After the discharge of California’s Grasp Plan for Ageing (“MPA” or “Plan”) in January 2021, the California Division of Ageing (CDA) appointed and convened the Implementing the Grasp Plan for Ageing in California Collectively (IMPACT) Stakeholder Committee to supply steering on implementation of the Plan. With numerous illustration and experience, the IMPACT Committee focuses on accountability, outcomes, and continued enchancment towards the conclusion of the 5 daring objectives of the MPA.
- Aim 1: Housing for All Ages and Levels
- Aim 2: Well being Reimagined
- Aim 3: Inclusion & Fairness, Not Isolation
- Aim 4: Caregiving that Works
- Aim 5: Affording Ageing
Now, 4 years into the implementation of the Plan, the IMPACT Committee has ready this report to supply suggestions on MPA implementation and proposals for the appreciable work forward. Whereas investments in ageing and incapacity companies have been made for the reason that launch of the MPA, the state now faces a problem on three fronts: instability on the federal degree, a state price range deficit, and a rising ageing and incapacity inhabitants in want of significant companies that should be strengthened.
It is a crucial juncture within the MPA implementation, and the state must be targeted on figuring out the trail ahead, together with income streams, to satisfy the house care wants of Californians, in addition to finish older grownup homelessness in California. Importantly, advancing fairness for older adults and folks with disabilities continues to be a elementary tenet of MPA implementation, and should stay a precedence for the Administration.
The report is split into two sections. The primary part outlines the committee’s response to the latest MPA annual report in addition to the brand new initiatives for 2025-2026. The second part delves into the areas of focus that the IMPACT committee has recognized prior to now that must be maintained and preserved in a tougher federal and financial local weather. These areas are:
- Constructing a house care system that works for all Californians
- Stopping and ending older grownup homelessness in California
Part 1: Response to Annual Report and 2025-2026 MPA Initiatives
The IMPACT Committee commends CDA for its work making ready this 12 months’s annual report, in addition to growing the brand new 2025-2026 initiatives following the CA For All Ages and Skills Day of Motion. The annual report reveals the breadth and depth of how the MPA is being applied throughout state authorities. The annual report additionally highlights the significance of partaking stakeholders within the implementation course of, and the way future implementation of the MPA will, partly, be guided by these with lived expertise.
Whereas the annual report does a very good job of laying out achievements of the MPA, one of many suggestions from the Committee in final 12 months’s report was that the annual report embrace a abstract of accomplished initiatives and an replace on incomplete initiatives. Particularly given the rollout of the brand new initiatives, from this annual report – it’s tough to trace the place we stand on our progress. As well as, the annual report highlights achievements that weren’t essentially MPA initiatives prior to now, compounding the problem in parsing out achievements on particular initiatives. As we enter this subsequent part of MPA implementation, and the unsure federal and state price range local weather, preserving observe of our progress is crucial.
We recognize that main as much as the event of the 2025-2026 initiatives, there was vital stakeholder engagement from the six MPA implementation committees, and that lots of the up to date initiatives replicate that stakeholder suggestions. Nonetheless, we’re dissatisfied that vital suggestions from the stakeholder committees weren’t included within the new spherical of MPA initiatives, and in some instances, some initiatives really feel watered down in comparison with earlier years. For instance, a give attention to rental subsidies is now not a standalone initiative, regardless of being a key stakeholder precedence and really helpful by a number of committees, together with IMPACT.
Moreover, reforming the Medi-Cal Share of Price program is now not an express MPA initiative, which is disappointing, provided that reforming that program is among the methods to virtually immediately improve entry to reasonably priced LTSS for these simply exterior of Medi-Cal eligibility, a key MPA precedence. Lastly, the IMPACT committee feels that in some situations, the brand new initiatives cowl implementation of ongoing work, moderately than the daring visioning that the MPA began with. We perceive that there have been vital shifts on the state and federal entrance for the reason that preliminary launch of the MPA, nonetheless, the necessity for a metamorphosis in our ageing and incapacity methods has not modified – and the MPA ought to stay conscious of that pressing want.
Lastly, since launch of the annual report and new initiatives, the IMPACT committee wish to acknowledge the departure of Kim McCoy Wade, the Governor’s Senior Advisor on Ageing, Incapacity and Alzheimer’s. This Senior Advisor position is crucial in being a bridge between the Administration and stakeholders, and in addition serving to to advertise the MPA, ageing, and incapacity throughout state authorities. The IMPACT committee recommends that this place be crammed so this necessary work can proceed.
Part 2: Sustaining and Defending Current MPA Investments
The IMPACT Committee acknowledges the tough fiscal situation that the state is presently experiencing, in addition to the numerous uncertainty relating to funding and applications from the federal authorities. The MPA was created as a roadmap to information state investments throughout surplus and financial downturns, and the IMPACT committee urges the Governor and the Legislature to keep up their dedication to companies for older adults and folks with disabilities. It’s crucial that the Governor and Legislature reaffirm their help to current expansions of applications and companies below the MPA and refuse to look to older adults, individuals with disabilities, and their households to bear the brunt of any price range shortfall the state is going through.
As well as, cuts to federal funding for applications will put additional pressure on state ageing and incapacity companies which are already underfunded. We can not afford to lose these crucial applications, and the state should work to seek out methods to keep up these crucial companies that older adults and folks with disabilities depend on. This 12 months’s MPA annual report reveals how profitable lots of the new investments in ageing and incapacity have been. Reversing these investments will solely set us again additional in making a state the place older adults and folks with disabilities can age with dignity.
The IMPACT committee has beforehand recognized creating a house care system for all Californians and stopping and ending older grownup homelessness as the 2 key priorities for funding and focus for MPA implementation. Regardless of challenges on the federal degree, and state price range uncertainty – these two key areas stay priorities for the IMPACT committee. By 2030, 30% of our state will likely be age 60 or older, and with the ageing of the state will come a urgent want for improved dwelling and community-based help. And older adults are the quickest rising group of individuals experiencing homelessness in California, with many of those people going through homelessness for the very first time. It’s the IMPACT Committee’s continued suggestion that the state preserve investments associated to LTSS and older grownup homelessness, and never pull again from the dedication to the important thing structural reforms within the MPA so as to help California’s rising inhabitants of older and disabled adults.
Delaying or reducing crucial investments in California’s ageing and incapacity companies will finally price the state extra. We all know that dwelling and community-based companies (HCBS) are less expensive for the state than institutional care. And we all know that stopping homelessness is less expensive for the state than serving to to rehouse somebody experiencing homelessness.
Constructing a house care system that works for all Californians
Our present system of take care of older and disabled Californians is inequitable. The ultra-wealthy are in a position to pay out-of-pocket for care. Very low-income people have protection, however battle to entry companies. The IMPACT Committee additionally acknowledges that these within the center – an more and more racially numerous group of older adults, also known as the “forgotten center” – battle to each afford and entry companies. By 2033, 89% of Californians aged 75 and older won’t have sufficient monetary assets to pay privately for care. A subset of the forgotten center inhabitants, Medicare beneficiaries simply over earnings eligibility for Medi-Cal, referred to as “near-duals,” are feeling the influence now.
Rising affordability and entry to long-term companies and helps (LTSS) has been a key tenet of the MPA, and vital investments have been made lately: increasing Medi-Cal to all income-eligible Californians no matter immigration standing, growing the Medi-Cal Aged, Blind, and Disabled earnings restrict to 138% FPL, eliminating the Medi-Cal asset restrict for older adults and folks with disabilities, investments round caregiver coaching, growing slots for HCBS applications, and rather more.
These investments have been crucial in making progress on making a extra equitable and accessible dwelling care system for all Californians. These investments in HCBS are additionally a wise fiscal resolution for the state, as a result of with out these HCBS we all know that the one possibility for older adults and folks with disabilities is institutionalized care – which is considerably dearer for the state.
By sustaining and bettering investments in at-home care and help, California can lead the nation in guaranteeing everybody can get the assistance they should stay with dignity as they age and forestall ageing into poverty. Sustaining financial safety is a crucial piece of this work. Many older Californians and their households are severely burdened by the price of long-term care. With a view to preserve older adults’ financial safety, and in addition not threaten their households’ monetary circumstances, the state must be targeted on addressing the affordability disaster in California. Regardless of uncertainty on the federal and state degree, the demographic developments in California aren’t altering. The necessity for funding in an reasonably priced, accessible dwelling care system for all Californians stays pressing.
Stopping and ending older grownup homelessness
Older adults are the quickest rising age group inside California’s homeless inhabitants. Older adults (age 50+) now make up virtually half (48%) of homeless people, and, of these older adults, virtually half (41%) had their first incident of homelessness after age 50. Since 2017, the variety of unhoused older adults over the age of 65 has elevated by greater than 166%. The first drivers of the surge in older grownup homelessness in California are unsustainable lease burdens and an insufficient provide of reasonably priced, accessible, and steady housing. In line with a current Justice in Ageing evaluation, Black older Californians face a considerably greater threat of homelessness, and 36% of individuals experiencing homelessness of all ages report disabling circumstances, and that proportion is far greater for older adults experiencing homelessness.
We recognize that there have been vital price range investments in addressing homelessness during the last a number of years together with Homelessness Housing, Help and Prevention (HHAP) grant, HomeSafe, and the Housing and Incapacity Advocacy Program (HDAP). CDA’s annual report this 12 months highlights how profitable HomeSafe and HDAP have been at stopping older grownup homelessness – and these two applications are the one applications throughout state authorities focused at homelessness prevention for older adults. These two applications are a few of the most profitable housing applications the state has, but funding is operating out. And whereas these applications have been very profitable, their scope has been restricted, and the problem of older grownup homelessness continues to be getting worse.
Now is just not the time to be reducing cost-effective applications that stop homelessness. Analysis reveals that stopping homelessness is cheaper for the state, moderately than paying for shelter beds and companies to rehouse individuals. And, for older adults and folks with disabilities, the rehousing course of may be tougher on account of their distinctive wants.
One other key driver of homelessness, particularly amongst older adults, is insufficient earnings advantages. Through the recession, the SSP grant was dramatically minimize, which pushed older adults and people with disabilities who depend on SSI/SSP into deep poverty. Within the ten years after that, rents dramatically elevated, and different prices of residing continued to rise on account of inflation, contributing to the excessive charges of homelessness we see right now. We recognize that the state made vital investments in 2021-2023 to begin bringing the SSP grants to their pre-recession degree. Nonetheless, older adults receiving SSI/SSP nonetheless have much less earnings relative to the poverty line than they’d pre-recession. It’s crucial that the state preserve the extent of the SSP grant. Reducing it would solely worsen our poverty and homelessness points, and make it tougher to recuperate from in a greater financial local weather.
The constantly rising development of older grownup homelessness signifies that the state should preserve the dedication to preserving applications, regardless of federal and state uncertainty, and proceed to discover investments in different confirmed options – like a focused rental subsidy program for older adults. As soon as older adults change into homeless, it’s rather more tough and costly to rehouse and stabilize them. The Committee continues to induce CDA and the Administration to give attention to homeless prevention as a key technique to assembly the purpose of ending older grownup homelessness.
Conclusion
The IMPACT Committee is grateful for the Governor’s management up to now and for the work of CDA and different businesses and departments to implement the MPA over the previous 4 years. We recognize the chance to supply suggestions and proposals through this report and our continued conferences. After we started the MPA course of over 5 years in the past, we couldn’t have imagined the state of affairs we’d be in right now. We’ve made immense progress within the objectives, however now going through vital challenges in persevering with to implement the daring objectives. Nonetheless, the underlying want and the impetus for creating the MPA has not modified. And regardless of vital uncertainty relating to federal and state applications, older adults and folks with disabilities will proceed to want companies.
The IMPACT committee urges the Administration to make use of the MPA and the objectives of the MPA as a guiding body to navigate this present local weather. Classes from the final recession present us that making cuts to safety-net applications are a short-term answer that result in long-term detrimental outcomes. Sustaining MPA investments round LTSS and homelessness aren’t solely equitable choices, they’re additionally probably the most financially prudent within the long-term. The IMPACT committee appears to be like ahead to persevering with to work with the Administration and supply suggestions and partnership on ongoing MPA implementation.
Endnotes
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https://www.norc.org/content material/dam/norc-org/paperwork/standard-projects-pdf/NORCpercent20Forgottenpercent20Middlepercent20CApercent20-%20Findingspercent20(1).pdf ↑
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https://justiceinaging.org/california-older-renters-unaffordability-homelessness/ ↑
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https://information.nd.edu/information/targeted-prevention-helps-stop-homelessness-before-it-starts/ ↑
