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State Profile: Missouri Selected State Background Characteristics Population Total Pop. (millions) 5.8 293.7 Pop. 60+ (thousands) 1,029.2 48,883.4 % 60+ 17.9 16.6 National Ranking 60+ 14 % White (60+) 90.1 81.4 % African American (60+) 7.5 8.5 % Hispanic/Latino (60+) 0.8 6.1 % Asian (60+) 0.7 2.9 % Native Hawaiian/ Pacific Islanders (60+) % American Indian/ Alaska Native (60+) % Two or More Races (60+) 0.0 0.1 0.3 0.5 0.6 0.6 Pop. 65+ (thousands) 765.7 36,294.0 % Pop. 65+ 13.3 12.4 National Ranking 65+ 15 Pop. 85+ (thousands) 100.4 4,859.6 % Pop. 85 1.7 1.7 National Ranking 85+ 19 Economic Indicators Per Capita Income $30,516 $33,041 Median Household Income $43,988 $44,473 Total State Expenditures Per Capita $3,116 $4,009 % Pop. 65+ Below Poverty 9.5 9.4 % Pop. 50+ Who Did t Visit Doctor Due to Cost 9.4 8.1 Socio-Demographics Average Household Size 2.4 2.6 Average Family Size 3.0 3.1 % Pop. in Rural Area 27.0 16.9 Households with Persons 65+ (millions) % Persons Age 65+ Living Alone 0.53 25.2 32.1 29.8 % Pop. 65+ in Major Cities 24.6 40.1 % Households with Internet Access Informal Caregivers 53.0 54.7 # of Caregivers 590,000 34,000,000 # of Caregiving Hours (millions) Value of Caregiving (millions) % Grandparents Living with Grandchildren % with Responsibility for the Grandchildren 640 36,720 $5,900 $350,000 2.5 3.4 1.3 1.4 Where to Call to Arrange Help in the Home for Elderly Relatives or Friends % Relative or Friend 15.1 21.5 % Self 20.6 17.2 % Medical Support 24.4 21.6 % Religious Support 0.2 0.4 % Area Agency on Aging 2.1 2.0 % Other 3.4 4.5 % Don t Know 34.2 32.7 Updated vember 2007. Data sources for characteristics are available at http://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=1185 1

Selected State Background Characteristics Long-Term Care Medicaid Spending on Long-Term Care % Spending on Nursing % Spending on Home Health & Personal Care # of Certified Nursing % of Certified with Family Councils # of Certified Nursing Facility Beds (thousands) Certified Nursing Facility Occupancy Rate Average Cost Per Day in a Nursing Home Average Assisted Living Monthly Cost Average Daily Cost for Adult Day Average Hourly Cost for Home Health Care Average Hourly Cost for Personal/Home Care Nursing Facility Residents as % of 65+ Pop. # of Licensed Adult Day 46.2 46.0 37.3 37.3 507 15,209 32.3 43.2 47.4 1,579.9 74.4 85.5 $149 $213 $2,849 $2,969 $64 $61 $17.50 $19 $17 $18 4.6 3.8 59 3,407 Care Receivers % Pop. 21-64 Years w/disability 13.7 12.1 % Pop. 65+ w/disability 41.0 39.6 % 65+ by Type of Disability Sensory 16.6 16.0 Physical 31.6 30.2 Self-Care 8.4 9.3 Mental 10.9 10.9 Difficulty Going Outside Home 15.5 16.3 Medicare Prescription Drug Plans # of Companies Offering PDPs 16 # of PDP 41 # of Companies Offering Medicare Advantage Drug Plans 11 # of Home Health Aides 10,350 751,480 Median Hourly Wage Certified Nursing Assistant $9.40 $10.67 Home Health Aide $8.39 $9.34 Personal Care/Home Care Aide $8.24 $8.54 Updated vember 2007. Data sources for characteristics are available at http://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=1185 2

State System of Home and Community-Based (HCBS) Legislation Enacted Within the Last Three Years (2001-2003) that Addresses Family Caregiving Issues Task Force or Commission Specifically to Examine Family Caregiver Issues Name of Task Force: Single Point of Entry for State System of HCBS Single Point of Entry Includes Access to State s Caregiver Support Program Uniform Assessment Tool for All HCBS Programs for the Elderly and Adults with Disabilities Assessment Includes Caregiver Component At Least One State Program with Consumer-Directed Option for Family Caregivers ne Lack of agreement Lack of agreement State Program Information Administrative Structure Administering State Agency Organizational Unit or Person Specifically Designated for Caregiving Programs or Activities Department of Health & Senior Geographic Region Served Statewide Statewide Local Program Administrative AAA Medicaid agency Responsibility Department of Health & Senior Funding & Caseload Major Sources of Program Funding Client contribution OAA, Title III-E Medicaid HCBS waiver State general fund Title XX FY 2001 Expenditures $2,337,876 $17,883,132 (respite only) FY 2002 Expenditures $2,666,197 $21,903,300 (respite only) FY 2003 Expenditures $2,920,908 $80,630,401 (total waiver) FY 2001 A/D Waiver Respite 4,525 Participants FY 2002 A/D Waiver Respite Participants 5,007 Francisco, CA: Family Caregiver Alliance. 3

Eligibility Caregiver Age Requirement 18+ 63+ Care Receiver Age Requirement 60+ 63+ Care Receiver Functional Status OAA guidelines Nursing home level of care Requirement Client Population Both family caregiver and care receiver Care receiver Assessment Program Assesses Both family caregiver and care Care receiver receiver Uniform Assessment Tool Includes Caregiver Assessment Areas Addressed by Caregiver Assessment All Caregivers Eligible for Program Have Access to Same Package of Provided Specifically to Family Caregivers Types of Respite Care Offered Assistive technology Care mgt. Cash grant Consum. supplies Consumer ehealth applications Counseling Educ. & training Emerg. response Family consult. Family meetings Home modification/repairs Info. & assistance Legal and/or financial consultation Respite care Support groups Transportation Other Adult day svcs. In-home Weekend/camp response Caregiver Must Live with Care Receiver to Receive Respite Respite Cap 16-20 hours/month cap Uniform Respite Cap Across Program Sites Entity that Formulates the Respite Administering local agency Cap Homemaker/chore/personal care Respite care Adult day svcs. In-home Overnight Francisco, CA: Family Caregiver Alliance. 4

Consumer Direction Consumer-Directed Options Family Members Can Be Paid to Provide Care Types of Families Can Be Paid to Provide A voucher or budget for respite and/or supplemental services Direct payments to family members for the purchase of goods or services Families have a choice of respite providers Respite care ne Francisco, CA: Family Caregiver Alliance. 5