Testimony to
The Commission on Affordable Housing and Health Facility
Needs for Seniors in the 21st Century

January 14th, 2002
Miami, FL

by
Dr. Pamela Elfenbein
Florida International University

DR. PAMELA ELFENBEIN: Thank you for inviting me here to speak. I'm going to speak about community academic partnerships.

I'm from the Center on Aging at Florida International University. I'm Director of Education and Training. Our mission is to expand our understanding about the lives of older adults through education and research.

I was approached by the Executive Director of what is in Miami known as the Tenant Advisory Organizations, the TAO. It's Miami-Dade Housing Resident Associations that were awarded funding under the TOP, the Tenant Opportunity Program.

I was approached after they were unable to spend their funds for three or four years and the funding period was running out.

What they wanted to do was empower residents to take charge of their health and improve their quality of life. They were unable to find a way to do that. They went to hospitals and other providers who were willing to come in and do lectures or to come in an do specific programs, but nobody that was willing to sit down with the residents and talk about what they wanted.

And what they wanted was programming based on resident perception of need by individual site and with programming on site. They wanted presentations to accommodate English, Spanish and Creole speakers and then we had to do it within the Tenant Opportunity Program guidelines.

Those guidelines included strengthening organizations of residents in public housing, supporting efforts to increase family self-sufficiency and help elderly or disabled residents to live independently and encourage resident partnerships with the Housing Authority and community organizations.

Included activities were social support activities and training on health, nutrition, safety and substance abuse.

So being an academic, after meeting with the residents, I went back to the literature and looked at our national priorities. The Department of Health and Human Services and the Health Resources and Services Administration, in particular. I looked at Healthy People 2010, who's mission is to increase quality and years of healthy life and eliminate health disparities. And HHS has written that:

"While Americans as a group are healthier and living longer, the nation's health status will never be as good as it can be as long as there are segments of the population with poor health.
"For too many racial and ethnic minorities in our country, good health is elusive since appropriate health care is often associated with an individual's economic status and race."

The Health Resources and Services Administration's mission to improve the nation's health by ensuring equitable access to comprehensive quality health for all and to train a health workforce that's both diverse and motivated to work in underserved communities.

The complexity and multiplicity of medical conditions common in older adults requires a team approach and World Health Organization, HHS and the authors of Healthy People 2010 have documented that need.

Interdisciplinary education as a tool for empowering health personnel's ability to respond to health care issues has also been documented by WHO and HHS. And so, a community academic partnership seemed natural.

For students working in a community requires the students to learn to view themselves as part of a larger world. And interdisciplinary education provided in communities where people live their lives brings the strength of all the disciplines and the visions of the community members together for the benefit of the whole.

Florida International University is a diverse university. It's a minority-serving university. Miami-Dade County is 54 percent Hispanic, 20 percent Black, and Florida International University student population mirrors that.

We also went out into the community to develop partnerships, and while we did partner with twenty different providers from Publix and the Daily Food Bank and the Kiwanis Club and the Police Department, our most important community partner was Farm Share.

Farm Share is a not-for-profit food distribution center here in southern Dade County and they distribute USDA and local farm surplus foods. And through them, we were able to distribute 36,000 pounds of food during the term of our project to the residents. It was a one-year project.

The biggest problem that we had in developing this partnership with the residents was building trust. The residents have had many negative organizations with others that come in. The first thing they told was they're not giving us their Social Security numbers. They're not paying for this service, right, and we had to keep reminding them that they owned the service, they were contracting with us.

So before we even went on site, we concentrated on building relationships, mutuality and trust with the presidents from each of the associations, each of the eleven sites. And we worked with the individual presidents to determining programming times, programming needs. We jointly invited with the president and the resident association the residents to participate in the initial get- together to review and talk about what they wanted.

We translated our flyers to join the program and every material that we handed out from English into Spanish, and Creole. And our students, that I'll get to in just a minute, also spoke depending on the site at least two languages and sometimes three languages and sometimes programming would be happening in three languages simultaneously.

So the students and the faculty -- we involved faculty also from our University, worked together to develop programs after we learned what the residents wanted. And each had discipline-specific goals.

Dietetics and nutrition, we had students from five different disciplines: Dietetics and nutrition, occupational therapy, physical therapy, nursing and social work -- all graduate students, Master's level students.

And in each resident association building, there was a team of these five students plus a faculty member.

And the goal of the Dietetics and Nutrition students were to improve the nutritional intake and hydration status of participants.

Nursing students helped to provide older adults with the skills to become the primary guardians of their health, focusing on health promotion and disease prevention.

The occupational therapy students strove to enhance participant's ability to perform activities of daily living and other activities designed to improve quality of life.

The physical therapy students worked on increasing participants' strength, endurance, balance, flexibility, coordination and to improve their overall health and prevent falls and other accidents.

And our social work students provided up-to-date and accurate health services, resources, education, including information on range of aging in place services, access criteria and how to navigate the system.

The program was so successful, the residents were joining us. The groups were twenty to thirty people every time that we did programming on site, which was twice a week.

As the program evolved, they actually gave us more of their Tenant Opportunity Program money and we did computer classes at FIU. We brought them over by bus and we had a room that was equipped with thirty computers and we got them all e-mail addresses. And the social work students helped them navigate the maze of social services online.

The occupational therapy students helped with assistive devices to help them get online.

And then they gave us even more money from the TOP money and we did cultural awareness programs. We took them to the Everglades. They met with the forest rangers. They went on tours of inland waterways and the islands.

We took them to the Kennedy Space Center. They had the tour of the space center. They were able to have dinner with astronauts who gave them little mementos and signed them.

We took them to Disneyworld and Sea World and then as also took each group on six to ten trips right here in Dade County from trips in Little Havana to Black Awareness Month to trips around South Beach and Art Deco.

They went on glass-bottom boat rides over the Coral Keys and we took them to the Planetarium, and they went to the theater.

I escorted them to see "The Last Emperor," which was a ballet and I was just amazed at the research that they did on their own before we went. It was a wonderful experience.

We've applied with the residents, or we did apply, under the SuperNOFA for Ross resident service delivery model. And we're not quite sure why we weren't funded on at least one of the projects. Our scores were such that we should have been funded and when I spoke with Washington, they weren't sure why not.

What I would urge you is to ask U.S. HUD to consider even a new category: academic partnerships in the SuperNOFAs. It was quite cost-effective. And I think that the most important thing was that the program was resident-owned. They contracted with us. They reminded our students quite often in the beginning, "I'm paying your salary" and that was correct. But it was a wonderful experience.

Thank you.