Visitability Train the Trainers Webinar: Presented by Eleanor Smith

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Slide 1. [Following is the transcription of the audio portion of the visitability Train the Trainers Webinar presented by Eleanor Smith on April 23, 2013 (her last public presentation before retiring as national director/organizer of Concrete Change).]

Slide 2. First, I want to say welcome. I am really glad you’re here. And I look forward to presenting on the subject of visitability.

Part I is going to cover definitions and four major persuasion points. Then we are going to have a short break in the middle to respond to questions. And then, in Part II, I will cover policy, allies and potential audiences.

This presentation will contain information and opinions based on my 26 years of working with visitability. Let me emphasize that the content is intended for you as current or future trainers. Therefore, the content and commentary are a little bit different or expanded from what would be presented to a general audience. So some of the comments you might include in your future presentations and others are not worded necessarily in the way you would present them in your presentations.

Slide 3. Part I: Definitions and four major persuasion points.

Slide 4. Beginning with definitions, What is visitability? Visitability, sometimes called inclusive home design, basic home access, core universal design or by any other name is a campaign for meaningful policy requiring a few essential access features in every new home.

In the next slides I will expand the topic of the few, the every, and the concept of meaningful policy.

Slide 5. Visitability involves “a few essential access features.”

  • First: A zero step entrance at the back, front or side or through a garage on an accessible route.
  • Second: All main floor, interior passage doors providing at least 32 inches of clear passage space.
  • And third: A main floor bathroom with basic maneuvering space.

Slide 6. Visitability involves access features in every new house: new houses intended for all, not just houses specifically designated for older people or people with disabilities. In whole neighborhoods, whole towns eventually whole states and countries. For example, the United Kingdom has had a law requiring basic access in every new home since 1988.

These three photos show visitable houses that have been built in the United Kingdom.

Slide 7. Visitability involves meaningful policy requiring access features. These mandates can be laws, or policies that are not laws. I will say more about laws and policies in the second part of the presentation.

Slide 8. What is not visitability?

Even though each of these I am listing here is important, they are not visitability per se:

  • Visitability does not involve access to parking, hotels, tourist sites and so on.
  • It does not involve a new home designated specifically for a person with disability.
  • It does not involve retro-fitting, adding access to an existing home for a person with a disability.
  • And visitability does not involve a single, individual home such as a Universal Design show home which has numerous access or U.D. features but is not replicated by additional homes with basic access in the whole development or neighborhood.

Let me repeat, I realize the above are important. For example, retro-fits. I developed a disability when I was three years old, and since that time I have not been able to walk. The other day I counted up how many houses over my lifetime I have lived where we had to add a ramp: seven houses. I could not have entered or exited those houses if ramps had not been added. So, obviously, retro-fitting to add access is essential for people to survive in the world if they have major mobility impairment.

But again, visitability doesn’t involve the above items, but rather keeps its focus very, very closely on basic access to every new house.

So when you are presenting, it will probably be necessary often to draw the audience back to the essentials of visitability: basic access to every new house. You will have people wanting to talk about roll-in showers or lowered cabinets, or wanting to talk about retrofits, and you will need to acknowledge the importance but move on quickly with visitability.

Slide 9. Now I am going to talk about four persuasion points:

  • The negative health results of basic barriers.
  • “The numbers,” or what is sometimes called “the need.”
  • The low cost of basic access for new homes.
  • The high cost of continuing to build as we are.

Slide 10. This slide shows nine houses with ramps added onto existing houses. These nine ramps are all within one square mile in my hometown, and there were many more. You probably have seen similar in your locale. If so, showing a slide like this to your audience will help you have the audience identify with what you are presenting. You can see from the pictures that many of the ramps are too steep for safety. They’re not to code. The people who added these ramps made do with what they had.

Furthermore, the next owners will probably remove the ramps because they’re add on and not integral parts of the home design. So, in this slide we see kind of encapsulated some the four persuasion points, namely the negative health impacts– the health dangers of these ramps, and the human rights and mental health aspects of inclusion in the community versus being shut off from the community. And certainly, the financial aspects of having to retro- fit or move to an institution. Or continuing to live in a situation where you don’t have access to your own house at all.

Slide 11. Because for every home you see with an added ramp, there are many more people who have no ramp on their own houses, even though they can’t get in and out. They lack the resources to modify their homes. They spend years unable to exit independently or get through their own bathroom door.

When it comes to health implications, the negative effects of basic barriers are major.

Slide 12. Several years ago, I began to identify numerous health impacts of barriers— from my own experience and what I noticed other people with mobility impairments were experiencing. In 2009, I had the opportunity to present about these impacts at two national health conferences, the Environmental Public Health conference and the conference of the American Public Health Association.

Taken together, these impacts have begun to cause visitability to be recognized as a major public health issue.

For example, lack of zero step entrance, increases falls. Falls are the number one reason people over 65 go to the emergency room and the number one reason they’re admitted to hospitals as patients. When we think of a person with poor balance attempting to get up a step into her house, holding her groceries while trying to manage the door, the danger of falling is high.

I did talk with a CDC expert on falls– the Centers for Disease Control—seeking more specific data about where people fall down. They have data showing that more than half the falls of people who go to the emergency room occur at home. Here’s the interesting part to me: Of the falls which do occur at home, more than half occur outside the house. If you are at home, outside, and you have fallen down, the most likely culprit is entry steps.

Another health implication is the inability to exit your home in case of fire or a gas leak or something of that nature.

Bladder and kidney health. How can bladder and kidney problems be a result of barriers? If you think through the inability of a person to enter a bathroom when they are visiting or even sometimes at their own home, you realize that what people do as a result is limit intake of fluids or not go to the bathroom for extensive periods of time. Saying, “Oh, I’m going to that party tonight; I had better not drink for three hours in advance.” If you do that repeatedly and chronically over time, as many mobility-impaired people do, it becomes a danger for bladder and kidney health.

Another health implication is care giver health. Numerous studies over the last few years show that the health of people who are doing major amounts of care giving is worse than the health of control groups who are not. When you think of the stress that barriers put on care givers, you can see the added effort and worry it takes to get a neighbor or someone else to assist your loved one in and out of the house if you can’t do it; the back problems that arise from attempting to carry your loved one up and down steps; and so on.

And the last item I will identify on this particular list– and this list is certainly not all of the health implications– is mental and emotional health….

…the mental health fall-out of suddenly or gradually not being able to attend the family reunion everyone else will be attending, go the super bowl party you have gone to for 20 years with your best friends….being cut off from visiting other people, or having it be so stressful that you choose not to go to their houses because of barriers. And then suffer from loneliness, depression.

I might add at this point that a person on this call, Dot Nary of the University of Kansas, is doing the first formal research on the effect on disabled people’s lives when architectural barriers keep them from visiting friends and relatives. So there should be some articles appearing before too long, on the results of Dot’s research.

So, having talked about some of the health implications of visitability, how many houses are we talking about when we consider the frequent phrase ‘meeting the need’ for accessible houses? I approached the University of Florida, asking them to research the following question:

What is the likelihood that any one new house will have, over the lifetime of the house itself, a resident with long term, severe mobility impairment?

And they did the research. We co-authored an article published in the Journal of the American Planning Association [”Aging and Disability: Implications for the Housing Industry and Housing Policy in the United States,“ Summer 2008].

Slide 13. How many houses? Of all new houses built in the year 2000, by one measure of disability 25% and by the more likely measure 60% of these houses will have a resident with a long term, severe mobility impairment at some time during the lifetime of the houses itself.

Often when people talk in terms of need, they make major errors in their formulations. Sometimes they seem to want to correlate the number of wheelchair users at any one point in time with the number of houses needed! When in fact the relevant population is not just wheelchair users at all, it’s people who use walkers, and people who don’t use a mobility device but have stiffness, weakness or poor balance. Also, like other people, disabled people move from house to house. What we need to look at is the likelihood that a high percentage of houses will be impacted at some point by a need for access by a resident with long-term, severe mobility impairment.

This doesn’t even take into account severe, short term mobility impairments; nor does it take into account the need to visit in the home of someone else.

Furthermore, it is not possible to predict in which houses disability will occur. So the data in the article underlines a strong argument to create basic access in all new homes. You know, we can’t predict which cars are going to have a severe car accident. We don’t say ‘Well, the percentage of cars involved in accidents should guide the percentage of cars where seat belts seat belts are installed.’

Moving on to the question of cost, the third of the persuasion points. When I first started the visitability quest, 26 years ago, I was so often told how expensive these features would be, how hard it would be to create basic access in houses. I would look around and see access to the new bank and access to the new restaurant. I would think, why would this be so expensive in a new house?

Fortunately, over the years, as advocates have succeeded locally in their areas and states to get visitability mandates to occur, we have now demonstrated, with tens of thousands of existing visitable houses already constructed, that the cost of the two most important features —getting in and getting through the interior doors —is extremely low.

And since nearly all new house plans already incorporate at least a half bath on the main floor, increasing square footage is not necessary.

Slide 14. On houses built on a concrete slab, the added cost will be maximum $110. And then, over a basement, when we were formerly told how many thousands of dollars a zero-step entrance would cost, by now thousands of visit-able houses have been put up over a basement. The city building department officials have said that $250 is what it has cost extra to incorporate the zero-step entrance. Or less. These extremely low costs are not theoretical. They have been widely demonstrated in practice.

I suggest you never talk about the low cost of access without talking about the high cost of what we are doing now. The cost of the status quo–of continuing to build as we are – is extremely unaffordable. Three costs resulting from continuing to build with barriers include:

  • The cost of renovations. Retro-fitting a house, as most everyone is aware, is exponentially more expensive than putting the basic access in up front. Two gentlemen who have done many renovations have offered me an interesting estimate. One of these men has done more than 2,000 retro-fits of houses for people who developed disabilities, and the other has done more than 50. And they said, independently, that anywhere from 75 to 90% of disability renovation costs overall would be avoided if the basic shell of access were already present in the form of a zero-step entrance and wide enough interior doors.
  • Next we have the medical costs due to injuries based on barriers. And there we go back to the health issues I raised earlier. It would be very good to research as accurately as possible the national costs of these items, and add them together as the aggregate estimated medical costs of barriers It is undoubtedly huge.
  • And perhaps the very highest cost is the increased institutionalization that occurs from barriers, where people can’t go home to their own home from the hospital after an injury. Particularly if they’re older, they go to the nursing home, because they don’t have time in the hospital to locate a contractor and get their home renovated before they’re dismissed. This applies to younger people as well, particularly those who are from lower-income families and those who are renting. Once in the nursing home, getting out becomes extremely difficult. Even though renovation costs and medical costs are both very high, I think probably the highest cost of all is increased institutionalization when home barriers were a factor.

So I suggest that even in casual conversation, as well as more formal presentations, you never discuss the low cost of basic access without also talking about the high cost of the status quo, of what we are building now.

Slide 15. At this point, I would like to pause to entertain any questions you might have, if you can type them into your chat box or your question box.

Question from participant: Why do you make a separate point about the cost of building a zero-step entrance over a basement?

Response from Eleanor Smith: Because we want policies and ordinances to be passed in the North, where single-family houses are often built over a basement. In the past, we have heard estimates of thousands of dollars as the alleged cost to build basic access over a basement, when in fact we have learned that this has been accomplished repeatedly for around $250, or less.

Question from participant: What do we do when we’re trying to get ordinances passed and the Home Builders Associations come in and lobby against us, with tremendous push-back.

Response from Eleanor Smith: That is an excellent question. It is a reality I have encountered with downheartedness and upsetness over the years, as have other advocates all over the country who have worked hard to get laws or policies passed. I am going to talk a little bit more about that in the second section when we talk about advisable strategies. But I’ll say now that so far the home builders’ associations have not shown willingness to stop fighting against mandates. What they don’t want is regulation. What they do want is voluntary programs, and leaving it to the market. But those things do not and will not meet the need, any more than other public health or justice issues have been solved solely through those means alone. We have to keep presenting the information and moving ahead with policy initiatives. I think over time the builders will perhaps become less virulent in their opposition. It is very important to keep dropping in legislation and pressing it.

I would also say, look for the occasional home builder–and they’re very rare– who will testify to the opposite of the allegations of the National Association of Home Builders and their local members and lobbyists.

As an in-between measure—and I am not talking about watered down, ineffective things–
there are possibilities for moving ahead with basic access based on policy-driven mandates which do not involve legislation. I will go into detail on that in Part Two.

Question from participant: Can you tell me more about the research that Dot Nary [University of Kansas] is doing?

Response from Eleanor Smith: Yes. She is doing formal research based on interviews with people who use wheelchairs. Dr. Nary [[email protected]] has interviewed people asking about the effects of their inability to visit in the homes of friends and relatives, and the difficulties that arise. The results haven’t been published yet, but she is planning to, so look for articles by her.

Question from participant: Will there be any national, universal national code for this?

Response from Eleanor Smith: There are people working on a broad-impact code initiative, which I have helped with also, a code approach through the International Code Committee called Type C Visitable Housing. That initiative is also being fought by the home builders.

Question from participant: Is there any data on regional cost differences such as mid-Atlantic versus southern and west coast?

Response from Eleanor Smith: I have not seen any data on this. I would not think there would be very many regional differences. A concrete slab is a slab wherever you lay it down. And a basement is what is often used to allege a huge cost difference, when in fact that is not the case, as I indicated earlier. Then again, hilly or mountainous terrain is sometimes raised as a sticking point. Again, not a show-stopper at all. I will talk about that briefly in Part II.

Question from participant: What are some of the best ordinances we can use as models with good language for future cities?

Response from Eleanor Smith: I would say the language used in Bolingbrook is very good. The Pima County language covers the bases well, but it is stated in ANSI language, American National Standard Institute, such as section 3.1.2 and so on. Bolingbrook is simple, straight-forward language, and the text is on my web site under the policies section.

And then, actually, the [1992] Atlanta ordinance is not bad, the first ordinance in the country requiring zero-step entrances [as well as other features] on some private, single-family homes. It has pretty good language for laws limited to houses that receive some form of federal, state or local financial assistance—as I said, it impacts some private houses, not limited to public housing. That ordinance is on the Concrete Change website, too.

Thank you for your questions. I will continue now with my remarks.

Slide 16. Moving ahead with Part II.

I will talk about successful examples and outcomes; policies types, the good as well as the unadvisable; and finding allies and audiences for you to present to.

Slide 17. Broad policies have already been put in place in some locales. In 2002, Pima County, Arizona, passed a law ‘every new home basic access,’ up against extreme opposition from the home builders association. What it has taken to pass legislation is, you have to have very strong advocacy and then at the same time you have to have a committed, respected lawmaker who will be persuasive along with you. If you don’t have a strong city councilperson or mayor or other major lawmaker, it becomes extremely difficult. [In Pima County, the primary movers were advocates Bill and Colette Altaffer and then-County Board of Supervisors Chairman Raul Grijalva, now a US Congressman.] Pima County had 21,000 visitable houses up by 2010. By now they have many more. The City of Tucson followed suit by passing a nearly identical law in 2007.

Bolingbrook, Illinois, also passed a law, because a strong advocate went to the mayor and the mayor became an advocate. He twisted arms and made it happen. [Primary movers: Advocate Edward Bannister and Mayor Roger Claar.] They have more than 4,000 houses up. In fact, I heard recently that they have 10,000. The terrific thing about Bolingbrook–I was so happy about this– this law passed in a city where nearly every house has a basement. So it has disproved the allegation that a broad law is not practical when you have basements. Initially in Bolingbrook there was some home builder push-back. For example, builders said, as they commonly say elsewhere, “If this passes we will be driven out of business here. We won’t be able to build in Bolingbrook.’ The mayor said well, we are going to do this. And in fact, no builder has pulled out of building in Bolingbrook.

Here you can see a photo of a house in Pima County and also a house in Bolingbrook.

Now I am going to address two misconceptions often raised when people attempt to pass legislation or policies involving new houses. These are often sincere objections, but not based on fact.

Slide 18. One common objection or misconception is that it is impractical to require a zero-step entrance on steep terrain. This is not the case. It can help clarify this if you point out that even on steep terrain, we always find a way to make a zero-step entrance for the garage. And in fact, some ordinances explicitly say the driveway may be steeper than 1:12 if it is on hilly land. Even with a steep driveway, a good 1:12 zero-step entrance can proceed from the top of the driveway to the houses. That is a good statement to make.

Slide 19. A second misconception about difficulty is the common belief that it is not possible to build an attractive, low-cost zero-step entrance when building over a basement. Here I am going to present a somewhat technical architectural slide. This shows the usual method as compared to the method used in Bolingbrook and some other places to build low-cost, zero-step entrances.

On the left you see the usual method for when a house has a basement, showing how the flooring system is typically laid on top of the concrete foundation, in order to keep earth from coming in contact with the wood and damaging it with moisture or termites. Builders typically lay the wood flooring system on top of the concrete foundation, and that causes the floor to be considerably above grade, so you need steps. So this traditional method would make it difficult or impossible to have an inexpensive, aesthetically pleasing zero-step entrance.

Let me go on to the second image on this slide, where we have the method used to create a zero-step entrance over a basement that costs $250 or less.

Here you can see that instead of setting the wood flooring on top of the concrete, the builder has nested the floor joists inside a notch inside the concrete foundation. This keeps the earth away from the wood foundation without requiring height. Therefore, steps are not required to reach the entrance.

Slide 20. Here are four photos of houses over basements in Bolingbrook. They appear to be built on a slab, but they’re not. The flooring system has been set inside the concrete foundation, and steps are not required. The sidewalks ties directly into the porches.

Let me make it clear that every good ordinance does include an exemption from the zero-step entrance for unusual site conditions. When you present, you may get the question, “What if you can’t do it?” And you say, there are very few cases where you can’t, and in those cases an exemption is available.

Slide 21. Is a zero step entrance always practical?

Not always. Not, for example, if the site offers all three of these challenges: is steep; has no driveway; and has no back approach.

Another example, of course, would be houses on pilings along the ocean shore. You might have an individual house on the shore where the owner has chosen to put in an elevator or long ramp to the elevated main story, but it would not be a good idea to have an ordinance requiring that.

However, in spite of the fact that it is not always possible, a zero-step entrance has been demonstrated to be practical in more than 95% of cases.

Slide 22. Now, sometimes when I am presenting, people will say they have noticed that some ordinances require a couple of other features beyond the three basics. I think one of the best routes to go, if you decide to go for more than the three basics, is to use the Fair Housing Act as your guide. The Fair Housing Act since 1991 has required several access features in all new multifamily residences with four or more units–public or private, rental or condo. If there’s an elevator in the building, the features must be incorporated in every unit on every floor. And if there is no elevator, in all ground floor units.

Because time has passed and this Act has finally begun to be widely applied, partly due to lawsuits from the DOJ, you are seeing many apartment buildings going up with access, which is a wonderful thing. Hundreds of thousands of apartments and condos now contain basic access.

On the screen you can see that the zero-step entrance and 32 inch clear doors are part of the requirements. Additionally you see rectangles of useable space in the bathroom which are 48 inches by 30 inches. The rectangles must be located by each every fixture [tub, toilet, sink and shower] but they can overlap, so they’re practical and do not increase square footage. And then you see blocking in the walls near the tub, shower and toilet for future grab bars if needed. The grab bars themselves are not required. Electrical plugs and switches must be at reachable heights. Additionally you see here a drawing of a very small home. You can see the accessible path through the first floor of the dwelling and the wide doors. I chose that graphic because it shows it is possible to meet all of these requirements within a small footprint. Now that builders have years of experience incorporating these features in multi-family residences, it makes a certain amount of sense to begin to lay the same template down for single-family. Yet, timing is all. If asking for rectangles of space would kill a visitability initiative, ‘back to the basics’ offers the best approach.

The question has been raised– it was raised by Congress when I testified in favor of the Inclusive Home Design Act– “If basic access is so needed by so many and is so easy to incorporate, why is it often so difficult to get it to occur in practice?”

Slide 23. In fact, as has been noted today, the opposition to visitability mandates is quite intense.
As noted earlier, the National Association of Home Builders and its state and local affiliates will have lobbyists against access bills, making claims of high costs and other issues, but at heart not wanting mandates, is what it comes down to. Sometimes they’re joined by the National Association of Realtors, which is unfortunate. These two trade groups sometimes lobby together because they tend to assist each other; in fact, the developer and the Realtor are sometimes the same company. We know there are personally wonderful builders who are exceptionally kind people, and fantastic Realtors who would go out of their way help you out of a hard situation. But I do think the members of those associations bear some responsibility for what their trade groups are doing. Builders and Realtors who care about home access should to ask their trade groups to stop lobbying against visitability laws. [I would like to see an advocacy group formed by builders who want to take positive action, ‘Professional Home Builders for visitability Requirements”]

Another factor slowing down visitability progress is that sometimes the general public just doesn’t understand how easy it is to do, how attractive, how needed. Also, some may be philosophically opposed to mandates in general. And we are sometimes up against ageism and ableism. We might wonder why, for example, green building is going relatively fast and visitability so slowly. Part of the reality–and it is hard to address directly– is that the public often doesn’t want to think about getting older. And as to disability, “It’s those disabled people over there. It’s not me or my family.” Prejudice and fear are sometimes inside people, inside the builder or perceived by the builder as being inside potential buyers.

We have to go forward in spite of all these forces. Things are changing for the better. We see more web sites and individuals recognizing ‘every new house with access’ is needed, as people experience their own parents needing modifications in their home, or their own friend unable to come home from the hospital with severely broken legs. The trends and forces are in the direction of in people “getting it”.

I am going to move on now with some analysis of law and policy strategies.

Slide 24. Law Initiatives/Examples.

Examples of good visitability laws initiatives:

  • Every new house. It helps the movement to keep trying to make that occur, pressing forth. It raises consciousness. Many advocates have worked hard, but even so their proposed law has not passed. But in the process they have generated dialogue. We do have the examples of passed laws, ‘every new house with access,’ which we have talked about here.
  • Second, every new house for which the developer or buyer receives any form of federal, state or local financial assistance; for example, whenever the developer or buyer receives construction funds, funds for infrastructure like streets or sewers, first-time homeowners’ down payment assistance, waivers of certain local fees, and so on. In other words, laws that tie access requirements to existing benefits which the developer or buyer wants to take advantage of. That, in fact, is the premise of the first visitability law in the country, passed in Atlanta in 1992, which has been a model for a number of laws that came later. I would not recommend tying the requirement strictly to construction funds because it won’t cover very many houses, but when you specify “any form of financial assistance”, that can then yield quite a few houses. Cities that passed that law include Austin and San Antonio, and thousands of Visit-able houses have resulted in those cities.
  • Also, I’ll mention here the Inclusive Home Design Act, which has been introduced in Congress but has not passed yet. Essentially it takes the premise of the Atlanta, Austin and San Antonia laws and expands it nationally. This Act would not permit the US government to continue to build or help fund inaccessible, new, single-family houses and townhouses, public or private, using public money or financial benefits such as Low Income Housing Tax breaks.
  • Another example of a good law is one allowing the builder to get certain nonfinancial benefits such as zoning for increased density in exchange for incorporating visitability.

What about unadvisible visitability laws and initiatives? In my view, the following are not helpful; they have a negative impact:

  • Laws that give developers new financial benefits such as tax breaks, as opposed to tying requirements to existing benefits. The builders don’t fight these laws because they do not involve mandates. In some locales, these laws have been passed, but they have not yielded a significant number of houses. They just have not worked in practice, either because the amount is so low that the builder doesn’t want to do the paper work or so high that the governor will veto it because it undermines the tax base. Also, giving a tax break for building with basic access wrongly implies the cost is significant, when it is not. That’s counter-productive.
  • A second unadvisable law is one that merely educates and has no actual teeth. An example is a law requiring a builder to hand out a list of possible access features to the buyer, or some other educational project. It is good to have education, but education should not be positioned as a law because it slows down attempts at laws with construction mandates. It gives the false impression that something adequate is actually being done.

Slide 25. What about policy initiatives?

Sometimes you don’t have to wait for a law to see action. You can get policies to go forward which are not based on laws.

  • For example, some Habitat for Humanity affiliate boards have made a board decision to build every new home Visit-able. Here is a beautiful little house from Birmingham, Alabama, Habitat for Humanity where they decided to build every new house with access. The board decision by Atlanta Habitat back in late 1989 was actually Concrete Change’s first victory. They have more than 950 houses up now.I understand the state of Michigan Habitat emphasizes visitability also, and has about 700 houses up.
  • Here is another example of good policy. Adding an extra point on applications for funding, in exchange for the requirement to do access. This occurred in HUD’s Hope VI program. We [the Disability Rights Action Coalition for Housing active from 1994 to about 2004] succeeded in getting HUD to add a point for visitability in the Hope VI projects that tear down old public housing and put up new all across the country. This has resulted in tens of thousands of houses with access around the country, which otherwise would have lacked access. For example, this photo shows some visitable townhouses from Macon, Georgia. The townhouses would have been inaccessible except for the 5% required by federal law, but because of the extra point, they not only have the 5% with full access but the rest all built visitable. If you are acquainted with a board that’s giving out construction money, planning money or other housing money, going to that board and pushing for policy changes is an option.

Slide 26. Another example of a policy initiative that did not require legislation:

The Ohio Housing Finance Authority made a board decision based on the advocacy of a forward-thinking staff person [Debbie Leasure]. She noticed that the previous policy let a builder be eligible for tax credits for their project just by putting in some relatively minor access features but skipping the zero-step entrance. This did not make sense to her. She crafted wording making the entrance one of the requirements, and she took it to her boss, who supported her, and then with her boss, up through the ranks to the board. The housing finance authority now requires developers who decide to take advantage of the low income housing tax credit, that they must put visitability in all their townhouses and single-family detached houses. Ohio has about the 2000 units up that would not have had access otherwise. Here is an image from Ohio. I understand that the state of Montana followed suit. Every state has an agency that gives out the low-income housing tax credits. But we in Georgia have not been able to get our tax credit agency to follow Ohio. If the federal Inclusive Home Design Act would pass, people would not have to work on the tax credit issue on a state by state basis.

Another example—I find this very interesting—is that sometimes a single individual within an agency can make a decision. For example, Paul Pierce, who was the assistant director of the Dekalb County (Georgia) Housing Authority at one point. Some years ago, the county was giving out first time homeowners’ down payment assistance for a development of new, private, single-family homes. Paul Pierce had just been to a visitability presentation. And when he hired the architect, he just said, “These houses are going to have access.” The architect and site engineer drew accordingly, and obviously then the builder built according to the architect’s plans. From the decision of this one individual, about 100 visitable houses resulted. We didn’t even find out about it ‘til a year or so later.

Slide 27. Another example of positive policy initiatives was East Lake Commons, a cohousing community where I live here in Decatur, Georgia. All 67 of our houses are visitable even though there’s no government money and no requirements for that. Having visitability was a decision the group made before we even had land, that all units would have access. It has been amazing for me to be able, for the first time, to go next door and play Scrabble or take soup to a mother who had a new baby.

And it is also possible for a single-family, for profit builder to decide he or she is going to build every new house with access. I happened on this builder in a neighborhood not too far from me, a developer who builds high-end, single-family homes. She automatically puts the wider doors in, the 32 inch clear. And she creates a zero-step entrance.

She doesn’t even talk to the buyers about the door width; she just does it. For architects: If you are designing houses, change the house plans and take out those 28 inch bathroom doors; replace them with 32 inch-clear doors on your drawings. Do not consult anyone. It is a normal-looking door.

For the zero step entrances, this builder does mention and promote it as an option in a positive way to buyers. Sometimes they ask, “Well won’t water run in?” She tells them why it will not. She creates these beautiful zero-step entrances. When I talked to the architect who works for her, she said none of the buyers so far have declined the zero-step entrance.

Slide 28. I am getting toward the end of this presentation, and I do hope you have been able to hear in spite of some of the technical difficulties.

I want to address the issue of alternatives to townhouses. Many communities don’t want high rises. They don’t want ten-story multifamily housing. So what tend to go up in many of those areas is townhouses. And unfortunately, although very common, townhouses are probably the least appropriate housing type going up at this time in history, when our aging population is growing so fast and when people who develop disabilities are living longer than ever….when the justice aspect, equal access, is coming to the forefront,….when the cost of barriers to individuals and society as a whole is becoming clearer.

While we probably are not at a point politically where new townhouses can be ruled illegal, there are alternatives. A good alternative to townhouses, when density is desired but not high rises, is to build low- rise multifamily buildings, three or four stories with elevators, which then triggers the Fair Housing Act, so that every unit within the building is one-story and has the access features required by the Act. For example, the building pictured here. The cost of elevators raises the costs somewhat, and also each added story raises cost per square foot because of more stringent structural requirements. But these costs are off-set by the ability to have more units in the space townhouses would otherwise occupy— more units for the developer to rent or sell.

Sometimes builders are denied the zoning change that permits multi-family buildings. Visitability advocates can help them out by offering to testify at public hearings, testify in favor of the builder getting zoning permission to build low-rise multifamily instead of townhouses.

Slide 29. We have allies; even though we have opposition forces, we have allies. Some of them don’t know yet they’re our allies:

  • Medicare and Medicaid savings groups, whether they’re on the left or right, will begin to understand the relationship of visitability to having fewer people in nursing homes. They are potential allies of this movement.
  • Emergency medical technicians and fire marshals love to see a zero-step entrance when they attempt to bring someone out who has broken a bone and is lying on the floor, or overcome by smoke in a fire. If we can get them to come forward with testimony about ease of assisting people when there’s a zero-step entrance that will be helpful to our quest.
  • Package delivery companies, UPS, Fed Ex, with these heavy packages and the back problems that result from carrying packages up steps. I recently heard about someone who ordered a heavy piece of exercise equipment. The package delivery company refused to bring it in. They told her it was on the sidewalk in front of her porch. That was company policy.
  • Certainly Workers Comp cases, the pizza deliverer who was hit by a car, Workers Comp could save a lot of money if more people were already living in houses with basic access.
  • Home insurance companies. It would be good if home insurance premiums were lower if the resident could demonstrate that they have a zero- step entrance. In fact, I received a call a couple of years ago from Hartford Insurance. They were beginning education programs about home access.

Slides 30. Good places for you to go to give presentations:

  • Local Habitat for Humanity affiliates, the boards of those affiliates.
  • Realtors, going to your realty association and teaching them about visitability.
  • Local and state AARP chapters.
  • Affordable housing boards and developers. So that affordable housing people realize that access on their new houses will not bite into their funding, it will not cost them a great deal more and will not be competitive trying to take dollars away from them, will ultimately lower some of their costs and the costs for their residents;
  • Chapters of the American Institute of Architects.
  • Planning agencies, for example state and local affiliates of the American Planning Association.
  • Green building groups. I am starting to see green building advocates including visitability in their recommendations. I have seen them advocating for visitability as a sustainable practice that doesn’t require as much retro-fit. This sustains communities as well, in that people are less likely to have to move as they age or develop disabilities. It is encouraging to see green and visitable come together.
  • City councils and mayors.
  • Boards of foundations that give money for housing development.
  • And conferences of many types, especially on panels where the topic is not disability or aging. If you could get on a panel on affordable housing, on green building, or community planning, or healthy communities and so on– where you are spreading the concept to people who would not be drawn to the topic of architectural access but rather people who came to that presentation for reasons other than aging and disability.

This is certainly not an exhaustive list of where you can give presentations.

Slide 31. I really offer you my very best wishes for your on-going visitability advocacy. I hope you will consider yourself able to go forward and give presentations. Some of you already have. If you haven’t, I ask you to be bold, go forward, and offer to give a presentation. You don’t have to know everything. You can say, “ I will get back to you” and get their business card and get back to them on an unanswered question. Just having heard what you have heard today, you know much more than most people about visitability.

Houses are the last piece of the built environment rarely affected by access mandates. I believe that someday people will say “I can’t believe they ever built houses that didn’t have basic access.”

That ends my remarks to you, and my images.

I certainly am available to you for the next month to assist you in any way I can.

At this point, let’s see if we can work it to get people to be able to make comments or ask questions.

Comment from participant: Habitat for Humanity should require all affiliates to follow visitability. When we went to our local one, they used all of the reasons discussed as to why they can’t do it.

Response from Eleanor Smith: You are right. Habitat for Humanity International puts a big emphasis on green building and much less emphasis on visitability. Yes, they do recommend it. You can find it on their web site. But they do not do the level of advocacy appropriate for the issue. They often say they don’t tell the affiliates what to do. That’s not entirely true; for instance, there’s a lot of pressure from national on affiliates not to build garages. A few affiliates build garages, but overall Habitat International has made it clear: “We can’t spend money on garages. We are building houses for people, not cars.’ Habitat International should be advocating strongly for every new house with access. As far as I know, they don’t keep track of which affiliates build with access.

Question from participant: Can you get us copies of this power point?

Response from Eleanor Smith: Yes, I will get it up on the Concrete Change website and let you know. You know, I just turned 70. I am bowing out of the national scene on visitability. I feel confident that more people will move forward and fill in and become primary advocates for this. A lot already have.

Comment from participant: Great ideas for groups to present to and link with. I’m adding the Older Women’s League to my list and also my Chamber of Commerce.

Response from Eleanor Smith: Good idea. That list of groups I gave to link with, there is probably double or triple places that would be good. The Chamber of Commerce, maybe they can be brought to see that a large number of visitable homes would draw the older population to settle in their community so they can be near their grandchildren and so on.

Comment from participant: Great work.

Response from Eleanor Smith: Thank you very much.

Question from participant: Do you have any suggestions for advocating for visitability in home renovations?

Response from Eleanor Smith: As a matter of fact, it would be complicated, in fact unwise, to say every houses being renovated should have access by law, because existing houses differ so much in terms of feasibility. I wouldn’t vote for that myself….for a renovated house with eight steps at the lowest entrance required to put on a 40-foot ramp. However, actually, at the request of the Georgia Statewide Independent Living Council, I am developing a draft template that could be laid down on a group of houses slated for renovation, to indicate ‘This particular house should be renovated for access for the general buyer or renter– not just a disabled person– whereas this other house right beside it is not practical.’ The template would help evaluate which houses are amenable to visibility, so that if some company or nonprofit is planning to do renovations, they can evaluate the houses one by one and say: ‘Here we can put in the accessible entrance and wide enough doors for about $1,000, so let’s do it on this house. And let’s skip the access for the one next door that would require a long ramp, or would require moving a wall to get a wide enough bathroom door.’

Question from participant: Have community development corporations been allies?

Response from Eleanor Smith: Not particularly yet. But possibly because they weren’t approached.

Question from participant: Would city ordinances generate a lot of houses if the housing stock is already built, such as in Boston?

Response from Eleanor Smith: If the housing stock is already completely built, it might be difficult to craft an ordinance that makes sense. But communities that appear to be built out often are not completely built out. Often there’s still some new construction going up. There are tear downs. Also, the outlying areas just outside the city limits might be places where building is going on.

Just one second here. My tech person just brought another note from a participant. “You are an inspiration. Thank you for all of your hard work over the years.” Well, thank you so much. Thank you for saying that.

I believe with all of us together, and the many working throughout the country, visitability will happen. Thanks, and I will sign off.