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.