontology. This year she contributed to a policy report on fall prevention for older Californians. The report concluded that home assessment and modification should be included in fall prevention programs as a part of the California Blueprint for Fall Prevention.

Dawn's primary research interest is the relationship between community infrastructure and health and quality of life for older adults. She is also researching ways in which state policymakers can link housing and services for low-income older adults living with a disability. She believes strongly that providing supportive services-ranging from meals to assisted living-in affordable housing can increase quality of life for residents and may help states manage long-term care costs.

Stephanie Cory

Stephanie Cory joined the Resource Center in the fall of 2001 and will be graduating this month with her Master of Science in Gerontology. Stephanie's research interests include disability issues and service delivery in rural areas. Her research focus at the Resource Center has been on centers for independent living (CILs) and their home modification (HM) efforts. She has completed a national study of State Independent Living Councils and another of California CILs.

At this year's Annual Joint Conference of the American Society on Aging and the National Council on the Aging, she hosted a poster session to present her findings on the comparison between rural and urban California CILs. A surprising conclusion was that rural CILs in California did not display the expected service disadvantage compared to their urban counterparts. On the contrary, rural CILs provided even more HM services. Stephanie has contributed to an article on continuing care retirement communities (CCRCs) to be published in the Encyclopedia of Finance and Retirement.

Nicholas Greco

Nicholas Greco (Nick) joined the Resource Center five years ago as a freshman. After receiving his Bachelor of Science in Gerontology and completing an internship at the National Institute on Disability and Rehabilitation Research in Washington, DC, he was admitted to the one-year accelerated graduate program in gerontology.

This year, Nick was actively involved with and succeeded in obtaining continuing education
accreditation for the online courses that have been developed through the Resource Center in conjunction with USC Ageworks.com. He graduates this month with the Master of Science in Gerontology, and will undergo a summer internship at a Medicaid Managed Care Organization in Orange County, California.

Nick plans on working towards a Master's in Medical Sciences during the following school year. After that, he plans to attend Medical School and specialize in Geriatric Medicine in the future.

Akemi Mayeda

Akemi Mayeda joined the Resource Center in the fall of 2002. She is pursuing her Master of Science in Gerontology and expects to graduate by the end of this year. She has been active in updating the Home Modification Resource Guide, a Center publication that features resources for professionals interested in home modification.

Akemi writes and updates news articles for the Center's website. Specifically, she has written articles on the passage of Proposition 46, the California Housing and Emergency Shelter Trust Fund Act, which was overwhelmingly approved last November. Among other things, the Act will fund grants to enable individuals with disabilities to make accessibility modifications to their rental units. She has written on the elimination of the Senior Housing Information and Support Center, a program of the California Department of Aging, and is now focusing on the states' budget crises. She is on the Editorial Team that produces this quarterly newsletter.

Christy Nishita

Christy Nishita is a fourth year Ph.D. candidate in gerontology. She joined the Resource Center in the fall of 1999. She appreciates her work at the Resource Center because it has exposed her to different types of research, including case study research, policy analysis, and quantitative research.
Her research has resulted in conference presentations, and she has co-authored book chapters, journal articles, and policy reports. One journal article was recently published in the Journal of Housing for the Elderly on the contributions of M. Powell Lawton to the home modifications field. In the policy arena, Christy has co-authored two policy reports on the housing needs for elderly Californians.

Christy's research interest is in the link between housing and health outcomes. Her dissertation topic is aligned with the interests of the Resource Center because she is looking at the use of self-care strategies (behavior modification, home modification, and personal assistance) to manage functional limitations and the effectiveness of these strategies.

Katie Spegal

Katie Spegal is a graduate student who joined the Resource Center in the summer of 2002. She graduates this month with the Master of Science in Gerontology and will continue with her Administrator-in-Training program. Katie was actively involved in planning for the 2002 annual Morton Kesten Summit on Home Modification. Last year's Summit focused on home modifications as a means for furthering independence for all Californians, with an emphasis on the elderly and individuals with disabilities. Katie has been active in tracking state laws and local ordinances that emphasize visitability* and/or universal design.**
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(*"Visitability" features often include zero step entryways, wide hallways, and a first floor accessible bathroom.
**"Universal design" is a concept that relates to the design of products and environments to be usable by all people, as much as possible, without the need for adaptation.)

Models of Home Modification Programs

Access Remodeling

Access Remodeling (AR) is a private for-profit business, founded by Louis Tenenbaum, that has provided residential accessibility services to clients in the Washington, D.C. and Potomac, Maryland areas since 1987. AR provides all aspects of the remodeling services for customers: a home visit, environmental assessment, and the installation of home modifications.

AR's objective is to reach the "planners"-individuals preparing to age in place within their own homes. In this respect, it is important to note that AR does not solely work with the aging population but also the disability community and younger individuals.

A critical component of AR's construction process involves the actual design of home adaptations to make the environment barrier free. AR subcontracts with an interior designer, who specializes in universal design, to ensure that the layout is aesthetically pleasing as well as safe. AR stresses that a change in health does not mean a change in residence.
(Editor's Note: Since this case study was conducted, Mr. Tenenbaum has refocused his efforts into the area of independent living strategies. For more information, call (301) 983-0131 or email him at HomeMods@aol.com. Mr. Tenenbaum also has a website at: http://www.louistenenbaum.com).


Home Modifications in Baltimore: SESHI

The South East Senior Housing Initiative (SESHI) began when local organizations in the community recognized the growing needs of the aging population in South East Baltimore. These organizations raised concerns about physical and environmental restrictions experienced by a large portion of older residents living in row homes, the challenges older residents confronted in preserving their homes, and the lack of affordable housing alternatives within the community. The outcome from these meetings resulted in a coordinated effort of non-profit organizations and a coalition known as SESHI. SESHI has become the primary organization in a comprehensive community delivery system, whose principal goal is to assist older adults to reside safely in their homes.

SESHI's service delivery does not entail installation of home modifications. Rather, SESHI is the entry point for many seniors lacking knowledge, awareness, and funds, to procure appropriate home adaptations and social services that will enable them to remain living independently. Through coordination of existing community-based services and home adaptations, SESHI, along with its coalition members, are testing the value of preventative health and the impact on the community in assisting older adults to live independently.

Editor's Note: Both of the above home modification programs were part of four case studies conducted by the Resource Center. A summary of these case studies can be found at the following website: http://www.usc.edu/dept/gero/nrcshhm/research/pages/hm_programs.htm.

From The Editorial Team

Chris Lee

Due to limited space, here is a brief report of our Center's other activities.
The Center is co-sponsoring a half-day workshop entitled "Aging in Place - What's The Problem?" on May 17 in Ventura, California. This event is being organized by the Ventura Home Modification Action Coalition. Co-incidentally, on April 1-2, the Center helped organize and participated at an Aging in Place workshop which took place at the University of Southern California Andrus Gerontology Center. Resource Center Director Jon Pynoos presented a talk entitled "Modifying Homes for Persons with Alzheimer's Disease." The Centerwas also actively present at the 2003 Third Joint Conference of the National Council on the Aging and American Society on Aging that was held in Chicago, Illinois from March 13-16. We look forward to next year's conference that will takeplace in San Francisco, California.

About the Resource Center

Maria Henke

The National Resource Center on Supportive Housing and Home Modification is headquartered at the University of Southern California Andrus Gerontology Center. The Resource Center is a project supported by The California Endowment and the Archstone Foundation.

The Resource Center sponsors the National Home Modification Action Coalition, an informal nation-wide network ofprofessionals and researchers interested in promoting aging in place and accessibility in the home. In addition to these efforts, we are currently developing a national initiative to help older adults maintain their independence and age in place.

Julie Overton

For more information about the Resource Center or any of the above, please contact us via email at homemods@usc.edu or call (213) 740-1364. You can also visit us on the web at www.homemods.org.

• February 2003 Newsletter

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