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Reports & Studies


A Long-Term Outlook: Disability Among California's Seniors

NOV 28, 2016 | California Legislative Analyst's Office

The rapid growth and changing demographics of California’s senior population raise issues about seniors’ long-term supports and services (LTSS) needs, LTSS system capacity, and the financial impact of LTSS on personal and state finances. California-specific projections are necessary to inform the conversation around the future of the LTSS system as California’s senior population grows over the next several decades. This report, an infographic, and a companion video are available using the following link:


New Atlas on Cost and Quality

AUG 11, 2016 | California Health Care Foundation (CHCF)

Benchmarking and tracking quality and cost measures is critical to reducing unwarranted variation and achieving high-quality, affordable care for all Californians. The new atlas is a collaboration of the Integrated Healthcare Association (IHA), the California Health Care Foundation (CHCF), and the California Health and Human Services (CHHS) Agency, and includes data for nearly two-thirds of Californians. See the new data tool and listen to a discussion.


Medicaid's Role in Meeting Seniors' Long-Term Services and Supports Needs

AUG 2, 2016 | The Henry J. Kaiser Family Foundation | Article

•  How Do Seniors Qualify for Medicaid LTSS?
•  Which LTSS Does Medicaid Cover?
•  How Much Does Medicaid Spend to Cover Seniors' LTSS Needs?
•  What are the Current Policy Issues in LTSS for Seniors?
•  Looking Ahead


Women and Poverty in California: We Must Do More

JUN 2016 | California Commission on Aging, the California Women’s Law Center, and the California Commission on the Status of Women and Girls

Aging, Women and Poverty in California: We Must Do More, written in collaboration by the California Commission on Aging, the California Women’s Law Center, and the California Commission on the Status of Women and Girls, with participation from Justice in Aging, outlines the reasons older women are more likely to live in poverty, describes the impact poverty has on women’s lives, and offers recommendations and action steps to ensure older women can age in dignity.

Additional Resources:
• How to Prevent and End Homelessness Among Older Adults
• The Faces of Senior Poverty are Likely Women of Color


Oral Health in California: What About Older Adults?

JUL 27, 2016 | Justice in Aging Health Network Alert | Issue Brief | Advocacy

Oral health is a critical aspect of overall health for people of all ages, but especially for older adults. Unfortunately, the oral health needs of older adults, particularly low-income older adults have been neglected.

A new Issue Brief by Justice in Aging, Oral Health in California: What About Older Adults? explores the reasons why the oral health of older adults in the state is suffering and offers recommendations for improvements. The issue brief launches a new area of advocacy for Justice in Aging in which we seek to improve oral health for low-income older adults in California. Justice in Aging presented a webinar on this topic on July 26, 2016. You can access the webinar slides or watch the video here.

This issue brief and its accompanying webinar were funded by a grant from The California Wellness Foundation (Cal Wellness). Created in 1992 as a private independent foundation, Cal Wellness’ mission is to improve the health of the people of California by making grants for health promotion, wellness, education and disease prevention.


Drop in Percentage of Physicians Participating in Medi-Cal Raises Red Flags

JUL 8, 2016 | California Health Care Foundation | REPORT by Amy Adams

Self-reported data from a voluntary survey of California physicians show physician participation in Medi-Cal declined from 69% in 2013 to 63% in 2015. (Physicians are identified as participating in Medi-Cal if they report any of their patients are covered by Medi-Cal.) The percentage of specialty care physicians participating in Medi-Cal likewise dropped during this time, from 70% to 64%.


Special Report: Meeting the Legal Needs of LGBT Seniors

JUN 22, 2016 | Justice in Aging

How Can Legal Services Better Meet the Needs of Low-Income LGBT Seniors? is a new Special Report by Justice in Aging, produced in partnership with Services and Advocacy for Gay, Lesbian, Bisexual, & Transgender Elders (SAGE). This report explains why LGBT older adults have higher rates of poverty, outlines how discrimination and other factors lead to unique legal needs, and provides practical tips for outreach, intakes, and providing culturally competent legal services to LGBT older adults.


Moving Medi-Cal Forward on the Path to Delivery System Transformation

JUN 21, 2016 | California Health Care Foundation | REPORT

Moving Medi-Cal Forward on the Path to Delivery System Transformation, commissioned by CHCF and written by Manatt Health, explores the reforms that are needed to ensure that Medi-Cal consistently delivers excellent access, quality, and patient experience while using resources efficiently. Manatt conducted a landscape review and in-depth interviews with a diverse array of over 50 Medi-Cal stakeholders and thought leaders. The report assesses key challenges and opportunities in Medi-Cal, establishes a vision for delivery system reform, and articulates a path forward. Topics discussed include capitation rates, behavioral health, workforce shortages, access to providers, and more.


Special Report: Prevent and End Homelessness Among Older Adults

APR 11, 2016 | Justice in Aging Health Network Alert | How to Prevent and End Homelessness Among Older Adults

A Special Report by Justice in Aging, How to Prevent and End Homelessness Among Older Adults, created in partnership with The National Alliance to End Homelessness, outlines the problems and recommends policy solutions that can be put in place now to ensure that all older adults have a safe place to age in dignity, with affordable health care, and sufficient income to meet their basic needs.

Read and watch the video about Bill, a 67 year-old Oakland, CA resident who has struggled with homelessness. Please share this information with others.


California's Uninsured: Coverage Expands, but Millions Left Behind

MAR 22, 2016 | California Health Care Foundation (CHCF) | REPORT | INFOGRAPHIC

The latest edition of California's Uninsured finds that implementation of the Affordable Care Act (ACA) helped lower the uninsured rate in California from 16% in 2013 to 11% in 2014, but 3.8 million Californians under 65 remained without coverage. A related infographic shows who gained coverage in California, who remains without it, and why.

This report is part of the CHCF California Health Care Almanac, an online clearinghouse for key data and analysis examining California's health care marketplace. Find all Almanac reports at


Special Report: Strengthening Supports for Low-Income Older Adults and Caregivers

FEB 8, 2016 | Justice in Aging | Advocacy Starts at Home: Strengthening Supports for Low-Income Older Adults and Caregivers | VIDEO
View the video, read the blog post, and access other materials on family caregivers here.

Margaret is a mom with two teenagers at home, a husband, and a full time job. Her mother Sadie lives alone on a limited income in an adjacent town. Margaret checks in on her every day, and is always on call for transportation to doctor’s appointments, help with bills, and groceries. Margaret is a family caregiver, one of nearly 35 million Americans providing unpaid care to an older adult. A new paper by Justice in Aging, Advocacy Starts at Home: Strengthening Supports for Low-Income Older Adults and Caregivers, and accompanying video outline the challenges Margaret faces in helping her mother age safely at home in dignity.


Report Addresses California’s Shortage of Primary-Care Physicians

FEB 8, 2016 | Physicians News Network | CPCA Report: HORIZON 2030: Meeting California’s Primary Care Workforce Needs

The California Primary Care Association (CPCA), which represents community health centers that provide care to one in seven Californians, released a report that provides a sobering analysis of California’s healthcare workforce today while detailing key opportunities to meet the workforce needs of tomorrow.

According to the California Academy of Family Physicians, well-qualified new physicians who would like to train in the state instead must leave California due to limited residency opportunities, often not returning to practice in California (CAFP, 2015).

As reported on ABC 10, California’s population growth, coupled with an increase in insured Californians under the Affordable Care Act, means that the state’s primary-care doctors are in higher demand than ever. The implications are that people could have longer wait times to get into the doctor as well as fewer doctors to coordinate their care.

At a national level, The Robert Graham Center suggests education reform that includes medical-school debt relief, increased primary-care training, and reimbursement reform to attract more physicians to the primary-care field.


CMS Releases Guide to Reduce Health Disparities in Hospital Readmissions

FEB 5, 2016 | Justice in Aging

Reducing health disparities for racial and ethnically diverse Medicare beneficiaries is a key part of the Center for Medicare and Medicaid Services (CMS) health equity plan. Medicare hospital readmissions have implications for quality improvement, cost savings, and health equity. Last week, the Center for Medicare & Medicaid Services (CMS) Office of Minority Health released a guide to preventing readmissions among racially and ethnically diverse Medicare beneficiaries. This guide outlines key issues and offers strategies to prevent readmissions for racially and ethnically diverse patients, high level recommendations for moving the needle on readmissions for diverse populations, and case studies demonstrating how these recommendations work in practice. The guide also contains useful data for advocates that detail health disparities in the top conditions in the CMS hospital readmissions reduction program and health disparities in top chronic conditions.

While the guide focuses on hospital readmissions, the ideas to improve communications and continuity of care for racially and ethnically diverse Medicare beneficiaries can be applied in many settings. For example, the guide highlights the importance of language access – during the hospital stay, at discharge, and when accessing post-hospital care. Advocates can work with providers in their communities to promote these practices to combat health disparities among racial minorities and individuals with limited English proficiency.

At Justice in Aging we work to ensure that low-income seniors have access to the health care they need and that the programs and services they are entitled to by law are delivered without discrimination.


California's Health Care Safety Net: A Sector in Transition

JAN 14, 2016 | California HealthCare Foundation (CHCF) | REPORT

California's Health Care Safety Net: A Sector in Transition covers a period of significant change, with the 2014 implementation of the federal Patient Protection and Affordable Care Act (ACA), which expanded Medi-Cal eligibility to most adults with incomes up to 138% of the federal poverty level (FPL) and established state health care exchanges that enables individuals to purchase insurance, often with federal subsidies.


Governor’s Budget is a Start But Doesn't Go Far Enough for Poor Seniors

JAN 2016 | Justice in Aging | Governor's Budget is a Start But Doesn't Go Far Enough for Poor Seniors

Rates of senior poverty in California are high and rising, with more than one million seniors in one of country’s wealthiest states struggling to pay rent, buy food, and cover health care costs. California Governor Jerry Brown released a proposed budget for fiscal year 2016-2017 that provided some relief, but more action and bolder policies are needed.


New Fact Sheet: Medicare Part D – 2016 Transition Right

JAN 2016 | Justice in Aging | FACT SHEET

The Centers for Medicare and Medicaid Services (CMS) requires that sponsors of Medicare Part D prescription drug plans provide beneficiaries with access to transition supplies of needed medications to protect them from disruption and give adequate time to move over to a drug that is on a plan’s formulary, file a formulary exception request or, particularly for Low Income Subsidy (LIS) recipients, enroll in a different plan.

Transition rules apply to stand-alone Medicare Prescription Drug Plans (PDPs), Medicare Advantage Plans with Prescription Drug Coverage (MA-PDs), and Medicare-Medicaid Managed Care Plans participating in the Dual Eligible Financial Alignment Demonstrations. Transition rules are particularly important for low income beneficiaries who were automatically reassigned to new plans, which may or may not cover their medications. In addition, all plans change their formularies each year, so even people who remain in the same plan may find that their plan no longer covers their medications or has newly imposed utilization management requirements.

To assist advocates with transition issues, this fact sheet sets out the CMS minimum requirements for all plans. For further information, contact Georgia Burke,