The document discusses aging services in Utah and proposes budget increases to better serve the state's growing senior population. It notes that Utah's population of those aged 65 and older is projected to dramatically increase in coming decades. Current programs like Meals on Wheels and caregiver support are underfunded and unable to meet existing needs. The presentation proposes targeted budget increases of $600,000 to expand aging-in-place services and $250,000 to better support caregivers. It argues that these investments will allow more seniors to remain in their homes and communities, improving quality of life while providing cost savings compared to facility-based care.

1. Utah Representative
Rebecca Chavez-Houck
Mallory Bateman
Scott McBeth
Alan Ormsby
Michael S. Styles
Nan Mendenhall
Anne Palmer
M I N D T H E G A P
OPTIMIZING QUALITY of LIFE
for AGING UTAHNS
H E A LT H and H U M A N S E R V I C E S I N T E R I M C O M M I T T E E P R E S E N TAT I O N

2. R E B E C C A C H A V E Z - H O U C K Democratic AssistantWhip, Utah House of Representatives
M I N D T H E G A P
OPTIMIZING QUALITY of LIFE
for AGING UTAHNS
OPTIMIZING QUALITY of LIFE
for AGING UTAHNS
M I N D T H E G A P

5. ACTUAL / PROJECTED
SENIOR POPULATION
85+Years
A C T U A
L
85+Years
P R O J E C T E D
65–84Years
A C T U A L
65–84Years
P R O J E C T E D

6. DELIVERY of CARE to
OLDER ADULTS in UTAH
3
M A I N T Y P E S

7. AGING in PLACE at HOME
with MINIMAL SUPPORTIVE SERVICES

8. RECEIVING
HOME and COMMUNITY-BASED
SERVICES

9. MOVING INTO a
SKILLED NURSING FACILITY

10. CONTINUUM of SERVICES
for OLDER ADULTS
Agencies recognize and support the need
for a full CONTINUUM of CARE to meet
the complex and varied needs of older adults.

11. Many older adults can REMAIN IN THEIR OWN
HOMES
with a minimal amount of supportive services
Many can remain in HOME AND COMMUNITY -
BASED SETTINGS with more structured supports
Others receive services in NURSING FACILITIES when
the complexity of the individual’s needs cannot be safely met in
a home and community based setting
Many older adults can REMAIN IN THEIR OWN
HOMES
with a minimal amount of supportive services
CONTINUUM of SERVICES
for OLDER ADULTS
Many can remain in HOME AND COMMUNITY -
BASED SETTINGS with more structured supports
Others receive services in NURSING FACILITIES when
the complexity of the individual’s needs cannot be safely met in
a home and community based setting

12. TYPICAL ANNUAL COST of
PUBLICLY-FUNDED SERVICES
$30 – 60,000
FAC ILITY
BASED
S E R V I C E S
AGIN G in
PLAC E
With limited
support services
When services
provided in home
HC BS
H O M E and C O M M U N I T Y -
B A S E D S E R V I C E S
<$1,000 $250 – 10,000
Alternatives Aging Waiver Including Publicly-
funded Services
Meals on Wheels
Respite

13. C H A N G I N G
D E M O G R A P H I C S
M A L L O R Y B A T E M A N Research Analyst, Utah Foundation
© Deseret News

14. 8.7 8.5
9
9.8
12.6 12.4
13
14.1
1990 2000 2010 2013
PERCENT OF POPULATION
65 YEARS OR OLDER
Utah U.S.
Source: U.S. Census Bureau

15. MEDIAN AGE, UTAH AND U.S.
Source:
U.S. Census
Bureau 1990 2000 2010 2013
UT 26.3 27.1 29.2 30.2
US 32.9 35.3 37.2 37.6

16. UTAH DEMOGRAPHICS 2010
Source:
U.S. Census Bureau
UT U.S.
Boomer 18.7 24.9
Gen X 20.9 21.2
Millennial 26.0 27.7
1946–1964
1965–1980
1981–1995
%
%
%

17. YOUTH, WORKING AGE, AND 65+
POPULATION PROJECTIONS (UT)
0
1,000,000
2,000,000
3,000,000
4,000,000
5,000,000
6,000,000
1990 2000 2010 2020 2030 2040 2050
18 to 64 0 to 17 65 to 84 85 and over
Source: Governor's Office of Management and Budget
2013 Population
2,900,872
2050 Population
5,257,242

18. 13% 17%
14%
6%
11% 12%
29%
19%
15%
15%
14%
10%
21%
24%
27%
38%
22%
23%
1990 to 2000 2000 to 2010 2010 to 2020 2020 to 2030 2030 to 2040 2040 to 2050
0 to 17 18 to 64 65 and over
PERCENT CHANGE by DECADE
1990 to 2050
Source: Governor’s Office of Management and Budget

19. 76.0
67.0 65.8
54.2 53.0 52.4
47.5 46.2 47.1 46.7
14.0
13.0 15.8
14.4 15.2 17.6 24.2 26.7 31.1 33.7
1970 1980 1990 2000 2010 2020 2030 2040 2050 2060
Youth Retirement Age
DEPENDENCY RATIO
1990 – 2050
90.0
80.0 81.6
68.5 68.2 70.0 71.7 72.9
78.2 80.4
Source: Bureau of Economic and Business Research analysis of Governor’s Office of Management and Budget, 2012 Projections. Note: Dependency Ratios are
computed as the number of nonworking age persons per 100 working age (18-64 years old) persons in the population. Youth are less than 18 years old and
retirement age is 65 years and older.

20. 2010
M A L E
2000
M A L E
150,000 100,000 50,000 0 50,000 100,000 150,000
Under 5
5 – 9
10 – 14
15 – 19
20 – 24
25 – 29
30 – 34
35 – 39
40 – 44
45 – 49
50 – 54
55 – 59
60 – 64
65 – 69
70 – 74
75 – 79
80 – 84
85 and over
UTAH POPULATION by AGE and SEX
2000 and 2010
2010
F E M A L E
2000
F E M A L E
Source: Bureau of Economic and Business Research analysis. U.S. Census Bureau, 2000 and 2010 Census.

21. 80% 60% 40% 20% 0% 20% 40% 60% 80%
0 to 4
5 to 17
18 to 29
30 to 39
40 to 64
65 to 84
85 and over
2010-2030 Female 2010-2030 Male2000-2010 Female 2000-2010 Male
POPULATION CHANGE
2000 to 2010 actual
and projections for 2010 and 2030
Source: Governor's Office of Planning and Budget

22. AGING in PLACE at HOME
with MINIMAL SUPPORTIVE SERVICES

23. A G I N G I N P L A C E
A T H O M E
S C O T T M C B E T H Director, MountainlandAging & Family Services Department
Mountainland Area Agency on Aging
smcbeth@mountainland.org
801-229-3805
© Deseret News

24. WHO ARE WE?
12 AREA AGENCIES ON AGING IN UTAH
(AAA’S)
LOCAL PROVIDERS OF SENIOR SERVICES
ASSOCIATED WITH:
Counties
Association of Governments
UTILIZING STATE, FEDERAL, AND LOCAL
MONIES TO PROVIDE SENIOR SERVICES

25. SERVICES PROVIDED THROUGH AAAs
Meals-on-Wheels
Senior activity centers / meals
Information and referral for
services and resources
Transportation
Non-medical, in-home
services programs
Volunteer programs
Health insurance
information / guidance
Ombudsman services in
assisted and skilled nursing
home facilities
Caregiver programs
© Enigma/Alamy
© Deseret News

26. WHAT DO SERVICES ACCOMPLISH?
Help seniors REMAIN AT HOME as they lose independence and
face challenges of aging such as declining health, having less income,
losing a spouse or not having family members nearby to assist them.
Help seniors REMAIN INDEPENDENT in the community as
they face transportation systems and community infrastructures that
are not adequately designed for an aging population.
Benefit tax payers by REDUCING ADDITIONAL
GOVERNMENTAL SERVICES as family resources and
informal social structures in the community are supported.

27. C A R E G I V I N G

28. ONE IN FOUR are CAREG IVERS in the US

29. 365,000,000 HOURS
382,000 CAREGIVERS in UTAH

30. 382,000 CAREGIVERS in UTAH
365,000,000 HOURS ofWORK

31. $4.2 BillionS E R V I C E S W O R T H
H O U R S
C A R E G I V E R S

32. C A R E G I V E R S
FOREGO
MEDICAL
TREATMENT
HIGHER
MORTALITY
RATE AMONG
SENIORS
DEPRESSION
67% 63% 40 –70%

33. C A R E G I V I N G FA C T S
46
Y/O
20
HOURS / WK
More years
spent caring for
parents than
children in
lifetime

34. C A R E G I V I N G FA C T S
2010 2020 2050
8.3 5.8 3.4

35. LOST REVENUE for BUSINESSES
$11– 29 Billion / yr.
R E S P O N S I B I L I T I E S
RELATED TO EMPLOYEE CAREGIVING

36. WHAT IS THE SOLUTION?
I NV E ST
in IN-HOME CAREGIVING support

37. CURRENT CAREGIVING PROGRAM
S TAT E / A A A s
YEAR
$1,500 OR

38. CURRENT CAREGIVING PROGRAM
S TAT E / A A A s
A C C E S S T O
Information and
Resources for Caregivers
Support Groups
Educational Classes
Short-Term Respite. Help with:
 Identifying needs and services
 PersonalCare
 Light house-cleaning
 Daycare for AdultsSupplemental Services

39. CURRENT COST / SERVICE LEVELS
F Y 2 0 1 3
$1,186,905

40. 4,700
CURRENT COST / SERVICE LEVELS
F Y 2 0 1 3
CAREGIVERS ASSISTED

41. $252
PER CAREGIVER PER YEAR
CURRENT COST / SERVICE LEVELS
F Y 2 0 1 3

42. LOCAL SURVEY of CAREGIVER NEEDS
50%
REQUESTED
HELP WITH
Reducing
Stress
Education
Respite

43. P R O P O S E D B U D G E T I N C R E A S E
2015
LEGISLATIVE SESSION
$600,000
ADDED TO BASE BUDGET
Division of Aging andAdult Services

44. TOMORROW
M E A L S: O N-G O I N G F U N D I N G
CURRENT
$300,000
?
PROPOSED
$350,000
ON-GOING

45. PROPOSED
C A R E G I V E R P R O G R A M S
$250,000
ON-GOING
= 1,000
more Caregivers
assisted with:
Education / Training / Info.
Support Groups
Respite Care
Volunteer Respite Programs

46. W E H A V E A N A G I N G P O P U L A T I O N
IT MAKES ECONOMIC SENSE
WE ARE NOT MEETING THEIR NEEDS
I F W E D O N ’ T A C T
WE WILL NOT MEET THEIR NEEDS
IT MAKES MORAL SENSE
MAKES NO SENSE
D O I N G L I T T L E O R N O T H I N G
© Deseret News

47. W E C A N D O B E T T E R
© Deseret News

48. S A F E
S T R E E T S
A L A N O R M S B Y State Director, AARP Utah

49. PROMOTE AGING IN PLACE
THROUGH SAFE, WALKABLE COMMUNITIES
aarp.org/livable

50. OVER HALF of CAREGIVERS PROVIDE:
C O M P L E X C A R E
 Multiple Medication Management
 Wound Care
 Specialized Diets
 Operation of Medical Equipment

51. ENSURING ADEQUATE
CAREGIVER TRAINING
 Limits Hospital Readmission
 Reduces Caregiver Stress

52. P O L I C Y
C H O I C E

53. ENACT
CARE
Caregiver Advise, Record, Enable Act
Records familyCaregiver Name
Notifies Caregiver in the event a
loved one is hospitalized
Ensures adequateCaregiver education
upon discharge of loved one from Hospital

54. EMPOWER CAREGIVERS to DO MORE
UTAH is RANKED
50th
IN SUPPORT for FAMILY
CAREG IVERS

55. EMPOWER CAREGIVERS to DO MORE
Administer Oral Medications
Administer Medication on an as Needed Basis
Administer Medication via Pre-Filled Insulin or Insulin Pen
Draw Up Insulin for Dosage Measurement
Administer Intramuscular Injection Medications
Administer GlucometerTest
Administer Medication throughTubes
Insert Suppository
Administer Eye/Ear Drops
GastrostomyTube Feeding
Administer Enema
Perform Intermittent Catheterization
Perform Ostomy Care Including Skin Care andChangingAppliance
Perform NebulizerTreatment
Administer OxygenTherapy
PerformVentilator Respiratory Care
Administer Oral Medications
Administer Medication on an as Needed Basis
Administer Medication via Pre-Filled Insulin or Insulin Pen
Draw Up Insulin for Dosage Measurement
Administer Intramuscular Injection Medications
Administer GlucometerTest
Administer Medication throughTubes
Insert Suppository
Administer Eye/Ear Drops
GastrostomyTube Feeding
Administer Enema
Perform Intermittent Catheterization
Perform Ostomy Care Including Skin Care andChangingAppliance
Perform NebulizerTreatment
Administer OxygenTherapy
PerformVentilator Respiratory Care
Perform Ostomy Care Including Skin Care andChangingAppliance
UTAH is ONLY ALLOWED
O N E
In other states,
16 medical tasks are
commonly delegated to
home health workers

56. P O L I C Y
C H O I C E

57. ALLOW DELEGATION OF
16
TO NURSE PRACTICE
ALL TASKS
www.longtermscorecard.org

58. RECEIVING
HOME and COMMUNITY-BASED
SERVICES
Medicaid Waivers and Services for Older Adults

59. MEDICAID AGING WAIVER
&
ALTERNATIVES PROGRAM
COST SAVING PROGRAMS
M I C H A E L S . S T Y L E S Assistant Director, Division of Aging andAdult Services
© PhotoAlto/Alamy

60. The goal of the Medicaid Aging Waiver
and Alternatives Program is to provide
services for low-income, medically frail
seniors that would otherwise be placed in a
nursing home or care facilities enabling them
to be cared for safely, independently, and
cost effectively in their homes.
MEDICAID AGING WAIVER
and the ALTERNATIVES PROGRAM
COST SAVING PROGRAMS

61. The Utah Division of Aging and Adult Services
is tasked with overseeing the Medicaid Aging
Waiver and Alternatives Program which are
carried out at the local level by county based
Area Agencies on Aging.
MEDICAID AGING WAIVER
and the ALTERNATIVES PROGRAM
COST SAVING PROGRAMS

62. On average, these individuals
can be served at home for
about one fifth the cost of
nursing home placement.
MEDICAID AGING WAIVER
and the ALTERNATIVES PROGRAM
COST SAVING PROGRAMS

63. Be 65 years of age or older
65
NURSING
FACILITY
LOC
ADL
IADL
MEDICAID
ELIGIBLE
MEDICAID AGING WAIVER 1915 (c)
The bulk of the funding is overseen by the
DEPARTMENT of HEALTH CARE FINANCING .
The Waiver is tasked with providing services statewide to help
older adults who are nursing home eligible remain in their
homes and live as independently as possible, provided it is cost
effective to do so.
ELIGIBILITY REQUIREMENTS

64. Require nursing facility level of care approval (LOC)
65
NURSING
FACILITY
LOC
ADL
IADL
MEDICAID
ELIGIBLE
MEDICAID AGING WAIVER 1915 (c)
The bulk of the funding is overseen by the
DEPARTMENT of HEALTH CARE FINANCING .
The Waiver is tasked with providing services statewide to help
older adults who are nursing home eligible remain in their
homes and live as independently as possible, provided it is cost
effective to do so.
ELIGIBILITY REQUIREMENTS

65. ADLs and IADLs score
65
NURSING
FACILITY
LOC
ADL
IADL
MEDICAID
ELIGIBLE
MEDICAID AGING WAIVER 1915 (c)
The bulk of the funding is overseen by the
DEPARTMENT of HEALTH CARE FINANCING .
The Waiver is tasked with providing services statewide to help
older adults who are nursing home eligible remain in their
homes and live as independently as possible, provided it is cost
effective to do so.
ELIGIBILITY REQUIREMENTS

66. Meet financial eligibility requirements for Medicaid
65
NURSING
FACILITY
LOC
ADL
IADL
MEDICAID
ELIGIBLE
MEDICAID AGING WAIVER 1915 (c)
The bulk of the funding is overseen by the
DEPARTMENT of HEALTH CARE FINANCING .
The Waiver is tasked with providing services statewide to help
older adults who are nursing home eligible remain in their
homes and live as independently as possible, provided it is cost
effective to do so.
ELIGIBILITY REQUIREMENTS

67. 3,000,000.00
3,500,000.00
4,000,000.00
4,500,000.00
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
MEDIC AID WAIV ER EXPEN DITURES
FY2004Through FY 2013
C LIENT SERVIC ES AND ADMINISTRATIVE C OST
$3,059,963
$3,362,053
$3,750,840
$3,922,632
$4,065,417 $4,065,417
$3,489,004
$3,506,592
$4,051,119
$4,289,625

68. 500
600
700
800
900
C L I E N T S
$2,000
$4,000
$6,000
$8,000
$10,000
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
C O S T P E R C L I E N T
UNDUPLICATED CLIENTS SERVED
and AVERAGE COST PER CLIENT
506
$9,606

69. 150
225
178 185
350
225
135
200
161
140
362
192
135
225
155
140
362
203
Semi-private
Low
Semi-private
High
Semi-private
Average
Private Low Private High Private Average
Salt Lake City Rest of Utah Averaged
Source: The 2012 MetLife Market Survey of Nursing Home, Assisted Living, Adult Day Services, and Home Care Costs, November 2012
http://www.massmutual.com/mmfg/pdf/Nursing_Home_Costs.pdf
MASS MUTUAL INSURANCE
AVERAGE $184 PER DAY, $67,343 PER YEAR

70. UNDUPLICATED
CLIENTS
AVERAGE
ANNUAL COST
1 $67,343
$184 per day
NURSING HOME STAY
1 $9,315MEDICAIDAGINGWAIVER 1915(c)
499 $4,648,815
499 $33,604,157
UNDUPLICATED
CLIENTS
AVERAGE
ANNUAL COST
1 $67,343
$184 per day
NURSING HOME STAY
1 $9,315
499 $4,648,815
499 $33,604,157
MEDICAIDAGINGWAIVER 1915(c)
MEDICAID AGING WAIVER
COST SAVINGS 2014
COST SAVINGS
$28,955,342
Current Medicaid Aging-
Waver Client

71. UNDUPLICATED
CLIENTS
AVERAGE
ANNUAL COST
1 $67,343
$184 per day
NURSING HOME STAY
1 $9,315MEDICAIDAGINGWAIVER 1915(c)
499 $4,648,815
499 $33,604,157
MEDICAIDAGINGWAIVER 1915(c)
MEDICAID AGING WAIVER
COST SAVINGS 2014
COST SAVINGS
$28,955,342
Current Medicaid Aging-
Waver Client

72. 60 DISABILITY
ADL
IADL
POVERTY
SLIDING
SCALE
ALTERNATIVES PROGRAM
In 1977 the Older AmericanAct allowed states
to develop programs for Home Community
Based Services /supportive Services.
The Alternatives Program is a state-funded,
non-Medicaid assistance program.
ELIGIBILITY REQUIREMENTS

73. 60 years of age or older, or
60 DISABILITY
ADL
IADL
POVERTY
SLIDING
SCALE
ALTERNATIVES PROGRAM
ELIGIBILITY REQUIREMENTS
It’s goal is to provide services to help older
adults who are not nursing home eligible, but
who are at risk for facility based care, remain in
their homes and as independent as possible.

74. 18 – 59 years of age with a disability
60 DISABILITY
ADL
IADL
POVERTY
SLIDING
SCALE
ALTERNATIVES PROGRAM
ELIGIBILITY REQUIREMENTS
It’s goal is to provide services to help older
adults who are not nursing home eligible, but
who are at risk for facility based care, remain in
their homes and as independent as possible.

75. Utilizes Activities of Daily Living (ADLs) and
Instrumental Activities of Daily Living (IADLs) score
60 DISABILITY
ADL
IADL
POVERTY
SLIDING
SCALE
ALTERNATIVES PROGRAM
ELIGIBILITY REQUIREMENTS
It’s goal is to provide services to help older
adults who are not nursing home eligible, but
who are at risk for facility based care, remain in
their homes and as independent as possible.

76. Meets financial eligibility based on the federal poverty level.
60 DISABILITY
ADL
IADL
POVERTY
SLIDING
SCALE
ALTERNATIVES PROGRAM
ELIGIBILITY REQUIREMENTS
It’s goal is to provide services to help older
adults who are not nursing home eligible, but
who are at risk for facility based care, remain in
their homes and as independent as possible.

77. Means tested
60 DISABILITY
ADL
IADL
POVERTY
SLIDING
SCALE
ALTERNATIVES PROGRAM
ELIGIBILITY REQUIREMENTS
It’s goal is to provide services to help older
adults who are not nursing home eligible, but
who are at risk for facility based care, remain in
their homes and as independent as possible.

78. CLIENT
DIAGNOSES
10% LUNG /
PULMONARY
35%
42%
13%
MUSCULOSKELETAL
HEART /
CIRCULATORY
DIGESTIVE

79. Falls
ERVisits
Hospital Stays
OUTCOME
MEASURES UTILIZED
Homemaker
Personal Care
Bathing Help
ERVisits
QUICK FACTS
627 CURRENT CLIENTS
$750 MONTHLY MAXIMUM
$9,000 yearly
MOST COMMON
SERVICES
Falls
ERVisits
Hospital Stays
OUTCOME
MEASURES UTILIZED
QUICK FACTS
627 CURRENT CLIENTS
$750 MONTHLY MAXIMUM
$9,000 yearly
Homemaker
Personal Care
Bathing Help
ERVisits
MOST COMMON
SERVICES

80. 3750000
3800000
3850000
3900000
3950000
4000000
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
$3,784,824
$3,909,906
$3,884,503
$3,945,226
$3,932,184
$3,950,492
$3,937,409
$3,881,090
$3,975,916
$3,883,473
In-Home ALTERNATIVES EXPENDITURES
FY 2004 through FY 2014
$3,855,166

81. UNDUPLICATED
CLIENTS
AVERAGE
ANNUAL COST
1 $30,000
Cost varies based on LOC
ASSISTED LIVING
FACILITY
1 $5,000
645 $3,225,000
645 $19,350,000
Source: Utah Assisted Living Association
ALTERNATIVES PROGRAM
COST SAVINGS
$16,125,000
UNDUPLICATED
CLIENTS
AVERAGE
ANNUAL COST
1 $30,000
Cost varies based on LOC
ASSISTED LIVING
FACILITY
1 $5,000
645 $3,225,000
645 $19,350,000
Source: Utah Assisted Living Association
ALTERNATIVES PROGRAM
COST SAVINGS 2014
Current Alternatives
Program Clients

82. UNDUPLICATED
CLIENTS
AVERAGE
ANNUAL COST
1 $30,000
Cost varies based on LOC
ASSISTED LIVING
FACILITY
1 $5,000
645 $3,225,000
645 $19,350,000
Source: Utah Assisted Living Association
ALTERNATIVES PROGRAM
COST SAVINGS
$16,125,000
ALTERNATIVES PROGRAM
COST SAVINGS 2014
Current Alternatives
Program Clients

83. TOTAL COST SAVINGS
For both Medicaid AgingWaiver Program
and the Alternatives Program
$45,080,300

84. With a current waiting list averaging around 165,
an increase of ongoing funding of $250,000 for the
Medicaid Aging Waiver Program could serve
throughout the state
111
AN ADDITIONAL
CLIENTS

85. WITH an INCREASE in the AGING POPULATION
and an INCREASE IN NURSING HOME CARE
and ASSISTED LIVING CARE
IS THE INCREASE in FUNDING
WORTH the COST SAVINGS?

86. A D U L T P R O T E C T I V E
S E R V I C E S
N A N M E N D E N H A L L State Director, Adult Protective Services
© Chariclo/Alamy

87. Investigate referrals of abuse,
neglect, or exploitation;
Conduct assessments of vulnerability
and functional capacity as it relates
to the allegation.
POWER and DUTIES of APS
Investigate referrals of abuse,
neglect, or exploitation;
Conduct assessments of vulnerability
and functional capacity as it relates
to the allegation.

88. Coordinate with and refer to
community resources for services;
Provide short-term limited services
when family or community
resources are not available to
provide protection.
POWER and DUTIES of APS
Provide short-term limited services
when family or community
resources are not available to
provide protection.
Coordinate with and refer to
community resources for services;

89. POWER and DUTIES of APS
Adults have the right to make personal
choices and decisions — APS respects the
lifestyle that is knowingly and voluntarily
chosen by the vulnerable adult (VA)

90. 678 744
1247 1306
1728
1416
1957
2248
3002
3258 3266
3027 3029
4196
2926
3746
4505 4572
4755
4445
6153
2008 2009 2010 2011 2012 2013 2014
Unaccepted Referrals Accepted Cases Total Reports
TOTAL APS REPORTS to INTAKE
FY 2008 – 2014

91. 2926
3746
4505 4572
4755
4445
6153
3 3 3 3 3 3 3
2008 2009 2010 2011 2012 2013 2014
REPORTS COMPARED to FTE INTAKE STAFF
FY 2008 – 2014
T O TA L R E P O R T S
N U M B E R of F U L L T I M E
I N TA K E W O R K E R S

92. 847
1261
1367 1342
1236
1423
1979
499
740
848
690
600
669
1195
444
674
718
666 686 697
976
886
1036 1066
1229
869
736
786
2008 2009 2010 2011 2012 2013 2014
Exploitation Abuse Neglect Self Neglect

93. WHO ARE the PERPETRATORS?
vs

94. of THOSE EXPLOITING SENIORS
ARE FAMILY MEMBERS
72%

95. UTAH LOSES
$52 million
A YEAR TO EXPLOITATION

96. APS CASES
FY 2008 – 2014
32.5 25 26 22.5 24 23 23
2248
3002
3258 3266
3027
3029
4196
2008 2009 2010 2011 2012 2013 2014
N U M B E R of C A S E S
I N V E S T I G AT O R S

97. 32.5
25 26 22.5 24 23 23
69.17
120.08
125.31
145.16
126.13
131.70
182.43
2008 2009 2010 2011 2012 2013 2014
C A S E S per
I N V E S T I G AT O R
I N V E S T I G AT O R S
CASES PER INVESTIGATOR
FY 2008 – 2014

98. A D D E D C A R E A T
H O M E
M I C H A E L H A L E S Deputy Director, Utah Department of Health, Director, Medicaid and Health Financing

99. UTAH MEDICAID SERVICES that
SUPPORT OLDER ADULTS
Medicaid services for older adults range in
intensity from intermittent home-health care,
to chronic care provided in home and
community based waiver programs, to skilled
nursing facility services and palliative care
provided through the hospice benefit.

100. MEDIC AID H O ME AN D C O MMUN ITY BASED WAIV ER
PRO GRAMS TH AT SERV E O LDER ADULTS FY 2013
Home and community based services (HCBS)
are provided to individuals who, absent the
availability of HCBS, would be eligible to
receive care in a nursing facility.
The following HCBS waivers are part of the
CONTINUUM of CARE for older adults.

101. MEDIC AID H O ME AN D C O MMUN ITY BASED WAIV ER
PRO GRAMS TH AT SERV E O LDER ADULTS FY 2013
PROGRAM NAME TOTAL # 55+ % 55+
AGING WAIVER
(Serves People 65 or Older) 523 523 100%
NEW CHOICES WAIVER 1,476 1,289 87%
ACQUIRED BRAIN INJURY WAIVER 109 13 12%
PHYSICAL DISABILITIES WAIVER 133 26 20%
COMMUNITY SUPPORTS WAIVER
for Individuals with Intellectual Disabilities 4,540 497 11%
TOTAL NUMBER SERVED
in Medicaid HCBS Aged 55 or Older 2,348

102. Home health, personal care and hospice
services are among the array of services that
assist older adults.
MEDIC AID H O ME H EALTH AN D H O SPIC E SERV IC ES
FY 2013

103. SERVICE TYPE TOTAL # 55+ % 55+
HOME HEALTH 5,122 2,336 46%
HOSPICE 1,346 1,167 87%
PERSONAL CARE 770 316
TOTAL NUMBER SERVED
Aged 55 or Older 3,819
MEDIC AID H O ME H EALTH AN D H O SPIC E SERV IC ES
FY 2013

104. MOVING INTO a
SKILLED NURSING FACILITY

105. MEDICAID
NURSING FACILITY SERVICES
Nursing facility services continue to be
an important component of services
available to older adults.

106. Nursing facility services are available to
meet a variety of needs such as a
SHORT-TERM STAY when a
person requires intensive rehabilitation
after an illness, injury or surgery.
MEDICAID
NURSING FACILITY SERVICES

107. MEDICAID
NURSING FACILITY SERVICES
Services are also provided on a
LONG-TERM basis when the
complexity of the individuals needs
can not be safely met in a home and
community based program.

108. MEDICAID
NURSING FACILITY SERVICES
FY 2013
TYPIC AL MO N TH LY
MEDIC AID C EN SUS
2,900people
AV ERAGE LEN GTH O F MEDIC AID
N URSING FAC ILITY STAY
206days
4,626
83%
55+Years

109. M O V I N G I N T O A S K I L L E D
N U R S I N G F A C I L I T Y
A N N E P A L M E R Executive Director, Utah Commission onAging

110. THE UTAH LEGISLATURE
HAS ASKED CoA TO:
Study, evaluate, and report on the
impact of the aging population on
government services

111. Identify and recommend
implementation of specific
policies, procedures, and
programs to respond to the
impact; and
THE UTAH LEGISLATURE
HAS ASKED CoA TO:

112. Encourage state government to
analyze, plan, and prepare for the
impacts on services and operations
THE UTAH LEGISLATURE
HAS ASKED CoA TO:

113. Helped in passage of state law creating
LIFE WITH DIGNITY orders
OUR ROLE in
ADVANCED CARE PLANNING
UT Code § 75 – 2a - 106

114. Utah Physician Orders for
Life-SustainingTreatment
OUR ROLE in
ADVANCED CARE PLANNING
Established POLST

115. Facilitator of
BEST PRACTICES training
OUR ROLE in
ADVANCED CARE PLANNING

116. Support COMMUNITY
ENGAGEMENT in crucial
conversations around advance
directives and end of life care
POLICYSETTING

117. Support end of life
COMFORT / PALLIATIVE
CARE
POLICYSETTING

118. Invest in the expansion of the
ePOLST from pilot stage to the
broader healthcare and electronic
medical record systems
POLICYSETTING

119. Mature Endorsed Developing None

120. WHY are
we HERE?

121. “There are only four kinds of people
in the world,
those who have been
caregivers,
those who are currently
caregivers,
those who will be
caregivers,
those who need
caregivers.”
—Rosalyn Carter