One in three Orange County residents will be older adults in the next few decades, a demographic change that county officials are struggling to address. 

Those changes are expected to play out not only in the county’s urban core in cities like Santa Ana but in South County cities like Rancho Santa Margarita. 

Later this month, county officials will be releasing a Master Plan for Aging – a road map of sorts for public investments to address the challenges facing older adults living in Orange County. 

OC’s grand jury concluded earlier this summer that county leaders have failed to prioritize the wellbeing of older adults, pointing to inadequate funding and staffing for the Office on Aging in their most recent report.

The gap is triggering an intense debate over the best way forward.

“You can say all you want, that we need to provide brain health, better exercise habits, better nutrition, but who’s going to pay for it?,” said Jim McAleer, Chief Executive Officer of Alzheimer’s Orange County in an interview last month. 

“Unless that plan immediately has some financial backing from whatever source,” McAleer said, “then it’ll just be talk.”

“To age is very expensive, so we know that Medicare, which is the primary insurer for people over 65, doesn’t cover very basic things, but things that do happen to be expensive. So for example, hearing aids and dental care are not covered,” said Dr. Sonia Sehgal, a UCI Health internist specializing in care for older adults in an interview last month. 

Immediately at issue for county officials is how to best structure their public Office on Aging – currently operating under a $36 million annual budget. 

Grand jurors are suggesting making the department its own agency while county officials want it to remain under OC Community Resources. 

“When we talk about creating this as a separate office, or taking the Office on Aging and making them their own entity with staff, you guys did sit down and have a discussion about it and that was good to hear, but I guess I feel like the county is more dismissive than I would like to see in that,” said Villa Park Councilwoman Crystal Miles at the Aug. 8 meeting of the OC Older Adults Advisory Commission, which she chairs.

County CEO Michelle Aguirre reaffirmed her office’s position against a separate department, stating that creating a separate department would cut into available funding for services or programs.

“If at some point in time, we’re like, ‘you know what, this really should be a separate department,’ then we won’t hesitate to do that,” Aguirre said following a presentation at the meeting on the Master Plan for Aging.

“So that’s another reason I don’t want to have a separate department, because a lot of the funding that is available will be eaten up by management staff rather than the work that needs to be done.”

Experts have expressed concerns about financial backing for the county’s plans, citing how health issues and meeting other basic needs can be a financial burden for some older adults.

Concerns about the county’s plans come at a time of uncertainty for some older adults.

The amount of uninsured older adults locally – especially those that are undocumented or low income – may increase in the coming months due to federal cuts to Medicaid and Medicare, according to McAleer.

“When you have people who are uninsured, with serious medical complications, they go to the emergency rooms because they can’t be refused service. So it’s way more expensive,” said McAleer. “It’s all crisis driven, and it puts a huge burden on the hospitals.”

Of Orange County’s 34 cities, the City of Rancho Santa Margarita has experienced the largest growth in its older adult population since 2013. The share of residents age 65 and older have increased about 80% over the last decade. 

The share of older adults in Santa Ana, Tustin, Yorba Linda and Laguna Niguel have also grown by more than half in the last decade. 

The county’s assessment of older adults revealed that their top concerns are health conditions: Alzheimer’s disease, arthritis, cancer, heart disease, stroke and more generally, emotional wellbeing. 

Seniors of color are disproportionately affected by health issues, with Latino, Black, and Native American residents experiencing several conditions at higher rates than their peers.

“Our older adults face an uphill challenge from the start when it comes to accessing care or even advocating for themselves due to the language barrier,” said Guillermo Alvares, Certified Health Education Specialist with Latino Health Access in an interview earlier this month. 

“English is not the first language of the majority of Latino older adults. Some may even have difficulty reading and writing Spanish due to their educational background or the fact that they grew up speaking one of the many dialects in the region.”

Erika Taylor is a Voice of OC Tracy Wood Reporting Fellow and photojournalist. Contact her at etaylor@voiceofoc.org or @camerakeepsrolling.