Health Care

Our Work Impacts Millions

As the state with the highest number of seniors living in poverty, and because California often leads the nation in innovative, progressive policies, our work to advance the health care needs of low-income seniors in California improves the lives of millions, and can serve as a model for other states. 

We advocate to ensure California’s large population of older adults who are eligible for both Medicare and Medicaid (dual eligibles) experience high quality, coordinated care. We were instrumental in getting the state to restore oral health benefits to Medi-Cal, and we are actively working in coalition with disability advocacy partners to improve the In-Home Supportive Services (IHSS) program. We are also working with state legislators on specific bills to improve California’s health care system for older adults, and serving on the stakeholder advisory committee for Governor Newsom’s Master Plan for Aging. Below California advocates will find Issue Briefs, Fact Sheets, and other resources on the state’s Cal Medi-Connect Duals demonstration, the state’s In-Home Supportive Services (IHSS) Program and more.

As home to 1.4 million low-income older adults who are eligible for both Medicare and Medicaid (more than any other state), California has been a test case for a massive effort to coordinate their care. Throughout the roll-out of the state's Coordinated Care Initiative (CCI), beginning in 2014, Justice in Aging has trained thousands of advocates on the changes, heard from them about issues in the roll-out, and pushed the state for fixes. We also share our knowledge with advocates in other states to help them as their states roll out similar programs.

Primer: Dual-Eligible Californians: How People Enrolled in Both Medicare and Medi-Cal Receive Their Care, September, 2020 (Justice in Aging for the California Health Care Foundation)

What’s Next for California’s Dual Eligibles? CalAIM and the Coordinated Care Initiative, January, 2020

Advocates Guide:  California’s Coordinated Care Initiative Version 6,
updated March 9, 2015

Fix List: California Duals Program – A Fix List for tracking problems in the roll out of California’s Coordinated Care Initiative (CCI), June, 14

Issue Brief: Cal MediConnect-Unmet Need and Great Opportunity in California’s Dual Eligible Demonstration, February, 2019

Fact Sheet: Cal MediConnect Deeming Fact Sheet
Cal MediConnect: Continuity of Care, May, 2015

Fact Sheet: Balance Billing in California, November, 2015

Issue Brief: Culturally Competent Outreach Strategies in Health Care Transitions, coauthored with Advocates for African American Elders, March 2015

Issue Brief: Duals Demonstration: A First Glimpse at Lessons Learned, March, 2016

Webinar: CCI: An Update, December, 2017
Slides: CCI: An Update Slides, December, 2017

Webinar: CCI: Two Years into Implementation, February, 2016
Slides: CCI: Two Years in Slides, February, 2016

Webinar: CCI Advanced, 2015
Slides: CCI Advanced Slides, 2015
Webinar: CCI Basics, 2015

Webinar: The California Coordinated Care Initiative: Advanced Training Consumer Protections and Benefit Package Summary, October, 2014

Webinar: The California Coordinated Care Initiative: What Advocates Need to Know: Basics, 2014

Short Version
Long Version

Fact Sheet: How is the CCI Working? Evaluations of the CCI, June, 2016


Evaluation of Cal MediConnect – Focus Group Results

Evaluation of Cal MediConnect – Telephone Survey Results

Rapid Cycle Polling Project October 2015 | December 2015

An earlier RTI evaluation focusing on implementation of demonstrations in California, Illinois, Massachusetts, Ohio, Virginia, and Washington can be found here.

Check out the Resource Library for additional resources and comments

The In-Home Supportive Services (IHSS) program is a life changing and life sustaining program for over 500,000 low-income older adults and people with disabilities throughout California. The program provides for personal care services to seniors and people with disabilities with limitations in activities of daily living. IHSS provides essential in-home support that allows these individuals to remain at home and in their communities instead of needing to move into an institution to receive care.

We are creating positive change in the IHSS program so that more low-income seniors can access the supports they need to remain connected to our families and communities. We currently have a special focus on improving access to the IHSS program in Alameda and Contra Costa. We are also working on broader systemic reform statewide.

Issue Brief: An Equity Framework for Evaluating California’s Medi-Cal Home and Community-Based Services for Older Adults & People with Disabilities, December 2022

Issue Brief: Beyond Spending--Measuring California's Progress Towards Equitable Home and Community-Based Services, August, 2022

FAQ: Medi-Cal Asset Limit Elimination and Older Adult Expansion, May 2022

Issue Brief: Using Data for Good: Towards More Equitable Home and Community-Based Services in Medi-Cal, December, 2021

Advocates Guide: In-Home Supportive Services (IHSS): An Advocates Guide, June, 2019

Advocates Guide in Spanish, June, 2019

Fact Sheet: In-Home Supportive Services Basics, Eligibility and the Application Process, August, 2017

Fact Sheet: In-Home Supportive Services Basics, Services, August, 2017

Read about our successful litigation in California that will enable thousands of older adults to qualify for in-home care through Medi-Cal and save couples tens of thousands of dollars a year in out-of-pocket costs. 

The dental health needs of low-income older adults have been neglected, yet, oral health is a critical aspect of overall health for older adults. Untreated dental decay and tooth loss can not only lead to pain and difficulty eating, but also the worsening of chronic conditions like diabetes and hypertension.

Our California advocacy has been focused on expanding access to oral health care for the state's low-income older adults. We were successful in pushing the state to fully restore dental benefits to Medi-Cal in 2017, and we continue to educate local advocates and service providers on how they can help the older adults they serve access oral health care. 

Oral Health Recommendations for California's Master Plan for Aging, July, 2020

Advocate Guide: Oral Health for Older Adults in California, June, 2018

Issue Brief:  Oral Health in California: What about Older Adults? July, 2016

Webinar:Oral Health in California: What about Older Adults? July 2016


The assisted living landscape is changing. Residents with higher medical needs, who once may have lived in nursing homes, now reside in assisted living facilities. State laws regulating assisted living are inconsistent and have not kept up with residents’ changing needs. In some states, this means that residents with fairly simple medical needs are not able to live in assisted living and instead are forced into nursing homes. Also, because assisted living standards are often lax, residents in some states and facilities receive substandard care from inadequately trained staff. We are particularly concerned with low-income older adults who rely on Medicaid.

Justice in Aging is currently focused on identifying and disseminating best practices from states all over the country. 

Series: How California’s Assisted Living System Falls Short in Addressing Resident’s Health Care Needs, 2015

The Problem: Pretending that Medication is Always Self-Administered

The Problem: A False Choice Between Community Living and Access to Health-Related Services

The Problem: Can you Spot the Legal Violations in this California Assisted Living Job Announcement?

California Proposes Positive Steps for Assisted Living

Issue Brief: Addressing-Problems-in-California's-Assisted-Living-System, 2014

Special Report: Best Practices in Assisted Living: Considering Potential Reforms in California, 2014

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