Senate Select Committee on Aging and Long Term Care Final Report and Progress in 2015 Suzanne Reed, Chief of Staff Senator Carol Liu (Chair)

Issues 2030: 20% of Californians will be 65 or older Our population is increasingly diverse People are living longer 70% will need LTSS 85+ (fastest growing segment of the U.S. population) are 4X more likely to need LTSS than those age 65 to 84 Few people engage in advanced planning WE AREN’T PREPARED!

Problems: No person-centered, individualized care Poor transitions Limited access to a range of services, especially in rural areas Lack of cultural competency Lack of skilled workforce across range of disciplines No uniform data No Universal Assessment tool Limited caregiver supports

The Current System Fails to organize around consumer needs Is plagued by fragmentation and years of budget cuts Is difficult, if not impossible, to navigate and access Lacks systematic and integrated data collection and evaluation

State A & LTC Programs

Current Service Delivery

Trying to Navigate the System

Establishing a New Structural Vision What values underlie an IDEAL system? What is the IDEAL system? What are the essential components? What are the major barriers & challenges? How do we achieve the IDEAL?

Underlying Values: Age appreciated as a stage of life, not a social problem or disease Consumer centered/family focused Culturally competent and linguistically accessible Community based Workforce trained in gerontology and geriatrics, in-home health care career ladder Systems that support interagency cooperation, collaboration, and partnerships Outcome and data driven accountability Caregivers recognized and supported as part of the system Long-term care should not require impoverishment

The IDEAL: Integrated senior services with single point of entry and smooth transitions Universally available and sustainably funded system Coordination across and within state agencies and departments Cost effective and outcome- driven policies, programs and services Parity of services in urban and rural settings Caregiver support Regional collaboration as the foundation of a statewide infrastructure Housing and mobility needs reflected in state/regional/ local plans. Trained workforce funded through public/private partnerships Culturally sensitive and compatible care Protections against fraud and abuse Strong consumer advocacy

Essential Components Holistic approach through a continuum of care Respect and social inclusion Communication and information on available health and social services Civic participation and employment opportunities Adequate and trained workforce Caregiver support services Cultural and ethnic considerations and linguistically accessible services Preventative information and care Public/private solutions for long-term care insurance Affordable housing, transportation oriented development, and transportation services Universal design of buildings, outdoor spaces, and homes

What is Missing? Coordinated policy (Executive Branch and Legislature) Statewide capacity to deliver services equitably Data and system- wide planning Workforce Cultural Competency Political leadership Public awareness Strong advocates with shared messages

Achieving the IDEAL: Make aging and long term care a state priority Raise awareness and build on the idea of shared risk Shine a light on the current system’s dysfunction Improve data, monitoring, and oversight Focus on prevention Improve access and quality of older adult services to vulnerable seniors Reform Long-term care financing Advocates develop a shared agenda We have the population. We have the expertise. We know the needs. We know the challenges. We know what has to be done. What we need is the political will to do it..

Progress Legislative Package Consultant collaboration Bills status Regional Capacity Workforce EDD and Community colleges WIOA

More Progress Long Term Care Financing LeadingAge – Hosted 3 facilitated sessions with A & LTC stakeholders and policy analysts 6 possible approaches developed Senate Select Committee on Aging and Long Term Care collaborative working group will continue to:  Seek input  Address regulatory issues (state and federal)  Address political feasibility issues  Refine proposal(s)  Draft, introduce, advocate for, and advance legislation