In Urban Omnibus’ early days, the partners of Interboro — Tobias Armborst, Daniel D’Oca, and Georgeen Theodore — shared their research on a phenomenon called Naturally Occurring Retirement Communities, or NORCs for short. As they wrote in 2010, NORCs in New York City allowed seniors to grow old in the places they’d long called home, where they had access to supportive services, and benefited from both the design and ownership structure of the towers-in-the-park, limited-equity cooperatives that NORCs most frequently occurred in. More than a decade later, the appeal of NORCs is still clear: as housing inequality continues to grow, along with the senior population, so does the need for more ways that people may age in place. With nursing homes becoming COVID-19’s most deadly, and often invisible, hotspots, the lack of safe, supportive, dignified housing for older folks has never been more apparent.
In the earliest months of the pandemic, we wondered how NYC’s NORCs were faring, and asked Interboro if they would revisit their research and share an update. Last spring and summer, working with Riley Gold, they spoke with NORC administrators, and reunited over zoom with a group of NORC residents they had interviewed back in 2015. They asked how NORCs were adapting to the unprecedented situation, how they have lived up to their promises, and what stands in the way of their becoming more widespread.
We love good ideas for cities and suburbs, but finding the next interesting thing often supplants keeping up with their implementation. When we follow up, the results are usually informative. NORCs remain both the best thing going, and routinely undervalued, as administrators report below. If we want them to succeed on a larger scale, then, as a society, we need to place real value (and investment) in places where seniors can live in community and maintain autonomy, whether in a tower with a shared garden, or in a suburb without any sidewalks.
NORC stands for Naturally Occurring Retirement Community. Back in 2010, we wrote an article about the history of NORCs in New York City. We defined a NORC as “a place (a building, a development, a neighborhood) with a sizable senior community that wasn’t purpose-built as a senior community.” Importantly, “NORC” is also an official designation: if a place meets predefined population thresholds, it can become eligible for local, state, and federal funds to retroactively provide the support services seniors need.
We were drawn to NORCs for many reasons. To start, we appreciated their contribution to the generational diversity of the city. We liked that they were not planned as retirement communities yet offered enough stability and amenities that people chose to stay. We also noted that most of New York City’s NORCs existed in modernist, towers-in-the-park developments: a much-maligned midcentury housing typology that was, at the time, undergoing reassessment by some architecture and urban historians. Moreover, many of the NORCs originated as limited-equity cooperatives: long-term, intentionally affordable communities. NORCs, it seemed, could teach us a lot about the relationship between architecture, policy, and social resilience.
In most NORCs, one can find case management and social work services, health-care management and prevention programs, education, socialization, and recreational activities, and volunteer opportunities for program participants and the community. These are known as SSPs: Supportive Service Programs. In some instances, NORCs have additionally taken measures to retrofit their physical environments, making dwelling units and interior and exterior common spaces more senior friendly with amenities like grab bars, ramps, and lighting.
In January 2015, we sat down with older residents of Morningside Gardens, a NORC in Manhattan, to conduct an interview for our book The Arsenal of Exclusion & Inclusion. Each interviewee had access to on-site medical checkups, mental health counseling, artist-led workshops, discussion groups, and other amenities organized by Morningside Retirement and Health Services, Inc. (MRHS). Morningside Gardens fits the description of a mid-20th century, towers-in-the-park limited-equity cooperative for middle-income earners. Or at least it did: at the time of our first interview, the residents reported that the development had voted to go open market, against its limited-equity cooperative roots. Our conversation touched on this subject (a cause of concern for some but not all of the group members) as well as a range of subjects related to everyday life at Morningside Gardens.
Then, in May 2020, we followed up with three of the residents we had spoken to: Nancy, Rose, and Sydney. Sadly, two other interviewees — John and Marge — had passed away. In our conversation via Zoom, we asked how the NORC-SSP continued to support their needs, changes they had noticed in the development and surrounding neighborhood, and generally what they were up to. Subsequently, throughout the summer we conducted over a dozen interviews with NORC-SSP directors. In these interviews, we discussed the challenges of funding and operating a NORC. Finally, we interviewed Anita Altman and Fredda Vladeck — two architects of the NORC movement — about the long-term prospects for NORCs in New York and beyond.
Some interesting themes emerged from these interviews. First, it became clear that NORC-SSPs helped older adults cope with the COVID-19 pandemic. Since the COVID-19 pandemic began, NORC staff have sprung into action to support older residents. The existing infrastructure, relationships, and trust between staff and residents allowed them to avoid some of the most tragic outcomes witnessed in many nursing homes across New York State. Neighbors were asked to check in on one another. Families were contacted and held accountable to check in on their parents. NORC staff engaged in a lot of tech training, and programming moved online (workouts, lectures, and hobbyist groups continued). In describing how Morningside Retirement & Health Services (MHRS) responded to the pandemic, its executive director, Ron Bruno, offered a concise summary of the responses we heard from other SSP directors:
We immediately recruited volunteers. We kept the office open but with a skeleton staff that would not be making home visits. People were going to need help with shopping, prescriptions, and other errands. It was advised that older people not go out. We put out an email blast for volunteers and ended up with about 40. We started sending out email blasts (three to four times a week) and really tried to include the latest information coming out from the city, state, and the Centers for Disease Control and Prevention. But we also included info about things that they could do while at home to keep themselves occupied, stimulated, and socialized. What I’m concerned about is people getting depressed and isolated. Throughout, we were still available nine to five at our number. Then we started moving our classes to an online platform. Right now we have about twelve or so classes that are online: art, writing, meditation, music appreciation, etc. What we continued to do on different platforms was stay in touch. We have social workers calling their clients or doing a video chat as frequently as before, if not more frequently.
More than one director we spoke to noted that the parks in the towers-in-the-park allowed older residents to safely spend time outside at a comfortable distance from others. (On the other hand, the elevators that worked so well in non-pandemic times suddenly became dangerous, which created an increased need for delivery services.)
For many NORC residents and directors, the role that NORC-SSPs is playing in the pandemic underlines the need for them in non-pandemic times. Indeed, many of the people we spoke to described investing in NORCs as a “no-brainer,” since the per-person cost is minuscule compared to, say, nursing homes, and since with health services on site, residents are less likely to make very expensive visits to the ER. Moreover, NORC programming keeps residents mentally and physically active. (Anecdotally, we were told that older residents were less likely to move into assisted living facilities because of this constant stimulation.) According to Bayla Butler, program director of NORC Supportive Services at Amalgamated-Park Reservoir, “NORCs can save our federal government billions of dollars,” while also enhancing quality of life by allowing residents to remain in their home and community, with access to loved ones and peers:
Your per-person cost is miniscule compared to how much it would cost to keep someone in a facility for one month. How much does it cost when you’re treating, say, 700 people a month? Not to mention quality of life, which is so much more enhanced by keeping people in their home in their community, where they have access to loved ones and peers.
Others however expressed the sentiment that, despite all the tangible benefits they provide, NORCs have failed to live up to their expectations. For example, Fredda Vladeck, a former director of the United Hospital Fund’s Aging in Place Initiative and author of a number of articles on NORCs, candidly expressed dismay about the scrappy pragmatism of the NORC model as it is actually practiced, describing how some residents are only consulted about their immediate needs. Both Vladeck and Anita Altman, a former deputy managing director at the UJA-Federation of New York who is something of an architect of the NORC movement, remarked how the more utopian, imaginative ideas that once animated NORCs have taken a backseat. What would it mean to dream again, to think creatively about living in community with others into old age, to imagine cities that are empowering to seniors and generationally-integrated with accessible designs and amenities for all? To quote Vladeck at length:
I am really concerned that continuing to pander to people’s pocket books, about saving money, is going to continue to doom us. The fact of the matter is, serving people in need costs money. And until this country wraps its head around it, you’re going to have insufficient funding and all these do-gooders doing the best they can when the deck is stacked against them. When we overpromise, we get into a trip bag, and you keep overpromising and overpromising.
Vladeck and Altman weren’t the only interviewees to express this sentiment. Mohini Mishra, Managing Director of Housing & NORCS at Selfhelp Community Services, Inc. stated that “we are looking for solutions here and there but not really looking ahead . . . Collectively what can we do as a society, as a community, for ourselves and others, to age? . . . We should design for community, and not for a short-sighted vision.” Similarly, Maria Scarfo, Program Director for the Vision Urbana NORC Program, insists that “people should know the link between health management and case management: you can go to a senior center and get a Medicaid application done or get food stamps, but only a NORC can do the socialization piece and promote self-advocacy. We’re the ones who talk to older adults about their health, and empower them to become primary agents.”
While most interviewees were optimistic about the promise of NORCs (in theory if not in practice), just about everyone we spoke to was quick to identify problems. More than one director spoke about the challenges NORCs have in addressing mental health needs. Butler put it this way:
I have people coming to me with severe mental health issues. There is not the structure to address those issues. Insurance doesn't normally pay for it. Or the providers cannot take new patients. Another problem we have concerns adult-dependent children who have aged into clients. These are adults who were not diagnosed as children and are now old and sick. These mental health issues are a real challenge to keeping them safe. They keep popping up.
Space-related problems are pervasive. Willing Irene Chin-Ma, deputy executive director of the Grand Street Settlement, which provides NORC services to the Baruch Houses in the Lower East Side, described her space in the Baruch Houses as “horrible.” Chin-Ma described ongoing leaks and electrical problems, and noted that the space was so small that they can only have five people in their office with distancing. Interestingly — and somewhat unsurprisingly — such space-related issues were identified more in NYCHA properties than non-NYCHA properties (the Baruch Houses are owned and operated by NYCHA). Chin-Ma also brought up the fact that despite the essential services Grand Street Settlement provides to older adults in the Baruch Houses, they have to pay rent, and don’t receive the rent match that other NORC-SSPs offer.
This leads to the problem that was identified the most in the interviews: the lack of adequate funding to support the myriad services that NORC SSPs provide. Chin-Ma put it succinctly: “Funding has always been a thorn.” For Fredda Vladeck, a key reason for this has to do with a fundamental disconnect:
When you think about the government role, it has been so weak. The state office on aging, the city department for the aging — NORCs are not priorities to them. If there’s money, they love it. But conceptually the NORC model was very hard for them. Their major business is getting government money to fund senior centers, meals on wheels, and other discrete, concrete services that are measured in units of hours, and numbers of referrals. They could never get the larger concept. All they want to know is how many nursing home admissions you prevented.
According to Ron Bruno, city and state funding has nonetheless gotten better over the years, so that “a greater percentage of our revenue is coming from public dollars.” Bruno pointed out that the New York City Council is now funding NORCs. Bruno pointed out that “This is good, but it’s less reliable: unlike the money budgeted for NORCs in the city budget, Council funds are discretionary, and vary year to year.” At the federal level, there was a pilot project for NORCs in Baltimore, Philadelphia, Cleveland, and Indianapolis, but according to Bruno, this didn’t amount to much.
Like Vladeck, Bruno feels that NORCs are undervalued, noting that “I feel like I’m on a mission to spread the news about this New York thing that’s working. I’m still amazed that NORCs haven’t caught on in other states.” Kathy Rosenthal, senior vice president for programs at the Family Services League, also spoke of a mission:
It's important to educate our elected officials and people who have the power; we need to remind them that there are ways to really improve life for this huge and burgeoning population of ours, that the NORC is a model that really has legs and can meet the needs of every community and its residents.
But as Keh-Yueh (Carrie) Chen, Chin-Ma’s colleague at Grand Street Settlement put it, “NORCs are not the best solution but they are the only solution right now.”
Next: Read edited transcripts of our two conversations with residents of Morningside Gardens in NORCS of NY Revisited, Part Two. These interviews are annotated with insights from our subsequent interviews with NORC directors and with Fredda Vladeck and Anita Altman.