By 2030, there will be over 8.6 million people aged 65 and older in California; one in five Californians will be a senior. As Californians live longer, we must develop better strategies at the State level to enable older people to remain engaged members of our communities and age with dignity.
Recognizing that this population shift presents challenges but also great opportunities, Governor Newsom signed an Executive Order in June to create California’s first Master Plan for Aging. This Plan will serve as a blueprint for state government, local communities, private organizations, and philanthropy to promote healthy aging. As part of this process, the State government and organizations across California have begun engaging more deeply in a conversation on just what is meant by these words: a “Master Plan for Aging.”
San Francisco has plentiful experience and insight to share. Our City has shown great leadership in building out better systems of care and support for older people and adults with disabilities. Our Community Living Fund program — which transitions people out of skilled nursing into the community — is being replicated in many other counties. In 2016, we led the way with Proposition I which established the Dignity Fund, a long-term tax set-aside for aging and disability services. We are piloting a home care subsidy for people who don’t qualify for Medi-Cal’s In-Home Supportive Services, and crafting specialized resources for LGBTQ community members. And we’re supporting innovative programs, from intergenerational initiatives to employment opportunities, that recognize the skills and talents that older people and adults with disabilities bring to our community.
To support the State’s efforts to gather input from diverse communities, we held a forum last week in San Francisco that was attended and livestreamed by over 1,000 people. Several local leaders — including Mayor London Breed, Senator Scott Wiener, Assemblymember David Chiu, Board President Norman Yee, and Supervisor Sandra Fewer – spoke about what the Master Plan means for San Francisco and what we hope to see included.
So, what should we be looking for in a State-level Master Plan?
First, the Master Plan must improve integration across systems. The State landscape for aging and disability services is vast and fragmented: over 100 programs spread across 20 agencies and administrative units. Lack of coordination across these system silos spills downward into counties and often inhibits integration at the local level. The result is a complicated network of services that requires people to go from place to place just to handle one item, like applying for housing. When multiplied across the array of services we need as we age, the task quickly becomes daunting. The Master Plan is an opportunity to align resources in a way that makes accessing them simpler.
Second, we must take a whole person approach. The Master Plan must go beyond health and human services to consider underlying social factors, like transportation and housing, that impact an individual’s outcomes. The disability community must be incorporated in a meaningful way. And the Master Plan must develop a network that supports all older people and adults with disabilities, including those ineligible for basic social safety net services but who can’t afford to pay out-of-pocket for the things they need.
Third, the Master Plan should incorporate flexibility. Our experience with the Dignity Fund has shown the value of allowing a community to have a strong voice in identifying its needs and developing the right solutions. California is incredibly diverse, and local communities must be supported to develop strategies tailored for their unique needs.
Fourth, the Master Plan needs to factor in the continued growth of the aging and disability populations so that we have enough resources to go around. By 2030, our senior population will have almost doubled. But we shouldn’t be scared: California is a leader in innovation, and our changing population is an opportunity to exhibit our ability to develop groundbreaking solutions. This is also a matter of equity and justice. Services like accessible transportation and coordinated healthcare support people to safely live and engage in their communities. We must uphold our State’s values of inclusion and justice so that older people are not marginalized but instead are empowered to participate and contribute to our society.
California’s first Master Plan for Aging can – and should – be ambitious and forward looking. As leaders in service delivery, policy development, and County systems administration, we look forward to sharing our knowledge and our voices to help make California a better place for all ages and abilities.
Shireen McSpadden is the executive director of the San Francisco Department of Aging and Adult Services and co-chair of the San Francisco Long Term Care Coordinating Council. Marie Jobling is the executive director of the Community Living Campaign, Co-Chair of the Dignity Fund Coalition, and a member of the San Francisco Long-Term Care Coordinating Council.