Older Adults with Complex Needs

As a result of fragmented financing, administration, and delivery of services, both within Medi-Cal and between Medi-Cal and Medicare, these adults often face major challenges getting the care and supports they need to live safely, independently, and with dignity at home or in whatever setting can best meet their needs and wants.

CHCF is launching new work that will support equitable policies and programs to simplify, standardize, integrate, and monitor care for older adults with low incomes and complex needs, with the goal of providing care that is responsive, coordinated, comprehensive, and supportive of health and well-being.

In-Home Supportive Services 101: Opportunities and Challenges Under CalAIM

Chapman Consulting

Older Adults with Complex Needs

This fact sheet provides an overview of the IHSS program and considerations to strengthen coordination of IHSS with other services.

Advancing Equity in Medi-Cal’s Home and Community-Based Services

Older Adults with Complex Needs

With support from CHCF, Justice in Aging is producing a series of issue briefs focused on helping state agencies, policymakers, and other stakeholders in efforts to support equitable HCBS rather than institutional care where possible and desirable.

Medi-Cal Managed Care and Long-Term Services and Supports

Chapman Consulting

Older Adults with Complex Needs

This report explores some design options for implementing Medi-Cal Managed Care and Long-Term Services and Supports that policymakers, agency leaders, advocates, and other stakeholders can consider as this work unfolds.

New CHCF Poll Shows Californians’ Concerns About Obtaining Home-Based Supports

February 16, 2023

Health Equity, Medi-Cal, Older Adults with Complex Needs, Workforce

From personal experience, Californians are acutely aware of our health systems’ weaknesses serving older adults and others with chronic illnesses or disabilities.

California’s Direct Care Workforce

University of California, San Francisco

Older Adults with Complex Needs

Direct care workers are the personal care aides, home health aides, and certified nurse assistants that provide hands-on, daily, and long-term assistance to older adults and people with disabilities. An issue brief and Quick Reference Guide provide overviews of this critical element of the health care workforce.

Partners in Vaccination

Keck School of Medicine, University of Southern California

Older Adults with Complex Needs

This community-based project leveraged longitudinal, trusting relationships of care managers with their medically fragile clients enrolled in Medi-Cal to try to increase COVID-19 vaccination rates. Although the project did not accomplish this goal, it offers insights into challenges and potential opportunities to improve the delivery of preventive health care among similarly vulnerable populations.

Creating Robust Provider Networks to Support Older Adults and People with Disabilities

December 12, 2022

Torshira Moffett, Carrie Graham

Medi-Cal, Older Adults with Complex Needs

Experts share strategies for Medicaid agencies to meet the health and social needs of these populations by partnering with community-based organizations, institutional long-term care facilities, and Medicare providers.

In Alignment: CalAIM’s Plan to Coordinate Care for Dual Enrollees in Medicare and Medi-Cal

Center for Health Care Strategies, Decipher Health Strategies, Chapman Consulting

Older Adults with Complex Needs

This issue brief provides an overview of a transition to Medicare Medi-Cal managed care plans for dually eligible enrollees in California, along with lessons from several state leaders about their experiences integrating care for this population.

Easing Transitions: CalAIM’s Changes for California’s Older Adults and People with Disabilities

Center for Health Care Strategies, Decipher Health Strategies, Chapman Consulting

Older Adults with Complex Needs

More than two million seniors and people with disabilities (SPDs) enrolled in Medi-Cal will be impacted by reforms, initiatives, and new policies as a result of CalAIM (California Advancing and Innovating Medi-Cal). This issue brief describes key care delivery transitions related to CalAIM implementation, and outlines challenges and opportunities to ensure these changes are as smooth as possible for SPDs, their caregivers, and providers.

Beyond the Doctor: Helping Trusted Care Managers Increase Vaccination Rates

Heather Stringer

Older Adults with Complex Needs, Medi-Cal

Researchers partner with community-based organizations to reach homebound, older adults at risk of severe illness from COVID-19.

Improving Care for California’s Older Adults: The Role of Community Health Centers and Public Hospital Systems

Pacific Health Consulting Group

Older Adults with Complex Needs

Older adults represent the fastest-growing age cohort receiving care through California’s safety-net provider system. This report outlines potential strategies and opportunities to meet the emerging care needs of older Californians with low incomes, and includes insights from interviews with safety-net system leaders around emerging approaches and challenges they face.

CalAIM Community Supports: Promoting Independent Living Among Older Adults and People with Disabilities

Older Adults with Complex Needs

Through CalAIM, Medi-Cal managed care plans now have the option to offer any of 14 Community Supports that provide person-centered services. This report provides an overview of and evidence summary for six Community Supports most relevant to supporting independent living for older adults and people with disabilities.

CalAIM and Institutional Long-Term Care: Lessons for Medi-Cal Managed Care

Center for Health Care Strategies, Decipher Health Strategies, Chapman Consulting

Older Adults with Complex Needs

Starting January 1, 2023, California's CalAIM reform initiative will require that care in nursing homes and other institutional settings be provided as a "carve-in" benefit through Medi-Cal managed care plans statewide. This report describes challenges, opportunities, and lessons learned from select California counties and other states where institutional long-term care has already been administered by managed care plans.

Medi-Cal and Opportunities for Health Tech in Home-Based Medical Care

Medi-Cal, Older Adults with Complex Needs

This report explores opportunities for innovation, challenges, current policies, and implications for innovators. It presents a range of stakeholder perspectives on home-based medical care and highlights different approaches to showcase how different models can work within California's health ecosystem.

Understanding What Works: Measuring and Monitoring Quality in Medi-Cal’s Home and Community-Based Services

RAND Corporation

Older Adults with Complex Needs

Medi-Cal spends an estimated $22 billion per year to provide home and community-based services to older adults and people with physical and/or cognitive disabilities, serious mental illness, and disabling chronic conditions. However, few data are currently collected to monitor the quality and outcomes of these services.