With more older adults aging in their own homes, a number of naturally occurring retirement communities have evolved in New Jersey --essentially neighborhoods or apartment buildings where long-time neighbors are growing old together.
These communities, or NORCs, as aging experts call them, provide supports that allow seniors to remain in their homes, instead of uprooting them to retirement communities or nursing homes.
"Seniors want to stay in their homes, but if the social supports or the safety net is not in place, it is difficult for them to remain," said Assemblyman Reed Gusciora (D-Hunterdon/Mercer).
The Jewish Federation of North America has provided assistance to NORCs in pockets of New Jersey. Now, in an effort to expand those efforts, legislation will come before the Assembly Health and Senior Services Committee for a hearing today to provide state funding for NORCs.
Naturally occurring concentrations of the elderly can be found across New Jersey, including "East Rutherford, where my grandmother used to live," said Gusciora, who is the bill's prime sponsor. "You have neighborhoods where the children have moved away, and the parents have remained."
His bill would appropriate $250,000 to fund NORC pilots in Mercer County and directs state Health Commissioner Mary E. O'Dowd to award grants for two-year NORC pilots to either a senior center or to one or more low or moderate income apartment buildings or housing complexes, where at least half the households are headed by someone 60 or older.
If the pilot is successful, ongoing state support for the NORC services might come from Medicaid, which now devotes the majority of its spending to long-term care for nursing home expenses -- but would save money if more seniors could age in place, Gusciora said.
The bill envisions providing NORC residents with a wide range of support services, including information, counseling, recreation, socialization, volunteer programs, support groups, health education, on-site nurses and doctors, health screenings, medication management, mental health services, transportation, and help with shopping and financial management.
By concentrating services to the NORC, "senior services will be brought to the community, and it allows seniors to stay in their homes, to keep healthier and keep their morale up," Gusciora said. "There are a lot of benefits to allowing seniors to stay in their homes: You would have less institutionalization of the seniors and also get a healthier community. It's just a win-win for everyone."
The bill proposes conducting the NORC pilots in Mercer County in part because Gusciora represents Mercer, but also because Mercer pilots will be more convenient for the health department staff in Trenton that will monitor them. "But if the state feels it should be somewhere else, I'm amenable to that as well."
More than a dozen NORC programs have been launched across New Jersey by member agencies of the Jewish Federation of North America, which since 2002 has piloted NORCs in 26 states.
The United Jewish Communities of MetroWest New Jersey is the lead agency for a NORC program called LIVE (Lifelong Involvement for Vital Elders) that it began about eight years ago in Parsippany, followed by Caldwell and Verona.
Karen Alexander, director of eldercare services for United Jewish Communities of MetroWest New Jersey, said her organization obtains federal grants to build the infrastructure for LIVE, and after several years a sustainable program is turned over to the local nonprofits, volunteers and community-based organizations.
LIVE has provided programs such as home repairs, retirement planning, transportation and exercise and wellness programs. A key component of LIVE is pulling together information on the senior supports available in the community, and making sure seniors are aware of them.
"Each community is slightly different and each community has a slightly different story to tell," Alexander said. "In Parsippany we've reached over 1,000 people over the years, between the employment program, and social work assistance and home repairs."
For instance, when the planning began in 2004, "we were surprised at the number of older adults [age 60 and over] who expressed interest in finding jobs," she said. The Jewish Vocational Service provided an employment counselor who specializes in working with older adults and the program has since helped more than 130 seniors find jobs.
"We have helped people well into their '80s to find work," Alexander said. Some seek jobs because they need income, but for many seniors "work provides meaning, structure and purpose. Having a place to go where you are making a contribution can be important for maintaining a sense of vitality."
The proposed NORC legislation to create a state program would benefit New Jersey, Alexander said. "I think the possibility of the state offering support to expand the model and explore it further is wonderful and unexpected news, particularly in this funding environment. It is a great investment."
Although the state would need to provide ongoing funding for NORCs "in the long run it would pay for itself" in reduced medical and nursing home expenses, Gusciora said.
The assemblyman said he has not spoken with state health officials to gauge their support for NORCs "and that is why we are having hearings -- to have that discussion with the executive branch at the same time that you have the legislative hearing."
AARP also supports the bill, according to Ev Liebman, state director for advocacy.
"We are certainly very familiar with these NORC projects and very supportive of them," she said. "They are very good programs, and the concept behind them is gaining in popularity [because] it's actually less expensive for people to be able to stay in their home as long as possible, which is really what folks want. Certainly that is what our members want. It's a big concern and worry for adults of all ages, to have the security of knowing that there will be sufficient supports to stay in their communities as long as they are able."
"One of the unique things about these (NORC) initiatives is that, if done well, they involve the residents themselves in figuring out what they need in their communities and how these programs should be governed," Liebman said.