1 New Hampshire Coalition on Aging Annual Meeting October 28, 2009 “…to raise new ideas and improve policy debates through quality information and analysis.

1

New Hampshire Coalition on Aging New Hampshire Coalition on Aging Annual MeetingAnnual Meeting

October 28, 2009October 28, 2009

“…to raise new ideas and improve policy debates through quality information and analysis on issues shaping New Hampshire’s future.”

Board of DirectorsDonna Sytek, Chair

John B. Andrews

John D. Crosier, Sr.

William H. Dunlap

Sheila T. Francoeur

Chuck Morse

Todd I. Selig

Stuart V. Smith, Jr.

James E. Tibbetts

Brian F. Walsh

Kimon S. Zachos

Martin L. Gross, Chair Emeritus

StaffSteve Norton, Executive Director

Ryan Tappin

Cathy Arredondo

Watching the World Change

2

Takeaways

• Challenge Myths

• Each Community Needs to Watch and Understand The Power of Demographics

• Planning for Workforce Issues

• Realities require different approaches

3

Myth? We are a state of natives who have been living here for 100s of years.

Percent Born in State of Residence

New Hampshire, 45

United States, 67

0

10

20

30

40

50

60

70

80

90

Louis

iana

Mich

igan

Ohio Iowa

Mas

sach

uset

ts

Alabam

a

Kentu

cky

Califo

rnia

India

na

Nebra

ska

Utah

United

Sta

tes

Hawaii

New Je

rsey

Oklaho

ma

Conne

cticu

t

South

Car

olina

Georg

ia

Virgini

a

Mar

yland

Was

hingt

on

Delawar

e

Colora

do

New H

amps

hire

Arizon

a

Alaska

4

Myth?Are We Old?

Median Age• Oldest? Maine = 42• Youngest? Utah = 29• Average of US = 37• New Hampshire = 40

NH Rank = 42

Percent Over 65• Oldest? Florida = 17%• Youngest? Alaska =

7%• Average of US = 13%• New Hampshire = 13%

NH Rank = 32

2006-2008 American Community Survey 3-Year Estimates 2008 Census Population

Estimates

5

Why Challenge These Myths?

6

Pay Attention to Demographics and Decisions Made Which Impact Migration

7

One Implication?

Voting Patterns Change

1984

8

1992

9

2004

10

2006

11

2008

12

What does the Future Look Like? We Don’t Really Know

Source: US Bureau of Economic Analysis

Ratio of Personal Income per Capita - NH to US

-15.0%

-10.0%

-5.0%

0.0%

5.0%

10.0%

15.0%

1970

1972

1974

1976

1978

1980

1982

1984

1986

1988

1990

1992

1994

1996

1998

2000

2002

2004

13

Aging Will HappenPopulation Projections by AgeOffice of Employment Security

674,885751,538 759,294 748,822 724,970 706,558

147,970

191,403 245,952 311,144 383,087 437,194

0

200,000

400,000

600,000

800,000

1,000,000

1,200,000

1,400,000

1,600,000

2000 2010 2015 2020 2025 2030

65+25-6415-24

5-14

14

Are We Aging In Place?

Source: Ken Johnson, “The Changing Faces of New Hampshire”

15

Disability has declined …

Percent of the Population Indicating 5 or 6 ADLs declined by almost 20% between 1982 and 1999

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

1982 1984 1989 1994 1999

16

17

What Happens to Demand if Population over 65 Doubles?

Provider Individuals Served 50%? 100%Belknap Merrimack 4,510 6,765 9,020 St. Josephs Community Services 3,235 4,853 6,470 Rockinhma Nutrition 3,252 4,878 6,504 North Country Elder Programs 3,293 4,940 6,586 HCS - Keene 3,352 5,028 6,704 Sullivan County Nutrition 1,098 1,647 2,196 Ossipee Concerned Citizen 491 737 982 Strafford County Nutrition 935 1,403 1,870 GCSCC 6,903 10,355 13,806

Source: Each individual provider provided a set of unique counts of individuals served. The Center was not able to assess whether these were duplicated or unduplicatedso the information should be viewed with caution

What If Caseloads/ Demand Increased by

18

AgingSchools

Housing

Health Care

What Will the Boomers Do?

Balance of GovernmentAnd Private

Economic Development

Quality Of Life

Transportation

Rails

I93

Zoning And Livable Communities

Migration

Uncertainty: It’s A System, Not Static

19

Major Policy Levers Which May Affect Issue of Aging and Migration

• Transportation • Housing Prices• ‘Retaining Youth’ Initiatives (55 Initiative, the

Arts)• Information Highway• Conservation, Quality of Life, Water and Sewer• Business Development• State and Community Investment• Taking Advantage of Regional Opportunities

20

Workforce: A Caregiver Crunch by 2030 (if not before!)

• How are we going to take care of the elderly?

• In Coos county, there is almost 1 resident over 85 for every 5 women age 25-44.

• By 2030, projections suggest there will be 1 resident over 85 for every 2 women age 25-44.

• We will not have enough caretakers if population grows as predicted.

NH residents over 85 per 100 women aged 25-44

0 10 20 30 40 50

Belknap

Carroll

Cheshire

Coos

Grafton

Hillsborough

Merrimack

Rockingham

Strafford

Sullivan

2000

2030

21

New Expectations

• World War II cohort (born from 1928 to 1945) – Key characteristics: conformity, conservatism, traditional family values

• Baby Boomer cohort #1 (born from 1946 to 1954) – Key characteristics: experimental, individualism, free spirited, social

cause oriented • Generation Jones or Boomer cohort #2 (born from 1955 to 1964)

– Key characteristics: less optimistic, pragmatic, general cynicism • Generation X cohort (born from 1965 to 1980)

– Key characteristics: quest for emotional security, independent, informality, entrepreneurial

• Millennial Generation cohort also called Generation Y (born from 1981 to 2001) – Key characteristics: quest for physical security and safety, heightened

fears, acceptance of change, technically savvy, environmental issues • Source: William Strauss and Neal Turning “Fourth Turning”

22

New Partnerships? Employers ….

Economic Value of Informal Caregiving, 1997

$115

$196

$288

$0

$50

$100

$150

$200

$250

$300

$350

Low Estimate: 24 millioncaregivers at $5.15 per hour

Midrange estimate: 25.8million caregivers at $8.18 per

hour

High estimate: 27.6 millioncaregivers at $11.20 per hour

Dol

lars

(bi

llion

s)

23

Balancing the NH General Fund & Education Trust Fund, 1979-2013

$0

$250

$500

$750

$1,000

$1,250

$1,500

$1,750

$2,000

$2,250

$2,500

$2,750

1979

1981

1983

1985

1987

1989

1991

1993

1995

1997

1999

2001

2003

2005

2007

2009

2011

2013

State Fiscal Year

Mil

lio

ns

of

Do

llar

s

Non-tax GF Revenue:Medicaid EnhancementTobacco Settlement (2002 & 03)Flexible Federal Grant (2003)

GF + ETF Expenditures

Merrill

GreggSununuGallen

Shaheen

Benson

Regular General Fund Taxes and Revenues

Statewide Property Tax

Other ETF Taxes

Lynch?

Stimulus (ARRA of 2009)

and JUA

Future Funding Gap (State and Local)

24

What is NH?

The Tech Corridor?

The Lakes RegionThe North Country

The Seacoast

The Capital RegionThe Monadnock Region

Mt Washington Valley

25

The Future is Uncertain but Opportunities Exist

• Speed of Change • Watch the Demographics

– Recession changing migration patterns Recession changes income – Aging will occur. – Yes, we are aging, but when do real problems emerge?

• Do the right models of care exist for a new generation?– Transportation (where are people living?)– Other services (meals on wheels, congregate meals, adult home and

adult day care?) • Changing disability and demand for services offer new opportunities

and partnerships– Mental Health/Health Care Needs?– Employers and care giving (we have childcare ….) ?

• Budget Realities require different approaches