1. Trends in Aging and Long-Term Care August 17, 2007

2. LTC Expenditures Florida

3. Trends in Aging & Long-Term Care 1.Number of aged will continue to grow 2.Increases in retirement age and favorable dependency ratios 3.Favorable long-term care nursing home utilization trends expected to carry for another 25 years Improved health and lower disability rates Lower rates of widowhood Growth of Assisted Living Facility (ALF) and Continuing Care Retirement Community (CCRC) industries Well developed network of home care providers

4. 4. Nursing home reimbursement rates growing five percent over inflation 5. Shortages of health care professionals and paraprofessionals Trends in Aging & Long-Term Care

5. Growth in Aging

7. Share of Elder Population Florida

8. Dependency Ratios

9. Disability Rates 1.Since 1984 disability rates have been declining at about one percent per year. 2.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. 3.Older Floridians are 45 percent less likely to require long-term nursing home care than elders from other states.

10. Source: AARP Public Policy Institute based on 1994 National Long Term Care Survey and U.S. Census Bureau population projection middle series. Disability Rates (cont.)

11. Shift to Assisted Living Facility (ALF) Care

12. Stable marriage rates and declining disability imply that growth in the elderly population can actually lower demand for nursing home care because: As the elderly male population grows more rapidly than the population of elder females, the availability of spousal care rises. The supply of healthy caregivers rises. Informal Care Trends

13. Informal Long-Term Care

14. Nursing Home Use Growth Florida

15. Trends in Demand Nursing Home Care

16. Summary Demand Factors

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

18. Growth Rate 6.7 Percent Yearly Negative Trend: Nursing Home Per Diem Growth

19. Costs: Nursing Home Budgets Growth

20. Trends in Nursing Home Costs

21. Policies to Control the Growth in the Public Cost of Long-Term Care Support and encourage family and personal responsibility Education Support and foster development of affordable long-term care options Aging Resource Centers as local contact for education, information and referral

22. Policies to Control the Growth in the Public Cost of Long-Term Care (cont.) Support health promotion and wellness Social Intellectual Physical

23. Policies to Control the Growth in the Public Cost of Long-Term Care (Cont.) Support a public long term care system that Favors community based care  Promotes deinstitutionalization  Removes any institutional bias Is customer centric Has flexibility  Funding follows the consumer across care settings  Service dollars can be used to supplement rather than substitute for personal/family resources  Services can be used on a preventive basis

24. Support a public long-term care system that Prioritizes and targets services based on risk Maximizes return on investment  Integration/maximization of federal funding streams  Integration of care  Risk transfers/sharing  Administrative efficiencies Policies to Control the Growth in the Public Cost of Long-Term Care (Cont.)

25. Comments & Suggestions Horacio Soberon-Ferrer, Ph.D. Florida Department of Elder Affairs 850-414-2089 ferrerh@elderaffairs.org