Monroe County Office for the Aging Public Hearing

September 27, 2007

Agenda9:00-9:15 Welcome9:15-10:00 Presentation of

Demographics, Capacity & Utilization of LTC

Services 10:00-11:00 Open forum

MONROE COUNTYNY CONNECTS

LONG TERM CARE COUNCIL

Demographics, LTC Capacity & Utilization Overview

September 27, 2007

Finger Lakes Health Systems Agency

05

10152025303540

Millions

20002005201020152020202520302035204020452050

65-74 Yrs Old 75-84 Yrs Old 85 & Older

U.S. Population 65 & Olderby Age Group

Data Source: U.S. Dept of Commerce, Bureau of the Census, 2004 Interim Projections

0

5

10

15

20

25M

illions

20002005201020152020202520302035204020452050

20.0%19.6%

11.4%6.6%10.2%

19.9%

29.4%

24.0%

20.0%

12.8%

U.S. 85 & Older Population2000 to 2050

Data Source: U.S. Census Bureau, 2004 Projections

% Change from previous period

0%

10%

20%

30%

40%

% o

f 65 &

Old

er

Popula

tion

2000 2010 2020 2030 2040 2050

African American Hispanic Other non-White

65 & Older Population U.S.Distribution by Race/Ethnicity

Data Source: U.S. Dept of Commerce, Bureau of the Census, Interim National Projections, March 2004

0%

10%

20%

30%

40%

50%

65-7475-84 85+ 65-7475-84 85+

1990 2000

% Living Alone by Age & GenderU.S. 1990 & 2000

M A L E S F E M A L E S

Data Source: U.S. Bureau of the Census, Census of Population, Special Tabulations on Aging

0

1,000

2,000

3,000

4,000

5,000N

um

ber

of P

eople

55-59 60-64 65-69 70-74 75-79 80-84 85+Age Group

Males Females

Monroe County Residents, 2000Living Alone

Data Source: U.S. Bureau of the Census, 2000 Census of Population, Special tabulation for US Office for Aging

0

10

20

30

40

50%

Liv

ing

Alo

ne

55-59 60-64 65-69 70-74 75-79 80-84 85+Age Group

Males Females

Monroe County Residents, 2000Percent Living Alone

Data Source: U.S. Bureau of the Census, 2000 Census of Population, Special tabulation for US Office for Aging

0 10 20 30 40% of 2000 Monroe Co Population

60-64 Yr Olds

65-74 Yr Olds

75-84 Yr Olds

85 & Older

Diff Residence in Monroe CoNYS Outside Monroe

Outside NYS

2000 Monroe County Residents

%Who Moved between 1995 and 2000

U.S. Bureau of the Census, 2000 Census of Population, Special tabulations for US Office for Aging

Improving Health Status

0%

3%

6%

9%

12%

15%

18%

21%

24%

27%

30%

Pe

rce

nt

of

65

+ P

op

.

1982 1984 1989 1994 1999

Total Disabled

Disabilities Among the ElderlyU.S., 1982-1999

Source: National LTC Surveys, as reported by M anton and Gu inProceedings of the National Academy of Sciences 98(11), 2001.

0

5

10

15

20

25%

of

Me

dic

are

En

rolle

es

1984 1989 1994 1999

1 ADL Only 1-2 ADLs 3-4 ADLs

5-6 ADLs Living in Institution

% of Medicare Enrollee 65 & OlderWho are Chronically Disabled

Percenages are age adjustedData Source: National Long Term Care Survey.

0

20

40

60

80%

of 2000 P

opula

tion D

isable

d

MaleFemale MaleFemale MaleFemale MaleFemale

U.S. Monroe Co

2000 % of Non-Institutional Populationwith One or More Disabilities

60 - 64 Yrs Old 65 - 74 Yrs Old 75 - 84 Yrs Old 85 & older

Data Source: 2000 Census of Population, U.S. Census Bureau

0

10

20

30

40

50%

of

Re

sp

on

de

nts

65-74 75-84 85 and over

White non-HispBlack non-Hisp Hispanic

65 & Older Self Assessed Health StatusFair or Poor, 2002-2004

Data Source: NCHS, National Health Interview Survey

8

10

12

14

16

18

% o

f N

on-institu

tionalized P

opula

tion

1997-19981998-19991999-20002000-20012001-20022002-20032003-2004

% of People Age 65 & OverReported Having Diabetes

Percentages are age-adjustedSource: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey

0

5000

10000

15000

20000

Hospital In

sura

nce

1983 1993 2003

30.4%

51.4%

Medicare Disabled BeneficiariesMonroe County

Center for Medicaid Medicare Services, HI-SMI Enrollment Tabulations

Percent Change fromPrevious Period

0

5,000

10,000

15,000

20,000

25,000

# E

ligib

les

1985 1996 2006

191.4%

37.0%

Medicaid & SubsistenceMedicaid Only

Monroe Co Medicaid EligiblesBlind & Disabled

Percent Change fromPrevious Period

Data Sources: NYS Dept of Social Services, & NYS Dept of Health

0

50

100

150

200

250M

illions

20002005201020152020202520302035204020452050

18-64 Yrs Old 65 & Older

US Population2000 - 2050

Data Source: U.S. Bureau of the Census, 2004 Projections

Long Term Care Capacity

&Utilization Overview

0 25 50 75 100 125 150 175Daily Capacity per 1,000 Pop. 65+

FL REGION

STEUBEN

SCHUYLER

CHEMUNG

YATES

WAYNE

SENECA

ONTARIO

MONROE

LIVINGSTON

Nursing Home Residential LTHHC Hospice Med. Day Care

Home Health Personal Care EISEP Soc. Day Care

LONG TERM CARE CAPACITY, 2005

Note:CHAA and EISEP are 2003 and 2000

0

20

40

60

80

100

120

140

160

180

200

1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005

Nursing Home Residential LTHHC Hospice Med. Day Care

Home Health Personal Care EISEP Soc. Day Care

LTC DAILY CAPACITY PER 1000 65 & OLDERMonroe County, 1985-2005

20% 40% 60% 80% 100%PERCENTAGE OF EACH SERVICE

FL REGION

STEUBEN

SCHUYLER

CHEMUNG

YATES

WAYNE

SENECA

ONTARIO

MONROE

LIVINGSTON

Residential

Nursing Home

VARIATIONS IN INSTITUTIONAL CAPACITYBY COUNTY 2005

Note:CHAA and EISEP are2003 and 2000

Use Rates

0

50

100

150

200

250N

H R

es

ide

nts

/1,0

00

Po

pu

lati

on

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

All Beds 55-64 All Beds 65-74 All Beds 75-84 All Beds 85+

Resident NH Use RatesFinger Lakes Region, 1994-2003

0

50

100

150

200

250

300

NH

Re

sid

en

ts/1

,00

0 P

op

ula

tio

n

1994 1997 2000 2003 2006 2009 2012 2015

Females 85+ M ales 85+ Regression Regression

Resident NH Use RatesFinger Lakes Region, 1994-2015

R2 = 0.98

R2 = 0.93

0

20

40

60

80%

of 2000 P

opula

tion D

isable

d

MaleFemale MaleFemale MaleFemale MaleFemale

U.S. Monroe Co

2000 % of Non-Institutional Populationwith One or More Disabilities

60 - 64 Yrs Old 65 - 74 Yrs Old 75 - 84 Yrs Old 85 & older

Data Source: 2000 Census of Population, U.S. Census Bureau

80.0%

82.0%

84.0%

86.0%

88.0%

90.0%

92.0%

94.0%

96.0%

98.0%

100.0%

OC

CU

PA

NC

Y R

AT

E

2001 2002 2003 2004 2005 2006YEAR

NYS

FLHSA Region

Monroe County

NURSING HOME OCCUPANCY2001-2006

SOURCE: NYS RHCF COSTREPORTS, 2001-2006* 2006 ISNOT COMPLETE.

20% 40% 60% 80% 100%Percent of Discharges

2001

2002

2003

2004

2005

2006

0-30 days 1-3 months 3-6 months

6-12 months 12-24 months 24-36 months

36-48 months 48+ months

NYS Nursing Homes Length of Stay2001-2006

20% 40% 60% 80% 100%Percent of Discharges

2001

2002

2003

2004

2005

2006

0-30 days 1-3 months 3-6 months

6-12 months 12-24 months24-36 months

36-48 months48+ months

NYS Nursing Homes Length of Stay2001-2006

Changes in Case Mix

0%

10%

20%

30%

40%

50%

60%

70%

80%

Pe

rc

en

t o

f P

ati

en

ts

Low Intensity High Intensity1986

1999

2004

Case MixLivingston Co. Nursing HomesHigh IntensityLow Intensity

1986 63121Facility A 113 11Facility B176132

57.1%42.9%

1999 12351Facility A 10915Facility B23266

77.9%22.1%

200410236Facility A9718Facility B19954

78.7%21.3%

0

20

40

60

80

100

Bed

s P

er

1000 6

5 a

nd

Over

19731976

19791982

19851988

19911994

19972000

2003

Year

Monroe

FLHSA Region

Chemung

SKILLED BED COMPARISONBeds Per 1000 65 and over 1973-2005

0

5

10

15

20

Sr

Housin

g p

er

1000 P

ers

ons 6

5 &

Old

er

19851986

19871988

19891990

19911992

19931994

19951996

19971998

19992000

Senior Housing / Population 65 & OlderMonroe County

Preliminary-Draft

20% 40% 60% 80% 100%PERCENTAGE OF EACH SERVICE

FL REGION

STEUBEN

SCHUYLER

CHEMUNG

YATES

WAYNE

SENECA

ONTARIO

MONROE

LIVINGSTON

LTHHC ADHC SOC DAY PCA CHHA HOSPICE

MIX IN COMMUNITY BASED CAPACITYBY COUNTY 2005

Note:CHAA and EISEP are2003 and 2000

0%

20%

40%

60%

80%

100%

PE

RC

EN

T C

AS

ES

2001 2002 2003 2004YEAR

Yr or More

6-12 months

3-6 months

Less 3months

CHHA ALOSNYS 2001-2004

0

5

10

15

20

25

30

35

40

45

50

55

VIS

ITS

PE

R D

AY

PE

R 1

00

0 6

5+

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

YEAR

MONROE COUNTY CHHASVISITS PER DAY PER 1000 65+

20000

22000

24000

26000

28000

30000

32000

PA

TIE

NT

S

2001 2002 2003 2004 2005 2006YEAR

CAPACITY CENSUS

LTHHCP UTILIZATIONNYS 2001-2006

SOURCE: NYS OFFICE OFLONG TERM CARE,

2001-2006

0

20

40

60

80

Dependents

/100 W

ork

ing A

ge P

opula

tion

20002005201020152020202520302035204020452050

65 & Older Under 18 Yrs Old

U.S. Dependency Ratio2000 - 2050

Data Source: U.S. Census Bureau, 2004 Projections

Public Forum “Ground Rules”

• Each speaker must fill out an index card (provided) with name, address, affiliation, phone and email.

• Each speaker has a maximum of 5 minutes to speak.

• The timekeeper will alert the speaker when s/he has 1 minute of time remaining.

• When a speaker’s allotted time is up, the time keeper will alert the speaker s/he has “no time remaining”.

• Depending on the number of speakers, the time keeper has discretion to allow a speaker more than 5 minutes total.

• Speakers are encouraged to leave a copy of their written testimony with the time keeper