Expanding Capacity:Organizational Capacity to Integrate Health and Social Services in California
Fully addressing the health and social needs of older adults relies on organizational capacity to provide coordinated care. Systems require teams trained to work together, offering care and services that meet the needs of older adults and caregivers. Technology and infrastructure are needed to connect varied systems.
The number of emergency departments with geriatric accreditation have been increasing.
Funding for Geriatrics Workforce Enhancement Programs in California has decreased in recent years.
California’s No Wrong Door infrastructure has improved, but it still ranks poorly in the United States overall.
Emergency Departments in California with Geriatric Accreditation
The number of California emergency departments with geriatric accreditation has increased by a factor of 25 over the past four years.
Since 2020, the number of California’s emergency departments with geriatric accreditation has increased substantially.
Geriatric accreditation means that an emergency department (sometimes referred to as an “emergency room”) is recognized for its ability to provide acute care that reflects the distinct needs of older adults. Care is provided by interdisciplinary teams that are better equipped to bolster successful transitions from the hospital setting (e.g., to home, rehabilitation) and able to provide resources and support for both medical and social needs.
Between 2020 and 2023, the number of geriatric-accredited emergency rooms grew from three to more than 80.
You can read more about geriatric accreditation at the American College of Emergency Physicians.
Geriatrics Workforce Enhancement Grants in California
Total funding for California-based Geriatric Workforce Enhancement Programs has declined by a third.
The Geriatric Workforce Enhancement Program (GWEP) is funded by the federal Health Resources & Services Administration.
GWEP grants fund education and training for a variety of professionals who serve older adults. Through this training, these professionals are better equipped to address the unique medical and social needs of older adults.
Annual funding (unadjusted for inflation) for California-based programs decreased by 31 percent between 2015 and 2023, to about $3.5 million. The constant dollars reflect the funding adjusted for inflation (2023)
California's No Wrong Door Score
California’s No Wrong Door score improved by 13.5 percent from 2019 to 2022.
No Wrong Door systems can help ensure that adults and their caregivers receive streamlined, timely, and accurate information when seeking long-term care services and supports.
The Long-Term Services and Supports State Scorecard, published by the AARP Public Policy Institute, tracks several state indicators that reflect the completeness of each state’s No Wrong Door system.
California’s score improved from 37 percent in 2019 to 42 percent in 2022, but it still lagged the national average of 72 percent. California ranked 46th among the states.
Call to Action!
Want to learn how you can help make a difference? Consider the following activities and ideas.
Funders
- Identify avenues to support and enhance organizational capacity to provide equitable, coordinated care. This may include funding individual efforts to address multiple needs simultaneously, as well as upstream activities that can bring together stakeholders from the often-disconnected worlds of health care and social service to develop innovative and joint solutions.
- Building capacity may also include general operating support for organizations seeking to coordinate across health and social services or establish sustainable billing solutions.
- Encourage potential grantees to explore and identify ways in which their work can be sustained through longer-term, big-picture capacity building.
- Identify opportunities to enhance geriatric training pipelines.
Policymakers
- Promote public policy and funding to support services, such as data sharing and integration, that can support longer-term capacity building.
- Consider opportunities to create local, state, and national learning communities of policymakers, payers, and providers to share and disseminate best practices and lessons learned for capacity building.
- Support policies and programs that may help break down silos separating services and agencies and facilitate No Wrong Door infrastructure.
- Develop funding models to cover critical services provided by lay health workers, navigators, and others who bridge health and social service systems.
Advocates
- Prioritize advocacy for funding and support to increase capacity as a long-term investment in systems change across health and social services to achieve equitable, coordinated care.
- Advocate for the inclusion of, and funding for, nonclinical providers who can expand care team capacity and bridge health and social service systems on behalf of older adults and caregivers, including community health workers and promotores.
- Encourage the growth of No Wrong Door infrastructure that can reduce barriers for older adults and caregivers.