Task Force Report Service Demand

As a way of thinking about the magnitude of future long term care needs, and the scope of the strategies required to address them, it is useful to make estimates of future service utilization and demand based upon current utilization and demand and projected population growth. These estimates assume, for planning purposes only, that current trends in population, disability rates, and other socioeconomic factors, as well as regulatory programmatic conditions, all remain the same. In reality, changes are likely to occur within the next 10 years that would affect the estimates provided in this section.

1. Adult Day Health Care
Currently there are 110 adult day health care clients served each day with a waiting list of 96 persons. The primary age group served is persons 75 and over. To meet 2010 projections, there would be 178 clients served each day and a waiting list of 156 persons.

2. Senior Centers
Currently there are 5,833 seniors enrolled at the County’s senior centers, and they made approximately 188,212 visits to the centers in FY 2001. In 2010, there would be a needed capacity for 11,700 enrolled seniors making 347,000 visits.

3.Transportation Service by FASTRAN
One-way rides provided by FASTRAN in FY 2001 totaled over 542,000 for elderly and disabled riders, a 9.6% increase over FY 2000. In 2010, it would take over 890,000 rides to provide an equivalent level of service.

4. Home Delivered Meals
In 2001, 237,657 meals were delivered to 1,323 persons. In 2010, 390,200 meals would be delivered to 1,900 persons.

5. Housing Authority’s Waiting List
In 1999, there were 548 elderly persons and 1,219 persons with disabilities on the Fairfax County Housing Authority’s waiting list for assisted housing. By 2010, growth in these segments of the population could increase these numbers to 787 elderly and 1,476 persons with disabilities.

6. Residential Mental Health Services
Currently, there are 560 persons awaiting admission to one of the four mental health group homes in the County. Projections for 2010 are not meaningful, since those who apply now do not have a chance of being admitted in their lifetime. The new 36-bed facility, Stevenson Place, already has a waiting list of 70 persons.

7. Group Homes for Persons with Mental Retardation, Concern over Caregivers
Based on 2001 survey data, there are 631 persons awaiting placement in a residential setting. Without more specific demographic information regarding the number and age distribution of persons with mental retardation, projections about 2010 demand cannot be made. However, there is concern over the age of the caregivers for the persons on the waiting list. Twelve percent are 70 or over; 16 percent are age 60-69; 39 percent are age 50-59. Currently, 37% of the individuals on the waiting list is considered to be in a "high-risk" situation; that is, the family feels they cannot continue with their current care arrangement. In ten years, as the current group of caregivers ages, the number of persons in high-risk situations is likely to increase.

8. Home Repair for the Elderly and Disabled
Approximately 80 homes are repaired each year by the Housing Authority’s home repair program for the elderly and disabled, with a waiting list of 40 homes. Currently, 36 percent of the Community’s housing stock is 30 years old or older, and nearly 9 percent of the population is 65 or over. In 2010, 59 percent of the housing stock will be 30 years old or older, and nearly 12 percent of the population will be 65 or over. It is difficult to predict what service requirements these two trends may combine to create.

9. Assisted Living Beds
In 2001, there were 3,209 assisted living beds in Fairfax. Assuming that persons age 75 and over are those most likely to live in assisted living facilities, the equivalent number of beds needed in 2010 would be 4,200. The current population of younger adults with more severe disabilities could well impact on that number beyond the year 2010.

10. Affordable Assisted Living Beds
A 2000 study commissioned by the Fairfax County Housing and Redevelopment Authority found no affordable assisted living beds in Fairfax and a current annual demand for 610 beds from residents and 406 from outside the Community for a total of 1,016 affordable assisted living beds. In 2010, assuming no changes in the percentage of low-income elderly, the annual demand would be 1,645.

11. Congregate Housing
There are currently 2,768 congregate housing units in Fairfax. In 2010, there would be a need for about 4,500.

12. Nursing Beds
There are currently 1,988 nursing home beds in Fairfax, and there is a state moratorium on the construction of new beds. Using 1995 national utilization rates per thousand for the age groups 65-74 (10 per thousand), 75-85 (46 per thousand), and 85 and over (199 per thousand), the number of beds needed in 2010 would be approximately 4,860. Using the 1998 Northern Virginia utilization rate for persons age 65 and over (27.9 per thousand), the number of beds in 2010 would be 3,710. The latter figure may be low due to the large increase in the group most likely to use nursing beds, persons age 85 and over, between 1998 and 2010.

13. Case Management
Currently, there are twenty-nine staff-year-equivalent positions providing case management services through the Fairfax County Department of Family Services, Adult Services and the Care Network for Seniors, with an average caseload of 45 each. To maintain this caseload ratio, there would need to be 35 staff-year-equivalent positions to provide case management to approximately 1,600 cases by the year 2010.

Recommendations

The Task Force is recommending twenty-one objectives and approximately ninety strategies for improving the system of long term care services in Fairfax. The strategies are organized into four theme areas: Increasing Public Awareness, Connecting People to Services, Promoting Independent, Supportive Living and Improving and Expanding a Qualified Long Term Care Workforce. In addition to the four theme areas, the Task Force felt it was important to recommend a structure for ensuring the accomplishment of the objectives it recommended. Therefore, an Overall Strategy was developed which, if executed, will ensure that the Task Force Recommendations are implemented.