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Intersectional Advocacy in Health Care and Long-Term Services and Supports

November 4, 2015

Partnerships are at the heart of our work at Justice in Aging. I’m a staff attorney in Justice in Aging’s Los Angeles office. Much of my work focuses on disparities in access to quality, person-centered health care and services for California’s dual eligibles (the low-income, high-need demographic eligible for both Medicare and Medicaid). My day-to-day consists of training and education of advocates “on the ground,” providers, health plans, and policymakers and meeting with these folks regularly to share issues and synthesize solutions. This includes opportunities to participate in forums, plenaries, and tele-town hall meetings that advance advocacy for older adults on a local level by engaging multiple sectors of the community in the same room.

An example of this advocacy is a regional forum on long-term care and related issues in Pasadena, CA held by California Senator Carol Liu’s office last week. Sen. Liu is the chair of the Senate Select Committee on Aging and Long Term Care. Earlier this year, Sen. Liu released a report entitled: A Shattered System: Reforming Long-Term Care in California. Sen. Liu’s staff envision the report as a blueprint that other legislators can pick up and continue her efforts. With California’s 65+ population projected to double from 4.3 million in 2010 to 8.4 million in 2030, this report urged major reform of California’s system of programs, services, and support for aging and disabled adults and offered new models of innovation.

However, change on this scale cannot happen only from the state level—successful reform also requires efforts on the local level. This invite-only regional forum was a follow up to the release of the report and had about fifty local stakeholders in attendance. It featured two panels, bringing together experts from many different perspectives on aging, including work force advocates, demographers, healthcare providers, and social service representatives. I had the opportunity to provide an update on the implementation of California’s Coordinated Care Initiative, a program that moves California’s dual eligibles and adults on Medi-Cal into managed care for almost all of their healthcare needs. I gave an overview of the major changes under the CCI, updates on current enrollment and disenrollment numbers, briefly discussed some implementation challenges, and also touched on future developments.

Following the two panels, panelists and stakeholders formed small groups to tackle tough questions, like what barriers prevented more coordination of senior services in the region and what were some of the greatest issues facing seniors in the area. After a report from the different groups, Sen. Liu’s staff announced the creation of a local regional workgroup to continue the conversation and take action to improve long-term care in Los Angeles from a regional perspective.

2015 is Sen. Liu’s last year in office, but it was inspiring to see how much she and her staff are still doing for long-term care in California and how crosscutting the audience and panelists were in their ideas and proposed improvements for older adults. It reinforced for me a crucial facet of advancing an agenda for all people to age in dignity: investment not just from those who work with older adults, but from diverse intersections of the community.

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