Forging a Trail to the Top: Strategic Planning for Respite Care in Texas Nicole Hawk, LMSW and Martha Diase, Ph.D.
Overview • Background to the development of the strategic plan Gathering caregiver data in Texas State legislative direction and funding Federal Lifespan Respite Grants direction and funding Texas Respite Coalition composition and activities
Overview • Drafting of the strategic plan Process Respite summit and focus groups Plan elements • Post-plan activities Texas Health and Human Services transformation
Background: Caregivers in Texas • The first step in strategic planning for respite is to gather data to understand: o How many caregivers are there in our state? o Who are they? o Where are they? o What are their needs? o Where is the greatest need?
Background: Caregivers in Texas • Obtain overview of state demographics • Literature review • State government actions to gather data: o Behavioral Risk Factor Surveillance System (BRFSS) Data o Interviews with individuals calling in to Area Agencies on Aging (AAAs) and Aging and Disability Resource Centers (ADRCs)
Background: Caregivers in Texas Total Estimated Population by County, Texas, 2015 Total Population 2015 = 27,695,284 Lipscomb Ochiltree Hansford Dallam Sherman Moore Roberts Hartley Hutchinson Hemphill Gray 112 - 10,000 Oldham Potter Carson Wheeler Armstrong Collingsworth Deaf Smith Randall Donley 10,001 - 50,000 Parmer Castro Childress Swisher Hall Briscoe Hardeman 50,001 - 100,000 Wilbarger Cottle Bailey Lamb Floyd Motley Hale Foard Clay Wichita Montague Grayson Dickens Lubbock Red Lamar Archer King Knox Baylor River 100,001 - 500,000 Cochran Fannin Cooke Crosby Bowie Hockley Stonewall Delta Titus Haskell Young Jack Wise Denton Lynn Collin Cass Yoakum Terry Garza Kent Hunt Franklin Throckmorton Morris Hopkins 500,001 - 4,538,028 Rockwall Camp Shackelford Tarrant Borden Scurry Jones Rains Wood Palo Dawson Parker Marion Gaines Upshur Fisher Dallas Stephens Pinto Van Harrison Kaufman Hood Zandt Nolan Johnson Taylor Eastland Erath Smith Gregg Ellis Andrews Martin Howard Mitchell Somervell Henderson Comanche Panola Callahan Rusk Glasscock Hill Navarro Bosque Coke El Paso Midland Runnels Anderson Loving Winkler Ector Cherokee Shelby NH Brown Sterling Hamilton Freestone Coleman Nacogdoches McLennan Ward Mills Hudspeth Crane Tom San NH Culberson Black Upton Coryell Reagan Concho Houston Irion Green Falls Leon Augustine Reeves San Lampasas McCulloch Angelina Trinity Saba Bell Robertson Other 11% Madison Newton Burnet Polk Schleicher Menard Crockett Jeff Pecos Milam Tyler Mason Walker Llano Williamson 6% Brazos Davis Jasper San Grimes Kimble Burleson Sutton Jacinto Travis Gillespie Lee Montgomery Hardin Blanco Washington Terrell Orange Kerr Hays Bastrop Liberty Edwards Presidio Kendall Val Waller Jefferson Austin Caldwell Fayette Harris Real Brewster Verde Comal Bandera Chambers Colorado Guadalupe Fort NH Bexar Gonzales Bend Galveston Uvalde Medina Kinney Lavaca Wharton Wilson White Brazoria DeWitt Zavala Hispanic Jackson Maverick Karnes Frio 45% Matagorda Atascosa Victoria Goliad or Live Calhoun Dimmit Bee La Salle Oak Refugio Latino McMullen Aransas San Patricio 38% Jim Webb Nueces Duval Wells Kleberg Jim Brooks Hogg Zapata Kenedy Starr Willacy Hidalgo Cameron Source: Texas Demographic Center population projections for 2015
Background: Caregivers in Texas Texas White (non-Hispanic) and Hispanic Populations by Age, 2014 250,000 White (non- 200,000 Hispanic) 150,000 Population 100,000 50,000 0 7 Age Source: U.S. Census Bureau 2010 Decennial Census, SF1
Background: Caregivers in Texas Estimated number in 2013: 3.4 million Source: AARP Public Policy Institute, Valuing the Invaluable: 2015 Update, July 2015.
Background: Caregivers in Texas Estimated number in 2013: 3.4 million Source: AARP Public Policy Institute, Valuing the Invaluable: 2015 Update, July 2015.
Background: Caregivers in Texas Estimated number in 2013: 3.4 million Source: AARP Public Policy Institute, Valuing the Invaluable: 2015 Update, July 2015.
Background: Caregivers in Texas Source: AARP Public Policy Institute, Valuing the Invaluable: 2015 Update, July 2015.
Background: Caregivers in Texas Texas caregivers provide an estimated 3.1 billion hours of uncompensated care annually – an estimated economic value of $36 billion. Source: AARP Public Policy Institute, Valuing the Invaluable: 2015 Update, July 2015.
Background: Caregivers in Texas Lipscomb Ochiltree Hansford Data from the 2010 Dallam Sherman Moore Roberts Hartley Hutchinson Behavioral Risk Factor Hemphill Gray Oldham Potter Carson Wheeler Armstrong Collingsworth Deaf Surveillance System Smith Randall Donley Parmer Castro Childress Swisher Hall Briscoe Hardeman Survey: 18% of adults Wilbarger Cottle Bailey Lamb Floyd Motley Hale Foard Clay Wichita Montague Grayson Dickens Lubbock Red identified as caregivers Lamar Baylor Archer River Cochran King Knox Fannin Cooke Crosby Bowie Hockley Stonewall Delta Titus Haskell Young Jack Wise Denton Lynn Collin Cass Yoakum Terry Garza Kent Hunt Franklin Throckmorton Morris Hopkins Rockwall Camp Shackelford Tarrant Borden Scurry Jones Rains Wood Palo Dawson Parker Marion Gaines Upshur Fisher Dallas Stephens Pinto Van Harrison Kaufman Hood Zandt Nolan Taylor Johnson Smith Gregg Eastland Erath Ellis Andrews Martin Howard Mitchell Somervell Henderson Panola Callahan Comanche Rusk Glasscock Hill Navarro Bosque Coke El Paso Midland Runnels Anderson Loving Winkler Ector Cherokee Shelby Brown Sterling Hamilton Freestone Coleman Nacogdoches Ward McLennan Hudspeth Tom Mills Crane Culberson San Upton Coryell Reagan Houston Green Concho Irion Falls Leon Augustine San Reeves Lampasas McCulloch Angelina Trinity Saba Bell Robertson Madison Newton Burnet Polk Schleicher Menard Crockett Jeff Pecos Milam Tyler Mason Walker Llano Williamson Brazos Davis Jasper San Grimes Kimble Burleson Sutton Jacinto Travis Gillespie Hardin Lee Montgomery Blanco Washington Terrell Orange Bastrop Kerr Hays Liberty Edwards Presidio Kendall Val Waller Austin Jefferson Fayette Harris Real Caldwell Brewster Verde Comal Bandera Chambers Colorado Guadalupe Fort Bexar Gonzales Bend Galveston Kinney Uvalde Medina Lavaca Wharton Wilson Brazoria DeWitt Zavala Jackson Maverick Karnes Frio Atascosa Matagorda Victoria Goliad Live Calhoun Dimmit Bee La Salle Oak Refugio McMullen Aransas San Patricio Webb Jim Nueces Duval Wells Kleberg Jim Brooks Hogg Zapata Kenedy Starr Willacy Hidalgo Cameron Sources: Texas Demographic Center, 2016; Behavioral Risk Factor Surveillance System, Texas Caregiver Module, 2010
Background: Caregivers in Texas Gender Female 58% Male 42% Age 18 to 29 12% 30 to 44 31% 45 to 64 41% 65+ 16% Race/Ethnicity White 65% Hispanic 23% Black 8% Other non-Hispanic 4% Source: Behavioral Risk Factor Surveillance System, Texas Caregiver Module, 2010
Background: Caregivers in Texas Care recipient Percent Parent 32% Spouse 14% Parent-in law 11% Grandparent 8% Child 8% Sibling 4% Grandchild >1% Other relative 6% Non-relative 17% Source: Behavioral Risk Factor Surveillance System, Texas Caregiver Module, 2010
Background: Caregivers in Texas Income </= $25,000 yr Percent Black 45% Hispanic 40% White 20% -------------------------------- ---------- Female 30% Male 23% Income >/= $75,000 yr Percent White 48% Hispanic 19% Black 10% -------------------------------- ---------- Male 46% Female 33% Source: Behavioral Risk Factor Surveillance System, Texas Caregiver Module, 2010
Background: Caregivers in Texas Income Income Income Income < or = $25,001- $50,001- > or = Indicator $25,000 <$50,000 <$75,000 $75,000 Physical health fair/poor 45% 14% 10% 6% Life is limited due to physical, 39% 29% 20% 17% mental, or emotional problems Physical health not good five or 44% 25% 17% 7% more of past 30 days Mental health not good five or more 54% 34% 22% 20% of past 30 days Physical or mental problems kept 33% 16% 7% 7% caregiver from usual activities Source: Behavioral Risk Factor Surveillance System, Texas Caregiver Module, 2010
Background: Caregivers in Texas White Hispanic Black Indicator Physical health good/ 56% 40% 27% very good Physical or mental problems prevented 14% 14% 25% usual activities Source: Behavioral Risk Factor Surveillance System, Texas Caregiver Module, 2010
Background: Caregivers in Texas Number of Hours per Week % Caregivers Providing Care 1 to 9 hours 42% 10 to 19 hours 13% 20 to 29 hours 12% 30 to 39 hours 4% 40 to 49 hours 5% 50 hours or more 11% Unspecified 13% Total 100% Number of Hours per Week % Male % Female Providing Care 1 to 9 hours 53% 35% 10+ hours 38% 50% Unspecified 9% 15% Source: Behavioral Risk Factor Surveillance System, Texas Caregiver Module, 2010
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