ALAMANCE An Overview of the COUNTY Aging Population & Individuals with Disabilities Publication Date: June 2018 Alamance County Letter from the Piedmont Triad Regional Council Area Agency on Aging Director ........... iii Introduction ................................................................................................................................... 1 Health Care.................................................................................................................................... 2 Health Outcomes ......................................................................................................................... 3 Chronic Disease .......................................................................................................................... 4 Health Care Cost ......................................................................................................................... 5 Medicare ..................................................................................................................................... 5 Health Care Facilities .................................................................................................................. 6 Long-Term Care Facilities .......................................................................................................... 8 Agencies Serving Older Adults and Individuals with Disabilities Directory ........................... 10 Demographics of the Total Population ..................................................................................... 12 Past and Present Total Population ............................................................................................ 12 Projected Total Population ........................................................................................................ 12 Demographics of the Older Adult Population .......................................................................... 13 Past and Present Older Adult Population .................................................................................. 13 Projected Older Adult Population ............................................................................................. 14 Working Adults ......................................................................................................................... 15 Piedmont Triad Region Growth ................................................................................................ 16 Population Density .................................................................................................................... 17 Household Types ...................................................................................................................... 19 Race & Ethnicity ....................................................................................................................... 20 Income ...................................................................................................................................... 22 Health Insurance ....................................................................................................................... 23 Vehicle Access .......................................................................................................................... 24 Language ................................................................................................................................... 26 Nutrition and Food Insecurity ................................................................................................... 27 Individuals with Disabilities ..................................................................................................... 27 Grandparent Caregivers ............................................................................................................ 28 Family Caregivers ..................................................................................................................... 28 References .................................................................................................................................... 29 P a g e | i Alamance County Figure 1: County Land Cover ......................................................................................................... 1 Figure 2: Total Population (1990-2016) ....................................................................................... 12 Figure 3: Projected Total Population Change (2016-2037) ......................................................... 13 Figure 4: Older Adult Population (1990-2016) ............................................................................ 13 Figure 5: Projected Older Adult Population Change (2016-2037) ............................................... 14 Figure 6: Population by Age Group (2000-2037) ......................................................................... 14 Figure 7: Ratio of Working Adults to Older Adults (1990-2035) ................................................ 15 Figure 8: Living Arrangements of the Population Age 65+ (2016) ............................................. 19 Figure 9: Income Benchmark Comparison ................................................................................... 22 Table 1: Population Overview (2016 & 2036) ............................................................................... 1 Table 2: Chronic Conditions of the Fee-for-service Population Ages 65+ (2015) ......................... 4 Table 3: County Expenditure by Service Category for Clients 60+ (FY16-17) ............................. 5 Table 4: Medicare Enrollment (2013-2017) ................................................................................... 5 Table 5: Health Care Professionals (2017) ..................................................................................... 6 Table 6: Health Care Facilities Directory ....................................................................................... 7 Table 7: Long-Term Care Facilities & Beds in Alamance County ................................................ 8 Table 8: Provider Agencies Directory .......................................................................................... 11 Table 9: Total Population Change (1990-2016) ........................................................................... 12 Table 10: Older Adult Population Change (1990-2016)............................................................... 14 Table 11: Percent Growth (2015-2035) ........................................................................................ 16 Table 12: Older Adult Population in Rural Areas (2016) ............................................................. 19 Table 13: Population by Race & Ethnicity (2016)........................................................................ 20 Table 14: 2016 Poverty Guidelines............................................................................................... 22 Table 15: Health Insurance Coverage (2016) ............................................................................... 23 Table 16: Disability by Type (2016) ............................................................................................. 27 Table 17: Grandparent Caregivers (2016) .................................................................................... 28 Map 1: 2018 NC Health Factors Map ............................................................................................. 3 Map 2: 2018 NC Health Outcomes Map ........................................................................................ 3 Map 3: Health Care Facilities ......................................................................................................... 7 Map 4: Long-Term Care Facilities ................................................................................................. 9 Map 5: Provider Agencies ............................................................................................................ 10 Map 6: Population Density of Older Adults (60 Year and Older), 2016 by Block group ............ 17 Map 7: Density of Older Adults in Rural, Suburban and Urban Areas (2016) ............................ 18 Map 8: Percent Minority of the Total Population by Block Group (2016) .................................. 21 Map 9: Older Adult Population without Access to a Vehicle (2016) ........................................... 24 Map 10: Transit Routes in Alamance County (2017) ................................................................... 25 Map 11: Older Adult Population: Speak a Language Other than English (2016) ........................ 26 ii | P a g e Alamance County Letter from the Piedmont Triad Regional Council Area Agency on Aging Director Health Care, Behavioral Health, and Human Services have undergone tremendous change in recent years. The Affordable Care Act (ACA), Medicare Access and CHIP Reauthorization Act (MACRA), the imminent transition from traditional Medicaid to Managed Care, the expected change of the Community Care Network and transformation in NC Department of Health and Human Services personnel, policies, and processes has significantly impacted service delivery systems. The mergers and acquisitions ongoing in Piedmont healthcare, bring new energy and potential to the industry. Other changes in Community Based Organizations (CBO) and the new Veterans Administration medical facility in Kernersville are adding potential and capacity to the regional healthcare system. While these reorganizations