Most older adults want to age at home and in their communities. Many will need long-term care, also known as long-term services and supports (LTSS) to do so. Long-term care must be robust, accessible, and affordable for those who need it most.
Why Long-Term Care Matters
While long-term care is essential to helping older adults live and age where they choose, current systems are not set up to offer and deliver the services and supports most need.
Focus Areas
State and federal policies and programs need to close coverage gaps, simplify systems, and ensure that every older adult has access to home and community-based supports (HCBS).
Addressing Gaps in Emergency Response Symptoms for Older Adults Impacted by Wildfires
Apr 2026
California
Long-Term Care
In January 2025, residents of Los Angeles County survived extensive wildfires and navigated its aftermath.Widespread evacuations resulted in the displacement of many older adults, who faced heightened risks due to mobility limitations, chronic conditions, sensory impairments, reliance on medications and medical equipment, and increased exposure to smoke and stress.
The rising costs of long-term services and supports (LTSS), also known as long-term care, are one of the biggest—and least understood—risks facing older adults and their families. Nearly 70 percent of Americans will need LTSS, yet most lack meaningful protection against the financial and practical challenges that come with needing help over time. Middle-income families are especially vulnerable, often earning too much to qualify for Medicaid while being unable to afford high out-of-pocket expenses.
California Philanthropic Funders Respond to Deferred Medicaid Funding
May 2026
California
Long-Term Care
Every society reveals its values through how it cares for people with the greatest health and support needs – and for the families, caregivers, providers, and community organizations that sustain them. For millions of Californians, Medicaid is not simply a budget line item, but a lifeline to the state’s health and social care infrastructure. It supports older adults, people with disabilities, children and families, those with low-incomes, and other Californians who rely on essential health, behavioral health, home- and community-based, and long-term care services.
Caregiving Crisis: Is Long-Term Care Financing Reform the Solution?
Mar 2026
Long-Term Care
The United States is at an inflection point. As our population ages, the demands on our long-term care system are accelerating; however, the system itself has not kept pace. What we are witnessing is often described as a “caregiving crisis,” but that framing understates the reality.
Medi-Cal 1115 Waiver Renewal: Policy Recommendations to Strengthen HCBS and CalAIM in California
Mar 2026
California
Long-Term Care
Medi-Cal continues to be a critical access point for health care and home and community-based services (HCBS) for older adults and people with disabilities. As these populations grow and their needs change, it’s imperative that Medi-Cal evolve to remain responsive.
