Ideas People: Talking with Rebuilding Together Dayton CEO

Q What is Rebuilding Together Dayton (RTD)?

A We are the Dayton affiliate of a national non-profit organization committed to creating safe and healthy homes for low-income seniors. According to the AARP, almost 90% of seniors over the age of 65 intend to age in place. We assist with urgent home repairs and modifications for our elderly neighbors, who have lived in their homes and communities for years.

 

Q How do you create “safe and healthy homes”?

A We utilize the seven principles of healthy housing to ensure homes are: dry, clean, pest-free, safe, contaminant-free, ventilated, and maintained. We engage 1,000 volunteers annually to participate in our Community Revitalization projects, which are coordinated efforts to build and sustain safe and healthy communities. In addition to the volunteer focused Seasonal Revitalization Programs, our NeighborCare Program employs local contractors to complete skilled work. We specifically address falls prevention, critical maintenance, and issues related to chronic conditions such as asthma.

We concentrate on our four focus areas: Safe and Healthy Housing, Youth and Corporate Engagement, Community Revitalization and Veterans Housing. These areas combined with the seven principles of healthy housing direct us with how to provide the most critical and cost-effective repairs and modifications to impact our homeowners. Simple, inexpensive modifications around the home – such as installing handrails, grab bars and improved lighting – have been shown to prevent falls and other accidents. Falls are the leading cause of injury-related deaths for older Americans – and most falls happen at home.

Our elderly neighbors need help year round, and we address them through skilled and volunteer efforts. In the spring, we concentrate our efforts on healthy homes and energy efficiency with our National Rebuilding Day event (the last Saturday in April); In the summer, we address exterior maintenance with our youth and corporate [Re]Build events; In autumn, we keep our homeowners warm through the annual Heat the Town event; And throughout the winter, our attention is directed towards fire safety and fall prevention with Fix-It-Kits.

 

Q What is the biggest challenge you face?

A Most homes are not built to facilitate aging in place. Families with fewer financial resources are more likely to experience unsafe, unhealthy housing conditions and are least able to remedy them. RTD constantly receives referrals from area hospitals and home health providers for seniors who have recently fallen and cannot be released from the hospital or a rehabilitation facility without a home modification, such as a ramp or step-in shower. Our limited funding prevents us from fully meeting these needs. Aging in place in your own home is typically more cost-effective compared to assisted living or nursing home facilities. Recent studies on Medicaid expenditures found that providing care and supportive services in the home – instead of nursing homes – resulted in savings of $22,588 – $49,078 annually per individual. Home and community-based supportive services for older adults are not only more cost-effective, but promote good quality of life.

A program developed at the Johns Hopkins School of Nursing called CAPABLE (Community Aging in Place, Advancing Better Living for Elders) teams a nurse, an occupational therapist and a handyman to help older people live more comfortably and safely in their homes. Models like this one are successful because they use the strengths of the older adults themselves to improve safety and independence. However, we still see disconnects between the overwhelming need of our neighbors and an underwhelming response from our local medical providers. Without an intensive focus to the preventative measures of creating safe and healthy housing for the growing population of seniors to age in place, the costs – human and dollar – will continue to rise rapidly.

 

Q How do these challenges affect the community?

A According to the CDC, a person’s zip code is more predictive of overall health status than his or her genetic code. The physical and social environments of neighborhoods directly impact our health, including disabilities, chronic health conditions, mental health, and injuries. Premier Health performed a Community Health Needs Assessment and identified addressing chronic disease as one of their top priorities. RTD partnered with Sinclair Community College’s Occupational Therapy students to complete 25-point home assessments for 100 senior homeowners. Outside of fall prevention interventions, the most needed repairs indicated were proper exhaust systems in the kitchen/bathrooms. Asthma currently affects an estimated 24 million Americans, and the CDC estimates the yearly cost of asthma in the United States to be around $56 billion. Additionally, one in three older adults fall each year, resulting in an estimated 2.5 million ER visits, 700,000 hospitalizations, and approximately $34 billion in health care costs. Many hospital visits – and readmissions – can be prevented with attention to the health and safety of the home.

The American Public Health Association and NCHH jointly developed the National Healthy Housing Standard to inform housing policy that reflects the connections between housing conditions and health. An NCHH research review in 2009 found that larger field evaluations are needed to identify the interventions likely to be consistently successful in reducing falls and fall injuries for those with and without a history of falling. The NCHH review found three methods appear promising: 1) home assessment followed by recommendations for modifications, 2) multi-faceted interventions that encompass home modification and other strategies such as exercise, medication review, nutritional supplements or mobility aids, and 3) community-based, coordinated, multi-strategy initiatives that include home hazard reduction.

RTD is already in the field doing home assessments with recommendations for modifications, and community-based efforts to decrease home hazards. We are looking to partner with medical providers in order to fully integrate their expertise with our ability to implement these repairs and modifications.

 

Q How can people get involved?

A All donations to RTD are tax deductible, and every dollar raised from the community generates another $4 of in-kind labor and materials. We invite volunteers to join us for our 23rd annual National Rebuilding Day on April 28th.

For the last three years, we targeted the Westwood neighborhood. Starting this year, we are focused in the Carillon neighborhood. This effort kicks off a five-year commitment to the HUD Choice area, which includes Edgemont, Madden Hills, Pineview, Lakeview, and Miami Chapel neighborhoods.

The Choice Neighborhoods program supports locally driven strategies to address struggling neighborhoods with distressed public or HUD-assisted housing through a comprehensive approach to neighborhood transformation. Local leaders, residents, and stakeholders, such as public housing authorities, cities, schools, police, business owners, nonprofits, and private developers, come together to create and implement a plan that transforms distressed HUD housing and addresses the challenges in the surrounding neighborhood. The program is designed to catalyze critical improvements in neighborhood assets, including vacant property, housing, services and schools.

In addition to volunteering on National Rebuilding Day, there are a lot of other ways to get involved. Your school, church, or company can organize a supply drive for our Fix-It-Kit program. We need a variety of household supplies, including fire extinguishers, furnace filters, and cleaning supplies. We also coordinate [Re]Build Days for volunteer groups and corporate sponsors to engage with their community while serving their neighbors in need.

For more information, or to sign up online, please visit rtdayton.org/volunteer.

Sources:

CDC (2016), “Important Facts about Falls,” http://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html

RWJF (2015), “Making the Case for Linking Community Development and Health,” http://www.nchh.org/Portals/0/Contents/Housing%20Interventions%20and%20Health.pdf

KFF (2015), “Distribution of Medicaid Spending on Long Term Care, Timeframe FY 2014,” http://kff.org/medicaid/stateindicator/spending-on-long-term-care/

NHC (2014), “Aging in Every Place: Supportive Service Programs for High and Low Density Communities,” http://media.wix.com/ugd/19cfbe_9861425bab344338b13c416fa8e3b6ed.pdf; cf. Office of Policy Development and Research, U.S. Department of Housing and Urban Development (2013), “Aging in Place: Facilitating Choice and Independence,” https://www.huduser.gov/portal/periodicals/em/fall13/highlight1.html

“Older Adults and In-Home Safety” (2017) https://www.mealsonwheelsamerica.org/docs/default-source/misc/olderadultsandinhomesafetyreport_final.pdf?sfvrsn=2

BHPN and RWJF 2015), “Making the Case for Linking Community Development and Health,” http://www.buildhealthyplaces.org/content/uploads/2015/10/making_the_case_090115.pdf; cf. NCHH (2009), “Housing Interventions and Health,” http://www.nchh.org/LinkClick.aspx?fileticket=2lvaEDNBIdU%3d&tabid=229

CDC (2016), “Important Facts about Falls,” http://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html.

Georges Benjamin and Thomas Vernon.  National Healthy Housing Standard, National Center for Healthy Housing & American Public Health Association. Columbia, MD: May 2014. www.nchh.org/standard.aspx. National Center for Healthy Housing & American Public Health Association.