1. Current Issues Affecting Aging Services Audrey Edmisten NC Division of Aging and Adult Services November 2014 Region G

2. A profile of North Carolinians NC is Aging! #Retirees #Foreign-born population (Immigrant and refugees) #Life expectancy #Baby boomers #Lower birth rates

3. Alexander Alleghany Ashe Avery Buncombe Burke Cabarrus Caldwell Catawba Cherokee Cleveland Davie Gaston Graham Haywood Henderson Iredell Jackson McDowell Macon Madison Mecklenburg Mitchell Polk Rowan Rutherford Surry Swain Union Watauga Wilkes Yadkin Yancey Clay Transylvania Lincoln Granville Nash Alamance Anson Bladen Caswell Chatham Columbus Cumberland Davidson Durham Forsyth Franklin Guilford Harnett Hoke Johnston Lee Montgomery Moore Orange Person Randolph Richmond Robeson Rockingham Sampson Scotland Stanly Stokes Vance Wake Warren Beaufort Bertie Carteret Chowan Craven Dare Duplin Edgecombe Gates Greene Halifax Hertford Hyde Jones Lenoir Martin Hanover Northampton Onslow Pamlico Pasquotank Pender Perquimans Pitt Tyrrell Brunswick Washington Wayne Wilson Camden Currituck Counties with more people 60 years old+ than age 0-17, 2012 Counties with more 60+ than 0-17 (59) Counties with more 0-17 than 60+ (41) Source: NC State Data Center, 10/1/2013

4. Alexander Alleghany Ashe Avery Buncombe Burke Cabarrus Caldwell Catawba Cherokee Cleveland Davie Gaston Graham Haywood Henderson Iredell Jackson McDowell Macon Madison Mecklenburg Mitchell Polk Rowan Rutherford Surry Swain Union Watauga Wilkes Yadkin Yancey Clay Transylvania Lincoln Granville Nash Alamance Anson Bladen Caswell Chatham Columbus Cumberland Davidson Durham Forsyth Franklin Guilford Harnett Hoke Johnston Lee Montgomery Moore Orange Person Randolph Richmond Robeson Rockingham Sampson Scotland Stanly Stokes Vance Wake Warren Beaufort Bertie Carteret Chowan Craven Dare Duplin Edgecombe Gates Greene Halifax Hertford Hyde Jones Lenoir Martin Hanover Northampton Onslow Pamlico Pasquotank Pender Perquimans Pitt Tyrrell Brunswick Washington Wayne Wilson Camden Currituck Counties with more people 60+ than 0-17, 2025 Counties with more 60+ than 0-17 Counties with more 0-17 than 60+ (89) (11) Source: NC State Data Center, 10/1/2013

5. Alexander Alleghany Ashe Avery Buncombe Burke Cabarrus Caldwell Catawba Cherokee Cleveland Davie Gaston Graham Haywood Henderson Iredell Jackson McDowell Macon Madison Mecklenburg Mitchell Polk Rowan Rutherford Surry Swain Union Watauga Wilkes Yadkin Yancey Clay Transylvania Lincoln Granville Nash Alamance Anson Bladen Caswell Chatham Columbus Cumberland Davidson Durham Forsyth Franklin Guilford Harnett Hoke Johnston Lee Montgomery Moore Orange Person Randolph Richmond Robeson Rockingham Sampson Scotland Stanly Stokes Vance Wake Warren Beaufort Bertie Carteret Chowan Craven Dare Duplin Edgecombe Gates Greene Halifax Hertford Hyde Jones Lenoir Martin Hanover Northampton Onslow Pamlico Pasquotank Pender Perquimans Pitt Tyrrell Brunswick Washington Wayne Wilson Camden Currituck % of population 65 and over, 2012 11% to 20% (75) 21% to 30% (19) Source: NC State Data Center, 10/1/2013 10% or less (6) North Carolina – 14% Range: 7.8%-27.7% *Number of counties in parenthesis

6. New Alexander Alleghany Ashe Avery Buncombe Burke Cabarrus Caldwell Catawba Cherokee Cleveland Davie Gaston Graham Haywood Henderson Iredell Jackson McDowell Macon Madison Mecklenburg Mitchell Polk Rowan Rutherford Surry Swain Union Watauga Wilkes Yadkin Yancey Clay Transylvania Lincoln Granville Nash Alamance Anson Bladen Caswell Chatham Columbus Cumberland Davidson Durham Forsyth Franklin Guilford Harnett Hoke Johnston Lee Montgomery Moore Orange Person Randolph Richmond Robeson Rockingham Sampson Scotland Stanly Stokes Vance Wake Warren Beaufort Bertie Carteret Chowan Craven Dare Duplin Edgecombe Gates Greene Halifax Hertford Hyde Jones Lenoir Martin Hanover Northampton Onslow Pamlico Pasquotank Pender Perquimans Pitt Tyrrell Brunswick Washington Wayne Wilson Camden Currituck % of population 65 and over, 2032 21% to 30% (70) 31% or more (8) Source: NC State Data Center, 10/1/2013 11% to 20% (22) North Carolina – 20% Range: 10.6%-32.6% *Number of counties in parenthesis

7. The State of Senior Hunger in North Carolina In 2012, 20.5% NC adults 60 years old+ facing the threat of hunger In 2011,16.9%; In 2010 15.66% Compared to other states and DC, NC ranks 45 th, with 1 being the best. Today, North Carolina is ranked #5 with hunger among the 50+ population and 1st for children five years old and younger. Ref. The State of Senior Hunger in America 2012: Annual Report National Foundation to End Senior Hunger May 2014

8. NC Senior Nutrition Program Congregate Nutrition Program  Targeted population: low income ≥ 60 y/o (331 sites statewide 7/12)  FY14 – 25,167 participants  Region G – 3, 129 participants  ~43% at moderate/high risk malnutrition  40% at/below poverty Home Delivered Meals Program  Targeted population: ≥ 60 y/o with physical/mental limitations  FY14 – 18,911 participants  Region G – 3,616 participants  ~90% at moderate/high risk malnutrition  51% at/below poverty For almost half of home-delivered meals recipients—our meal provides 1/2 or more of their daily food intake. Waiting List: over 2054 older adults

9. Home Food Delivery for the Elderly Strengthens Communities According to the analysis from a decade of spending and nursing home resident data, states that invest more on home-delivered meals to seniors have lower rates of seniors in nursing homes. Brown Univ 12/12

10. Good Nutrition and Nutrition Programs helps keep older adults in their home and out of the hospital or a nursing home Costs much less to feed a person in their home versus an institution helps management chronic diseases and symptoms 80% of older adult have a chronic disease

11. The World has changed - we need to change too! Federal funding is limited Local program providers must be more cost effective: start running like a business Consolidate Purchasing Power Know your actual cost – administrative cost, labor costs, utilities, food, delivery Identify budget lines that may be driving up excessive costs Strong food caterer contracts More than a Meal Partnerships and collaboration Food Bank DSS – Foods Stamps (SNAP), Food and Nutrition Services

12. NC Food and Nutrition Services NC Participation Rate including all ages: 74% NC Participation Rate 55y/o+: 43% NC monthly allotment average 55y/o+: $96 Forsyth County 55+ Participation Rate: 41% Forsyth County 55+ monthly allotment average : $105 Randolph Co 55+ Participation Rate: 32% Randolph Co 55+ monthly allotment average: $97 January 2012

13. Current Issues Meals on Wheels Association of NC Private pay for program services Arms – edit checks Who can participate in the congregate nutrition program? Are Take-out meals allowable in the congregate nutrition program? Can we provide Ensure/Boost to our nutrition program participants? ?

14. NEW Meals On Wheels Association of North Carolina! State affiliate of Meals on Wheels Association of America Lee Covington, MOWANC President lcovington@adtsrc.orglcovington@adtsrc.org Vision The vision of MOWANC is to serve as the principle advocate and leadership organization for Meals On Wheels and other nonprofit senior nutrition providers in the state of NC Goals Advocacy Education & Training Networking & Mentoring Collaboration