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s The state of MONTANASTATELIBRARY 3P3602s.a6irf i s i np in Montana 3 0864 0014 5471 2 I 9.99 STATE OF ITtiMt Summary Final Report Backsround Between now and the year 2025, Montana will experience one of the most dramatic demographic transformationsinitshistory. Withtheagingofthebabyboomersandincreasedlongevity,wewillbecomea significantlyoldercommunity. By 2025,Montana's65 andolderpopulation isprojectedtoconstitute20% ofMontana'stotal population. The 85 andolderage group isexpectedtoincrease statewide97.5% over 1997censusfigures. By2025,thepopulationinallbut7 ofMontana'scounties will includebetween 18to 40% seniorcitizens. What is "The State ofAging in Montana"? "The StateofAging in Montana" is areportdevelopedbythe MontanaDepartmentofPublic Healthand HumanServices,SeniorandLongTermCaredivision. Thereportexaminesthechallengesandopportunities Montanafaces, frames atleastsomeofthe issueswe will needto address, andoutlinesactivities thatare already underwaytohelp prepare forthe future. This agingreport isthefirstofitskindforMontanaand focusesprimarilyonimplicationsforstategovernment. Thedivisionplanstoproduceadditionalreportsin anticipationofthecomingagingboom. I About the Report Thefinal47pagereportistheresultofoversixmonthsofresearchandinterviewswithtwenty-onedivisions ofstategovernment,including: DepartmentofTransportation,threedivisionsoftheDepartmentofJustice, DepartmentofAgriculture, DepartmentofLaborand Industry,CommissionerofHigherEducation, two divisionsoftheDepartmentofCommerce,StateAuditor,DepartmentofCorrections,DepartmentofRevenue, DepartmentofAdministration,DepartmentofMilitaryAffairs,andsixdivisionsoftheDepartmentofPublic HealthandHumanServices. ThereportexaminesthedemographichistoryofMontana'sAgingpopulation, ourcurrentdemographicmakeup, andthedemographictransformationthatisprojectedforthefuture. The reportalsoexaminestheimplicationsfor state government, the issues that are expected to develop as ourpopulation Projected Growth In State Populations 1930-2025 ages,andwhatstategovernmentisdoing to prepare for this demographic transformation. Demographic Realities ^ Since 1970, Montana has experienceda69% increase in its aging population. In 1997, 85* 6216 14.287 21.226 26262 65-84 26.7 68.736 116.143 143.01 224.27 Montanans aged 65 and older Under65 510.906 619.457 748382 828334 876.008 comprisedover 13% ( 1 16,143)of ProjectionsfromU.S.CensusBureau Montana's total population. The 14,285 Montanansaged 85 andolderaccountedforapproximately 12%ofMontana'selderlypopulation. The 1998Censusprojections indicatethatMontanacountieswiththegreatestpercentageofseniorcitizensincludes PrairieandSheridanCountiesat24%,DanielsandLibertyCountiesat23%,andWheatlandandPowderRiverCounties at20%. By2025,Montana'sprojectedpopulationwillbe 1, 126, 540people. Thestate's agingpopulationisprojectedtototal 224,270,or20%ofMontana'stotalpopulation. Montanans 85+areexpectedtoreach26,262, a97.5% increaseover 1997censusfigures. By2025,censusprojectionsindicatethatMontanacountieswiththegreatestpercentageofseniorcitizenswill include: GraniteCountyat40%,PowellCountyat39%,ValleyCountyat32%,PrairieCountyat31%,andDeerLodgeCounty at 30%. Statewide Automobile Accidents By Age of Driver % of Drivers Involved in Accidents and # of Fatal Accidents Implications for State Government % Involved in Accidents # Fatal Accidents 12 70 PercentInvolved inCrashes Department of Transportation 10 NumberofFatal Crashes 60 50 40 Aging baby boomers will impact transportation in 30 Montana AnincreaseinMontana'sagingpopulationisexpectedtoresult 20 in more crashes involving aged drivers. Department of 10 Transportation staffare workingtoward decreasing accidents 14-19 20-29 30-39 40-49 50-59 60-69 70+ relatingtoage. Departmentcrews aremakingenvironmental Datafrom Mt. Dept. ofTransportationand Mt. Dept. ofJustice changestoimprovethevisibilityofsignsandpavementmarkings on Montana highways by painting road markings wider and paintingsignswithhighintensitypaints. Departmentofficialsarealsoworkingwithlawenforcementtohelptheelderlywith trafficinfractionsinlieuofissuingtickets. Theyarealsoprovidingeducationalpublicationsforolderdriverstopromotesafe driving. Thetransitdependentpopulationisexpectedtoincreaseastheagingpopulationincreases. DepartmentofTransportation officialshaveidentifiedpublictransportationgapsintheeasternportionofthestate,andtheyaredevelopingwaystoincrease theavailabilityoftransit. CurrentfundingisnotadequatetoprovidethetransitservicesneededinMontana,sothedepartment isutilizingahighwayconstructionfundingsourcetoincreasetheresourcesneededfortransitprograms. Department of Justice ^ TheDepartmentofJusticeistakingpositivestepstopreparetostudy theimpactofanagingpopulationand toprepareforincreasingMedicaid Fraud caseloads TheCrimeControlDivisioncurrentlydoesnotmaintainrecordsregardingthepercentageofcrimesthatvictimizetheelderly. However, staffareintheprocessofmodifyingtheirrecordsmanagementsystem, sovictimizationratesandcrimepatterns maybeavailableforanalysisinthefuture. TheMotorVehiclesDivisionispresentlynotpreparedto studyorevaluatethe impactthattheincreaseinMontana'sagingpopulationwillhaveonthelicensingofdrivers. But,divisionstaffarestudying modelprogramsforagingdriverswhicharebeingtestedinMarylandandOregon. MedicaidFraudinvestigatorsarepreparing foran increasing caseloadby working more closely with Adult Protective Services andcoordinating with anumberof organizationstoprotecttheelderlyfromabuse. Inadditiontoeducatingnursinghomeresidentsandthepublicaboutfraud andabuseandwhatactiontotakeifitdoesoccur,theMedicaidFraudControlUnithasestablishedafraudandabusehotline. Department ofAgriculture ^ AgingofMontana'sfarmersisnotexpectedtoimpacttheagriculture industry TheaveragefarmerinMontanaisbetween57and58yearsold. Theaverageageoffanners isexpectedtoincrease. This isnotexpectedtoaffectMontana's agriculture industry,becausethedevelopmentofnewtechnologieshasdecreasedthe physicaldemandsoffanningandranching. TheDepartmentofAgricultureistakingstepstoattractmoreyoungpeopleto farmingandranching. Whilethe numberoffamily farmshasdeclined, theacreageoftheremainingfarms is increasing. Therefore,theagricultureindustryiscontinuingtoproduceatthesamerate. Department ofLabor and Industry Distribution of Montana's Labor Force ^ Retiring baby boomers will cause significant Thousands ofWorkers changes in the laborforce 400 In 1990, nearly 55% ofMontana's laborforcewerebaby 300 boomers, (age 25-44). The baby boomers increasedthe size ofthe labor force when they reached working age, 200 andtheyarenowraisingtheaverageageoftheworkforce. The retiring ofbaby boomers raises concerns about the 100 extent to which these baby boomers will be financially preparedforoldage,theaddedcoststotheSocialSecurity 1960 1970 1980 1990 system,andincreasedpressureonthenation'shealthcare Data from U.S. Census Bureau system. DepartmentofLaborandIndustryofficialsanticipatetheagingboomwillincreasedemandforhealthcareoccupationssuch asnurses,nursingaides,orderlies,homehealthaides,andmedicalassistants. AlthoughaDepartmentofLaborandIndustry officialtheorizestherewillbeenoughworkersworldwidetofilljobsleftopenbyretiringbabyboomersthroughtheImmigration ReformAct,changingethnicity,cultures,dialects,managementpractices,andworkethicswillmostcertainlyhaveanimpact onthelaborforceandsocietyasawhole. TheMontanaDepartmentofLaborandIndustryofficialshavenoplansatthistime toaddresstheimplicationsofanagingworkforce. Years of School Completed Commissioner ofHigher Education For Montanans Over 24 Thousands Baby Boomers are expected to increase 600 demandforhighereducation 500 Montana's baby boomers have obtained H 4+YearsCollege I 400 1 considerablymoreeducationthantheirparents. The SomeCollege Commissioner of Higher Education's office 300 H |HSGraduate Ikui anticipates thatbabyboomerswill seekadditional 200 l| |9-11 YrsCompleted education for recreational or self-improvement 100 _-_ |0-8YrsCompleted purposes as they age, as the more educated an individualis,themoreeducationthatindividualislikely 1940 1950 1960 1970 1980 1990 topursue.Awiderrangeofeducationalopportunities 1Over24 315.147 335.745 356.087 364.508 450.862 507.851 maybecomeavailableforbaby boomersreturning DatafromMontanaCommissionerofHigherEducation toschool,withthedevelopmentofnewtechnologies liketheeducationviatheinternetandfinancialincentivestoentiremorestudentstoattendcollegeslocatedinruralMontana communities. Anincreaseintheagingpopulationandadecreaseinthebirthratemayalsoresultingreatersupportforfunding highereducation. The needs ofan increasingly olderpopulation are expected to increase demand foreducation which Digitized by the Internet Archive in 2011 with funding from Montana State Library http://www.archive.org/details/stateofaginginmo1999mont specificallyaddressesagingissues, suchasgerontology,agingservices,socialwork,sociology,nursing,humandevelopment, MSU psychology,andhealthcare. Currently,nogerontologydegreesareofferedbyMontana'suniversitysystem,although inBillingsoffersaminoringerontologyattheundergraduatelevel. Department of Commerce The aging boom is expected to impact the Consumer Affairs and Housing Divisions ofthe Department of Commerce The consumers who are most affected by violations ofthe consumerprotection laws are seniorcitizens. As the aging populationincreases,thenumberofseniorcitizenswhoarevictimizedbyconsumerfraudisexpectedtoincrease. Consumer AffairsstaffarefightingfraudbypursuinglegislationwhichwillprovideadditionalremediesforviolationsoftheConsumer ProtectionAct. TheofficeisalsoworkingwithAARPindevelopinglegislationwhichaddressestelemarketingconcerns. The lackofaffordable housing is aproblem formany ofMontana's seniorcitizens. The gapbetween Montana's lower incomecitizensandaccesstoaffordablehousingiswidening. Althoughfederalguidelinesindicatethatpovertyisrisingin Montanaandcurrentlyexceeds 16%,housingpricescontinuetorise. TheBoardofHousingiscommittedtoassistinglow incomeelderlyinremainingindependentandutilizingtheequityintheirhomes. State Auditor Theaging ofthe baby boomers isexpected toimpact the insurance industry Asbabyboomersage,theneedforregulatinginsuranceproducts willincrease. Inaddition, insurancecompaniesneedto make policy changes toprovidecoverage foran increasingly olderpopulation. The State Auditor's office iseducating seniorsaboutinsuranceproducts. Currently,6% ofMontananshavelongtermcareinsurance. Theaverageageofaperson purchasinglongtermcareinsuranceis72,whichoftenmakestheinsurancedifficulttoobtainbecauseofpreexistingconditions oraffordability. Theinsuranceindustryiscreatingincentivesforpeople to purchase long term care insurance through tax policy changes, by reducing gate keeping mechanisms, and by standardizing insurance An estimated 80% ofthe packages. cases involving securities and insurance fraud Anotherareaofconcernforthe StateAuditor'soffice is securitiesand insurancefraud. TheInsuranceCommissionanticipatesthatasthesenior involve seniors who are population increases, they are more likelytobetargetedas victimsof 65 and older. fraud. Department ofCorrections Anaginginmate population isexpectedtoimpactcorrectionalfacilities The Department ofCorrections considers an inmate elderly at the age of50. Currently, about 10% ofMontana's male inmatesand5% ofMontana'sfemaleinmatesareoverage50. Inmatesaregenerallyabout 1 1.5 yearsolderinhealthstatus thantheirchronologicalage. Thisisattributabletoassaultivebehaviors,drugandalcoholabuse,poorhealthanddentalcare, andotherlifestylerelatedbehaviors. ThecostpermedicalencounterforinmatesinMontanaoverage50ismorethandouble thatoftheyoungerpopulation. Astheelderlyinmatepopulationincreases,therewillbeanincreaseinneedforhealthservices andsafetyimprovementsincorrectionalfacilities. Thecostofincarceratingolderinmatesisexpectedtoincreasesignificantly asthepercentageofolderinmatesincreases. Becauseofthecostofincarceratingaginginmateswithseriousillnesses,atask forceisdevelopingpolicytokeepaginginmateswithseriousillnessesinthecommunitywhensafeforthecommunity. Department of Revenue Montana's tax system will beimpacted by an increasein theaging population TheMontanaDepartmentofRevenueispreparingfortheagingboombyidentifyingtheneedsoftaxpayersandre-engineering servicestoaddresstheseneeds. Thedepartmentofferstaxeducation,assistance,andadvantagesforseniorcitizens. Department officialsareimprovingefficiency,communication,accessibility,andonlineservices. Oneexampleofhowthedepartmentis re-engineering services isthecreationofa"onecaircenterfortax assistance, which isexpectedtohandle 80% ofalltax questions. Otherexamples includetherecentdevelopmentofTelefileanddirectdepositoptionsforindividual incometax filings and refunds. In addition, the department has launchedacomprehensive projectcalled "META" which has been designedspecifically to improve customerservice. Aging babyboomers alsowill have easieraccess totaxandrevenue informationatthelocallevel. Department ofAdministration State Employees By Age + Retiringbabyboomersemployed bythestate ThousandsofEmployees INumberofEmployees are expected to impact all areas of state government Approximately 69% ofMontanaStateemployeesare of the baby boom generation (born between 1946- 1964). Asbabyboomersretire,resultingvacancieswill impactallareasofstategovernment. Thedepartmentis preparingforan aging anddecreasing state workforce AgeofEmployee <20 20-29 30-39 40-49 50-59 60-69 70-79 byconducting anextensiveanalysisofcurrenthiring NumberofEmployees 28 practicesandguidelinestobeginin 1999. Theinquiry Asof1/98 will focusonexistingemployeebenefits,competitive salary ranges, and other employment issues. The DepartmentofAdministration isdedicatedtohelping stateemployeesplantheirretirement. Severalemployeebenefits programsencourageandassiststateemployeesinplanningfortheirfutures. Adeferredcompensationprogramprovidesfor supplementalretirementsavings. Inaddition,stateemployees,theirspouses,andparentsrecentlybecameeligibletopurchase longtermcareinsurance. Department ofMilitary Affairs The aging of the WWII and Korean Conflict Veterans will cause an "T Agingveteransneed changesinlongtermcareandmental aging boom for the veteran healthoptions population in the year 2000, eleven DepartmentofMilitaryAffairs' statisticalinformationindicatesthat, years before the first baby boomer historically, the number of Montana veterans 65 and older has remained fairly stable at 35% to 36% of the veteran population. turns 65. Althoughthenumberof65+veteranshasremainedstable, increased longevityisexpectedtoresultinanincreaseinthepercentageofolder veterans. Bytheyear2010,42%oftheentireveteranpopulationwill be65 yearsorolder. AccordingtoareportbytheU.S. DepartmentofVeteransAffairsagingveteransneedchangesin longtermcareandmental healthoptions. Thedepartment recommendstheVAexpandoptionsandservicesforhomeandcommunitybasedcare,makingtheseservicesthepreferred placementsite, whenclinicallyappropriate,forveteransneedinglongtermcare. AccordingtoanofficialfromtheMontana DepartmentofVeteransaffairs,nonewprogramsareplannedatthistimetomeetthechanging needsofMontana'sretiring veterans,withtheexceptionoftheplanneddevelopmentoftheAlzheimer'sunitplannedfortheColumbiaFallsfacility. Department ofPublic Health and Human Services The aging boom is expected to increase elder abuse, neglect, and exploitation and affect quality ofcare AdultProtective Services anticipates thatelderabuse, neglect, andexploitation will increase withthe agingboom. Adult ProtectiveServices isparticipatinginprivate/publicpartnershipstoexpandprotectionforvulnerableadultsandenhancing servicedeliverytovulnerableadults. APS isalsosupportinglegislationthatprovidesbetterprotectionfortheelderly. The DisabilityServicesDivisionexpectsaminimalimpactontheirprogramduetotheincreaseintheagingpopulation. Theaging ofMontanans withdevelopmental disabilities is generatingchange inthe services that are available. While vocational rehabilitation servicesmay notbe seriously impactedby an increase in theagingpopulation, servicesfortheblindwillbe impacted. TheQualityAssuranceDivisionofficialsanticipateanincreaseintheagingpopulationmayaffectthequalityofcare thatisavailabletotheelderly. Increasingacuity intheelderly maygeneratechangeinservicesprovidedbyPersonalCare facilities. •^ Health services forthe elderly areexpanding and becoming more efficient Accesstohealthcarefortheelderly is improving. The HealthPolicy and Services Division anticipatesthatdiseasesand healthcareissuesaffectingtheelderlyareexpectedtoincrease. Thedivisionisdevelopingwaystoprovidemoreefficient health services forthe public. The staffofthe Addictive andMental Disorders Division have recognized the need for expanding supportive mentalhealth servicesfortheelderly; innursing homes,personalcarehomes, andthroughMetNet "Telemedicine"broadcasts. Mentalhealthservicesforagingcitizensarecurrentlyunder-utilized. Thereisaneedtoincrease chemicaldependencyservicesfortheelderly. Total Medicaid Expenditures For Long Term Care Services > Pressures to increase long term care SFY 90 -98 expenditureswill makeinformationservices Million$ animportantpriority 140 SeniorandLongTermCareDivisionofficialsnotethat 120 an aging population and demand for home and 100 community based services will result in pressure to increaselongtermcareexpenditures. Nursinghomes arestrugglingtoremaincompetitiveinthehealthcare industry. Thehealthcare industry issufferingfroma growing shortage of health care workers. And, information is becoming an increasingly important service. TheSeniorandLongTermCareDivisionhas StateFiscalYear anumberofprojectsunderwaytomakeaccurateand Expenditures reliableagingrelatedinformationmorereadilyavailable FY90and91 HomeHealthDataNotAvailable.UsedFY92level. toMontanans. Conclusion "TheStateofAginginMontana"identifiesanddiscussestheimplicationsthattheincreaseinMontana'sagingpopulationwill have on our state government and is intended to inspire an ongoing public conversation about how this demographic transformationislikelytoaffectthewayweliveandworkinMontana. Futurereportscall formaintainingthemomentum begun throughoutthe state, completing furtherspecificresearchon aging issues, andmonitoringthe progressofthe state towardpreparingforanolderpopulation. Thisisasummaryofthefullreportentitled"TheStateofAginginMontana." Copiesof thefull reportareavailableona limited basisduetothecostofproduction. Foracopyof thefull report, pleasecontact: DPHHS-Seniorand LongTerm Care AgingServices P.O. Box4210 Helena.MT59604-4210 1-800-332-2272 http://vtww.dphhs.state.mt.us/sltc