Understanding Medi-Cal: Long Term Care (Revised Edition)

This is archived content; for historical reference only.

The long term care system in California, including the programs and services funded by Medi-Cal, is complex and fragmented. The system serves a diverse group of individuals with different needs, from the frail elderly to chronically ill children.

Medi-Cal pays for 64% of all nursing home days in the state and accounts for 45% of total nursing home expenditures. In 1998, it paid for 42% ($5 billion) of all public long term care expenditures. It covers a wide array of short and long term care services through more than 20 different programs.

But Medi-Cal encompasses much more than just nursing home care: It covers a range of services provided to the elderly and people with disabilities who need care due to chronic conditions. These services include medical care, therapy, rehabilitation, case management, protective supervision, and assistance in daily activities (bathing and eating).

This guide serves as a primer to understanding the Medi-Cal long term care system. The booklet is published in an easy-to-understand format that combines data and descriptions to give readers a snapshot of a complicated network of services. It covers:

  • Defining Medi-Cal and long term care;
  • Eligibility and enrollment;
  • Funding and administration;
  • Covered services; and
  • Policy issues.

Readers will also find that the issues facing Medi-Cal long term care are issues that face the health system in California as a whole. These include the swelling of the Medicare population as baby boomers age, lack of workforce to meet demands, lack of integrated and coordinated services, quality of care, and funding for services.

The complete primer can be found under Document Downloads.