Show-Me State has begun to make plans for its aging population

Time marches on.

In just a little more than a decade, seniors will make up a quarter of Missouri’s population.

It’s a concern for the state, which is already short of providing the ideal volume of services seniors require, according to Mindy Ulstad, chief of the Missouri Bureau of Seniors Program.

So people at the Missouri Department of Health and Senior Services (DHSS) approached Gov. Mike Parson’s Office about developing a state aging plan.

“Missouri, like the rest of the nation is aging. We have 22.88 percent of our population is seniors. They expect by 2034 for that population to grow to 25 percent,” Ulstad said. “That will be the first time in our history that older adults outnumber children.”

The population range is reversing. In the past, youths outnumbered seniors. The bureau considers people seniors who are 60 and older.

“As time goes on, they expect for older adults to greatly outnumber children,” she said. “We know now there aren’t enough services for the older adults we have. So if we don’t start preparing, we’re going to be playing catch-up, and we don’t want to do that. So we’re preparing now, while we can.”

Missouri Senior Report points out that the age of the Baby Boomers reaching seniority was much-anticipated. The report doesn’t consider people seniors until they are 65. So data are different than the Bureau of Seniors Program.

The first of the boomers reached 65 years old in 2011, according to the Senior Report. It points to data from the U.S. Census Bureau, which has documented the country’s aging population.

“Since (2011), there’s been a rapid increase in 65-and-older population across the United States, which grew by over a third since 2010,” the report states. “Due to changing demographics in all age groups, those turning 65 now are concerned about quality of life, continuing or encore careers, and physical activity.”

Concerns of seniors are often related to health care, social isolation and assistance with daily living, it stated.

Data within the reports show that in Cole County in 2018, there were 11,811 residents ages 65 and older, about 15.4 percent of the population. That figure grew to 12,096 (15.3 percent) in 2020. It is expected to reach 14,064 (17.2 percent) in 2025 and 15,684 (18.8 percent) in 2030.

Governor sets team in motion

DHSS staff looked at five other states that have already completed their own aging plans. Two — Texas and California — inspired DHSS to approach the governor about creating a plan for Missouri.

The Missouri governor agreed now is the time to make plans for the aging population.

Parson’s first executive order for 2023 was to create a Missourians Aging with Dignity Initiative. He pointed out that Missouri already has 1.1 million residents who are 60 or older. He directed all his departments’ executives to participate in the project. Each of the state agencies should strive to ensure programming that includes older Missourians and adults with disabilities when possible, and to ensure they have safe and healthy environments that can help them avoid institutionalization.

As part of the initiative, Parson directed the development of an advisory council to develop a Missouri Master Plan on Aging.

That council, he directed, will include a member of each state agency and stakeholders, including a cross-section of groups concerned with aging in place, groups supporting people with disabilities, local government, health care providers, and health research institutions and associations.

The council is to review and assess current aging services in Missouri, coordinate at least 10 listening sessions with stakeholders in regions defined by Area Agencies on Aging (including two statewide listening sessions), complete a statewide senior citizen and adults with disabilities needs assessment, establish priorities for each state agency and develop the state’s master plan on aging.

California’s plan, for example, is considered a blueprint for state and local governments and the private sector as the state’s demographics change.

“This is not a plan simply for today’s older adults,” the plan’s website states. “Instead, it is a blueprint for aging across the lifespan.”

It calls on California communities to build a state for all ages and abilities — including older residents navigating the second halves of their lives, younger generations who may expect to live longer than their elders, and the communities surrounding adults or people with disabilities.

Missouri’s Master Plan on Aging Advisory Council has a web page at Members of the council are listed there. The council met for the first time (virtually) Friday morning. Led by Laura Newland, director of Alvarez and Marcel Public Sector Services, LLC, a consulting firm based in Washington, D.C., the council began to workshop how it intends to go about developing the master plan. The governor set Dec. 31, 2025, as the deadline for its development.

Newland told more than 40 participants in the meeting that they’d be holding a conversation about how they might be able to age with dignity. She and acting DHSS Director Paula Nickelson said they embraced a lesson from Melanie Highland — that aging is so cool, everyone is doing it.

Highland, the director of Missouri’s Division of Senior and Disability Services, acknowledged that many in the meeting probably didn’t know exactly why they were there.

But aging touches all the agencies in Missouri. She said it is certain that any of the agencies represented Friday is struggling to fill vacant positions. Many Missourians have left the workforce, and the agencies could possibly fill them with older workers.

Beside that, questions arise about whether communities are designed with older adults in mind. Also, seniors are targets for criminals looking to exploit them. And questions arise about whether state parks are designed with aging populations in mind.

“We want your ideas and solutions to help meet the needs,” Highland said. “We need to know what partners and organizations we need, so this plan does not sit on a shelf and collect dust.”

The master plan on aging must be a report that is going to be implemented, Newland said.

“We spend a lot of time on reports, most of which are only read by the people who put them together,” she said. “We want the master plan to be a community effort. It is a plan, but also a conversation that we will be continuing throughout the year.”

Aging is not something that only happens to other people, Newland pointed out.

“None of our systems are actually built for people who are growing older,” she said.

She added the plan needs to include people aging within the prison system. That it needs to include babies, teenagers and everyone else.

“Think about what’s important to you now. Think about what you think is going to be important to you in the future — as a caregiver, as a person raising children,” Newland said. “Think about … I wish the community had better support in this area. Or, I think the community is doing a better job in this area.

“As our culture changes, this is something we have to think about. How do we make sure that as we age, the system adapts to who we are?”

She challenged the group to think about how it could attain equity, access and choice for everybody in the state.

When people actually think through those concepts, she said, it becomes obvious to them that it is very complicated to reach all three for everybody.

Community engagement is going to drive the new plan, Newland said. She warned the group not to just give lip-service to ideas surrounding the plan. For example, she said, “a lot of times when states talk about stakeholder engagement, it’s to check off a box.” But stakeholder engagement is what is going to create the plan.

The council is starting out with seven subcommittees.

They are to be Transportation and Mobility, Housing and Aging in Place, Whole-Person Health, Employment and Volunteerism, Safety and Security, Family Caregiving and Long-Term Services and Supports.

Where to begin

Ulstad said the council wants to start by doing a current needs assessment.

It will look into who is already doing those needs assessments, such as hospitals, community action centers, the Area Agencies on Aging and the Centers for Independent Living.

“We want to see what they are seeing. What needs are they identifying?” Ulstad asked. “We then want to do a scan of the state departments, and the programs they are currently providing. We want to see where there are overlaps and where there are gaps in services. We want to know how they are preparing for those aging populations.”

Historically, council organizers know, social services agencies like DHSS, Department of Mental Health and Department of Social Services serve the older adult population fairly regularly, she said. But the other departments don’t necessarily do that. So the council wants to prepare them to think about the aging population.

“That’ll be another next step,” Ulstad said.

A next major step is to ask state government for funding, she said.

“We want to procure a needs assessment so we can do a survey statewide,” she said. “And we want to get a lot of input.”

They are seeking information that can be validated.

The council will be doing a great deal of outreach across the state to get people to complete that needs assessment, Ulstad continued, because it wants the input.

“We know what we know from our aging network — the people that we serve already,” Ulstad said. “But not the people that we don’t serve. Not the younger folks that are aging. So we need to know what they think they’re going to need to be able to age in Missouri. That’s going to be a huge part of that too.”

Then the council will conduct 10 in-person town halls across the state — probably in 2024.

The council will task organizations with doing what they have expertise in — such as the Missouri Hospital Association (MHA), which is going to be represented on the advisory counsel. So the council will ask MHA to help it gather information from hospitals.

“We’re trying to get as much input from Missourians as we can,” Ulstad said. “This truly is their plan. We’re coordinating it, but it truly is their plan. That’s what we want it to be.

“We think we know what needs there are, but until we actually hear from everyone, we can’t lay that out. Those are kind of the big pieces that we’re planning.”

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