Public Policy

Key Public Policy Issues

As the voice for over 800 mission-driven aging services providers across the state, our expert Government Affairs team advances public policy ideas to make California a great place to age. California must innovate and adapt to meet the needs of our growing older adult population. We offer common sense solutions for leveraging existing resources to expand housing, care and services for older adults. Below are our 2025-2026 public policy priorities:
 

Older adults are becoming unhoused at an unprecedented rate. Older adults living on fixed-income sources cannot keep pace with California’s rising cost of living. LeadingAge California is working to address this growing problem with a multi-faceted advocacy approach, focusing on increasing California’s supply of affordable housing, addressing income inequality, promoting innovative housing models and integrating housing with healthcare.

Every Californian should have access to the healthcare they need. LeadingAge California continues to be a strong voice in protecting and expanding access to care and services in a variety of settings, including skilled nursing facilities, assisted living, PACE, and home and community-based services. In addition, we are committed to advocating for older adults to be a priority population of focus in California within CalAIM, Proposition 1, and the Data Exchange Framework.

The United States is facing a critical caregiver labor shortage, with projections indicating a shortfall of up to 355,000 caregivers by 2040. LeadingAge California is spearheading solutions to grow our workforce through supporting legislation and fund allocation efforts that enable caregiver education, recruitment, and retention. Visit the Workforce Blueprint for Action for more information.

Despite increasing internet adoption, one in four adults over sixty-five doesn’t use the internet, highlighting a significant digital divide that disproportionately affects older adults. Although older adults urgently require telehealth services and digital social connections, they continue to be systematically overlooked in technology inclusion and digital equity initiatives. Their essential needs for technological access remain unaddressed, creating significant barriers to communication, healthcare, and social engagement. LeadingAge California has partnered with CITRIS Health, Eskaton, and Front Porch to expand Lighthouse for Older Adults, an innovative public-private initiative designed to provide internet accessibility, digital literacy training, and telehealth technology to low-income seniors in affordable housing communities, with the goal of improving their health, engagement, and well-being.

The long-term care mutual aid system would facilitate urgent emergency evacuation, surge capacity, and resources to prepare these facilities for single facility/isolated incidents, county-wide events, and state-wide disasters. In addition, the program would establish local mutual aid strategies for long-term care facilities, such as equipment, staffing, planning, training, and disaster exercises, to support the aging services industry, local governments, and emergency responders.

 

2025 Legislative Priorities

Adopt Presumptive Eligibility for Older Adults

LeadingAge California is leading the effort to implement Medi-Cal presumptive eligibility and provisional plans of care for adults aged 65 and older for home and community-based services.

Adopting presumptive eligibility for older adults will help eliminate barriers to accessing timely and appropriate care, reduce the risk of costly and avoidable hospitalization and/or institutionalization, and support individuals who wish to live in the most integrated community setting of their choice.

Presumptive eligibility implementation aligns with CalAIM’s broader population health goals by promoting early intervention and more efficient care delivery, ensuring better outcomes for vulnerable adults.


Train and Certify New Certified Nursing Assistants, Home Health Aides, and Health Care Social Workers

California is in dire need of additional support to bolster its older adult care workforce. Recent forecasts by UCSF project a statewide deficit of 40,567 nurses, nearly 3 times the amount of the next state with a shortfall.

LeadingAge California is committed to advocating for the expansion of programs to bolster the state’s nursing workforce and ensure that it is fully prepared to care for its quickly growing aging population. LeadingAge California strongly supports growing the career lattice for clinicians serving older adults.

Create a Rental Assistance Program for Older Adults

Older adults are becoming unhoused in record numbers. Nearly half of California’s unhoused population is age 50 and over. This is largely due to a rise in income inequality among older adults who have seen housing costs increase much faster than their fixed incomes.

On average, it takes two years to start accessing services when an older adult becomes unhoused. Unhoused older adults often have a functional health status of someone much older, exacerbating chronic disease and disability resulting in high utilization of our health care systems.

California’s Master Plan for Aging calls out housing and homelessness as a key initiative. Multiple state committees, including the MPA Impact Committee and the Disability and Aging Community Living Advisory Committee, have identified targeted rental subsidies as the top need for older Californians.

For the last three years, the Aging and Disability Homelessness Advocacy Coalition has been introducing a rental assistance bill (SB 37, authored by Senator Caballero last year). A coalition of stakeholders, including LeadingAge California, will be pursuing a rental assistance solution in 2025.
 

Expand Home Share Programs to Create More Housing Opportunities

Home Sharing––when people rent out extra rooms in their house or apartment––has great potential to help address California’s housing and homelessness crisis, especially among older adults.

Older Adults are much more likely than other Californians to be housing rich but cash-poor; they may own their home but also have a limited fixed income that doesn’t completely cover all their costs. Home sharing can provide the additional benefit of remaining stably housed and aging in place for as long as possible for older adults. Across California, dozens of organizations facilitate home sharing, including many Area Agencies on Aging.

Incentivizing home sharing is a powerful, near-zero-cost way to increase housing supply and address the housing and homelessness crisis, especially among older adults. Ways to incentivize home sharing include exempting low-income landlords from income tax on income earned through renting a room in their home, ensuring additional income earned through renting a room would not affect eligibility for government assistance programs for low-income people, and ensuring caregiver move-in is exempt from just cause lease termination for lease in room in home and ADUs, among other things.

LeadingAge California is sponsoring legislation to make it easier for low-income Californians to become landlords by putting their extra rooms in home share programs.

 


 

2024 Legislative Wrap-Up

See what key bills were passed and vetoed in 2024.

  

Regulatory Compliance Bulletins

  • Acquiring and Using Automated External Defibrillators (AEDs)
  • Admitting or Retaining RCFE Residents who are Bedridden or Require Assistance with Multiple ADLs
  • Reducing Legionella Risk from Facility Water Systems
  • Use of Mechanical Devices or Equipment to Aid in Repositioning or Transferring Residents
  • Video Surveillance or the Use of Cameras

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