After the release of California’s Master Plan for Aging (“MPA” or “Plan”) in January 2021, the California Department of Aging (CDA) appointed and convened the Implementing the Master Plan for Aging in California Together (IMPACT) Stakeholder Committee to provide guidance on implementation of the Plan. With diverse representation and expertise, the IMPACT Committee focuses on accountability, outcomes, and continued improvement toward the realization of the five bold goals of the MPA.
Now at the halfway point, five years into the implementation of the Plan, the IMPACT Committee has prepared this report to provide feedback on MPA implementation and recommendations for the considerable work ahead. The Committee has consistently emphasized accountability, equity, and meaningful outcomes for older adults, people with disabilities, and caregivers. This midpoint offers a unique opportunity not only to reflect on progress and challenges, but also to prepare for the next five years at a time when fiscal, demographic, and policy realities are in a state of uncertainty.
Additionally, beginning in 2027, a new state administration will be tasked with following through on the implementation of the MPA. California is at a critical juncture in the MPA implementation, and the state should be focused on identifying the path forward, including revenue streams, to meet the needs of older Californians.
The report is divided into four sections. The first section reviews the current landscape for older adults and people with disabilities, both nationally and in California. The second section outlines the committee’s response to the most recent MPA annual report. The third section reviews the lessons learned from the first 5 years of MPA implementation, and the fourth section delves into the areas of focus that the IMPACT committee has identified for the next 5 years of implementation.
Section 1: State and Federal Landscape for Older Adults and People with Disabilities
The IMPACT Committee recognizes the difficult fiscal condition that the state is currently experiencing, the significant uncertainty regarding funding and programs from the federal government, and the upcoming transition of the current state administration. The MPA was created as a road map to guide state investments in services during both times of surplus and fiscal downturns, and the IMPACT committee urges the Governor and the Legislature to maintain their commitment to services for older adults and people with disabilities.
Additionally, cuts to federal funding for programs will put further strain on state aging and disability services that are already underfunded. We cannot afford to lose these critical programs, and the state must work to find ways to maintain these critical services that older adults and people with disabilities rely on. This year’s MPA annual report shows how successful many of the new investments in aging and disability have been. Reversing those investments will only set us back further in creating a state where older adults and people with disabilities can age with dignity.
With this understanding, the IMPACT committee is opposed to many of the proposals included in the Governor’s January proposal and May Revision of the 2026-27 state budget. Unfortunately, the Governor’s budget proposals roll back many recent MPA investments, erasing years of work and breaking the Master Plan for Aging’s promise to build a California for all ages and stages.
Specifically, the budget proposals include cuts to the IHSS program, lowering the Medi-Cal asset limit to $2,000 for older adults and people with disabilities, raising the eligibility age for Adult Protective Services (APS) to 65, additional rate cuts to the Program for All-Inclusive Care for the Elderly (PACE), and further cuts to immigrant health – including lawfully-present immigrants.
Taken together, these cuts represent over $1 billion in cuts to health and human services programs for older adults and people with disabilities – completely counter to the goals of the MPA and the accomplishments that this administration has taken credit for. It is critical that the Governor and Legislature reaffirm their support for recent expansions of programs and services under the MPA and reject any proposals that look to older adults, people with disabilities, and their families to bear the brunt of any budget shortfall the state is facing.
We must acknowledge the growing needs of older adults and people with disabilities. California’s aging demographic, combined with the rising number of adults living with disabilities, continues to expand rapidly, placing greater demands on systems of care. At the same time, the aging network itself is navigating significant transition and transformation through ongoing statewide initiatives such as CA2030 and broader changes impacting the Area Agency on Aging network. During periods of system change, preserving stability in community-based services and supports becomes even more critical for the Californians who rely on them every day.
Section 2: Response to Annual Report
The IMPACT Committee appreciates CDA for its work preparing this year’s annual report. The annual report shows the breadth and depth of how the MPA is being implemented across state government. The annual report also highlights the importance of engaging stakeholders in the implementation process, and how future implementation of the MPA will, in part, be guided by those with lived experience. The ongoing success and future of the MPA must involve meaningful stakeholder involvement. Moving beyond feedback alone and toward deeper partnership and engagement with local voices will be essential as the state continues advancing the MPA initiatives and broader aging network transformation efforts.
While the annual report does a good job of laying out achievements of the MPA, one of the previous recommendations from the Committee was that the annual report include a summary of completed initiatives and an update on incomplete initiatives. Once again, the annual report does not address the status of initiatives. Especially given the frequent updating of initiatives – it is difficult to track where we stand on our progress. In addition, the annual report highlights achievements that were not necessarily MPA initiatives in the past, compounding the difficulty of parsing out achievements on specific initiatives.
Furthermore, in its 2023 report “Early Implementation of California’s Master Plan for Aging”, the Little Hoover Commission shared recommendations on how to better ensure, measure, and sustain progress on the MPA. The recommendations include clarifying leadership roles, clearly delineating the status of initiatives, establishing a roadmap for implementation of all initiatives, and merging datasets across the administration to inform future planning and ensure accountability. It is vital that the administration incorporate these recommendations into future reporting on MPA implementation and progress.
As we enter this next phase of MPA implementation, amid an uncertain federal and state budget climate, keeping track of our progress is critical. If the Governor’s budget proposals are included in the final budget, it will be essential that any reversals or cuts to previous MPA investments are specified.
Section 3: Lessons Learned in First Five Years of MPA Implementation
Goal 1 – Housing for All Ages and Stages
Over the first five years of implementation, California has made meaningful progress in advancing Goal 1. The state has elevated housing stability as a central issue in aging policy and taken important steps to align housing, health, and social services. Key milestones include the launch of a three-year Statewide Action Plan for Preventing and Ending Homelessness, the expansion of housing-related Medi-Cal supports such as Transitional Rent, continued investments in programs like Home Safe and the Housing and Disability Advocacy Program (HDAP).
At the same time, the state has significantly advanced efforts to accelerate housing production and reduce regulatory barriers, recognizing that long-term housing stability for older adults depends on both immediate supports and increased housing supply. To increase supply, the state has enacted laws to expand accessory dwelling units, allow residential lot splits, promote adaptive reuse of existing buildings, and streamline approvals to promote infill housing. In addition, the state’s decision to establish a new California Housing and Homelessness Agency represents a significant structural shift intended to strengthen coordination and oversight of housing and homelessness policy.
These efforts reflect real progress and a growing recognition that housing is foundational to health, stability, and the ability to age with dignity. However, the scale of need continues to outpace the current response. Older adults are the fastest-growing population experiencing homelessness. Adults aged 50+ now represent nearly half of the homeless population, and many are experiencing homelessness for the first time later in life.
Housing affordability remains a primary driver of older adult homelessness. A significant share of older adults—particularly those living on fixed incomes such as SSI/SSP—are severely rent-burdened, leaving them one unexpected expense away from losing housing. Over 400,000 older adults are paying more than 50% of their income towards rent. The IMPACT Committee has consistently emphasized that rental subsidies are a critical missing component, yet they are no longer a clearly defined standalone priority within current MPA initiatives. At the same time, while programs like Home Safe and HDAP have demonstrated strong outcomes in preventing homelessness, they are limited in scale and funding is uncertain.
California has made important investments and structural changes, but housing instability among older adults continues to grow, and prevention must become a central strategy moving forward.
Goal 2 – Health Reimagined
Over the first five years of implementation, California has made meaningful progress in advancing Goal 2. The state has elevated investments in health care and long-term services and supports (LTSS) as a central issue in aging policy. Key accomplishments include: expanding Medi-Cal to all income-eligible Californians regardless of immigration status; increasing the Medi-Cal Aged, Blind, and Disabled income limit to 138% FPL; reforming the Medi-Cal asset limit for older adults and people with disabilities; implementation of the CalAIM community supports and enhanced care management. The state has also made investments around caregiver training, increased the number of slots for HCBS programs, and launched the LTSS financing initiative.
These investments have been critical in making progress on creating a more equitable and accessible home care system for all Californians. These investments in HCBS are also a smart fiscal decision for the state. Without these HCBS, we know that the only option for older adults and people with disabilities is institutionalized care – which is significantly more expensive for the state.
The majority of older adults and people with disabilities want to live at home, even as their needs for care change. However, despite the gains made in the first five years of MPA implementation, California still lacks an affordable, inclusive, and equitable system to support them. Right now, too many Californians cannot afford in-home care. In fact, between 2019 and 2024, private pay long-term services and supports (LTSS) costs increased by nearly 50%, with the steepest rises in the most commonly used services — home care and assisted living.
Many people, especially those with complex needs, and people of color—due to structural discrimination and systemic health inequities – are forced to ultimately receive their care in more expensive institutional settings, like nursing facilities. By maintaining and improving investments in at-home care and support, California can lead the nation in ensuring everyone can get the help they need to live with dignity as they age and prevent aging into poverty. The need for investment in an affordable, accessible home care system for all Californians remains urgent.
Goal 3 – Inclusion and Equity, not Isolation
Over the past 5 years, the state has made progress in advancing Goal 3 on inclusion and equity. Notably, progress has expanded opportunities for older adults and people with disabilities to remain socially connected, engaged, and protected within their communities. The state has increased access to work, volunteering, and intergenerational engagement programs to reduce isolation, while also investing in broadband access and digital literacy to help close the digital divide and improve access to services and social connections.
At the same time, California strengthened protections against elder abuse, neglect, and financial exploitation through improved coordination, awareness, and support systems – but there is more work to be done. The state made progress in increasing eligibility for Adult Protective Services by lowering the eligibility age to 60, however, that progress is now at risk with the Governor’s proposal to increase the age back to 65.
Equity has been a central focus across all efforts of the MPA, with policies designed to address disparities affecting diverse populations based on race, income, language, and disability, ensuring more inclusive access to resources and opportunities. Importantly, CDA conducted its first statewide survey of LGBTQ+ older adults.
Additionally, initiatives promoting age-friendly employment have supported economic participation and stability for older adults. CDA has also launched the lived experience advisory committee, which is aimed at better understanding the needs of and hearing directly from older adults in the MPA implementation process. Finally, there has been an increased effort to focus on older adult behavioral health – recognizing that there are significant and unique needs that older adults have.
Goal 4 – Caregiving that Works
Over the past five years of implementation, California has made progress in advancing Goal 4, particularly by having access to one-time funds. Key accomplishments include implementation of CalAIM Community Supports, including respite care, and advancing plans to serve diverse caregivers across communities and geography, and improving understanding of the needs and training resources for the direct care workforce.
The California Department of Aging, in collaboration with the University of California, Davis Family Caregiving Institute, developed the CA Caregiver Equity Plan to create a more inclusive, responsive, and equitable system of caregiving services and supports for all Californians. Current efforts focus on developing a minimum dataset across settings and to better understand caregiver demographics, needs, assessment practices, and service gaps across California. CDA, through a grant from the Administration for Community Living (ACL), is developing, testing, and scaling models to improve awareness, navigation, and educational opportunities for California’s caregivers, in alignment with the National Strategy for Family Caregivers.
Several efforts have focused on preparing the direct care workforce. Funded by an ACL grant, CDA with LWDA, CCCCO, DDS are developing a training curriculum for Direct Support Professionals who serve individuals with I/DD, other direct care workers, and family caregivers. The CA Employment Development Department (EDD) and LWDA have expanded training opportunities as well as career ladder avenues to strengthen the pipeline into various opportunities to care for older adults and persons with disabilities.
CA has demonstrated commitment to building the capacity of families and direct care workers. However, the longer-term plan for investment in both family caregivers and direct care workers, who provide the majority of community-based care, has not been formalized and many of the services and supports face threats based on federal policy and funding changes.
Goal 5 – Affording Aging
Over the past 5 years, the state has made progress on advancing Goal 5 of affording aging by working to improve economic security for older adults and people with disabilities. California’s older adults are caught between two crises that reinforce each other: declining health and financial insecurity. About half of Californians 60 and older in fair or poor health report facing material hardships — food insecurity, housing instability, or the threat of losing utility access — making clear that health and poverty do not arrive separately. Affordability is not a parallel concern to health. It is a determinant of it — and for older Californians already living below the cost of living on fixed incomes, the two are inseparable.
Importantly, in 2024 the SSI/SSP grant amount was reinstated to the pre-recession level, however the grant amount has not kept up with rising inflation. The state has also made investments in nutrition programs, including a planned expansion of the CFAP program to all those age 50 and over regardless of immigration status. The state utilized one-time federal funds to increase funding for critical senior nutrition programs. In addition, broader investments across the Master Plan—including expanded transportation, health care affordability, and community services—have helped reduce the financial burden associated with aging.
Section 4: Recommendations for Next Five Years of MPA Implementation
Goal 1 – Housing for All Ages and Stages
Building on the progress of the first five years of the MPA, the IMPACT committee has the following 4 recommendations for making progress under Goal 1:
Establish a statewide shallow rental subsidy program
California should create a statewide shallow rental subsidy program targeted to older adults and people with disabilities at risk of homelessness. This has been a main priority for the IMPACT committee for the last five years, and shallow rental subsidies are an evidence-based solution to preventing older adult homelessness. This program should: focus on prevention by assisting those who are rent-burdened, but not yet homeless, as well as prioritize individuals on fixed incomes (e.g., SSI/SSP), those with health vulnerabilities, and those at risk of displacement.
Preserve and expand proven prevention programs
Programs such as Home Safe and HDAP should be sustained with ongoing funding, implement expanded eligibility, and be better integrated into broader housing and health care systems. These programs are among the only targeted homelessness prevention tools for older adults and have demonstrated strong outcomes.
Accelerate production of affordable and accessible Housing
Rental assistance alone is insufficient without an adequate housing supply. The state should continue to streamline housing development, prioritize accessible, service-enriched housing for older adults, and align housing investments with health care and long-term services and supports (LTSS).
Clarify governance, accountability, and outcomes for the Housing and Homelessness Agency
As California establishes the new Housing and Homelessness Agency, it will be critical to define clear roles and responsibilities across housing, health, and aging systems. We recommend the Agency adopt specific performance metrics focused on older adults including: reduction in older adult homelessness, increase of accessible units, number of individuals prevented from homelessness, housing stability outcomes (e.g., 12+ month retention), and reduction in first-time homelessness among older adults. Ensuring that the agency’s work is explicitly aligned with MPA Goal 1 and that outcomes for older adults are tracked will be essential to achieving meaningful system change.
Goal 2 – Health Reimagined
Building on the progress of the first five years of the MPA, the IMPACT committee has the following 6 recommendations for making progress under Goal 2:
Reform the Medi-Cal share of cost program
The Medi-Cal share of cost program extends Medi-Cal eligibility to low-income older adults and people with disabilities who have significant health care needs but are just above the free Medi-Cal income limit. The share of cost program acts as a critical pathway to health care coverage and long-term supports and services. But outdated income limits force people to spend more than half of their income on health care needs every month, forcing older adults and people with disabilities into deep poverty. The administration should fund share of cost reform, as included in the 2022-23 state budget, and raise the maintenance need level to 138% of the federal poverty level.
Creation of a stable and dedicated financing structure for LTSS
In order to ensure that the state can make the critical investments in our LTSS system, as well as prepare for the increased utilization of LTSS – there must be a stable and dedicated financing structure for LTSS in California. The Administration should focus on identifying the revenue streams that will fund a universal, accessible and affordable LTSS system. Without developing a plan for the funding stream, we will never see the scale of investment that is needed in order to realize the goals of the Master Plan for Aging.
Build an accessible, cohesive, statewide Home and Community Based Services (HCBS) system
Older adults and people with disabilities overwhelmingly want to live in their homes and communities. In fact, HCBS services are far more cost effective for the state than permanent institutional settings like nursing facilities. California should prioritize investing in our HCBS programs to make them more accessible to the Californians who need them. For instance, increasing slots and removing waitlists in HCBS waivers, taking the Assisted Living Waiver statewide, improving access to Community Supports, investing in the IHSS program, creating presumptive eligibility for HCBS, and increasing the Home Upkeep Allowance would put California on the path to truly harness the power of HCBS, and provide the support people so desperately need.
Make cognitive health assessment a standard component of primary care for every older Californian
Build on California’s existing infrastructure to support dementia screening in primary care through Dementia Care Aware, which has trained nearly 6,000 primary care clinicians across all 58 counties. BHSA implementation should explicitly fund and require integration of this infrastructure into Medi-Cal managed care contracts, ensuring that cognitive health assessment becomes a standard component of primary care for older adults.
Ensure California’s Rural Health Transformation Award builds digital health infrastructure that works for older adults from day one
California’s $233.6 million Rural Health Transformation Award presents an opportunity to embed aging-forward digital infrastructure into the state’s rural health system from the ground up. Rural Californians over 65 represent 26.5% of the target population; the state must treat their needs as a design requirement, not an accommodation.
The Administration should integrate aging-readiness requirements into CalRHT’s provider grant criteria, technology procurement standards, and hub-and-spoke network design. Specifically, the state should require that telehealth platforms, remote patient monitoring tools, and health information exchange systems funded through the award meet accessibility standards for older adults — including those with limited digital literacy, low broadband access, or sensory and cognitive challenges.
Expand eligibility for the Medicare Savings Program so that low-income older Californians are protected from the cost barriers that Medicare coverage alone does not resolve
The West Health-Gallup Healthcare Affordability Index found that 8.1 million Americans aged 65 and older did not seek needed health care in a three-month period due to cost — and 31% of older adults were concerned about their ability to pay for prescription drugs in the next year, up from 25% in 2022. This is happening to a population that is already on Medicare, meaning coverage alone is not sufficient protection against cost-driven poverty.
The Medicare Savings Program is a critical state-administered program that helps to make health care more affordable for low-income Medicare beneficiaries by providing assistance with paying the premiums and cost sharing associated with Medicare Parts A and B. The administration has taken great steps to make the program more accessible to older adults by lifting the asset requirement for the MSP program, but the administration should also raise the income requirement for the Qualified Medicare Beneficiary (QMB) program, as other states have done.
Goal 3 – Inclusion and Equity, not Isolation
Building on the progress of the first five years of the MPA, the IMPACT committee has the following 3 recommendations for making progress under Goal 3:
Focus on investing in older adult behavioral health
Behavioral health services are integral in supporting older adults to age with dignity. Older adults face significant behavioral health needs, and existing data show these needs often go unmet. The risk of suicide also increases with age, and is highest for those 85 and older. In 2019, 21% of all suicide deaths in California occurred among individuals age 65 and older. Older adults also experience high rates of cognitive decline and dementia that can compound their behavioral health needs and impact the behavioral health of their caregivers. The state should be focused on making targeted investments in programs that specifically support older adult behavioral health, as well as their caregivers. Investing in proven programs like the friendship line, local visitor programs that increase social connectedness, suicide prevention programs, and caregiver supports is critical.
Protecting sexual orientation and gender identity (SOGI) data for LGBTQ+ older adults and against discrimination in HCBS
At the federal level, policies seek to roll back the collection of SOGI data, making it much more difficult to track inequities at the intersection of age and sexual orientation/gender identity. State agencies should build upon AB 959, to improve data collection so that we have a better understanding of what happens as LGBTQ+ Californians age.
In addition, as other states expand non-discrimination protections for LGBTQ+ older adults in state-funded HCBS settings, California should explore building upon the success of SB 219 to include discrimination against LGBTQ+ older adults in home and community-based services, as well as in long-term care facilities.
Promoting age-inclusive employment practices across both the public and private sectors
The state should work to become a model employer for older adults by tracking, reporting, and increasing the hiring and retention of older workers across state government. As California’s population ages, creating pathways for older adults who want or need to remain in the workforce will help reduce isolation, improve economic security, and recognize the value, experience, and contributions older adults bring to the workforce and their communities.
Goal 4 – Caregiving that Works
Building on the progress of the first five years of the MPA, the IMPACT committee has the following 4 recommendations for making progress under Goal 4:
Implement statewide collective bargaining for IHSS workers
The state should transition to a statewide collective bargaining model for IHSS wages. IHSS workers are the backbone of the state’s HCBS system, serving nearly 900,000 IHSS recipients. Moving to statewide collective bargaining would standardize pay and benefits, strengthen the IHSS workforce, and improve stability in home care services, while addressing long-standing issues like low wages and fragmentation across counties.
Create a stable and dedicated financing structure for caregiver supports and services
California is one of few states with comprehensive caregiver supports in the form of the statewide Caregiver Resource Centers. California relies on family caregivers to provide the vast majority of long-term care and caregivers’ economic contributions are substantial in furthering cost savings for institutional care. Ongoing funding for these centers and the services they provide (consultation, counseling, respite, education, etc.) is essential to ensure that caregivers across diverse communities and geographies have equitable access to services and supports and can continue to contribute to the health and well-being of older adults and persons with disabilities.
Accelerate supports for the direct care workforce
Projected shortages in direct care workers, exacerbated by current immigration policies, threaten the health and well-being of older adults and persons with disabilities. The state should continue to expand and increase access to training opportunities, career ladder programs, and appropriate pay for IHSS workers. CDA partnerships with the Community College system is a promising approach to embed infrastructure that supports direct care worker preparation.
Implement a state-wide minimum dataset for family caregivers
The state should be collecting vital information about caregiver characteristics, needs, and outcomes across various programs and regions. This information is critical for both planning and advocacy.
Goal 5 – Affording Aging
Building on the progress of the first five years of the MPA, the IMPACT committee has the following 5 recommendations for making progress under Goal 5:
Strengthening programs that reduce poverty and food insecurity among older adults and people with disabilities
The state should be focused on protecting and expanding access to nutrition and income support programs for older adults and people with disabilities. The SSI/SSP program is one of the most important programs statewide for combatting poverty. It is critical for the state to increase the grant amount to keep up with rising costs and inflation.
Additionally, the state should be focused on ensuring the economic security of older adults and people with disabilities, regardless of immigration status. As federal eligibility rules continue to shift, the state must ensure older Californians are not left without access to the basic supports that protect health, safety, and independence.
Expand the Guaranteed Income Pilot beyond San Joaquin County if early data supports effectiveness
California’s high cost of living means that the federal Supplemental Security Income payment covers just 31.2% of basic costs of living in the state, one of the lowest coverage rates in the country, leaving older Californians with the fewest resources to manage the very conditions that drive their health needs. In June 2025, CDSS awarded the GI Pilot Program for Older Adults to GiveDirectly, in partnership with the Housing Authority of the County of San Joaquin. The program will provide $1,200 per month for 12 months to 240 adults aged 60+, residing in San Joaquin County, who are currently on the waitlist for Housing Choice Vouchers or Project-based Vouchers. If this program is showing promise, the state should expand to additional counties.
Expand access to cost sharing relief for older adults
National data confirms that out-of-pocket healthcare costs are not just a health care problem — they are an economic security problem. Millions of older Californians make at least one trade-off with daily living expenses to afford health care, from rationing prescriptions to cutting utilities, to depleting savings, and the burden falls hardest on the lowest income older adults and people with disabilities. The administration should expand access to programs that subsidize the high cost sharing associated with seeking health care such as the Medicare Savings Program and the Low-Income Subsidy program for Part D drugs.
Prioritize the LTSS Financing report due June 2026 as the foundational deliverable for the next five years; commit to acting on its recommendations
Long-term services and supports represent one of the most significant and least insured financial risks older adults face. Unlike acute medical care, LTSS, including home care, assisted living, and nursing facility services, are largely excluded from Medicare coverage, leaving most older Californians to pay out-of-pocket until they spend down to Medi-Cal eligibility. The result is a system that forces middle-income older adults into poverty as the price of getting care. With California’s 65 and older population projected to grow substantially over the next decade, the fiscal and human cost of inaction will only compound.
The LTSS Financing Report, due June 2026, represents the state’s most significant near-term opportunity to chart a sustainable path forward, one that gives Californians a way to plan for and finance long-term care without exhausting everything they have built over a lifetime. The state should treat this report not as a planning exercise but as the foundation for durable policy action, and commit publicly to acting on its recommendations.
Make the Older Californians Act Modernization funding permanent
Demand for services continues to grow, and waitlists for critical programs such as nutrition continue to expand across the state. While the modernization funding provided important short-term relief and helped stabilize local aging services, the current funding is set to sunset in 2029, and in some parts of the state, funding may no longer be available after this year. Without sustained investment, California risks losing critical infrastructure and progress made toward advancing the goals of the Master Plan on Aging.
Conclusion
The IMPACT Committee is grateful for the Governor’s leadership to date and for the work of the California Department of Aging and other agencies and departments to implement the Master Plan for Aging (MPA) over the past five years. We appreciate the opportunity to provide feedback and recommendations through this report and through our ongoing meetings.
When we began the MPA process more than five years ago, we could not have anticipated the circumstances we face today. However, the underlying need for, and the impetus behind, the MPA remain unchanged. Despite significant uncertainty surrounding federal and state programs, older adults and people with disabilities will continue to rely on services, supports, and systems that are responsive to the realities shaping their lives.
Among those realities, immigration warrants particular attention. California is home to nearly 11 million immigrants, representing 28 percent of the state’s population – the highest share of any state, and the share of older Californians who are foreign-born is projected to exceed 40 percent by 2040. Immigrants also play a central role in the state’s care infrastructure, comprising nearly half of California’s direct care workforce.
As immigration policy and enforcement pressures intensify, the effects ripple across communities, disrupting access to care, housing stability, the direct care workforce, and the behavioral health and well-being of older adults, families, and caregivers. These dynamics are not peripheral to the MPA. They are increasingly central to California’s ability to build an age- and disability-friendly state that is equitable, inclusive, and prepared for the future.
The IMPACT Committee urges the Administration to use the MPA and its goals as a guiding framework to navigate the current climate, including the evolving implications of immigration for older adults, people with disabilities, caregivers, and the systems that serve them.
Lessons from the last recession demonstrate that cuts to safety net programs may yield short-term fiscal relief but often result in deeper and more persistent negative consequences. The IMPACT Committee looks forward to continuing to work with the Administration and to providing feedback and partnership on the ongoing implementation of the MPA.