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California

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.

Advocate Guide: CalAIM for Older Adults and People with Disabilities, March 9, 2023

Webinar: CalAIM and Older Adults: Upcoming Changes in 2023—Part 3, December 20, 2022

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)

Fact Sheet: Balance Billing in California, November, 2015

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: California’s In-Home Supportive Services Program: An Equity Analysis, June, 2023

Alert: 4 Things to Know as Medicaid Redeterminations Resume, April 3, 2023

Issue Brief: California’s Assisted Living Waiver: An Equity Analysis, March, 2023

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

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

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. 

Issue Brief: An Equity Analysis of California’s Assisted Living Waiver, March 27, 2023

Webinar: An Equity Analysis of California’s Assisted Living Waiver, March 27, 2023

Webinar: Using California’s Home Safe Program to Get and Keep Older Adults Housed, January 27, 2023

Webinar: California’s New Backup Provider System—What You Need to Know, November 10, 2022

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