Assembly Standing Committee on Aging and Long-Term Care

All right. Good afternoon, everyone. Thank you for joining us today for the first, very first Aging hearing for 2023. So thank you, guys, everyone in the room. I am Dr. Jasmeet Bains. I am very excited to Chair this Committee. I'm the first medical doctor to Chair the Aging & Long Term Care, and I bring that lens to all of my policy work. Thank you, Assemblymember Reyes, for being here, Assemblymember Tri for being here as well. So thank you, guys.

Super excited to bring my background, which brings my work as a family medicine physician, and also my work bringing change to those living with developmental disabilities as well. I was the Chair for - I was actually the Board President for Kern Regional Center, in addition to my work with the DDS Task Force, trying to bring resources for people with intellectual and developmental disabilities to communities like Kern.

I've always been told if you want to fix health care, start with the most vulnerable populations first, and that will give you the roadmap for what you need to do. So I bring my commitment to underserved communities, specifically my community of Kern, my home of Kern County, which has been my home my entire life, and my hometown of Delano, California as well.

I'm grateful to all of the advocates who have met with me over these past two months and look forward to working together in the future. Before I open on the topic of today's hearing, I am instructed to go over a few housekeeping items. So I will go over steps we are taking to preserve the safety of everyone here and to ensure the public's access to the discussion, to ensure members of the media and public have access to our proceedings today, this hearing will be streamed on the Assembly's website, and members of the public can provide testimony in person here in room 127 or via the phone. Transparency is very important. Not everyone has the opportunity or ability to be in Sacramento or have representation in Sacramento.

We will remain accessible through live streaming, and I'm committed to leave the phone lines open for public testimony as long as it remains prudent to do so. So for the public in the room. If any member of the public in the room would like to speak during public comment at the end of the hearing, please sign in with the sergeants in the back. I will ask you to approach the microphone at the appropriate time.

For any members of the public that will be providing public comment via telephone, we are using a moderated telephone service. The call in number for this hearing is 877-692-8957 and the PIN is 131-5127. Again, that number is 877-692-8957 and the PIN is 131-5127 their operator on the line will give you instructions on how to be placed in the queue. If you are calling in, please eliminate all background noise. This includes muting your live stream broadcast and your devices to reduce sound issues.

If you're having any problems with the moderated phone service, you can call my capital office at 916-319-2035 for help. Finally, I want to acknowledge that the Assembly has experienced a number of disruptions to Committee and floor proceedings in the last few years. We will ensure all voices are heard. However, anything that disrupts or disturbs or otherwise impedes the orderly conduct of the hearing is prohibited. Thank you for your cooperation. Thank you so much, Assemblymember, for joining us.

I would now like to call this hearing of the Aging & Long Term Care Committee to order. There has been an incredible amount of change and attention given to the Aging & Long Term Care through the Master Plan for Aging. It is a blueprint that will lead to success, but can only be successful with our support. The pandemic didn't create disparities for aging and disabled Californians. It highlighted what has long existed.

I encourage all of my colleagues to carry bills and budget asks that are specific to older Californians and people living with disabilities. These policy areas have long been underfunded and underappreciated. With every policy before us, we should be asking, how does this impact older Californians and people with disabilities. Do any of the other Members wish to say anything?

First, I would like to thank our Chair for holding this hearing today. I think it's so important that as we begin the new year that we talk about this Master Plan for Aging. It's really important. Committee since the beginning and I look forward to now.

Is that better?

Yes.

And can you hear me? You could hear me anyway, right? But it's such an honor to be here now with the new members and with Dr. Baines as our chair. Thank you.

Assembly member Alvarez.

Thank you, chair Dr. Baines. I'm really pleased to be able to be part of the Committee. I'm looking forward to your leadership on these issues. I know we had a chance to connect last week. I am also, as my colleague just mentioned, very interested in ensuring that this population is one that is not just taken into consideration, but that we are as proactive with our policies and with our fiscal decisions in the state as we have been with many other populations in our state.

And so I'm looking forward to the work being done in this committee, obviously to today's hearing. And as the chair stated, the commitment extends to also carrying legislation that specifically positively impacts this population. And I'm pleased to be able to do that this legislative session and look forward to coming back to the committee to present on those pieces of legislation. And again, thank you very much for your leadership on this. Looking forward to it.

I'm really honored to be here. And I believe that this is the opportunity for all the members from the committee, as well as the committee to raise on the concerns in my district. And I'm really sure that for many other districts, we have a large population of seniors, and they really need help in many, many issues. So I'm looking forward to work with all the members, I hope at the end of the day, so we can come up with a really good solution to improve the quality of life our seniors. Thank you.

Thank you guys for those comments. I have to share. This is a pretty emotional moment for me. Five years ago, I was a primary caregiver for my grandmother before she died. And I went through that process. I know someone, Ralph, and I connected with memories that you had of your father and the process of being a caregiver, the process of being there for your loved ones. And I just want to highlight the support that caregivers need.

It's not easy to have a full time job and still be there for your loved ones. And sometimes it can lead to frustration for not being able to be there in two places at once. And that's where we need to do more to protect those caregivers and to give them more support.

It's not easy, the breakdown that you have dealing with family members, dealing with taking care of your loved one, seeing your loved one pass away in front of your eyes, and then it doesn't end there. After your loved one leaves, now you have to go back and relive all those memories and come to a peace inside yourself, but then become an advocate for others. So this is an emotional time for me. It's a historic moment for me to be sitting here as the chair. I know grandma would be really proud. Now we will move on to Susan DeMarois, who is the part of the Executive Director of the California Department of Aging.

Good afternoon, Madam Chair and Members. I'm Susan DeMarois, director of the California Department of Aging, and I'm honored to be in front of you today talking about the remarkable progress we've made together on California's master plan for aging. Welcome to your first committee, Madam Chair, and your grandmother most certainly would be proud and is proud of you today.

Today we're going to be talking about the progress that we've made building off of the incredible foundation we first established in 2021, the plans inaugural year, and we'll be focusing on the five bold goal areas. One, housing for all ages and stages two, health reimagined three, inclusion and equity, not isolation, four, caregiving that works and five, affording aging. Together, we're delivering results for Californians of all ages and abilities.

The California Department of Aging has the privilege of leading the master plan work for this administration under the direction of California Health and Human Services Agency Secretary Dr. Mark Ghaly. Our state is also fortunate to have a senior advisor on aging, disability and Alzheimer's in the governor's office, my predecessor, Kim McCoy Wade.

In Governor Newsom's first state of the state speech in February 2019, he called for the development of a master plan for aging, commenting that we need to get ready for the major demographic challenge headed our way when one in four Californians will be aged 60 or over in the year 2030. At that time, and many times since, the Governor has shared his own family's experience caring for an aging parent, an experience many of us in this hearing room can relate to, as we just heard.

To put the coming demographic challenge in context, 10.9 million Californians will be 60 or older in just seven years. That is larger than the entire County of Los Angeles and about the size of the entire State of Georgia. Californians also enjoy one of the longest, nearly the longest longevity, it's hard to say, in the nation, and we've seen record numbers of Californians attain the age of 100 and more.

Older adults, as we know, are also increasingly diverse, racially diverse, ethnically diverse and culturally diverse, with increases in Latino, Black, Asian, and Indigenous people and more older individuals identify as LGBTQ plus than ever before. In June 2019, the Governor issued Executive order N-14-19 formally calling for the creation of a master plan for aging. The order established a cabinet workgroup and three working committees to help develop and guide the plan. Since the beginning, California's MPA has been grounded in robust stakeholder engagement.

Formally appointed committee members brought lived and learned experience, and they actively solicited feedback from 240 organizations and more than 1000 members of the public. After all of the input was synthesized, the stakeholder advisory committee submitted over 800 recommendations to the administration to inform the creation of the final master plan for aging. From today's discussion, you'll hear that the MPA is far more than a report.

It's a movement towards a better future for all Californians, a living document that serves as a guiding framework from which to design, develop and deliver a blueprint for California that is age and disability friendly for all. California's plan is a testament to our state's commitment to collaboration and inclusion beyond government and beyond Sacramento. The four cornerstones of California's effort are first, legislative leadership second, cabinet level engagement third, diverse stakeholder involvement from public and private sectors and fourth, local planning and prioritization.

Strong legislative leadership has been, and will continue to be critical to building the system we all envision. In fact, the call for a strategic state plan on aging began over 20 years ago, culminating with Senator Hannabeth Jackson, whose legislation, SB 228, codified in statute the creation of the master plan for aging. Legislative leaders hosted community roundtables throughout California, starting in Bakersfield with Senator Hurtado and ending in Humboldt County with Assemblymember Wood.

We appreciate the unwavering bipartisan support in the legislature, as well as the collaboration, subject matter, expertise and technical assistance provided by Liz Foler, chief consultant to this committee. I want to specially thank Assemblymember Bains for her active engagement in the MPA kickoff events last month, just weeks after being named to this committee. And we are honored to also have Senate President Pro Tem Toni Atkins provide inspiring personal context from the critically important lens of our legislative leadership.

A California for all ages and abilities cannot be achieved in silos. The administration is prioritizing older adults, people with disabilities, family caregivers, and direct care workers in program and fiscal planning across agencies. The master plan for aging cabinet workgroup, comprised of leadership from the governor's office and each agency secretary, advanced dozens of initiatives for implementation in the first two years of the MPA.

The cabinet workgroup has once again collectively developed 95 initiatives for implementation in 2023-24 in pursuit of a shared vision of a California for all. The MPA is a plan for all Californians. The progress we have made to date is only possible because of engagement from seven stakeholder advisory committees as well as the California Commission on Aging.

The administration is grateful to the many stakeholders, past and present, who continue to advocate on behalf of older adults, people with disabilities, and family caregivers. Many of our stakeholders are joining us today in person and by phone. A record number of communities across California are actively engaged in age and disability friendly planning. More than 70 cities have enrolled in AARP's age friendly network, with California leading the way by joining the network in July 2021.

Less than 10 states have that honor, and we were followed by Ventura County launching its very own master plan for aging in 2022. This morning, the Department of Aging launched the Local Aging and Disability Action Planning grant program, with funding made possible by the legislature. $4.5 million for capacity building grants that will fund up to 36 California communities to develop their own aging and disability friendly action plans.

The RFA that was released today is due on March 24, and all of your districts are encouraged to participate. Community based organizations, local government and tribal partners can apply for grants between 75,000 and $200,000. It is a point of pride that California has inspired other states to follow our lead, with more than a dozen states joining the master plan for aging movement last year.

I'm honored to report to this committee, and especially to California's older adults, people with disabilities and family caregivers, that this administration and the legislature have disrupted the status quo with historic investments, groundbreaking new initiatives and collaborative public private partnerships. Our time today allows for just a few highlights. And if I may, as noted in the 2022 MPA annual report that you have copies of, the new MPA implementation tracker and the data dashboard for aging were delivering real results.

First Health access the 2021-22 state budget invested $1 billion ongoing to expand access to full scope medical benefits for undocumented adults aged 50 and over, which has already provided well over 235 Californians with access to health care. The budget also fully eliminates the medical asset test by January 1, 2024. And in the past year, the Department of Healthcare Services gained federal approval for the groundbreaking CalAIM initiative, broadening access to enhanced care management and community supports such as respite and home delivered meals.

As of last week, the Department of Social Services has awarded a combined total of $206,000,000 to 29 organizations to fund 33 projects to create more residential care options for older adults and people with disabilities, including people at risk of or experiencing homelessness. The department has also awarded $186,000,000 to 35 participating California counties through the CCE preservation program for the immediate preservation of licensed adult and senior care facilities.

Direct care workforce advancement, the Department of Social Services in home supportive services career pathways program provides training and financial incentives to IHSS providers in the areas of general health and safety, caring for recipients with dementia, behavioral health needs, and complex care needs. The program's online and in person classes launched in October 2022, CDA has launched a $150,000,000 statewide direct care workforce training and stipends program.

Cal Grows, including an innovation fund that has awarded $89 million in grants to support 78 community partners in training, incentives and support of the non-IHS home and community based services workforce, including unpaid family and friend caregivers. While the state has made significant progress, much work remains to address the problems facing California's growing and diverse older adult population. As we heard from the chair, the COVID pandemic led to a decline in average life expectancy from 81 years in 2019 to 78 years in 2021.

We face an increasing mortality gap between the highest and lowest income census tracts, 11.5 years in 2019 to 15.5 years in 2021. Covid-19 continues to magnify historical inequities, systemic racism, and health disparities that impact communities of color while revealing widespread ageist and ableist societal views of older adults and people with disabilities. The administration has redoubled its commitment to equity and strives to eliminate disparities by improving access and affordability for all Californians. California is both aspirational and pragmatic. We know the intractable issues of our time.

Confronting inequality, addressing historic wrongs, and eliminating disparities requires steadfast commitment to make the California dream a reality for every one of us. While we pause today to reflect on our master plan for aging success over the past year, I recognize our work is just beginning. Together, we have enormous equity, housing, transportation, health care and caregiving challenges ahead, just as we have unprecedented opportunities to empower all generations to live well and thrive across the lifespan.

As partners in progress, we have much more work to do in preparation for 2030, we turn to our stakeholders to inform our understanding of what is needed to address the longstanding system challenges. There was no better example of our collective spirit than the California for All Ages and Abilities Day of Action, held in September, when more than 1000 community constituents joined together to present stakeholder recommendations and priorities to the administration.

We were also joined by our legislative colleagues and legislative staff at that event based on their extensive stakeholder input and in consultation with cabinet agencies and departments, last month, the Administration released the second iteration of MPA initiatives, replacing the original 132 initiatives from 2021-22 with 95 new initiatives for 2023-2024.

While the original five bold goals and 23 strategies remain unchanged, the administration is committed to updating the initiatives with each legislative session, in partnership with all of you, per the requirement in Senator Jackson's SB 228 to reflect on the progress that we've made together, new priorities that have emerged from your communities and constituents, and continued work towards system change. Today, we are charged with the immediate responsibility of successfully implementing these early actions while simultaneously positioning California for transformative system change opportunities.

Accountability and transparency are essential to MPA advancement, and data collection and reporting are necessary to measure progress and track outcomes. Through the data dashboard for aging, we continue to make great strides in tracking, measuring, and monitoring outcomes to drive fiscal and policy decisions as well as system change. The brand new MPA implementation tracker offers up to date information in a user friendly webpage that provides real time progress on each goal, strategy and initiative for the public, for your constituents, and for the legislature.

The Impact Advisory Committee offers important feedback and guidance in our MPA efforts and will continue to be a critical partner moving forward. I'm so pleased today that two of our impact committee members, Kevin Prindiville and Dr. Sarita Mohanty, will follow me on this panel as we move forward. There are five high priority items we want to highlight as critical to our MPA efforts over the next two years of this legislative session. The first is embedding equity in aging.

From the start, the MPA has embraced equity, inclusion and belonging to reflect the rich diversity of our state's growing demographic of older adults and people with disabilities. It's critically important to acknowledge and address the unique and inequitable experience and influence of race, ethnicity, culture, language, socioeconomic status, gender identity, and sexual orientation in all policies and in all places. In September, Governor Newsom signed an Executive Order directing state agencies and departments to take additional actions to embed equity, analysis and considerations in their mission, policies and practices.

This order encourages us all to examine the intersectionality of social drivers of health. As one example, the Department of Aging is partnering with San Francisco's Open House to develop a survey on the aging experience of LGBTQ plus Californians to collect data on the health, economic stability and well being of older LGBTQ plus residents in California to help us better understand where the gaps are, which will then allow us to tailor services and supports accordingly. The second of five focus areas in the coming years, analyzing gaps in home and community care.

While California is fortunate to have an array of home and community based services that enable some people to remain at home and avoid institutionalization, we know that many people cannot access the services they need. For example, in many rural areas there are few, if any, HCBS services available, and in other areas there may be availability but long waiting lists.

In partnership with the Department of Healthcare Services, we recently launched the HCBS gap analysis and roadmap to build system capacity and community infrastructure. Three addressing older adult isolation and behavioral health. According to the UCLA Center for Health Policy Research, close to half of all Americans will have experienced a diagnosable behavioral health disorder by the age of 75, and yet less than one third of those older adults in need of mental health services receive appropriate care.

We are proud to be partnering with the Mental Health Services Oversight and Accountability Commission to advance $20 million in community grants that will support evidence informed best practices to help fight this growing impact, this growing epidemic impacting older adults, including victims of recent horrific mass shootings in Monterey Park and Half Moon Bay.

Fourth, adopting a no wrongdoor system approach navigating a fragmented healthcare and social services delivery system is daunting, making it hard to know how and where to access services, especially for individuals whose primary language is not English. The Department of Aging is advancing efforts to launch a centralized, statewide consumer contact center that will serve as a resource for anyone calling anytime from any location who needs personalized assistance and support, with a warm handoff to local partners.

This will also include a consumer facing web portal to provide consistent, streamlined, and standardized information on the array of services available to older adults, people with disabilities, and caregivers. And fifth, we will make further progress in the next two years on affording home and community care. We acknowledge the lack of Medi-Care coverage and the high cost for individuals purchasing home and community care or long term services and supports.

And we're eager to build off the work of the long term care insurance task force and other efforts to further examine pathways to a solution for our affordability crisis for the missing middle and the very low income. From inception, every aspect of the MPA has been generously supported by seven active foundation partners who are true champions for California and the nation's older adults, people with disabilities and family caregivers.

In alphabetical order, I want to acknowledge the Archstone foundation, the Rosalind and Arthur Gilbert Foundation, Meta Fund, San Diego foundation, the Scan Foundation, May and Stanley Smith Charitable Trust, and the Gary and Mary West foundation. Each of these philanthropic partners remain active in the work today and we are incredibly grateful to them individually and for their collective leadership. Earlier this month, we provided every member of the legislature with copies of the administration's second annual MPA report and the 95 new MPA initiatives.

In addition, we provided copies of CDA's statewide resource guide for your constituents with information available in Spanish, Chinese, Vietnamese, and Korean. We have more of all materials and we're happy to provide to you and your district offices if you just reach out to our staff. In closing, I want to thank chair Baines and each of the members of this committee and the committee staff for the opportunity to be with you here today. I look forward to hearing from the other panelists and I welcome any questions that you have now or at the conclusion of the hearing. Thank you.

Thank you so much, Susan, for those very strong and detailed message. Very exciting to see the work that has been done prior to me being on this committee. Excited to work together to implementing some of what's been highlighted in your comments. Across California, access to care is still a very big problem. Access to linguistically and culturally sensitive resources for people, specifically in Spanish speaking and Punjabi speaking communities, is very important, and I look forward to working together to make these programs accessible for everyone. And thank you for your comments. Any comments from anyone else? Yeah.

General question. You will probably answer it throughout this hearing, but what can we, as legislators, do to help the Department of Aging as you implement this master plan for aging?

I love that question, Assembly Member Reyes, and you have already done so much. Thank you for your continued support of the master plan for aging. I can tell you that today when we launched the local planning grants, we'd love you to promote those in your district to make sure that your communities participate and receive funding. That's something that we would appreciate as we have the benefit now of these historic investments flowing into communities. We want to make sure that all communities have equal opportunity.

I can say that there's also a healthy brain initiative, RFA, pending right now through the Department of Public Health, that focuses on Alzheimer's, dementia and family caregiving that your communities can apply for. And we know that next week the Mental Health Services Commission will be releasing their RFA for older adult behavioral health. So that's something immediately that I can think of.

We're also eager to take this information to your communities and to partner with our stakeholders to deliver this information, raise awareness, and help explain and articulate these investments, and to continue seeking feedback and input directly from people who are most impacted so that the master plan remains fresh and current and doesn't sit on a shelf and become stale.

Thank you. I also wanted to mention that I will be holding a formal hearing in my district of Kern County in mid May on this plan and how it impacts underserved communities like mine. This is a statewide plan but doesn't meet the needs in the state equally, and I look forward to implementing it across the state. Next we've got Kevin Prindiville, Executive Director of the Impact Committee for Justice and Aging. Okay.

Thank you. Chair, Dr. Bains and Vice Chair Ta and Assemblymember Alvarez. Really appreciate you all being here today. Welcome to those of you that are new to the assembly or new to this committee. And, of course, welcome back to those that have been on this committee and doing this work for a long time. We're really excited to have your time, your talent, talent, your energy, your attention to these important topics of aging and long term care. I'm Kevin Prindiville.

I'm the executive director of Justice and Aging. We're a nonprofit legal advocacy organization that uses the power of law to fight senior poverty and advance equity for all of us as we age. We're a national organization, but we do a lot of really important work, specifically in California. I'm very involved in the master plan for aging process. I've been part of this process since it started.

I was a member of the original master plan for Aging Stakeholder Advisory Committee, and I'm here today representing the IMPAC Committee. So the IMPAC Committee stands for implementing the MPA in California. Together, there's nine of us on the committee, and we were put together as a kind of oversight and advice stakeholder group to inform the implementation of the master plan for Aging.

We meet quarterly through public meetings, and we write an annual report to the department of Aging and CalHS on how we think it's going, how we think they're doing, and where the opportunities exist for improvement going forward. It's been a tremendous opportunity and a challenge to work on the MPA. This work started just before COVID hit and then became so much more urgent and relevant throughout the crisis.

And I'm really proud of what the state has accomplished by working at the Governor, the legislature, all the stakeholders, and from my view, as the executive director of a national organization, I can say that California is really leading the nation on these efforts. We're seeing opportunities now. Lots of states are considering creating similar plans to prepare for their aging future and asking us repeatedly, what did you do in California? How did you do it? How can we make that happen here?

Today I want to use my time. I really thank Director DeMarois for going over so much of the background. So I get to focus specifically on three key successes and three key opportunities that the impact committee has been talking about in our public meetings. The first real success that we see from the master plan for aging has been community engagement. The aging and disability communities are completely committed to the MPA.

From day one, there was incredible excitement, incredible buy in and participation from older adults themselves, people with disabilities, community organizations, caregivers aging advocates, disability advocates, academics, service providers, philanthropy, everybody was involved in this process. And the continued buy in and interest in implementation is incredibly high even now moving into the third year of implementation. So people are really paying attention to the work that you're all doing here to support the MPA.

In my nearly 20 years in the field, I've never seen a group of stakeholders this supported, this committed, this engaged over such a long period of time. We're talking about four years now that these groups have been working to build and implement this plan. So the community is excited and they're watching you closely. The legislator, their Governor, they're really counting on you to continue to demonstrate this commitment to the community.

So the second success I want to lay out is the way that the master plan for aging has kicked off an all of government approach to aging. And you heard Director DeMarois talk about this. The MPA is not a plan for just the Department of Aging or just Cal HHS. The MPA reflects the reality that all policy is aging policy, that older adults don't live in a silo of aging programs or aging departments. As we all age, we live full lives, robust lives.

We're part of families, we're part of communities, and we interact with and contribute to and rely on all parts of government. Health policy, you know, is aging policy. You talked about that, chair Bains, in your opening remarks. Long term care policy is aging policy. Obviously, that's the name of the committee, but housing policy is aging policy. Parks and Recs policy is aging policy. Employment and workforce policy is aging policy. Climate policy is aging policy. Veterans policy is aging policy. Transportation policy is aging policy.

You get it, and the MPA gets it by leveraging the cabinet level workgroup, including initiatives in nearly every agency across state government. So we view that as a real success. And the third success I want to highlight relates to those first two successes, and that is because of the community engagement, because of the olive government approach, we've been able to deliver several specific concrete wins, changes and policy and programs that are impacting the lives of members in your district today.

Director DeMarois outlined a lot of these that the Governor and the legislature, that you all working together, were able to use the recent budget surpluses to make important systemic changes at justice and aging. We've been particularly excited about in the expansions of healthcare affordability by expanding Medi-Cal coverage to undocumented older adults and eliminating the asset test and increasing income limits for older adults and people with disabilities in the Medi-Cal program.

Again, this is a place where California has become the leader in the country in how we treat older adults in our Medi-Cal program. So these three successes, the specific expansions of programs and all of government approach and strong community engagement, put us in a great position to now take advantage of some of the opportunities where more work and more progress is needed. So I'm going to outline again, three of those that we would love your attention over the next two years.

So, first, we have the opportunity in California to build a home care system that works for all Californians. The majority of older adults, people with disabilities, all of us, as we age, we want to be at home. Even as our care needs change, we want to be at home. So we need an affordable, inclusive, and equitable system to support ourselves. But right now, too many Californians cannot afford in home care.

And many people, especially those with complex conditions and people of color, instead have to receive that care in institutions like nursing facilities, at home care and support things like helping with bathing, dressing, cooking, care coordination, those things are key to helping people get what they need at home and in the communities that they're connected to today. Much of that support, as you all talked about, is provided by caregivers, and that comes with significant financial and emotional burdens and risk to families' long term financial security.

So California can address these problems by building a system that everyone can afford that's easy to navigate and can provide services that people need at the right time and in the setting of their choice. That's going to help family caregivers, that's going to help build a strong care workforce, and it's going to help older adults. So to do that, we need to continue to invest in and grow our medi Cal home and community based services system.

And the next big step that California needs to take is to develop additional models for financing and providing universal access to long term care for those that can't afford it today. If California is able to figure this out, we once again will be leading the nation in solving a problem that is facing us all. The second opportunity that we see at the IMPAC Committee is to put an end to elder homelessness in California.

Older adults are the fastest growing part of the homeless population in most parts of the state. In some counties, older adults now make up nearly half of the homeless population. For many older homeless people, they became homeless for the first time after age 50. This is an absolute crisis facing our state. Lots of money has been directed towards homelessness over the last couple of years. However, none of it has been specifically targeted to older people and specifically targeted to the unique needs of older adult homelessness.

We need dedicated attention, dedicated strategies, dedicated funding to support older adults facing homelessness. One specific type of support that we're calling for is to create a new, targeted rental subsidy program that will provide very low income older adults and people with disabilities with just enough of a subsidy to allow them to maintain housing they have today so that we cut off the flow of older people into homelessness. This number of homeless older adults in California is, like I said, a crisis. It's a tragedy.

It's a preventable tragedy. We can fix this problem, and we must fix this problem. And my final, third opportunity that the IMPAC Committee has talked about, Director DeMarois also talked about, which is using the master plan for aging to advance equity for all of us as we age.

Aging is an equity issue for generations, systemic inequities and racism in healthcare, housing, access to wealth and resources have kept people of color, women, LGBTQ individuals, people living with disabilities, immigrants, and those who are limited English proficient from accessing the full array of opportunities and supports that are provided to other groups. And when people from these communities age, the impacts of all that discrimination compounds, and then they get faced with a new type of discrimination in ageism.

So as the state prioritizes equity in so many spaces and places, aging must be included as an important consideration. And as we continue to implement the MPA, we must do so centering those communities that we haven't reached yet or who have been underserved to date. The New York Times last week had an article about aging societies around the world, and it focused on Asia, in particular, Japan. And the writer was talking about Japan because 30% of the population in Japan is 65 and over today.

The writer talks about numerous impacts that's had on Japanese society, on health care, on long term care infrastructure, on the workforce, on economic security of older people. And the writer made the point that these challenges and opportunities are coming to the rest of the world very soon, and his main advice for societies was to plan ahead for these changes. Well, in California, we're not too far behind Japan. You heard Director DeMarois say in 2030 25% of California's population will be 60 and over.

So we're a few years behind some countries and a few years ahead of a lot of the rest of the United States. But fortunately, we have a plan. The MPA gives us a path and a vehicle for navigating challenges and opportunities that are awaiting all of us as individuals, as families, as communities, and as a state. And we've got time to prepare but planning and preparing is not enough. What we need to do is we need to take action.

We need to act on that plan, to reform our systems today, to be prepared for what's ahead. And at justice and aging and the IMPAC Committee, we look forward to working with all of you to put the MPA into action.

Thank you so much. Mr. Prindiville, any comments from anyone? Yes.

Assemblymember Alvarez. Thank you Assemblymember Rubio. for joining us.

Thank you for the report. Two things that caught my attention in your recommendations. I think it was recommendation number three. I'm doing this by memory. Now, regarding housing insecurity, homelessness. You've pointed out, well, that over the last several years, the state budget has included billions of dollars for homelessness programs, and you made a statement that none of them were directly related to potential solutions that are specifically related to this population.

Do you know if any of those programs did have, were there any that actually did have a positive impact? And that's the first question.

Yes. So many of the programs were broadly available to older adults. Project Roomkey was very effective at helping older adults maintain housing and get housing during the COVID crisis. The community care expansion is an effort to revitalize and renovate several RCFEs that older adults can take advantage of to be housed. However, there's no statewide strategy. There's no, even in most local communities, no strategy, no dedicated funding or dedicated approaches to address the unique issues of older adults who are homeless.

It'd be great if you could score what those were in terms of dollar amounts to see out of the. I think we're now reaching the $5 billion investment in homelessness, if I remember that correctly, to see how much of that was set aside for this population. I think that'd be really interesting for this committee. And then you mentioned a second proposal, which I have heard about, but I don't know if it's been introduced.

I don't know if you know whether it has or it hasn't in assistance for older adults when it comes to their rental and maybe even mortgage. I don't know, but definitely in the rental community to make sure that there's some support so that they don't find themselves having to go out on the street. I mean, you mentioned 50% figure now of homelessness are older adults. So certainly there should be some attention paid to this.

Yeah. So there is a Bill, SB 37, that will create this rental subsidy program. We're requesting $500 million. It'll help about 13,000 people remain housed, which we think is a more effective use of dollars than some of the other interventions that we've seen in the space. It will require new and additional funding. We're part of a coalition of groups that's calling for about $8 billion in new funding to address affordable housing and issues of homelessness.

And this is the part of that proposal that most uniquely targets older adults.

Do you have data that shows that that specific program has been successful?

We do. So we've seen a program like this has been in operation for a few years in Santa Monica. San Diego is just starting a new program, and several other jurisdictions are creating local programs. So we're learning a lot from those local jurisdictions, and we think we've learned enough to take something statewide that starts to reach a broader population.

Sure. Thank you. I would just add my comments that I think as we are being requested to set priorities for our budget, if it's the desire of the chair of this Committee, we identify maybe not new funding. That's going to be tough to do in this budget, but existing funding proposals so that some of those get set aside for the programs that have demonstrated to be effective and supportive, particularly in the housing space.

Obviously there are other needs, but this one is one that seems to be appropriate and ripe, and potentially we could achieve some success. So again, if anybody's putting forward any proposals in the budget request or the budget prioritization, this is one that I'd love to sign on to. Thank you very much for your time.

Thank you.

Thank you. Yes, Assemblymember Rubio.

Thank you. So my question is along the same lines. When we had the COVID crisis and we were providing funding for rent subsidies and utility subsidies, there was a big especially, I will speak for my district. It was very difficult for us to access that money, for the landlords to access it and for the tenants. Do you have data of how much of that money was taken advantage of by 50 plus aged folks, the folks that you're talking about, were they able to access that?

The reason that I'm asking is also there was so much confusion and so much backlog, I think is the most appropriate that some of that money was federal money. And from what I understood was if we didn't use the money, we were going to return it to the Federal Government. So was any of that money set aside for this population, number one. Number two, how difficult was it to access it, or did you have a different system?

I'm looking for help, I guess, is what I'm trying to do, because it was very difficult just for the regular population to access that money. Did you have more successes or any success in trying to access that money.

I'm not an expert in that program, but from what I do understand about it, it was not targeted in a specific way to certain populations by age. And I don't know that we have data about how many older people were able to take advantage of that rent relief program that was in existence. So that's an issue around data collection. In many of these efforts, even in programs that target older people, we're not often collecting data about disparities in who's accessing services and who's not.

And then in programs that aren't specifically targeted towards older people, we're not collecting data about how they might be experiencing those programs differently than others. So we can get back to you about that. I'm not sure about that specific program.

Well, but then it goes back to, I guess, the conversation that we're having. Who's tracking all of this? Do you have suggestions? Obviously, you don't have to answer right now, but I think for our purposes. Do you have suggestions as to who might be able to collect that data and who would be able to assist? Because the experience that I've had is everybody points fingers at the other department. You name the department, they're pointing it to the other as to who's responsible for it.

And I don't think that we are able to have any success unless we have data. And so maybe some proposals from the department or some suggestions as to who should keep that data so that this committee can say, hey, department A, can we task you with this? And if we do, then when we're asking for money, then we can say, then department A gets it because they're the ones in charge of this.

I know you all do a really good job of this, but the bureaucracy gets in everybody's way. And so how can we eliminate some of that bureaucracy and have one department or one, even two in charge of this so that a, we can collect data but make sure that that money is set aside. And when we come back later, we can say, hey, how successful was this program? Because it's happening to us now with, just in general, with the homeless crisis.

I can ask five different departments how many people we've housed, and I'll get five different answers. That's frustrating because how do we support you if we don't have the accurate information to be able to say, hey, $500 million is going to be enough, or et cetera, et cetera. Again, you don't have to answer, but I think moving forward, if we're going to be helping in this avenue.

That data would be very helpful for us so that we can all help with some strategies as to how we give you that money, but more so how do I distribute it to the folks in my area and everybody else's areas?

Yeah, absolutely. Thank you.

Yes.

Yes. I'm really impressed with your presentation. That's amazing. And along the line with Member Rubio about how to access, regarding the funding or any assistance for our seniors, I have mentioned that in the past, is there any program that our state.

So at the state level, we have the really good partnership with all the local government, because at the end of the day, I think that the local government is, I think that it's a level that interact and provide all the assistance to our seniors. So is there any program right now or in the past that coordination, that is a coordination between the state, the local government and the nonprofit organization?

I think that if we have that in place, I think that we could be able to get all the data that we want. But if we don't have that, I mean, it's not easy to get all the data because the local government, they have the aging Department and they've been providing all the different services. And other state, I think that other state, if we want to get the data, we probably ask for the local government or at least a nonprofit.

So I'm not really sure that in the past or right now do we have any program that coordinate that.

So I can't speak to that as well as probably Director DeMarois could. But certainly the strength of the aging network is built upon a strong state, county nonprofit partnership for services that are provided.

But that has historically meant sometimes some disparities in how services are provided from county to county, different priorities from county to county, some lost opportunities for broader connection and collaboration and efficiency, and then to speak to the all the government approach I was talking about, it's also created situations where the aging departments are siloed.

So they might be doing some things that effectively address homelessness for older adults, but it's happening outside of a department that's more broadly in control of dollars or policy around housing and homelessness. So we need to break down those barriers. We need all agencies at the state level, at the local level to be thinking about older adults for it not just to be siloed off to those departments of aging.

So to the conversation about housing, I mean, that's what we're calling for is, I think you're making great points about broadly understanding where dollars have flown have gone. And we also want to see aging elevated in those conversations as a group that we are paying attention to, that we are tracking data about, and then we're making new investments in as well.

Awesome. Any other comments? Thank you so much, Kevin Prindiville, for that amazing presentation. I think what I'm hearing from a lot of my colleagues as well is the biggest problem that we have here is how do we implement the dollars and get it down to areas that need it so vitally. I mean, every day could mean a difference between life and death for someone. Every day could be the difference between having a roof over your head or not. So we are on a timestamp, literally.

People are counting on us to work diligently because a matter of seconds can mean a whole lifetime for someone. So that's what we look forward to working with you guys on. How do we implement this? How do we implement this in a strong way? Yes, bureaucracy is definitely a big problem. Assemblymember Rubio, your comments. But how do we get that implementation to the level that it needs to go? We have to do a stronger job. We just have to. Thank you.

Thank you, Chairwoman.

Thank you. My Siri is talking. Siri said, good job. Awesome. Next we have Dr. Sarita Mohanty, who is president CEO of the SCAN Foundation. She is on WebmX. Webex.

I was about to say WebMD.

Wonderful. Can you hear me okay?

Yes.

Okay. Wonderful. Well, good afternoon, Assemblymember Baines and members of the Aging and Long Term Committee. I really appreciate you holding this hearing and for inviting me to speak virtually. I'm Dr. Sarita Mohanty. I serve as the President and CEO of the SCAN Foundation, which is a California based public charity, and Assemblymember Bains and all these members of this committee, I want to thank you all for your commitment, commitment to vulnerable populations, commitment to older adults and those with disabilities.

At the foundation, we are devoted to igniting bold and equitable change in how older adults age in both home and community. And this foundation, our foundation has long advocated and really led some of the approaches for a master plan for aging, or what is now being referred to as a multi sector plan for aging, or MPA, nationally.

I actually had the fortunate opportunity to join this foundation a little over two years ago, and as Kevin noted, I have similarly been awed by the multi stakeholder collaborative engagement of this MPA. I also have the pleasure of serving on the implementing the MPA in California together impact Committee, along with Kevin and other incredible leaders here in California. And we're a group of stakeholders charged with advising the state on MPA implementation.

So I am excited about California's continued commitment and advancement as we enter the third year of the MPA. And as you heard, this was developed through a robust stakeholder process in partnership with the state. And the MPA has been and will continue to be a guide for the state not only to respond to immediate needs like public health emergencies, but also to achieve long term health and aging goals, elevate funding priorities and advance program equity.

And building on the valuable information and insights shared by my esteemed colleagues today, I'd like to speak to the future of the MPA and the importance of continued support for this 10 year blueprint. Why does the MPA matter? As a physician, I've seen the challenges older adults, people with disabilities, and family caregivers face in navigating and accessing affordable health and social services as needs and as abilities change. Recently, I'll give an example.

I was seeing a patient, older adult in her 70s, who had been discharged from a skilled nursing facility after a fall fracturing her hip. And she was discharged with home health. And per this individual, she was receiving excellent clinical care in the home. However, her visit with me was not about setting up her medications or her durable medical equipment. Her questions were essentially non clinical. They were questions like, who's going to help me put away my groceries?

Who's going to make sure I can get help with my laundry? Who will make sure I'm not actually going to fall when I get up from bed in the morning? And she lived alone, so she had a daughter who periodically came to help. But this person did not want her daughter to be burdened, given her daughter's own medical issues and that she was caring for her own family.

And finally, this individual was on Medicare, had some savings, and quickly started to do the math in her head, how long was she going to need help? And if this was going to be lifelong, how soon would her savings be depleted? And she wanted to really, her emphasis was, what do I need to do to stay independently in the home? So this anec.e reinforces that people broadly want to age in their homes and in their communities.

And we noted that most California voters believe the MPA can help achieve that goal. 80% of Californians supported the California's master plan for aging. So therefore, having a public strategy that is properly implemented really means that people stand a better chance to age well and with choices. In addition to the broad support behind the MPA, we also know it is working. We've already achieved great successes as a direct result of the MPA and its initiatives.

And Susan Demoris noted the California Department of Aging launching the Calgrows initiative, which is, as noted, providing $89 million in grants to 78 community based organizations for the development, recruitment and retention of direct care workers. And this will certainly reduce turnover among the current workforce and also increase the number of direct care workers available to support older adults and people with disabilities in their homes.

The other mentioned area is the long term Care Insurance Task Force, which is exploring universal long term care financing options to increase access to services and supports. And finding a solution is critical, as more than 70% of people aged 65 and older will need long term care at some point. For those not eligible for medical, paying for long term care is often out of reach.

In fact, there was a recent Newark study out of the University of Chicago of the California's missing middle or forgotten middle, as they deemed it in their report that showed that 89% of older Californians will unlikely be able to pay privately for care in 2033.

And then if you look at this population, a few other notable data points is that this middle income senior cohort, in addition to nearly doubling in size, will be more diverse in 2033, with people of color comprising 22% of this group, and they're going to have continued health needs, mobility limitations, cognitive impairments that make it hard to live independently and without selling their homes. This report also noted that nearly three quarters of middle income seniors will have insufficient resources to pay for private assisted living.

So the state has adopted regulatory changes and financial incentives to increase affordable housing options, as we heard, for older adults and people with disabilities. And we know that the rising cost of housing presents a barrier for people that want to remain in the community as they age. So it is critical and vital that we celebrate these successes and build on their momentum to achieve broader change. We now have growing attention to issues impacting older adults, people with disabilities, and family caregivers.

But there are long standing change that will require a sustained effort over the life of the MPA and beyond to really create a state where we can all age well. These efforts have to be cross sector, applying an aging and disability lens across state priorities beyond the traditional health care and community services to really ensure initiatives addressing climate change, transportation, and employment incorporate these populations.

As Kevin also highlighted in his talking points, we also must continue to sharpen our focus on equity and addressing the long term standing disparities for historically underserved communities, including people of color, LGBTQ plus, and those in geographic areas that lack access to care, such as rural populations and health deserts. This requires developing reliable, desegregated or disaggregated data sources to identify those disparities and targeted solutions.

And as well as it's critically important to bring the voices of the community to the forefront of our work and engage community Members in providing input and helping to co create these strategies and initiatives we seek to execute. There's no one entity that can or should do this work alone. Therefore, the benefits of the MPA is that it provides this not only for state leadership, but, as we also heard, for local governments, private entities and philanthropy as well.

Seeking opportunities to develop and strengthen public private partnerships remains critical to realizing this meaningful system change we seek to achieve. However, continued public commitment and investment from the Legislature and Administration is critical to ensuring that these multi sector efforts can advance and scale. This hearing signals the state leader's dedication to the MPA, and I ask that you continue to support its progress. We can influence how people experience aging in healthcare, not only in California, but also nationally.

And we also heard that as a result of the MPA, California is viewed as a leader in planning for the needs of a population that is growing older and more diverse. People across the country are looking to California to see the impact of the MPA, with nearly 29 other states engaging in some level of MPA development, mostly inspired by our collective work here in California.

So showcasing those tangible results and outcomes and impact could influence how people experience aging and access to care, not only in California but across the country. The MPA provides this comprehensive approach for reimagining aging, influencing how society thinks about it, plans for and responds with equity and inclusion to the needs of a diverse aging population that is often forgotten. So, in summary, I'm going to wrap up with the following three considerations for future MPA efforts.

One, that health equity must be placed at the center as a core focus to ensure everyone has equitable care as they age. As both Kevin and Susan highlighted, aging is an equity issue. We ask that as legislators are developing health and aging policies, it is done comprehensively through an equity lens. Second, aging impacts all ages, stages, and abilities across generations.

So recognizing that we are all aging, younger generations have a really significant stake in ensuring our communities are inclusive and equitable places for people of every aging ability. So, as Members of the Aging and Long Term Care Committee, I encourage you to be a leading voice for aging through this Committee, but also in policy making that is not traditionally perceived as an aging space.

And then third, public private partnerships are crucial to building this movement and successful implementation of the MPA and continued financial and policy support from the state is essential to enabling these partnerships to work. So I really thank you again for hosting this hearing and bringing attention to the importance of the MPA to support this growing aging population. I'm certainly happy to answer any questions you may have, and I thank you for your time today.

Thank you so much for that Dr. Mohanty. Any questions from, okay hearing none. We will go ahead and ask for public comment in the room.

Thank you so much, Committee Chair Bains and members and so of staff. My name is Jared Giarrusso-Khlok. I'm the government affairs director for the Alzheimer's Association. We're really proud of the work that's been done on the master plan and how it's advanced issues related to Alzheimers and dementia. We've seen significant investments on public awareness campaigns, on the Healthy Brain initiative, on I got to breathe, on screening, innovative screening programs.

And we're really excited to see the opportunities for the next two years as well focus on the healthy brain initiative as well as those screening programs that I had discussed. And we are also very much interested in the long term services and supports benefits that have been mentioned already. We thank you all so much for your laser focus on these issues on aging, Californians and those living with Alzheimer's and dementia. Thank you.

Thank you, Madam Chair and members. Amber King with LeadingAge California, representing over 700 nonprofit providers of care and affordable housing throughout the state, we too applaud the Department of Aging, the administration, the legislature on this important work through the master plan for Aging. Want to just touch on a few points. We encourage the committee and the legislature to pass legislation this year, specifically SB 17, which would increase funding for the development of senior affordable housing.

We also would encourage your support of SB 37, as you heard about already, which would create a rent stabilization program for older adults to prevent homelessness. Additionally, AB 839, which would modernize the California health facilities Financing Authority act for nonprofit residential care facilities. In addition, we're seeking state funding to demonstrate California integrated care at home, which is a housing based population health model, to bridge the gap between housing and health care.

And then lastly, we would urge the state to defer, to, not to defer the funding for education and training to grow the healthcare workforce, in particular the 21st Century Nursing initiative, which is vitally important to the workforce challenges that we have been currently facing. Thank you.

Thank you.

Thank you Madam Chair and members. Vanessa Cajina, on behalf of CalPACE, the Statewide Association of Programs of all inclusive care for the elderly, we really appreciate the work that the Department of Aging has done and the inclusive nature of it in terms of the stakeholders who have come to the table on it. We were very gratified to hear Director DeMarois' mention of the HCBS gap analysis that they're doing with DHCs.

CalPACE members have learned a lot in our time of providing almost every kind of care that you need for older, frail people enrolled in Medi-Cal who are otherwise eligible for nursing home level of care. We encourage you to work with us and to learn from us and our from experience on the equity based work that we've done to keep people safe at home in the way that they want to be taken care of amongst their community. Thank you very much for this hearing.

Thank you so much. Any public comment on the phone?

Okay, ladies and gentlemen, if you do wish to make public comment, please press one, then zero. At this time, please press 10. We do have a few queuing up to just be a moment while we gather their line or give them their line numbers.

Good afternoon. This is Dan Okenfuss from the California Foundation for Independent Living Centers. We are a nonprofit organization representing 25 independent living centers across the state. We've been part of the discussions on master plan of aging for a number of years, and I just want to reach out to members of this committee that you have your district offices that have field representatives and case workers who work with our independent living centers in your districts to help connect them to appropriate resources for the aging and peoples with disability. So thank you much for your service.

Next we'll go to line 17. Please go ahead.

Thank you, Madam Chair and members, thank you for holding this hearing and thank you to Director DeMarois for her great work in the department. My name is Roxanne Gould. I represent an organization called six Beds. It's an association of small six beds or fewer residential care facilities for the elderly. There are homes in residential neighborhoods that provide a highly sought after family style setting for loved ones.

I'm asking that you consider supporting a bill AB 770 that would actually amend a code section that would allow these RCFEs to have more than six residents in their home if they have capacity and are in compliance with state, local and fire marshal rules. The code section was adopted about 40 years ago when homes were much smaller, and we think allowing for them to meet the capacity of their home and provide much needed housing would help chip away at some of the housing needs that we have today for that vulnerable community. Thank you.

Next, we'll go to line 30. Please go ahead. Your line is open.

Thank you. My name is Gene Dorio. I've been a house call physician in Santa Clarita for over three decades and have had the pulse of the community and needs of older adults literally at my fingertips. I've been Chairman of the Department of Medicine for our local hospital, President of the LA County Commission for Older Adults, and serve on the California Senior Legislature.

Last year, my wife and I proposed a law which was signed by Governor Newsom last September, AB 2338 which assured family members have the right to make medical decisions for their ill loved ones. We have two more proposals presented through the California Senior Legislature this year. My wife and I request the Aging and Long Term Care Committee look at all potential older adult legislation carefully and ensure special interest stakeholders not interfere with laws that might profoundly and positively affect the quality of life of seniors. Thank you.

Next, we'll go to the line 15. Please go ahead. Your line is open.

Good afternoon. My name is Brynn Miller, representing the Department of Homelessness and Supportive Housing from the city and County of San Francisco. Just calling in to express general support for this plan and all the work that you do. Thank you so much. Lucky to have such good partners at the state.

Next we're going to line 16. Please go ahead. Your line is open.

Hi, thank you. Donna Benton from the California Coalition on Family Caregiving. I want to thank you for having this really informative hearing and also want to thank you, madam. Emphasizing the impact on family caregivers and the need for advocacy and support, particularly for family caregivers who provide 80% of the care and services for long term care services and support.

We know that the master plan on aging is working toward the goal of helping family caregivers, and we want to continue that education, support, and respite for family caregivers over the next eight years of the master plan for aging. So thank you, and thank you to everyone today at the hearing.

As a reminder, to make public comment, please press one, then zero. Our last public comment in queue comes from the line 19. Please go ahead.

Good afternoon, chair Bains and committee members. My name is Debbie Toth, and I'm the President and CEO of Choice in Aging, a 73 year old nonprofit organization providing community based health and social services that prevents a warehousing of elders and adults with disabilities. I also had the opportunity of a lifetime to work with Kevin Prindeville and 33 other colleagues as the stakeholder advisory committee member working together on the master plan for aging.

I just want to take a moment to share my gratitude for a chair who is not just a family practice doc, as is my baby sister, but one who starts the work with talking about personal experience and commitment to disability and aging. Thank you, Dr. Bains. I'm also deeply grateful for Susan and her team at CDA, as well as the other, sorry, Director DeMarois, as well as the other members of this committee, for their commitment to the master plan for aging and inclusion for all in all aspects of life in California. I want to ditto the comments of my colleagues Kevin and Dr. Mohanty, each and every word. And I want to offer a bit of a dive down on why each of the speakers today lifted transportation.

We have a 30 year history of study and stagnation when it comes to elder and disabled, or what we call accessible transportation. We are fortunate that Assembly Member Wicks is authoring legislation that will break the cycle of discarding older adults and the disabled who cannot drive or take fixed route transportation. There is no equitable world where one can age or be disabled out of being able to get to the grocery store or place of worship or friend's house or outings.

While we've invested in roads, trails, bikes, paths, bridges and so on, we have done nothing to increase available, affordable and accessible transportation. I hope this committee will join the many stakeholders in lifting AB 540 so we truly can have a California for all where everyone can get where they want, when they want. Thank you so very much.

All right, that was our last call.

We do have a few more that are queued up here. We do have another line. 35, please. Go ahead.

Hi, Chairman, Members Kathy Mossberg, representing C4A. We are the statewide Association for the area agencies on aging in Sacramento. And just a couple of comments. Sorry, I stopped the end of the queue. Just want to thank this Committee for having this hearing and this overview.

Thank the legislature and the department for all they've done on the master plan and just sort of put in your minds that in order for the master plan to be sort of fully realized, we do need to continue to put additional resources in place and understand the situation and the fiscal situation the state is in at this point.

But think that through some support in key areas, we can continue to further the master plan with resources particularly, and want to emphasize comments that were made by a prior speaker on caregiver. Think that some additional dollars that would be able to support locals on their 15% match could further thus caregiver support in the state and particularly in those small communities that cannot afford that, and then additional funds to support the ADRC system. The no wrong door.

Currently, there is only a limited amount of dollar in that system, so it doesn't allow us to keep up with cost and also continue to expand the services there. So really know that it's important for seniors to have a one place to go to get all their resources. So look forward to working with this committee as well as the legislature generally on these items as we move forward. Thank you for your time today.

Do we only have one more comment in the queue?

We have three in queue at this time. The next one comes from line 26. Please go ahead.

So I'm going to just take one more comment operator, and then we'll cut it off there and encourage them to come to the next. Yes. Okay. Thank you.

Okay, 26, your line is open. Please go ahead.

Okay, thank you. My name is Minerva Garcia and I'm on CSL. I serve on there, and I'm also a representative from Fresno, Madeira area on aging. And there's so many good things that have been mentioned here. So much work and so much effort. I would like to see some data on some of these things, and I know that's difficult to collect, but if possible, I also wonder how there's so much here and so much in the community.

How are you going to get all these other agencies that have their own programs, that have their own master plan and combine it into this plan? And my third question is, how do you get all this information when it's resolved and settled to the communities, especially minority communities?

I'm Hispanic and some of the things I've seen, and I'm a retired social worker, and there's so many regulations, so many things that you need to explain to people, which I have done all my life, but I'm only one person, and how is this organization going to be able to do it to everybody? I know that's a lot. I think you guys are doing fantastic.

Maria, como te llamas?. What was your name? Was it Maria Minerva?

One moment. I had closed your line. I'll get her back.

Thank you.

Okay, 26, your line is open.

Ola Minerva.

Ola Minerva. Which program are you with?

I serve on the California senior legislation.

Okay.

And I am with the Fresno Madeira area on aging. I represent that area up in Sacramento. Okay.

Thank you so much. Okay. Thank you. We just wanted to know where you're commenting from. Thank you so much. Awesome. So thank you so much. Thank you so much, operator. And thank you, everybody, for attending. We look forward to our next meeting. So thank you so much for being here.