addressing the boom trends in aging and long-term care florida conference on agingaugust 31, 2004
TRANSCRIPT
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Addressing The Boom
Trends in Aging and Long-Term Care
Florida Conference on Aging August 31, 2004
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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
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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
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Age Cohorts
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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
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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
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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.
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Lower Widowhood
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Lower Disability Rates
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Disability Rates Florida 2004
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Trends in Demand NH Care
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Trends in Nursing Home Costs
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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
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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
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Informal Long-Term CareFlorida Long Term Care
Resources (Dollars in Billion)
1.9
11.2
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LTC Expenditures Florida
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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
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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.
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Policy Areas
Access
Coordination and Integration
Financing and Resources
Quality and Evaluation
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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.
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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.
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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.
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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.
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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
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Implementing Strategies (cont)
Long-Term Care financing systems must have:
Predictably
Prioritization
Expand options to all regardless of geography and ability to pay
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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
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Comments & Suggestions
Horacio Soberon-Ferrer
Florida Department of Elder Affairs
850-414-2000