| By Haya El Nasser Six days a week, County Express vans and buses roam the vast plains of northeastern Colorado. They pick up older residents of this rural region and drive them sometimes more than 100 miles to the town of Sterling. It has the only dialysis center in 9,600 square miles, an area the size of Maryland. The passengers get their treatment, board the bus mid-afternoon and cover the same ground in reverse. They're dropped off at their doorsteps before 5 p.m. For Jean Peeples, 66, a church secretary who lives alone, and Verleen Howe, 72, a retired cook and widow of a state trooper, the County Express is a lifeline. Without it, the women, who live in the tiny town of Wray on the Nebraska border, would have to move. This is the new reality for cities and towns everywhere: If they don't provide services for seniors, they will lose them. Had local officials not worked out a way to use government grants and strike a deal with Banner Health, which operates the dialysis center in Sterling, the shuttle service would cost each passenger $125 a trip. Under the current agreement, patients pay just $10. "There needs to be a bit of a wake-up call to communities across the country," says Sybil Jacobson, president of the MetLife Foundation, which is funding a report on America's seniors to be released Thursday. Entitled A Blueprint for Action, the report is designed to prod communities to start planning for what's about to hit them: 79 million baby boomers who are aging. The oldest turn 61 this year. If patterns hold, most will age where they live rather than move. The report, containing research by the National Association of Area Agencies on Aging, Partners for a Livable Community and other advocacy groups, lays out steps cities and counties can take to anticipate the needs of older residents. Assessing services In a 2005 survey by the National League of Cities, more city officials said they were concerned about the increase in seniors (72%) than other demographic changes such as rapid growth (58%), immigration (54%) and increasing school-age populations (51%). "We're seeing an elderly population not just here but across the state," says Larry Worth, general manager of the Association of Local Governments of Northeast Colorado, which runs the County Express buses. Older adults make up 19% of the region's population and are projected to hit 21% in five years. "In many cases, they come for recreation, employment opportunities and then age in place," Worth says. Currently, only 9% of the 113,363 trips the County Express provides annually are for non-emergency medical transportation, but they consume 37% of the bus system's operating budget because of the distance, says Worth, also president of the Colorado Association of Transit Agencies. Federal grants and financing from the health care provider help defray costs. Besides transportation, other crucial needs are housing, health maintenance programs, public safety, human services and civic engagement. No one is suggesting that communities cater to seniors at the expense of families and children, Jacobson says. "Improving areas of public safety and transportation will help everyone," she says. "For some cities, the promise of older people can speak to some kind of rejuvenation of core areas of the city. It's an opportunity to improve things for everybody." This week's report also encourages tapping the skills and experience of seniors through civic involvement, consulting and tutoring in schools. Mostly, it urges incorporating the needs of seniors in all public planning. "There are things you can do by tweaking programs and services," says Sandy Markwood, head of the National Association of Area Agencies on Aging. Programs and efforts Among programs communities are developing: ? In Milwaukee, Lapham Park public housing has a high proportion of residents over 70. Private and public groups joined to find ways to let them stay in their homes. They built a clinic at the complex, and 43 residents who needed assisted living were able to continue living there rather than go to a nursing home. ? In Seattle, Sound Steps encourages adults 50 and older to walk for fun and fitness. ? In Maumelle, Ark., outside Little Rock, the city partnered with the University of Central Arkansas in Conway to provide computer classes free to residents 60 and older. ?Mecklenburg County, N.C., which includes Charlotte, created Just1Call, an information line staffed by social workers who answer questions. ?Reno supports the Senior Farmers' Market Nutrition program, funded by a federal grant. It gives low-income seniors vouchers they can use at accredited farmers markets. "We have the healthiest, wealthiest group of older adults in the country's history," Markwood says. "They're starting to ask questions: 'Is my community going to meet my needs as I get older?' " Jean Peeples has needed dialysis twice a week for 3½ years. She drives but isn't supposed to after treatments. Counting on friends or relatives to transport her doesn't work, she says. Verleen Howe's daughter lives 200 miles away in Colorado Springs and her son almost as far away in Littleton. She has needed dialysis three days a week for almost five years. Each trip to Sterling takes 10 hours, but she doesn't mind. "I figure that's my job," she says. Without the service, "I probably would've had to move," she says. | 
