Project 2015 State Agencies Prepare for the Impact of an Aging New York White Paper for Discussion New York State George E. Pataki, Governor Office for the Aging Patricia P. Pine, Ph.D., Director Albany, New York October 2002 Dear Governor Pataki: This White Paper entitled “Project 2015: State Agencies Prepare for an Aging New York” is a compendium of 36 briefs developed by state agencies as part of your continuing commitment to make state government responsive to the needs of all New Yorkers. In February, you asked the state agencies to consider the significant demographic changes that will occur in New York State over the next 13 years, particularly the aging of the State’s population. The agencies were asked to reflect upon the impacts these changes will have on state government and to recommend actions and strategies that can effectively address these impacts. The Project 2015 Work Group comprised of agencies’ representatives was led by the Office for the Aging, and these 36 briefs are the result of the agencies’ deliberations. Their work provides a substantial, practical guide for assuring that the goods and services provided by government meet the needs of New York’s increasingly diverse population. I invite you to use the information and ideas in this document for further work by the state agencies followed by discussions among the citizens and organizations in local communities around the state. Together we can move forward to make sure that New York State continues to be the best, most vital place to live for all its residents. Sincerely, Patricia P. Pine, Ph.D. Project 2015: State Agencies Prepare for the Impact of an Aging New York TABLE OF CONTENTS Page Introduction .................................................................... 1 The Face of New York The Numbers...................................................................... 5 The People ...................................................................... 15 Analysis and Summary of 36 State Agency Briefs Introduction..................................................................... 21 Questions Forming the Basis for Deliberations ................................... 21 Trends .......................................................................... 22 Overarching Themes............................................................... 22 Cross-Cutting Topic Areas........................................................ 22 Synopsis of the Agencies’ Deliberations: Trends and Impacts...................... 23 Aging of the Population—Increase In Older People and People With Disabilities ... 23 Aging of the Population—Decline in Number of Younger People ..................... 28 Immigration, Migration, Racial and Ethnic Diversity ............................. 30 Synopsis of the Agencies’ Deliberations: Suggested Responses and Actions......... 32 Quality of Life—Optimal Fit ..................................................... 32 Quality of Life—Personal Living Environment...................................... 35 Quality of Life—Health .......................................................... 36 Quality of Life—Safety and Security ............................................. 37 Statewide Vitality—Community Living Environment ................................. 39 Statewide Vitality—Technology.................................................... 39 Statewide Vitality—Workforce .................................................... 40 Conclusion ...................................................................... 43 Project 2015: State Agencies’ Briefs Office of Advocate for Persons with Disabilities................................. 47 Office for the Aging............................................................. 51 Department of Agriculture and Markets ........................................... 57 Office of Alcoholism and Substance Abuse Services................................ 63 Banking Department............................................................... 69 Division of the Budget........................................................... 75 Council On Children and Families................................................. 81 Office of Children and Family Services........................................... 89 Department of Civil Service ..................................................... 97 Consumer Protection Board........................................................ 103 Department of Correctional Services.............................................. 109 Education Department............................................................. 115 Empire State Development ........................................................ 121 Governor’s Office of Employee Relations ......................................... 127 Department of Environmental Conservation ........................................ 133 Office of General Services ...................................................... 139 Department of Health..............................................................145 Division of Housing and Community Renewal.........................................153 Insurance Department..............................................................159 Department of Labor.............................................................. 167 Office of Mental Health ......................................................... 173 Office of Mental Retardation and Developmental Disabilities.......................179 Department of Motor Vehicles .................................................... 185 Office of Parks, Recreation and Historic Preservation ........................... 191 Public Service Commission........................................................ 195 Commission On Quality of Care for the Mentally Disabled ......................... 201 Office of Real Property Services................................................. 205 State Emergency Management Office ............................................... 209 Division of State Police......................................................... 215 State University of New York..................................................... 223 Department of State ............................................................. 229 Department of Taxation and Finance............................................... 235 Office for Technology.............................................................241 Office of Temporary and Disability Assistance.................................... 247 Department of Transportation......................................................253 Division of Veterans’ Affairs.................................................... 259 Appendix A Project 2015: Lead Conveners....................................................... i Project 2015: Participating State Agencies ........................................ i Appendix B Project 2015: Coordinating Team ................................................... v Project 2015: White Paper Editors ................................................. v Project 2015: Individuals Who Developed Documents To Accompany the White Paper.....vi Project 2015: Agencies That Provided Support for Project 2015 .................... vi Appendix C List of Resources for Additional Demographic Data and Information ................ vi INTRODUCTION Patricia P. Pine, Ph.D. The purpose of this paper is to provide the history and background of Project 2015, a unique initiative in New York State. Preparing for demographic change is a formidable and risky task, as predicting the future is not clear-cut. New York State is undertaking this task. The work presented in this paper represents the best efforts of New York State government agencies to predict the changes within their missions in the hope of effectively serving older New Yorkers and a more diverse New York in the future. Project 2015 is a series of endeavors to assist New York State to prepare for the anticipated changing demographics of the state early in the 21st century. It is a near certainty that there will be an increased older population, as the Baby Boom generation becomes age 65 and older and becomes the Elder Boom generation. In addition, due to New York’s hospitality, there also will be an increased number of new immigrants, many of whom will be neither fluent nor conversant in English. These populations will place demands on New York State, its government, and its communities. History and Context of Project 2015 In 1998, Dr. Patricia Pine, Director of the New York State Office for the Aging, asked the State Society on Aging of New York (SSA) for assistance in bringing the message of an increasing older population to policy makers, planners, and other leaders in the state. Dr. Joanna Mellor was President of the State Society at that time, and she offered the expertise of the SSA members. The SSA is a thirty-year-old membership organization of researchers, teachers, providers of services, and others interested in aging. SSA members offered to participate with staff from the State Office for the Aging to write articles on what would be the effect of a dramatically increased aging population on New York State in such areas as housing, health care, mental health services, transportation, economics, and other life style areas. There are 24 articles and briefs written by more than forty authors in Project 2015: The Future of Aging in New York State. The articles included the demographic projections of aging for the year 2015 and recommendations on how to prepare for the increased demand. To accompany this publication, the New York State Office for the Aging compiled a booklet on the demographic projections of the older population entitled Demographic Projections to 2025. This publication is based on U.S. Census data and includes population projections by five-year age groups from 1995 to 2025, including 2015. This publication also points out the increasing number of minority older people who will reside in New York State. Following publication of the two documents, the State Office for the Aging and the State Society on Aging held Community Forums across the state to discuss the topics presented in the Project 2015 articles and briefs. Very few states have endeavored to accomplish a planning project similar to the one that New York State has undertaken. Examples include North Carolina and Minnesota; both have reviewed the projections of an older population, and the State of Minnesota has undertaken some major changes in the provision of long term care as a result of its predicted number of older people. Neither state has the double impact of both an older population and a more culturally diverse population of all ages. California has developed a Strategic Planning Initiative for Older Californians, and it used New York State as part of its model. In 1999, the United Nations hosted an International Year of Older Persons, which focused international attention on an increasing older population in industrialized nations worldwide. As part of this yearlong focus, events held in New York City and Washington, D.C. promoted the economic and cultural value of older people to society. In April 2002, the United Nations hosted the Second World Assembly on Aging in Madrid in order to discuss and adopt an International Plan of Action on Aging. The Plan calls for changes in attitudes, in national and international policies, and in community, corporate and organizational practices so that the enormous potential of aging in the 21st century is fulfilled. The Plan seeks to ensure that people everywhere will be enabled to age with security and dignity, and continue to participate in their societies as citizens with full rights. Current Activities In February 2002, Governor George E. Pataki charged 36 cabinet-level state government agencies to review their major policies, programs, and structure in light of the State’s increasingly older and more diverse population, particularly the aging of the Baby Boomer generation into the elder cohort. The Governor’s Director of Operations, James Natoli, likened the forthcoming Elder Boom to that of the Baby Boom when they were to begin school in the 1950s. Major plans for consolidation and expansion were put in place for them at that time. It is now time to prepare for their old age. The Governor titled this initiative “Project 2015: State Agencies Prepare for the Impact ofan Aging New York.” During 2002, the 36 state agencies, led by the State Office for the Aging, established a workgroup with representation from senior staff of the agencies. The Governor’s Office of Employee Relations provided valuable assistance in facilitation and workgroup and meeting organization, and the Empire State Development State Data Center contributed significant demographic data to assist the agencies in their deliberations and planning. The state agencies reviewed their major programs, policies, and procedures and each developed a policy brief that highlighted critical functions or issue areas that would be affected by the State’s shifting demographic profile and which should be addressed within the next ten years. Through a prioritization process, each agency selected the three most important functions or issue areas, identified action steps, and forecast expected results. These briefs, arranged alphabetically by agency, are included in this White Paper. The White Paper includes an overview of the most major demographic changes expected in the State, a sociological overview of the changes expected in New York, and a compendium of the briefs prepared by the state agencies. The overviews are important in that they lay the groundwork for the Baby Boomers becoming the Elder Boomers in New York State, and they provide a framework within which to understand the content of the agencies’ briefs. This is societal change; the impact of a large cohort of older people and a significantly diverse population will have a major effect on how New York State “does business.” The population statistics provided in the demographic overview are vital to the discussion. Without their numbers, the dramatic shifts in several of the State’s demographics can be overlooked. For example, the result of immigration patterns in New York is vividly pointed out in the expected numbers of minority people of all ages. The state agency briefs in this White Paper provide the results of the state agencies’ work in 2002. The briefs are a study in comparing and contrasting; they can be considered both individually and collectively as a compendium of issues important in the state. They reflect the individual agencies' areas of responsibility concerning the impact of our changing population. In the future, the White Paper can be utilized by other levels of government and local communities for their work in preparing for a changing population. For example, county officials, members of the business community, regional development organizations, citizen groups, and community leaders can review the work of the state agencies and consider the proposed action steps and how these or other steps may be appropriate to best serve their populations. The Center for Excellence in Aging Services, School of Social Welfare, University at Albany, State University of New York is working with the Office for the Aging to produce a manual documenting the process New York State used to implement this model project. The manual will be available for use by other states and organizations wishing to plan for their own increasingly older and diversified populations. The efforts of many people, including New York State employees, other professionals, and community advocates and volunteers have contributed to the work of Project 2015. This work has laid the foundation to assure the continuing viability of the State’s communities in the future and has begun a movement that will make New York a quality place for all its residents to live. THE FACE OF NEW YORK – The Numbers Robert Scardamalia New York’s demographic structure reflects the results of some of the same major demographic forces that have shaped the nation’s population; for example, like the nation, New York’s population is getting older. However, the State’s population characteristics are unique in many ways. New York’s population size, distribution, and composition have been driven by very dynamic demographic events both internal and external to the State. Such forces as foreign immigration, high levels of domestic in- and out-migration, and the high fertility levels of the Baby Boom generation have shaped New York’s population and will continue to do so in the future. Historical Population Change U.S. and New York State, 1930 to 2000 A picture of a graph appears here. Please contact the Office of the Provost at 518-443-5152 for more information. Percent Change U.S.- NYS • High foreign immigration accounted for rapid growth well into the 1920’s but by 1930 federal immigration quotas significantly reduced foreign entry. • The 1940’s and 50’s were characterized by industrial growth which was a magnet for migration from rural to urban areas and from the South to the North. • The Baby Boom and continued migration accounted for rapid growth into the 1960’s. • The national economic dislocation of the 1970’s resulted in the loss of nearly three quarters of a million residents from New York. Almost every city saw a decline in population between 1970 and 1980. • Economic recovery in the 1980’s and 90’s was modest driven by an improved economic climate, increased births due to the echo effect of the Baby Boom, and continued high levels of foreign immigration. COMPONENTS OF POPULATION CHANGE Migration and Immigration: Migration is the most volatile component of population change, and the most difficult to accurately measure. While data on the number of births and deaths are measured directly through the vital statistics registration systems, migration data must be estimated from indirect sources. Foreign and domestic migration have been significant demographic forces affecting the size and composition of the population. New York has traditionally been a high turnover state benefiting from being an entry point for large pools of in-migrant population, but it has also lost population through heavy out-migration to other locations in the nation. Net migration is the driving force behind population growth or decline in New York as the State has experienced only brief periods of net in-migration over the last 30 years. Foreign immigration is a large positive component of total net migration and accounts for the addition of more than 100,000 persons each year. Even with this increase, New York has a net loss of population through migration because of the high level of domestic out-migration. Components of Population Change New York, 1960 to 2001 A picture of a graph appears here. Please contact the Office of the Provost at 518-443-5152 for more information. • Roughly 20 percent of New York’s in-migrants come from Florida and other Southern States. California and other Western states account for about 10 percent of in-migrants, while New Jersey and other Northeastern states provide 20 percent. Nearly 45 percent of New York in-migrants are from foreign locations and approximately 95 percent of those locate initially in the New York City area. • Most of New York’s out-migrants seek Florida and other Southern states as their destination. Approximately 45 percent of out-migrants go south. California and other Western states pick up about 13 percent of New York out-migrants, and our bordering states in the Northeast pick up nearly 35 percent. • As the following chart shows, net migration by age follows a distinct life-course pattern for New York. The highest rates of net out-migration occur among young adults (age 20 to 35) and among the middle and older ages (age 40 to 75). The frail elderly tend to move back to New York for family and services. Age-Specific Net Migration New York State, 1990-2000 A picture of a graph appears here. Please contact the Office of the Provost at 518-443-5152 for more information. • New York births have remained very stable following the post Baby Boom decline in fertility and showed moderate increases during the period known as the “echo” effect of the Baby Boom. Births have again stabilized and will likely decline again with continued low fertility rates and a declining number of women of childbearing age. • The number of deaths has been very stable throughout the last few decades but this figure will rise rapidly in the next 10 years as the Baby Boom ages. Racial and Ethnic Diversification New York’s foreign-born population increased by more than 35 percent between 1990 and 2000 due to the continued high level of foreign immigration. This increase is most important in New York City and Nassau-Suffolk metropolitan areas where the foreign born make up nearly 30 percent of the total population. The foreign born population represents only 5 percent of the total population in the balance of the State, but has seen an increase between 1990 and 2000 of more than 13 percent. Total Population by Nativity, New York State 1990 - 2000 A picture of a graph appears here. Please contact the Office of the Provost at 518-443-5152 for more information. For the first time ever, the 2000 Census allowed for multi-racial identification. More than 590,000 persons in New York State identified themselves as being of two or more races. This represents 3.1 percent of the total population. Comparisons over time are difficult because racial definitions are not strictly comparable between 1990 and 2000. The following uses the 1990 definition of a single race response compared to the combined 2000 definition of a single race response plus those responding with other combinations of races. • The non-white population in 2000 was 5.7 million persons or 30 percent of the total. This population increased by about 1 million or more than 20 percent. • The Black or African American population increased by 13 percent to 3.2 million. • The Asian, Hawaii, and Pacific Islander population increased from 694,000 in 1990 to nearly 1.2 million in 2000. This is an increase of more than 70 percent and represents the most rapid increase of all major racial groups. · The Hispanic population also grew rapidly between 1990 and 2000 increasing to 2.9 million persons. In 1990 the Hispanic Origin population was 2.2 million and increased by 30 percent. The Decennial Census also identifies persons by their reported ancestry. While New York residents continue to represent a predominantly European ancestry, Indian and African populations have grown rapidly. Largest Ancestry Groups – New York State Ancestry Group - 1990 - 2000 - Percent Change Italian 2,843,872 / 2,737,146 / -3.8 Irish 2,800,839 / 2,454,469 /-12.4 German 2,900,879 / 2,122,620 /-26.8 English 1,566,123 / 1,140,036 /-27.2 Polish 1,181,077 / 986,141 / -16.5 United States or American 468,760 / 717,234 / 53.0 West Indian 476,563 / 685,874 / 43.9 French 625,459 / 479,199 / -23.4 Russian 596,583 / 460,261 / -22.9 New York’s diverse racial and foreign-born populations speak many different languages and are less proficient in speaking English than in 1990. Of the population five years and older, nearly 5 million people, or 28 percent, speak a language other than English at home. In 1990, the proportion was 21 percent. Persons who don’t speak English at home are concentrated in New York City where 47.6 percent speak a language other than English, up from 41 percent in 1990. Ability to speak English in the Census is categorized as those who speak “very well,” “well,” “not well,” or “not at all.” English Language Proficiency of Speakers of Selected Languages, New York State 2000 A picture of a graph appears here. Please contact the Office of the Provost at 518-443-5152 for more information. THE FACE OF NEW YORK – The Numbers • Of persons who speak Spanish at home, nearly 50 percent speak English less than “very well.” For Indo-European languages, 40 percent are not proficient in English compared to 59 percent using Asian and Pacific Island languages and 31 percent using other languages at home. • Of the 2.3 million people who are not proficient in speaking English, 51 percent speak Spanish at home, 29 percent speak Indo-European languages, 17 percent speak Asian and Pacific Island languages and only 3 percent speak some other language. Changing Age Structure New York’s population is getting older. The State’s median age increased from 30.3 years in 1970 to 32 years in 1980 and now exceeds 36 years. This increase is due to the aging of the Baby Boom, the leading edge of which (those born in 1947) has now reached the early retirement age of 55. The Baby Boom was followed by a much smaller cohort as fertility rates dropped rapidly in the 1970’s. Though fertility rates remain at very low levels, the absolute number of births increased rapidly again in the late 1970’s through the early 1990’s as Baby Boom women reached their childbearing ages. Now, at the turn of the century, births are declining again as Baby Boom women age towards retirement. This cyclical effect tends to create wide variation in the size of one generation compared to the next. However, high rates of out-migration among those age 30 to 65 have diminished the size of the Baby Boom cohort in New York. This, in turn, has reduced the size of the “echo” effect resulting in an older age population. • New York’s age distribution is approaching a more mature and stable structure than many states experiencing rapid growth and high rates of in-migration. • The proportion of the population age 0 to 19 will remain relatively stable between 2000 and 2015 making up approximately 27 percent of the total population in both years. • The population 20 to 44 years old will decline from 37 percent of the total to 33 percent by 2015 as the tail end of the Baby Boom leaves this cohort. Population Pyramid New York State 2000 A picture of a graph appears here. Please contact the Office of the Provost at 518-443-5152 for more information. THE FACE OF NEW YORK – The Numbers • The youngest of the Baby Boom will be over 50 years old by 2015 while the oldest will approach 70 years old. This group will increase from 18 percent in 2000 to nearly 24 percent by 2015. • The population age 70 and over will remain relatively constant at around 9 percent of the State’s total population. Population Pyramid New York State 2015 A picture of a graph appears here. Please contact the Office of the Provost at 518-443-5152 for more information. There is an important distinction between the Census definitions of households and families. A household includes all of the individuals who occupy a housing unit. A household may consist of one family, two or more families living together, one person living alone, or any other group of related or unrelated people living together. A family is made up of two or more individuals living together who are related by blood, marriage, or adoption. Persons who are living alone constitute a household but not a family. The 1960’s and 1970’s saw rapid increases in household and family formation as Baby Boomers established independent households. The number of households increased by nearly 13 percent between 1960 and 1970 and average household size actually declined from 3.1 to 3.0 persons per household due to a large increase in single person and couple households. The number of families increased by almost 6 percent and average family size remained stable at 3.5 persons per family. A table appears here. Please contact the Office of the Provost at 518-443-5152 for more information. The characteristics of household and family living arrangements continue to change. As fertility rates declined through the 70’s and 80’s, marriage rates slowed and divorce rates increased resulting in a decline in average household and family size. Both average household and family size have stabilized in the last decade. Households and Families by Type, New York State A picture of a graph appears here. Please contact the Office of the Provost at 518-443-5152 for more information. • In 1970, more than 83 percent of all families were married couple families. By 2000, the proportion of married couple families had dropped to 71 percent. • While the number of families with a single male householder is small at 312,000, the number has more than doubled since 1970 and now makes up nearly 7 percent of all families. • Families with a single female householder made up 13 percent of all families in 1970 but increased to more than 22 percent by 2000 and totals 1,038,000 families. • Non-family households include persons living alone or with other non-relatives. In 1970 these households represented 22 percent of all households and by 2000 had increased to more than 34 percent. • The number of married couple families with children under 18 declined rapidly during the 1970’s and 80’s. The decline stopped after 1990 and the number has increased slightly by 2 percent between 1990 and 2000. They now represent 33 percent of all families. • Though the number of single male householders with children is small, (130,000) the number has increased rapidly and is more than 3 times the 1970 level. • The number of single female householders with children has also increased since 1970 growing by more than 85 percent. The number showed a slight decline between 1980 and 1990 but has since grown by nearly 20 percent to 573,000 in 2000. Families by Type and Presence of Children New York State A picture of a graph appears here. Please contact the Office of the Provost at 518-443-5152 for more information. • With continued low fertility and the aging of Baby Boom women who are out of their childbearing years, the number of families without children has increased in virtually all time periods and for all family types. Only among married couple families between 1990 and 2000 has there been a decline in the number without children. Summary New York State has weathered many changes in economic climate and demographic forces both internal and external. The State has shown a moderate rate of growth over the last two decades and is projected to continue in the future. Underlying this moderate growth, New York, like most states, is undergoing changes in the size, geographic distribution, and composition of its population. Changes in the age structure will present an ongoing challenge, as will meeting the needs of children, the elderly, and an increasingly diverse population with special needs. THE FACE OF NEW YORK - The People Vanderlyn R. Pine, Ph.D. The power of social change is immense. Looking around our own lives provides most of us with a sense of permanence and stability. Our physical surroundings remain fairly static until we knowingly change something such as repainting the woodwork, hanging a new picture, or replacing the carpet. The seasons come and go with a comforting familiarity through which changes are gradual, incremental, and able to be anticipated. Our personal physical appearance undergoes daily, subtle changes which seem to accumulate to the eventual point at which, even though we know we are older, we feel surprised by how old we “suddenly” now look. Our social world changes in the same fashion, and after what seems to have been many years of stability, we “suddenly” become aware that a massive change is taking place. We are in one of those historical moments right now. As the early 21st Century emerges, the Baby Boom is rapidly becoming older, and it seems as if “suddenly” the post-war cohort is about to become the Elder Boom. In 1946, after World War II (WW II) had ended and after many months or even years having been apart from their families and other loved ones, military personnel stopped making war, returned home and began making babies. The so-called GI Generation (born 1904-1924) is often referred to as the “Greatest Generation,” and they certainly proved that when it came time to have children. Between 1946 and 1964, 76 to 78 million babies were born achieving the highest level of offspring productivity in the history of the U.S. Early on, this new cohort was called the “Baby Boom,” using the metaphor of the Boom of the atomic bomb. At the same time, demographers, while observing the pre-WW II family, came to call it the Extended Family and the post-WW II family as the metaphorical “Nuclear Family.” Not only did Baby Boomers outnumber earlier generations, they received the pent-up generosity of post-Depression/post-Wartime parents and were given vast new attention and resources. Rather “suddenly,” this generation was seen to be physically larger and stronger and better fed and nurtured. Eventually, the cohort was more trained and better educated, listened to and paid attention to, and better paid and rewarded than all previous American generations. It is important to note that the post-WW II era brought huge demographic changes to the entire world, with many of the health improvements arising from wartime medical research. In 2002, the vast majority of these Baby Boomers are alive and well, and they are fast becoming the Elder Boom, even though many of them do not like the idea of growing old at all. TV and print ads are constantly trying to sell “anti-aging” patents, pills, potions, and products, all intended to halt, hamper, hide, or hinder a person’s aging. Of course, other than death itself, such things really will not prevent the inevitable process of aging. It is at this level that the present and the future collide, because, like it or not, in 2015, American society will not just seem different, it will be different. The oldest Boomers will be 69 years old, and the youngest will be 51 years old, a span in the life cycle that traditionally embodies physical and psychological maturity, social power, and community prestige. Moreover, this large cohort will numerically outnumber both those older and those younger cohorts, providing much enhanced Boomer clout in the marketplace, the voting booth, public policy, and all those areas of government concern. Additionally, the growing racial, ethnic, religious, and ideological diversity cited so often today will be far more obvious, not just in faraway cities or states, but actually within the families of the children of the Boomers, because there will be many more so-called “mixed marriages” across all the lines just noted and children and grandchildren will be of vast combinations of backgrounds. These characteristics will be very valuable and beneficial as more and more Americans work within the global economy, use the Internet for cross national communication, and travel throughout the world in increasing numbers. Our national diversity will enable greater understanding of other cultures and nations and will make the process of international integration both feasible and desirable. As these changes occur, and since Boomers and their contemporaries also will be growing older, aging community leaders will not seem “so old,” nor will they be as threatening as they once were when the Baby Boomers were younger and said “never trust anyone over 30.” In 2015, age as a defining variable will seem less relevant because those positions of community prestige and political power will be concentrated in the hands of middle-aged and early retirement Boomers. At the same time, there will be many emergent responsibilities that will shape the lifestyles of the Boomers. Many will be trying to cope with aging parents, those very people who provided such indulgence and freedom when they were growing up. It is always difficult to watch your elders become more elderly, but for people who hoped for eternal youth, this experience will be both frustrating and in ways frightening. The physical declines that come with age will occur regardless of most of the now exciting new treatments and advertising promises. Watching such declines happen to one’s own parents will reinforce the realization that “I, too, am mortal,” making many Boomers hope for more promises for themselves. The demands of the Elder Boom will continue to push the envelope for increased and improved health care, short- and long-term aging care, and parental care. These demands will bring about many new initiatives, none of which are actually likely to stop or reverse the aging process, but certainly they are likely to help make the process easier and more people-oriented. These changes will exact a price from younger generations that follow, and eventually it will have to be balanced from a societal perspective. The Baby Boom cohort was raised to believe that they did not have to accept existing, long-standing solutions to life’s vicissitudes. As the Boomers were growing up, many institutions came under fire, partly because their parents were committed to providing “non-Depression, non-Wartime” lives for their children, but also because the sheer numbers were over-taxing the existing social institutions of the time. Specifically, vast changes were wrought to the schools of the era; teenage sexual restrictions became passe and in many instances largely irrelevant; compulsory military service became a burden too unbearable to allow. The protocols for work shifted massively, paving the way for a new world of leisure time activities; many religious institutions were altered to make them “more relevant.” Meanwhile, the Boomers marched on, leading the social revolution of the late 20th century. Today, the Elder Boomers will not accept the existing solutions for growing old. A quick glance at the emerging metaphors used to describe what were once seen as “problems of old age” helps emphasize the shifting landscape of everyday language. For example, we now have many treatments for “erectile dysfunction” rather than silence for dealing with “impotence;” what formerly was called “deafness” is no longer addressed with large, cumbersome hearing aids but with tiny, almost invisible, chip-like devices intended to help those with “hearing loss” to get the most from their conversations, and with years of booming music played directly into the ears of the Boomers by head sets, proportionately more of them will need help than ever before; variations of old-age care are increasingly being called different levels of “assisted living” or “life care communities,” and Boomers will demand not just assistance but “assistance with amenities.” All these lifestyle matters will continue to receive the ongoing attention of aging Boomers, and by 2015, it is certain that the demands and the metaphors used to describe them will be very different from those of today. People of the Elder Boom have already made it clear that they do not like the idea of nursing homes for their parents, and certainly not for themselves. It is much more likely that in 2015, retirement communities are likely to be structured around resort-like full-service hospitality centers. It is already the case that in some parts of the country, the vaunted Senior Centers which began to emerge after WW II are today being called “Fitness Centers,” and the workers in them are becoming “Personal Trainers.” Again, the metaphors that are used to describe everyday life reflect not just verbal distinctions but also reveal people’s world view and their sense of the assumptive nature of life. People no longer own “a family car,” rather most people within a family, young and old alike, now own their own individual car (or, increasingly, cars), creating multiple vehicles per household. In the immediate post WW II years, new roads and highways were built to accommodate what were expected to be more traveling families, individuals, truckers, and other newly mobile drivers. Most of the licensed drivers were men and many of the women neither were licensed nor even knew how to drive. We are riding on those same roads over 40 and 50 years later but with many more drivers, of all ages and both genders, and almost all Baby Boom men and women are behind the wheel of their own car. By 2015, virtually all Baby Boomers will still be driving, and will be on the road for work and leisure travel, pre-retirement and retirement trips, and parenting and grandparenting activities. Our streets and highways and traffic signals will need serious modernization and not just repaving. Today, government agencies, commissions, and departments are in a difficult bind in this regard. Most programs are under stable management, have been “long-” or “fairly long-established,” have well-developed protocols and deeply entrenched methods for accomplishing their stated goals. Unfortunately, a stable management model is not always the most effective system to deal with rapid and dynamic social change. Furthermore, most programs for the older population were developed and implemented to address or solve what was seen to be or perceived as a problem for everyday life at that time. As noted, “the times, they are achangin’,” and those programs may no longer be relevant or appropriate, but to change them is likely to be difficult. All units of government should now be considering what the needs are likely to be in 2015 and what can we do today to be prepared for them at that time. In addition, it will be essential to assume a more adaptive system for dealing with social changes so that as government agencies are confronted with obstacles in the years to come, they will be better able to deal effectively with the needs at hand, simultaneously re-addressing the then future needs. Those Boomers who are relatively healthy, more affluent, better educated, and technologically sophisticated are likely to provide the primary impetus for change. Policy makers must bear in mind that those who are not as healthy, financially poorer, less educated, and outside the “mainstream” cannot be ignored even if they are less visible and less likely to be able to press for new, relevant programs. There are many examples that we can observe right now that emphasize how Elder Boomers will make new and different demands on the state system of solutions. In the health care domain, it is likely that new pressures will be brought to bear on such matters as the openness of medical procedures. Just as the Boomers demanded the right for fathers to be present for the births of their children, so will they likely seek the right to be present for medical procedures for aging conditions. In the same arena, as Viagra and other sex stimulants become more widespread doctors will be faced with new pressures to help keep AIDS and other STDs under control among the older population of sexually active Boomers. Similarly, as nursing homes and other long-term care facilities have more of these same sexually active Boomers under their care, the distribution of condoms will signal a new face on the institutionalized elderly. Add to these issues such systemic matters as the growth of preventive health care and maintaining wellness, and the existing solutions fall short of the demands. Children and families will also have a new (or greatly changed) face. Starting in the 1970s, there was an emerging shift in that there were proportionately many more divorces among the Boomers than in previous generations. Today, that shift is translating into the beginning of a generation of kids with multiple grandparents. For the children of 2015, there will be vast numbers of compounded and often very complex family dynamics. The fact of several sets of grandparents may mean some advantages for child care. However, a more likely scenario is that Elder Boom grandparents will have too many personal activities, both professional and leisure time, that will make them choose not to provide baby sitting services. Conversely, there will be some Elder Boom grandparents who are totally responsible for raising their grandchildren. These paradoxes and predicaments will put new burdens of a unique variety on agencies dealing with children, families, caretaking, and aging. It is fairly easy to predict many of the immense demographic changes that are already taking place, and although it is absolutely critical to understand them and their potential impact, it is quite another matter to handle them effectively. Today, governments and communities are contemplating their futures. The task of reinventing public policy is a prodigious responsibility, especially when dealing with a group as vocal and demanding as the Elder Boom. It goes without saying that their voices must be heard. The trick is listening today to predict for tomorrow. A sensible place to start is to observe the facts as presented in the White Paper article on the demographic realities of the State and to review the agencies’ policy briefs. As the years pass, it will become evident that some of the predicted patterns will happen in ways that support the predictions. Others will be slightly off the mark, while some will miss by the proverbial country mile. Regardless of such successes and failures, the process of planning is the key to dealing with the future successfully. The challenge for readers of this ambitious project is to accept the premise that trying to anticipate the future is a more productive and valuable experience than just allowing life to happen as it will. For practitioners of the art of policy formation, development, and implementation, the greater challenge is to winnow from the projections as many creative ways as possible to deal with the Elder Boomers in 2015. ANALYSIS AND SUMMARY OF 36 STATE AGENCY BRIEFS Vera Prosper, Ph.D. INTRODUCTION Much work is being done across the country and throughout the world to increase awareness of the overall aging of the population and to advance wider understanding of the implications of this aging phenomenon for countries and for communities. New York State is engaging in similar work. In the United States, the large baby boom cohort has been a dominating factor in shaping the country's demographic profile and this group will continue in this role. Baby boomers have begun to reach early-retirement age, and by 2015 the first huge wave of boomers will be over the age of 65. Among the country's states, New York ranks third in the number of older people, which has focused increasing discussion on the impending growth and impact of this segment of the State's population. In addition to the aging phenomenon, however, New York is one of the very few states whose future profile is also being profoundly shaped by additional demographic trends-- most notably, patterns of immigration, migration, and minority status. Questions Forming the Basis for State Agencies’ Deliberations— As part of New York's ongoing effort to prepare for the future, Governor George E. Pataki directed state government agencies to consider what the resident makeup of the State is expected to be by 2015. The agencies were further directed to identify strategies for assuring that the State is prepared to recognize the advantages and to meet the challenges of the expected demographic change in creative, productive ways. Specifically, the agencies were asked to deliberate and report on the following questions: 1. Consider the impact of the State's changing demographics on your agency. What are your agency's overarching policy issues, direction, program considerations, changing constituency needs, and management issues related to these changing demographics? 2. Some agencies may have already begun to address the impact. If yours has done so, what is your agency currently doing to address or respond to these anticipated changes? 3. What recommended actions could your agency take in the next five to seven years to address the priorities you have identified that reflect the impact of the anticipated demographic changes? Also, consider collaborative approaches among state agencies and how such collaborations could fit into an overall state planning process. 4. What are several results you expect to achieve through your recommended actions? Trends— An analysis of briefs written by 36 agencies found that deliberation focused primarily on: 1. The increase expected in the State's elderly population, with some discussion of the expected decline in the nonelderly population; 2. The growth in the number of people with disabilities, which is due to increasing longevity of both persons who were born with disabilities and those who acquired disabilities during their nonelderly years, as well as the dramatic growth in the group aged 85 and over, who are most vulnerable to aging- related impairments; and 3. New York's growing racial and cultural diversity, which is heavily influenced by the State's strong immigration and migration patterns. Overarching Themes— The impacts identified and the solutions, strategies, and actions suggested by agencies can be viewed as falling under two overarching themes that are highly interrelated: Quality of life, as the impacts and the responses affect the individual, and Statewide vitality, as the impacts and the responses affect the State of New Yo rk as a whole community. Cross-cutting Topic Areas— Four topic areas emerged from the analysis that cut across all agencies and across all demographic groups: 1. Optimal Fit: Every agency asserted that the need will grow for optimizing the fit between what is provided by government and the diverse set of consumers being served by government, in order to support the overall well-being of individual citizens and the State as a whole. This is reflected in the call for customizing programs, services, products, forms, information, and communication to fit the demographic diversity of age, language, race, ethnic culture, disability, and circumstances that will characterize the State's population. It is reflected in the call to make public facilities, transportation, and housing both accessible and appropriate to users' needs. It is reflected in the call to train agencies' existing and new staff in aging and diversity issues, in understanding the differing characteristics of people being served, and in effective communication with the various population groups. It is reflected in the current practice of several agencies and the future desire of others to hire aging specialists and consultants or incorporate task forces or bureaus on aging within their agencies. 2. Collaboration: Thirty two agencies recommended both conventional and original partnerships among state agencies, as well as between state agencies and community organizations and between government and the private business sector, as the most logical and resourceful means of addressing the impact of the State's shifting demographic profile. Going beyond suggesting the concept of collaboration as a planning or issue-resolving approach, agencies identified specific entities to form these collaborative alliances and specific task areas to be handled. 3. Technology: Twenty two agencies recommended an increasing reliance on various existing and new technologies as an efficient and effective method of improving communication and interaction with consumers, streamlining service and product delivery, increasing round-the-clock access to services, assisting people with disabilities and impairments, and responding to increasing consumer demand for (1) "self-service" information and transactions; (2) alternative technological options, including Internet- based services; and (3) seamless, across-government integration of transactions with the public. However, agencies cautioned about the need to (1) adapt all technological solutions and tools to the age, language, racial, cultural, educational, and disability characteristics of users; (2) recognize that many users will continue to need education and personal assistance in using the Internet and other technologies; and (3) be vigilant about the growing reliability, security, and privacy issues associated with the Internet and data- sharing technologies. 4. The Workforce: Twenty agencies underscored the implications of the aging of the current workforce, the mass retirements expected across the State within a few years, the shrinking younger labor pool, and the markedly changing demographic characteristics of the State's future labor pool. To close the impending workforce gap, as well as to match workers with ongoing demand changes in the labor market, creative solutions were given to retain experienced older workers, recruit retirees, stem the out- migration of the State's educated young adults, educate and train members of an increasingly diverse labor pool, and draw workers from groups not traditionally considered for workforce recruitment and retention. SYNOPSIS OF THE AGENCIES' DELIBERATIONS: TRENDS and IMPACTS: Aging of the Population (Increase In the Number of Older People and People With Disabilities) Trends— All agencies identified the growth in the number of elderly people as a major demographic force that will affect their services and programs, the makeup of their constituency groups, or the way agency business will be conducted. Most agencies also discussed the growth in the number of people with disabilities, both those who will age with long-standing disabilities and those who will incur disabilities during the elder years. While overall aging was acknowledged, discussions of the impacts of numerous distinctive subgroups of elderly people emphasize the complexity of planning for an aging New York. For example, agencies highlighted: the escalating numbers of retirees, elderly property owners, older drivers, people over the age of 85, custodial grandparents of adult children and grandchildren; the increase in the age of farm owners and the age of the government workforce; the growth in the number of elderly people represented in a variety of special needs groups, such as those with dementia, drug and alcohol addic tion, HIV/AIDS, lifelong disabilities, recent physical or mental impairments, those who live alone or are isolated or lacking family; the rising numbers of older people in such diverse subgroups as prison inmates, college students, and elderly parents of also-elderly adult children with developmental disabilities; the expanding numbers of immigrant, minority, ethnic, and poor elderly; as well as the sharp increase expected in the number of deaths, which will have an impact on cemetery space and burial policies and regulations. Impacts— The major issues that emerged from deliberating the aging and disability trends reflected the missions and functions of the agencies expressing them. Increasing number and longevity of older people, their vulnerability to impairment, and the diversity of their circumstances: Multiple agencies voiced the following issues in response to the growth expected in the number of older people, the continued increasing longevity among this population, and the variation that characterizes this population group: · The changing characteristics of the State’s consumer base will alter the interactions between providers and citizens. The State can expect a growing need and demand to modify and customize services, programs, materials, products, information- disseminating formats, outreach methods and procedures, and practical communication to be easily understood and useable by all subgroups of elderly people (age segments, race, culture, language ability, educational level, disability, geographic location, lifestyle) and to be useful to them. · The need will intensify to train both internal agency staff and front line workers (such as health care workers, teachers, bank tellers) in aging issues and in effective communication with elderly people to reflect the changing marketplace and to competently respond to all types of older consumers. The need will increase to provide specialized training to specific worker and professional groups to assure implementation of features and actions that meet the needs of aging persons and people with disabilities. · Increases can be expected in the incidence and variety of chronic diseases and disabilities, chronic physical and mental health conditions, and occupation-related diseases and injuries among the elderly population, which will increase the demand for information and assistance, case management, long-term care insurance products, supportive assistance and long term care services, informal and formal caregivers, and physical modifications to housing environments. In addition, the need will grow to explore integrating mental health services with the public health system. · The characteristics and traits of the baby boomer generation vary from those traditionally associated with elderly people. The baby boomers will bring increasing expectations for lifestyles and services that accommodate individual choice and that will focus on preventative health care, healthy lifestyles, good nutrition, and adequate and flexible community-based activities and services. · Data from the New York State Office for the Aging (NYSOFA) show that the greater majority of older people are well, healthy, agile, and financially stable. Data also indicate that the expectations of succeeding groups of older people to remain integrated as active, participating, productive members of their communities will grow. This is reflected in the notations of some agencies of the growing need to balance the issues of well-elderly and frail-elderly persons, while others noted that ways must be found to utilize the talents, skills, and experience imbedded within the elder cohort. · Safety and security issues regarding the elderly population will increase significantly in amount and type, requiring increasing attention, tools, innovative strategies, staffing, community and neighbor involvement, and consumer education. Areas of concern include: financial, Internet, and predatory business crimes; personal crimes; elder abuse, neglect, and exploitation; consumer fraud and scams; service-related consumer protections such as utility shut-offs; community-wide disaster and emergency situations; accessibility and safety of public places (for example, lighting, stairs, sidewalks, curbs, trails, acoustics, signage); the home environment (falls, accidents, fires, isolation, no heat, fear of crime); security staff in all modes of public transportation; and food safety. · There is a need to devote increasing attention to the topic of older drivers. Various agencies related specific issues, some conflicting, which illustrates the complexity of the impact of this topic: current and future elderly people will drive more than previous generations of elderly people, but will continue to drive less than younger people; the proportion of accidents among older drivers will not increase, but the number will increase because of the growth in the number of older drivers; vision, hearing, strength, and reaction time for driving declines among many older people; however, older drivers are generally characterized as self-assessing their own driving skills, limiting driving to less congested times of day, driving less during night hours and in poor weather, driving fewer miles per trip, and driving fewer miles overall; the reluctance of older drivers to give up driving will continue; giving up driving means dependence upon family members to meet mobility needs; changing family structures will increase the need for continued driving into the elder years (for example, custodial grandparents of grandchildren, single elderly people, elderly people with no available family members); the majority of older drivers reside in suburban and rural areas where alternative transportation modes are limited or nonexistent; the current status of street signage, road markings, parking areas, etc., is not adequate to accommodate the needs of older drivers or persons with disabilities; and suggestions for more restrictive licenses, shorter renewal cycles, and greater oversight of older drivers are politically sensitive. · A review of New York’s policies over the past 20 years shows a shift from institutional to community-based living environments for both elderly and nonelderly populations. This will intensify in response to the 1999 federal court decision in Olmstead v L. C., which requires states to provide chronic and long-term care services in least-restrictive, community-based living environments. Consumer demand will increase the need for additional accessible, adaptable, affordable, supportive housing and specialized housing units in a variety of choices that meet elderly and nonelderly populations' needs and preferences. Loss of existing affordable units across the State through various types of market rate conversions, as well as losses of specific housing options, such as Family Type Homes and Single Room Occupancies (SROs), will intensify this demand. The State’s revenue picture: Multiple agencies reported that the shifting age composition of the State's population will re-fashion the State's overall revenue picture, affecting a variety of public and private entities, consumers, and the State's economy. While some noted that there could be a negative impact on revenues used to fund specific infrastructure and services, others noted that increases in other revenue sources could temper or offset the overall effects of decreases. Some examples include: · Rising numbers of health insurance claims by aging policyholders could put some health insurers at risk of financial instability. The stability of the health, homeowner, and auto insurance industries may rest on increasing premium costs for consumers of all ages. Interest will grow in Medicare supplement policies, continuing care retirement communities, and long term care insurance products, which help enable older people to stretch their money over their lifetimes; and there will be an increasing demand on the insurance industry to develop alternative innovative products to assure that older people do not outlive their available funds. · Many of the State's aging immigrants will have spent none of their working careers in the United States and may not qualify for Medicare, Medicaid, or other federal assistance programs, which will increase the financial burden on state, county, and city health and social services departments, shift costs to all taxpayers, and may change overall benefit structures. Can these effects be tempered by the increasing use of immigrants to address the State's work force issues? · The increasing ratio of retirees to workers will affect the State's income tax base, as well as communities' property and income tax revenues. However, will retention of older workers and hiring retirees mitigate losses in the income tax base? Will the increasing demand for second homes, vacation homes, and larger homes among the elderly population increase property taxes? · A declining upstate population, particularly the migration of younger people out of rural areas and the graying of the suburbs, may erode the customer revenue base that funds county clerk operations. However, as retirees engage in certain second and third careers and occupations, revenues from professional license and registration fees may increase. · There may be increasing numbers of participants in the STAR (property tax) and SCRIE (rent subsidy) programs, but a declining number of veterans eligible for veterans’ exemption programs. · Exemption, reduced-cost, and free programs that target a growing number of older people and persons with disabilities will strain program and community operating budgets. However, policy changes in these types of programs may result in increased revenues. The workforce: For several years, through the Governor's Office of Employee Relations, state agencies have been engaged in a government-wide workforce succession planning initiative in response to the aging of the State's public sector workforce and the rapidly changing nature of the New York's labor pool. In their deliberations for the Project 2015 initiative, agencies described the impact of the aging of their own staffs and the staffs of their statewide networks of voluntary providers, the impact of impending general mass retirements, and the implications of mass retirements expected among specific occupations, such as the state police, fire department personnel, teachers, and state agency management-level personnel. Some examples include: · The impending loss of a large number of qualified workers through retirement will result in less stability and increased turnover in the state workforce. The magnitude of the impending retirements will result in the State losing the institutional memory, high level skills, experience, fundamental program knowledge, mentoring capacity, and talents gained by workers over the course of 20- and 30-year careers. · Both the increasing numbers of public sector retirees and their longer retirement periods will dramatically increase the State's benefits costs (pensions and health care), resulting in hard choices about resource allocation. Agencies questioned whether new, creative fringe benefit products and new, flexible work options need to be developed to constrain costs and to respond to the changing preferences of the public workforce. · For many agencies, over half their staffs are over the age of 50. There will be a growing demand for changes to create work-site environments that respond to the needs of older and disabled workers, including physical modifications, assistive devices, flexible work schedules and work arrangements, greater use of family leave for caregiving responsibilities, educational programs on aging and caregiving issues, and sensitivity training for managers regarding the traits and needs of older workers. · Greater flexibility is needed in hiring and retention policies. Current civil service practices must be reconsidered, and new, creative strategies are needed to recruit younger-aged workers; recruit from nontraditional applicant pools, such as immigrant and ethnic groups, people with disabilities, and volunteers; retain current older workers; and entice skilled and talented retired people back into the labor force. · Traditional workforce planning procedures and models do not sufficiently account for the implications of more aging workers, increasing retirements, fewer younger worker applicants, and the State's geographic population shift (greater growth in high-cost urban areas). Longer planning horizons, beyond three- or five-year periods, are needed for a more relevant planning process. Better simulation and forecasting tools and methodologies are needed to more accurately forecast labor force needs and costs. TRENDS and IMPACTS: Aging of the Population (Decline In the Number of Younger People) Trends— For the United States as a whole, there will be an overall decline in the population under age 60, primarily because of the aging of the large baby boom generation, a decline in the number of women of childbearing age, and continued low fertility rates. Similarly in New York, the growth in the State's elderly population is coinciding with an expected decline in the State's nonelderly population; and agencies' discussions underscore the amplified effect of the two age trends occurring simultaneously. In addition, while national trends are generally echoed in New York, the State's shifting proportional relationship of the elderly and nonelderly groups is magnified by the significant out- migration patterns of people aged 20-40. Impacts— The decline of specific younger-age subgroups raised specific issues, highlighting the complex nature of demographic change and heightening an appreciation of the interrelationships among the various generations. Some examples include: · The population group aged 30-64 will decline, and the number of people in the prime workforce age (aged 20-40) will remain static or decline slightly, particularly due to significant out-migration by this age group. At the same time, mass retirements of aging workers is expected, with many retirees leaving the State, draining highly experienced workers and the volunteer pool. The joint impact will affect both the public and the private sectors' ability to attract, retain, and retrain a qualified workforce, which is critical to the State's economic growth and vitality. Specific occupations, particularly in the health care industry, will increase in response to the needs of greater numbers of older people, but will experience labor shortages because of the shrinking labor pool. There will be a growing gap between available workers and the workforce needs of the State's manufacturing, skilled trade, and technician sectors. There will be fewer seasonal workers and volunteers available for programs that are expanded to adapt to a changing customer base (for example, the State's park systems may extend the camping season, change activities, and increase such amenities as RV sites, electric camp sites, resting areas, restrooms, first aid stations, food concessions, playgrounds for grandchildren, and police and ranger presence to accommodate a growing number of older participants). · New York's family farm owners are aging, many have no younger family members to take on the family business, and a declining number of younger people are available as prospective farm operators. This situation, together with escalating farmland values, will continue to exert great pressure on elderly farmers to convert prime farmland into real estate developments. The effect is the loss of available farmland and small family farms, the evolution of fewer but larger farming operations, and significant changes in New York's rural land use patterns. · A sizable portion of the informal, unpaid caregiving assistance provided to elderly people is performed by nonelderly family members and friends. The decline in the number of younger people will result in fewer available informal caregivers at the same time that the number of elderly persons needing caregiving assistance will expand, swelling the demand on the formal care system. However, the decline in the workforce population will change the State's dependency ratio (number of workers:nonworkers), affecting the availability of paid health care workers. The decreasing supply of both informal and formal caregivers will affect the quality of life of all family members. · The population pool from which the central core of university enrollment is selected (those aged 18-21) is expected to decline. The proportion of students in this age group has declined in the State University system, while the proportion of students aged 50 and over is increasing. Increasing attention will be required to meet the needs of a growing number of older, "place-bound" students, whose demands for supplemental courses, online distance learning, campus-business partnerships, degree and non-degree studies, classroom formats, and teaching methods differ substantially from those of younger students. · The numbers and traits of some younger and older population subgroups will not follow consistent patterns, but will ebb and flow through 2015. For example, the size of the State's overall veteran population is related to historical wartime demands. The elderly veteran population peaked in 1999 (World War II and Korean War), will decline for a few years, will increase to peak again in 2015 (Vietnam War), and will decline again (shorter, smaller military actions). The varying physical and mental characteristics and consumer demands of specific wartime subgroups require continual attention to match programming and benefits to subgroup needs and traits. · The decline in the State's younger population is expected to reduce the overall number of inmates in New York's prisons, but the proportion of inmates over the age of 50 is increasing. This changing age composition will require modifications in policies, system directives, and programming to balance the requirements for younger inmates with the growing requirements for elderly inmates (including changes in transportation, activities, and policies for the also-aging family member visitors of older prisoners), and will result in a growing need for specialized living units and greater amounts and types of health and long-term care services to accommodate elderly inmates' needs. TRENDS and IMPACTS: Immigration, Migration, Racial and Ethnic Diversity Trends— Immigration: New York's population profile, like other northeastern states, is profoundly shaped by significant levels of in- and out-migration of both foreign-born immigrants and domestic residents. According to the Center for Labor Studies at Northeastern University (2002), during the 1990's, the nine-state northeastern region experienced the greatest wave (3.1 million people) of foreign-born immigrants since the beginning of the 20th century. In 2000, the proportion of New York's population that was foreign-born (23 percent) was almost twice the proportion (12.4 percent) of foreign-born residents in the nation's population (Center for Labor Studies, 2002), reflecting an influx pattern of more than 100,000 foreign immigrants into New York each year (New York State Data Center, 2002). Migration: During the 1990's, of the nine northeastern states, New York had the largest number of foreign and domestic residents (1.7 million, or just under 10 per cent of the population) leave the State. The substantial out-migration of young, educated prime- work-age people and financially secure retirees affects both New York's workforce and its economy. The overall movement of both foreign immigrants and domestic citizens in and out of New York results in net losses in the State's population, and these immigration and migration patterns are expected to continue. Diversity: The State's substantial ethnic and minority populations of all ages will increase in both size and in subgroup diversity, due to immigration, to natural increase (more births than deaths), and to added options in the Census for self-identification. According to NYSOFA, among the State's total elderly population, minority and ethnic elderly persons will increase at the fastest rate (projected to grow from 20 percent of New York's elderly population in 1995 to 31 per cent in 2015 and 35 percent in 2025). Impacts— Agencies reported the impact of increasing foreign immigration, the impacts associated with the migration patterns of specific population groups, and the effects of the dramatically increasing diversity of New York's population profile. Some examples include: · There will be an increase in the number of New Yorkers who have little or no English-speaking skills and an increase in the variety of languages that will be used in households as the primary means of communication. Both will have an impact on the State's educational and training systems. For example, more students will need more than four years to complete high school. There will be more adults learning English. There will be an increasing need to recruit bilingual and culturally diverse teachers and professors and to train teachers at all levels of educational programs in customs and characteristics to reflect the multi-cultural composition of the State's student bodies. There will be a need to increase and to modify vocational classes, job-training programs, and professional curricula to prepare immigrants and ethnic and minority persons for the labor force. · Agencies emphasized the vulnerability of immigrant, ethnic, and minority populations. For example, many lack education or relevant job training and will take lower-paying jobs or jobs that are more dangerous or involve adverse exposure to hazardous materials. This will increase issues of environmental protection and require new ways of communicating information and assuring job safety. Immigrant populations, unfamiliar with the language and customs of their communities, are more vulnerable to deceptive and fraudulent business and other practices; and many immigrant and minority families are poor. This will increase the need for new areas of consumer protections and consumer education about service-related rights and responsibilities; and environmental justice issues may increase in minority and economically disadvantaged communities. · Conversely, an increasing number of immigrants and members of minority groups are skilled and are establishing new businesses, needing greater information, consultation, and services in relevant languages and cultural contexts to successfully access credit and financing opportunities and to understand business, tax, and regulatory requirements. As the employment and economic status of immigrant, ethnic, and minority population groups increase, their involvement may increase in activities not traditionally utilized, such as the State's outdoor, recreational, and vacation facilities, requiring greater attention to matching activities and services to cultural characteristics. · Cultural and religious competence may not be sufficiently instituted throughout the State's community-based networks and systems providing health, mental health, and social services. This will require increased attention in order to respond effectively to the varying cultural, educational, economic, health, and lifestyle circumstances characterizing New York's population. · The significant out-migration of New York's educated young adults, as well as a net out-migration among the general workforce population aged 30-64, is expected to continue. This will affect the ability of the public and private sectors to attract and retain a sufficient number of qualified workers and will increase the gap in workers for the manufacturing, skilled trade, and technician fields. There is underutilization of the accumulated talents and skills of retirees and insufficient education, training, and use of workers from population groups not traditionally considered in the primary workforce base (for example, immigrants, older people, people with disabilities, ethnic and minority subgroups, volunteers, part-time workers). · In tandem with the talent-drain associated with the out-migration of the State's educated young population, there is a wealth-drain associated with the substantial out- migration of affluent well-elderly retirees and financially secure veterans, to western and Sunbelt states. Poorer veterans tend to remain in the State, and many frail elderly persons return to New York for health and long term care services and to be near family members. · Both in-migration and internal migration patterns are changing the State's urban/nonmetropolitan composition, with various implications. For example, the projected growth in New York's downstate urban area will drive up the demand, and the budgets, for social services and job training/recruitment programs in this high-cost area. The State's disaster response plans for elderly people and people with disabilities differ in urban vs. rural settings. The needs of growing numbers of subgroups will require customized emergency response plans (for example, (1) when schools close in a disaster, what effective means can be used to pick up children who are the responsibility of frail or nondriving grandparents, (2) what alternative emergency warning systems can accommodate elderly or other people with hearing or vision impairment, and (3) how can emergency warnings and evacuation instructions be communicated in ways that accommodate non-English-speaking families). SYNOPSIS OF THE AGENCIES' DELIBERATIONS: SUGGESTED RESPONSES and ACTIONS At the start of Project 2015, many state agencies were already engaged in activities to prepare for the State's changing future, and these can be reviewed by reading the agencies' briefs. As an outcome of the agencies’ deliberations for Project 2015, both conventional and innovative ideas emerged as additional actions or strategies that can help prepare for the impact of the State's changing demographic profile. These are summarized below under the two highly interrelated overarching themes: 1. "Quality of Life: affecting the individual," categorized under the four headings of Optimal Fit, Personal Living Environment, Health, and Safety and Security; 2. "Statewide Vitality: affecting New York State as a community," categorized under the two headings of Technology and The Workforce. In addition, almost all agencies suggested specific collaborations, involving entities that have an interest in a specific constituent group or issue, as an effective means of understanding the multi-faceted nature of issues and of pooling skills and resources for better outcomes; and these are noted throughout the summary. Some examples of suggested responses and actions for each of the categories include: RESPONSES and ACTIONS: Quality of Life (Optimal Fit) · Targeted outreach strategies will attract staff and employees from diverse population groups for the State's educational system to more closely reflect the system's student population. Opportunities for employees of the educational system to acquire skills in languages other than English can be provided and supported. Academic courses and programs that focus on other world cultures, governments, religions, immigration issues, assimilation, and national identity can be offered to make the State's residents more aware and knowledgeable about other cultures. · Agencies will provide ongoing training for both internal and direct line staff to ensure that programs, services, and information provided are easily accessed, are understandable by people of varying educational levels, are consistent with cultural traits, are useable by the intended consumers, and are communicated in ways that are responsive to all types of individuals, including elderly people, people with disabilities, people with limited or no English-speaking skills, and foreign immigrants. · Increase the number of community-based service-delivery offices, outreach stations, information centers, and counselors and locate them close to consumers and in nontraditional, but high-use, sites (such as health clinics, community centers, kiosks in state government agencies and malls, county fairs, senior citizen organizations' meetings) in order to increase consumer awareness and to increase access to and use of information and services. Suggested collaboration: Banking Department, Office for the Aging, and AARP to: provide sensitivity training to internal and direct line staff to make banking information relevant to older people, services easier to use, and to identify other contexts in which to provide bank services and outreach to seniors. · Sensitivity training will be provided for state agency managers to ensure that the workplace environment is responsive to the needs of aging staff. Suggested collaboration: Several agencies suggested involving the Office for the Aging, Office of Employee Relations, Office of Children and Family Services, AARP, and others to develop sensitivity programs for state agencies to educate and support aging workers regarding their own aging issues, as well as to help them with aging and caregiving issues regarding elderly family members. · Train staff and potential employers about workplace accessibility standards and features and about workers' rights under the Americans with Disabilities Act. · For a variety of consumer-protection issues (such as fraudulent business, financial, credit, and insurance practices; car repair scams; telemarketing and Internet scams; identity theft; and personal crimes), expand both the types of information provided to consumers, community leaders, and professionals and the alternative methods of disseminating that information in ways that are responsive to the needs of the diverse individuals being served. · Many agencies suggested adding aging-specific consultants or bureaus to assure adequate and appropriate attention to aging issues. Some included: (1) Suggested collaboration: Create an aging taskforce of the Banking Department, other government agencies, and aging-related community groups to: develop new banking products and services wanted by older people and to determine banking regulations needed to protect elderly and other consumers. (2) Create an office of the aging driver in the Department of Motor Vehicles to coordinate agency programs, service delivery, and communications. (3) Division heads will analyze operational manuals, and executive staff, unit directors, and supervising superintendents of regional facilities will analyze and modify the Department of Corrections' directives, manuals, and Title VII to assure that all policies and procedures reflect the appropriate needs of elderly prison inmates. (4) Older employees will be used to address consumer hotline issues. (5) Designate an agency policy coordinator within the Department of Parks and Recreation and appoint an aging advocate within the Office of Consumer Education and Advocacy in the Public Service Commission; these will form liaisons with the Office for the Aging and other agencies to assure that programming, policies, and consumer protections reflect the needs of elderly persons. (6) Create specialized units within the State Police to investigate crimes against elderly persons, including specially trained troopers with expertise in elder crime prevention. (7) Retain specialized consultants in the Office of General Services to assist with aging-related designs for the State's real estate planning and facility design and construction. (8) Suggested collaboration: Establish a seniors advisory council in the Department of Insurance, together with the Office for the Aging, AARP, and other senior groups to: advise the Department on seniors’ insurance needs and issues. (9) Suggested collaboration: Office for the Aging, in concert with the statewide Area Agency on Aging network, consumers, and community organizations to: determine the diverse needs of older New Yorkers as they change over time. (10) "Aging issues" will be included as a regular agenda item on the planning and operational meeting agendas of various agencies. (11) The Department of Insurance will establish a section on their exclusively devoted to seniors, with font sizes, layout, and functionality to meet the needs of elderly people and with links to other senior-related s. (12) Establish a task force in the State University system to inventory all programs serving aging populations and identify areas where programming structure is lacking. · Make physical modifications and increased use of Braille, other specialty signage, and multiple languages in State facilities, other public-use buildings, access areas, roads and parking lots, sidewalks and hiking trails, fishing areas, all transportation modes and related facilities, parks and recreational areas, prisons' family visiting areas, and housing developments to accommodate the needs of elderly people, people with disabilities, and other population groups. · The State Emergency Management Office recommended developing alternate means of warning and communication in times of emergencies and disasters for people with hearing, vision, and mobility impairments and for those with language barriers. · Create various driving license options to accommodate senior drivers' actual driving patterns. · Suggested collaboration: State Police, Department of Motor Vehicles, and Department of Transportation to: improve driver training programs for older people, safety programs, traffic control device design, road design, and licensing guidelines. · Amend the Insurance Law to require third party notification when long-term care policy premiums are due, as currently applies to Medicare Supplement and other types of insurance, to decrease the lapse rate among seniors who forget to pay premiums and find it virtually impossible to be reinstated if their health status has changed. Extend the "free-look" period for consumers to evaluate the purchase of a long-term care policy from 10 to 30 days, as is currently required for Medicare Supplement policies, for more informed decision-making. Encourage the insurance industry to create more senior- oriented products that more flexibly and comprehensively meet the needs of an aging population. RESPONSES and ACTIONS: Quality of Life (Personal Living Environment) · Review the regulations governing day service options for elderly people with developmental disabilities living in residential facilities to assure that there are no deterrents to retirement for this elderly population. · Train building inspectors on code accessibility requirements. · Draft legislation to extend the benefits of Article 2 Mitchell-Lama housing to housing companies that have paid off or will soon pay off their mortgages to stem the loss of affordable housing units in the State and to encourage housing companies to maintain their "affordable housing" status to serve lower-income residents. · Adapt the administration of rent laws to enable seniors on fixed low incomes to remain in their rent-controlled and rent-regulated apartments. · Enroll additional eligible elderly tenants into the Senior Citizens Rent Increase Exemption program to assist the close to half the population of rent-regulated housing in New York who will be aged 55 or over by 2015. · Increase interagency collaborations to: explore innovative and affordable housing options and increase the availability of housing options that provide supportive services in least-restrictive environments for people with disabilities and elderly people. Suggested collaboration: The Division of Housing and Community Renewal (DHCR), together with other state agencies, to: address the legislative authority changes necessary for incorporating models of community-based supportive services, resident service coordinators, and other models of support that prolong aging in place in senior housing. Suggested collaboration: DHCR, together with city, county, and state services agencies, to: identify supportive housing models for various population groups through pilot programs and policy initiatives. · Increase the number of temporary shelters and supportive services for victims of elder abuse. · Convert the State's 8- to 12-bed residential group homes into supportive housing for seniors as younger-aged persons with developmental disabilities are moved from group homes into conventional apartment units. Develop pilot housing programs to study the best ways to meet the residential needs of elderly persons with developmental disabilities. · Suggested collaboration: Office of Children and Family Services, Office of Mental Health, and Office of Mental Retardation and Developmental Disabilities to: increase the Supplemental Security Income Level I reimbursement payments to low income persons. · Recruit more operators for Family Type Homes for Adults: (1) give finder's fees to existing operators, (2) coordinate statewide marketing and publicity efforts about the program, (3) increase training for operators, (4) increase training for County Department of Social Services staff about the program, and (5) increase the benefits, including use of a Medicaid waiver, to operators of Family Type Homes for Adults to meet the same reimbursements that are available to operators of Family Care Homes for persons with developmental disabilities. · Suggested collaboration: Office for the Aging, Office of Alcohol and Substance Abuse Services, Office of Children and Family Services, Office of Mental Health, Office of Temporary and Disability Assistance, and Department of Education to: analyze the latest census data on grandparents assuming custodial responsibility for grandchildren, determine issues and barriers encountered by this group, and identify activities and avenues for effectively addressing service, legal, and other needs of this population group. · Suggested collaboration: A taskforce including the Departme nt of Corrections, Division of Parole, Office of Mental Health, and Office for the Aging to: address appropriate levels of housing and care for elderly prison inmates, including infirmaries, skilled nursing care, and dementia living units. RESPONSES and ACTIONS: Quality of Life (Health) · Suggested collaboration: Interagency work group to: get affordable prescription drug coverage for nonelderly people with disabilities; identify federal, state, and private prescription coverage plans that cover this population group; and work with the Governor's office in Washington, D.C., and state governments across the country to explore the feasibility of changing the eligibility for prescription drug plans to include nonelderly persons with disabilities and to expand the Medicare program to include prescription drug coverage. · Suggested collaboration: Through the Department of Health, create regional coalitions and educational programs to: increase adult immunization for influenza and pneumococcal diseases, and a statewide partnership to prevent oral cancer. · Increase the emphasis on education, screening, and testing for prevention and early treatment of osteoporosis, diabetes, and asthma; improve public health initiatives that promote physical activity, good nutrition, and oral health; provide treatment and services to individuals with Alzheimer's. · Trend factors and adjustment tools will be used by the Department of Health in the methodology used to determine the State's need for nursing home beds and for alternative forms of noninstitutional long-term care options. · Support federal tax incentives for the purchase of long-term care insurance. · Develop and disseminate evidence-based practice models of home and community-based care that are cost-effective and appropriate across cultures. · Suggested collaboration: Partnerships among key state agencies to: achieve systems change in the provision of long-term care to reflect the preferences of elderly people and people with disabilities for choice in where to receive care and decision- making autonomy in how care is received, to change regulatory and statutory barriers impeding long-term care change, and to provide adequate and flexible funding for home and community-based services. · Expand the Winds of Change evidence-based practice initiative to include older individuals experiencing serious mental illness and dementia. Standardize the collection, documentation, and archiving of mental health patient, billing, and operational data. · Develop training materials for providers and professionals that are focused on the prevention of alcohol and substance abuse problems among seniors. · Amend the State's health law to allow non-wartime veterans access to the state-ofthe- art veterans' skilled nursing facilities, which are now available only to wartime veterans and certain dependents. This would take advantage of increased federal operating subsidies and would ensure the occupancy rates needed to sustain financial operating self-sufficiency. · Suggested collaboration: The Division of Veterans’ Affairs, together with county and city veterans’ service agencies and other veterans’ organizations to: maximize use of veterans’ transportation systems to allow eligible veterans greater access to affordable Veterans Administration medical centers and health clinics, which are often an alternative to Medicare- and Medicaid-financed private health care. RESPONSES and ACTIONS: Quality of Life (Safety and Security) · Enhance state-level staff and reimbursement levels for investigation, assessment, and service targeted to vulnerable older people at risk of abuse and neglect to equal the staff and reimbursement devoted for child protective services. · Increase training for Adult Protective Service caseworkers and supervisors regarding elder abuse and neglect to keep older adults safely in the community for as long as possible. Bring more state-level oversight and uniformity to Adult Protective Service programs. Suggested collaboration: Statewide coalition to: coordinate a comprehensive approach to improve detection and resolution of abuse and neglect cases, and to increase public education and an outreach campaign on adult abuse and neglect. · Suggested collaboration: Commission on Quality of Care, Office of Mental Health, and Department of Health to: explore alternatives to guardianship services, such as surrogate decision-making and health care proxies, which are less restrictive options for elderly people, and to explore a statewide public guardianship program. · Impose fines and revoke Intrastate Operating Certificates for companies that commit predatory business practices. Keep a cramming and slamming watch list of telephone companies to monitor customer complaints. · Draft legislation to prevent personal crimes against the elderly and address civil issues such as the fraudulent sale of personal belongings or coerced changes in estate planning options. · Suggested collaboration: Create a structured framework involving individual citizens and community groups, similar to neighborhood watch programs for children, to: work with law enforcement officials to provide informal monitoring of elderly shut-ins and those who live alone. · Expand utility and energy programs for elderly, blind, and low-income customers and those with disabilities. · Require food retailers to demonstrate a minimum level of food safety knowledge. Improve rules regulating food-handling practices. · Suggested collaboration: State Emergency Management Office (SEMO), Department of Health (DOH), Office for the Aging (NYSOFA), and Office of Fire Prevention and Control to: identify residents living in senior housing developments in order to enhance awareness of these residents and plan for their needs in emergency situations. Suggested collaboration: SEMO, DOH, NYSOFA, and Disaster Preparedness Conference liaisons to: identify demographics in health care facilities for planning, training, and public education activities. · Create safer and more useable mobility accommodations for all population groups: wider pavement edges, more visible roadway and pavement signage and markings (day and night), additional handicapped parking spaces, traffic calming techniques, safer rail stations and intermodal centers, improved and audible pedestrian signals, high-visibility cross walks, more sidewalks and benches for resting, and modified physical accommodations for passenger trains and buses (such as wheelchair tie-downs, larger seating and leg room, hand rails or grips, improved lighting, benches in sheltered transit waiting areas, buses with intercom systems, and other features). Suggested collaboration: Department of Motor Vehicles and Governor's Traffic Safety Committee to: coordinate activities that respond to the needs of older drivers. · Suggested collaboration: Government agencies and industries to: develop consumer-protection policies and procedures for aging and non-English-speaking consumers. RESPONSES and ACTIONS: Statewide Vitality (Community Living Environment) · Increase the siting of energy generation plants to assure that future energy supply and demand imbalances will be addressed in communities across the State. · Suggested collaboration: Department of Environmental Conservation and targeted strategic planning partnerships to: negotiate discussions among differing population groups in order to identify shared public expectations, values, and policies; balance conflicting goals regarding individual topics (such as natural use of the outdoors vs. accommodating less-mobile visitors, or growth vs. control of wildlife); and to garner support from nontraditional participants in the value of protecting the environment and the appropriate use of natural resources. · Build on New York's Quality Communities Initiative to improve the State's environmental infrastructure and the quality of its natural resources. RESPONSES and ACTIONS: Statewide Vitality (Technology) · Web sites updated to make information useable and culturally relevant to elderly people, people with disabilities, and members of ethnic and minority groups. · Web sites that provide instantaneous translations into alternative languages. · Train staff to develop and maintain their competencies in the use of new and emerging technology in order to deliver efficient and effective services to the public. · Mapping technology to project census data that identify geographic locations and concentrations of ethnic and religious communities to target outreach efforts and public awareness. · A statewide 211 number for one-stop-shopping for information and assistance. · Expand the Government Without Walls initiative to fully integrate automated government systems for seamless consumer access and use (for example, credit card payments and account review, income tax filings, benefits option transfers, changes of address, license applications). Expand the Map NY mapping applications. · A Mobile Information Center, using a van to travel throughout the State with trained staff to answer consumers' insurance questions and resolve problems. · Automated case management and tracking system for elder abuse services. · Statewide electronic academic calendar. · Continue the State University of New York’s Learning Network, the online distance learning program providing college courses at all levels of an “anytimeanywhere” format. · Internet-based technologies to strengthen the integration of all components of the public mental health system. · Suggested collaboration: Department of Health, Office of Employee Relations, and Department of Civil Service to: continue installing accessible defibrillators in state facilities. · Simulators to provide senior drivers with self-assessment tools. · Laptop computers, with remote access to client records and health and benefits resources, to take services to the client for efficient assessment and service delivery. · Launch the Acoustaguide initiative to equip the State Capitol, the Plaza Art Collection, and other Plaza visitor attractions with self-guided tour equipment that is designed to be useable and accessible for seniors and other population groups. · Robotics and other technologies to free up employees for other work. · Workplace devices for lifting patients to decrease workplace injuries. · On-line recruitment and testing for the State workforce. · Web-based and interactive-telephone self-service options to reduce reliance on costly service personnel. · Public television and Web-based programs for lifelong learning classes, specifically targeting diverse audiences. The Technology Academy to deliver educational services to constituents. · Suggested collaboration: Department of State's Division of Coastal Resources, Department of Parks, Recreation and Historic Preservation, Office for the Aging, and Office for Technology to: develop and use a Geographic Information System program to plan and develop the State's waterfront areas for land and housing uses, recreational sites, and public access to vacation lands as the demand expands among elderly and other population groups. RESPONSES and ACTIONS: Statewide Vitality (The Workforce) To help close the impending Workforce Gap: · Draft legislation to remove barriers to the employment and retention of retired professionals such as teachers, librarians, military personnel, rehabilitation workers, and those retired from cultural institutions. · Modify the State's recruitment and retention policies to attract and retain workers, including flexible work schedules, part-time employment and pro-rated benefit packages, telecommuting, raising the income ceiling for retirees returning to work, and phased retirement plans. · Broaden the marketing of public sector jobs to attract and retain older people, retirees, and members of other nontraditional employee pools. Market employment and education in New York as the State presently markets tourism. · Promote available jobs in New York as part of foreign trade missions. · Suggested collaboration: Empire State Development to coordinate partnerships among state agencies and with the business community to: target workforce growth. · Funding awards to providers who recruit low-income persons. · Recruit workers from among those leaving the armed services. · Tax credits to companies that hire nontraditional workers or that pay for continuing work-related education. Tax credits to families who invest in higher education. · Strengthen FarmLink, which matches older farmers with young prospective farm operators looking to enter the business. Increase the Agricultural Workforce Certification Program to increase the number of new qualified farm employees. · Financial incentives to achieve voluntary agreements from family farmers to continue farming instead of selling prime farmland for another purpose. · Take advantage of the skills and talents of the growing pool of retired people and people with disabilities. Increase employment and volunteer opportunities for older people. Suggested collaboration: Office of Advocate for Persons with Disabilities and Department of Labor to: expand opportunities for older workers who remain in the workforce or are re-entering the workforce. Expand the Office of General Services' Ambassador Program to operate at other state agencies or instituted as a statewide program, which trains and uses older volunteers as tour guides for all Empire State Plaza visitor attractions and to operate Plaza information booths. To provide Well-Trained Workers and increase workers in Demand Occupations: · Internships for students in careers in schools, libraries, and cultural institutions. · Expand adult continuing education programs to prepare older people and retirees to work in needed occupations and volunteer areas. Use local schools as sites for lifelong learning. · Prepare minority, foreign-born, and non-English-speaking people for successful workforce participation and to feel they have a stake in the State's economic growth by: augmenting English-as-a-second-language in primary, secondary, and vocational school programs; using bilingual training to increase participation among skilled workers with language barriers; partnering with companies to develop mentor programs. · Training and technical assistance programs to help existing farmers maintain profitability in a difficult business and regulatory environment. · Empire Scholarships to provide tuition and reimbursement to high school graduates. Equivalent Grants to graduates of private New York colleges and universities. Paid internships at businesses through the Workforce Investment Act. Grants and loans to part-time students. Certified Worker programs delivered through secondary and technical schools. · Tuition reimbursement for workers who combine work and study in the area of mental retardation and developmental disabilities, as well as career ladder opportunities for direct care workers. · Suggested collaboration: Empire State Development and the State University of New York (SUNY) to: establish targeted, industry cluster-driven education, training, and employment hubs at selected community colleges and technical schools. · The missions of the 64 SUNY campuses will be updated to incorporate serving the training and retraining needs of the aging population. To help Stem Out-Migration of the State's prime workforce-age population: · An I Love New York passport given to young workers, providing low cost access to parks and recreational facilities. · Communities give young workers an enduring stake in their communities by involving them in developing the commercial and cultural amenities that make a community attractive. · To attract more skilled workers to communities: provide accessible transportation, childcare, and affordable housing. For general Workforce Planning: · Incorporate the changing demographic statistics into the State's economic forecast to accurately estimate changes in the labor force. · Draft legislation to overcome physical, technical, educational, and prejudicial barriers to work for immigrants, people with disabilities, and those receiving public assistance. · Suggested collaboration: The Office of Employee Relations and the Civil Service Department to: bring agencies together around specific workforce issues, including finding more creative approaches to the design of workplace benefit programs, making these programs tailored to a more diverse workforce, responding to the needs of the State's Career Mobility Offices, and recruitment and retention of personnel. CONCLUSION The state agencies were given a comparatively short period of time in which to analyze recently available trend projections, identify the major impacts of these trends, and suggest action steps; and each was held to reporting their deliberations in four pages. Within these constraints, their analyses produced an enormous amount of excellent and substantial information. In addition to the discussions by agencies on aging, immigration, migration, and diversity, six acknowledged the continuing changes in traditional family structures and configurations. This is a major trend in New York, affecting the dynamics of family and intergenerational interactions as well as the dynamics of the workplace. Growing numbers of nontraditional households and families include: those living alone because of divorce or spousal death; those never married; childless couples; elderly and nonelderly unmarried cohabiting couples; grandparents as custodial parents; three- and four- generation families in a household; lesbian and gay households; those married multiple times with multiple sets of extended family members, step children, and aging parents; households made up of groups of unrelated individuals; single mothers and single fathers with children; and elderly parents caring for elderly adult children with developmental and other disabilities. One agency mentioned the increasing changes in living and work patterns, specifically that more people will live in multiple residences and have multiple employers over their lifetimes. One agency stated that the implications of an aging population will have an impact on families as a whole and that the needs of the elderly (as well as other population groups) must be examined within the context of their communities as a whole. Another agency suggested that government could sustain ongoing appropriate attention to the impact of the impending demographic changes by including this area of consideration as an official part of the Executive Budget development process. The requirements of the Project 2015 deliberation and reporting activities compelled the individual agencies to zero in on specific population subgroups and discrete consequences and strategies. However, a reading of the 36 briefs as a unified policy document provides a stunning, sweeping framework for creating livable communities customized to the residents living in them, which, in turn, will be reflected in the viability of New York State as a whole. Project 2015 - State Agencies’ Briefs Office of Advocate for Persons with Disabilities Office for the Aging Department of Agriculture and Markets Office of Alcoholism and Substance Abuse Services Banking Department Division of the Budget Council on Children and Families Office of Children and Family Services Department of Civil Service Consumer Protection Board Department of Correctional Services Education Department Empire State Development Governor’s Office of Employee Relations Department of Environment al Conservation Office of General Services Department of Health Division of Housing and Community Renewal Insurance Department Department of Labor Office of Mental Health Office of Mental Retardation and Developmental Disabilities Department of Motor Vehic les Office of Parks, Recreation and Historic Preservation Public Service Commission Commission On Quality of Care for the Mentally Disabled Office of Real Property Services State Emergency Management Office Division of State Police State University of New York Department of State Department of Taxation and Finance Office for Technology Office of Temporary and Disability Assistance Department of Transportation Division of Veterans’ Affairs OFFICE OF ADVOCATE FOR PERSONS WITH DISABILITIES I. INTRODUCTION: INTERNAL SCAN The Office of Advocate for Persons with Disabilities (OAPwD) is a systems advocacy agency whose primary mission is to ensure that persons with all disabilities of all ages have an opportunity to be productive and participating citizens. The Advocate’s Office provides individuals with access to emerging technology, access to comprehensive information and referral to programs and services for individuals with disabilities and their families, and technical assistance and training on progressive legislation protecting the rights of persons with disabilities. As a systems change agency, the Advocate’s Office role is often as collaborator with other state agencies to ensure the needs of persons with disabilities are addressed in other agencies policies and provision of services. OAPwD is positioned to easily adapt to the changing demographic trends of New York State since many of the issues that affect persons with disabilities and their families impact the aging population as well. OAPwD has identified a variety of overarching policy issues that the agency is currently involved in, and is assessing the potential affect that the changing demographics could have on agency programs and service provision. A critical issue the agency is actively involved in is increasing the availability of accessible and affordable housing to individuals with disabilities. This need will continue to increase as a greater number of New Yorkers continue to age and experience limited functional abilities. In addition, implementation of the Olmstead decision, requiring states to allow persons to live in least restrictive environments, will place a greater demand on the current limited availability of accessible housing. OAPwD staff, in turn, will face a greater demand on their resources and time as increases on information requests, technical assistance and training occur as a result of Olmstead implementation. Another issue identified from the large volume of calls answered by information and referral staff is the lack of affordable prescription plans for persons with disabilities. Of the total 1200 information calls received per month by OAPwD, over 250 calls concern the lack of prescription coverage for persons who are disabled but under the age for the Elderly Prescription Insurance Coverage (EPIC) program. Demographic trends show that the population between 50-64 years of age is increasing rapidly which will provide a greater demand on OAPwD to assist in facilitating solutions to this problem. Employment and workforce issues will continue to be areas in which OAPwD will remain actively involved. OAPwD staff members have collaborated with other agencies’ stakeholders in Workforce Investment Act initiatives to assist people with disabilities obtain and maintain competitive employment. Changes in demographics have shown the need to expand opportunities for older persons re-entering the workforce. Legislative and legal staff currently provide outreach training on the rights of persons with disabilities under the Americans with Disabilities Act (ADA) and other civil rights legislation. As greater numbers of older Americans retain their jobs or re-enter the workforce, OAPwD will need to expand training programs to include age discrimination information and other relevant provisions under the Older Americans Act. OAPwD staff also foresee greater demand on training for assistive technology and worksite modifications for older employees. OAPwD anticipates that the changing demographics will foster an increase in demand of services provided by staff. This is a concern given that OAPwD is a small agency of fewer than 20 staff employees, 35% of which are over the age of fifty. There is a concern that within the next five to seven years staff shortages could be an obstacle in supplying services as demand increases. OAPwD staff persons are in the process of assessing current program operations and have begun to adapt service provision in anticipation of a greater demand on services. For example, the OAPwD website has been expanded to provide information on disability-related issues. OAPwD staff are working to put a fully operational Self Advocacy Training and Information and Referral Network (SATIRN) database of resources on the website. This will enable consumers to search for disability-related resources without having to call the toll-free number to speak to an information and referral specialist. Additionally, OAPwD’s assistive technology project, Technology Related Assistance for Individuals with Disabilities (TRAID), is increasingly utilizing the twelve regional centers located across the state as means to provide outreach and awareness training to seniors, program staff, and caregivers regarding the benefits of assistive technology to maintain independence. As an alternative to compiling a quarterly newsletter that tended to be labor intensive, OAPwD has increasingly used group e-mails and listservs as a way to get timely information out on disability-related legislation and issues to consumers in communities across New York State. However, OAPwD staff need to explore expanding group mailing lists to include a wider variety of groups and address the issues of non- English speaking consumers. II. PRIORITY ISSUE AREAS 1. Affordable/Accessible Housing: Access to affordable, universally designed housing was the highest priority identified by OAPwD staff. As demographic trends show, increasing numbers of New Yorkers are aging, and long term care, ho using, and community based service options need to be developed to adapt to this trend. Staff discussed that OAPwD’s role of collaborator may have limited impact since the agency is not directly involved in developing housing options. However, staff continue to provide valuable input through interagency workgroups. Staff determined that the cost to implement new programs would be high, however, costs would be even higher if planning for housing and community based services is not done. Pre-planning for a continuum of care will ultimately reduce costs for all New Yorkers. 2. Affordable Prescription Coverage: OAPwD continues to receive a large volume of calls regarding the lack of affordable prescription coverage. Although the Advocate’s Office has had little impact in changing the system thus far, agency staff determined that this problem will persist if federal/state systems don’t change eligibility of existing programs. This issue could be more costly in the end if action is not taken to reform current systems. 3. Employment and Workforce Issues: The third overarching issue identified was the area of employment and changing workforce. OAPwD has been involved in employment issues for persons with disabilities since the inception of the office. Staff determined that this was a critical area to continue focus, given recent legislation that promotes work incentives for persons with disabilities. Staff will continue to be active involved in interagency collaborations, with a greater emphasis on expanding outreach to older workers to accommodate needs in the workplace. III. ACTIONS AND RESULTS Priority Issue #1: Affordable and Accessible Housing Actions: • OAPwD will continue collaboration with the Department of State, Governor’s Office, and other stakeholders to ensure building codes address accessibility and incorporate universal design elements. • OAPwD will continue to provide training and technical assistance to local building inspectors on the accessibility requirements of the state building code. • OAPwD will continue to collaborate in interagency efforts to explore innovative housing options that enable persons with disabilities and elderly persons to rent or purchase affordable/accessible housing, as well as assist in identifying federal and private funding sources for home modifications that would allow individuals to stay in their own homes. Results: The action steps will result in the development of programs that will increase availability of housing options that are affordable and accessible to elderly individuals and persons with disabilities in New York State. Housing provided in the least restrictive environment, with community based support services will result in a cost effective and quality means to address the needs of an aging population. Priority Issue #2: Affordable Prescription Coverage Actions: • OAPwD staff will research current federal, state, and private prescription drug plans including, but not limited to, Medicare and the Elderly Prescription Insurance Coverage (EPIC). • Staff will convene an interagency workgroup with key stakeholders to compare eligibility requirements and coverage of various prescription programs and identify programs that currently include coverage for persons with disabilities under 65 years old, as well as those with the potential to be adapted to include this population. • OAPwD staff will work with the Governor’s office in Washington, D.C. and partners in other states to explore the feasibility of changing eligibility to include persons with disabilities under 65 years old, and expanding federal programs such as Medicare to include prescription drug coverage. Results: Affordable prescription coverage will be available to persons with disabilities with limited income under the age of 65 years old. Priority Issue #3: Employment and Workforce Issues Actions: • OAPwD staff will continue to collaborate with the Department of Labor and other stakeholders on Workforce Investment Act initiatives and work to expand opportunities for older workers who want to remain employed or re-enter the workforce. • OAPwD staff will continue to work through an interagency partnership to assist One Stop Centers to identify accessibility solutions in the workplace, and provide ongoing technical assistance to employment staff, potent ial employers, and persons with disabilities seeking to maintain employment, initially enter, or re-enter the workforce. • OAPwD legal staff will expand current statewide training on the rights of persons with disabilities under the Americans with Disabilities Act (ADA) and other civil rights legislation to include information on age discrimination and other protections under the Older Americans Act. Results: The action steps taken will result in an increase in employment opportunities for older persons seeking to maintain employment, enter, or re-enter the workforce. OFFICE FOR THE AGING I. INTRODUCTION: INTERNAL SCAN The mission of the New York State Office for the Aging (NYSOFA) and its network of local area agencies on aging (AAAs) is to provide and advocate for services that allow older people to maintain their quality of life by enabling them to remain independent for as long as possible. All older people and their families are potential customers of NYSOFA and the AAAs. The impending demographic changes will result in the state’s older population growing at a much faster rate than the rest of the population. The most rapid growth will occur among the oldest of the old, older women, minorities and older people living alone. The following key points highlight other selected demographic trends that will impact the agency and the AAAs. • The number of informal caregivers available to support elders is decreasing. • Many older New Yorkers are relatively independent, but large numbers of elderly are at risk due to a variety of economic, health and social factors. • The subgroups of the elderly most at risk are the same subgroups experiencing the fastest rates of growth. What follows is a brief look at issue areas that affect an older person’s independence and govern the policy and program direction of NYSOFA. Long Term Care -Elders needing long term care should be able to gain access to the services they need in a timely and reliable manner. They should have choices that meet their preferences, the security of knowing that the care will be affordable, and feel confident that they will be able to make a smooth transition to other forms of long term care whenever appropriate. NYSOFA needs to work closely with other state agencies to address the increased demand for more long term care services that accommodate choice by emphasizing appropriate community-based alternatives to institutionalized care. Informal Caregiving -Eighty percent of personal care and assistance to the elderly is provided by informal caregivers, that is family, friends and neighbors who help older people remain in their communities. At the same time, the number of grandparents caring for children at risk is increasing dramatically. The ratio of persons age 85+ to persons age 50-64 will change from 11:1 in 1990 to 6:1 in 2030. The strength or weakness of the frail person’s informal support system is a better predictor of nursing home placement than the older person’s physical or mental status. Sustaining informal caregivers is a key to preventing dramatic increases in long term care costs and maintaining a high quality of life. A critical issue in doing so will be the diminished availability of informal supports to meet increased demand for caregiver services due to smaller sized families and greater geographic dispersion of family members. OFFICE FOR THE AGING Housing - Affordable and secure housing that allows individuals the opportunity to age in place in one’s own community is one of the greatest problems older New Yorkers face. The housing needs of the elderly are closely related to inadequate income, changes in family structure, health, threats of personal safety from crime, and from architectural and structural inadequacies. Changes in these factors, and an impending increase in demand, mak