Approaches by the Aging Network to coordinate and seek funding and service providers for home modification and repairs include establishing formal joint partnerships to leverage other state and local agencies’ home modification and repair efforts (e.g., with Departments of Rehabilitation, Housing, Human Services, and Medicaid, weatherization, and Independent Living Programs/Centers for Independent Living). State Units on Aging (SUAs) reported funding collaborations with other governmental entities, the most common of which (34%) was with state Medicaid offices related to home-and community-based waivers. For example, the Vermont SUA conducted an analysis of Medicaid Waiver participants and found that very few were accessing funds available for home modification and repairs, yet the Waiver program’s fall rate was very high. In response, the SUA and the Medicaid team worked together to improve education and training of case managers about the use of Medicaid Waiver funds for home modification and repairs.

Another strategic approach by the Aging Network to build partnerships across sectors is leading or participating in cross agency workgroups, coalitions, or task forces on home modification and repairs to address overlaps and gaps in state and local program missions and funding mechanisms. These efforts might include taking inventory of other home modification and repair funding sources and programs that may be available and vetting those sources so that cross-referrals can occur, ultimately leading to more formalized partnerships and maximizing unexpected resources.

Examples of partnership efforts by the Aging Network to work with housing, disability, and health care agencies and groups provide opportunities for other agencies to emulate and include: 1) formal collaboration with other organizations; and 2) home modification coalition building and advisory board membership.

Formal collaboration by the Aging Network with non-aging organizations enhances home modification and repair availability and awareness. SUAs indicate that the most common home modification and repair collaboration with other state agencies includes efforts with the Departments of Weatherization, Rehabilitation, Housing and Community Development, Medicaid, and Housing Finance Agencies. For example, the North Carolina SUA coordinates directly with the North Carolina Housing Finance Agency on planning activities related to HMRs. Twenty-two percent of SUAs reported collaborations that promote access to state general revenues. For example, the New York SUA received $15 million in general state fund support to address unmet service needs of older adults. Home modifications and repairs were identified as a needed service and thus, a portion of the $15 million was dedicated to HMRs. About 1 out of 5 (20%) SUAs reported collaborating with state assistive technology programs (e.g., the Nevada SUA oversees and participates on the Nevada Assistive Technology Council which includes home modification and repair efforts). About 16% report working with rehabilitation services to formally collaborate in home modification and repair service provision.

For low-income older adults and persons with disabilities who may not have the funds to finance home modification services or have access to or qualify for programs that cover home modifications and repairs, many Area Agencies on Aging (AAAs) and Title VI grantees engage in formal collaboration at the local level to enhance access. At the local level, nearly 40% of AAAs and 10% of Title VI grantees engage in partnerships with local-non-profits and voluntary groups in the housing, health care, and disability sectors; for example, nonprofits with volunteer no-cost providers such as  Rebuilding Together and Habitat for Humanity.

Examples of formal collaborative efforts by the Aging Network to work with housing, disability, and health care agencies and groups provide opportunities for other agencies to emulate and include:

• The Agency on Aging/Area 4 in Sacramento, California funds and partners with three programs that deliver home modification and repair serves to diverse communities from urban Sacramento to the very rural Sierra County. The programs provide innovative home modification and repairs that utilize volunteer installers and handymen/women: 1) FREED Center for Independent Living (Nevada, Yuba, Sutter, and Sierra Counties) administers the “Fix It” program which removes hazards in the home such as securing loose rugs, repairing loose floorboards, stairs, or decking as well as provides assistive devices such as handrails, grab bars for the shower or tub, raised toilet seats, and shower chairs; 2) Placer Independent Resource Services (PIRS) (Placer County) serves the home modification needs of renters with written permission from the property owner. PIRS does an in-home safety check to insure the homes are safe and as barrier-free as possible; and 3) Rebuilding Together Sacramento (Sacramento County) fills a home modification service gap in the community by targeting older adults who live in mobile homes, which can be challenging due to fiberglass showers and very steep entryways.
• The Connecticut State Department of Aging and Disability Services (State Unit on Aging) works with bureaus within its larger Aging and Disability Department to connect older adults with low-interest loans for minor modifications like ramps, stairlifts, and grab bars as well as connect older adults with agencies who provide home modifications.
• The Iowa Department on Aging (IDA) has a strong partnership with Habitat for Humanity at both the state and local levels. The Greater Des Moines Habitat for Humanity became interested in aging in place through projects in Denver, Iowa. This interest rose to the statewide Habitat for Humanity, which then connected with IDA to explore collaboration. It helped facilitate introductions at the local Habitat for Humanity chapter levels, as all of Iowa’s counties are covered by a local Habitat chapter. AAAs have also independently built strong relationships with their Habitat chapters, often due to regularly occurring natural disasters, and look to Habitat chapters for assistance in finding solutions to meet the needs of their communities.
• The Maryland Department of Aging (State Unit on Aging) is involved with several efforts to increase home modifications and repairs through partnerships. It oversees Community for Life (CFL) which provides a package of services for Maryland homeowners and renters 65 years of age and older. CFL is administered through local partners in the state (11 as of 2022), including community service and community health agencies, Human Resources Development Commissions, the Living Well Center of Excellence, and Partners in Care affiliates. CFL includes home maintenance/light home repair provided by a community “handyman” based on a list of vetted contractors, transportation, and community access navigation in a cost-effective and supportive manner. This fee-based, local nonprofit model involves three pillars of support including initial home assessment and handyman support, transportation, service navigation. The Maryland Department of Aging also partners with the Maryland Department of Housing and Community Development which administers the Accessible Homes for Seniors Program. The Program provides zero-interest loans to modify a home space for adults aged 55 or older. Modifications may include grab bars and railing installation, widening of doorways and installation of ramps. Loan payments are deferred for 30 years or until the sale or transfer of ownership of the home. It targets Maryland residents with at least one resident age 55 or older who must own and occupy the home to be renovated as their principal residence.
• The Minnesota Board on Aging (SUA) works with the Minnesota Housing Finance Agency’s (MHFA) Rehabilitation Loan Program to fund home modifications and maintenance for very low-income older homeowners.
• The Mississippi Department of Human Services: Division of Aging and Adult Services (State Unit on Aging) partners with the state’s Low-Income Weatherization Assistance Program to weatherize hundreds of homes annually, which increases home’s energy efficiency to lower energy costs. It also conducts health and safety measures in homes and makes referrals to other organizations if a family needs additional services not covered by the Weatherization Program such as home modifications or repairs.
• The Missouri Department of Health and Senior Services, Division of Senior and Disability Services administers the Independent Living Medicaid Waiver program through an inter-agency agreement with the Missouri HealthNet Division. It provides personal assistance services, including environmental accessibility adaptations, beyond the limitations of the Missouri Consumer-Directed State Plan Personal Care program to Medicaid eligible individuals aged 60 or older and to adults with disabilities between the ages of 18 and 59 who qualify for the Consumer-Directed Personal Care program.
• The Ohio Department of Aging and the Ohio Department of Medicaid worked together to align the rules governing home modifications ensuring the standards for service delivery are the same across all Medicaid waivers serving individuals with a nursing facility level of care.
• The Tennessee Commission on Aging and Disability (State Unit on Aging) builds partnerships between managed care organizations, the Area Agencies on Aging and Disabilities Network, and housing development organizations to better serve the aging population through its TennCARE CHOICES program. TennCare CHOICES in Long-Term Services and Supports is for adults (21 years and older) with a physical disability and older adults (age 65 and older) who need services to live in their own home or in the community. TennCare allows for minor home modification funding to not only the CHOICES program, but also the Employment and Community First CHOICES program which focuses its efforts on the Intellectual and Developmental Disabilities population. This includes $6,000 for a single home modification project, $10,000 for a year and $20,000 for a lifetime.
• Washington State Aging and Long-Term Support Administration (ALTSA) (State Unit on Aging) has partnered with the University of Washington Center for Technology and Disability Studies to create a lending library of assistive technology devices for consumers to try before purchase to decide if the devices are a good fit for their needs.
• The Wisconsin Department of Health Services, Services for Older Adults (State Unit on Aging) works directly with the State Independent Living Council and its Centers for Independent Living to facilitate home modification assessments for programs and, in some cases, provide funding for needed home modifications.
• The Vermont Disabilities, Aging and Independent Living (State Unit on Aging) promotes a pilot program called “One Touch” through a partnership with the Vermont Department of Health. Experts who are called to a home for weatherization services can do a falls risk screening and make simple modifications during the visit.
• The Governor’s Office of Elderly Affairs State of Louisiana (State Unit on Aging) engages in partnership development at the local level for home modifications (e.g., a partnership with St. John Parish provides ramps through donations of lumber from the community and also the donation of labor).
• The New Mexico Aging and Long-Term Services Department (ALTSD) (State Unit on Aging) engages in multiple partnerships to ensure home modification and repair access. It has an agreement with the Nevada State Medicaid Agency to ensure that consumers transitioning from long-term care receive necessary home modifications. ALTSD also partners with the Veterans Administration through the Veteran’s Directed Care Program to ensure eligible Veterans receive home modifications and partners with the Governor’s Commission on Disability’s Residential Accessibility Modification Program (RAMP) to provide referrals for funding for home modifications.
• The Valley Program for Aging Services, an Area Agency on Aging in Waynesboro, Virginia administers the Home Renovation and Repair Program in partnership with the local non-profit, Rebuilding Together. This Home Renovation and Repair program has case managers who handle phone requests for assistance from older adults, caregivers, professionals, and others. Requests may include information about home modifications in general, in-home assessments, and recommendations on how to meet an older adult’s home modification needs.

A home modification advisory board, task force or coalition can increase home modification activity and awareness at the state and local levels, stimulating demand and advocating for home modification programs, policies, and funding. It is a mutually beneficial alliance of individuals, groups, and/or organizations that is entered into for a specific purpose. This coordinated effort can enlarge the base of support and visibility for policies, alternatives, and initiatives among a broad range of groups. Aging Network agencies often participate in task forces or coalitions with other agencies, professionals, and non-and for-profit businesses. Also, many states and communities have fall prevention task forces and home modification is a key component of these fall prevention efforts.  Coalitions can advocate to get home modification and repairs integrated into state and local general funds or home and community-based programs that may not include home modification and repairs.

Examples of Aging Network involvement in coalitions and task forces provide opportunities for other agencies to emulate and include:

• The Iowa Department on Aging (IDA) actively participates in the Iowa Livable Homes Coalition to strategize and develop a better network of local and statewide providers to create a State Program Hub for home modifications. IDA provides technical assistance and the state perspective to the coalition. The coalition has been advocating for support from the state General Fund This funding could be part of an annual appropriations process to build a broad-based home modification service delivery system that has a unified language between aging and disability sectors that IDA can integrate into its services for Iowa’s older adult population.
• The Minnesota Board on Aging (State Unit on Aging) is working to implement a state-level multi-agency task force assigned to focus solely on the needs and opportunities related to older adult housing. It is also launching a public-private partnership to complete all home modifications and home maintenance repairs needed by the 16,400 very low-income older homeowners in Minnesota who are at risk of needing to move from their primary home. As part of the MN203O initiative addressing the first Baby Boomers turning 85 in 2030, the Minnesota Board on Aging conducted research on home modification and assistive technology availability and compiled it in a report, “ Status Check: Technology and Home Modifications to Help Older Minnesotans Age Well.”
• The Nevada Department of Health and Human Services/ Aging and Disability Services Division (ADSD) (State Unit on Aging) oversees and participates in the Nevada Assistive Technology (AT) Council. The AT Council’s mission is to provide consumer-responsive, consumer-driven advice for the planning, implementation, and evaluation of assistive technology programs which includes home modification or repair efforts.
• The State Of New Jersey Department of Human Services Division of Aging Services (State Unit on Aging) participates in the New Jersey Falls Prevention Work Group which sponsors annual Falls Prevention Awareness Weeks, promotes consumer and professional home modification resources, and fosters partnerships with disability and aging agencies to offer evidence-based fall prevention programs that include home modifications.
• The Vermont Disabilities, Aging and Independent Living (State Unit on Aging) co-chairs the statewide Falls Free Vermont coalition, working alongside other state and local agencies to raise awareness of falls and home modifications, expand programs and resources including home modification and repairs, increase surveillance of falls, and advocate for support. Several home modification and repair programs and businesses are part of the coalition.
• The Wyoming Department of Health Aging Division (State Unit on Aging) co-founded the Wyoming Home Modification Action Coalition (WYHMAC) with the University of Wyoming. It was developed as a resource for Wyoming residents and professionals who serve older adults and persons with disabilities throughout the state. Its purpose is to increase awareness of the role of supportive housing in healthful living and to facilitate access to home modifications when and where they are needed in Wyoming. The coalition represents a partnership between organizations who share the goals of improving safety and facilitating independent living and aging-in-place among older adults and younger persons with disabilities. As of 2022, WYHMAC is made up of professionals from the following organizations: Wyoming Older Adults Falls Prevention, Wyoming Center on Aging, University of Wyoming, Wyoming Department of Health, Aging Division, Habitat for Humanity of Laramie County, and Wyoming Independent Living. The mission is to promote home safety, independence and quality of life of Wyoming residents through increased access to home modifications.