Transcript MNHouse_AgingLTCare_Jan2015_Final

MINNESOTA HOUSE OF REPRESENTATIVES
AGING AND LONG-TERM CARE COMMITTEE
Susan Brower, Minnesota State Demographer
January 14, 2015
TOPICS FOR TODAY
1. Aging Trends in Minnesota
2. Factors Impacting the Need for Long-Term
Care (LTC)
3. Costs of LTC and income of older adults in MN
4. Labor force needed to care for aging residents
NUMBER OF MN’S OLDER ADULTS WILL
INCREASE SUBSTANTIALLY OVER THE
NEXT 20 YEARS
Change in older adults, age 65+ (Thousands)
85
55
1950s 60s
71
70s
67
80s
91
47
90s
00s
-
-
-
10s
20s
30s
Sources: U.S. Census Bureau and Minnesota State Demographic Center
-
-
40s 2050s
NUMBER OF MN’S OLDER ADULTS WILL
INCREASE SUBSTANTIALLY OVER THE
NEXT 20 YEARS
Change in older adults, age 65+ (Thousands)
335
285
85
55
71
67
1950s 60s
70s
80s
97
91
47
90s
00s
10s
20s
30s
Sources: U.S. Census Bureau and Minnesota State Demographic Center
66
56
40s 2050s
FOR THE FIRST TIME IN MN HISTORY:
MORE 65+ THAN SCHOOL- AGE BY 2020
1,800,000
1,600,000
1,400,000
1,200,000
1,000,000
18-24
65+
5-17
800,000
600,000
400,000
200,000
0
2060
2050
2040
2030
2020
2010
2000
1990
1980
1970
1960
1950
Source: U.S. Census Bureau & Minnesota State Demographic Center
DEMOGRAPHIC SHIFTS WILL CHANGE DEMAND
FOR PUBLIC SERVICES
General Fund Expenditures
2014-2015
Higher
Education
8%
All other
areas
19%
Health &
Human
Services
31%
K-12
Education
41%
Within Health & Human
Services
 Medical Assistance
Expenditures: 25% of GF
spending (8.5 billion)
 Medical Assistance
Expenditures for the Elderly
and Disabled: 16% of GF
spending (5.5 billion)
 MA expenditures include
basic care, long -term care
waivers and long -term
institutional care
Sources: Minnesota Management and Budget, February 2013. House Research, Long-Term
Care Services for the Elderly, November 2012
WHAT FACTORS IMPACT THE NEED FOR LONG TERM CARE (LTC)?
Demographic: Age & Gender
Health status
Disability
Living arrangements
NEED FOR LONG-TERM CARE IS SUBSTANTIAL
AFTER AGE 85
Source: Stone, 2000
70% OF OLDER ADULTS NEED LONG -TERM
CARE
Estimated Years of Long-Term Care Need After Turning
Age 65
31%
17%
20%
20%
2-5 years
More than 5
years
12%
None
1 year or less
Source: Kemper, Komisar and Alecxih, 2006.
1-2 years
OLDER ADULTS LIVING IN INSTITUTIONS
MINNESOTA 2010
20%
15%
Men
Women
10%
5%
0%
65-69
70-74
75-79
80-84
85+
Source: Tabulated by the MN State Demographic Center from the Integrated Public Use Microdata
Series.
MN HAS REDUCED THE NUMBER OF
RESIDENTS LIVING IN NURSING HOMES
Percent change in nursing home
population by decade
Minnesota
U.S.
Population in Nursing
Homes
29%
1980: 40,000
1990: 43,000
2000: 38,000
2010: 30,000
8%
1980-1990
1990-2000
-2%
2000-2010
-14%
-21% -20%
Source: U.S. Census Bureau
HEALTHY LIFE EXPECTANCY AT 65, 2007-2009
At age 65, the
average
Minnesotan
will live an
additional 20
years.
15 of those
years will be
disability-free,
on average.
Source: Centers for Disease Control, 2013
2/3 OF ADULTS RECEIVING LONG-TERM
CARE ARE IN “FAIR” OR “POOR” HEALTH
Percent Reporting Own Health Status as Fair or Poor
Adults with Long-Term Care Needs
65%
Other Adults
66%
21%
7%
18-64
65+
Source: Health Policy Institute, George Washington University. 2000 National Health Interview
Survey.
HEALTH
OUTCOMES
2014
A i n d ex o f s e l f r a te d h e a l t h
a n d l i fe
ex p e c t a nc y
MN’s healthiest
c o u n t ie s a r e
c o n c e n t r a te d i n
the south
AGING BRINGS HIGHER RATES OF DISABILIT Y
Percent with an independentliving disability by age
2008-2012
Percent with a self-care
disability by age
2008-2012
60%
60%
50%
50%
40%
40%
MN
30%
US
20%
10%
0%
0%
85+
US
20%
10%
18-64 65-74 75-84
MN
30%
18-64 65-74 75-84
85+
Source: Tabulated by the MN State Demographic Center from the Integrated Public Use Microdata
Series. Includes only the civilian, non-institutionalized population
PREVALENCE OF DISABILIT Y DECLINING SLOWLY,
AGE PATTERN REMAINS
Disability limiting
independent living
Disability limiting
self-care
Source: Crimmons, et al 2009. Estimates are for the U.S.
RATES OF
DISABILIT Y
AMONG
OLDER
ADULTS
S o u rc e :
mncompass.org
MN Counties with the greatest number of
older adults (Age 65+) by living
arrangement
Hennepin
Ramsey
Dakota
Anoka
St. Louis
Washington
Olmsted
Stearns
Wright
Otter Tail
Crow Wing
Scott
Itasca
Carver
Rice
29% OF
OLDER
ADULTS
(AGE 65+)
LIVE
ALONE;
200,000
IN MN
0
50,000
In household, not alone
In Group Quarters
100,000
150,000
In household, alone
Source: 2008-2012 American Community Survey, U.S. Census Bureau
LONG-TERM CARE COSTS IN MINNESOTA
Average
Daily
Nursing
Home Rate
Private
Room
Average
Daily
Nursing
Home Rate
Semiprivate
Room
Average
Monthly
Cost in
Assisted
Living
Facility
Adult Day
Care Daily
Rate
Home
Health
Aide
Average
Hourly
Rate
Homemaker
Services
Average
Hourly Rate
$234
$210
$3,316*
$75
$25
$22
$85,775/
annual
$76,650/
annual
$39,792/
annual
$27,375/
annual
$20,000/
annual
Est.
$20,000/
annual
Est.
*Not all-inclusive; additional charges for home care services.
Source: Genworth 2012 Cost of Care Survey, Genworth Financial
WHO PAYS FOR LONG TERM CARE
IN MINNESOTA ? (2010)
Private
Insurance/Other
7%
Out-of-Pocket
26%
Medicare
32%
Source: MN Department of Human Services, 2010
Medicaid
35%
OF U.S. ADULTS NEEDING LTC, ONLY 22%
RECEIVE FORMAL (PAID) CARE
PLANS TO PAY FOR LONG-TERM CARE
MN BABY BOOMERS, 2010
Source: Transform 2010 Survey, Minnesota Department of Human Services
WHAT IS MIDDLE INCOME?
Difficult to come up with a meaningful
number for “middle class” or “middle income”
The middle 20% of all MN households with a
householder age 40+ has income between
$44,000 and $68,000
But there is wide variation, especially when
household size is considered
Source: MN State Demographic Center analysis of ipums data, 2007-2011
American Community Survey
MEDIAN HOUSEHOLD INCOME
DECLINES WITH AGE
Median household income by age of householder
Minnesota, 2007-2011
$71,912
$69,368
$53,070
$34,456
$22,889
40-49
50-59
60-69
70-79
80+
Source: MN State Demographic Center analysis of ipums data, 2007-2011 American Community
Survey
MEDIAN HOUSEHOLD INCOME BY AGE OF
HOUSEHOLDER AND HOUSEHOLD SIZE
$100,000
$90,000
$80,000
$70,000
$60,000
$50,000
$40,000
$30,000
$20,000
$10,000
$-
One
Two
Three or more
40-49
50-59
60-69
70-79
80+
Source: MN State Demographic Center analysis of ipums data, 2007-2011
American Community Survey
T WIN CITIES,
ROCHESTER
OLDER
ADULTS:
RELATIVELY
HIGH
MEDIAN
INCOMES
NATIONALLY, ½ OF PEOPLE BUYING LONGTERM CARE INSURANCE HAVE INCOMES OF
$75,000+
AVAILABILIT Y
OF WORKERS
TO CARE FOR
AGING
POPULATION:
DARKER
AREAS WILL
STRUGGLE
MORE
20% = 5
working-age
a d u l t f o r ev e r y
older adult
33%=3
working-age
a d u l t s f o r ev e r y
older adult
FOR THE FIRST TIME IN MN HISTORY:
MORE 65+ THAN SCHOOL- AGE BY 2020
1,800,000
1,600,000
1,400,000
1,200,000
1,000,000
18-24
65+
5-17
800,000
600,000
400,000
200,000
0
2060
2050
2040
2030
2020
2010
2000
1990
1980
1970
1960
1950
Source: U.S. Census Bureau & Minnesota State Demographic Center
MN.GOV/DEMOGRAPHY
T WITTER: @MN_STATEDATA