A report released by AARP shows Wyoming’s state budget could benefit from continued and increased investment in Home and Community Based Services in an effort to keep its citizens aging in their homes, and out of nursing facilities, which are often paid for by the state.
Among the most pressing concerns revealed by AARP’s “Across the States” report is the fact Wyoming is aging faster than other states, and its caregiver pool – the number of residents in the age band most likely to act as caregivers for family and loved ones – will drop significantly, meaning those who choose to age in Wyoming will increase their reliance on the state as they age.
“The Across the States report and its Wyoming-specific profile present some very real concerns for Wyoming in the coming years.,” said AARP Wyoming State Director Sam Shumway. “Given the fact the state pays for residents who need a nursing home level of care, but cannot afford to pay for it on their own, this has large-scale impacts on state budgets and makes Home and Community-Based Services funding more important going into the future.”
Wyoming Gets Older, Faster and is More Rural Than The National Average
In the latest edition of Across The States: A Profile of Long-Term Services and Supports (LTSS), research trends suggest that by 2055 Wyoming’s population of those age 85 and over will grow by 227 percent, or 20 percent more than the national average, while the number of Wyomingites under the age of 65 will drop 2 percent from 2015. It is estimated those age 85 and over will make up 5.3 percent of Wyoming’s population, up from its current 1.8 percent.
That aging process is already underway. The Wyoming Department of Administration and Information Economic Analysis Division pointed out in June of 2018 that what it terms the elderly population” (age 65 and over) in the state grew 3.7 percent between July 2016 and July 2017, according to U.S. Census Bureau estimates. The figure indicates that the aging of Wyoming’s population has picked up speed, and the pace was the fastest in the country.
The AARP report also states Wyoming ranks second in the nation for number of residents age 65 and over living in nonmetropolitan areas with 70.4 percent of Wyomingites living in rural areas.
Wyoming’s Family Caregiver Pool to Decrease
The state’s lower percentage of state residents under the age of 65 means fewer adults available to provide informal, unpaid caregiving to the older population in the future. In Wyoming, there are an estimated 66,200 family caregivers performing an estimated $817 million in uncompensated care per year.
A Wyoming Department of Employment, Research, and Planning document suggests that by the end of the 11-year tracking period, 56.6 percent of the youth who worked in 1993 were no longer employed in Wyoming. Another 2012 Department of Workforce Services study, from 1992 to 2006, indicated that the average five-year retention rate for 18-year-olds with Wyoming as a primary state of wages was 55.8%. The average 10-year retention rate from 1992 to 2001 was just 43.8%.
Wyoming’s inability to retain its youth after high school has long been statistically illustrated, but the connection between young residents leaving the state, and state budget impacts due to a lack of family caregivers has not been previously considered.
Presently, the Caregiver Support Ratio – the number of state residents age 45-64 per residents age 80 and over in Wyoming is 7.6, which is 10th best in the nation. By the year 2050, it is projected to drop to just 2.8.
“A shortage of family caregivers will have a significant human and economic impact in Wyoming,” says Shumway. ”Without the support of a caregiver, many older Wyomingites will be forced to move into a state-funded institutional setting and rely on other state programs.”
Home and Community-Based Services and State Budget Impacts
Home and Community-Based Services are performed by private companies and include tasks such as bathing, doing chores around the house, home health aides, congregate meals, transportation to appointments, and other work that helps seniors or those with disabilities stay in the home as they age instead of being institutionalized. Home and Community-Based Services are paid through federal and state programs and tend to cost much less than nursing homes, which can be paid for by the state through the Medicaid Program.
Currently, the State of Wyoming pays $130 million per year on long-term care for its residents. That number could increase between $184-312 million by 2030, according to the Department of Health. According to AARP’s “Across the States” report, private nursing home care in Wyoming costs an average of $96,725 per year for a private room, or just short of $85,000 a year for a shared room in a private facility. Assisted Living in Wyoming costs an average of $40,000 a year, while a home health aide (at an average of 30 hours per week) costs $42,120 per year.
AARP’s report wasn’t the first to note the impacts of the state’s rapidly aging population on Wyoming’s budget. The October 2017 study, “Long-term Care in Wyoming” details the budgetary impacts the state will be faced to bear.
The state’s study suggests Wyoming will bear the brunt of increased costs from its aging population resulting from a lack of long-term private care insurance among residents, the high cost of long-term care, and a lack of retirement readiness.. That led the study’s authors to point out, “In order to contain long-term care costs in the future, the State of Wyoming should therefore aim to maximize the percentage of individuals served in home – and community-based settings.”
State Efforts Underway
The State of Wyoming does currently fund some Home and Community-Based Services. The Wyoming Home Services Program is a state-funded grant program contracted to 23 providers (one per county) to provide in-home services to persons 18 and older who are at-risk for placement in nursing homes, assisted living facilities, or other institutional care on a cost-reimbursement basis. The program primarily pays for care coordination, homemaking, and personal care. In 2018, the program served 1,933 residents at a cost of $2.85 million at an average cost of $1,476 per year per beneficiary.
The program, which is 100 percent state funded, and requires a 5 percent match by the local grantee, had a waiting list in 2018 of between 64 and 101 residents who cannot receive services due to a lack of trained staff including Certified Nursing Assistants (CNA’s). The program has also suffered from a cut in funding. In 2017, the program received a reduction in state funding of $931,000 for the biennium.
While the Department of Health’s programs are impactful, it appears there is still room for growth in funding, as waiting lists still exist for the Wyoming Home Services Program. The “Across The State” report noted that nationally there was a 3.9 percent decrease in the percentage of residents in nursing facilities from 2011-2016. However, Wyoming actually saw an increase of 0.6 percent over that same period of time. Wyoming’s percentage of nursing facility residents with a low-care need of 15.2 percent is 4 percent higher than the national average and also suggests a higher availability of Home and Community-Based Services may have led to a lower level of institutionalization.
One area in which Wyoming ranked exceptionally high was the number of those in the state who receive congregate meals and home delivered meals. Currently, Wyoming ranks tops in the nation per 1,000 people age 65 and over with a 195 of every 1,000 residents age 65 and over enjoying congregate meals. The national average is just 32 out of 1,000 residents age 65 and over. Wyoming ranks second in the nation per 1,000 residents age 65 and over who receive home delivered meals with 55 for every 1,000 residents age 65 and over. The national average is 17.
However, while there are many people taking part in these congregate meals, the federal and state governments only reimburse senior centers about $3 per meal, which also places a financial burden on local centers and communities for funding.
About The Report
Published for the past 24 years, “Across the States” is printed to help policy makers, administrators, and stakeholders make informed decisions about LTSS public policies and programs. Topics include: age demographics and projections; living arrangements, income, and poverty; disability rates; costs of care; private long-term care insurance; Medicaid long-term services and supports (LTSS); family caregivers; home – and community-based services (HCBS); and nursing facilities.