The Senate Select Committee on Aging and Long Term Care released a final report on issues and progress in 2015. The report found that California is unprepared for its aging population and lacks an integrated system to provide long term services and support. It outlined an "IDEAL" system with values of consumer-centered care, cultural competency, and caregiver support. Realizing this vision will require addressing workforce shortages, improving data and coordination, and reforming long-term care financing. The Committee is working on legislative solutions and engaging stakeholders to achieve necessary reforms.

1. Senate Select Committee on AgingSenate Select Committee on Aging
and Long Term Careand Long Term Care
Final Report and Progress in 2015Final Report and Progress in 2015
Suzanne Reed, Chief of Staff
Senator Carol Liu (Chair)
Suzanne.Reed@sen.ca.gov

2. IssuesIssues
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!

3. ProblemsProblems
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

4. The Current SystemThe 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

5. State A & LTC ProgramsState A & LTC Programs

6. Current Service DeliveryCurrent Service Delivery

7. Trying to Navigate the SystemTrying to Navigate the System

8. Establishing a New StructuralEstablishing a New Structural
VisionVision
•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?

9. Underlying Values: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
• Preventative care, aging in place supports and LTSS

10. The IDEAL: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
data/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

11. Essential ComponentsEssential 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, care,
and opportunities
• Public/private solutions for
long-term care insurance
• Affordable housing,
transportation oriented
development, and home to
office transportation services
• Universal design of buildings,
outdoor spaces, and homes
• Effective use of technology

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

13. Achieving the IDEAL:Achieving the IDEAL:
• Raise awareness and build on the idea of shared risk
• Shine a light on the current system’s dysfunction
• Make aging and long term care a state priority
• Improve data, monitoring, and oversight
• Increase focus on prevention, aging in place
• Improve access to and quality of older adult services statewide
• 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..

14. ProgressProgress
Legislative Package
 37 bills introduced, 17 authors, 13 signed into law, 3
vetoed, several still pending
Committee Consultant collaboration
 Senate and Assembly consultants to committees with
A & LTC jurisdiction are coordinating on policy
Regional Capacity
◦ Local events to encourage collaboration, the
statewide Collaborative, SCAN Foundation

15. Long Term Care FinancingLong 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

16. WorkforceWorkforce
According to PPIC*:
 Over the next decade, California’s health workforce is
expected to require almost 450,000 new workers—
mostly due to population growth and aging
 40 percent of health care jobs to be filled over the next
decade will require some college but less than a B.A.
 California’s two-year higher education institutions need
to provide training opportunities for jobs that are well
matched with future workforce demand.
*http://www.ppic.org/content/pubs/rb/RB_914SMRB.pdf

17. WorkforceWorkforce
Select Committee Report* Recommendation:
 California LTC Plan that includes analysis of LTC
workforce needs, outlines training and education
requirements, and aligns resources accordingly (p. 18)
 Include primary care physicians (including osteopathic
physicians), geriatricians, registered nurses, nurse
practitioners, pharmacists, direct care workers, mental
health and social workers
 Examine career pathways and scope of practice.
 Address cultural competency
*http://archive.senate.ca.gov/sites/archive.senate.ca.gov/files/committees/2013-
14/committeepages.senate.ca.gov/agingandlongtermcare/AgingLong%20TermCareReport.pdf

18. Workforce ActivitiesWorkforce Activities
http://doingwhatmatters.cccco.edu/
http://doingwhatmatters.cccco.edu/Portals/6
(2015)
http://aebg.cccco.edu/
http://www.oshpd.ca.gov/Reform/CareerPat
(2012)

19. Workforce Activities (cont’d.)Workforce Activities (cont’d.)
WIOA
increase access to education, training and
employment, particularly for people with
barriers to employment
create a comprehensive, high-quality workforce
system by aligning work force investment
education and economic development
statewide and regionally
www.edd.ca.gov/Jobs_and_Training/Workforce_Inno
vation_and_Opportunity_Act.htm

20. ConclusionsConclusions
 Aging and Long Term Care workforce covers a broad
spectrum of disciplines (including care coordination and case
management) and levels of education and training
 Meeting 21st
Century health care workforce needs
should be a high priority statewide goal
 Identifying needs and aligning resources efforts are
happening at a regional level
 Engagement in regional activities is needed from all
segments of education and training and the full range of
service providers
 Health care work should be a career, not just a “job.”