Older Adults with Complex Needs

As a result of fragmented, uncoordinated systems, as well as insufficient services and a shortage of direct care workers, older 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 working to support equitable policies and programs that 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.

Learn more about why this work matters and how CHCF is approaching the issue.

Improving Care for Older Adults with Complex Needs

Older Adults with Complex Needs, Health Equity

By 2030, it is projected that one in four Californians will be an older adult. This growth — and the needs of an increasingly diverse aging population — demands that Californians take action to ensure older people with low incomes get the support they need to live well.

CalAIM FAQ for Assisted Living Community Operators

Paula Hertel, Athena Chapman

Older Adults with Complex Needs

This fact sheet provides general information and resources for operators interested in learning more about CalAIM and how its Community Supports program may support the populations they serve.

What’s Next for CalAIM?

October 20, 2023

Medi-Cal, Behavioral Health, Homelessness & Health Care, Older Adults with Complex Needs

How DHCS is responding to early implementation barriers facing this transformative initiative.

CalAIM Explained for Assisted Living Community Operators

Paula Hertel, Athena Chapman

Older Adults with Complex Needs

This brief focuses on CalAIM's provisions for older adults, explaining how it seeks to increase access and to improve the delivery of long-term services and supports.

Alliance with Black Churches Closes Care Gaps for Aging People

August 25, 2023

Heather Stringer

Older Adults with Complex Needs, Serious Illness & End-of-Life Care, Health Equity

Trusted navigators help caregivers obtain holistic care and support for seniors with serious illnesses.

The Promise and Perils of Assisted Living for Medi-Cal Enrollees

Older Adults with Complex Needs, Medi-Cal

Many seniors and people with disabilities prefer the independence and social opportunities offered by assisted living communities over nursing homes. But assisted living is expensive, and federal Medicaid requirements do not mandate coverage of such care. Medi-Cal has developed its own coverage options.

Managed Long-Term Services and Supports: Quality Improvement Initiatives

Chapman Consulting

Medi-Cal, Older Adults with Complex Needs

This fact sheet examines several initiatives that could help support oversight and transparency of Medi-Cal long-term services and supports quality, with the intention to drive improvements in care coordination and delivery.

Making CalAIM Work for Older Adults Experiencing Homelessness

Center for Health Care Strategies

Older Adults with Complex Needs, Homelessness & Health Care

This brief describes the population of older adults experiencing homelessness in California and highlights CalAIM initiatives that can help address homelessness in this group.

Targeted Use of Agencies for Personal Care Services

Older Adults with Complex Needs, Medi-Cal

This report describes findings from a small observational study of Medi-Cal enrollees with high needs who lost access to contract mode In-Home Supportive Services due to policy changes.

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.

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.

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 15, 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.