Jewish Family Service of Wilkes-Barre, PA

INTRODUCTION

A plan for a Naturally Occurring Retirement Community (NORC) for B’nai B’rith Apartments came about as a result of the work of the Pennsylvania Jewish Coalition in fiscal year 2008-09 that resulted in funds being set aside in the Commonwealth of Pennsylvania of $200,000. These funds were administered through the Pennsylvania Department of Public Welfare. Jewish Family Service (JFS) of Greater Wilkes-Barre applied for a small portion of these funds to initiate a NORC planning process in association with B’nai B’rith Apartments in downtown Wilkes-Barre. Other than Philadelphia and Pittsburgh, no other community in the Commonwealth ever received funding for a NORC. In addition to Wilkes-Barre, the Jewish Family Service agency in York also received funding, as well as the two larger cities. It is one of the first times in the United States that State funding has been found for NORC work.

The goal of a NORC is to enhance aging in place for residents. In many cases, neighborhoods are selected where there exists a predominant number of seniors who are either living in single family homes, town houses, and/or hi-rise apartments. In the case of Wilkes-Barre, several years ago, an attempt was made to submit an application to the Federal government for appropriate funding, using B’nai B’rith Apartments as a model for the development of a NORC. No funding ever came about for that project, however, when State funding became a possibility, staff at JFS contacted the management and staff of the Apartments. Based upon discussions and meetings, it was concluded that the Apartments would be a suitable location for the planning of a NORC. The basic goal would be to create a NORC plan that could then be implemented if additional funds were found in later fiscal years. The year July 1, 2009- June 30, 2010 was chosen as the year in which the Plan would be developed and finalized, and that staff of JFS, together with officials from the Apartments would seek implementation funding.

The Board of the Apartments was notified by management of the NORC planning process and endorsed this approach. JFS staff began the planning process with a series of meeting with three officials of the Apartments, including Hector Torres, Pat Confer, and Kristen Makowski. These meetings were held near the end of fiscal year 2008-09, into the early part of the 2009-10.A review of the work program was held, a copy of which is attached as an Appendix to this report. During the course of the work program, it was discovered that the City of Wilkes-Barre had commissioned an update to their Comprehensive Plan and the new Plan is based upon defined neighborhoods in the City. The Apartments, however, are considered part of the downtown area or central business district and were not included in the neighborhood Plan. Contact was made with the planning consultant, Jack Varaly, however, and his work was utilized as background to the development of the NORC Plan.

WHAT IS A NORC?

There are many NORCS located across the United States. They are mainly in larger cities and have been federally funded. They represent a growing interest in the aging in place theme, but are administered differently, based upon the type, size, and scope of activities as well as their location. They offer a variety of services to residents, sometimes have a small fee to encourage participation, and have been refunded over several years in the case of earlier NORCs. Their role shoes a common thread that permeates the planning, development, and implementation of the NORC. Among these unified activities are the following:

Designed to offer flexible services, responsive to the needs of the residents
Accelerate the opportunity to age in place
Have available case management, assistance, and social work services
Have available health care management services, assistance and prevention services
Education, socialization, and recreational services
Volunteer opportunities for residents
Arrange partnerships with appropriate agencies such as Area Agency on Aging, Jewish Community Center, home health agencies, YMCA, local businesses, hospitals, and others
Establish ancillary services that could include, but not be limited to such examples as, adult day care, nutrition and fitness programs, transportation, residence and personal care, delivery of meals, information and referral, intergenerational programming, mental health counseling, financial planning, legal advice, chronic care management, and much more.

THE DEMOGRAPHIC TREND

There is a noticeable demographic trend across the nation that has caused a strong interest in NORCs. Persons who are getting older want to either stay in their homes or their current living arrangement, or, in the alternative, downsize from what might have been a larger residential unit to something more suitable to a decreased family size. In some cases, this means concern over property taxes, spiraling costs of utility services, and other expenses such as those associated with health maintenance. The statistical trend is based upon the following:

Nearly 14% of the U.S. population, or 40 million will be at least 65 years old in 2010.
By 2040, there will be twice as many, and 28 million will be at least 80 years old.
In Pennsylvania, and the Pocono-Northeast, these data are even higher in proportionate terms, and lead to the need for an advanced system of initiatives such as the spreading of NORCs, way beyond current levels.
People are living much longer, and the growth demographic that has shocked the system is the vast number living to 85 years and beyond.

There are at least 300 NORCs across the nation, and while Pennsylvania has a handful, the opportunity exists to create many more, especially with the multiplicity of local governments that exist in the Commonwealth. In fact, communities should consider banding together in developing the NORC theme in coming years.

HISTORY OF B’NAI B’RITH APARTMENTS

In the socially conscious years of the 60’s, Congress passed a bill authorizing the construction of low income housing for the elderly. B’nai B’rith, an international philanthropic organization of Jewish men, recognized the importance of this law, and felt that is where they could make a real contribution. They established a committee of elder statesmen who understood the workings of Congress, HUD and B’nai B’rith. The committee, then, proceeded to contact B’nai B’rith Lodges throughout the United States.

The Seligman J. Strauss Lodge #139 in Wilkes-Barre, PA was the first to respond. They presented an ideal set of qualifications:

The number of elderly living in this area was greater than that of the Miami Beach area.
This area was economically depressed, disproportionately affecting the elderly.
The Lodge would provide a strong cadre of volunteers including lawyers, accountants, businessmen and construction specialists.
The Lodge leadership was young, intelligent and willing and able to a long tern project.

The building today stands majestically near the center of downtown Wilkes-Barre and it looks as if it were built yesterday. Now named for Martin D. Popky, the late Board of Directors President, and one of its original volunteers, the property is managed by SPM, a management company with considerable experience and a talented workforce.

This management has been true to its original commitment providing quality housing at affordable pricing to the elderly and handicapped. It is a tribute to those who had the foresight, so many years ago, to make all this come true.

PROCESS

The process by which B’nai B’rith Apartments was designated as a site for the NORC Plan was based upon an evaluation of the site and its residents as well as the opportunity to work closely with management and staff. The location of this facility in a downtown setting was an important criteria since there is an extraordinary high percentage of Wilkes-Barre residents who are senior citizens, and it was felt that by concentrating on a facility that was designed as an aging in place venue, this could lead to other areas of the City and environs to eventually be involved in a NORC process. Northeastern Pennsylvania always has had a significantly high percentage of older Americans, and if this project was workable, then it could serve as a model for other geographic areas in Wyoming Valley that had clusters of older citizens. While many NORCs that have been federally funded are neighborhoods that may include single family homes, town houses and perhaps one or more high rise apartments, the first attempt at a NORC plan for greater Wilkes-Barre was felt to be better suited to a single high rise. Many of the NORC projects across the nation have been located in major cities, and therefore, the thought process was to distinguish a mid sized city as the initial location of a NORC function that could be further replicated in the future and extended to defined neighborhoods, especially since the current City Plan is built around these types of geographic areas.

Furthermore, it is highly likely that these Apartments will be retained for a long period of time as a site for senior citizens, and that management will be capable of assisting in the implementation of the NORC Plan, upon its completion. Many of the recommendations found in this Plan are the type that can be instituted easily and are in concert with those found in other NORCs throughout the nation, irrespective of the type and scope of facilities.

QUESTIONNAIRE SURVEYS

Two questionnaire surveys were conducted of the residents of the Apartments during the course of the development of this NORC plan. Approximately forty percent of the residents responded to each survey and were defined as being a valid representation of all residents. The first was published in September 2009 and the second in March 2010. They were designed to elicit facts, opinions, and thoughts of the residents concerning NORC related topics. The first survey resulted in information that enhanced the NORC process so that residents could provide both factual and opinion data and information to further the opportunity to address the Tenants Association and involve them in the NORC community work. The survey and presentation led to the involvement of the JFS Social Worker in the presentation of his capabilities and eventually led to his providing counseling to at least two residents of the Apartments, with more likely in the future.

The results of the first survey may be summarized as follows:

The vast majority of residents responding seem to be satisfied with their residence and the facilities and services that are available.
There is a defined need for a grocery or supermarket (nutritional) service nearby and/or a convenience store for items that are normally utilized by residents.
A variety of other items or services would be desirable based upon the types of topics mentioned in several questions. Consideration should be given to ways that some of these suggestions can be best implemented.
Planned activities including bingo, entertainment and related events should be studied and a determination made as to whether or not they can be fully supported. This could be part of the NORC Plan as developed further in coming months.
Police protection and security are important factors. During the course of discussions with the Apartment management and staff, an unfortunate accident occurred to one of the residents at one of the nearby crosswalks, lending great interest in the topic of safety as defined by traffic conditions nearby. This subject needs further study and should be discussed with appropriate City officials.
Maintenance of the building is rated high as well as the overall value of having this type of facility within the City. In addition, residents believe that religious life is important to them as a local resource, and some study should be given to ways that this topic can be further advanced.
A variety of classes would seem to be desired, but this needs further clarification as to the number of residents who might register for each class. Nevertheless, there seems to be interest in developing ways that classes can be strengthened within the building.
Health services would seem to be desired by enough residents that special attention to vision, dental, and general health needs would be an important factor in the NORC model and aging in place. In a separate discussion with some residents, it was found that some residents have difficulty in finding a doctor.
Friendships often define a positive quality of life. As more residents move in or leave, the friendships change. There is sufficient evidence from the questionnaire that steps can be taken to reinforce these friendships and expand emergency steps during times of crisis as well as furthering the social interaction that comes with these relationships to help establish even more ways that communications take place within the building between and among residents.
The respondents have raised issues / concerns / desires that demonstrate the need for continued activities as the respondents did when they were 10 to 20 years younger. Our Senior population is more independent, much more savvy, and exposed to more media and technological advances than ever before. The aging in place today is not the same aging in place that was thought of 30 to 40 years ago. The level of independence, eagerness to keep active and stay healthy is why buildings such as the one noted herein are critical to the health and safety of our seniors in the years to come.

The second survey was targeted to questions that were designed to obtain specific ideas from tenants as to their needs, either inside or outside the Apartment building. The results are important factors in the eventual development of this Plan. The summary of these results include the following:

Friendships are important in light of the number of respondents who rely on friends or family for shopping, although a fair number use a van or bus, so the entire transportation system available in Greater Wilkes-Barre should be analyzed in relation to the future of the Apartments.
It would appear that eye glasses are an important medical item that needs to be pursued and that financial assistance for this purpose should be developed.
Some assistance is needed to help residents meet their needs, and while many have taken care of their own need, an evaluation of the needs for the entire building would be helpful.
Some definition needs to be given to the types of services requested through the questionnaire and how these can best be evaluated, and as needed, provided.
There would seem to be possible steps that can be undertaken to relate even more between the residents at the Apartments and senior centers as well as the Jewish Community Center.
Steps should be taken to examine what benefits can be looked at that would help residents as well as what utility programs can be made available to residents.
The Benefits CheckUp program should be expanded inside the building to help residents determine their eligibility for governmental assistance.
Dental and other services should be examined as a way to meet the needs of some residents.
There is a clear need to have agencies make presentations to residents and to have, available, information flyers inside the building. In addition, since some residents have computers, if not most, this is another tool that can be expanded to make such information known.
Inside the building, consideration should be given to mini shopping, stamp machines and other services. Vending machines may be upgraded to expand service inside the building.
There seems to be sufficient interest to having residents serve on a NORC Advisory Committee.

It is recommended that in future years, a survey of residents be conducted, at least annually. In this way, the views of the tenants will always be taken into account and the NORC Plan can be updated in accordance with any changes that tenants express as their needs.

One of the insights noted in the questionnaires is that there is interest of the tenants in both what goes on inside the building and what additional needs may be desired as well as the external role that the City of Wilkes-Barre can and should play incoming months and years. This is key in relation to the forthcoming City Neighborhood plan and the impact that City government plays in meeting the needs of residents located in this building, and in the future, other potential NORC sites.

BUILDING A NORC PLAN

There are many ways in which a NORC plan can be created and implemented. Whether it be a neighborhood, variety of housing types, or in this case a high rise apartment building, the theme of aging in place is designed to avoid higher cost solutions to housing such as assisted living or nursing home care as long as possible. Aging in place is often associated with decades of living in a familiar setting and wishing to continue this pattern lifestyle. In some NORC situations, the housing based approach includes a “closed” or vertical style in a single integrated apartment building, or where they exist, a housing complex with multiple buildings under common management, or an area where a number of apartment buildings are clustered together. The theme is to take advantage of the skills and experiences of senior residents and other resources to support aging in place.

NORCs are creative strategies that coordinate a broad range of social and health care services to support the senior residents of that venue. Since the Apartments clearly have tenants with many skills, there is every possibility to develop a proactive approach, seeking to strengthen the connections that older adults have to their communities before crises occur.

The Plan for the Apartments includes a partnership theme between the private and public entities that serve the City of Wilkes-Barre. Working together, includes City government, the Tenants Association, the management and staff of the Apartments, the philanthropic community such as the Luzerne Foundation, social service and health care providers, higher educational institutions, and other service related organizations such as nonprofits and the United Way. They all can be helpful in expanding the services to the tenants of the Apartments.

This plan is inclusive of not only direct services that benefit the residents in the Apartments, but includes the following conceptual themes:

Empower older adults to take on new roles in shaping the community in which they live
Weave a tighter social fabric and foster connections among residents
Maximize the health and well-being of all older adults in this NORC.

Part of this plan is to emphasize civic engagement such as community educational programming, volunteerism, community action initiatives, and related topics. It, also, includes social work services to individuals, caregivers and seniors as a group, to learn from one another and coordinate a series of events and activities that will benefit all. The third leg of this triangle is to address health management needs and the health of the community that touches the specific NORC venue, in this case, the Apartments.

NORCs often incorporate a Supportive Services Program (SSP). This is usually a community based intervention designed to reduce service fragmentation and create healthy, integrated communities in which seniors are able to age in place with greater comfort in their residences. The SSP should be flexible based upon the local community and client assessments and changes over time. It is one strong reason why this Plan urges that surveys be conducted at least annually of the tenants.

Core program components of the SSP include the following:

Case management, assistance and social work services are being carried out by the staff of the Apartments and now has added the assistance of the JFS Social Worker and other JFS staff as needed for case management.
Health care management, assistance and prevention programs (this is being recommended in the NORC Plan through the use of talent within Wyoming Valley such as the School of Pharmacy of Wilkes University and other health providers, on an as needed basis).
Education, socialization and recreational activities(this is being proposed through the involvement of the various colleges and universities based in Luzerne County and the Wyoming Valley, to be available for the appropriate education of the tenants).
Volunteer opportunities for program participants (this is being suggested through the development of lists of contacts where tenants can lend their support such as those mentioned in the Help Line Directory of Family Service Association, the member agencies of United Way of Wyoming Valley, and other sources found within the nonprofit community).

There are many ancillary services that can be considered for the benefit of the tenants of the Apartments. Some examples include the following:

Transportation services
Adult day care where needed
Home and personal care services
Intergenerational programming (such as Generation to Generation, Jewish Community Center, YMCA, and others)
Mental health counseling (such as the Social Work professional of JFS).
Financial planning( such as Consumer Credit Counseling Service of NEPA)
Legal advice

NEIGHBORHOOD SURVEY RESULTS FROM THE CITY PLAN OF 2010

The trends are dramatic in Greater Wilkes-Barre and the City itself, with recent data being developed by professional planner Jack Varaly who is with Pasonick Associates, and the neighborhood dataset demonstrates the extent to which senior citizens have a more than significant role in representing City life. Therefore, the surveys in the neighborhoods demonstrate a basis for thinking regarding what actions are important to citizens living in facilities such as the Apartments. The results of the neighborhood surveys that have are significant to the future of senior citizens across the City are summarized below.

The following represents some of the survey results of the Neighborhood based plan for the City of Wilkes-Barre. They are placed here to provide a context to what the residents of the Apartments feel are important to them, and are not directly applicable to the NORC plan. They are critical to whatever actions may be taken in the future regarding expansion of the NORC concept. The Neighborhood based plan as of this writing has been handed to City officials for their thinking and action, and it is likely that approval may be given sometime in the summer of 2010.

732 people said they would like to move out of the City, while 1240 said they would not.
By far, the greatest reason of leaving is crime with drugs, overall City decay and taxes being the highest.
1421 people said they do not feel safe in walking in their neighborhood while 1208 said they feel safe.
1067 people said that crime is normally a problem on their street while 1992 said crime was a problem.
317 people said facilities for senior for recreation were adequate, 588 said they were fairly adequate, 770 said they were inadequate, and 1031 had no opinion

There is certainly a feeling among citizens in many neighborhoods that crime and related problems need to be addressed. While the NORC site may not have the same feelings to the level expressed in neighborhoods, there is a need to connect what the neighborhood citizens are saying to the setting that exists at the Apartments and to focus attention on ways that can be supportive of the quality of life of the NORC residents.

ABOUT B’NAI B’RITH

The Apartments represent a 12 story high rise residential community for individuals/and or couples ages 62 and older and mobility impaired adults ages 18 and older. The facility is located in the heart of Wilkes-Barre- directly across the street from the new downtown movie theaters and one block from Public Square- and within walking distance of government buildings, churches, social agencies, entertainment venues, restaurants, and shopping centers.

As a housing provider in the Wilkes-Barre area for over 35 years, the complex has a professional staff that takes pride in meeting all the needs of the residents. A variety of amenities for their convenience exists, including in-house activities for social enjoyment. There are high standards of safety and security, including a front door security entry system and smoke detectors.

Included as living amenities are the following:

Cable television
Central heat and air conditioning (controlled by each resident)
Clean, painted rooms
Front door/ television security entry system
Gas stoves
Large linen closets
Refrigerators
Smoke Detectors
Triple track storm windows
Wall – to –wall carpeting (newly installed)
Window Shades

Some special features that are available either in-house or nearby, include the following:

Beauty Shop
Bingo
Board Games
Coin operated Laundry
Guest Speakers
Holiday Parties
Neighborhood Network Computer Center
Monthly Birthday Parties
Planned Activities
Pool Table
Residents Council

The type of residence includes efficiencies, one bedroom, one bath, one bedroom, one bath (ADA Compliant), and one bedroom, two bath.

The Apartments are a project of the Seligman J. Strauss Lodge of B’nai B’rith Housing Foundation, Inc. and were more recently named in honor of Martin Popky. There are 150 units. Service coordination is available, and the HUD funded project provides an opportunity for semi-annual reports that delineate services that are offered, including the following, found in a recent report.

Assessments
Advocacy
Benefits-Entitlements-Insurance
Case Management
Conflict resolution
Crisis intervention/Support Counseling
Education/Employment
Family Support
Health Care Services
Homemaker
Home Management
Lease Education
Meals
Mental Health
Monitoring Services
Substance Abuse
Transfer to Alternative Housing or Hospital
Transportation
Other

The importance of this list for the NORC Plan is based upon new ways to enhance and further develop a coordinated plan of supportive services with the assistance of JFS and the management and staff of the Apartments. Based upon the results of the surveys and the information supplied by the management and staff of the Apartments, here are a few opportunities that can be incorporated into the Plan and implemented over the next few years. These ideas are represented and designed to extend residence based services, programming and assistance, obtaining knowledge of all components of an older adult’s life, including friendships, introspection of what the resident’s feel about themselves , the relationship to surrounding neighborhoods and the central business district, coordination with the community of greater Wilkes-Barre, and the health and safety of the residents.

Examining the residents and their lifestyle, interests, needs, and human and physical habits. It may be titled a “Get to Know Yourself Inventory.” Most importantly, the results would be viewed as people who are expressed as friends, citizens, neighbors, and not clients.
The NORC Plan contemplates friendship facilitation based upon the Inventory data, so that as much as possible, there is a safety net of support for all residents, led by the role that staff and management play as well as others who can offer supportive services such as JFS, the YMCA, and other nearby social service agents.
NORCS that are neighborhood based, often offer what is called a Concierge Service to enhance the role of service providers that may be needed to support the residents. This concept should be made available to the Apartments, and can be implemented through a trusted single entry point, probably the Apartment’s Social Service Coordinator.
An Information and Assistance Program will be developed to help answer all questions and identify and respond to the specific needs of residents as they arise, and provide guidance on such requirements as meals, geriatric care, counseling, , shopping, legal, and other necessities that become known.
Household Chore Service may be key to the interests of residents. Such chores as spring cleaning, mattress flip, battery replacement, energy conservation, maintenance, and other topics are part of this Service that should be considered.
Transition Services may be needed as part of the NORC Plan. This can be a shock to the life of the resident in moving out of the Apartments. When seniors decide to move or need to be moved for medical reasons, the NORC Plan calls for a social service action that can be provided by a team, including the Apartment’s Social service Coordinator, the JFS Social Worker, and other professionals.

NEW INITIATIVES

The NORC plan includes several new initiatives that should be considered in relation to the role that the tenants and management and staff will play in coming months and years. These initiatives are tailored to the location of the Apartments and the opportunity for many seniors to get together beyond the specific location of the Apartments. There are many organizations that can add their strength and support to the implementation of these ideas. Here are a few potential activities that would add to the quality of life of NORC residents.

There are a variety of trails that are leading to the center of Wilkes-Barre. These trails are designed to meet all demographic population groups, including seniors. It would be useful to have representatives of the various trails make presentations to the residents of the Apartments, and to have groups of residents participate in the use of trails in Wyoming Valley. There is an Active Keystone Passport program that has been made known to the management and staff, and will be made known to the tenants.
There are community gardens in and around Wyoming Valley. This is an activity that can be beneficial to the residents who desire to have outdoor interests and who like to have an opportunity to participate in garden and vegetable growing and then utilize the products for their own purposes. Again, presentations can be made to the tenants at appropriate occasions.
Planned trips that can provide recreational experiences to tenants are being discussed, but there is a need to have transportation systems that can allow movement of tenants to venues that may be of interest to residents. One idea would be to develop a specific planned program of trips that are minimal in cost, and have physical activity benefits as well as other assets that can help expand the mindset of many residents.
The health and welfare of tenants is an important factor in the development of this NORC. There is evidence that health care maintenance makes it easier to reduce health care costs and reduction of loneliness and social isolation. Physical exercise by either the use of equipment inside the facility or special arrangements at the Jewish Community Center and the YMCA would enhance the ability of tenants to limit the onset of Alzheimer’s Disease and other negative health factors. NORCs are especially critical to the person who lives alone, has limited contact with friends or family, and needs to find resources that they may not be familiar with in the past. Therefore, this NORC plan suggests that a comprehensive health maintenance plan be prepared for the benefit of tenants, and that a task force of health agencies be established that can meet inside the building periodically and create a specifically tailored health maintenance process that can be generated by the end of 2010.
Colleges and universities prevail in Wyoming Valley. There is an opportunity to channel their resources inside the building and develop a series of courses that can be considered adult continuing education, based upon the results of the questionnaires as well as other tools that can define what residents feel would be very beneficial to them. There are many types of educational courses that can be considered, and steps should be taken to involve as many of the higher educational institutions as possible.
Intergenerational programs should be developed that can help promote ways that youngsters and seniors can interact with one another. For example, at one time, JFS had a Teens Do Care program that enabled teenagers to have a significant relationship with a senior citizen. The youngster could learn what it means to be a senior, and the senior would have the ability to explain and outline his or her history and experiences. It was a methodology that worked for over 20 years. It could be revitalized inside the Apartments. Additionally, there is a JFS program called Kids Care Club whereby youngsters as early as kindergarten prepared projects that either benefit less fortunate youngsters and/or senior citizens. It is strongly recommended that this program be instituted inside the building by having youngsters meet and prepare projects that can benefit residents.
Community engagement or civic engagement is a method for voluntary service learning that could be a way to enhance the role that residents play in meeting the needs of the entire community. A great opportunity exists to utilize the talent and skills of tenants to not only participate in their own Association but in many social, religious, nonprofit, and other community projects. The NORC plan suggests that a program be established that enables as many residents as possible to volunteer their services to as many community organizations as may be widely supported as needed. This can be further developed by the Institute for Service Learning at King’s College.
Nursing services, such as meeting the needs of chronic conditions, may be an important NORC activity that can be expanded in coming months. This individual care for older adults should start with a series of educational seminars, using the talents of physicians and nurses who can create a strong educational health presence that would add benefits that relate to physical and emotional improvements to tenants.
The educational and recreational processes that can be shared with tenants as part of the NORC plan would include lectures, concerts, classes, field trips, card games, cultural activities, discussion groups and much more. They should be diverse an designed to engage as broad a list of tenants as possible.

EXTENDING SERVICES AT B’NAI B’RITH APARTMENTS

While this NORC Plan does not contemplate implementation until fiscal year 2010-11, certain steps have been taken to begin the process. The following example provides steps that have been taken to achieve some positive results. Most importantly, is the team spirit and cooperation between and among the management and staff of the Apartments and the Jewish Family Service Social Worker. The following represents the type of service delivery envisioned in the NORC process in coming months and years.

The Jewish Family Service Licensed Social Worker met with the agency Executive Director to review the purpose and goals of the NORC grant and to discuss social work availability to the Resident Service Coordinator and residents of B’nai B’rith Apartments. A meeting was arranged between the JFS LSW and the Resident Service Coordinator to discuss the roles and responsibilities and outline ways to make residents aware of counseling services. An article was placed in the resident newsletter, which served as an introduction to the social work consultant and procedure for referral for counseling services. The social worker agreed to speak to the Tenant’s Association to discuss aging issues and availability of counseling services. Initial concerns expressed were traffic related. The social worker discussed civic responsibilities and recommended approaching WB City Council regarding these issues.

The social worker quickly became involved in the case of a resident who became very depressed after incurring a severe hip fracture in a fall outside her church. Resident had hip pinning surgery done and was subsequently transferred to an area skilled nursing and rehab facility for ongoing care and therapy. The social worker visited the resident several times at the nursing home and attempted to boost her spirits and allay her fears. The social worker met with therapists (PT, OT and Speech) individually to discuss resident’s progress or lack thereof. Resident was greatly offended by Speech Therapist’s cognitive testing and social worker intervened by discussing with the therapist the need to explain procedures to resident – i.e. take a few minutes to discuss the “why and wherefore” of conducting cognitive evaluation as a precursor to anticipating and addressing possible ramifications with regard to the therapy process. The social worker cautioned the resident that her slow healing process and eventual return to B’nai B’rith Apartments could be jeopardized if she did not consistently follow protocol of therapists regarding wheelchair positioning and safety.

The resident stayed for three months, but has since returned to B’nai B’rith and is doing well.

The social worker remains involved with another client suffering from mild depression and frequently communicates with the Resident Service Coordinator.

The social worker has also arranged a tour of B’nai B’rith Apartments with a client from JFS who is currently in a personal care facility, but running low on funds.

Also, the social worker has strongly encouraged another client to consider relocating to B’nai B’rith from her large home, which has become hard to manage. Client does not drive and her spouse is a resident of a nursing home close to B’nai B’rith. She and her out of town grown children are considering the move.

FINANCIAL CONSIDERATIONS

Discussions have been held with the management and staff of the Apartments regarding continuing funding for the NORC to help implement the findings and recommendations found in this plan. The intent is to make the plan available to appropriate officials connected with the Apartments, to receive feedback regarding the plan, and to take whatever steps are necessary to secure additional funding that would assist in developing actions that are important to the future use of the plan. The following list is designed to begin the process of evaluating options and alternatives that would be supportive of this goal. These ideas will be further developed in coming months to aid in seeking resources for the betterment of the NORC.

The Luzerne Foundation is a source of potential funding and should be approached regarding the role that this NORC will play and how they might utilize one or more of their fund sources for aspects of the NORC implementation.
A variety of family foundations exist in Wyoming Valley, and may be interested in supporting some of the steps outlined in the NORC plan.
The Nonprofit & Community Assistance Center (NCAC) at the NEPA Alliance should be contacted relative to any potential funding opportunity they may be aware of and could direct suggestions and ideas to the management and staff of the Apartments as well as JFS.
There may be governmental sources that could be contacted at the federal and state levels to help advance the financial needs of the NORC. This may be through appropriations measures or a specific line item either the federal or state budgets.
There may be opportunities short of direct funding that could be studied such as in lieu of funding that perhaps could help advance the NORC in coming years. This could include the YMCA, JCC, United Way, and many others.
In other NORCS around the nation, especially those that relate to full neighborhoods, there is normally a member fee that is utilized as a way to “buy into” the NORC and to utilize this fee as a method to support some of the recommendations. On the other hand, the nature of the tenant and his or her income is such that this may not be feasible for this particular NORC.
Since the Apartments may be free of HUD restrictions within a year or two, there may be an opportunity to utilize some funding from any reserve that is generated in the future to help advance the NORC.
Corporate foundations may exist that could be approached such as those associated with a financial institution or similar places to make an investment into helping meet the needs of the NORC.
A Friends of the NORC Campaign could be undertaken within the community to help raise some funds that otherwise would not be available, based upon this NORC being a demonstration of aging in place and highlighted as a model for other later NORCS in Wyoming Valley.
The Area Agency on Aging should be communicated with regarding ways to advance the NORC concept based upon this experience, and if funding is available, could be requested to help support the implementation of the plan.

There are, undoubtedly, other possible avenues to pursue. Therefore, it is suggested that whatever advisory group may be established in the future to continue the NORC theme at the Apartments be charged with furthering financial suggestions to advance this concept.

GUIDING PRINCIPLES

It is noteworthy that enough examples have surfaced for the NORC movement that guiding principles are available to be used, interpreted, and organized for the betterment of the residents involved. Such principles are categorized under five headings, and have been outlined by the United Hospital Fund, based in New York City. In their interpretation of the NORC for which they are a prime mover, they have found the following steps as being critical to a successful NORC.

The first is Understanding the Community, and there are five guiding principles as follows:

Effective NORC programs are built on a thorough understanding of the community and the residents who live there.
NORC programs gather different types of information from many sources at different points in time and use them for many purposes and multiple audiences.
Involving a variety of stakeholders in the process of understanding the community forges relationships that sustain a NORC program.
Once information is organized in a coherent framework, community stakeholders begin to interpret it.
The process of understanding the community enables NORC program planners and community stakeholders to craft an agenda for action.

The second is Partnering with the Community, and there are seven guiding principles as follows:

Forming partnerships is central to the function and operation of a NORC program.
Core partners align their goals and priorities.
Partners make different levels of commitment to a NORC program,
A NORC program is guided by a governance structure that meets local needs and clearly defines the roles and responsibilities of each partner.
Relationships among NORC program partners are continually evolving.
Effective communication strategies allow partners to break down the barriers that traditionally separate them.
A NORC program becomes woven into the fabric of the surrounding community through its partnerships.

The third is Designing and Implementing a NORC Program, and there are six guiding principles as follows:

A NORC program plans a core set of integrated services that meet individual needs and promote community change.
Effective NORC programs have in place adequate people resources-staff and volunteers with the right skill mix- and other resources, including space, equipment, supplies, and a budget, before the programs are launched.
A stable mix of public and private financial resources supports the basic activities and services of a NORC program.
A NORC program drills down to identify the component parts of a problem and to set priorities for action.
A NORC program plans and launches specific projects that collectively address the many dimensions of a problem.
A NORC program measures its progress to determine whether its projects are on track to reach their goals.

The fourth is Evaluating Projects of a NORC program, and there are five guiding principles as follows:

A NORC program incorporates a well-planned evaluation into projects as early as possible.
Each project evaluation is sharply focused and designed to be practical.
To conduct a useful evaluation, a NORC program commits adequate human and financial resources and develops efficient recordkeeping systems.
A NORC program involves its partners in the process of deriving meaning from its evaluation findings.
A well-structured evaluation generates knowledge that the program communicates to the larger community and translates into action.

The fifth is Sustaining a NORC Program, and there are seven guiding principles, as follows:

Strategic planning guides the evolution of a NORC program and is essential to its future.
As a NORC program moves beyond its start-up phase, it continuously pursues more stable and diversified funding.
Visionary leaders and strong managers are both critical to the success of a NORC program.
A NORC program communicates its goals and accomplishments to the broader community in order to secure buy-in and a lasting commitment.
A NORC program remains relevant by anticipating and responding to change, and refreshing itself with new people.
NORC programs become advocates for state and local legislation that provides stable, long-term funds.
As an agent of change, a NORC program reflects and challenges its partners and the community it serves.

SUMMARY

This plan is a start toward an eventual series of actions that are encouraged, enhanced, and warrant a constantly evolving process that has many components. The five guiding principles may not all be carried out in the context of the plan, but they serve as reminders of what a truly developed NORC can and should accomplish. There are involved tenants, a professional management and staff, and an advisory partner that are all woven into a tapestry of collaboration that can carry out a generation of partnerships that will enable tenants of this NORC to benefit from the demonstration of commitment to an integrated service system and a goal of excellence.

Additionally, the purpose of this plan is to serve as a guide for maximizing a full range of services that are all committed to the eventual vision of aging in place in a setting that can constantly improve. This can occur through the scores of partner organizations that can be brought into the NORC mix of talent and resources, both internal to the building and externally through the various agencies and entities that have been mentioned in this document, plus others that will become part of the implementation process in coming months and years.