Newsflash!!! The country is aging at an alarming rate. It is estimated that 10,000 individuals reach age 65 each day in this country. What does that mean for the nation and West Virginia as we age in place?
Here in Hancock County we possess the highest percentage of total population, 30,660, comprised of seniors in the state, at 25.8 percent, according to the 2010 U. S. Census. A similar finding was reported as part of the 2000 census. The Northern Panhandle counties represent the region of West Virginia with the highest median age.
I must say that West Virginia's aging network has worked hard in recent years to meet the demands of the state with the second highest median age in the nation. New programs and initiatives are always, or so it seems, on the drawing board.
One of the strongest areas of development is within the home and community-based services arena. The passage of table games legislation in 2007 in counties operating racetracks and casinos nets an additional $9 million each year in up-front licensing fees for programs providing nutrition, transportation and in-home care. The West Virginia Bureau of Senior Services, the state unit on aging, administers the funds.
West Virginia's senior population now stands at somewhere around 385,000 or 21.4 percent of the total population. Our average median age is 41.3 years. Studies indicate that between 2000 and 2030, the number of young people will drop while that of older people increases significantly.
It is estimated that individuals age 25 and below will lose 7.7 percent, while those between 25 and 44 years of age lose 10.6 percent. Yet, the number of people age 65 and older jumps by 57.9 percent. Many of us working in the field of aging refer to this as our "gray tsunami." That percent of total population I mentioned earlier jumps from 15.3 percent in 2000 to 23.3 percent in 2030. Plus, by 2030, baby boomers will be older. Those age 85 and older increase from 31,779 in 2000 to 47,843 in 2030. The Mountain State is projected to become one of the grayest entities in both the nation and the world.
It is well documented that West Virginia is medically under-served. It is especially true in rural settings where 50 of our 55 counties have such distinction. When applying that to our aging population, the need for in-home care comes to the forefront. Quality care, provided in the homes of our aging population, benefits the state and serves many purposes. As noted in the April 15, 2012 editorial in the Sunday News-Register entitled, "Caring for Infirm Elderly at Home," "the state should expand in-home care programs."
Again, the West Virginia Bureau of Senior Services has worked diligently to do just that in recent years. Their addition of the Lighthouse and Family Alzheimer's In-Home Respite programs has been overwhelmingly received. Lighthouse provides up to 60 hours each month of assistance with activities of daily living while F.A.I.R. provides up to 16 hours per week of Alzheimer's respite for family members. Seniors can obtain these services for as little as $1 per hour, based on income. The problem is that many counties have waiting lists because of funding limitations in these programs. For example, we have 48 on our waiting list in Hancock County for the Lighthouse program. Added to that, the Aged and Disabled Waiver program as administered by WV Medicaid invoked a freeze on new applicants after December 5, 2011. You can see the problem. It takes money to run, improve and monitor these programs. All at a time when we are seeing cuts in federal funding and await Congressional reauthorization of the Older Americans Act.
One of the great complicating factors related to home and community-based programs is the availability of trained, competent workers. Many things make this especially difficult for non-profit agencies such as your local county aging program.
According to a report entitled, "Caregivers on the Front Line: Building a Better Direct-Care Workforce," published in the Journal of the American Society on Aging in the winter of 2011, by the year 2018, there are expected to be more direct care workers than K-12 teachers, law enforcement and public safety workers, or registered nurses. The report was written by Dorie Seavey, Ph. D., director of policy research for PHI, a national "think tank" located in the Bronx, N. Y. Seavey asserts that 4.3 million individuals will be delivering in-home direct care services by that year as compared to 3.2 million at the time of the report. That's just six years away.
She further states, "The industries in which direct-care workers are employed form the employment core of one of the most powerful "job creation engines" in the American economy-the elder/disabilities sector.
Speaking of the economy, there exists the ever-present matter of wages and benefits for these workers. According to Seavy, "In 2009, the median hourly wage for all direct-care workers nationwide was just $10.58 per hour." I would estimate West Virginia's average wage at somewhere around $8 per hour. Many counties, like Hancock, pay mileage plus vacations and holidays. Having said that, non-profits have a difficult time paying, and subsequently keeping, workers who can easily travel to Pittsburgh or Ohio and receive a higher wage. Currently, 57 percent of our in-home direct care staff has less than one year of experience.
You may be asking, "Why don't you pay more?" Reimbursement rates from the state are my initial response. Should I begin with a base rate of $7.25 per hour and add workers compensation (these workers have a high rate because of the above-average incident of injury) unemployment compensation, Social Security, mileage at 47 cents per mile, paid vacation and holidays, it eats up any reimbursement rate quickly. Add that Certified Nursing Assistants start at a higher rate, and it becomes more difficult to pay a livable wage. It's no wonder, as Seavey reports, that 48 percent of all direct-care workers and personal care aides receive some sort of public assistance.
At this point I am pleased to report the work of a group of individuals from around the state who have come together to address the issue of worker training and compensation. The Hancock County Senior Wellness Center, of which I serve as executive director, sought and received a grant in September of 2010 from the West Virginia Long Term Care Partnership which is now known as the WV Partnership for Elder Living. The members of the group have performed wonderfully and I'm pleased to be able to tell you that Senate Bill 171 and House Bill 4062 both passed their respective chambers at the most recent legislative session. This legislation clears the way to establish an In-Home Direct Care Worker Registry for West Virginia. I am privileged to chair the In-Home Direct Care Worker Curriculum & Registry work group. The result is a means of checking to ensure workers have secured the required criminal background checks, educational requirements and more. The registry is to be housed at the West Virginia Bureau of Senior Services.
I must be honest and say that the legislation moved through more quickly than I or members of the work group had envisioned. Delegate Larry Williams, D-Preston, chairs the Senior Citizens Issues Committee in the House of Delegates and pushed it through the House. He is a true champion of this cause and a friend of seniors across West Virginia.
There are four important things which must now take place. First,WVBoSS Commissioner Robert E. Roswall and his team must write the rules for the legislation. This is to be completed by July of this year. The rules are just that, the rules. They will spell out the particulars of the legislation.
Second, the final component of the work being done by the work group is to be completed. That is to develop a curriculum for all In-Home Direct Care Workers and determine where it will be offered. We have put together a draft curriculum which covers many specific disciplines.
Third, we must get a "buy-in" from all agencies providing in-home direct care services. I do not anticipate a difficult sell at this point. West Virginia has a unique opportunity to move in such a proactive manner with this project. To my knowledge, we are the 16th state to implement a registry of this nature.
And finally, the entire package goes back before the legislature for final approval during the next regular session and implementation in July 2013.
I sincerely thank all who have participated with me to see this portion of the dream come to fruition.
The issue of caring for West Virginia's aging population is not going to go away any time soon. It is imperative that collaborative, well-planned efforts continue to ensure it happens. The aged and disabled deserve no less.
Knabenshue serves as Executive Director of the Committee for Hancock County Senior Citizens, Inc., a position he has held since May 2001. Working with his local Board of Directors he has developed and implemented new programs and services aimed at serving Hancock County's aged and disabled population. He and his wife, Sally, reside in Chester, West Virginia.