Alaska Commission on Aging Presentation to the Alaska

Alaska Commission on Aging Presentation to the Alaska Mental Health Trust Authority September 5, 2006

Presentation Overview • ACo. A’s Purpose and Who We Are • What We Do; FY 06 Accomplishments • Data on Our Beneficiaries – Contributions, Demographics, Needs, ADRD Research, Services, Funding • FY 08/09 Funding Recommendations • Policy Recommendations • Questions and Closing

The Mission of the Alaska Commission on Aging… is to advocate for policies, programs and services that promote the dignity and independence of Alaska’s seniors and help them maintain a meaningful quality of life. The Commission was established in 1982. Effective July 1, 2003, the ACo. A is housed within the Department of Health & Social Services. We coordinate and collaborate with agencies and institutions statewide to improve services for seniors. The Commission advocates for: • Public awareness of aging issues and trends to increase preparedness for future impacts • Increased coordination of all State programs that impact seniors and their caregivers • A state plan for senior services that offers leadership and guidance for the provision of in-home services and other senior needs; a longterm care strategic plan that will guide the development of the increased long-term care facilities and services needed in the future • Accessible, affordable, sustainable housing options for seniors • Legislation and policies that support the unique needs of seniors (e. g. , Senior. Care, Medicaid coverage for ADRD individuals, etc. )

Alaska Commission on Aging Members: • • • Frank Appel (Anchorage) – Board Chair Michael Black (Anchorage) – DCED Designee Patricia Branson (Kodiak) - Provider Sharon Howerton-Clark (Homer) – Vice Chair Betty Keegan (Wrangell) Banarsi Lal (Fairbanks) Iver Malutin (Kodiak) Rod Moline (Juneau) – DSDS Designee Ed Zastrow (Ketchikan) – Pioneers’ Homes Advisory Board Chair • 2 Vacant Seats

Alaska Commission on Aging Staff: • Denise Daniello, Executive Director • Mary. Ann Vande. Castle, H&SS Planner II • April Thomas, Administrative Assistant • Jeannette Lacey, MSW Student Intern • H&SS Planner I (currently vacant)

The ACOA works with the Trust and other beneficiary boards on: • Advocacy • • Legislative advocacy on joint concerns Legislative teleconferences Medicaid task force Advocacy summit • Planning • Development of the Comprehensive Integrated Mental Health Plan • Other planning efforts for ADRD individuals and seniors with behavioral health needs • Data gathering • Bristol Observatory project • Other data gathering on seniors and those with ADRD • Public awareness and outreach • Coordinated communications – media campaigns • Rural outreach meetings • Trust focus areas • Housing, Workforce Development, TBGI (Trust Beneficiary Group Initiatives) • Trustee standing committees

Other ACo. A Activities: • Planning – developing a comprehensive state plan for senior services by spring of 2007 • Advocacy & Education – promoting public awareness of aging issues and trends; providing information to policymakers and the public on senior concerns; making recommendations to the governor and legislature for legislation, regulations, and appropriations for programs and services that benefit older Alaskans

FY 2006 ACo. A Accomplishments • 2005 White House Conference on Aging reports summarizing input from 5 community forums • Processed results of 2005 senior survey (1, 256 responses) • Coordinated aging advocacy conference (June, 2006) attended by 175 seniors and senior advocates, with initiation of Alaska Aging Advocacy Network • Obtained increased GF/MH funding for ADRD support services; also staff increases for Pioneers’ Homes and Adult Protective Services • Sponsored bi-weekly legislative teleconferences; advocated on legislation of interest to seniors • Began work on 2007 -2011 state plan for senior services • Made a rural outreach visit to numerous sites on Kenai Peninsula (September, 2005) • Contracted with ISER for a report on senior economic status (not yet public) • Worked with DHSS on Comprehensive Integrated Mental Health Plan

Data on Older Alaskans • Value of seniors to Alaskan communities and economy • Demographics of older Alaskans – age, income, disability • Senior needs • Latest research on ADRD risk factors • Current senior services and funding

Seniors: A Sustainable Resource for Alaska

In 2004, Alaskans age 60 and older brought in $1. 461 billion to the Alaskan economy. • This contribution came mostly from retirement income and health care spending. • Senior spending on a broad range of goods and services in Alaska has an economic multiplier effect resulting in the creation of Alaskan jobs and income that further expands the size of the economy.

The retirement industry is a healthy enterprise for the Alaskan economy, characterized by: • Local spending – most income spent within Alaska’s economy • Diverse job mix – jobs created in trades and services as well as health care and other high-paying sectors • Year-round employment – very little seasonality • Stable from year to year – not dependent on fluctuating world market conditions • Environmentally benign – no significant adverse impacts on the natural environment • Compatible with other industries – does not compete for scarce resources • Non-enclave – economic impacts occur throughout the state, not concentrated in remote rural areas • Stable potential tax base • Economies of scale – allows fixed costs of operation to be spread over a larger customer base, reducing unit costs

Seniors also contribute to communities through volunteer activity. • Seniors act as volunteers in a wide range of capacities, assisting in fields as diverse as tourism, health care, education, and senior services. • The economic value of their contributions is between $60 million and $100 million annually, not counting caregiving activity. • Alaska has the fifth highest rate of volunteerism, with 39% of the population participating in volunteer efforts. • Older Alaskans volunteer even more than the average adult. A 2005 survey conducted by the Alaska Commission on Aging found that 56% of Alaskan seniors volunteer their services to the community on a regular basis. • Many seniors also fill the role of family caregiver. The ACOA senior survey found that 9% cared for senior family members, 8% cared for a disabled family member, and 8% provided child care for family members.

Alaska’s Seniors • Alaska has the second-fastest growing senior population in the country (ISER 2006) • By 2025, 17% of Alaskans will be seniors – the same proportion as Florida today (ISER 2006) • Alaska’s baby boomers (currently age 42 through 60) will drive the growth in the senior population; the oldest baby boomers became seniors this year (2006) • The majority (90%) of older Alaskans wish to remain living in the state after retirement (Mc. Dowell Group 2000)

The number of seniors age 85 and older in Alaska will more than triple in the next 25 years. The total number of seniors will more than double. (ISER)

The number of seniors with disabilities will triple over the next 25 years, based on the percentage reporting disabilities in the 2000 census.

Income Though the average income of Alaska seniors is higher than that of seniors in the U. S. as a whole, many still live on very limited incomes.

Top Senior Concerns (based on ACo. A’s 2005 senior survey and 2005 White House Conference on Aging Forums) • • Adequacy of income to meet future expenses Health care costs and access to care Housing options Political leadership willing to prioritize senior needs • Access to long-term care services • Affordable, available transportation • Integration of seniors into civic and social activities

Prevalence of ADRD in Alaska • As Alaska’s senior population increases, so does the number of individuals with Alzheimer’s Disease and Related Dementias (ADRD). • It is estimated that 10% of the senior population has some form of dementia. • The prevalence of ADRD increases 5% every year after age 65. • Nearly half of all people age 85 and older experience symptoms of dementia. • 80% of individuals with ADRD receive care at home. • Based on projected population growth, Alaska is predicted to have the second-fastest growing number of people with ADRD in the nation. (Alzheimer’s Association)

New Research on Risk Factors for ADRD • Physical activity and good nutrition help to “maintain the brain” • ADRD is linked to risk factors such as diabetes, high cholesterol, and obesity • Activities such as puzzles, word and number games, and reading are correlated with a lower risk of developing ADRD • Social involvement and volunteer work provide a protective factor • Higher concentrations of individuals with ADRD are found in areas of low socio-economic status (Alaska Division of Public Health)

Home- and Community-Based Services are a Win/Win Choice • Seniors prefer to remain at home or in their communities, close to family, friends and culture • The cost of inhome services is a fraction of the cost of care in a nursing home (13% for a person receiving 20 hours/week of in-home care)

Senior Home- and Community-Based Services Funded through the Division of Senior & Disabilities Services • Congregate meals at senior centers • Home-delivered meals • Adult day services • Care coordination • Respite care • Family caregiver support • ADRD support services • Senior transportation • Chore service • Information, assistance and referral

FY 2006 Senior In-Home Services (DSDS)

Spending for Senior In-Home Services Grants • The number of older Alaskans increased by 56. 2% from 1995 to 2005 (AK DOL) • Federal funds spent for in-home services grants increased by 61. 2% from FY 1996 to FY 2005. • State general funds spent for in -home services grants decreased by 14. 3% during that period. • Overall spending for in-home services grants increased by 19. 6% - about one-third the rate of the senior population increase during that period.

What Seniors Need Now • Increased funding for home- and community-based services for seniors and caregivers, including those ineligible for Medicaid (in FY 2006, less then 15% of seniors received care through the Medicaid program) • Continuation of Senior. Care program (due to expire on June 30, 2007) • Medicaid waiver services for individuals with ADRD • Accessible, affordable health care services • Heating fuel assistance (for individuals and senior programs) • Long-term care strategic planning to prepare for needs of a rapidly increasing population of seniors • A continuum of senior housing options • Workforce development to recruit, train, and retain senior services workers • Behavioral health care targeted specifically to seniors • Programs and information campaigns addressing ADRD risk factors • Municipal assistance to allow municipalities to provide social services programs • Rural advocacy network to emphasize the needs of rural elders • Assurance of stable funding for senior programs (2005 ACo. A senior survey; 2005 WHCOA forums)

FY 08/09 Funding Requests to the Alaska Mental Health Trust Authority • H&SS Planner I Position • Board Rural Outreach • Healthy Body, Healthy Brain Campaign • Public & Policymaker Senior Education Campaign • ADRD Caregiver Education & Training • Behavioral Health Services for Seniors & Family Caregivers (presented by ABADA/MHBd) • Alaska Brain Injury Network (presented by Alaska Brain Injury Network) • ADRD Support Services (GF/MH) • Keep the Elders Home (End a Decade of Neglect) Initiative - NEW

H&SS Planner I Position FY 08 $75, 500 / FY 09 $75, 500 • Funds one staff person, including salary, benefits, and some travel • Position assists with coordinating projects and programs that serve persons with ADRD and their caregivers, as well as seniors with TBI, developmental disabilities, and behavioral health issues

ACo. A Board Rural Outreach FY 08 $15, 000 / FY 09 $15, 000 • Allows ACo. A to continue rural outreach efforts to reach elders and seniors living in rural, remote communities by holding one quarterly board meeting in a rural area • Assists ACo. A to develop a rural advocacy network to advocate for issues of particular concern to rural seniors and elders

Healthy Body, Healthy Brain Campaign FY 08 $80, 000 / FY 09 $100, 000 • Create public awareness of ADRD risk factors including lifestyle factors, certain chronic diseases, head injuries, depression • Highlight the benefits of physical activity and a healthy diet to control some risk factors • Initiate a program of risk factor reduction to be carried out through local senior centers

Public & Policymaker Senior Education Campaign FY 08 $50, 000 / FY 09 $50, 000 • Educate the general public and local and statewide policymakers about senior issues, including ADRD, traumatic brain injury, and behavioral health issues, along with demographic projections for the next quarter century • Generate understanding and support for senior programs by emphasizing the connection between this information and the budgetary needs of programs that serve seniors

ADRD Caregiver Education & Training FY 08 $80, 000 / FY 09 $60, 000 • Provide a one-day education and training program for caregivers (family and friends) of persons with ADRD, to be repeated in urban and rural hub communities • Give informal caregivers basic information, resources, and community contacts • Provide respite care as needed during the one-day program

ADRD Support Services GF/MH Only: FY 08 $125, 000 / FY 09 $0 • Continue providing in-home services to individuals with ADRD who are ineligible for Medicaid services – care coordination, adult day care, respite, and chore services • Substitute GF/MH for MHTAAR funds provided during FY 07 • Transition to full state GF/MH and/or General Fund funding for the future

NEW! Keep the Elders Home (End a Decade of Neglect) Initiative FY 08 $1, 250. 0 GF/MH, $1, 250. 0 GF / FY 09 $1, 250. 0 GF/MH, $1, 250. 0 GF • Develop an appropriate continuum of services to keep up with the long -term care needs of the rapidly increasing number of older Alaskans • Increase the amount of grant funds available to support senior homeand community-based services

ACo. A Recommendations for Policies and Future Directions • Long-term care strategic plan – must be in place before growth of senior population takes off • Medicaid waiver services should be available for those with ADRD • An increase in total funding for senior services is critical as our senior population grows • Create a continuum of housing options for seniors • Address needs of low- and moderate-income seniors not eligible for Medicaid • Implement strategies to encourage physicians to take on Medicare and Medicaid patients

Thank You for Caring About Older Alaskans! “Problems are only opportunities in work clothes. ” --Henry J. Kaiser “We are confronted with insurmountable opportunities. ” --Pogo