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California Creates a 'Master Plan for Aging’

From housing and health care to inclusion and equity, AARP helped shape the agenda and bold goals

In January 2021, Governor Gavin Newsom unveiled the California Master Plan for Aging — an agenda aimed at preparing America’s most populous state for massive demographic change over the coming decade. The plan, in which AARP played a central role, resulted from a collaborative effort involving a range of stakeholders and state agencies.

California Master Plan for Aging report

California Department of Aging

The cover of the report "Master Plan for Aging: California for All Ages."


Click on the image to visit the Master Plan on Aging website and download the 44-page PDF of the plan.

“By 2030, 10.8 million Californians will be age 60 or over,” explains AARP California State Director Nancy McPherson. “That means older adults will make up one quarter of the state’s population, nearly double the number 10 years ago — a growth rate larger than any other age group. The cost of being unprepared for this shift is unaffordable and untenable.”

The Master Plan for Aging (MPA) outlines five “bold goals,” as they’re officially designated, along with 23 long-term strategies and more than 100 initiatives meant to launch within two years. (See the box at the end of this page for details.)

Each goal is assigned to a lead agency, which will work in partnership with businesses, nonprofits, the federal government, the state legislature and other entities. The MPA Local Playbook offers guidance for getting projects up and running. Members of the public can monitor progress via an online Data Dashboard for Aging that will be updated over time.

“The Master Plan for Aging promotes an age-friendly California for all,” McPherson says. “It lays out a broad vision of actions we all must take — residents, advocates, the public and private sectors — to ensure older adults can remain in their communities as they age, while living, working, playing, and accessing care and services where and how they choose. It’s the required blueprint for driving action on the goals and ensuring transparent accountability for the results.”


Paving the Way for a Plan

Master Plan for Aging is a blueprint that:

  • includes planning for 10 or more years

  • is generally led by a governor with other executive and legislative leaders

  • is developed to guide restructuring of state and local policy, programs, and funding geared toward aging well in the community

“Our nation as a whole — and every state across the country — is getting older and will likely be older in perpetuity. California’s comprehensive Master Plan for Aging is an important step toward ensuring that state residents will have the support they need to thrive as they age. It’s a great example that other states and communities can look to as they address their particular needs and challenges.”

— Nancy LeaMond, AARP Executive Vice President and Chief Advocacy and Engagement Officer

"A successful master plan joins the public, private and independent sectors in creating systems-based solutions that touch all major areas of the aging life experience," says William Armbruster, a senior adviser for AARP Livable Communities and manager of the AARP Network of Age-Friendly States and Communities. "It identifies priorities using data and stakeholder input, and it establishes measurable outcomes to address those priorities. A master plan is designed to be adaptable — to be reviewed and updated over time."
 
The drive to bring an MPA to California kicked off during the 2018 gubernatorial race, when AARP, along with at least a dozen other organizations, raised the issue at the candidate forums it hosted. After the election, AARP sponsored Assembly Bill 1118, which would oblige California to consider joining the AARP Network of Age-Friendly States and Communities (the U.S. affiliate of an international program aimed at preparing cities for the impacts of a rapidly aging population).
 
Although the bill as originally written didn’t mention an MPA, statewide membership in the AARP age-friendly network requires creating such a plan. Officials from the nearly 50 California communities that already belonged to the network signaled their support. Meanwhile, AARP representatives lobbied the California Health and Human Services Agency (CHHS) on the urgency of the task at meetings of a state work group on long-term disability programs.
 
In June 2019, the newly elected Newsom responded to this growing momentum — and delivered on his own campaign promise — with an executive order setting the development of California’s plan in motion. It called for CHHS to convene a cabinet-level Work Group for Aging, as well as an MPA Stakeholder Advisory Committee and subcommittees focused on research and long-term care.

Priorities for an Age-Friendly Future

The 25-member Stakeholder Advisory Committee began meeting that September — just as the state legislature passed AB 1118, with an amendment stipulating that consideration of age-friendly network membership be added to the master plan. Subcommittees and work groups on other topics were later established. (After the COVID-19 pandemic hit in March 2020, most business was conducted virtually.)

Early on, AARP California State Director Nancy McPherson laid out the organization’s priorities for the MPA in a letter to California Health and Human Services director Mark Ghaly. These included:

The 5 'Bold' Goals

Goals of the California Master Plan for Aging

California Department of Aging


Read the "Plan Details and To-Do's" box at the end of this page to learn about the goals, strategies and initiatives that make up the California Master Plan for Aging.

  • Laying the groundwork for the state to join the AARP Network of Age-Friendly States and Communities

  • Enabling the creation of an innovative, viable and sustainable social insurance LTSS program

  • Providing greater support for family caregivers, including expansion of paid family leave

  • Advancing solutions to alleviate long-term care workforce shortages

  • Examining the disparities in health and wealth experienced by multiracial communities of older adults, and making recommendations to address the inequities

Three AARP representatives participated directly in the drafting process:

  • Associate State Director Nina Weiler-Harwell was appointed to the Stakeholder Advisory Committee; she also served on the Long-Term Services and Supports Subcommittee and co-led the Livable Communities writing team.

  • Planning and Research Advisor Stacey Moore was named to the Research Subcommittee, helping to generate data that informed every aspect of the master plan.

  • Executive Council Member Rita Saenz joined the Equity Work Group, which strove to ensure that the plan provided equity in services to members of vulnerable, underserved and diverse population cohorts.

When the California Master Plan for Aging was released, after more than a year of work, all of these imperatives were woven into its fabric. As implementation of the plan moves forward, AARP will continue to provide advice, advocacy and expertise. “The ultimate goal,” says Jennifer Berdugo, Planning Advisor for AARP California, “is for this state to be a place where people can see themselves living at all stages of their life.”

California may also become a model for other states faced with an aging populace, inspiring them to design their own master plans.

“Our nation as a whole — and every state across the country — is getting older and will likely be older in perpetuity,” says Nancy LeaMond, AARP Executive Vice President and Chief Advocacy and Engagement Officer. “California’s comprehensive Master Plan for Aging is an important step toward ensuring that state residents will have the support they need to thrive as they age. It’s a great example that other states and communities can look to as they address their particular needs and challenges.”

The Plan Details and To-Do's

The California Master Plan for Aging (MPA) calls for action in five areas. Listed with each are some of the strategies and initiatives that AARP California took a lead role in developing.

GOAL 1: Housing for All Stages and Ages

TARGET: Provide millions of new housing options where residents can age well.

Older adults should have access to housing that meets their changing needs across the decades. Yet such options are limited in California, where median home prices are more than double the national average in some urban areas. The MPA commits the state to providing affordable communities that are age-, disability- and dementia-friendly, and capable of withstanding the challenges of climate change and natural disasters.

STRATEGIES INCLUDE:

Producing more homes to fill the state’s multimillion-unit shortfall

Providing outdoor and community spaces for all ages

INITIATIVES INCLUDE:

Initiative 1: Identify ways to increase production of affordable housing options — such as accessory dwelling units on existing properties — in urban, suburban and rural communities.

Initiative 20: Explore approaches for targeting public and private park funds to age- and disability-friendly activities for all ages, in all areas of the state.


GOAL 2: Health Reimagined

TARGET: Close health equity gaps and increase life expectancy.

Older adults should have access to the services they need to live in their homes and communities while optimizing health and quality of life. Yet many Californians — particularly those with lower incomes, living in rural areas, or without U.S. citizenship — find it difficult to obtain adequate health care. Another problem area is home care, which can be unaffordable even to middle-income individuals due to lack of coverage by Medicare. And as the COVID-19 pandemic has shown, care at skilled nursing facilities is often tragically inadequate. The MPA addresses all these issues.

STRATEGIES INCLUDE:

Bolstering older adults’ ability to receive healthcare at home or in community settings

Promoting innovation in nursing homes

INITIATIVES INCLUDE:

Initiative 33: Advocate with the federal government to create a universal Long-Term Services and Supports (LTSS) benefit, and assess opportunities for federal/state partnerships.

Initiative 69: Expand transparency on state nursing-home data — including quality, staffing and financing — in COVID-19 and other areas.


GOAL 3: Inclusion and Equity, Not Isolation

TARGET: Keep increasing life satisfaction as California residents age.

Older adults should have lifelong opportunities for activities that offer a sense of purpose and connection, such as work, volunteering and community leadership. Digital technologies are key to such opportunities in our web-centric society. Yet more than two million Californians lack access to high-speed internet, and over one-third of Americans over 60 don’t go online at all. In addition, two-thirds of older adults seeking employment cite age discrimination as an obstacle. The MPA offers a variety of remedies.

STRATEGIES INCLUDE:

Closing the digital divide

Expanding older adults’ access to trustworthy sources of information, assistance, and opportunities for engagement

INITIATIVES INCLUDE:

Initiative 81: Execute the State Broadband Council’s strategic plan for increasing internet access, with a focus on including adults aged 60-plus.

Initiative 83: Develop a plan to launch digital literacy support for older adults and providers.

Initiative 98: Implement an online “No Wrong Door” system, designed to assist individuals in accessing long-term services and supports.  

Initiative 100: Enroll California in the AARP Network of Age-Friendly States and Communities.


GOAL 4: Caregiving that Works

TARGET: Create one-million high-quality caregiving jobs.

Individuals who do the daily and hands-on work of caring for older adults should have the support they need to perform this essential service without sacrificing their own physical, emotional or financial health. Across California, almost five million family caregivers assist loved ones with daily tasks. The work can be deeply rewarding, but it can also result in serious hardships for those who perform it. Paid caregivers, for their part, face low wages, high levels of stress and an elevated risk of bodily injury. The MPA outlines measures to improve life for all caregivers; it also mandates expanding virtual care and telehealth to offset an expected shortfall of 3.2 million paid care workers in the coming years.

STRATEGIES INCLUDE:

Providing support for family and friend caregivers

Expanding access to virtual care

INITIATIVES INCLUDE:

Initiative 107: Promote current state paid family leave benefits to older Californians, people with disabilities and family caregivers.

Initiative 109: Develop options to include family caregivers in home and community assessments.

Initiative 114: Identify innovative models and solutions to enhance telehealth access for Californians of all ages, races and ethnicities.

Initiative 115: Expand telehealth access to multiple Medi-Cal delivery systems, incorporating lessons from COVID-19.


GOAL 5: Affording Aging

TARGET: Close financial equity gaps and increase elder economic security.

Older adults need economic security to live and age well. Yet retirement savings are lower than for previous generations, and growing numbers of older Californians are overly reliant on Social Security alone — which leaves them unable to keep up with the rising costs of housing, healthcare and other necessities. California has the second-highest rate of poverty among older adults in the country, leading to high levels of hunger and increasing homelessness. The MPA attacks these trends on several fronts.

STRATEGIES INCLUDE:

Ending homelessness for older adults

Ensuring income security as Californians age

Protecting older adults from poverty and hunger

INITIATIVES INCLUDE:

Initiative 117: Further develop the network of housing needed to prevent older adults from falling into homelessness, and provide expanded support at housing placements.

Initiative 123: Promote CalSavers, the state’s retirement savings program for workers whose employers do not offer a retirement plan.

Initiative 131: Streamline older and disabled adult enrollment, renewal and online shopping in CalFresh, the state’s Supplemental Nutrition Assistance Program.

Kenneth Miller is an award-winning writer and editor based in Los Angeles. His work has appeared in Time, Life, Esquire, Rolling Stone, Discover, Mother Jones, Salon, Reader’s Digest, Parade, Prevention, Los Angeles Times Magazine and many other publications.

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