Universal Design, Visitability and Home Modifications: Providing Access and Independence

1. Universal Design, Visitability and Home Modifications: Providing Access and Independence 2007 Annual Conference of AT ACT ProgramsMay 22-24, 2007 Denver, Colorado Lifetime Home Project Diane Sprague, Director

2. In this session, we’ll... • Provide you with a global perspective on “accommodating housing” • Background • Current trends, barriers, opportunities • Useful information, resources • Learn about legal, administrative and financing programming from three states

3. “We shape our dwellings, and afterwards our dwellings shape us.” Sir Winston Churchill

4. Housing design background • “Built environment” historically standardized for an average user • Model – active male in 20s, about 180 lbs. • Came from WWII human factors data • Design based on his • Height • Weight • Range of reach • Capabilities, etc.

5. Housing design background, con’t. • Upside of average user model • Streamlined, cost-effective manufacturing, construction, building code enforcement • Model’s downside • Doesn’t fit children, short/very tall adults, persons with disabilities/frailty!!

6. Housing design background, con’t. • Basing design on the average user model fulfills Churchill’s quote • Buildings/houses turn “disability” into “handicap” for many • Design discriminates against people structurally

7. Accommodation movement • Started in the civil rights era • Adapted the average user model • Condensed broad array of disabilities, equipment, etc. • Result – “exceptional user model” • Male in 20s, using wheelchair • Limits in upper body, sensory capabilities

8. Accommodation movement -- Accessible (rental) housing • First-generation application in housing (late 1960s) • Mandated nationally • Applied to multifamily rental properties with federal $$s in development • 5% of units required to contain set of prescribed accessible (wheelchair) design features

9. Accommodation movement -- Accessible (rental) housing, con’t. • Some states incorporated federal 5% multifamily rental standard into their building codes (starting in early 1970s) • e.g., North Carolina, Minnesota • Mandated to apply to affected properties, not just with federal $$

10. Accommodation movement – “Adaptable” (rental) housing • Second advance in mid-1980s • Enhanced 5% requirement in multifamily rental properties funded with federal $$s • Units were to have certain “adaptable” features • (Leading edge of “universal design”) • Found in “Uniform Federal Accessibility Standards” (UFAS) design code

11. Accomodation movement – Adaptable (rental) housing, con’t. • Third advance in early 1990s • Mandated by amendments to federal Fair Housing Act • Applied to multifamily rental property nationwide, regardless of how funded, also some owned multifamily units (e.g., condos) • Required a set of adaptable features in all units, not just 5%

12. Universal design • Fourth advance in early/mid-1990s • a.k.a., “Design for All” in Europe • Concept promoted in many fields • i.e., Transportation, communications, consumer products, housing • Goal – design to fit as broad a segment of the population as possible • From children to seniors, short to tall, those without /with disabilities

13. (Home) universal design • Initially promoted for construction of owned single-family homes • Voluntary efforts around the country • Broad range of useful/helpful design features • Note: NOT identical to accessible design!! • Later, application of certain features promoted for retrofit as well

14. (Home) Visitability • Fifth advance – “visitability” concept (late 1990s/early 2000s) • First promoted by Concrete Change (GA) • Applies to owned single-family homes • Set of core features sought -- vary around the U.S. • Application varies around the U.S. – some legislative mandates (from cities to states), voluntary in others, draft federal legislation

15. Visitability, con’t. • Basic visitability features • Zero-step entrance • First-floor bath • Open first-floor circulation • Also in some locales • Accessible outlets and light switches • Grab bar wall backing in bathroom walls • Lever door handles

16. “Easy-Living” Homes • Sixth advance an enhancement of visitability (early/mid-2000s) • Promoted by Concrete Change • Additions to core features • e.g., First-floor area that can be used for bedroom • Voluntary certification program now in progress

17. Accommodations summary

18. Current status • Outcome for rental properties • Pre-1960s stock lacks design features • Units from 1960s to present are a mix of mandated design features • Some have accessible, some have adaptable features • Presence of mandated features may not be sufficient, though! • e.g., Need for units with roll-in showers

19. Current status • Outcomes for owned properties (single-family, condos, townhomes, etc.) • Great need to promote in new construction • Vast stock lacking important design features • Great potential/demand/need for retrofit! • Approaches for modifying • Custom-tailored design • Universal design/install features that adjust • A mix of the two approaches

20. Colliding trends • Needs/desires of current “young” seniors, BOOMER TSUMANI starting... • Both groups want to stay at home • Needs/desires of younger persons with disabilities, e.g., • Olmstead vs. LC • “Real Choice Systems Change” • “Money Follows the Person” • “Consumer-Directed Community Supports”

21. Colliding trends, con’t. • Health care/long-term care cost crises • Severe federal/state budget pressures • Rapid exit from acute care, from rehab, back home • “Home is where the....health care is...” • Consumers proactive with their health care • Seeking increased knowledge, decision-making control • Increased responsibility for costs • e.g., Health care savings accounts

22. Colliding trends, con’t. • Great increase in prevalence of persons with cognitive needs • Dementia, Alzheimer’s, traumatic brain injury • Memory care demand influencing national long-term care costs • Escalating housing costs – impairs readily developing “purpose-built” assisted living, affordable new homes

23. Colliding trends, con’t. • Explosion of “electronic lifestyle” at home, products for • Communications/entertainment • General security • Safety/security for those vulnerable, frail • e.g., Wireless sensing networks, products

24. Colliding trends, con’t. • Clear outcome from many of these trends • Our homes will become hubs for proactive health/wellness activities, and acute and chronic health care support • Health care delivery may significantly/ permanently change from its historic institutional delivery base • “Point of service” will be the consumer, wherever he/she is!!

25. Policy agenda, challenges • Start of recognition of • Need for accommodating housing • Impact because we have relatively little! • Practitioners looking for “hook” to boost awareness/promotion, institutionalize • Like global warming’s impetus for “green building” • Long-term care costs? Property insurance?

26. Policy challenges • Confusion over basic definitions • Public avoids paying attention to becoming older, disabled • Extreme homebuilder reluctance to incorporate even core UD/visitability • Remarkably “old-fashioned” industry... • Lack of adequate training/expertise

27. Policy challenges, con’t. • Lack of trained personnel for assessments • Emerging market of products, but confusing “supply chain” • Consumers lack • Awareness/education • Assertiveness with builders/remodelers • Guidance in negotiation the “non-system”

28. Policy challenge, con’t. • Funding resources for low-/moderate income households

29. Information resources • Universities active in the field • Center for Universal Design, North Carolina State • IDEA Center, SUNY Buffalo • National Center for Supportive Housing and Home Modification, USC • Collectively sponsor listservs on home modifications and visitability

30. Information resources, con’t. • Range of allied organizations growing, e.g., • American Occupational Therapy Ass’n. • American Ass’n. of Retired Persons • Alzheimer’s Ass’n. • Adaptive Environments (MA) • Concrete Change (GA) • National Kitchen and Bath Ass’n. • Reverse Mortgage Lenders’ Ass’n.

31. Role for AT Programs • Continue your funding programs! • Help promote awareness/education for contractor, consumers, the public • Partner with others to create a roadmap in the fragmented delivery non-system • Facilitate information and referral • Advocate/lobby for financing, resources for coordination, laws/regulations

32. Thanks for the presentation opportunity! The Lifetime Home Project’s mission is to advance universal/accessible design and assistive technologies to promote independence at home. It accomplishes its mission through community education, professional training, and technical services. Lifetime Home Project Diane Sprague, Director PO Box 17097 Minneapolis, MN 55417 612.722.3048 www.lifetimehome.us