California’s demographics are changing, with the proportion of the state’s population age 50 or older increasing at a record pace. Older adults also represent the fastest-growing age cohort receiving care through California’s safety-net provider system. As the state’s population shifts, so do the care needs for the older adult population, particularly those with low incomes, many of whom are eligible for both Medicare and Medi-Cal. These dually eligible enrollees are more likely to experience multiple health and social needs compared to the general Medicare population. This complexity calls for tailored and highly coordinated services inside and beyond clinical settings.

While California’s community health centers and public hospitals have long provided integrated care to adults, children, and families with low incomes, historically these care settings have not emphasized services specifically focused on older people with complex medical conditions. Despite this gap, the community health centers and public hospitals that compose California’s safety net are well positioned to provide coordinated, integrated care to this growing group of Californians, given the organizations’ unique skill set and culture supporting comprehensive care for complex populations.

This report outlines potential strategies and opportunities to meet the emerging care needs of older Californians with low incomes, describes a range of policy initiatives launching in California that present new opportunities for improved care for this population, highlights findings from a literature review of practices and programs designed to improve access and quality for older adults, and summarizes perspectives and insights from interviews with community health center and public hospital system leaders.

Webinar

Authors of this report and a panel of safety-net health care leaders discussed the report’s findings and implications at a webinar on Tuesday, June 28 at 11:00 AM (PT). Panelists explored why and how safety-net providers can expand services for older adults with low incomes by building on their experiences and strengths in delivering integrated medical care, behavioral health care, and social supports.