Summary

Published Date: January 31, 2025

As California transitions to an integrated, managed long-term services and supports (MLTSS) system, this report identifies current and future gaps in the state’s Medi-Cal home and community-based services (HCBS) and long-term services and supports (LTSS) programs and service delivery systems that hinder Medi-Cal members’ access to HCBS.

  • Findings: 
    California's population is aging rapidly, particularly in rural areas where current access to HCBS programs is already limited.
  • To meet the needs of a growing population of Medi-Cal members in need of HCBS, the number of HCBS providers participating in Medi-Cal must increase.
  • A fragmented system of HCBS programs with differing eligibility requirements and enrollment procedures makes it difficult for Medi-Cal members to access the care they need in a timely manner.
  • California's highly decentralized HCBS program design makes it difficult for DHCS to effectively monitor access, unmet need, and the quality of care delivered to Medi-Cal members.

This study references a related UCLA Center for Health Policy Research fact sheet.