Among the growing population experiencing homelessness in California and nationally, older adults — defined here as age 50 or older — are the fastest-growing segment. The circumstances that trigger homelessness in older adults are often different than those for younger people, and older adults experiencing homelessness are often at risk for worse health outcomes, including much higher mortality than their younger unhoused counterparts.

CalAIM (California Advancing and Innovating Medi-Cal), California’s Medi-Cal reform effort, offers new opportunities to help the growing number of older adults experiencing homelessness. Specific CalAIM initiatives with the potential to address homelessness include Enhanced Care Management, Community Supports, the Justice-Involved Initiative, and the institutional long-term care carve-in.

Drawing from literature reviews, expert interviews, and examples from other states, this brief provides an overview of California’s population of older adults experiencing homelessness, describes CalAIM initiatives that can help address homelessness among older adults with disabilities or complex care needs or both, and highlights the challenges and opportunities for improving services and outcomes for this population.

About the Authors

Carrie Graham, PhD, is the director of long-term services and supports; Sarah Triano is the associate director of LTSS and disability policy; and Torshira Moffett, MPH, is a senior program officer at the Center for Health Care Strategies.