California’s population is rapidly aging, and the over-60 population is growing racially and ethnically diverse faster than any other age group. By 2030, it is projected that one in four Californians will be an older adult.
This growth demands action to ensure older Californians get the support they need to live well. Many people want to continue living independently in their homes and communities as they age, and they need high-quality health care and community-based supports to do so.
On this page, explore our subtopics and read our publishing on older adults in California.
Essential Resources on Older Adults
Our Approach
Our communities are enriched when they enable the full participation of our older family members, friends, and neighbors. CHCF is committed to ensuring that older people with low incomes and complex needs get the support they need to live well at home and in their communities.
Furthermore, several major state initiatives are underway to improve services and quality of life for older adults. CHCF is seizing this moment to support partners implementing system improvements.
Why This Work Matters
The impacts of aging eventually affect us all. And yet, the needs of older Californians are often invisible to those not experiencing the challenges of aging themselves or caring for an aging loved one.
Fragmented systems, insufficient services, and a shortage of direct care workers make it difficult for many older adults who want to live independently to do so. Among adults who report needing help with day-to-day personal care or household needs, about 40% say they could use more help or that they have no help at all.
Older Californians with low incomes face particular health and social challenges. Three times as many older Californians with low incomes report fair or poor health status compared to their peers with higher incomes, and older adults are the fastest-growing cohort among Californians experiencing homelessness. Yet many safety-net providers, despite their expertise in coordinating care for people with low incomes, lack geriatric focus.
Highlights of Our Work
Supporting Integrated and Home-Based Care
California’s CalAIM (California Advancing and Innovating Medi-Cal) initiative aims to help Medi-Cal enrollees – including older adults and people with disabilities – get the care and services they need to live well and age in their homes and communities. But poor coordination between Medicare and Medi-Cal and difficult-to-access supportive services present real barriers. CHCF provides trainings and resources to help stakeholders navigate these challenges and build a better system. Examples of this work include:
- Medi-Cal home and community-based services: Resources on overlaps and gaps in Medi-Cal services that help people stay in their homes and communities.
- Assisted living: Explainers on assisted living basics and how “hub” organizations can help connect Medi-Cal enrollees to assisted living communities; virtual learning series on assisted living exploring the roles different stakeholders play in a person’s journey to care.
- Integrated care for people enrolled in both Medicare and Medi-Cal: Forums for learning and peer exchange for California’s new Medicare Medi-Cal Plans.
- Medi-Cal policy and program changes impacting older adults: Implementation considerations for a variety of CalAIM services and approaches to long-term services and supports.
Lifting Up Data, Stories, and Community-Driven Action
Older adults face unique equity challenges shaped by the age, race and ethnicity, gender, disability, and socioeconomic status. CHCF has collaborated with philanthropy, advocacy, and research partners to advance health equity for older adults, with an emphasis on communities of color. Examples of this work include:
- Community action: Equity Community Organizing groups in four California communities – including older adults and local stakeholders representing diverse perspectives – are codesigning solutions to address health inequities.
- Experiences of older Black Californians: Three fact sheets examining health care experiences and perspectives, using data from CHCF’s landmark Listening to Black Californians study.
- Data on people needing extra supports: Issue brief and fact sheets about the health and well-being of adults with a disability or chronic conditions who also need long-term services and supports.
- Equity in Medi-Cal home and community-based services (HCBS): Series of issue briefs to help state agencies, policymakers, and other stakeholders support equitable supports that help people age in place and avoid nursing facility care.
Building Safety Net Capacity for an Aging Population
California’s community health centers and public health care systems have long served adults, children, and families with low incomes but they have not historically focused on older people. Recognizing that these organizations are well positioned to provide coordinated, integrated care to older adults, CHCF has supported a variety of efforts to prepare the field. Examples of this work include:
- Medicare education and guidance: Webinar series and tip sheets on Medicare basics, special programs, and reimbursement (free registration required); overview of Medicare billing considerations for federally qualified health centers.
- Vision and roadmap: The Strategies for Older Adult Services Task Force defined a 10-year vision and roadmap to help health centers leverage their strengths as they prepare to serve more older adults.
- Health center learning community: The Accelerating Readiness for an Aging Population Learning Community supported seven health centers to take stock of their strengths and challenges, launch small projects to test new ways of working, and learn from experts and peers about clinical, financial, and operational improvement opportunities.
- Overview of needs, opportunities, and approaches: Issue brief exploring the safety net’s changing demographics, innovative care models, and clinical and financial opportunities.
Recent Resources
