Session abstract: Assessing and addressing the needs of the most vulnerable of older adults in California

America is graying rapidly. Between 2011 and 2029, we will see the greatest growth in the 65+ population as the “boomers” turn 65. While many older adults are living longer and healthier lives, the prevalence of chronic disease in the older population remains high. For those of limited economic means, the challenges associated with accessing care and managing complex health conditions are heightened. In California, the elderly population will double to nearly 8 million by 2026. Currently, 1.1 million Californians are “dual-eligibles” – those who qualify for both Medicaid and Medicare and are typically the most medically and financially vulnerable. This panel examines how the physical, psychological and social care needs of vulnerable California seniors are being assessed and addressed. The first presentation highlights differences in mental health need among older subgroups in California and identifies their characteristics. The second presentation provides details about the Elder Index -- an alternative to the Federal Poverty Level that better gauges poverty among the elderly, particularly in states such as California where living costs are high. The third paper assesses older adult “dual-eligibles” utilization of care as compared to other Medicare beneficiaries and examines whether cost-sharing is associated with their utilization of health services. The final presentation offers “lessons learned” from the Helping Older-adults Maintain independencE (HOME) study, which is following older adult “dual-eligibles” over time, and evaluating how they have managed a fragmented network of informal and formal care, along with unlinked medical care, to continue to live independently at home.