​Summary: About 14 million adults in the United States need home and community-based services (HCBS) to maintain their independence and support their quality of life. The ability to access long-term services and supports (LTSS) at home — both paid and unpaid — is essential to maintaining the physical and mental health and well-being of older adults and adults with disabilities.

In this fact sheet, authors provide a state-level population view of the needs of older adults and adults with disabilities in California. Data were gathered from the California Long-Term Services and Supports (CA-LTSS) study, a follow-on survey of the 2019–2020 California Health Interview Survey (CHIS). They examine the prevalence of need and unmet need for LTSS and document the adverse consequences of unmet need. 

Findings: More than half (54.6%) of those who completed the LTSS survey reported needing help from another person for routine care; about 1 in 5 (20.9%) reported needing help with personal care; and 2 in 5 reported either that they could use more help or that they get no help at all with either routine or personal care. Black/African American and biracial/multiracial respondents were among those most likely to report they need help with routine or personal care, 73.5% and 72.4%, respectively. The data also show adverse consequences experienced by adults with unmet needs for LTSS, with nearly half (45.8%) staying at home due to difficulty going outside, 18.8% going without groceries or personal items due to difficulties shopping, and more than 1 in 4 (27.4%) making a mistake when taking their medications. Authors discuss goals and strategies advanced by California’s Master Plan for Aging to address the unmet need for LTSS among older adults and adults with disability.

This fact sheet is funded by the California Department of Health Care Services (Grant Agreement 18-95340).