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California Health Care Foundation
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          The California Health Care Foundation is an independent, nonprofit philanthropy that works to improve the health care system so that all Californians have the care they need.

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          CHCF works on many different fronts to support California’s health care system. Explore resources, events, or networks related to each topic.

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          CHCF publishes reports, issue briefs, resource libraries, fact sheets, and more to help make meaningful change in California’s health care system.

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          CHCF funds projects that are aligned with its strategic goals and relevant to California health care as outlined in these goals.

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        • About Us

          The California Health Care Foundation is an independent, nonprofit philanthropy that works to improve the health care system so that all Californians have the care they need.

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CalAIM in Focus

Seniors and People with Disabilities

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California’s growing population of older adults are a diverse and vibrant group who are often active in their communities as leaders, volunteers, caregivers, and advocates. Some also remain in the workforce for many years. At the same time, aging frequently brings health challenges, and many people need support to live independently in their own homes and communities as they age. These supports range from help with activities like meal preparation, bathing, and dressing to help getting out and about or remembering which medications to take.

Although 2.2 million older adults and people with disabilities receive care through Medi-Cal, California’s Medicaid program, obtaining the right health care and supports requires navigating a maze of agencies. Each program offers different services, has different contact people and eligibility rules, and presents different restrictions and constraints, all of which make it challenging for people to get what they need to stay safely at home.

CalAIM presents an historic opportunity to transform care for Medi-Cal’s seniors and people with disabilities. CalAIM’s ambitious vision includes:

  • Making programs and services more consistently available across the state
  • Providing specialized coordination and support to those with the most complex needs
  • Increasing access to services, like personal care, medically tailored meals, home modifications, and other supports to help people live independently at home or in an assisted living facility
  • Consolidating accountability for more services through Medi-Cal managed care plans, including residential care in a nursing home
  • Improving coordination, integration, and alignment of care for the 1.6 million Californians eligible for both Medi-Cal and Medicare

Realizing the potential of these reforms is both essential and challenging. While California has experimented with similar reforms in the past, there were mixed results. Still, those experiences provide a foundation to build upon.

CHCF supports the diverse organizations leading planning, implementation, and ongoing assessment and refinement of CalAIM’s reforms impacting Medi-Cal’s seniors and people with disabilities. This includes elevating experiences from past efforts so stakeholders can quickly identify best practices and avoid past mistakes; synthesizing complex information and evidence about care models and services under CalAIM; learning directly from Medi-Cal enrollees about what is and isn’t working; and supporting learning and readiness for organizations on the ground. See all CHCF’s work in this area below.

Featured Resources

Explainer

Medi-Cal Home and Community-Based Services: Understanding Overlaps and Gaps

In four short explainers learn about the Assisted Living Waiver, the Home and Community Based Alternatives Waiver, Multipurpose Senior Services Program Waiver, California Community Transitions and each program’s overlap and gaps with CalAIM Community Supports.

January 13, 2025
Home and Community-Based Services, Older Adults
Home health aid helps client in the kitchen

Personal Care Services for Older Adults and People with Disabilities — Policy at a Glance

December 12, 2024
Older Adults
Home health care worker shows patient information on a tablet.

CalAIM Explained for Assisted Living Community Operators

October 04, 2023
CalAIM, Home and Community-Based Services, Medi-Cal, Older Adults
Group of senior women in assisted living facility participate in a seated exercise class.

What Is Assisted Living? Opportunities to Advance Community-Based Care for Medi-Cal Enrollees

August 07, 2024
Older Adults
Younger woman assists older woman at home

In-Home Supportive Services 101: Opportunities and Challenges Under CalAIM

May 16, 2023
CalAIM, Medi-Cal, Older Adults
Doctor listens to patient's breathing.
Report

Building Provider Networks for Enrollees in Both Medicare and Medi-Cal

Learn about the importance of provider networks in attracting new members to Medicare Medi-Cal Plans (also known as “EAE D-SNPs”). These new plans aim to make it easier for people to get the care and services they need while improving coordination across Medicare and Medi-Cal.

January 24, 2025
CalAIM, Health Insurance Coverage, Medi-Cal, Older Adults, Primary Care
Elderly man with caregiver eating breakfast

The Health of Diverse Californians with Needs for Long-Term Services and Supports

July 31, 2024
Older Adults
Assisted living caregiver delivers groceries to woman at home.

Innovation Landscape: Services to Support Independent Living in the Community

April 18, 2023
Older Adults
Elderly man petting his dog

CalAIM Community Supports Early Adopters: Spotlight on Nursing Home Transitions and Diversion

July 16, 2024
CalAIM, Home and Community-Based Services, Medi-Cal, Older Adults
Case manager Jesse Aires, left, accompanies Ofisi Latu around the neighborhood of the Daly City care facility where he now lives.

How a Managed Care Plan Helped a Young Man Move Out of a Nursing Home

December 13, 2022
Medi-Cal
Home health aide helps elderly woman rise from bed
Case Study

CalAIM Community Supports Early Adopters: Personal Care and Homemaker Services, and Respite Services

Two organizations in Kern County are partnering successfully to offer Community Supports to people who need help with activities of daily living. This fact sheet provides strategies for other organizations seeking to offer these services.

July 16, 2024
CalAIM, Home and Community-Based Services, Medi-Cal, Older Adults

Advancing Equity in Medi-Cal’s Home and Community-Based Services

June 14, 2023
Home and Community-Based Services, Medi-Cal, Older Adults, Racial Health Equity
Elderly woman having her hair styled by an in-home aid.

Targeted Use of Agencies for Personal Care Services

July 12, 2023
Home and Community-Based Services, Older Adults

Making CalAIM Work for Older Adults Experiencing Homelessness

July 17, 2023
CalAIM, Medi-Cal, Older Adults
young woman helps older woman with laundry

Medi-Cal Managed Care and Long-Term Services and Supports

March 16, 2023
Medi-Cal, Older Adults
Younger women helps older woman put on sweater.
Expert Perspective

New CHCF Poll Shows Californians’ Concerns About Obtaining Home-Based Supports

From personal experience, Californians are acutely aware of our health systems’ weaknesses serving older adults and others with chronic illnesses or disabilities.

February 16, 2023
Consumer Affordability, Older Adults, Surveys and Polls
Elderly woman at home receiving medical care

Creating Robust Provider Networks to Support Older Adults and People with Disabilities

December 12, 2022
Older Adults

In Alignment: CalAIM’s Plan to Coordinate Care for Dual Enrollees in Medicare and Medi-Cal

November 14, 2022
CalAIM, Medi-Cal, Older Adults
health care provider helping elderly woman stand up from sitting

Easing Transitions: CalAIM’s Changes for California’s Older Adults and People with Disabilities

August 05, 2022
CalAIM, Medi-Cal, Older Adults

Webinar — Opportunities for CalAIM to Support Community Living

May 19, 2022
CalAIM, Medi-Cal
Illustration of multicolored plys signs, also represents health care cross
Report

CalAIM and Institutional Long-Term Care: Lessons for Medi-Cal Managed Care

Starting January 1, 2023, California’s CalAIM reform initiative will require that care in nursing homes and other institutional settings be provided as a “carve-in” benefit through Medi-Cal managed care plans statewide. This report describes challenges, opportunities, and lessons learned from select California counties and other states where institutional long-term care has already been administered by…

March 15, 2022
CalAIM, Home and Community-Based Services, Medi-Cal, Older Adults, Racial Health Equity
Younger women helps older woman put on sweater.

Understanding What Works: Measuring and Monitoring Quality in Medi-Cal’s Home and Community-Based Services

January 25, 2022
Medi-Cal
Close up of a group of people's hands giving a high five.

Meeting the Moment: Strengthening Managed Care’s Capacity to Serve California’s Seniors and Persons with Disabilities

April 12, 2021
Older Adults

Using Data for Good: Toward More Equitable Home and Community-Based Services in Medi-Cal

December 03, 2021
Home and Community-Based Services, Medi-Cal, Older Adults, Racial Health Equity
home health worker assist man in putting on his shoes

Long-Term Services and Supports in Medi-Cal

October 13, 2020
Medi-Cal
wood game pieces in a maze made of toy blocks
Explainer

A Primer on Dual-Eligible Californians

More than a million Californians receive health care coverage from both Medicare and Medi-Cal. These dual-eligible enrollees are older adults with low incomes and people with disabilities. The goal of the paper is to help stakeholders understand the complexities of service delivery for dual-eligible enrollees and to assess the impact of proposed changes on how…

September 24, 2020
Medi-Cal
Chris Austin sits outside resting his arms on elaborately carved cane

Californians with Low Incomes Struggle to Navigate Both Medi-Cal and Medicare

October 28, 2020
Medi-Cal, Older Adults
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OAKLAND
1438 Webster Street #400
Oakland, CA 94612
Tel: 510.238.1040 Fax: 510.201.2991
Directions to CHCF Oakland

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1415 L Street #820
Sacramento, CA 95814
Tel: 916.329.4540 Fax: 916.329.4544
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