Visitability: a MAJOR “NO-STEP” TOWARDS INCLUSIVE HOUSING the Current Housing Stock Fails by Jordana L
FEATURE Visitability: A MAJOR “NO-STEP” TOWARDS INCLUSIVE HOUSING The current housing stock fails by Jordana L. Maisel of Housing and Urban Development to meet the needs and preferences emphasized the discrepancy between the of today’s aging population and need for and supply of accessible homes. The research found that those with disabilities. While over one million elderly homeown- the lack of affordable housing often ers have unmet housing needs that attracts attention, much less notice could force them to reluctantly is taken of the shortage of accessible abandon their homes, prematurely housing. Homes that empower the move to institutional settings, and elderly and people with disabilities reduce their quality of life.2 No are all too uncommon, particularly known data exists to indicate how in the single-family housing mar- many nursing home residents are ket. Many homes are still being there partly due to a lack of accessi- built with steps at all entrances and ble housing. However, anecdotal hallways, and doorways that are too evidence abounds that elderly peo- narrow for wheelchair users. ple are often discharged from a hos- With the aging of the baby pital directly to a nursing home boomer generation, homes that after a stroke, broken hip, or other allow seniors to age in place will impairment, because the design of become increasingly desirable. their home cannot accommodate Changes in public policy and design their now limited mobility. practices must begin to prepare for The growing need for accessible the growing number of seniors who housing is further exacerbated by want to age in their own homes. demographic trends. The country’s Visitability – an affordable and sus- population is experiencing a drastic tainable design strategy – strives to IDEA, BUFFALO transformation, with a growing sec- increase the supply of accessible No step entries help make housing accessible to a diverse popu- tor of the population above the age single-family housing. Its simplicity lation, including people who use wheelchairs. of 65. Many demographic factors, has led to thousands of open- impairments and the elderly. This including the aging baby boomer genera- market homes with basic access across includes many with disabling injuries, a tion, lower birth rates, and longer life the country. number that is increasing dramatically spans, are combining forces to create this THE HOUSING PROBLEM AND with tens of thousands of wounded Iraq changing population landscape. CHANGING DEMOGRAPHICS war veterans.1 But it can also include • Since 1900, the percentage of Amer- The lack of accessible housing most just about anyone who, at one time or icans 65 years and older has more than directly impacts people with mobility another, has broken a leg, a hip, or had tripled (4.1 percent in 1900 to 12.4 per- some accident limiting cent in 2000), with the actual number of 80 mobility. The design of elderly citizens increasing 11 fold (from 70 the house and its 3.1 million to 35.0 million) over the 60 entryway can pose seri- 50 ous obstacles, and also 1 According to a report in the Los Angeles Times, 40 there have already been over 50,000 soldiers wound- hinder many individu- ed in the Iraq war, with many additional wounded in 30 als’ ability to remain Afghanistan. See Linda Bilmes, “The Battle of Iraq’s 20 Wounded” (Jan. 5, 2007). 10 actively engaged and 2 Housing our Elders (U.S. Dept. of Housing and
NUMBER OF PERSONS (MILLIONS) participate in the com- 0 Urban Development, 1999). 2000 2005 2010 2015 2020 2025 2030 munity. 3 A Profile of Older Americans: 2003 (Administration Projection of Number of Americans over Age 64 (in millions) A study published on Aging, U.S. Dept. of Health & Human Services, Source: U.S. Census, Population Projections, 2000 by the U.S. Department 2003).
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1 same period.3 solution to the shortage of accessible the word “visitability.” In other words, • Projections based on U.S. Census housing. Originating in Europe, the vis- a visitable home is intended to be a resi- Bureau data indicate that the number of itability movement was initiated in the dence for anyone and to provide basic persons age 65 and older will grow to United States in 1986 by Eleanor Smith, access to everyone. Visitability strives to almost 40 million by the year 2010 and a disability rights advocate. Along with provide a baseline level of accessibility in 70 million by 2030.4 her organization, Concrete Change, all new home construction, in hopes of As they age, seniors prefer to live Smith’s ultimate goal is to make all new benefiting the entire population. independently rather than move to a new homes “accessible enough” for not just A visitable home is any new single- home or assisted living facility. A 2003 the homeowner (or renter), but for a vis- family dwelling unit, duplex, triplex, or study sponsored by AARP found that itor with a disability – hence the use of continued on next page older Americans overwhelmingly pre- ferred this outcome.5 The ability to “age in place” also Olmstead v. L.C relations, social contacts, work options, received an important boost from the economic independence, educational by Michael Allen, Esq. U.S. Supreme Court. In its 1999 ruling in advancement, and cultural enrichment.” Olmstead v. L.C., the Court held that When the United States The same principles apply not only to Supreme Court announced its decision in “unnecessary segregation of individuals people who are currently institutionalized Olmstead v. L.C., it set in motion powerful with disabilities in institutions consti- unnecessarily, but also to people at risk of forces that may reshape the way society unnecessary institutionalization. Often, tutes discrimination based on disability 1 thinks about housing for older people older people end up in nursing homes or because it perpetuates unwarranted and people with disabilities. That case, in assumptions that people with disabilities assisted living because they cannot find which the Court held that the unnecessary housing that is minimally accessible, or are incapable of participating in commu- institutionalization of people with disabili- need minor supports that are not readily nity life.” This decision has important ties is a form of discrimination prohibited available. implications for housing and the right to by the Americans with Disabilities Act The underlying principles declared in age in place. (ADA), has been hailed by some advocates Olmstead will require states to think care- as the equivalent of Brown v. Board of WHAT IS VISITABILITY? fully about how to maximize the use of Education. scarce public resources to support an Visitability has emerged as an innovative The Olmstead case involved two infrastructure of housing and services that women who were will keep people out of institutional set- unnecessarily tings. Visitability ordinances are one key detained in a state to solving both these problems, by psychiatric hospital expanding the number of residential units long after their treat- with basic accessibility, and permitting ing professionals seniors and people with disabilities to live determined they with families or friends who can provide were prepared to live assistance on an informal basis. in the community. When the state of Michael Allen is a partner with Relman & Georgia refused to Associates, PLLC, in Washington, DC. This move them out of the article is adapted, with permission, from his institution, citing the article “The Olmstead Decision: The Legal lack of community- Framework,” in The Olmstead Factor:
TORTI GALLAS based housing and Integrating Housing For People With LeMoyne Gardens, in Memphis, Tennessee, is another publicly assisted visitable supports, the women Disabilities / The NIMBY Report (National development. This project, by Torti Gallas and partners, won a 2005 American sued under the Low Income Housing Coalition, Spring 2002). Institute of Architects award. Americans with Disabilities Act (ADA). In determining 1 While not all older people will have a “disability” 4 Michael Jones & Jon Sanford, “People With Mobili- that the ADA required such housing and or “handicap” as those terms are defined in federal ty Impairments in the United States Today and In supports, the Supreme Court said: civil rights laws, disability status is dramatically 2010,” Assistive Technology, 8(1): 43-53 (1996). associated with old age. According to the 2000 “[I]nstitutional placement of persons who 5 These Four Walls… Americans 45+ Talk about Home Census, some 49.7 million Americans have some and Community (AARP Public Policy Institute, 2003). can handle and benefit from community type of “long lasting condition or disability,” which Finding that 83 percent of respondents age 45 and settings perpetuates unwarranted assump- represents 19.3% of the relevant population stud- older strongly or somewhat agree that they would like tions that persons so isolated are incapable ied (i.e., people who were age 5 and older in the to remain in their current residence for as long as pos- or unworthy of participating in commu- civilian noninstitutionalized population). See sible. See also, Beyond 50.03: A Report to the Nation on nity life. … Confinement in an institution Judith Waldrop & Sharon M. Stern, U.S. Dep’t. of Independent Living and Disability (AARP 2003). Avail- Commerce, Disability Status: 2000 1 (Mar. 2003), able at:
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2 Vistability… continued from previous page townhouse that is intentionally built with at least the following three features: • One zero-step entrance on an acces- sible route. • Doorways that provide at least 32 inches of clearance and wider hallways. • Basic access to at least a half bath on the main floor. While the benefits of these features are most essential for a person with mobility impairments to visit or live in a home, they can be invaluable to all of us (as even an otherwise healthy individual may suffer from an unexpected, but tem- porarily disabling injury). Visitability ELEANOR SMITH, CONCRETE CHANGE strives to create an opportunity for all Tatnall Place in Macon, Georgia, is a completely visitable, mixed-income neighborhood. As seen here, it neighbors in a community to socialize, is sometimes possible to provide both no-step and stepped entries. help each other, and interact more effec- tively. It attempts to break down attitudi- type of community, and include both Illinois; Pima County, Arizona; and nal as well as physical barriers to social urban and rural locales. Bolingbrook, Illinois – have visitability integration of people with disabilities. Despite their common goal of increa- ordinances that apply to all new housing, sing the supply of accessible housing, including privately financed homes. THE VISITABILITY MOVEMENT visitability programs vary significantly. In addition, some programs strictly Recognizing the benefits and growing The three primary ways they tend to dif- adhere to the three basic visitability fea- need for more accessible housing, many fer are in the types of housing they cover, tures (a stepless entrance, wider door- state and local jurisdictions have joined the scope of features they include, and ways and hallways, and a half bathroom the visitability movement. As of June the strategies by which they are imple- on the main floor), while others include 2006, approximately 45 state govern- mented. additional architectural elements such ments and local municipalities had vis- For instance, while most local and as lever handles, blocking for grab bars itability programs in place. These state visitability requirements only apply in bathroom walls, and lowered light programs are neither limited to a specific to new publicly funded housing, some switches and raised electric outlets. region of the country nor to a particular jurisdictions – including Naperville, Visitability programs also differ in
Terminology requirements apply to federally or publicly for a person in a wheelchair. assisted housing and to privately owned mul- Visitable Housing. Visitability is a move- What’s the difference tifamily housing: between “accessible” and ment to change home construction practices • At least one building entrance must be on “visitable” housing? To briefly clarify, so that virtually all new homes offer a few an accessible route. without (hopefully) over-simplifying: essential features that make the home easier • Public and common use areas must be Accessible Housing. Federal law requires for people who have and/or develop a mobil- accessible to and usable by people with dis- certain new housing to be accessible and ity impairment to live in or visit. It is broader abilities. usable by people with disabilities. The Fair than the Fair Housing Act in that it applies Housing Act requires that “covered multi- • All doors must be wide enough to allow to all housing, including single-family units. family dwellings” built for first occupancy passage by people using wheelchairs. However, it is narrower than the Fair Hous- after March 13, 1991, be designed and con- • An accessible route into and through the ing Act requirements, since it emphasizes structed to include certain features of acces- dwelling unit. just three essential features: sible design (summarized in the bullets • Lowered light switches, raised electrical • One zero-step entrance on an accessible below). Covered multifamily dwellings are outlets, thermostats, and environmental con- route. found in buildings consisting of four or more trols. • All main floor interior doors – including units, if the buildings have an elevator; if • Reinforced walls in bathrooms around toi- bathrooms – with 32 inches of clear passage there’s no elevator in a building with four or let; tub, shower stall, and shower seat, to space. more units, only the ground floor units need allow later installation of grab bars. • At least a half bath on the main floor. to be accessible. The design and construction • Kitchens and bathrooms must be usable
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3 how they are implemented. Some are plying with the ordinance would cost only The California mandatory, requiring builders to include about $100. … The Board of Supervisors ★ Checklist visitable features during new construc- found that the cost of including the ordi- As of January 2006, California tion. Other programs are voluntary, with nance’s designs into a new home was sub- law requires all residential homebuilders to builders encouraged, but not obligated, stantially less than the cost of renovating a provide a “checklist” of universal accessi- to include the visitability features. Volun- home to accommodate a person confined to bility features to potential home buyers. tary programs often include financial a wheelchair. On this record, the Board of This requirement applies to single-family, incentives, certifications, and public Supervisors could have rationally conclud- duplex, townhouse, condominium, and awareness campaigns. Voluntary Certi- ed that the benefit to the community in pro- other dwellings. fication. viding for the disabled justified the The California Department of Housing Besides the mandatory and voluntary comparatively minimal cost of implement- and Community Development has pre- pared a model universal design checklist programs already in place, there are ing the required design features.” 6 numerous efforts to establish visitability for homebuilders to use. The builder is Despite this landmark decision, required to check off whether each of some programs in other states, counties, and visitability initiatives continue to face one hundred possible exterior and interior cities. They range from organized groups opposition from some builders and features (e.g., no-step entry; wide door- or individuals with an expressed interest policymakers. ways; accessible light switches and appli- in beginning a visitability program, to Besides citing infringement on home- ances) is either “standard,” “limited,” locations that are in the final stages of owners’ “rights,” many critics of visitabil- “optional,” or “not available” on the house. The Department’s guidelines note that developing a program. ity also argue that inclusive design costs “not every feature listed must actually be CHALLENGES AND CONTROVERSIES too much and negatively affects the aes- available or offered by the builder. In addi- Despite its rise in popularity, visitabil- thetic quality of homes. However, visit- tion, certain items must be requested [by ity continues to face some challenges and ability rests on the notion that, through the buyer] prior to certain phases of con- controversies. good design, basic accessibility to single- struction, as specified by the builder. The builder may provide estimated costs for Questions regarding the legality of family housing can be provided in most the special features.” local ordinances have been raised. After cases with minimal financial cost. Equal- Pima County enacted a visitability ordi- ly important, incorporating accessible Voluntary architecture features into housing nance in 2002 (requiring a no-step ★ Certification entrance and doors at least 32 inches designs before construction is much less The EasyLiving HomeCM pro- wide), the Southern Arizona Home expensive than having to make retrofits years later. gram is a certification program designed to Builders Association took aim at the law’s encourage builders of single-family homes According to Concrete Change, constitutionality, arguing that the ordi- and townhomes to incorporate several nance deprived homeowners and “When visitability features are planned features that increase the sellers’ market builders of the right to design private in advance by a well-informed builder, and offer buyers a home easy for all to live homes. However, the Arizona Court of [the] typical added cost is very low for a in and visit. Established in Georgia in Appeals ruled that the County did have new, single-family detached home …. 2002, the EasyLiving HomeCM program was the authority to adopt visitability legisla- Less than $100 for homes on concrete developed by a group of public and private organizations to encourage the voluntary tion. As the Court noted: slabs, and $300 to $600 for homes with inclusion of key accessible features in crawl spaces or basements.”7 “Disability is a growing problem both single-family homes. In contrast, modifying an existing nationally and locally, and the county … Extending beyond the three elements introduced evidence that Arizona’s popula- house to incorporate these same features of visitability, the EasyLiving HomeCM tion of people over the age of sixty is expect- can cost several thousand dollars.8 More- program also requires a bedroom on the ed to triple by 2025. Although many of over, as Jon Pynoos, a professor of urban main floor, as well as some entertainment these disabled people will not be confined to planning at the University of Southern space and a kitchen in its list of approvable wheelchairs, the county concluded from California, and researcher Christy Nishita features. Homes that incorporate these features receive a seal of approval from the these figures that the number of people con- continued on next page EasyLiving Home Coalition. As a recog- fined to wheelchairs is rising. For these rea- CM 6 The Washburn v. Pima County decision can be nized brand name, the EasyLiving Home sons, the county addressed a legitimate downloaded at:
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4 Vistability… Visitable homes can also be aestheti- tion of its popularity and continued sup- continued from previous page cally pleasing. Features like the stepless port is a relatively new federal bill, The explain, these steep costs are particularly entrance can be successfully incorporat- Inclusive Home Design Act. First intro- a barrier for those with low incomes.9 ed into the design without sacrificing duced in the House of Representatives by They note that, “financing sources are visual appeal. Illinois Representative Jan Schakowsky, a available for home modifications, but One area in which even visitability revised bill now has a growing number of individuals and programs face the daunt- supporters disagree is the best approach co-sponsors, and is supported by over 25 ing task of searching for program sources to incorporating it into new construc- organizations. and wading through eligibility require- tion. While some supporters argue for How is this different from Fair Hous- ments.” Because of the cost and difficulty mandatory visitability legislation, others ing Act requirements? The legislation of home modifications, Pynoos and believe voluntary efforts are more feasi- would mandate that all federally finan- Nishita advocate visitability, “where ble and just as effective. ced housing include visitability features. accessible homes become mainstream Unfortunately, little data currently Such revolutionary legislation would sig- within the community.” exists to document whether a mandatory nificantly contribute to closing the gap or voluntary approach works best. Only between the demand for and the supply 9 “The Cost and Financing of Home Modifications in a few locations with visitability programs of accessible housing available in today’s the United States,” Journal of Disability Policy Studies, actually track the number of homes built housing stock. As the bill works its way 14:2 (2003). with such features, and those that do through various congressional commit- often do not have a formalized documen- tees, advocates continue to garner addi- The Costs tation procedure in place. tional support. of Omission Estimates suggest roughly 24,000 vis- Until federal legislation passes, the itable homes have been built as a result adoption of visitability provisions will by Eleanor Smith of mandated approaches, with approxi- depend on continued efforts from advo- Some of the costs of omitting visitable mately 1,000 built through voluntary cates – including local planners. features in new housing at the time of efforts. Despite these numbers, it One of the best ways to encourage construction: remains unclear which type of imple- visitability is to provide recognition and Retrofits to Remove Barriers 1 mentation strategy (i.e., mandatory or economic support to both non-profit and Entrances: $3,300 average voluntary) is the most successful in get- for-profit developers and builders who Widening one interior door: $700 average ting visitable housing built. are currently knowledgeable about vis- Increased Institutionalization Perhaps the most severe obstacle for itability, as well as those willing to learn Cost of nursing homes per year: proposed mandatory initiatives exists in about it in response to customers’ $62,000 per year 2 states that have legal restrictions that requests. Local advocacy groups can also Percent of this cost borne by public impede adoption of local visitability ordi- give public recognition to developers dollars: 64% 3 nances. For instance, Michigan has a law who adopt visitability and help promote Percent of nursing homes residents stating that no city, county, or village can such projects as examples of convenient who enter directly from hospitals (many pass a building code or ordinance that is and safe housing. barred by architecture from returning to more restrictive than the state building If a local planning department is their own home): 60% 4 code. Similarly, mandatory visitability interested in pursuing a visitability initia- Plus (unquantifiable): Decreased Social/Emotional Health efforts in New York State have stalled due tive, it is best to tap into the existing Isolation of people with disabilities and to laws that limit their families, impeded from visiting local legislation from friends and extended family exceeding the requirements of the 1 Estimates from contractors, 2007 State Building Con- 2 Genworth Financial Cost of Care Survey, March 2006 struction Code. 3 Kaiser Commission on Medicaid and the Unin- VISITABILITY IN sured, “Medicaid and Long-Term Care,” May 2004 THE FUTURE 4 Centers for Medicare and Medicaid Services (CMS) Minimum Data Sets, 2005 Regardless of Eleanor Smith is Director of Concrete Change, these challenges, the a non-profit advocating for increased visitability move- visitability in all new houses: ment continues to
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5 Editor’s Note: LEED-ND & Accessibility Accessible housing will get a boost from the new LEED for Neighborhood Develop- ment (“LEED-ND”) certification program, which includes a credit for developments that include accessibility features in at least 20 percent of their units. For those not familiar, LEED-ND is the U.S. Green Building Council’s newest certi- fication program, being developed in part- nership with the Congress for New Urbanism and the Natural Resources Defense Council. LEED-ND is just now entering a year-long pilot phase. Like all LEED certification programs, it’s complete- ly voluntary. But developers have increas- ingly recognized the benefits of LEED certification as demonstrating their envi- ronmental commitment, which can help in marketing their project (as we reported in
IDEA, BUFFALO our Winter 2006 issue; see “Leading the Visitable housing can include attractively designed entries. This residence in Buffalo, New York includes Way”). an accessible ramp pathway to the front door, partially hidden from view by the stone edgework. The LEED-ND program, like LEED’s existing certification program for commer- advocacy network. This will reduce the Engineering Research Center on Universal Design cial buildings, allows the developer/builder and the Built Environment at Buffalo and an learning curve and help make the project to accumulate credits by selecting from a Adjunct Assistant Professor in the University’s more effective. There are many groups number of features from the LEED check- School of Architecture and Urban and Regional that can be of assistance, including Con- list. Once enough credits are obtained (and Planning. Her current research includes projects on crete Change and local and regional certified after construction) the LEED cer- the effectiveness of universal design, and policy Independent Living Centers. If you are tification is awarded. and planning issues related to inclusive housing new to advocating for legislation, consid- Under LEED-ND, “universal accessibil- design. er coordinating your efforts with one of ity” is defined as complying “with the accessible design provisions of the Fair these organizations, which have substan- Housing Act Amendments and Section 504 tial experience in this area. Note from the Editor of the Rehabilitation Act, as applicable.” SUMMING UP: Visitability is an important, but The credit provides that an accessible entrance “can be located at the front, side, As demographic shifts compound the controversial issue. On our PCJ or back of the residential unit, which may current lack of accessible housing, more +Plus web site, PCJ Editorial Advi- sometimes be determined by the topogra- and more of us will confront the need for sory Board member Wayne Lem- phy of the site.” such housing. Planners and elected offi- mon, who authored the article Why do only 20 percent of the units cials need to look to more proactive, “Proforma 101” in our Winter issue need to be accessible to obtain the credit? innovative, and cost-effective strategies and works for a regional home- According to Jennifer Henry, the Green to solve these problems. Visitability pro- builder, responds to the question: Building Council’s Program Manager for LEED-ND, the figure represents a balance vides a viable, low-cost approach to “Why is there resistance to embrac- transforming and improving the nation’s between trying to promote accessible units ing standards and allocations for and “what we think the market can bear.” housing supply and meeting the needs of enhanced accessibility homes on Henry also acknowledges that the envi- our changing population. ◆ the part of homebuilders?” ronmental benefits of having accessible Jordana Maisel is the Whatever your perspective on units is indirect, but notes that LEED-ND Director of Outreach and visitability requirements, we hope also incorporates other civic values. For Policy Studies at the Cen- you’ll visit the PCJ +Plus site and example, there’s also a credit available for ter for Inclusive Design offer your questions, thoughts, and “community participation” efforts (when and Environmental Access developers host open community meetings (IDEA), located at the Uni- feedback. A healthy dialogue will during a project’s design phase and seek versity at Buffalo. She also benefit all. Go to:
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