NORC Advisory Meeting Notes Teleconference call held on November 14, 2007
In attendance:
| Attendees | Representing |
|---|---|
| Mary Kanerva | Aging & Adult Service, Catholic Family Center |
| Eileen Mullarkey | Long Term Care, Dept. for the Aging, NYC |
| Fredda Vladeck | Aging in Place Initiative, United Hospital Fund |
| Anita Altman | Gov't and External Affairs, UJA Federation of NY, Inc. |
| Marianne Fahs | Brookdale Center for Healthy Aging and Longevity |
| Joseph Cybulski | Rensselaer Unified Family Services Dept. of Aging |
| Ronald Soloway | Gov't and External Relations, UJA- Federation of NY, Inc. |
| Evelyn (Evie) Rich | NYC Chapter of Americans for Democratic Action, Member of NYC NORC Coalition |
| Ken Harris | NYAHSA Ctr for Senior Living and Community Services |
| Sondra Mattick | Resident of Jewish Family Services of NENY NNORC |
| John Krout | Gerontology Inst. and Prof. of Gerontology, Ithaca College |
| Joseph Pofit | Long Term Care Campuses and Senior Housing, Roman Catholic Diocese of Albany |
| Jennifer Best | Legislative Analyst, Committee On Aging, NYS Assembly |
| Rick Iannello | Albany Guardian Society |
| Stephanie Pinder | Lincoln Square Neighborhood Center, Inc. |
| Annie Hines | Resident at Lincoln Square Neighborhood Center NORC |
| Edward Woda | Legislative Coordinator, Comm. on Aging, NYS Assembly |
| Michael J. Burgess | NYSOFA |
| Greg Olsen | NYSOFA |
| Marcus Harazin | NYSOFA |
| Cyndy Marshall | NYSOFA |
| Gail Myers | NYSOFA |
| Larry Shapiro | NYSOFA |
| Tim Kovarik | NYSOFA |
| Monica Seeber | NYSOFA |
1. Mike Burgess Welcome
Mike Burgess welcomed everyone to the meeting and expressed his support for NORCS. He then handed out two articles about NORC's. One was entitled "Programs Offer Seniors Option to Age at Home." It was published in USA Today. The other article was dated November 14 and was from U.S. News and World Report.
2. Packet Information
An orientation to materials provided in the meeting folder was then made. Fredda Vladeck then distributed the "Preliminary Summary of the NORC-SSPs in New York Table."
3. Power Point Presentation
A Power Point presentation entitled "A New Approach to Services for the Aging was made by Tim Kovarik. The Power Point presentation included:
- The history of the NORC programs in New York State
- How the program is funded
- Regulations of both the NORC and NNORC programs
- Services offered at a NORC
- Physical characteristics across programs
- How NYSOFA is trying to enhance the program through communication with existing NORC programs
Mike Burgess noted that a responsibility of the Committee is to provide NYSOFA and the State guidance on these issues.
4. Health Indicators Project/Blue Print Project
It should be noted that there was not enough time for the Blue Print Project presentation and Fredda Vladeck said she would make that presentation at a future meeting.
Fredda described the Health Indicators Project. The United Hospital Fund has received money, some of it State funds, to conduct a project that would measure health care indicators. The project has created a tool by which the NORC programs can identify health care risk factors in their communities and then plan and implement targeted interventions and measure the effectiveness of those interventions. Fredda noted that there are three domains that NORCs can affect in regards to healthy Aging:
- Access to health care
- Health promotion, prevention measures and wellness
- Management of health care
The Project has recently completed the survey with 12 programs and is in the process of completing the survey in all 20 state funded NORCs. A 75 item questionnaire was developed and data was collected and is being assessed. Individuals from initial 12 NORC programs were involved in completing the questionnaire. Preliminary results are as follows:
- People are doing extremely well in obtaining screening and immunizations. The NORCS are exceeding citywide data on its residents taking advantage of preventive services.
- 99 percent of people surveyed have primary health insurance.
- 84 percent of the people are enrolled in Medicare.
- Very few people have no health insurance
- 16 percent of the people surveyed had no secondary insurance.
- 97 percent have prescription drug coverage, 47 percent of them through Medicare.
- 16 percent are enrolled in EPIC.
- 33 percent of people surveyed went to the ER within the past year. Approximately 20 percent of those using the ER used it more than once.
- 49 percent of people rated their own health as fair to poor. The national average is 15 - 20 percent of older people rate their health fair - poor.
Fredda noted that as a result of the findings, four of the twelve projects have designed interventions that focus on prevention of falls, especially falls that occur out-of-doors (as a result of medications, poor vision, etc).
A comment was made that the survey should be administered every 3-5 years. The need for a uniform tool and system of measurement is apparent.
A discussion ensued about how to measure the effectiveness of NORCS. Do people continue to be engaged in NORCs? Does being a part of a NORC add longevity to lives? Can we measure the length of stay in a NORC community? In Senior Housing?
A comment was made noting that there is a need for valid measurements of connectivity. It was stated that New York State has a tendency to 'medicalize' everything. This puts outcomes into a clinical or medical model. We should be cautious of this tendency.
It was stated that the exciting thing about NORCs is how comprehensive they are. It is the partnerships that make this so. Staff may go home at 5 but the NORC still functions. Data shows baby boomers are turning 60 - and there are 76 million of them. Recognizing the importance of connectivity, NORCS has brought them in by providing programs/events (evening and weekend) that are geared to the baby boomers and the new generation of seniors. They are involving the larger community.
5. Second Power Point Presentation
A second Power Point presentation was made focusing on emerging NORC issues.
- The vision for NORCs
- The need for NORCs in rural areas
- The infrastructure of NORCs - how to relate to people and organizations?
- Does a NORC "model" work?
- The need to keep older people in their homes
Matching funds - What does NORC money buy? Money received for NORC does not pay for total programming. Marcus Harazin spoke about the reorganization going on within NYSOFA, the intent of which is to better respond to the Aging Community's needs and issues. We do need to target services to the low-income/frail population but not limit services solely to that segment.
Larry then asked participants to identify issues. Following are those that came forth:
- Need for more reference/research articles about NORCs. Can a collection of websites and links be generated to establish a common basis?
- Look at rural areas and the barriers and challenges there. Need to create a community atmosphere in these areas.
- How do we better use the services of the Area Agency on Aging and the State Department of Housing and Community Renewal? Need for infrastructures. The problem sometimes can be there is no one to answer an RFP for NORC establishment money, despite the need.
- Connecting the AAA's to the process is important.
- Concerned with the minimum number of people required to make a NORC.
- How to expand NORC concept to seniors not currently living in a classic NORC? Need pilot program to train seniors as advocates for NORCs. Civic engagement is critical to the success of a NORC.
- There's an absence of NORCs in communities with people of color.
- Issues of oversight need to be addressed - how to determine/monitor the quality of a NORC program? Is a NORC grant one for life? If the NORC is not succeeding should its contract be renewed?
- NORCS need to maintain their flexibility. Want to be inclusive for demonstration programs.
- It's important to coordinate services within (and without) NORCs.
- Want to be consistent in the message about NORCs - NYSOFA role.
- Do we want/need a national conference exploring different models and best practices?
- Seniors don't even know about NORCs - How to publicize and make services available?
- NYSOFA needs to be a strong advocate for those wanting to provide NORC services.
- The qualities that make a NORC should be reinforced.
- Affordable housing is an issue - how do we bring services to people who can't afford them? We need to better understand how people are housed across NYS.
- Standards are needed. Definition is needed.
- Quality of NORC programs is uneven across the network.
- Legislative language.
- Population changes. Are NORCs forever NORCs?
- While NORCs provide for social work, housing, and health care, they really are all about Community organizing.
- Programs are thinly funded and a portion of future funding should be used to strengthen current programs.
- NORCs are about building Elder friendly communities. Leadership development should be part of the model.
- What is the role of housing managers? What do we expect them to deliver?
- The population changes from time to time. What happens when a current NORC no longer meets the definition of NORC?
- Licensing may become an issue.
- There is a need to provide mental health services.
- Legislation should be worked on for the Jan. - Feb. hospital changes.
- Program should move toward creating a White Paper.
- NYSOFA should be a strong advocate in teaching people how to organize a NORC.
- Have housing directors mandated to assist with NORC's.
- How do you measure time and efforts of the NORC case managers?
- How can we prepare students for future NORC models?
- NORC's were not considered in the states current COLA laws and future language should be drafted to include them.
Mike Burgess stated it's all about the community taking ownership - tying things altogether.
Jennifer Best spoke to the need for consensus as to where NORC's are going before legislative changes are made.
After a brief discussion regarding program match Tim said he would email a copy of NYSOFA's match policy to each board member.
There will be a NORC advisory committee conference call on January 11, from 10 - 11:30a.m. Legislative issues will be the primary agenda item for that call.