By Sen. Cynthia Stone Creem
The Provider, November 2009

I am so pleased to be able to speak directly to the human service providers of Massachusetts and to say “thank you” to all the people who work with – and on behalf of – our most vulnerable residents. Our state is fortunate to have an extensive safety net of services and programs for the disabled and elderly – and an outstanding group of caregivers. I am particularly proud that the Governor and those of us in the Massachusetts legislature have made advances toward the “Community First” policy, allowing the elderly and people with disabilities to live with dignity and independence in their communities. With the help and support of caregivers who work with people in their own homes, at day programs, and in small residential settings, we will continue to promote programs that adhere to the Community First agenda. One simple but effective model of Community First service provision is working within “Naturally Occurring Retirement Communities” (NORCs).

NORCs are apartment complexes or clusters of homes where most of the occupants have lived for many years, and in which the residents find themselves in need of services because they have “aged in place.” NORCs are identified through census data, and often house frail and isolated seniors. Many of these elders need some community supports, but do not yet need full-time care in a nursing home setting. Bringing supportive services to these communities is an effective way to help elders remain independent for as long as possible.

NORC programs bring social workers, nursing and other care services to clients at their homes, where the residents are then able to participate in evaluations and receive individualized assistance. Apartments can be assessed for risks – like area rugs that are easy to trip on, or hot water that is set at too high a temperature – and residents can be evaluated and matched with programs and services. They can be linked with resources, including caregivers that match their level of need, transportation for shopping and doctors’ appointments, Meals on Wheels, and other appropriate programs. Onsite nursing staff can also monitor general health to prevent unnoticed health issues from becoming a crisis.

NORC programs around the country are successfully preventing hospitalizations and injuries that can cause elderly residents to prematurely become patients in nursing homes. NORC programs also offer important social opportunities for residents by using shared space in the building – as happens in my district in Brookline – for exercise classes and other community activities like movies or performances by visiting schoolchildren.

Studies have shown that providing home care services can delay or prevent seniors from being placed in nursing homes. And, this model of delivery is the one favored by seniors themselves. We know that people overwhelmingly wish to remain in their homes as they age, and we know that NORC programs are a cost-effective and successful way to organize the services that seniors need. Right now only about a thousand people in Massachusetts are receiving supportive services in areas that have been identified as NORCs – but thousands more could benefit. I look forward to the expansion of these programs in the future, as the public learns more about the benefits in quality of life and in cost savings of the onsite NORC programs.