How Does NORC Help Our Community?

The goal of the Georgia Naturally Occurring Retirement Communities (NORC) Initiative is to help support older adults in the community so they can remain in their homes for as long as possible and avoid premature institutionalization. The project is based on a community-level intervention designed to reduce service fragmentation and create healthy, integrated communities.

It's no secret: Our population is aging. With so many baby boomers in their mid-50's, the older adult population in the Atlanta region is expected to double by 2015.

What is a NORC?

In the face of a rapidly expanding senior population, diminishing public and private resources and the rising costs of long-term care, it is more important than ever to create viable alternatives to institutional care. Research shows that 91 percent of the older adults plan to "age in place," that is, remain in their homes as they grow older. As a result, older adults are living in buildings (vertical NORCs) and neighborhoods (horizontal NORCs) where people over 60 are a majority. They didn't move there to be with other older adults; these places just came to be. Thus, NORCs or Naturally Occurring Retirement Communities is a demographic term used to describe a community not originally built for seniors that now has a significant proportion of its residents who are seniors. Today, there are over 50 NORCs in the state of New York. Outside New York, there are 24 states that have developing NORC sites.

The population density of older adults in NORCs presents an ideal opportunity for the community to design tailored programs that enable older adults to live in their homes for as long as possible. Thus, NORC is also a model to organize and develop services and programs to help seniors successfully age in place.

·     NORCs are designed to serve all older adults in the community - from the well to the extremely frail.

·     NORCs are collaborative partnerships.

·     The NORC model is designed to enhance existing services to respond to the gaps in the service safety net.

·     NORCS are rooted in the community. The community should have input and influence in developing its NORCs programs and services.

How does it work?

·     A NORC program develops partnerships between community organizations, businesses, philanthropies, government agencies and residents to assist older people who are living at home.

·     NORCs use economies of scale to create efficient and cost-effective ways to support older adults aging in place.

·     NORCs are consumer-driven. Identifying community needs is an important component of NORCs.  Programs are developed based on a needs assessment and outreach campaign performed first at each site.

·     Through NORC programs, older adults receive home and community-based services such as medical and homecare, social activities, home modification, friendly visitors or transportation assistance.

·     NORCs help older adults maintain a high quality of life and save the government and families the cost of unnecessary institutionalization.

·     NORCs build on the strengths of the community. Avoiding duplication of services, NORCs engage in outreach to identify people and their needs, and seek to remove barriers that prevent seniors from having access to care.

Building Community in Georgia

In Georgia, communities are implementing the NORC model by... 

·     Reaching out to older adults in isolation to connect them with existing services

·     Bringing together local stakeholders to evaluate community needs and resources

·     Developing local strategies and innovative programs to fill the gaps in services

·     Working with partners to keep neighborhoods affordable and accessible to older adults

What is JFGA’s Role with Georgia’s NORC Initiative?

The Jewish Federation of Greater Atlanta serves as the umbrella organization, providing overall coordination across all the NORC sites. We also assist with fundraising and advocacy by leveraging public dollars with private funds and in-kind support. In addition, JFGA also provides assistance with overall marketing. We help to improve awareness of the NORC initiative and older adult issues. Evaluation is another important role for JFGA. We believe that we are doing a good job but want to know if we’re doing it well. We measure impact factors like whether participants experience decreased isolation and greater access to needed resources. We created a NORC Advisory Council comprised of volunteer leaders with expertise in the aging field. The group provides oversight for the NORC Initiative and makes decisions on how best to utilize the available dollars (government, Federation and foundation), which impact each NORC site.

Who are our partners?

JFGA does not provide direct services but rather subcontracts with a lead agency at each site. The lead agency coordinates the site’s efforts, provides direct services and finds additional partners to enhance service delivery. In addition to delivering services, lead agencies are collaborative, and have a track record for innovation.

What about additional partners?

Our partners are traditional aging service providers & non-traditional entities such as businesses, civic organizations, schools and universities. These partners help to leverage resources, create new ways of serving seniors and improve overall service delivery.

The seniors we serve are also partners. NORC programs are consumer-driven and based on survey and focus group results. A Senior Advisory Council at each site gives older adults a voice in the planning process. NORC is unique in Georgia in that it especially targets those seniors with an income level in that “gray area.” These are seniors who are unable to afford to purchase services but are not income-eligible for government aid.

How did the NORC Initiative Begin in Georgia?

As the central planning body for Atlanta’s Jewish community, JFGA’s Aging Task Force was looking for innovative ways to meet the needs of a growing senior population. This Task Force had already expanded senior transportation and created a single point of entry to aging services in the Jewish Community – Jewish Elder Access.

We knew that the Jewish older adult population was growing faster than the general population and learned of NY’s success in developing a NORC services model. Our research led us in the direction of piloting a NORC in the Atlanta Jewish community with seed money from the JFGA annual campaign. At the same time, the United Jewish Communities, the umbrella organization of the Jewish Federations, decided to advocate for federal funding (earmarks) to implement NORC demonstration projects nationally.

In 2003, all of these factors created a perfect storm when $100,000 became available from the federal government for us to jumpstart a NORC model in Georgia. With these dollars, along with JFGA funding, we reached out beyond the Jewish community to partner in this effort. This funding was used to develop NORC sites in Toco Hills and East Point.

JFGA chose Toco Hills because it had a high percentage of Jewish older adults age 85 and over with low to moderate income. Also, one of our affiliates, Jewish Family & Career Services, was already serving seniors in that area and was ready to move forward. 

East Point became the second site because of an opportunity for us to partner with the Atlanta Regional Commission (ARC). The ARC had just become the recipient of a Robert Wood Johnson grant for the Aging Atlanta Project. The NORC Initiative seemed like a nice fit for the ARC’s project goals.

The East Point site was especially of interest because it had a large population of African-American older adults who were living below the poverty line. These two sites provided diverse populations to see how the NORC model would look in different communities.

With this new partnership with the ARC, JFGA was able to leverage resources with our own funds in the Toco Hills site, and with Robert Wood Johnson funding and in-kind support from the ARC at the East Point site. At both sites, there were federal dollars and private foundation funds.

There are now six NORC sites in Georgia.

In September 2003, we established the NORC Initiative in two different communities – Toco Hills and East Point. Since then, the project has grown from two to six NORC sites to pilot the NORC model and address one of Georgia’s greatest challenges: meeting the needs of our growing older adult population. Since the Initiative’s inception, more than 2,500 older adults have been served. Of these six NORC sites, four are in metropolitan Atlanta, one is in Savannah, and our newest site is being implemented in a rural community.

How did the sites start?

The first step at each site was a needs assessment & outreach campaign. In East Point, the ARC & Fulton County partnered with the Fulton County Council on Aging to do a door-to-door outreach campaign & focus groups. Results showed that there were four need areas: Home repair & modification, access to information & referral, safety, and transportation.

In Toco Hills, social work graduate students from Georgia State University partnered with lead agency, Jewish Family and Career Services, to provide a needs assessment of the community’s residents using mailed out surveys and focus groups. Results from this needs assessment showed that home repair & modification, as well as social and educational programming were top priorities to the seniors residing in the Toco Hills NORC.

With those assessments, NORC sites became a good place to pilot innovative programs to meet identified needs. One such program has been the Voucher Program, a flexible way to allow seniors choice in purchasing the services they need. In East Point, the voucher was specifically designed for transportation, while in Toco Hills it was a general voucher to help seniors afford the cost of a wide variety of services including in-home supports, transportation, etc. 

Another program piloted in East Point is the Walking Club, which was developed not only to engage residents in physical activity, but to also improve community safety and reduce social isolation. Approximately three clubs have been developed through neighborhood associations. Residents agree to complete a 10-week walking program. The fire department provides blood pressure screenings to walkers and often walks the route with them which enhances feelings of safety among walkers.

The information and referral service is important at every site. This is done by both site staff and by bringing in speakers that provide important information to older adults. Information on health, lifelong planning, local resources, fall prevention, and other topics are provided on a regular basis.

In Toco Hills, educational/social programming helps to keep the NORC residents active and engaged. Additionally, caregiver support groups and senior-led initiatives such as the phone tree, classes, and events reduce social isolation.

Home repair & modification are critical issues in both Toco Hills and East Point, where residents have been living in their homes for many years and the houses are not necessarily senior-friendly.  In East Point, the Safe Home for Seniors Program uses volunteers to assist with minor home repairs. And in both sites, partnerships with other groups that bring their own funding streams (e.g. Senior Connections, Senior Citizens Services, Rebuilding Together Atlanta) have provided needed repair and modification services.

What about Funding?

JFGA made sure not to depend on federal earmarks, which only funded the first three years of the NORC Initiative. For this reason, JFGA began advocating for funding on the State level resulting in funding through the State Office on Aging.  Even with that, JFGA continues to work to diversify our funding sources by partnering with a variety of organizations and seeking other funds such as private foundations.  Moreover, in addition to in-kind support and funding, we also utilize volunteer support (i.e. students from GA State and other universities, One Good Deed, a small non-profit that mobilizes volunteers to support older adults in their homes).

Growth in dollars, particularly State dollars, has allowed us to experiment with different models. The original sites were horizontal NORCs, so in expanding we wanted to experiment with different combinations of vertical & horizontal, different populations, different focuses, and different locations (including outside of Atlanta)…All with the goal of making this program replicable throughout the state.

Where has expansion led us?

Beginning January 2006, the partnership with the ARC was expanded and a NORC site was established at the Marian Road Apartments with the ARC as the lead agency. The site is located in an Atlanta Housing Authority high-rise serving a diverse community of low-income senior citizens, 75% are age 60+ primarily immigrants (Koreans, Chinese, Russians, Hispanics), and 25% younger adults with disabilities.

One of the greatest challenges at this site is communication. The replication of the Voucher Program at this site took a different twist with a focus on translation. Vouchers are given to neighbors, residents’ family & friends, and professionals to translate, interpret, and teach language classes.

Around the same time, we also began a site in Savannah in the Ardsley Park area, a neighborhood of single family homes where seniors often have equity in their home, but struggle financially to make ends meet. We partnered with Senior Citizens, Inc. to act as the lead agency for this site. One of the innovative programs at this NORC is the Summer Angels Program, a partnership with a neighborhood middle school to have students provide yard work and chore services for the older adults in Ardsley Park.

In December 2006, we began the Meyer Balser NORC in NW Atlanta. The lead agency is a nursing home, the William Breman Jewish Home, and the site is made up of both independent living HUD high-rises and single-family homes. This NORC has more of a health focus – providing wellness programming such as nutrition and fall prevention – and is experimenting with a membership model.

In these new sites, as well as the two original sites, new partnerships have been formed. With funding this year from a private foundation, JFGA will be able to provide vision & hearing clinics, eyeglasses, and hearing aids to multiple sites. Through a partnership with Brenau University, Occupational Therapy services delivered by graduate students will be provided at two of the sites – Marian Road and Meyer Balser. Also, through a partnership with Housemate Match, NORC participants will be able to receive homesharing services if they wish.

Lastly, thanks to additional dollars from the State this past fiscal year, we piloted the NORC model in a rural site. Our lead agency partner, Concerted Services, Inc. is developing a NORC site in Candler County.

Is the NORC model working?

To determine whether the NORC initiative has been successful in helping seniors age in place, JFGA contracted with Georgia State University to develop and implement an evaluation on the NORC project.  Piloted in summer 2006, administration of the tool was conducted via telephone for both the East Point and Toco Hills NORC sites.

A pilot report describing the results was completed, evaluating key impact factors such as fall prevention and home safety, social isolation, access to community resources, and seniors’ perception of their ability to remain at home. Results from the pilot show a positive trend in helping to keep seniors at home and in improving seniors’ overall quality of life. Sample results were:

·         79% of seniors believe they are more likely to stay in the community since their NORC involvement.

·         85% of seniors report that their emotional well-being is at least as good as or better than it was one year ago.

·         74% of seniors know more about community services for older adults than they did pre-NORC.

·         57% of seniors receiving assistance with home modifications and repairs believe that their home is safer than before changes were made.

Additionally (and perhaps anecdotally) after four years, we believe that NORC has:

·         Increased neighborhood awareness of senior issues

·         Coordinated services between agencies

·         Identified service gaps

·         Connected isolated older adults to services

·         Enlisted additional partner agencies; particularly non-traditional partners

·         Created opportunities for innovative solutions

·         Created an evaluation tool to help measure the success of the NORC model

What is the Future of Georgia’s NORC Initiative?

Each NORC site will provide a great deal of information that we believe will be useful for us as a State. We currently have six very different models that can help us plan for our growing aging population. 

Because of the diversity of each project, we’ll be able to help any community build and replicate a successful collaborative based on what we learn. Best of all, it is building on entities that already exist – agencies as lead partners that know how to provide community based services, the seniors themselves, businesses, and nonprofits.

JFGA does not desire to develop NORCs all over the state as it wouldn’t be consistent with our mission. Instead, piloting all these different models and testing them out so that other organizations or groups can replicate them while enhancing services to the Jewish and general community is critical to us. JFGA can then enter a new role of providing technical assistance to those organizations that wish to create their own models. 

For more information about JFGA’s Georgia NORC Initiative, please contact Deborah Kahan, NORC Project Director at 404-870-1624.