Community Development Block Grant
Success Stories

St. Paul, MN - Mayor Norm Coleman

Living at Home/Block Nurse Program

The Living at Home/Block Nurse Program is based on the premise that elderly persons will more often accept help from neighbors than from strangers. Pioneered by a Saint Paul neighborhood group in 1981, its founders also believed that a small amount of service to a person in the home will often prevent costly institutionalization.

Instituted and run by a local Board of Directors, the Program uses nurses, home health aides and volunteers to serve all residents over 65 years of age, regardless of their ability to pay, in specific geographic areas - currently 10 neighborhoods in St. Paul. Nurses and aides are employed through a contract with a Medicare-certified nursing agency to ensure quality care and to allow for billing of Medicare, Medicaid and private insurance. The individuals employed, however, are recommended by the local Board of Directors.

The professional services are bolstered by a large cadre of volunteers from the neighborhood who help by visiting, shopping, providing transportation, doing yard work and other tasks which contribute to the quality of life of those served. In FY 1998, more than 800 elderly residents were helped by 283 volunteers who devoted over 2,700 hours to these activities. Another 269 volunteers trained in special listening skills devoted nearly 7,300 hours to clients. In one neighborhood, a local contractor has volunteered to help elderly residents with some of the minor repairs needed to keep up their homes. A small local grocery store will take telephone orders which then are delivered by volunteers. And there are many other examples of cooperation and service.

The clients pay according to income on a sliding scale; neighborhood fund-raising drives make up the difference between the cost of services provided, the amount the client can pay and the third party insurance payment. Many local contributions come from grateful family and friends of clients.

The City's annual investment of $100,000 in CDBG funds leverages more than $500,000 in State, corporate and foundation funding for the Program. The same funding is provided by Ramsey County each year. An independent evaluation of the Program found that the monthly cost per individual served was approximately $500; monthly nursing home costs for that individual would be in the $2,000-3,000 range.

Since its start in one St. Paul neighborhood in 1981, the Program has spread throughout the City, the State of Minnesota, and to other states. As its reputation grew, the originators were receiving so many requests for information that an organization was needed to oversee the replication of the Program and to integrate it into the mainstream health system. A Ford Foundation Innovations in Government award made it possible to incorporate the Living at Home/Block Nurse Program for these purposes.

Contact: Ann Copeland, Department of Planning and Economic Development, (651) 266-6595 or Malcolm Mitchell, Executive Director, Living at Home/Block Nurse, Inc., (651) 649-0315

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The United States Conference of Mayors

J. Thomas Cochran, Executive Director
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