Mead's budget contains millions for senior care

CHEYENNE — As lawmakers parse through Gov. Matt Mead’s supplemental budget requests during the 2019 general session, a question they will have to find an answer to is how to ensure Wyoming’s aging population has the care it needs.

Included in Mead’s supplemental request for the second half of the state’s biennium budget is $13.5 million to take care of the state’s aging population. About $2.5 million is being requested for increased enrollment in nursing facilities in Wyoming, which is being matched by $2.5 million in federal funds. Another $5.72 million is being requested for increases in Medicare costs related to both inpatient and outpatient medical treatments.

“The demographics of the state are changing quickly, and these changes will continue to impact the budget over the next few decades,” said Tom Forslund, director of the Department of Health, during a Joint Appropriations Meeting this month. “It’s simply a matter of demographics. The state is getting older.”

When compared to the rest of the country, a study by the AARP found that by 2055, the number of citizens in Wyoming age 85 and older could increase by as much as 227 percent, and make up more than 5 percent of the total population. Another major issue with that aging population is the prevalence of more chronic diseases. As Wyomingites are aging, they are doing so with more health issues that require expensive treatments.

As the state gets older and people live longer with more diseases, the cost of providing care will continue to increase. That is especially true when the long-term financial health of Wyoming is taken into consideration. Many people who are reaching retirement are doing so with very little money put aside for care after they stop working. And when someone can’t afford treatment, the state takes up that burden, Forslund said.

Wyoming is already seeing the impacts on its budgets, he said. And as baby boomers age, the state will have to find more money to provide care. Forslund estimated the Department of Health will need $17 million more in additional funding with each biennium budget cycle for decades to come.

“When I have people say what can you do to resolve it, the bottom line is I can’t. Nobody can. It’s demographics,” he said.

The state is estimating now that Wyoming’s long-term Medicaid costs are likely to increase from approximately $130 million a year to $312 million per year by 2030, with half of that falling to the state to fund, Forslund said.

The increase in older residents will go hand in hand with a drop in the number of Wyomingites under the age of 65, which is set to decrease by 2 percent from 2015’s population. That means there will be fewer people of working age to provide care, whether it is as health-care workers or as family members taking care of elderly relatives, Forslund said.

“The issue is who is going to work in the homes, who is going to work in the nursing homes?” Forslund said. “We have a significant labor shortage facing us in the state.”

A major reason for the shortage of health-care workers is the tightening on immigration into the country, Forslund said. Traditionally, new immigrants to the country work in the positions that are now difficult to fill, in large part because they typically are on the lower end of the pay scale.

The state needs to focus now on working to keep people in their homes as long as possible and out of nursing homes or assisted living facilities, Forslund said. The cost of providing assistance to someone living in place verses in a facility of some kind is significantly less and will allow state dollars to go further.

That means looking at everything from funding educational programs for nursing to increasing funding for adult day-care programs to looking at ways to fast-track the use of new technologies that can help people age in home.

Finding ways to keep people in their homes is one of the main focuses of AARP Wyoming’s advocacy on the state level, said Sam Shumway, the group’s director in Wyoming. He said the state needs to invest now in in-home care to help prevent an increase in the reliance of nursing home and assisted living facilities, which will eventually cause the state’s health-care budget to balloon.

“Home service providers throughout state that offer services are so important for two reasons. One, it allows people to age in their home and keeps them from having to move out into a nursing home,” Shumway said. “And two, providing in-home care is a fraction of the cost of a nursing home. It costs about $90,000 on average for care in a nursing home. Compare that to less than $2,000 a year for in-home care.”