California: The State of Aging

1. California: The State of Aging June 23, 2014

2. No Wrong Door ....

3. The door to NO where ….

4. CA Commission on Aging Los Angeles – March 2014

5. Since 1974 …. a citizens voice in state government

6. … a robust statewide service system that supports older adults and their caregivers, provides an array of resources for independent living, embraces diversity, and respects the aging process. The Commission Envisions

7. What the Commission Does • Meetings, Conferences & Hearings • Publishes Reports • Partnerships & Connections • Legislative Solutions • Analyzes policy issues • Adopts initiatives

8. How California Got Here • Demographics • Fear of aging • Woodwork Myth • Lack of understanding • Lack of Political Will • Silos • Diminished resources

11. Alzheimer’s Disease & Related Disorders Advisory Committee Olmstead Advisory Committee California Health & Human Services Agency California’s Departments and Programs for Long-Term Care Dept. of Social Services Dept. of Aging Dept. of Health Care Services Dept. of Public Health Dept. of Rehabilitation Dept. of Developmental Services • - In-Home supportive Services Program (IHSS) • - Supplemental Security Income/ State Supplementary Payment • - Social Security Disability Insurance Program • Community Care Licensing • Adult Protective Services*** • - Multipurpose Senior Services Program (MSSP) • - Community-Based Adult Services • - Older Americans Act Programs (congregate/home-delivered meals, other) • -Older Californians Act Programs (program funding eliminated) • Family Caregiver Support Program • Senior Community Service Employment Program • Medi-Cal State Plan Services • Medi-Cal Managed Care • -Community-Based Adult Services (CBAS) • - Medi-Cal HCBS Waivers (Assisted Living, IHO, Acute Hospital, MSSP, AIDS) • - Program of All-Inclusive Care for the Elderly • - Caregiver Resource Centers - Nursing Home Licensing and Certification, Citations - Licensing of CBAS Centers, Nursing homes, and Home Health Aide Certification - Alzheimer’s Disease Program - Independent Living Centers - Traumatic Brain Injury Program - State Plan for Independent Living • Regional Centers • HCBS –DD Waiver • - Developmental Centers Note: Organizational chart displays departments in CHHSA that administer long-term care programs, along with a list of most of the related programs. Departments that do not play a significant role are omitted. *** Per Budget Act of 2011, funding for the APS program has been realigned to the counties.

12. The Sky is Falling

14. Influences in California

15. Elephant(s) In the Room • CCI – Duals Demonstration – Off ramps – Rural • Managed Care • LTSS – funding & delivery • Ageism

17. Threats Chronic underfunding Increase in service demand Federal funding level Economic Insecurity Struggling service network Workforce

18. We’re still Working On … • Uniform Assessment & Data • Elder Justice • OAA Reauthorization & WHCOA • How to tell our story • Government “catching up” • after all these years ….

19. Trends • Future of Aging: A California Conversation • Self Responsibility • Importance of COMMUNITY

20. Getting Better: • Senate Select Committee • State Finances • Regional Coalitions

21. The State of Aging • A decade of reductions/diminishments • Dynamic intersection of demographics & longevity • System transformation at state • Service transformation at local • Save for a “rainy day” mentality not a reinvestment in aging services

22. 2014 Budget Outcomes • IHSS Provider Overtime • $2.79 million for senior nutrition • $ 50,000 APS staffing – state level (1 position)

23. Let’s go back to the door …. From Alice in Wonderland` • Door: Why it's simply impassible!” • Alice: Why, don't you mean impossible? • Door: No, I do mean impassible. (chuckles) … Nothing's impossible!”

24. Nothing’s impossible!

25. AGE. RIGHT. CALIFORNIA California Commission on Aging 1300 National Drive, Suite 173 Sacramento, CA 95814 (916) 419 7591 www.ccoa.ca.gov ccoa@ccoa.ca.gov Virgie P. Walker, CCoA Chair Sandi Fitzpatrick, MA, Executive Director