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Published: 8/22/2011

Graying of America

Americans are getting older; indeed, seniors are the fastest-growing segment of the U.S. population. As America ages, it is crucial that federal, state, and local officials and agencies prepare to provide the services they will need, and to protect them from people who would take advantage of them.

The Census Bureau says the median age in the United States is about 37; half the population is older. By contrast, the median age of the country was 28 in 1970, about the time young people were told never to trust anyone over 30.

There are about 37 million Americans 65 years of age and older. That includes the first trickle of retiring Baby Boomers, people born between 1946 and 1964. As 79 million Boomers are set to reach retirement age in the next two decades, that trickle soon will turn into a tsunami.

Americans expect to live not just longer but also healthier and more active lives than their parents or grandparents. But age catches up with everyone.

Federal and state governments are concerned about the effect retiring Baby Boomers will have on the already escalating costs of Medicaid and Medicare. USA Today reports that 80 million seniors are expected to be Medicare clients by 2030, up from 47 million in 2010. The program is expected to double in cost by 2020, to $929 billion a year.

Medicaid, the federal-state insurance program for low-income Americans, is shouldering a larger share of the cost to fill growing gaps in Medicare coverage. That puts a strain on state governments, which are responsible for 40 percent of Medicaid costs.

About 32,000 people are registered in PASSPORT, an Ohio Medicaid program that screens seniors and matches those who qualify with a case worker who will help get them the services they need to stay in their homes. Services include nurse visits, health aides, transportation, and adult day care.

The average cost is $1,334 a month per person. The state will spend $518.7 million on PASSPORT this year.

In contrast, the Ohio Department of Aging says nearly 1,000 nursing homes care for about 80,000 Ohio residents. The state pays an average of $4,017 a month for each person in a nursing home -- three times the cost of in-home care.

The new two-year state budget cuts $360 million from state spending for nursing home care. It increases state funding for PASSPORT by nearly 38 percent, to $201.8 million in 2013.

A spokesman for Gov. John Kasich says that change will allow 12,890 more seniors to be cared for at home. This will cut in half the annual rate at which Medicaid expenditures are expected to grow in coming years, from 8 to 4 percent.

More seniors staying in their homes is a desirable goal, but it will put more pressure on the people -- often family members -- who care for them. That will make PASSPORT and its service providers even more important.

As the number of seniors will grow, so will instances of people -- including caregivers and family members -- taking advantage of them. Older people are frequent targets of a variety of telephone and Internet scams.

In one popular scenario, an older person gets a call from a supposed relative who is in trouble and needs money wired to him or her immediately. Too often, the senior sends the money first, then discovers the story is bogus.

A recent Blade report notes that relatives and neighbors sometimes take advantage of older people in the guise of helping them. Last month, a local man pleaded no contest to charges of taking a blank check and debit card from an 88-year-old neighbor. He forged and cashed the check for $5,000, and used the debit card for another $5,000 in charges, including cash withdrawals. On the same day, a local woman was found guilty of stealing more than $80,000 from her 89-year-old step-grandmother.

These examples, sadly, are just the tip of the iceberg. Many incidents go unreported. Agencies such as the Lucas County Prosecutor's Senior Protection Unit will see their caseloads -- and taxpayer-funded budgets -- increase as the elderly population grows.

It will take plenty of green to pay for the graying of America. Exploding federal and state budget shortfalls notwithstanding, it's an obligation that will have to be met.



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