Home Modification Resources

Introduction

"The number and types of individuals who need home modifications will grow dramatically over the next 20 years."

Our society's changing demographics include the aging of our Population and an increase in the number of persons with disabling conditions. As a result, many people experience obstacles in their homes that are inconvenient, limiting, and dangerous. They are beginning to realize that their homes can better support their needs through home modifications; that they can remain in their homes and neighborhoods rather than move to more institutional settings. While most people can benefit from small scale modifications, the range of changes is broad-from simple assistive technology to home additions. Inexpensive devices include door hardware, hand held showers, added lighting, hand rails, and grab bars. Ramps, powered lifts, and remodeled bathrooms and kitchens are more expensive and complicated projects.

The number and types of individuals who need home modifications will grow dramatically over the next 20 years; families with children with disabilities, adults with disabilities, middle-aged couples planning for the future, families who accept aging parents into their homes, and an increasingly older population aging in place. All are seeking homes that are attractive and that offer them convenience, safety, ease-of-use, continued independence, and retained value.

Barriers to Home Modifications

The ability to meet this growing need for home modifications is hampered by several barriers: lack of information, limited funding, and inadequate services.

Lack of Information

Aerial view of houses Many households can benefit from home modifications that improve safety and accessibility. However, many consumers don't seek help because they have a limited awareness of the benefits of home modifications and a lack of understanding of the low cost of most modifications. Some households also perceive a stigma associated with disability "accommodations." Consumers are not yet demanding modifications in sufficient numbers to command the attention of policymakers, manufacturers, retailers. and remodelers.

Limited Funding

The many resources for home modifications are hard to locate, limited, and increasingly threatened. There is especially limited funding to provide assistance to low-income households, which have a disproportionately high level of need for modifications. The situation has become more complex with changes in the federal government's role. Over the past 30 years, the federal government has aided home modifications with programs in seven cabin et-level federal departments. While many see the value in modifications, federal government's role. Over the past 30 years, the federal government has aided home modifications with programs in seven cabinet-level federal departments. While many see the value in modifications, federal dollars continue to shrink. The changing scene is demonstrated by HUD's Reinvention, announced in 1995. It offers both hope and concern. This plan for change, HUD Reinvention: From Blueprint to Action, reveals a commitment to low- and moderate-income families, choice for households, community discretion, community participation, compliance with fair housing laws, and program consolidation. With the best of intentions, but against a background of shrinking allocations, consolidated programs will result in tougher competition for scarce funds within HUD. Federal funding for home modifications is likely to diminish further and block grants will make state level decision-making more crucial.

Inadequate Services

People in a meeting pic In most communities, coordination of home modification services is limited or nonexistent even among professionals who are aware of the need for assistance: health care, rehabilitation, housing, and social service professionals. There is no effective service deliverv system to connect those who need home modifications with experienced remodeling and other pro- IO& fessionals who can make adaptations. Fortunately, more non-profit and for-profit providers are gaining experience as training and service delivery models emerge.

These three major issues are linked; limited information contributes to a lack of consumer demand; limited demand for home modification services results in few experienced providers and remodelers; inexperienced providers and remodelers produce poorly crafted, ill-suited modifications; small, scattered, little known, and underutilized funding sources produce a patchwork of public service programs and make it hard for low-income households to undertake projects. Consumers are often frustrated by the process of obtaining and making home modifications and discouraged by the results.

The Response

In response to these issues, The Center for Universal Design (formerly the Center for Accessible Housing) convened the First National Conference on Home Modification Policy in November 1993. Funded by the North Carolina Assistive Technology Project and the National Institute on Disability and Rehabilitation Research, this conference addressed the growing gap between the need and available assistance for home accessibility. The conference brought together policy makers, professionals, and consumers with a common interest in bridging this gap. The conference resulted in a commitment to continue exchanges among the participants and work toward a national agenda for increasing the availability and funding for home modification services.

The Second National Conference, planned by the National Home Modifications Action Coalition, took place on April 22-23, 1996, at the Georgetown University Conference Center in Washington, D.C. The conference had public and private sponsorship which included the National Institute on Disability and Rehabilitation Research, the U.S. Department of Housing and Urban Development, Lowe's Home Safety Council, the Administration on Aging, the U.S. Department of Health and Human Services, and GE Appliances. Additional support was provided by The Home Depot, the North Carolina Assistive Technology Project, and KraftMaid Cabinctry, Inc. This conference was an opportunity to develop an action plan whereby community, state, and national organizations could:

create and coordinate service delivery systems,
increase the availability of home modifica- tions to all who need them, and
document the impact of home modification assistance on improved safety and independence in the home.

The two-day working conference, A Blueprint for Action: The Second National Working Conference on Home Modifications Policy, brought together over 60 of the nation's leading experts in disability, aging, housing finance, remodeling, design and construction, community development, and long term care. Participants shared service delivery strategies and models that have proven successful in diverse communities.

The conference began with opening remarks by William Benson, Deputy Assistant Secretary for the Administration on Aging (AoA), U.S. Department of Health and Human Services, who emphasized the needs of the large and growing number of people who can benefit from home modifications. He acknowledged the important contribution of home modifications in maintaining independence as a part of a communitybased care system. He reminded participants that AoA continues its 15-year commitment to this issue and congratulated everyone for working on this important topic.

CAD drawing pictures The conference was organized around four key themes-Consumer Knowledge, Funding, Service Delivery, and Systems Change. Panels on these topics were formed around paper presentations developed for the conference. Working groups convened to address the issues raised in the papers and during the panel discussions.

A Blueprint for Action was developed from the major paper topics, discussions and working groups at this second conference. Portions of the papers are excerpted. This report includes a discussion of barriers and recommendations for change at the national, state, and community levels. it reflects the diverse perspectives and approaches of the many experts who contributed to the conference and the papers. Most importantly, A Blueprint for Action is an action plan for promoting home modifications through coalition building, and sustained and coordinated activities.

Purpose of Blueprint for ACTION

Measuring something picture A Blueprint for Action is intended to stimulate productive and coordinated efforts to promote home modifications. It is an educational tool designed to increase awareness of the need for and the benefits of home modifications, to provide an incentive for groups to take action, and to stimulate the creation and utilization of resources. This report will help community, state, and national organizations develop and coordinate home modification service delivery systems that will increase the availability and quality of home modifications. A Blueprint for Action is designed to be used in a variety of settings, including public agencies, businesses, non-profit groups, associations, and other coalitions.

Goals

A Blueprint for Action has two goals:

Catalyze leadership on the national, state, and community levels.
Organizations need to make a long-term commitment to home modifications as a priority issue.
Promote effective public and private collaborations between national, state, and community stakeholders.

Because home modifications are needed by households of all income levels, public and private collaborations will ensure adequate funding and broad targeting of efforts.

Objectives

A Blueprint for Action is intended to:

1. Increase awareness of the need for and benefits of home modifications. Promotional efforts begin with demographic information and include the individual and societal benefits of home modifications.

2. Establish working collaborations between public, non-profit, and industry organizations, including the disability community, the aging network, housing advocates, and the medical industry. The consumer and practitioner constituencies for home modifications are broad. Effective programs need to include these diverse groups and organizations if they are to be successful.

3. Increase consumer knowledge and demand for quality services and products. The acknowledged large need for modifications can be converted into productive action if consumers know about the benefits and low cost of modifications and products, and if they know about financing sources, product retailers, and experienced remodelers and installers.

4. Increase expertise within the service delivery system. Practitioners working in all related professions and trades need information and training in assessments, needs, design, and product availability.

5. Increase the quantity and quality of home modifications. More public programs and private sector remodelers need to focus on home modifications using trained staff. All need to know of other practitioners for improved referrals.

6. Strengthen the delivery of home support services as a complement to home modifications. Awareness of the role of home modifications in a comprehensive approach to maintaining independence will lead to better service referrals and more efficient use of funds.

7. Increase awareness and availability of funding and financing sources. Public housing and medical funders as well as private funding sources need to maintain and expand home modification and repair opportunities for low- and moderate-income households. innovative collaborations need to be created that demonstrate new affordable financing mechanisms.

Roundtable meeting picture

The conference made it clear that individuals and organizations operating at national, state, or local levels, in the public or private sector alike, can adopt a portion of the home modifications agenda that is now outlined in A Blueprint for ActionThe opportunities are numerous. A Blueprint for Action can be used by organizations to develop action agendas, to stimulate additional meetings or conferences, and to create local or state level working groups to promote home modifications. other possibilities include the following:

Service providers can target funds for home modifications and related community services.
Researchers can collect outcomes data, survey consumer preferences, or review service delivery quality.
Remodelers can gather information about home modifications and work with independent living centers or senior centers to market their services to those in most need.
information dissemination specialists can add home modifications referral information and link up with other home modifications information services.
Training professionals can use research data to develop materials and programs for all stakeholder groups.
Manufacturers and retailers can integrate universal features and services into their products and displays and conduct market research to alter marketing strategies.

These groups and others can find a place to start or continue in A Blueprint for Action.

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