California’s master plan for aging key to continued success

OPINION – It’s been four years since Governor Newsom signed the executive order for the Master Plan for Aging (MPA) to ensure that all Californians can age well.

The MPA sets five goals for the state to achieve by 2030 that address housing, health, equity and inclusion, caregiving, and financial security.

The MPA provides a roadmap for state agencies, local governments, private organizations, and philanthropy to address aging well. Included topics such as health care, housing, nutrition, transportation, belonging, equity, and economic security have touchpoints to each of our daily lives.

The SCAN Foundation (TSF) envisions a society where everyone can age well with purpose. As TSF president and CEO, I and my team are committed to the MPA’s success.

Great progress has been made on achieving the MPA’s goals, but we’re still in the early stages of implementation. As an expert witness at a recent Little Hoover Commission hearing on “The Implementation of CA’s Master Plan for Aging,” I put forward four recommendations to ensure continued progress.

Embed equity, diversity, and inclusion

Rooting these principles in the MPA is critical, because long-standing disparities for historically underserved communities (people of color, LGBTQ+ individuals, people with lower incomes, and those living in geographically underserved areas) are compounded as we age.

Earlier this year, I and members of the IMPACT committee proposed a framework to evaluate how well the MPA addresses equity. Among other recommendations, the framework includes a racial equity analysis and stresses the importance of collecting data to allow for continual evaluation.

Build a home care system that works for all Californians

Seventy-seven percent of adults ages 50 and older want to age at home. But many cannot access or afford the services they need to do so.

Access to long-term services and supports (LTSS) requires that you are low-income, live where services are available, and know your options. Those with higher incomes who can pay out of pocket must also live near and know what services are available. In between is the “forgotten middle,” those unlikely to qualify for Medi-Cal but unable to pay for LTSS.  Most older adults are included in this group, according to research commissioned by TSF and conducted by NORC at the University of Chicago. Without access to affordable LTSS in the community, many must enter nursing facilities or rely on family caregivers, who bear a significant financial and emotional burden. People of color, a growing portion of the “forgotten middle,” are particularly impacted by disparities in access to LTSS.

The MPA includes initiatives to study the state’s LTSS system, such as exploring statewide insurance programs for long-term care. Equity must be central to these efforts, especially as women of color disproportionately assume caregiving responsibilities.

Improve financial security, address homelessness

Rising costs of housing are increasingly jeopardizing older adults’ ability to age at home. As a result, older adults make up the fastest-growing portion of California’s growing homeless population, with 43 percent of Californians age 50 and older experiencing homelessness.

Lawmakers have made investments to address homelessness, but funds have not been targeted toward older adult homelessness specifically. Strategies tailored to this subgroup would prove more effective in addressing high housing costs and accessibility.

Stress “all-of-government” approach

The MPA was designed to prioritize aging across multiple sectors. Initiatives address factors like climate change, housing, transportation, and employment, and the California Department of Aging (CDA) has done well guiding work across departments.

However, CDA isn’t the only responsible entity for MPA implementation. As part of its formation, a cabinet-level working group was convened to engage the Governor’s office on cross-collaborative solutions to better serve older Californians. This group could report annually on MPA progress.

The legislature also has a role to play; more could be done to embed aging in policy discussions across committees, especially those covering high-priority issues like housing, homelessness, transportation, and the workforce.

The MPA provides an opportunity to reimagine aging and transform how we think about, plan for, and respond to the needs of a diverse aging population. Creating enduring change demands a sustained commitment throughout the lifespan of the MPA and well into the future.

Sarita A. Mohanty, MD, MPH, MBA serves the President and CEO of The SCAN Foundation, which envisions a society where all of us can age well and with purpose