Research has shown that most older adults think that their homes will support aging in place. This can be explained, in part, by consumer denial and lack of awareness of the home environment’s role in compensating for physical limitations. Beliefs about home modifications having an institutional appearance, high costs, and potential for scams add to reluctance to carry out modifications.  As key entities at the state and local levels responsible for planning and providing services that help older adults to live independently in their homes and communities, the Aging Network plays an integral role in raising consumer awareness about the importance of a supportive home environment.

Approaches include: 1) raising awareness about available home modification and repair programs and funding sources that exist through non-aging sector agencies; and 2) increasing consumer awareness and access to home modifications through educational activities,  information sharing, and referrals. Examples of Aging Network roles in raising consumer awareness provide opportunities for agencies to emulate.

Home modification and repair services are funded and delivered at the local, state, and national levels by disparate government agencies and private providers. They are often embedded within broader housing, aging, health, and disability programs. With different purposes, practices, agendas, time horizons, and fiscal capacity, the result is often a confusing array of services with diverse eligibility requirements, methods of assessment, coverage specifications, types of installers, and caps on costs. Agencies within the Aging Network can help to improve consumer access to non-aging sector home modification and repair funding sources and services. For example, a home modification may be a covered Medicaid waiver service; however, older adults and their case managers may not be aware of this coverage so there is under-usage.

• The Massachusetts Executive Office of Elder Affairs (State Unit on Aging) provides strategic support to Area Agencies on Aging for home modification and repair access and availability through the Older Americans Act Title III, the National Family Caregiver Support Program, and Medicaid Home and Community-Based Services Waivers. It engages in activities to raise consumer awareness about home modifications through engagement with the Area Agencies on Aging (AAAs) and Aging Disability Resource Consortia and leverages other state agency home modification and repair programs through the Massachusetts Rehabilitation Commission.
• The New Mexico Aging and Long-Term Services Department (State Unit On Aging) provides counseling to Medicaid waiver and state assistive technology program participants about accessing their home modification benefit under these programs after it found that participants are often unaware of this benefit.
• The Rhode Island Office of Healthy Aging (State Unit on Aging) helps to promote The Rhode Island Livable Home Modification Grant through Aging and Disability Resource Centers across the state. This grant program, administered by the State of Rhode Island Governor’s Commission on Disabilities, partially reimburses accessible home modifications for individuals who have disabilities so that they may live more safely in their homes and remain in the community. The grant is 50% of the total retrofit costs and up to $5,000. Grant awards include the cost of the needs assessment and post renovation certification of compliance. The grant is available to individuals who have a physical or mental disability that substantially limits one or more major life activities. Individuals must either live in the home to be modified or be living in the home once modifications are completed.
• The Vermont Disabilities, Aging, and Independent Living (State Unit on Aging), through a partnership with the Vermont Department of Health,promotes a pilot program called “One Touch.” Experts who are called to a home for weatherization services conduct a falls risk screening and make simple modifications during the visit. The One Touch: Creating Healthy and Energy Efficient Housing initiative is recognized by the U.S. Department of Housing and Urban Development as a model program integrating health, housing and energy services.

While informing consumers about aging related services and topics is a common role for the Aging Network, some state and local level agencies have elevated home modification and repair as an area to promote through educational activities, information sharing, and referrals.  Just over a third of AAAs disseminate information on home modification and repairs through fact sheets or conducting presentations. About one-third of State Units on Aging, 40% of AAAs, and 15% of Title VI grantees conduct specific activities that raise awareness about home modification and repair. While one of the key roles of the Aging Network is referrals and connecting consumers to needed services, nearly half of the AAA respondents indicated a key role for them is direct referrals to  funding sources and other non-profits for home modifications or repairs (e.g., city/county housing and community development departments, etc..). This is important because while an Aging Network agency may not necessarily provide or fund home modification and repair, staying knowledgeable about funding sources in the housing, disability, and healthcare sectors is key. Specific Aging Network efforts to increase consumer awareness through educational activities, information sharing, and referrals include:

• CICOA Aging and In-Home Solutions, an Area Agency on Aging in Indianapolis, Indiana hosts an annual Safe at Home event, an organized, direct impact half-day of service to homeowners over the age of 60 or to persons of any age with a disability. Each year, volunteers and CICOA help make homes and yards safe and accessible for daily living to a central Indiana community. The event coincides with Fall Prevention Awareness Week in September each year.
• The Iowa Department on Aging (State Unit on Aging) created an entire section on home modification on their web site that includes information on “How to Get Started,” “Hiring a Contractor,” “Funding the Home Modification,” and “Additional Directories” to access home modification providers.
• The Michigan State Aging and Adult Services Agency (State Unit on Aging) has an online “Aging Service Searchable Database” that features the keywords “Home Repair” and “Home Injury Control” (defined as providing adaptations to the home environment of an older adult in order to prevent or minimize the occurrence of injuries). Upon choosing a keyword, the user can pull up home repair or home injury control providers and services by zip code, county, or city.
• The New Hampshire Department of Health and Human Services: Bureau Of Elderly And Adult Services (State Unit On Aging) included home modification and repairs as a topic of listening sessions for consumers throughout the state, raising consumer awareness while also informing their own home modification service programming.
• Region 2 Area Agency on Aging in Brooklyn, Michigan has Information and Referral staff especially knowledgeable in resources to assist with any home modifications or repairs. In particular, they identify candidates for the AAA’s Home Safety Assessments program that examines safety issues inside and outside of the house for individuals in the community. The assessments are conducted by a home safety specialist and a report is provided with recommended modifications.
• Valley Program for Aging Services (Area Agency on Aging) offers the Home Renovation and Repair Program in Waynesboro, Virginia and works in partnership with the local non-profit, Rebuilding Together. The program has case managers knowledgeable in home modifications and repairs who handle phone requests for assistance from older adults, caregivers, professionals, and others. Requests may include information about how to access home modifications, in-home assessments, and recommendations on how to meet an older adult’s home modification needs, including the construction of a wheelchair ramp to provide easier access into the home or repairs to a deteriorating home to make the environment safer.
• The Vermont Department of Disabilities, Aging and Independent Living (State Unit On Aging) co-chairs the statewide Falls Free Vermont coalition, working alongside other state agencies and community-based organizations to raise awareness of falls, expand programs and resources to prevent falls (including home safety and home modifications), increase surveillance of falls, and advocate for support.
• The West Virginia Department of Health and Human Resources, Bureau for Medical Services administers the Money Follow’s the Person demonstration program, Take Me Home, under the Aged and Disabled and Traumatic Brain Injury Waiver programs, assisting individuals transitioning from long-term care facilities to receive long-term services and supports in the community. The program developed a guide, “Navigating Accessible Community Housing: A Guide for Individuals with Disabilities and their Support Teams Seeking Housing in the Community.” This document includes guidelines for how to request reasonable accommodations and reasonable home modifications from landlords; descriptions of ADA requirements for buildings; and design elements to look for to support independence in the new housing setting.