1. Welcome to the Third Age Living Options ® Adventure Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 1

2. My First Task at ANIBIC Consumer in the hospital for over a year Needed wound care Find a Skilled Nursing Facility for Rehab Looked at many found none acceptable Rockville – from a former “life” Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 2

3. Aging Committee Representing ANIBIC Looking at the problem Seeking a solution to a growing issue Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 3

4. Third Age Conference Attended the conference to learn what others are doing or intend to do Took ideas away and stored them Began to consider what kind of services I would offer Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 4

5. How will we serve the Aging DD Population?

6. For the first time the Developmentally Disabled population is approaching the average life expectancy of the general population. Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 6

7. The Issues Relatively new population – 1930: the average life expectancy of a DD individual was 19. 1993: the average life expectancy had increased to 66. Today the average life expectancy is within five years of the unimpaired population. Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 7

8. The Issues By 2010 approximately 40% of all those with DD will be over the age of 45. Nursing homes are generally unprepared for an influx of our folks. Many will develop some form of dementia and at an earlier age. Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 8

9. How Many People in New York? 18/1000 1.8% of the population 342,000 individuals Over 45 2005: 85,000 By 2010: 137,000 Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 9

10. The Age Range Today Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 10

11. The Problems Down syndrome: Almost all will die of a dementia related illness. Symptoms of Alzheimer’s disease may begin to manifest as early as age 40. As we grow older we learn to adapt – this is not always so with the DD population. We learn that we can no longer run fast or have the strength we once had. We understand that we will grow tired after physical activity. Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 11

12. The Problems Although many of our consumers have been successful despite their disability and have attained a certain level of achievement and comfort… they may not fully understand new limitations that come along with aging. Many of our current group homes are not suited for older individuals. As we age we often move to different living arrangements… Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 12

13. Focus on Housing Issues I began to look at the housing issues facing an aging population Our current group homes Too small for wheel chairs Not very accessible What would I do differently Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 13

14. The Issues The current philosophy is to maintain smaller group living units. Many have lived independently with the same small group and don’t want to move – What is the alternative? Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 14

15. What Will We Do? Retrofit existing structures – Add elevators Add ramps Move folks to first floor bedrooms – by renovating living rooms We may find that even after incurring renovation expenses – we still don’t have what we want! Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 15

16. What Will We Do? Build new facilities that are more “user friendly”? Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 16

17. What Will We Do? Develop a new paradigm perhaps using Assisted Living as a model… Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 17

18. A Different Type of Facility Third Age Living Options (R), Inc. An Innovative Assisted Living Community

19. Direct Care Staff A new staffing pattern to address new needs! Director of Nursing to oversee operations LPN’s – Shift supervisors CNA’s – Direct consumer care Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 19

20. Day Program Plan Day Service Plans will be included for each resident. ISP’s will reflect consumer choice – THIS IS PARAMOUNT!!! Those who would like to retire and not participate will be encouraged to participate but not required – the choice of many options will be offered to individuals. Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 20

21. Day Program Plan Senior program open to any senior who would like to participate. An opportunity to fully integrate the complex. Community projects are planned offered in conjunction with: Nearby Colleges Local Development Corporations Chambers of Commerce Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 21

22. Integration Build near public transportation, a shopping center and a movie theater to assure choice and community integration. Senior Center to be fully integrated inviting non-disabled individuals to be part of the activities. Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 22

23. Soft Costs Project manager Consultants to include Architect Gerontologist Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 23

24. Problems The Biggest Problem: AFFORDABLE Was to Find a suitable and AFFORDABLE parcel of land in Queens! Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 24

25. Resolution Through the kind efforts of Senator Frank Padavan, and cooperation between the NYS Departments of Mental Health and OMRDD land has been obtained! Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 25

26. The Land Current Building N 17 Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 26

27. The Land Lies at the northeast corner of the Creedmore Complex. It will serve as the site for the complex. The area is large, ANIBIC is exploring additional innovative programs for the unused portion of the site. Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 27

28. Possible Configurations The original idea for a 40 bed complex evolved as input from consumers, and their advocates, and discussions with other professionals in the field suggested that a proposal for 20 beds would be more conducive to a “person centered” environment.

29. What will it look like? The drawings presented here are guesses and conjecture. Possible configuration changes To open the complex to easier integration. To increase accessibility and services. The grade of the land Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 29

30. Original 20 Bed Configuration

31. Common Hall Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 31

32. The Floor Plan Living Room/Dining Room Kitchen Bedroom Bathroom Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 32

33. Administration & Maintenance Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 33

34. Revised 20 Bed Plan 10 two bedroom apartments The configuration may ultimately change

35. Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 35

36. Where the Projects Stands: The concept was developed with input from potential consumers, their advocates and other human services professionals. ─ It took nearly three years to develop fully. Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 36

37. Where the Projects Stands: We have 10+ letters of support from parents, consumers and advocates. 20 affirmations of interest from potential residents. Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 37

38. Where the Projects Stands: The initial OPTS proposal was submitted in August 2005. It was reviewed by OMRDD. They suggested that the project be scaled back to exclude the Shops Clinic Pool Fully integrated Living space Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 38

39. Where the Projects Stands: The proposal was revised and resubmitted in January 2006. Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 39

40. Where the Projects Stands: The proposal has been approved by OMRDD… The land has been found… Let the toil begin! Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 40

41. If You Have Questions Contact: John F. DeBiase 347 594 2124 - Or - Jdebiase@anibic.org Third Age Living Options ® is an ANIBIC Project Developed & Executed by John F. DeBiase, Associate Executive Director 41

42. Stay Tuned!