​Summary: As Californians age and more people live longer with multiple chronic and disabling conditions, health and social care program administrators must anticipate and plan delivery of supportive services that respond to the needs of a rapidly growing and diversifying population. This policy brief assesses the use of two home- and community-based Medi-Cal programs that served the aging and disability populations in California in 2020 — the Multipurpose Senior Services Program (MSSP) and Community-Based Adult Services (CBAS) — and projects the future need for these services in 2025, 2030, and 2050.

Findings: Results show that more than 240,000 people who are potentially eligible for CBAS and more than 100,000 who are potentially eligible for MSSP statewide are not receiving these services. In addition, there are noteworthy demographic and geographic differences between actual and potential users. Projections of future demand for these services indicate that in the between 2020 and 2050, the number of CBAS participants is expected to grow by 8%, while the number of MSSP participants is estimated to grow by 18%. In combination with other data, such as the number of available providers, this information can be used to plan, promote, and target these home- and community-based services to the people who need them the most and help prevent or delay unwanted, unnecessary, and more costly institutional care.