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Nash Hernandez Intergenerational Resource and Activity Center (IRAC) Overview and Background July 21, 2022 Version 1 Updated 10/7/22 IDC Advisory Group Email: jangel@austin.utexas.edu Phone: 512.970 4068 UT Repository https://repositories.lib.utexas.edu/handle/2152/65188 Resolution #89 (June 16, 2022) Nash Hernandez Intergenerational Resource and Activity Center (IRAC) Adult Day Health Care and Child Care Centers, Intergenerational Programming, Tele- behavioral Health Services, Transportation, Service Coordination 2 Target Audience: 25 preschool age children and 50 older adults Timeline: PARD-UT LBJ School, Feasibility Study, deadline October 12, 2022 Services: Social, cognitive and physical activities, aging supportive resources, health and social service coordination, as well as tele-behavioral health screening Hours of Operation: 7:30-5:30 pm (children); 9-12 pm; 12-1 pm lunch; 1-2 pm (nap time); 2-5 pm (older adults/varsity generation) Days: weekly Space and Staff Requirements The Intergenerational Day Pilot Program, which is the first among planned Resource and Activity Centers (IRAC) requires 9,600 square feet (sf) plus 1,250 (sf) of outdoor space to accommodate both seniors and preschool-aged children in a way they have room to interact amongst their own age groups and together. The building will house both seniors and children, as well as indoor and outdoor spaces for single-generation and intergenerational activities. These spaces include an Adult Day Room where older adults can spend their day with their peers and away from children if they choose to do so. The space at Nash Hernandez would include several common spaces, such as outdoor and indoor gardens, and a community kitchen. The Pilot provides a homelike atmosphere with multipurpose, flexible spaces that can support different types of interactions (e.g., one-on-one, small group, large group [single- or multi-generation]). Importantly, the Pilot fosters fully accessible and direct and indirect access to different levels of interactions. The Center needs to include a private, sound-proof space with internet access in order to provide confidential tele-behavioral health screening to facilitate the services the IDC can offer, such as mental health screenings and aging resources navigation assessments. Additionally, the space should include distinct rooms for each age group of children who will attend the program, while including windows for guests and older participants to look in at the children playing. Space is needed for a preschool area. There needs to be two classrooms for the children, split by  age group 3 and 4-year-olds. Each classroom should have windows through which the younger children can see the environment where they will move to in the future. 3 According to the Piaget Theory of Cognitive Development, this allows the children to become accustomed to the environment, which will ease the eventual transition. A media room and gathering space could be a room featuring a drop-down projector for movie and informative presentation opportunities. In the same area there will be a 1,720-sf gathering space that includes a seating area, community kitchen, and an indoor herb garden. See Appendix A for renderings (photos) and detailed description of space requirements. This Center offers opportunities for intergenerational gardening, cooking, and celebration opportunities for the Dove Springs Recreation Center. Directly off the herb garden could be a covered outdoor vegetable garden, walking trail for older adults, and the intergenerational playscape that is accessible to those with a disability. There should also be an outdoor area for children, which will be separate from the adult area but feature openings for the participants to interact. The Center also will need a commercial kitchen for the preparation of food for Center participants. Adult Day Health Center We estimate the following ratios: • The proposed adult day health facility could potentially serve up to 50 people daily. • Group activity space for recreational therapy programs • 500 (sf) Laundry Room (shared) • Kitchenette- Meals on Wheels will deliver breakfast and lunch (shared space) • 2,000 (sf) Varsity Activity room • 500 (sf) office space for supervisor, Licensed Vocational Nurse, staff and assistants. • 1,500 (sf) outdoor space for physical exercise Given the above information, we estimate a minimum need of about 4,000 (sf) for 50 Varsity Generation/Older Adult participants. Older Adults Age Group 50- 90 years Number of Adults 50 Staff Pay Rate $49.62/hour $34.32/hour Cost of Operational and Space requirements Personnel LVN Activity Coordinator Social Worker Social Work Assistant Driver Program Costs $38.33 $25.00 TBD Number of Staff 1 VPN Full time 1 Activity Coordinator 2 Staff 1 Assistant Hours 6 8 8 6 3 Indoor Space 4,000 (sf) 500 (shared) Cost $5,954/month $5,491/month $6,133 $3,000 $ negotiable 4 $40/day $40/day Activities Health and Wellness Meals $10/per participant (50) Lunch $5000/month Source: LBJ School PRP Report Young Hip Austin is Getting Old: A New Experiment in Confronting the Challenge 2018, and 2018 Bond Proposal https://repositories.lib.utexas.edu/handle/2152/65188; Lydia Missaelides, Executive Director, California Association for Adult Day Services, 9/22/22 https://caads.org/ Service Coordination Estimated Number of Clients 30-40/social worker • 3 rooms (private office space) per 1 geriatric social worker serving 30-40 clients • 400 sq. ft. per staff member Given the above information, we estimate a need of about 1,200 square ft. Source: Family Eldercare Inc., 2018 Child Care Center Estimated Number of Children- toddlers two-four years old: 25 pupils/day Indoor Space 12-18 months 19-24 months 25+ months 8 10 16 Age Group Number of Children Indoor Space Number of Teachers 2 FT & 1 PT 280 (sf) 2 FT & 1 PT 350 (sf) 2 FT & 1 PT 560 (sf) • 1,190 (sf)Toddlers 2 – 4 years, including appropriately sized bathrooms • 1 Lead Teacher • 2 Assistant Teachers • 200 (sf). Office Space • 50 (sf) Observational booth attached to each classroom • 400 (sf) 2 Storage closets • 100 (sf) 2 Adult Bathrooms • 400 (sf) Mechanical Space In total, the childcare center will require 2,340 (sf) of indoor space. 2023 Start-up Budget Item 5 Classrooms, including furnishings, toys, and other materials Outdoor Learning Environment playground transportation van (option traditional playground) 6 months of operational support Cost $250,000 $250,000 $200,000 $tbd Total Estimated staffing costs For research purposes, we'd like to have three small observation booths (50 sq.ft each; one attached to each classroom). Altogether, our indoor early childhood space would need to be about 2,440 sq.ft and our outdoor space would need to be about 2,000 sq.ft. 5 Position # Needed Salary (each) Benefits (each) Total Lead Teachers 6 FT $36,000 $14,400 $302,400 Assistant Teachers/Floaters Director Administrative Assistant Family Support Specialist 3 PT 1 FT 1 PT $18,000 $7,200 $75,600 $60,000 $24,000 $84,000 $22,500 $9,000 $31,500 1 PT $22,500 $9,000 $31,500 We'd need to operate from 7:30 AM to 5:30 PM. Annually, once we're fully operational, we expect the operating budget (salaries + basic expenses) to be about $750,000. Rent and utilities would add to that. Cynthia said that each of her sites has a full operating budget of about $1.2 million. Typically, 75% of Open Door's budget is covered by revenue (tuition + childcare subsidies) and 25% is covered by philanthropy. Source: Open Door Preschool, Cynthia McCollum, 2020; U.T. Austin Child Development Center, 2019 Outdoor Space In total the communal space for activities that includes an outdoor playground for children, VG exercise activity area, gardens and IDC programming is estimated at 1,250 (sf). Communal/Shared Space It is necessary that a group room include (700 sf) for special activities, a staff lounge, a laundry room (150 sf), 3 adult bathrooms, (150 sf) and a commercial kitchen (250 sf) for full-meal preparation and service. Intergenerational Recreational Activities : Social activities or program at the Adult Day Center Department of Parks and Recreation offers three major activities for the Varsity Generation (VG) ages 60 and older. Since reopening, VG participants range in age from 65 to 75 and average between 2 to 5 seniors per day (liaise with Russell Diggs, 2/18/22). The Center offers an after-school program for children 5 to 12 for approximately 30 participants per day. Activities include arts and crafts, knitting, brain exercises, ping pong Tai Chi, and a fitness room designed for physical wellness. https://www.austintexas.gov/sites/default/files/images/Parks/Recreation_Centers/Varsity%20Generati ons%20(3)%20DOVE.pdf In addition to these activities, the adult day program would include the following things to do with young children (intergenerational day programming). A. Recreational Activities 1. Group exercise activities 2. Cards and board games 3. Outings and excursions 6 Reading 4. Arts and crafts (quilt squares) 5. 6. Gardening (planting seeds) 7. Music (listening to participant original CDs) 8. Watching TV/educational shows in theater room 9. Dance parties 10. Tai-chi and Mindfulness 11. Yoga (ask separately about chair yoga) 12. Chair volleyball 13. Cooking classes (baking projects) 14. Bird watching, and Bird shows 15. Hula Dance Club 16. Live music (also ask if they play an instrument or sing themselves) B. Social Support Activities 1. Mindfulness meditation workshops 2. Pet therapy 4. Art therapy 5. 6. Child daycare lunch helpers Blow bubbles Learning programs C. 1. Nutrition and education 2. Healthy lifestyle workshops 3. Multi Language classes taught by seniors with teacher or facilitators 4. 5. 6. 7. 8. 9. Art classes (making watercolor paintings, maracas- musical instruments) 10. Computer and cell phone technology use and fraud prevention classes 11. Personal and cultural heritage exploration (genealogy and local historical research) Sign language Tutoring Technology courses Sound Bingo (listening to sounds and identifying the sound source) Photography classes Source: Building an Intergenerational Metropolis: An Intergenerational Day Center Pilot, Austin, 2020 https://repositories.lib.utexas.edu/bitstream/handle/2152/65188/Final%20Report%20Intergenerational %20Day%20Center%20Pilot%20July%2016%202020.pdf?sequence=25&isAllowed=y See Appendix B for sample curriculum. Source: IDC Advisory Group, 2021 Tele-Behavioral Activation Health Treatment Service • Estimated number of participants: Up to 50 7 • • • • • • • Tele-behavioral Activation (T-BA) health program provides short-term depressional treatment and/or fall prevention for individuals age 50 and older with mobility impairment and other disabilities. Space required for Tele-BA participant access to ipad or internet service. All sessions for individual older adults are via videoconferencing and all assessments are done via telephone or video conferencing. Source: Dr. Namkee Choi, Steve Hicks School of Social Work, The University of Texas at Austin, 2022 Transportation Services • Transportation plan ensures each adult participant of the IDC has access to safe, reliable and affordable transportation that allows them to participate in the IDC programs and future implementations at other locations across the community. Serve vulnerable and low-income seniors across the greater Austin community. Round trip transportation to adult day center and IDC. Service requires additional time in our trip planning for clients who let us know they need assistance. The day before a trip, each client is contacted by the driver to determine the exact pickup location, time window, and whether they have additional needs. On a group trip, if a client is not ready at the end of their agreed-upon pickup window, then the driver must leave on time in order to pick up the next client at their scheduled time (and ultimately arrive at the group's destination on time). Coordinate with other non-profits providing transportation in underserved neighborhoods Provide older adults opportunities for stimulating socialization and intergenerational activities. Drive clients to locations where they volunteer their time. Provide rides to programs for older adults with dementia and to “Power for Parkinson’s” for caregiver respite. • Group rides in small buses for weekly grocery shopping, trips to activity centers and other outings enhance our riders’ quality of life. Providing ten to twelve IDC participants with a reliable and pleasant ride to and from the IDC location. In later phases, expand this service to include a weekly grocery shopping trip one day a week or schedule other popular stops such as a neighborhood Walmart. Source: Chariot, July 17, 2022; PARD (TBD) Evaluation The IDC Program evaluation would take place in three steps: prior to the intergenerational activity, during the activity and after the activity. The evaluation would be conducted along with the participants but completed by the facilitating staff member or volunteer to obtain an outside perspective that is not actively engaged in the activity. Process evaluations measure whether actual program performance was faithful to the initial plan (see attached tool). Appendix C is the pre and post-test Wellness Survey. Appendix D is the interview guide for the monthly focus groups (conversation) to evaluate satisfaction, including information on what changes they might like. Many of the evaluation questions focus on activity effectiveness and relevance, facilitators’ performance and level of engagement and concordance with the participants' social behaviors and reactions. 8 A comprehensive evaluation of the IDC Program pilot will assess the relative cost versus benefits of the services and resources in year 1. The survey instrument encompasses the following considerations as shown in Appendix E. Conclusion This IDC Pilot aligns with current national needs as well as the City of Austin’s own drive to focus on underserved citizens, the displacement of low-income seniors, and the need for co-located affordable housing linked to behavioral health services and supports. Additionally, the IDC Pilot contributes to implementation of the Age Friendly Austin Plan http://www.austintexas.gov/edims/document.cfm?id=260993, bridging the gap in service delivery of education, health, and wellness across generations for working families including first responders. The implementation of the project has entailed liaising with Austin Public Health, Department of Parks and Recreation, Assistant City Manager’s Office, and Commission on Seniors https://www.austintexas.gov/content/commission-seniorshttps://data.austintexas.gov/stories/s/AFA- Age-Friendly-Austin/iiyj-8kq8/ as well as partners and foundations who have provided letters of commitment and support. https://nam03.safelinks.protection.outlook.com/?url=https%3A%2F%2Frepositories.lib.utexas.edu%2Fh andle%2F2152%2F65188&data=02%7C01%7Cneda.norouzi%40utsa.edu%7C58dbf6d11ed4407d33a208 d84186d858%7C3a228dfbc64744cb88357b20617fc906%7C0%7C0%7C637331394707728430&sdata=1% 2BgZq2lTFhwk32Ge1LY53DfpemKVdbzn6XWEAMyMwrM%3D&reserved=0 9 APPENDIX A IDC Design: Optimizing the Use of Public Space The architectural goal is to create high quality spaces for single-generation activities as well as intentionally designed spaces that offer opportunities for differ types and levels of intergenerational interactions. The spatial program will focus on respecting autonomy and independence for everyone involved while providing spaces that encourage intergenerational interactions. Single-generation spaces include an Adult Day Room where older adults can spend their day with their peers and away from children if they choose to as well as four different classrooms for different ages groups of 0-1, 1-2, 2-3-, and 3-4-years old children. Each classroom will have an outdoor natural playground for children. These playgrounds will be adjacent to an outdoor adult gym with the purpose of offering opportunities for older adults and children to exercise and play separately but also have the option of spontaneous interactions if they choose to. Other spaces designed to foster intergenerational interaction include (1) the lobby set as an art gallery to display intergenerational art, (2) an indoor/outdoor garden adjacent to an intergenerational kitchen where older adults and children can plant herbs, root vegetables, and salad greens in the garden and use the community kitchen to make fresh meals. The outdoor area surrounding the facility will serve as an outdoor learning environment providing a blend of natural areas, environmental features, and plants to interest children in learning about nature and its elements. These initial designs for the IDC are meant to facilitate interaction between the various age groups that will participate in programming at the center. While IDC will be a community center that will bring together older adults and children, it is important to keep everyone safe. Therefore, after finalizing the site location, we will make sure to design and build a fence to embrace the center. 10 APPENDIX A (continued) 11 APPENDIX A (continued) Source: Dr. Neda Norouzi, PhD, School of Architecture and Planning, The University of Texas at San Antonio, 2022, IDC Advisory Group Meeting, July 22, 2022. 12 APPENDIX B Next Steps 1.Conduct feasibility of IDC Pilot Study with Parks and Recreation Department , Resolution #89 (6/16/22) 2. Provide Seniors monthly Domain 8 Working reports Group to the City of Austin 's Commission on 3.Report findings "Livability and Longevity Symposium "Changing Care Needs in an Aging Metropolis" April 17, 2023 Hosted by UT Austin LBJ School and TALC ITEXAS nw,u_,.,- 111.,-.. • ......., WH,.T ST,.RTS HERE CHANCl!:S THE ..,_ORLD Partnerships Letters of Support and Commitment UT Austin Collaborators Community Supports School • Anderson Charitable Foundation • Dell Medical • Austin Geriatric (formerly • Chariot Center (RBJ) Drive-A-Senior • Moody College of Communication •Faculty • McCombs School of Business Officials •Elected Leaders •Community • CommUnityCare •Family Eldercare • Steve Hicks School of Social Wor •Lakeside Apartments Texas • Meals on Wheels Central of Public Health • UT Health Science Center Schoo •Varsity Generation/Senior •UT Students •St. David's Foundation • Toler Keep Families Giving Foundation Greater • United Way of Austin • UT School of Nursing • TX Aging & Longevity Consortium 13 APPENDIX C Program Evaluation Survey- IDC Pilot Study Phase I Section A Pre-Assessment 1. Age What is your age? (Answer in number) 2. Gender What is your gender? - Female - Male - Non-binary - Other (please specify) 3. Marital status What is your current marital status? - Single and have never been married - Married - Divorced - Widowed - In relationship - Other (please specify) 4. Grandchildren Do you have grandchildren? - Yes - No 5. Cognitive function Have you been diagnosed with dementia by a medical professional? - Yes - No 6. Physical health How would you rate your physical health at the present time? - Excellent - Very good - Good - Fair - Poor 16 APPENDIX C (continued) Program Evaluation Survey- IDC Pilot Study Phase I 7. Mental health- Depression How often did you feel depressed during the past week? - Rarely/None of the time - Some/Little of the time - Occasionally or a moderate amount of time - Most/All of the time 8. Mental health- Loneliness How often did you feel lonely during the past week? - Rarely/None of the time - Some/Little of the time - Occasionally or a moderate amount of time - Most/All of the time Section B Post-Assessment 1. Participation How often How often do you participate in the program? - Once a month - Two or three times a month - Once a week - Several times a week - Other (please specify) For the following questions, please indicate to what extent you agree with the following statements: 2. Satisfaction- Recreational activities I am satisfied with the recreational activities (e.g., group exercise) provided in the program. - Strongly Disagree - Disagree - Not Sure/Neutral - Agree - Strongly Agree - NA  17 APPENDIX C (continued) Program Evaluation Survey- IDC Pilot Study Phase I 3. Satisfaction- Social support activities I am satisfied with the social support activities (e.g., therapy) provided in the program. - Strongly Disagree - Disagree - Not Sure/Neutral - Agree - Strongly Agree - NA 4. Satisfaction- Learning programs I am satisfied with the learning programs provided in the program. - Strongly Disagree - Disagree - Not Sure/Neutral - Agree - Strongly Agree - NA 5. Intergenerational interactions I am happy with the opportunities to interact with kids. - Strongly Disagree - Disagree - Not Sure/Neutral - Agree - Strongly Agree - NA 6. Physical health How would you rate your physical health at the present time? - Excellent - Very good - Good - Fair - Poor 7. Mental health- Depression How often did you feel depressed during the past week? - Rarely/None of the time - Some/Little of the time - Occasionally or a moderate amount of time - Most/All of the time 18 APPENDIX C (continued) Program Evaluation Survey- IDC Pilot Study Phase I 8. Mental health- Loneliness How often did you feel lonely during the past week? - Rarely/None of the time - Some/Little of the time - Occasionally or a moderate amount of time - Most/All of the time 9. How likely are you to recommend this program to other people? - Very unlikely - Unlikely - Not Sure/Neutral - Likely - Very likely Source: UT Austin, LBJ School IDC Advisory Group and Texas Aging and Longevity Center, 7/21/2022 19 APPENDIX D (continued) Section C Periodic Focus Group Interview Guide (Monthly) 1. How often do you participate in Adult Day Center and IDC? 2. Are there any barriers that hinder your participation? 3. Do you think the program provides you opportunities for socializing? 4. Do you think the program provides you a wide variety of physical activities? 5. Does the IDC address needs of what you would like? 6. Has your health improved since the start of the program? 7. Has your mental improved since the start of the program? 8. What improvements or changes would you like to see in the program? 20 APPENDIX E Comprehensive IDC Evaluation Guide Who should be evaluated? All program participants (seniors and children), program staff and volunteers Why is an evaluation being conducted? To evaluate the sustainability of the programming, having feasibility/outcome data to provide to stakeholders/funders, sustain funding from public/private sources, attract larger pool of participants - Know if stakeholders think the program is sustainable and feasible; conducting focus groups with stakeholders participants and their caregivers - As facilitator practice contributes to short-term outcomes, using Intergenerational Practice Evaluation Tool to assess - Observe short-term behaviors from elderly and young participants after intergenerational activity - The Intergenerational Practice Evaluation Tool will be conducted for each intergenerational activity during month 1 of programming and then during week 1 of each month thereafter - Stakeholder focus groups should be conducted 4-5 months following the launch of the program - Community advisory group, including participants and program staff - to be incorporated into requests-for-funding analyses Detailed - Older adults read to aloud in person if safe to do so, over phone if What should be evaluated? When should the evaluation be done? Who will receive the evaluation results? How should the evaluation be completed? Who will conduct the evaluation? What should be done with the evaluation results? 21 permitted or digital correspondence; translated to Spanish if needed - Via digital correspondence (google forms) to all other adult stakeholder, caregivers of young children - Focus groups will be conducted separately for each group, over Video Meeting or in person if safe - - - - - - Program facilitators and staff administering the survey, research team students Research team conducting focus groups separately Infographic and analysis incorporated into annual report and presentation to stakeholders A parallel discussion with elderly participants and their facilitators - Caregivers of young children to discuss survey and results Uploading results to research team’s repository of literature Sent via digital or physical communication to stakeholders and presented at monthly Community Advisory Group meeting Source: Nathan Fernandes, IDC Pilot Evaluation Practicum Report, The University of Texas Health Science Center at Houston, 2020; pp. 18-19.