Public Policy Agenda

    San Diego County is home to more than 3 million individuals, of whom 350,000 are persons 65 years and older, 11.4% of the total population.  Approximately 500,700 individuals 60+ were living in San Diego in 2010.

    The growth rate for older persons will continue to accelerate as the Baby Boomers (those born between 1946 and 1964) turn 60 years of age.  Between 2010 and 2050, older age cohorts in the San Diego Region are expected to increase by 118.3% for the 60+ group, 145.8% for those 65+, 186.7% for persons 75+ and 244.6% for those 85 and older.  These age groups have the highest likelihood of being impacted by functional disabilities and chronic conditions.  They also represent the greatest challenge for the Senior Alliance partners to serve effectively in order to allow those able to age in place for as long as possible.

    The San Diego Senior Alliance is a group of 20 distinct organizations which collectively serve 63,000 seniors, with a combined annual budget of $277,400,000.  They employ 2,840 individuals and have more than 30,000 volunteers.  Some of the organizations have been in place for more than 100 years and together they have more than 1,000 years of history providing services for seniors.  Representatives from elected officials’ offices have also participated in the Alliance meetings.  Successes for the group include legislative lobbying on issues as broad as food insecurity, Food Stamps/CalFresh, Older Americans Act reauthorization, and the Elder Economic Index.

    The Senior Alliance is part of The SCAN Foundation’s Community of Constituents initiative, building a statewide movement to transform the system of care so that all Californians can age with dignity, choice and independence.

    The scope of services provided by the membership of the San Diego Senior Alliance is appended in an easy to read spreadsheet format.

    SDSA Member Services

    Our 2013 priorities include:

    A.          Participation in the implementation of the Dual Eligible Demonstration/Coordinated Care Initiative

    The County of San Diego and many of the Senior Alliance partners have worked for 13 years to develop integrated care models for older adults and persons with disabilities, beginning with the passage of AB 1040 in 1995.  With County Board of Supervisors’ support, more than $750,000 in funding has been received to plan for and promote long term care integration from the State Department of Health Care Services as well as from the California Department on Aging, the County of San Diego, the California Endowment and from the Alliance Healthcare Foundation.  Over the past 13 years, more than 800 stakeholders, spending more than 30,000 hours, have helped to envision and recommend a better model of care for low income seniors and persons with disabilities in our community.   More information on the efforts undertaken by the partners can be found at:  http://www.sdcounty.ca.gov/hhsa/programs/ais/ltcip/index.html.

    With this lengthy history of planning and with a strong belief that a better system of care can be created, the San Diego community was viewed by the State as a key environment to implement the Dual Eligible Demonstration Project.  In April 2012, the San Diego community received word that they were selected as one of the four counties to initiate implementation of this pilot project.

    Efforts taken by Senior Alliance members since that date have included the following:

    1. Creation of a Dual Eligible Advisory Committee that includes participation from three different Senior Alliance members as well as other impacted community based organizations and businesses.
    2. Meetings with the health plans to educate representatives about the vision for integrated care developed during the 13 year journey.
    3. Development of an initial plan for coordinating and brokering home and community based care services through the Senior Alliance, which while not yet successful, allowed the Alliance to begin planning how best to partner with the plans.
    4. Advocacy to ensure PACE remained an option for care for Dual Eligibles.
    5. Participation at SCAN Foundation Summits on Integrated Care in 2011 and 2012.
    6. Representation on State workgroups to help design the system of care.
    7. Continual feedback provided through legislators and the State on how best to design and implement the initiative.

    Future strategic efforts the Senior Alliance will be involved in to include the following:

    1. Continued involvement with the health plans through the Dual Eligible Advisory Committee and through direct meetings with health plan representatives to educate them about the home and community based system of care in San Diego.
    2. In conjunction with the Outreach Coordinators, to be funded by the federal government, Alliance members will ensure all client populations are educated to the fullest extent possible on the enrollment process for the Coordinated Care Initiative.
    3. Advocacy for the inclusion of additional benefits in the plan design, such as transportation, respite care for caregivers, dental and vision care, legal assistance and others, in order to truly provide wrap-around services for consumers and ensure their willing participation in managed care.

    B.           Advocate for the Inclusion of the Principles of Person-Centered Care and the Five Pillars of System Transformation in the Design of the Coordinated Care Initiative and in Other Appropriate Arenas

    The five pillars of systems transformation will be integral parts of the Coordinated Care Initiative (CCI) and some of them (the creation of a Universal Assessment form) are called out as specific deliverables in the CCI legislation for California.  The Senior Alliance will assist with focusing the discussion on these pillars through the following activities:

    1. Sharing information on the five pillars with the full Senior Alliance to generate discussion on how to further these efforts as a community.
    2. Collecting and providing formal feedback on key data elements to include as part of the Universal Assessment Form.
    3. Hosting an educational/seminar event for community stakeholders on System Transformation.

    Efforts we are Watching

    Other issues are of great importance to the Senior Alliance members including the following:

    1. The status of family and paid caregivers – how will this important work be recognized within the new paradigm?  How will the core programs provided by the Caregiver Resource Centers, IHSS and CBAS be supported so they can continue offering services to paid and unpaid caregivers?
    2. The importance of good nutrition, exercise and socialization in ensuring successful aging – how can the Senior Alliance continue to offer and expand programs providing these core services that help to prevent the premature onset of chronic health conditions?
    3. The need for transportation services that go beyond medical transportation – how can the Senior Alliance continue to support innovation in transportation services so that seniors can continue to engage in the world and participate in socialization activities of their choice?
    4. The need for housing for seniors that is accompanied by social services – how can the Senior Alliance continue to advocate for housing that allows individuals to age in place and which includes the provision of social services to ensure that the older adult is linked to needed financial and caregiving resources.