In a county known for wealth, hiking trails and waterfront views, one demographic is reshaping the reality of Marin County: older adults.
About 60,000 Marin County residents are 65 or older, according to data collected by Neilsberg Research, meaning roughly one in four county residents are seniors, significantly higher than California’s statewide average of about one in six. Yet advocates and service providers say many older adults remain unaware of the public programs and support services they already qualify for, often discovering them only after a health crisis.
At a recent senior resource panel in Marin City called the Aging Well Expo, health care providers, county agencies and nonprofit organizations described a recurring pattern: families searching for help too late.
“Your mom just got a dementia diagnosis. What’s covered? Who do you call Monday morning?” said Deka Dike, CEO and founder of Omatochi, an in-home nonclinical provider. “The problem isn’t supply. Navigation is the real issue — medical care, social services, food, transportation, Medi-Cal benefits — each one is a separate door, a separate form, a separate vocabulary.”
“The system is already built. Most families don’t know they’re inside it.”
Deka Dike, CEO and founder of Omatochi
Dike said most families find out after a fall sends a parent to the hospital, or after Mom forgets she left the stove on.
“By then we’re not planning care; we’re managing damage,” she said. “It doesn’t have to work that way. The system is already built. Most families don’t know they’re inside it.”
Medi-Cal provides health care coverage for almost 40% of Californians, according to the Legislative Analyst’s Office, a nonpartisan state policy advisor, but the program’s complexity makes it difficult for some to access appropriate care.
Taking AIM at senior support
After the pandemic, the California Department of Health Care Services received federal approval for the California Advancing and Innovating Medi-Cal. CalAIM, launched in 2022, expanded Medi-Cal services by allowing managed care plans to pay for nontraditional supports such as medically tailored meals, transportation assistance and care coordination.
Federal funding allowed for two new benefits intended to provide more affordable services to high-cost, high-need Medi-Cal recipients: Community Supports and Enhanced Care Management.
The ECM allows counties to contract and reimburse independent service providers, if those providers have been licensed by the California Department of Health Care Services and certified by the county insurance office, according to Dike.
“When you go to the DHCS website, they have a list of providers that can do this work,” Dike said. “There are several organizations that can qualify.”
CalAIM provides eligible residents with a dedicated care manager who can then coordinate appointments, transportation, food access, home modifications and social services. If they are hearing impaired and need a special telephone with legible captions, they can ask their care manager, who will navigate the system and get them one. Community-based services can include health-related social needs, transitions from hospitals to community living, and home modifications like adding wheelchair access.
Dike said many eligible seniors have never heard of the benefit.
The licensed care managers talk with the resident as well as their care team, which may include doctors, mental health providers, specialists, pharmacists, case managers, social services providers and others to make sure everyone works together, she said. They can help a senior find doctors and get appointments, understand and keep track of their medications, set up rides to and from health care visits, find and apply for community-based services and get follow-up care after they leave the hospital. All qualified services can be reimbursed by the CalAIM program.
Other events for older Marin County residents
- The Financial Abuse Specialists Team of Marin County’s Aging and Adult Services will host a Scam Jam on Tuesday, April 28, between 9 a.m. and 1 p.m. at the Westminster Presbyterian Church at 240 Tiburon Blvd in Tiburon.
- Nutritious lunches are available on Mondays at the San Geronimo Valley Community Center; Tuesdays at the Margaret Todd Senior Center; Wednesdays at the San Rafael Community Center and the Albert J. Boro Community Center; and Thursdays at the Corte Madera Community Center, the Margaret Todd Senior Center and the Dance Palace in Point Reyes Station. For information call 415-473-4636.
- The Hearing Loss Association of America, North Bay of California Chapter holds monthly meetings on zoom and in person.
“We have what’s called a ‘no wrong door’ policy,” said expo panelist Bella Bunker of the nonprofit Mom’s Meals, which creates health plans tailored to individual medical needs. That means if someone wants to get meals, they can get connected through a case manager, their doctor, a family member, a friend, or for themselves.
“We have a very simple form that we at Mom’s meals have made for the member,” Bunker said. “They fill out that simple form, then we go back and send it in and wait for an authorization from their Medi-Cal health plan. It’s that simple.”
In 2021, the federal agency that administers Medicare and Medicaid announced CalAIM would provide $4.3 billion in total funding for home and community-based services. That federal approval came during the Biden Administration and was intended to roll out over five years.
“When it was rolled out in 2022, they got billions of dollars for providers to change their systems and grow their workforce capacities,” said Dike. “There was a lot of money put into starting the project that may not come back after the five years, but the program is still on.”
More information on the CalAIM program is available online.
