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As the population ages and more people live with physical disabilities, housing and community development must be re-examined. Inaccessible housing makes daily life difficult for people with reduced mobility due to illness, accident or age. Visitors to inaccessible homes face the danger of falling on the front steps, the worry of not being able to get into the bathroom, and the embarrassment of being carried down the stairs. An affordable, sustainable, and inclusive design approach to integrating basic accessibility features into all new-build housing is a movement known as Visitability.

In 1988, the Fair Housing Amendments Act created affordable units in all new multi-family housing apartments and condominiums with four or more units. In 1990, the Americans with Disabilities Act greatly increased accessibility to all government and public buildings. But detached single-family homes and row houses, where the majority of the population lives, are the last part of the built environment not covered by federal law. There are no accessibility codes. To this day, private and semi-detached houses continue to be built with the same basic accessibility barriers: steps at all entrances and narrow doors to bathrooms.

In an effort to pass legislation for accessibility in new single-family home construction, Eleanor Smith, the founder of Concrete Change, started the Visitability Movement in the U.S. The movement calls for three basic accessibility needs to be met:

* An entrance without steps on a route accessible from a public driveway or sidewalk.

* Entrances with a minimum free passage space of 32″.

* A half bath on the main floor to accommodate a wheelchair.

If these three requirements are met in the construction of each new home, future adaptations for specialized needs can occur as needed. Visitability features make it easy for people with reduced mobility to visit friends and family and stay active in their communities.


Over the life of a home, 25-60% of all new homes will have a resident with mobility issues. This may be muscle weakness, poor balance, arthritic stiffness, or confined to a wheelchair. 95% of all new homes are built with steps at every entryway and narrow doors to the bathroom. Due to architectural barriers, the risk of falling in love with the homeowner is greatly increased and the success rate of first responders can be compromised during medical emergencies.

In 2005, 1.8 million Americans over the age of 65 were treated in emergency rooms for injuries caused by falls, and 460,000 were hospitalized. 60% of all nursing home residents enter these facilities directly from hospitals after a fall, stroke or heart attack. Since most homes have steps at all entrances and narrow bathroom doors, it can only be assumed that a large number of people do not return home after accidents due to lack of accessibility.

Below is a cost comparison of Visitability built into a new home versus Visitability retrofitted into an existing home. The cost of the nursing home reflects the extreme expense of “doing nothing.” (Maisel, Smith, and Steinfeld, 2008, “Increasing Home Access: Design for Visitability”)

Construction of visitability of new houses

* Stepless Entry on Concrete Slab – Add $100

* Entry above crawl space or basement – add $300-$600

* 34″ door: add $2 to the cost of a 32″ door

* Average cost of visitability features, depending on region: add $98 to $573

* Average cost for Universal Design features: add 1% to total project cost

Modernization of the visitability of the existing home

* Step-less entry -add $3,300

* Expand interior doorway: add $700 per doorway ($22 for a drop hinge)

*Home Elevator: Add $15,000-$25,000

Nursing Home Costs

* Nursing home for individuals: $85,000 per year

* Nursing home for US$122 billion in 2005 (60% of the cost assumed by the public through Medicare and Medicaid)

* Cost of falls among the elderly by US$19 billion in direct medical costs (Maisel, Smith, & Steinfeld, 2008)


Cities and towns across the country are gearing up to help their ever-growing older populations. With a shortage of affordable housing for seniors and the desire of most seniors to remain in their homes, home-based programs are at the forefront: meals on wheels, home health care, home hospice , physiotherapy at home, transportation from home. But for home-based programs to be successful, basic accessibility must be provided in the home. Visitability in private homes is crucial for the safety and social sustainability of older adults with mobility problems. Without the independence to enter or leave their home or to use the bathroom when needed, older adults can become isolated, depressed, and ill. Visitable homes are necessary for the safety and safety of everyone: older adults, physically disabled, visitors, caregivers and first responders.

In the late 1980s, Eleanor Smith of Concrete Change began lobbying Atlanta homebuilders to incorporate Visitable features into their new homes, but was met with strong opposition. Habitat for Humanity listened and today there are more than 800 Visitable Habitat homes in the Atlanta area.

1992- Atlanta Visitability Ordinance

Atlanta became the first city to adopt a visitability ordinance that requires all builders of new single-family, duplex or triplex homes that receive any financial benefit from or through the city must meet several basic access requirements, including at least one zero step. suitable entrance and interior door widths.

2002- Pima County Inclusive Housing Design Ordinance, Tucson, AZ

Pima County adopted the first ordinance in the nation requiring step-free entry for single-family homes with door openings at least 34 inches wide, lever door handles, reinforced bathroom walls for grab bars, over 48″ and 36″ wide aisles throughout main floor.

In 2003, the Southern Arizona Home Builders Association sued Pima County over the legality of the Visitability Ordinance. In a unanimous decision, the Arizona Court ended Tucson builders’ efforts to strike down Pima County’s law requiring minimum access in newly built single-family homes. By 2008, Tucson, AZ had built 15,000 visitable homes.

2004- Visitability Code, Bolingbrook, IL

Bolingbrook initially passed a voluntary visitation ordinance that was unsuccessful with homebuilders. To enforce homebuilders, Bolingbrook enforced the ordinance requiring all new homes to be built to visitability standards:

* A minimum of one zero crossing input

* Entries with 32″ clearance space

* A bathroom on the main floor that will accommodate a wheelchair

Bolingbrook currently has 3,600 single-family homes that can be viewed.

Inclusive Housing Design Act of 2009

US Representative Jan Schakowsky (D-ILL) introduced legislation that would apply visitability standards to all new single-family homes and townhouses receiving federal funds. Currently, 95% of new single-family homes and townhomes built with federal assistance do not incorporate accessibility features, making it impossible for many people with disabilities to live in or visit the homes. Representative Schakowsky reintroduced the bill in 2010.

Since the introduction of the Atlanta City Ordinance of 1992, more than 50 ordinances of varying quality have been passed across the country. The legislation has resulted in more than 30,000 visitable homes being built for the open market, regardless of whether or not the first occupant has a disability. States whose cities are adopting visitability ordinances or voluntary programs are: GA, FL, TX, VA, VT, MN, NM, KN, IL, OR, KY, NJ, MI, PA, OH.

ICC/ANSI A117.1, the accessibility standard referenced by most building codes in the US, is currently developing a Type C section that includes technical design criteria for visitability. This will provide a model of accessibility that can be adopted in new single-family homes and will clarify the design of a no-step entry, accessible bathroom, and accessible doors. The standard can be referenced by visitability laws and programs, thus promoting uniformity in applications and aiding in their interpretation. Please note that the IBC will not require Type C dwelling units. If a jurisdiction or state chooses to require visitability in single-family dwellings, the Type C unit criteria will be available for adoption as a reference. The 2010 edition of ANSI A117.1 will contain the specifications for Type C (visitable) dwelling units. (Maisel, Smith, and Steinfeld, 2008, “Increasing Home Access: Design for Visitability”)


Jordana Maisel and Edward Steinfeld, Buffalo, NY, IDEA Center and Eleanor Smith, Concrete Change, Atlanta, GA, “Increasing Home Access: Design for Visitability”

related links

IDEA Center:

Concrete Change:

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