Millions of Californians living with disabling circumstances or chronic illnesses need help with prevalent activities of day-to-day living, such as bathing, dressing, and consuming. Other people want transportation, housekeeping, meal preparation, or other help to reside safely and independently at house or in a nursing house, assisted living neighborhood, or other facility setting.

The state delivers a patchwork of solutions, collectively recognized as extended-term solutions and supports (LTSS), to enable address these desires. For lots of Californians with low incomes, some of these solutions are offered via Medi-Cal, the state’s Medicaid plan. Beneath CalAIM (California Advancing and Innovating Medi-Cal), the state is placing far more duty for provision or coordination of some of these solutions on its contracted Medi-Cal managed care plans.

Even though a assortment of approaches could enable California attain far more standardized LTSS positive aspects and enhance the enrollee expertise, the Division of Wellness Care Solutions, which has oversight of Medi-Cal, desires to move toward a delivery method referred to as statewide Managed Extended-Term Solutions and Supports (MLTSS) by 2027.

This report explores some style choices for implementing MLTSS that policymakers, agency leaders, advocates, and other stakeholders can look at as this function unfolds. The findings are primarily based on study of current LTSS in California and other states, far more than 20 stakeholder interviews, and input from an advisory committee composed of regulators and topic matter specialists.

The report delivers an overview of the challenges of the existing method of supports and describes the possible positive aspects of statewide MLTSS. It gives perspectives and lessons discovered that can inform how the method could be created, an overview of the improvements that a new method could deliver, as effectively as diverse scenarios for implementation.