Senior Living Business

August 2007 issue

Intergenerational Shared-Site Programs--
Practical Tips On IGSS Operations And Funding Sources

Discover practical tips on operating and funding sources for programs that serve different age groups in the same facility — a model that benefits everyone.
...
Benefits of a ‘Blue Ocean Strategy’--
Metropolitan Jewish Health System — An Eager Adopter

Eli Feldman, CEO of Metropolitan Jewish Hospital System in New York City, is an eager adopter of this practical, creative business strategy.
...
Q&A With David B. Fields
David B. Fields, Managing Director and Senior Living Sector Leader at RBC Capital Markets, talks about issues impacting not-for-profit financing and RBC’s new focus on this market.
...
Low-Income Housing Tax Credit Program: How It Works
National Equity Fund’s Deborah Burkhart takes the mystery out of this beneficial government program.
...
Recent Not-For-Profit, M&A Refinancings
These deals closed in recent weeks.


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Companies Mentioned in this issue:
August 2007

B
Brinton Woods Senior Living p3
C
Covington Investments p3
D
Deupree Health Care Center p3
E
Extendicare Health p3
G
Generations United p1
H
Herbert J. Sims p2
I
IDE Management Group p3
L
Landmark Nursing & Rehab p3
Lorien-Frankford Nursing & Rehab p3
Love Funding p3
M
Mather Hospital p3
Metropolitan Jewish Health System p1
Milwaukee South p3
N
National Equity Fund p3
R
RBC Capital Markets p2
S
St. Ann Center for Intergenerational Care p1
Summerfield Plaza Apartments p3
T
The Marilyn and Gordon Macklin Intergenerational I p4
U
UBS p2
V
Village on the Isle p3
W
Westchester Villages p3
Z
Ziegler Capital Markets p3
 

Intergenerational Shared-Site Programs--
Practical Tips On IGSS Operations And Funding Sources

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Intergenerational shared-site (IGSS) programs serve different age groups in the same facility. They are formal programs that intentionally promote and actually plan intergenerational interaction. IGSS programs often have an intergenerational coordinator, who works with the staff to plan and steward the interactions or the opportunities for interaction.
“Using resources to connect generations makes a lot of sense,” says Donna Butts, executive director of Generations United. “In an IGSS facility, we see benefits for young people, older people, the community, and the staff. Some elders don’t see their own grandchildren, and vice versa, so this type of program is good for the adults and good for the children.” The most common IGSS model is the combined adult day care and child day care run by not-for-profit groups.

The IGSS model
“I’ve found that the best design has specific areas for adults with frailties, older adults with frailties, and then children,” says Sister Edna Lonergan, president of St. Ann Center for Intergenerational Care in Milwaukee, Wisconsin. “They each have their own space and then common areas by choice.”
St. Ann Center is a freestanding facility that provides day care for children, ages six weeks to six years, and adults. It also operates before- and after-school programs, a summer camp, and buddy programs, in addition to a new residential respite program.
“We’ve expanded seven times since 1983,” says Sr. Edna. “We went from a $500,000 annual operation to about $4.5 million almost overnight. Our most recent expansion was the respite program for caregivers who either become ill themselves or just need a break. We’ll take care of their loved ones for up to 20 days.”
Sr. Edna believes that every room in the facility should be geared to people of all ages and abilities. “For example, when we built the child-care center, “ she says, “we made sure that all the chairs – even the littlest ones – were sturdy enough to hold adults. No area isolates any age group or anyone with any disability.”
The theme at St. Ann Center is “Love Knows No Age” — something that is evident to any visitor. According to state regulations, the facility must have a crib for each infant, but they’re rarely ever in a crib. They’re almost always sleeping in someone’s arms – “because we have so many arms available,” says Sr. Edna. “The adults and children both benefit from their contact with each other.”
Also, the children grow up — often from infancy — familiar with people dependent on, say, tubes or oxygen and have no shyness about jumping onto the lap of someone without legs. The environment has become part of their daily life. “The diversity here is very broad,” says Sr. Edna. “You see wheelchairs, walkers, crutches, oxygen tanks, baby packs, dogs...all sorts of things coming through the door at any given time. A lot goes on here.”
Activities are planned to some degree, because the child-care center must remain secured. So while each area may be accessed by anyone, the participants don’t just wander around freely. The Rock-a-Bye Club, for example, is an activity where older adults go to the baby room and rock the babies. Other times, children are taken to visit the adults. “We usually have two formal, planned, intergenerational activities every day, but there’s also a lot of spontaneity. We have a 5,000 sq. ft. glass-enclosed park, so those who aren’t feeling well or who may not want to participate in an interactive activity can sit and watch the children play.”
There’s also a resident Scottie puppy. “We have a lot of animals, a lot of children, and a lot of people with disabilities,” says Sr. Edna. “And it’s fun for everyone, because everyone feels loved and needed.”

An “awesome” program
The Marilyn and Gordon Macklin Intergenerational Institute in Findlay, Ohio, began in 1997 as an academic program affiliated with the University of Findlay. In July 2003, the Institute was spun off “to do the practical part,” says Vicki Rosebrook, executive director. “We needed to test our theories and concepts, and the only way to do that was to actually put them into practice.”
The Macklin Institute provides training, does research, and offers an intergenerational certification. “We also consult with groups that are interested in starting an intergenerational program,” says Rosebrook, “but the most important thing that we do is provide intergenerational care. We provide day care for 72 children, ages six weeks to five years, and about 300 elders in independent living or adult day care programs or needing skilled nursing, Alzheimer’s and dementia, rehabilitative therapy, or hospice care.” Children interact with all of those individuals throughout the day.
“I believe we’re the only program where children interact with that full range of aging,” says Rosebrook. “We feel it’s important for children to interact with well and active adults, as well as the frailest of the frail. Our child care and adult day services are conjoined, so participants move freely back and forth.” The children are also taught sign language very early on, so they can communicate with elders who can’t hear.
Most of the children’s activities and experiences occur with residents in the residential neighborhoods (independent living, adult day care, assisted living, etc.). “Just about everything the children do is with the elders,” Rosebrook explains. “I call it a lifelong learning lab, because it’s all based on contextual learning. Throughout the day, the children go on ‘friendly visits’ to apartments, rooms, or the hospice. If the kids have a math project – shapes, for example – they’ll go out with the elders and look for shapes, talk about the shapes, the colors, and so on. In our backyard – we’re very careful not to use institutional terms, so we have a backyard instead of a playground — we have dogs, cats, birds, and teaching gardens, where the elders tell the kids about the plants and flowers.” The children and elders have very tight-knit relationships and connections, often spontaneously teaming up with one another. It’s all about community.
“IGSS is an awesome program model,” she adds, “and it’s changing society. It’s changing the way children look at aging as well as the way elders look at youth today.”

Finding funding
The funding sources available to start an IGSS facility depend on whether the provider is building from the ground up and needs to finance it through a capital campaign or is retrofitting or expanding an existing facility to include an intergenerational component. In either case, the funding is usually through gifts, grants, or bequests rather than loans. “Some have borrowed as part of their capital campaign or for certain specific initiatives,” says Butts, “but the financing is most often accomplished through philanthropic dollars.”
Some providers receive grants from the HUD Sec. 202 senior housing program. “Government funding offers a lot of possibilities,” she adds, “but those projects are often either underfunded at the federal level or undertapped by people.” Otherwise, providers back their facility with private funding — perhaps from a primary donor (or donors) who have a particular interest in the model and may want the facility named for them.
Since The Macklin Institute began as part of the university, it initially got federal grants from the U.S. Department of Education. “We got two grants almost immediately, back to back,” says Rosebrook. “Then we had an independent benefactor. Gordon Macklin, founder of the Nasdaq, lived in Findlay for about eight years back in the 1950s and credited the town with helping to make him a millionaire for the first time. He wanted to give back by endowing our program — thus, our name.” On occasion, when the facility needed to raise capital for a new building, for example, Macklin made challenge grants — a fairly large gift — and challenged others to match it.
Ongoing operations are generally funded through an annual campaign and a variety of additional fundraising activities throughout the year, as well as tuition or registration fees. Faith-based programs often receive support from their national organizations, as well as from local churches or synagogues.
St. Ann Center, which has used no HUD funds, has had capital appeals a couple of times and initiates an annual appeal every year to fund operations and build its endowment. “While most of the money comes from philanthropic individuals and some foundations,” says Sr. Edna, “we also hold raffles, we have shops, we collect, refurbish, and resell antique jewelry and we sell gerbils!” The center subsidizes the care of very poor people — to the tune of about $17,000 per month — and, therefore, depends a lot on the generosity of individual donors.

For more information on IGSS programs...
A wealth of helpful resources on how to operate and fund an IGSS program is available on the Generations United website (gu.org). The organization’s fact sheets, guides, reports, and other material can be downloaded for free.
St. Ann Center has published a comprehensive replication manual, Caring for Generations: A Guide for Creating an Intergenerational Day Services Center ($49.95), that includes information ranging from how to do a needs assessment and choose an architect to how to run a capital campaign, market the program, and develop intergenerational activities. To order, call Ron Zeilinger at St. Ann Center (414-977-5064).
 

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