Across California, we are at an inflection point. We are living longer, and our state’s older adult population is growing more diverse. At the same time, we are navigating significant policy shifts that shape how older adults experience care. Medicare reforms, Medi-Cal transformation through CalAIM, and the Master Plan for Aging all present real opportunities for progress, progress that places people at the center of their care.
Recently, at a convening hosted by Chapman Consulting, we gathered with our colleagues across sectors to reflect on this moment. What stayed with us most was not a policy framework or program model, but a reminder of how personal these systems are for all of us as we get older. They are not abstractions. They are the difference between feeling supported as we navigate care or feeling alone and falling through the gaps.
Why Centering Older Adult Voices Matters
As Archstone Foundation refreshed our strategy to improve health and social care for all older adults in California, we began with and continue to prioritize listening, deeply and intentionally. We do this by sitting with older adults, caregivers, and community leaders across the state. In one small recent community gathering, an older gentleman leaned forward and offered a simple observation that brought the room to a pause:
“Sometimes it feels like decisions are made somewhere else, and we just have to figure out how to live with them.”
What struck us was not frustration, but clarity. Clarity about the distance people can feel from systems meant to serve them, and about what it will take to close that distance.
Improving Medicare, strengthening care coordination, and advancing better outcomes require more than technical fixes. They require shared ownership. Older adults do not experience their lives in silos or program categories. They experience them as whole people, balancing health needs with housing, caregiving, language, food, culture, transportation, and community. If systems are to work differently, they must be shaped holistically.
As one partner told us, “If we want systems to work differently, communities have to be resourced to participate differently.” That insight anchors our approach to collective advocacy. Community leadership, organizing, and mobilization—these activities need investment and resources to reach the scale that this moment requires.
From Individual Efforts to Collective Action
Historically, philanthropy—including Archstone Foundation—has often supported organizations one by one. We have supported direct services through a variety of organizations for many years. That support has mattered deeply, and it continues to. But listening across communities made something clear: lasting policy and systems change will not happen through isolated efforts alone. Community organizations are trusted local anchors, but they are often stretched thin.
This moment calls for supporting these organizations differently to achieve social justice. It calls for collective action and movement building: connecting local leadership, lived experience, the voices of older adults, and advocacy, so policy and program solutions can emerge together. Our role is not to be the architect of these answers, but a partner in a process of shared learning, including convening, that produces new approaches. It also means flexible investing to support these ideas and helping steward needed connections among partners and aligned interests.
What This Looks Like in Practice
Our mission remains focused on improving health and social care for older adults across California. We are sharpening how we do that by focusing on where we believe we can make the greatest difference, especially for older adults facing significant barriers, including those dually eligible for Medicare and Medi-Cal, older adults with disabilities, low-income communities, and culturally and linguistically diverse populations.
In order to shift our focus to making change focused on the root causes of structural inequality, we are prioritizing two interconnected areas, both driving towards collective action for improved coordination of health and social care:
1. Mobilizing communities and amplifying older adult voices
With our new strategy, we are investing in efforts that position older adults as leaders, not just participants. This includes supporting initiatives that:
- Build understanding with and for older adults of how Medicare and Medi-Cal decisions are made, and how to inform those policy decisions.
- Strengthen grassroots organizing so older adults can advocate for improvements in care coordination, access, and culturally responsive services.
- Create direct pathways for older adults and caregivers to share their experiences with policymakers and health system leaders.
We are also exploring ways to strengthen communication across the state, so lessons and momentum can travel more easily among communities. When older adults are equipped with knowledge and connections, they become powerful partners in shaping systems in ways that serve their needs.
2. Building adaptability for organizations serving older adults
Community-based organizations are navigating rapid change, from cuts to Medicaid/Medi-Cal and CalAIM implementation to evolving Medicare models and new health plan expectations. We are moving beyond individual grants toward collective action and investing in the capacity and resilience of organizations by:
- Providing flexible support and cohort-learning opportunities.
- Supporting peer learning and technical assistance so organizations can participate in new care models.
- Strengthening coalitions that allow providers, advocates, and system partners to align and speak with a more powerful collective voice.
How We’re Showing Up as a Partner
Across both areas, we are leaning into funding that is flexible, responsive, and relationship-based, paired with convening and learning spaces that connect policy, practice, and lived experience. For current partners, this builds on existing trust and may include new opportunities to connect local work to broader system change. For those we have not yet worked with, we see real opportunity to collaborate.
If you’re a government leader, we hope to be a bridge to community insight. If you’re a community organization, we hope to be a flexible partner connecting you to others doing similar work, and to the voices of older adults, as you navigate change. If you’re a researcher or healthcare leader, we hope to connect the evidence and information you provide with lived experience and wisdom from older adult communities.
A Shared Invitation
As we think about the future of Medicare, Medi-Cal and the systems that support aging, the question is not only what changes we make, but how we make them. Do we design solutions with communities, or around them? Do we create space for older adults to shape decisions, or simply respond to them?
California has long been a place of possibility. With today’s policy momentum, we have a chance to model what partnership can look like, grounded in humility, trust, and collective action. At Archstone Foundation, we see ourselves as stewards of that shared journey, ready to take risks, which means sometimes we’ll get it right and sometimes we’ll make mistakes. Through it all we will remain committed to walking alongside you.
Because in the end, the measure of our systems is not how well they are designed, but how well they honor the people they are meant to serve.
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If you’d like to join our network and learn more about how we can work together to improve health and social care, we invite you to fill out this interest form.
If you’d like more details and information about our vision and strategy, watch our recent webinar.
