Addressing The Boom

Trends in Aging and Long-Term Care

Florida Conference on Aging August 31, 2004

Trends in Aging & Long-Term Care

1. Number of aged will continue to grow

2. Increases in retirement age

3. Improved health and lower disability rates

• Lower rates of Medicaid use among elders

• Lower rates of widowhood

• Continuing shifts in long-term care setting Favorable long-term care nursing home

utilization trends expected to carry for another 25 years

• Boomers not likely to overwhelm long-term care system for the next 20-30 years

Growth in Aging

Growth in Retirees and Oldest OldFlorida

01,000,000

2,000,0003,000,000

4,000,0005,000,000

6,000,0007,000,000

1970 1990 2004 2010 2020 2030

Year

Persons 85 and Older Persons at Retirement Age

Age Cohorts

Dependency RatiosShare of Elder Population

Florida

0%

5%

10%

15%

20%

25%

30%

1970 1990 2004 2010 2020 2030

Year

85+ Share Ret.Age Share

Dependency RatiosFlorida

0.00

0.20

0.40

0.60

0.80

1.00

1.20

1970 1990 2004 2010 2020 2030

Year

Dep

end

ents

per

wo

rkin

g

age

adu

lt

Retirees Children <20

Positive TrendsDisability rates are declining and this trend is expected to continue. Between 2000 and 2050 the rate of severe disability among the elderly is projected to be cut by half.

Older Floridians are 45% less likely to require long-term nursing home care than elders from other states.

Stable rates of marriage and declining disability implies that growth in the elderly population can actually lower demand for nursing home care because:

As elderly male population grows more rapidly than the population of elder females the availability of spousal care rises.

The supply of healthy caregivers rises.

Lower Widowhood

Lower Disability Rates

Disability Rates Florida 2004

Trends in Demand NH Care

Trends in Nursing Home Costs

Nursing Home Use Growth Florida

10.18%

7.58%

0.54%

-0.55%0.25%1.44%

1.63%

1.32%

2.15%

2.12%

3.00%3.34%

-2.00%

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

Shift to ALF Care

18,543

81,21881,30579,55077,92876,108

74,72372,960

70,62468,84267,189

64,706

75,671

80,99876,514

70,59067,43966,295

56,918

51,064

44,181

39,473

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

Nursing Home Beds ALF Beds

Informal Long-Term CareFlorida Long Term Care

Resources (Dollars in Billion)

1.9

11.2

LTC Expenditures Florida

FL O R U S

A ll Lon g-Term Ca reExpenditures Per 65+

N ursing H om e Expenditures Per 65+

FL O R U S

Percen t of 65+ Popu la tionin N ursing Fa cilities

FL O R U S

Florida’s Long-Term Care Costs Are Lower Than Other States

To control the growth in the public cost of long-term care

The Office of Long-Term Care Policy Advisory Council recommends the adoption of a set of policies to address issues identified in four broad policy areas.

Policy Areas

Access

Coordination and Integration

Financing and Resources

Quality and Evaluation

Access 1. Long-term care options are to be available on the basis of

service need, regardless of geographic, cultural or financial differences;

2. The long-term care system is to be accessible through multiple points, supported by a single administrative entity;

3. Specific programs to enable caregivers to provide care for at-risk persons in the community will be supported; and

4. The long-term care system will include programs for prevention, maintenance, early intervention and restoration.

Coordination/Integration

1. The long-term care system must reduce the level of fragmentation and duplication of services ;

2. Long-term care services and programs will be coordinated across state agencies ;

3. Coordination between acute care and long-term care is to be supported and encouraged;

4. Mental health, substance abuse and other social support services are to be integrated with long-term care; and

5. Continuity of care is to be emphasized and enforced in the long-term care system.

Financing/Resources 1. The effective and efficient utilization of all funding

resources will be maximized through greater personal and community responsibility;

2. The effective and efficient utilization of all funding resources will be maximized through private sector involvement ;

3. The effective and efficient utilization of all funding resources will be maximized through contracting, administrative and financing innovations ; and

4. The long-term care system will safeguard the financial integrity of assessment, case management and service provision.

Quality/Evaluation

1. The development and training of a quality long-term care workforce will be supported;

2. The long-term care system will have a person-centered performance measurement system based on outcomes ; and

3. A long-term care information management system, with a focus on outcome measures, is necessary and will be promoted and supported.

Implementing StrategiesRemodel Long-Term Care Delivery System Aging Resource Center Interagency Team

Foster more competitive market environment Existing network of community providers to be

strengthened to transition to competitive environment

Strengthen Caregiver Support Programs

Foster healthy ALF industry

Basic array of services throughout Florida

Implementing Strategies (cont)

Long-Term Care financing systems must have:

Predictably

Prioritization

Expand options to all regardless of geography and ability to pay

Next StepsInteragency workgroup

DOEA, AHCA and DCF to implement the Aging Resource Center

Coordinate LTC evaluatory activities to ensure a system wide approach

Work with key stakeholders to integrate LTC with acute care

Comments & Suggestions

Horacio Soberon-Ferrer

Florida Department of Elder Affairs

850-414-2000

ferrerh@elderaffairs.org