Transcript BCOA August 2012 Workshop

1
INTRODUCTION
Philip Koechlein, AARP Florida, District 15
2
Brevard County
Commission on Aging (BCOA)
• On February 15, 2000, the Board of
County Commissioners adopted
Resolution 2000-042 creating the BCOA.
• The BCOA was extended by Resolution
2002-261, 2005-265, 2007-235, 2010-162,
until September 30, 2013.
3
BCOA Purpose
VISION –To create and sustain a community that
accommodates, supports and values aging.
MISSION –To plan for the future of the elder
population in Brevard County.
VALUES – To maximize opportunities of self
sufficiency and personal independence
for older adults in Brevard.
4
Life Expectancy during the 20th Century
5
Definition of Aging
The most commonly used indicator is
chronological age
• Anyone 50 or older can join AARP. Many
businesses offer "senior citizen" discounts beginning
at 50 or 55. Eligibility for Social Security benefits
begins at 62 with full benefits available at age 66.
• Eligibility for services under the Older Americans
Act (federal) and Community Care for the Elderly
programs (state) begins at 60.
6
Definition of Aging
Chronological Ages:
•
Young Old
65-74
•
Old or Aged
75-84
•
Oldest Old
85 and older
Data presented will follow Chronological Aging Standards.
Data will also be presented in the areas of Baby Boomers
ages 48-66 and age 60 and older .
7
Brevard Population 2000 – 2030
By Chronological Age Groups
120,000
100,000
65 - 74
Series2
Population
80,000
75 - 84
60,000
Series3
40,000
Series4
85+
20,000
0
1
2000
2
2010
3
2015
4
2020
5
2030
Year
8
Source: Shimberg/Florida Housing Data 2000-2030
2010 Proportion of Population by Age Group
U.S., Florida, & Brevard
40
35
Percent
30
25
U.S.
20
Florida
15
Brevard
10
5
0
0-17
18-44
Age
45-64
65 +
9
Source: U.S. Census Bureau/Florida Charts 2010
Florida 60 / 65+ Population
Projections 2005-2030
9,000,000
8,000,000
7,000,000
8 Million by 2030
60 and up
65 and up
Population
6,000,000
5,000,000
4,000,000
3,000,000
2,000,000
1,000,000
0
Year
Source: U.S. Census Bureau/Florida Charts 2010
10
Brevard’s Baby Boomer
• Are you a baby boomer?
If you were born between 1946 – 1964…
You are a Baby Boomer.
Baby Boomers are between the ages of
48 and 66.
Every 7 seconds a baby boomer turns 50
Every 8 seconds a baby boomer turns 60
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Brevard’s Baby Boomers
• 8.8 percent of Florida’s total population is made
up of Baby Boomers - 4.9 Million.
• Brevard County is currently home to more than
160,000 Baby Boomer’s which make up 10
percent of our total population.
• The aging of Brevard’s Baby Boomers will result
in a 104 percent increase in the 85 and older
population between 2015 – 2030.
12
85+ Brevard’s Fastest Growing Population
Florida & Brevard Projections 2000-2030
400
368.5
350
Brevard's Silver Tsunami
Percent
300
250
214.1
200
184.9
Brevard
166.8
150
100
Florida
264.5
140.2
136
106.6
94.7
50
57.8
0
2000
2005
2010
2015
Year
Source: U.S. Census Projections /eflorida.com 1990-2020
2030
13
Brevard’s Fastest Growing
Population 85+
The number and proportion of people
over the age of 85 is especially
important in planning for utilization of
health and social services, as these
individuals tend to be the most frail
and require more supportive services .
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Just the Facts, Ma’am.
Just the Facts.
15
Florida Facts
• Florida is the 2nd most populous state for adults age 65 and older (3.2 million) and age 85 and older
(434,000).
• Florida’s elder population will double to over 8
million by 2030.
• Nationally, Florida has the highest concentration of
adults 60 and older at 17.3 percent, Brevard County
is higher than the state at 20.4 percent.
• Florida currently is home to more elders than 22
states have in their total population.
16
Florida Facts
Florida’s Elders – A Valuable Resource
• A study conducted by the Florida DOEA determined that
elder Floridian’s brought more to the state than they cost in
services:
• 50 percent of new home construction
• 7.5 million community volunteer days
• $135 billion in spending power
• $3.5 billion in donations to charities
• $1 billion in local school taxes
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Brevard County Snapshot
• Brevard's 65 and older population is 27 percent of
the county population and 10 percent higher than the
State average.
• 13 percent of the 65 and older population is over the
age of 85 (17,000), this is our fastest growing
population.
• 33 percent of the 65 and older population have a
disability (38,517).
• Over 18,000 – 65 and older residents suffer from
Alzheimer’s / Dementia.
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Brevard County Snapshot
• Over 10,000 – 65 and older residents are living at or
below the Federal Poverty Level ($10,830).
• Over 97,000 – 65 and older residents are receiving
Social Security ($800 Monthly Average).
• Over 36,000 – 60 and older residents are living
alone.
• Over 32,000 – 60 and older residents are caregivers,
most of them are grandparents raising their
grandchildren.
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Florida’s Workforce
Florida’s 'Working-Age Population'
The working age is considered to be an age group
that is able and likely to work. Typically ages 25 to
65.
• Between 2000 - 2010, Florida’s workforce
represented 50 percent of the total population.
• By 2020, Florida’s “Baby Boomer” workforce
population will represent 47 percent of the total
population and by 2030, it will represent 42
percent.
20
Brevard’s Workforce
Currently, Brevard’s workforce represents
44 percent of the total population (237,000).
Of this percentage • The “Baby Boomer” workforce represents
27 percent of Brevard’s total workforce
(65,000).
• While the 65 and older population represents
18 percent of the Brevard’s workforce (43,000).
21
Veterans
• Florida’s veteran population is over 1.6 million,
representing 15 percent of the total population.
• Florida has the second highest veterans
population in the nation.
• Brevard is home to over 50,000 veterans age 55
and older.
• Brevard’s largest veterans population is the 75
and older.
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Brevard County 2010 Veterans
Population by Age Group
Age Group
Total
50,105
75+
55-64
18,116
65-74
65-74
75+
15,541
Total
55-64
16,448
0
20,000
40,000
60,000
23
Brevard County Racial and Ethnic Composition
Age 60 and Older - 2010
10%
8%
82%
White
Black
Hispanic
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Brevard County Snapshot
• Between
2000 - 2010, the median age in
Brevard County increased from 41.4 years
to 45.5 years, an increase of 4.1 years
resulting in a 10 percent increase in the
median age.
• Between 2010 – 2020, the projected
median age in Brevard will increase to 50.
25
Brevard County Snapshot
• Micco has the oldest median age in Brevard at 67,
and also the highest proportion of older adults in
Brevard County.
• The youngest median age is in West Cocoa at 35.
• Palm Bay (20,423), has the largest number of
residents 60 and older.
• Melbourne has the highest number of residents
ages 75 and older (7,811), and 85 and older
(2,390).
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Children vs. Older Adults
In 2011, for the first time in history the senior
population surpassed that of children.
Brevard
County has more people over the age of 65 (115,080)
than under the age of 15 (85,993).
Children
under the age of 15
(85,993)
Adults Age 65+
(115,080)
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Florida Dept. of Elder Affairs/Florida Charts 2012
District 1 - 60 and older Population Estimates 2010
Sharpes, 4%, 857
Cocoa West,
6% - 1,173
Titusville
Uninc. Other
Port St. John
11%
2,253,
Mims
Titusville
62%
11,272
Mims
11%
2,357
Port Saint John
Cocoa West
Uninc.,
14%
2,828
Sharpes
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Source: U.S. Census Bureau, American Community Survey Estimates 2006-10
District 2 – 60 and Older Population Estimates 2010
Cocoa
9%
3,202
Cape Canaveral
10%
3,539
Merritt Island
Merritt Island,
28%
9,376
Uninc. Other
Rockledge
Cocoa Beach
15%
4,908
Rockledge
17%
5,601
Cocoa Beach
Uninc. & Other
21%
7,135
Cape Canaveral
Cocoa
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Source: U.S. Census Bureau, American Community Survey Estimates 2006-10
District 3 – 60 and Older Population Estimates 2010
Mel. Beach
4%
809
Grant-Valkaria
4% 745
Malabar
Mel./Palm Bay &
Uninc.
14%
2,838
Malabar
35%
7,317
Micco
Mel. Shores/Fl. Beach
Mel. Shores/
Fl. Beach
15%
3,235
Uninc.-Mel./Palm Bay
Micco
28%
5,814
Mel. Beach
Grant-Valkaria
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District 4 – 60 and Older Population Estimates 2010
Uninc. Mel /
Rockledge, 7%
982
Palm Shores, 207
1%
Viera East/West
So. Patrick
Shores
13%
1,660
Viera
East/West
38%
4,890
Indian Harbor Beach
Satellite Beach
So. Patrick Shores
Satellite Beach
20%
2,567
Uninc. Mel/Rockledge
Indian Harbor
Beach
21%
2,676
Palm Shores
31
Source: U.S. Census Bureau, American Community Survey Estimates 2006-10
District 5 - 60 and Older Population Estimates 2010
Indialantic
2%
821
Mel. Village, 193
W. Melbourne
8%
4,380
Indialantic/Mel.
Bchs & Uninc.
14%
7,200
Palm Bay
Melbourne
Palm Bay
39%
20,423
Uninc. Indialantic/Mel.
Bchs
West Melbourne
Melbourne
37%
19,560
Indialantic
Mel. Village
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Brevard County 60 and Older Population by Districts 2010
District 1
15%
20,740
District 5
37%
52,577
Comm. Anderson
District 1
Comm. Fisher
District 2
District 2
24%
33,761
District 3
Comm. Nelson
District 4
District 4 District 3
15%
9%
20,758
12,982
Comm.
Bolin-Lewis Comm. Infantini
District 5
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BCOA PLANNING PROCESS
Communities for a Lifetime Model
Ron Morgan, Brevard TRIAD
34
Communities for a Lifetime
Communities for a Lifetime (CFAL) is a
Statewide initiative of the Florida Department
of Elder Affairs (DOEA) that assists Florida
cities, towns and counties in:
• Evaluating current conditions within the
community;
• Planning for the future; and
• Implementing recommended improvements.
35
Communities for a Lifetime
Communities for a Lifetime enhances
opportunities for people to continue living in
their own communities for a lifetime.
Promotes opportunities for seniors to
“Age in Place” in their homes for as long as
they choose.
The Communities for a Lifetime initiative
benefits all residents, youthful and senior.
36
BCOA Focus Areas
• LONG TERM CARE
Ensure sufficient capacity and quality long term care for older adults
or those with disabilities, including family support and education.
• HEALTH & WELLNESS
Promote a healthy lifestyle that encourages the appropriate use of
medical services and focuses on the nutritional, social, emotional,
intellectual, physical, and spiritual aspects of well-being.
• TRANSPORTATION
Improve Brevard transportation services by increasing public transit
options, use of universal design and expand education and outreach
with a focus on safety.
• ELDER RIGHTS / ADVOCACY / LEGISLATION
Protect older adults from abuse, neglect, and exploitation, while
advocating for resources and actions to meet their needs.
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Mayors Receive CFAL Designations
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BCOA /CFAL Current Efforts
In 2006, the Housing and Human Services Dept.
and the BCOA developed a Strategic Plan for a
CFAL countywide recruitment process, which was
then adopted at the state level.
Brevard County was the first county in the State to
have all 17 municipalities designated Communities
for a Lifetime.
The DOEA presented the BOCC with a Milestone
Achievement Award.
39
Milestone Achievement
40
BCOA /CFAL Current Efforts
The Brevard County partnership with the
DOEA assisted in increasing statewide
Communities for a Lifetime designations by
55 percent.
Housing and Human Services Dept. was invited
to present their CFAL Strategic Planning
process at regional workshops and state
conferences.
41
Communities for a Lifetime Designations
Florida 2005-2010
2010
2006
2002
0
50
100
150
42
Source: Florida Department of Elder Affairs 2011
Current CFAL Efforts
The Housing and Human Services Department
and the BCOA have been awarded three (3)
DOEA CFAL Grants.
These grants have aided in furthering such Focus
Areas as; Elder Falls Prevention, installation of
Ramps and Grab Bars, Senior focused Health
Fairs, Florida Licensing on Wheels and Car-Fit
events, Scams against Seniors Seminars, Public
Service Announcements and Intergenerational
Programs.
43
Palm Bay Falls Prevent Seminar
Educates 375 Seniors
Asbury Arms Residents
Receive “free” Florida ID Cards
45
Ramp for a Hospice Client
CFAL Intergenerational Program
47
CFAL Future Efforts
The BCOA will continue to plan for
Brevard’s aging population following the
DOEA CFAL Model.
We will continue to apply for grants that will
allow us to further our focus areas and
sustain a community that respects and
supports older adults, allowing them to
“Age in Place” with dignity.
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Long-Term Care
Mark Brimer, PhD, Co-Chair, Florida Dept. of
Elder Affairs Statewide Falls Coalition
49
National Falls Facts
Falls are the leading cause of fatal and nonfatal
injury to older adults
• Each year in the U.S., 18,000 seniors die due to
injuries related to unintentional falls.
• Falls are the 5th leading cause of death in older adults.
• Each year 11 million elders 65 and older fall.
By 2020, the annual direct and indirect cost of
fall injuries is expected to reach
$54.9 billion
50
National Falls Facts
Following a hip fracture:
• 25 percent will make a full recovery.
• 40 percent will require a nursing home
admission.
• 50 percent will be dependent on a walker or
cane
• 20 percent will die within one year of the event
51
Florida 2008
“Unintentional Falls”
Resulting in Hospitalization
14000
12000
Falls
10000
8000
6000
4000
2000
0
55-64
65-74
75-84
Age
Florida Department of Health – Published January 2010
85+
Brevard County
Falls Projections
• In 2013 – a projected 7.5 percent of Brevard’s 65
and older population will experience a fall (10,350).
Resulting in:
– 6,000 - emergency department visits
– 4,140 - physician office visits
– 3,415 - will require assistance with daily living
– 1,706 - will require long term care
53
Falls Prevention
Injuries from falls are a preventable community health problem.
Falls Prevention workshops, are the key to increasing public awareness
and result in;
•
•
•
•
•
Fewer 911 calls;
Fewer emergency room visits
Fewer hospitalizations needed;
Fewer doctor office visits;
Fall proofing is intergenerational and beneficial for grandchildren
(falls are the most common cause of injury among children under
the age of (5) five); and
• Quality of life stabilization for older adults, resulting in their ability
to Age-in-Place.
54
Falls Prevention Current Efforts
• The BCOA hosted four (4) DOEA grant funded Falls
Prevention workshops, educating over 900 seniors on how to
fall-proof their homes.
• Hosted a Falls Prevention Tri-County Conference for social
services staff and medical professionals offering CEU’s.
• BCOA was awarded a DOEA grant for $12,500 and
partnered with Aging Matters in Brevard to install wheelchair
ramps, upgrade bathrooms with grab bars and toilet lifts,
install smoke detectors, security lighting and ceiling fans for
low-income elderly residents.
55
Palm Bay Fire Rescue
56
Falls Prevention Current Efforts
Through a grant from the Florida DOEA, the BCOA,
Housing and Human Services Dept. and the City of Satellite
Beach, developed a Falls Prevention Toolkit.
The Falls Prevention Toolkit was designed as a Train-theTrainer Model to educate first-responders, health care
professionals, CNA’s and caregivers on the importance of falls
prevention.
In 2008, Brevard County received an “Outstanding
Achievement Award” from the Florida DOEA for their Falls
Prevention Initiatives.
57
Future Efforts
• Continue to apply for DOEA grants to
educate health care professionals, long-term
care staff and discharge planners of the
importance of falls prevention.
• Work closely with the Florida Statewide Falls
Prevention Coalition to develop and
implement plans and strategies that bring
awareness to falls prevention.
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“Aging in Place”
59
SHINE
Serving Health Insurance Needs of Elders
Lynne Meagher, SHINE Area 7
Volunteer Coordinator
60
Medicare is Difficult to Understand!
61
SHINE
Serving Health Insurance Needs of Elders
SHINE provides free and unbiased health
insurance counseling through a dedicated
network of volunteers, empowering Florida
seniors to make informed healthcare
choices.
SHINE provided assistance to 7,400
Florida Medicare beneficiaries, a 35
percent increase over 2010.
62
SHINE Program Structure
Federal
CMS
State
Florida Dept.
of Elder Affairs
Aging Resource
Centers
Local
SHINE
Volunteers
63
SHINE
• Explain Medicare options to new enrollees.
• Assist with access benefits.
• Assist with explaining paperwork.
• Provide enrollment and prescription assistance.
• Assist with appeals and grievance resolution
process.
• In 2011, SHIP Volunteers provided assistance to
2.2 Million clients Nationally, 105,697 clients
Statewide, and 7,430 in Brevard.
64
SHINE Volunteers
65
Affordable Care Act
5 Key Facts about the Affordable Health Care Act –
• The law protects your basic Medicare benefits and improves
some benefits.
• The law reduces Medicare spending growth, extends Medicare
solvency, and is projected to reduce the budget deficit.
• The makes it easier to receive and pay for long-term care at
home.
• The law improves care for older adults.
• The law improves health insurance access and coverage for
most younger Americans who don’t have Medicare.
66
Florida’s Uninsured
•1 of every 6 Floridians are uninsured.
•1 of every 4 children are uninsured.
•Florida has the 3rd highest uninsured rate
in the Nation.
•Florida has the 4th highest uninsured rate
of children.
67
NACo Prescription Discount Card
“Brevard Card”
In 2008, the Board of County Commissioners and the
BCOA brought this free program to Brevard’s 95,000
uninsured and underinsured residents.
• Over 6,000 residents utilize the Brevard Card each
month.
• Over 11,000 prescriptions are purchased each month
using the card.
• Brevard residents save over $120,000 a month when
utilizing the card.
68
NACo Prescription Discount
Card
• Brevard County ranks 1st in the Nation for the
number of residents that utilize the card, and
3rd for the number of prescriptions receiving a
discount.
Currently, Brevard County residents have
saved over $5.7 Million
on the costs of prescription medications.
69
Brevard Card
70
Future Efforts
• Recruit additional volunteers for the SHINE
Program to assist seniors with Medicare
enrollment.
• Educate the Brevard residents on the free and
unbiased services SHINE offers.
• Participate in community health fairs distributing
the NACo “Brevard Card” to our residents.
• Continue to educate Brevard’s residents through
the use of PSAs.
71
Nutrition
Cindy Flachmeier, CEO
Aging Matters in Brevard
72
National Nutrition
• Every day, 2.3 million senior households must
choose between buying groceries, filling
prescriptions or paying utility bills.
• Seniors remain on a fixed income while the
cost of living continues to increase.
• As seniors age, they struggle with physical
ability to prepare meals and navigate
transportation to a grocery store or food pantry.
73
National Nutrition
• 1 in 7 seniors face hunger every day.
Seniors facing hunger are a family member
or friend, a co-worker or a customer, a
neighbor or the person sitting next to you at
church.
In 2010, Florida Ranked 9th in the Nation in
Senior Hunger
74
Meals on Wheels
75
Supplemental Nutrition Assistance
Program (SNAP)
SNAP makes food more affordable and reduces
health costs by helping seniors prevent and
manage chronic diseases such as,
• Diabetes
• Renal failure
• Heart Diseases, and
• Hypertension
Every $1 worth of SNAP benefits turns into
a $1.73 in benefits to a community.
76
Brevard Nutrition
• The Brevard Community Kitchen prepares
specialized meals for Brevard’s seniors with special
dietary needs to ensure they are receiving the
proper nutrition.
• Meals and proper nutrition are as important to
seniors as proper health care, as they strengthen
the seniors body, balance, and mental acuity.
• The daily visit from a Meals on Wheels volunteer
reduces the loneliness, fear and depression of
77
home-bound seniors.
Seniors At Lunch
78
Brevard Nutrition
• Brevard has 85 food pantries that provide food to
over 85,000 people.
• In 2006, 51,000 residents received food
assistance, and in 2010, the need had increased
by 145 percent to 125,000 residents.
Feeding America has estimated that the 2010 meal
gap could cost Brevard Communities an
estimated $39 million to close.
79
2011 Meals on Wheels
• 700 - MOW volunteers delivered over 227,000
meals to homebound seniors.
• 250 - Senior at Lunch volunteers served over
96,000 meals at 13 neighborhood dining sites.
• The Brevard Community Kitchen prepared and
delivered nearly 500,000 meals.
Aging Matters In Brevard nutritional volunteers
donated over 74,300 hours annually totaling
$1.6 million
80
Seniors at Lunch Volunteers
81
Senior Nutrition
• The Brevard Senior Nutrition Program strains
to keep up with current demands of serving
500,000 meals annually.
• Food prices have gone up 6 percent and rising
gas prices continue to be a budgetary challenge
for a program that relies on volunteers to
deliver meals to home-bound seniors.
No senior should ever go hungry.
82
Transportation
John H. Potomski, Jr., BCOA Chair
Florida Medical Directors Assoc., President
83
National Facts
•In 2010, there were 5,750 fatal traffic
accidents involving a driver 65 or older.
•Of the accidents, 3,398 drivers 65 and
older were killed.
•37 percent of these fatal accidents
occurred at an intersection.
84
Florida Facts
Florida leads the Nation in the number of
drivers 65 and older killed in traffic accidents.
• Florida has 2.3 million licensed drivers 65
and older.
• In 2010, 271 senior drivers died in car
accidents, and an additional 503 crash
fatalities involved a senior driver.
• By 2030, one in four Florida drivers will be
over the age of 65.
85
Keeping Seniors Mobile
Florida’s population will gain 5 million
new residents by 2030.
•50 percent will be over the age of 60
•New to our State, and
•New to our roadways.
Will we be ready for them?
86
Brevard’s Senior Drivers
In Brevard County –
• 97 percent of the 60 and older population
has a driver’s license.
– 126,448 Drivers age 60-84
– 9,630 Drivers age 85-89
– 1,485 Drivers age 90 and older
87
SCAT Stats
Space Coast Area Transit (SCAT) provided 211,300
trips for elderly residents in 2011 -
• 55,000 - Door to Door trips
• 149,000 - Fixed Route trips
• 7,300 - Volunteers In Motion
77 Aging Matters Senior TranServe volunteers
provided 239 trips using their own vehicles and fuel.
88
SCAT 2011
Customer Survey
60+ make up 73%
of Ridership
75+ make up 40%
of Ridership
60 to 74 75 to 84
33.1%
14.1%
85+
25.9% 14.5%
5.2%
Source: Space Coast Area Transit/Local Coordinating Board 2011 Customer Survey
89
58% of paratransit trips
are for medical reasons
90
Source: Space Coast Area Transit/Local Coordinating Board 2011 Customer Survey
CarFit
CarFit is an educational safety program designed to
keep drivers safe and comfortable by improving the
“fit” between the driver and their vehicle.
• Brevard hosted four (4) countywide CarFit events.
• Over 40 seniors received education and training to fit
with their vehicle as their needs change.
• 12 Aging Matters in Brevard Volunteer drivers
received safe driving evaluations.
91
Transportation Future Efforts
Increasing transportation options for the elderly,
persons with disabilities and special needs
populations can be an investment in your
community –
• In 2008, Florida State University completed a
“Return on Investment Study for Transportation
Disadvantaged Programs”, which showed that for
every $1 invested there was a return of $8.35 to
the community in added benefits.
92
Transportation Future Efforts
Continue to work closely with Transportation
Management Services, Brevard’s local service provider for
Medicaid Non-emergency Transportation, to ensure our
elderly, persons with disabilities and special needs;
• Receivie medically necessary transportation in a timely
manner, and
• Are treated with compassion and respect in order to
maintain their privacy and dignity.
• Seek additional State funding to increase the quantity of
trips provided, and improve the quality with which they
are delivered.
93
Transportation Future Efforts
Advocate for:
• Transportation alternatives.
• Highly visible signs, pavement marking and traffic
signals.
• Increased widths of pavement lane markings.
• Improved pedestrian features at intersections.
• Increased size of signs and lettering.
• Better driver testing.
• Education and outreach to seniors who choose to
drive, as well as, those who choose to no longer drive.
94
The City of Cape Canaveral
Signage Improvement Program
Elder Abuse, Crimes and Rights
William “Jack” Sidoran, EdD
State Certified Ombudsman
FL Dept. of Elder Affairs, Long Term Care Ombudsman Program
96
Florida Department of Elder Affairs
Ombudsman Program
The Long-Term Care Ombudsman Program
advocates on behalf of residents of long-term care
facilities through a statewide system of 17 district
councils of volunteer ombudsmen.
Ombudsmen identify, investigate, and resolve
complaints made by or on behalf of residents of nursing
homes, assisted living facilities, and adult family care
homes, as well as, administrative assessments.
97
Florida Ombudsman Program
• Florida has 350 Statewide volunteer Ombudsman,
that donate approximately 68,640 hours annually,
estimated at $1.5 million each year.
• Each volunteer is trained, certified, and must agree to
a background screening.
• Complaints are occasionally filed by residents; more
likely a family member or the residents POA.
• To bring resolution to the resident and the facility,
the Ombudsman will schedule meetings with facility
administration, family members, and POA.
98
Brevard’s Program
6 Volunteer Ombudsman provide assistance to the
residents residing in 137 Facilities:
• 14 Adult Family Care Homes, providing beds for
63 residents,
• 20 Skilled Nursing Facilities, providing 2,629 beds
for very frail elders, and
• 103 Assisted Living Facilities, providing housing
for 2,619 older adults.
A total of 5,311 Long-Term Care residents
99
Brevard’s Program
Brevard’s Cases and Complaints by FY –
• FY 2010 – 2011 – 59 Cases, 135 Complaints
• FY 2009 – 2010 – 77 Cases, 161 Complaints
• FY 2008 – 2009 - 73 Cases, 142 Complaints
Brevard County’s Volunteer Ombudsman:
Donate approximately 2,044 hours annually in
facility assessments and the investigation process,
estimated at $45 thousand annually.
100
Elder Crime, Abuse and Rights
Laura Moody, Elder Services Division
Office of the State Attorney 18th Circuit
101
National Crimes
Top five (5) crimes against older adults • Grandparent Scams
• Free Lunch Investment Seminars
• Medicare Fraud
• Bogus Sweepstakes
• Dialing for Dollars
Scam artists prey on the elderly because they
are trustworthy and vulnerable. 102
National Crimes
• 1 in 5 individuals are victims of scams
annually.
• 1 in 13 persons age 60 and older will be
abused, neglected, and/or financially
exploited.
• 9 percent of financial abuse victims must turn
to Medicaid after their nest egg is stolen.
• Only 1 in 44 elder financial abuse cases is ever
reported.
103
Reasons for not Reporting
Why most crimes go unreported –
• Older adults are afraid they will appear
incompetent.
• Afraid family and friends will think that they
cannot manage on their own.
• Fear that family will take over their personal
finances and move them into their home, a
retirement home or a nursing home.
104
Elder Crimes in Florida
In Florida, the Department of Children and
Families (DCF), Adult Protective Services
(APS), are the first responders to offer victims
of abuse, neglect and exploitation a range of
remedial services. The case managers;
• Investigate the reports,
• Monitor and evaluate the situation, and
• Arrange medical and long-term care, housing
and legal services.
105
Elder Crimes in Brevard
• In Brevard, DCF reports cases of abuse,
neglect and exploitation to the Office of the
State Attorney 18th Circuit.
• In 2011, there were 1607 reported cases of
abuse, neglect and exploitation of older
adults.
• This reflects a 10.6 percent increase over
2010.
106
Elder Crimes in Brevard
107
Elder Crimes in Brevard
108
Elder Crimes in Brevard
109
Future Efforts
• Educate older adults on the issues of abuse,
neglect, and exploitation and available
resources.
• Conduct Scams Against Seniors seminars
throughout Brevard County.
• Educate seniors about various scams through
Public Service Announcements.
110
Legislative
Randy Hunt, CEO, Senior Resource Alliance
PSA 7 Area Agency on Aging
111
CONTINUUM OF CARE
CHORE/
HOMEMAKER
PRIMARY
CARE
MEDICATION
MANAGEMENT
HOMEDELIVERED
MEAL
SENIOR CENTER
SELF CARE
PERSONAL
CARE
COMPANION
PUBLIC/
LEGAL
GUARDIAN
ADULT DAY
CARE
ADULT
FAMILY CARE
HOMES
ASSISTED
LIVING
FACILITY
NURSING
HOME
INSTITUTIONAL CARE
112
Florida Home & Community Care
Programs
• Without home care assistance, older adults
are left with only one choice – more costly
nursing home care.
• As of November 2010, over 63,000 Florida
seniors were on waiting lists for home care
programs.
Waiting Lists = Increased Medicaid Costs to
Counties and Taxpayers
113
Brevard Clients
• Aging Matters In Brevard is the lead agency for Federal
Older American Act Services and State Community Care
for the Elderly Services
– 2,000 clients are served annually
• Average Client
– Late 70’s or early 80’s
– Female
– Living alone
• Priority is given to those individuals who are considered at
imminent risk of entering a nursing home.
114
Brevard Medicaid Stats
• Brevard County has 10,100 Medicaid
Recipients 60 and olderAges: 60-64 – 1,810
65-74 – 3,780
75-84 – 2,710
85 and older - 1,800
115
Brevard Medicaid Stats
• Brevard County’s Top Unfunded State
Mandate is Medicaid –
FY 2012-13 - $6.6 Million (Budgeted)
2011-12 - $4.1 Million (through April 2012)
2010-11 - $2.6 Million
2009-10 - $2,1 Million
2008-09 - $3.6 Million
116
Strategies for Reducing
Medicaid Costs
Home Care Programs can avoid nursing home
placement, allowing seniors to remain at home.
• Home Care for the Elderly = $3,624 / Yr.
• A & D Medicaid Waiver = $4,531 / Yr.
• Community Care for the Elder = $5,340 / Yr.
• Alzheimer’s Respite = $6,300 / Yr.
Annual Costs of Medicaid Nursing Home Care
$25,529 / Yr.
117
Home Care Program
118
Strategies for Reducing
Medicaid Costs
Continue to support:
• Funding for home care programs, they cost
less and employ thousands.
• Home care programs delay the need for
nursing home placement.
• Home care allows seniors to “Age in Place”
and remain in their homes for as long as they
choose.
119
Smart Cap Florida CS/SJR 958 - Amendment 3
Tax Payer Bills of Rights (TABOR)
Florida’s Smart Cap
Amendment 3
Philip Koechlein, AARP Florida, District 15
120
TABOR
Smart Cap Florida CS/SJR 958 - Amendment 3
History of Tax Payer Bills of Rights (TABOR)
• TABOR began in Colorado in 1992 as a
constitutional amendment.
• Encompassed all levels of government.
• Has since been considered in 22 states and
did not pass legislation.
• Florida is the only other state besides
Colorado to place it on ballot.
121
Colorado’s Infrastructure/turmoil
• Highways in disrepair.
• Buildings needing repair.
• Parents buying all school supplies.
• Parents paying winter heat bills for schools.
• People and legislators in conflict. And unable
to make change.
• Finally took action by legislators to “suspend”
temporarily.
Source: Center for Budget and Policy Priorities, Wash, DC
122
Smart Cap vs. TABOR
• Smart Cap regulates spending limits at state level only.
• Smart Cap, like TABOR, ratchets the available funds
so that each year the available money is less.
• As the federal government begins cutting, the state has
Smart Cap, who will the costs of services pass to?
• Unfunded mandates will become a greater problem as
additional burden passes to the County/City levels.
• How can County/City borrow money or have bond
issues at a decent interest rate because of the
uncertainty?
123
Smart Cap is
Restrictive and Inflexible
• It is a constitutional limit on state revenue growth by the
combined rate of inflation and population growth.
• The limitation would apply broadly to state taxes, fees,
assessments, licenses, fines, and charges for services.
• It provides an incremental reduction of flexibility in the limit
with full-implementation of the limit in FY 2019.
Government Spending = Inflation + Population Growth
– TABOR’s inflation PLUS population formula doesn’t
capture the growth in costs of the goods and services
purchased by the state or local governments.
124
Florida Property Tax
Amendment 4
• Amendment 4 would prohibit increases in the assessed
value of homestead property if the fair market value of
the property decreases; reduces the limitation on annual
assessment increases to non-homestead property; and
provides an additional homestead exemption.
• Local Government are already capped –
Rollback rate capped at Consumer Price Index +
Growth
- If Amendment 4 passes pushing back non-homestead
cap from 10% to 5% local governments will be capped
at essentially 4%.
125
Transitions of Care (TOC) Document
Brevard Pilot Program
John H. Potomski, Jr, DO, CMD
Florida Medical Directors Association
126
Transitions of Care (TOC) Document
The TOC DOC is a two (2) page checklist that is
completed by the transferring physician and
included in the patient file.
Goals –
• Ensure the Continuity of Care between the
acute care setting and various post acute settings.
• Improve patient care and outcomes by
providing the “highest quality” of health care.
127
Transitions of Care (TOC) Document
Upon implementation of the TOC DOC –
• Medical errors should be reduced, providing
improved patient care.
• Eliminate duplicative testing, which can cause
unnecessary hospitalization, which often times is
not covered by insurance transferring the
additional cost to the patient, hospital and
taxpayers.
128
Transitions of Care (TOC) Document
The United States has the highest percentage rate
of duplicate medical tests internationally,
increasing from 18 percent in 2005 to 20
percent in 2007.
This increase in medical testing error has
contributed to the devastating increase in
working Americans in debt due to medical bills.
(79 million).
129
HB 7095 Pill Mill Bill
Necessary Revisions
130
HB 7095 Pill Mill Bill
Unintended negative impact of the Pill Mill Bill Physicians overseeing Skilled Nursing and
Hospice Care Facilities critically require an
exemption from the Pill Mill Bill for controlled
substances prescribing in order to prevent the
needless pain and suffering patients are
experiencing due to the implementation of the
new requirements.
131
HB 7095 Pill Mill Bill
Necessary Revisions are needed to –
• Ensure that timely pain medication is administer to
chronically ill and frail patients residing in LongTerm Care and Hospice Facilities.
• A delay in pain management for these frail elders can
result in an emergency room transfer and a lengthy
hospital stay.
• An exemption to HB 7095 should be in place for
patients residing in these already highly-controlled
and regulated environments.
132
HB 7095 Pill Mill Bill
FL Medical Directors Assoc. surveyed 250 LongTerm Care Medical Directors and found that:
• 88 percent reported that patients are suffering with
untreated pain, have poor outcomes, and are being
unnecessarily transferred to an acute care facility.
• 91 percent were aware that patients in FL Skilled Nursing
Facilities may not be getting their pain medications and are
suffering because physicians are afraid to prescribe these
drugs.
Please support a revision to the Pill Mill Bill
133
HB 217 Internet Cafes
134
HB 217 Internet Cafes
• Internet Sweepstakes Cafes are unregulated
predatory gambling parlors.
• Approximately 1000 Internet Sweepstake Cafes
are operating statewide.
• There are approximately 30 Internet Cafes located
in incorporated and unincorporated areas of
Brevard County.
• Internet Sweepstakes Cafes target high retirement
areas and prey on retirees.
135
HB 217 Internet Cafes
• Internet Sweepstakes Cafes target blighted mini
malls and shopping centers, in low to moderate
income areas.
• These Cafes operate as copy centers, fax centers
and sell “Internet Access” through phone cards
that are used to play online casino-style games.
• Internet Sweepstakes Cafes dark tinted windows
are a public safety hazard for both the patrons and
law enforcement.
136
Lunch and Dinner is Served to keep
patrons there longer
137
HB 217 Internet Cafes
Florida Association of Counties Supports:
Statewide oversight and regulation of
so-called Sweepstakes Gambling facilities
and Internet Cafes, including ensuring the
reliability of computer terminals, while
allowing counties to allow or deny the
operation of such businesses within their
jurisdiction.
138
HB 217 Internet Cafes
We would like the BOCC to consider a 1-Year
Moratorium, (unless an ordinance passes before
hand), on the opening of Internet Cafes in the
unincorporated areas of Brevard County, until
Planning & Development Office reports back to
the BOCC and bring forward provisions and
regulations for their operation.
This would not be a ban.
139
Questions