Policy Implications of Michigan’s Policy Implications of Michigan’s Aging Population for LongAging Population for Long--term Care term Care and Abuse Preventionand Abuse Prevention

Lori A. PostLori A. PostMichigan State UniversityMichigan State University

Demographic TrendsDemographic Trends

The proportion of persons > 65 The proportion of persons > 65 years is growing at a rapid rate.years is growing at a rapid rate.In 2007, the first baby boomers In 2007, the first baby boomers have reached the age of have reached the age of retirement.retirement.By 2030 (end of the baby boom By 2030 (end of the baby boom retiring), the number of persons retiring), the number of persons > 65 will double and the > 65 will double and the average age will increase by 5 average age will increase by 5 years.years.

Michigan’s PopulationMichigan’s Population

Longer life Longer life expectancyexpectancyDelayed Delayed childbearingchildbearingFewer childrenFewer childrenBy 2030, there By 2030, there will be a relatively will be a relatively smaller working smaller working population to population to support the support the elderlyelderly

Top Heavy PopulationTop Heavy Population

Fewer caretakersFewer caretakersSmaller tax baseSmaller tax baseExacerbated by economy where Exacerbated by economy where younger population leaves the younger population leaves the state for employment state for employment opportunitiesopportunities

Elder Dependency RatioElder Dependency Ratio

Represents the Represents the ratio of elderly to ratio of elderly to working age working age populationpopulationBy 2030, most By 2030, most counties will have counties will have more elderly than more elderly than working populationworking populationRural counties are Rural counties are outpacing urban outpacing urban countiescounties

EDR 1970 EDR 1970 -- 20302030

Highest EDR in MichiganHighest EDR in Michigan

Most people do Most people do not move to not move to Arizona and Arizona and FloridaFloridaElderly Elderly migration trends migration trends –– new old, new old, middle old, and middle old, and old old oldoldThe middle old The middle old return to family return to family and the familiarand the familiar

ImplicationsImplications

Fewer resourcesFewer resourcesIncreased need for services as a Increased need for services as a result of aging and obesityresult of aging and obesityProjected labor shortagesProjected labor shortagesExpected increases in abuse, Expected increases in abuse, neglect, and Exploitationneglect, and Exploitation

4.7

12.6 1213.6 16.2

0.9

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26.8

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Type of Abuse

Prevalence of Abuse in Past Year

Policies to insure an adequate Policies to insure an adequate supply of qualified caregiverssupply of qualified caregivers

Maximize improvements in health Maximize improvements in health care delivery, home health care, care delivery, home health care, skilled nursing care, community skilled nursing care, community servicesservicesEnsure adequate pay for nursing Ensure adequate pay for nursing staffstaffEducate workers about abuse, Educate workers about abuse, neglect, and exploitationneglect, and exploitationBackground checks for direct care Background checks for direct care providersprovidersAppeals ProcessAppeals Process

Costs of CrimesCosts of Crimes

Victim and family and Victim and family and communitycommunityInstitutional (training, legal, Institutional (training, legal, licensing, insurance)licensing, insurance)Costs to Medicaid/Medicare Costs to Medicaid/Medicare (injuries, rehab, prescriptions)(injuries, rehab, prescriptions)Criminal justice processing Criminal justice processing (police, trials, law suits)(police, trials, law suits)Precautionary CostsPrecautionary Costs

Total Crime Cost (2007 $)Total Crime Cost (2007 $)

$3,037.00$3,037.00FraudFraud

$3,512.00$3,512.00Larceny/theftLarceny/theft

$25,297.00$25,297.00AssaultAssault

$116,714.00$116,714.00RapeRape

$3,859,245.00$3,859,245.00HomicideHomicide

© 2007 Michigan State University Board of Trustees

© 2007 Michigan State University Board of Trustees

Process Stage Statistics

202,450 202,450 ApplicationsApplications 92,361 92,361

ApplicationsApplications

© 2007 Michigan State University Board of Trustees

Registry Checks

202,450 Applications Registry Searches Completed202,450 Applications Registry Searches Completed

© 2007 Michigan State University Board of Trustees

Fingerprint Hits

111,354 Fingerprints Taken111,354 Fingerprints Taken

© 2007 Michigan State University Board of Trustees

13,483 Fingerprint Hits13,483 Fingerprint Hits

ExclusionsExclusions

© 2007 Michigan State University Board of Trustees

AppealsAppealsBases for appeal are limited to an inaccurate Bases for appeal are limited to an inaccurate record or expunging the disqualifying record or expunging the disqualifying conviction. Michigan legislation integrates conviction. Michigan legislation integrates the rehabilitation process through a tiered the rehabilitation process through a tiered system of exclusionary periods.system of exclusionary periods.

Crime Policy ImplicationsCrime Policy Implications

Most crime is committed by Most crime is committed by youthful offendersyouthful offendersMany criminals never reMany criminals never re--offendoffendConsider an appeals process Consider an appeals process whereby one time juvenile whereby one time juvenile offense is separated from offense is separated from serious or habitual offendersserious or habitual offenders

ConclusionsConclusions

Vulnerable Medicaid Population Vulnerable Medicaid Population StudyStudy was funded by CFDA was funded by CFDA 93.77893.778This study provided the impact This study provided the impact evaluation of the Michigan evaluation of the Michigan Program for Background ChecksProgram for Background ChecksThe MPBC was a collaborative The MPBC was a collaborative project headed by MDCH. Other project headed by MDCH. Other partners included DHS and MSPpartners included DHS and MSP