As another year draws to a close, we are reflecting on our work in 2023 and our vision for 2024. Top of mind are our valued partnerships with grantees, stakeholders, and colleagues to build a coordinated, equitable system of care for older Californians and their caregivers.
This year, we released our annual report exclusively online for the first time. Forward Together: Building Momentum for Equitable, Coordinated Care shows that 72 percent of newly awarded grants during the past two years focused on care equity and reducing health disparities — a welcome shift toward fostering justice in our mission. In the report, President and CEO Christopher A. Langston and Board Chair Heather M. Young share our vision for the future and how we organize our grantmaking to make a lasting impact in bridging health and social services.
A crucial starting point for the new year will be the release of Gov. Gavin Newsom’s budget in early January. This will inform our analysis of the care landscape and where our dollars can do the most to support older adult care teams, geriatric training, and technologies to facilitate information exchange in California. Although we anticipate a difficult budget year, we will continue our long and consistent support for the Master Plan for Aging. We encourage the state to maintain its focus on working to improve the systems that provide care for older Californians and their caregivers.
This year we launched important learning collaboratives – focused on improving dementia care and training in geriatric psychiatry – and supported additional opportunities to improve care for persons living with dementia and their caregivers. Details about our CalAIM Statewide Learning Collaborative are below, and we encourage you to visit our website to learn about the opportunity to apply for the GUIDE model by Jan. 30.
This year also brought staff transition and team building to the Foundation. We wished farewell and best wishes to colleagues Ryan DoyLoo and Jolene Fassbinder and welcomed Gerson Galdamez and Carly Roman as new program officers. If you haven’t yet met Gerson (“Herson”) and Carly, we think you will enjoy working with them as much as we do and encourage you to reach out to introduce yourself.
We remain grateful for your ongoing dedication to improving the lives of older Californians and wish you and yours all the best for the new year. And to mark the occasion, we invite you to revisit our Top 10 blog posts of 2023.
1. Medi-Cal Transformation Creates Urgent Opportunity to Help Older Californians by Christopher A. Langston
CalAIM is an ambitious effort to improve and reshape Medi-Cal and creates an urgent opportunity for us to partner with others to ensure older persons benefit from these transformation efforts. More than 1 million low-income older adults from marginalized communities are in both Medi-Cal and Medicare, and several hundred thousand more receive their only healthcare coverage from Medi-Cal. For all but the wealthiest, the costs of aging – especially long-term care – can exhaust resources and make one dependent on Medi-Cal to fill the gap. Having the Medi-Cal program work well to address comprehensive needs, using whole-person care approaches and social drivers of health, is closely aligned with our vision of what integrated, coordinated care should look like for all older people and their families.
Specifically, we see an opportunity to improve care for persons living with dementia and their caregivers through the focus on two populations within CalAIM – people at risk of institutionalization and high utilizers – recognizing that, while not specifically called out, many who qualify will be older adults with dementia. We are working with CalHPS to support a CalAIM Statewide Dementia Learning Collaborative to bring together providers relevant to caring for people with dementia (including those from adult day health, respite, and home modification), along with the managed care plans, advocates, and experts in the field to support community-based organizations that are serving older dual eligibles and persons with dementia at high risk of institutionalization.
2. Why Funders and Grantees Should Take a ‘Candid’ Look at Their Own Diversity by Tanisha Davis
We have been looking both inward and outward as we endeavor to make our world more just, equitable, diverse, and inclusive. One step in this process has been to join the philanthropic research group Candid's campaign for funders — and grantees — to detail the demographics of their staff and boards, and to make this part of our grantmaking process. We believe this will help us ensure the programs we fund reflect the rich diversity of the communities we serve.
This year we collected and reported demographic data on our Board and staff as part of our Candid profile, which we updated in February. Demographics via Candid is a form where both funders and grantees can detail the races and ethnicities, gender identities, sexual orientations, and disability statuses of their staff and boards. We are committed to updating our profile at the start of each fiscal year and encourage others to join the campaign for greater transparency, self-awareness, and accountability.
3. Our 5 Grantmaking Principles for Reducing Racial Health Disparities by Laura Rath
As we further our commitment to justice, equity, diversity, and inclusion— both internally and externally — one area of high priority is our grantmaking. Part of implementing our strategic plan is changing from a responsive grantmaker to working proactively with our partners to design and develop projects. As we do this, we will continue to share our thinking and approach.
As we put our plans into action, we have committed to working with our partners to adhere to five principles when constructing, selecting, and implementing grant projects:
- Inclusive, person-and family-centered, and universal design;
- Focus on historically and currently marginalized populations;
- Focus on areas with the greatest disparities between racial and ethnic groups;
- Test and determine if disparities are reduced; and
- Seek relevant staff and community expertise in the form of lived experiences.
4. Why Incubating More Teams Is Central to Expanding Coordinated Care by Jasmine Lacsamana
This summer, we wrote a series of three blogs about our work to refine and clarify the theory of change behind our strategic plan for integrating health and social services. The first addressed our interest in promoting team care.
No individual healthcare or social service professional has all the skills required to meet all the needs of older adults and their caregivers. We view the ideal care team as an interdisciplinary group of people who coordinate to provide both medical treatment and social services – working to eliminate traditional silos of care and placing the people they’re caring for, along with their family and friend caregivers, at the center. This post lays out our vision of team care and the types of work we intend to support.
5. Inside Our View of Training’s Transformative Power to Improve Coordinated Care by Gerson Galdamez
Second in our series was a spotlight on our work to enhance training. Improved training plays a key role in shrinking the quality gap in care and reducing racial and ethnic health disparities. Through cultural competence and equity-focused training in healthcare curricula and professional development programs, direct care workers build a strong understanding of equitable care delivery that influences their practice. More of this training is needed, prioritizing the unique needs, perspectives, and experiences of the diverse populations they serve. Effective team care is rooted in effective team training. Aging-related care requires a multidisciplinary approach, with professionals from health and social fields collaborating seamlessly.
6. Envisioning a Future in Which Technology Enhances Coordinated Care by Ryan DoyLoo and Carly Roman
We believe in the power of partnerships and effective funding to create a future where better and more universally available technology integrates health and social services, connects more people, and improves the health of all older adults. We envision technologies that facilitate teamwork, make training accessible and more efficient, and promote coordinated care. This post reviews our ideas for projects and partnerships to achieve effective sharing of data among providers, caregivers, and the people being cared for.
7. Recommitting to Training in Geriatrics by Christopher A. Langston
This was a response to Dr. Jerry Gurwitz’s opinion piece in JAMA, “The Paradoxical Decline of Geriatric Medicine as a Profession,” which called our attention to a serious workforce issue that transcends medicine alone and extends to all health professions: a critical shortage of skilled professionals ready and able to provide expert care for our growing aging population.
We see training as essential to delivering needed, equitable, and high-quality coordinated care to older adults. To meet the need for trained professionals to care for older adults, Chris describes what has been tried before – and failed – and outlines options for new ideas to address this challenge.
8. Solutions to Expand Training in Geriatric Psychiatry by Jürgen Unützer
Building upon Chris’ post about the shortage of skilled professionals to provide expert care for our growing aging population, Foundation Board member Jürgen Unützer, MD, Chair of the University of Washington Department of Psychiatry and Behavioral Sciences, reflected on the impact this has had on the field of geriatric psychiatry and shared some promising approaches to building the field.
One idea that we are supporting is a West Coast Geriatric Psychiatry Learning Collaborative of fellows and residents who will work together to bring forward possible solutions to achieve better care and outcomes for older people.
9. Strong Start to CalAIM Statewide Dementia Learning Collaborative by David Panush
In collaboration with California Health Policy Strategies, LLC (CalHPS), we are spearheading a CalAIM Statewide Dementia Learning Collaborative. This collaborative focuses on seamlessly integrating community-based dementia programs and services for those at high risk of institutionalization. Guest author David Panush, President of CalHPS, detailed the collaborative’s launch.
A helpful resource we’ve since added to our website is a report we commissioned from experts in dementia care at UCSF, “How CalAIM Supports Best Practices in Dementia Care.” If your organization serves persons with dementia and their caregivers, we hope you’ll join with community-based organizations, providers, managed care plans, and us in this collective effort to enhance care coordination and delivery for Medi-Cal and dually eligible older adults, heralding a transformative era in healthcare across the state.
10. Aligning Capacity Building with Care Coordination by Laura Rath
Our annual capacity building grants remain a greatly in-demand resource for non-profit organizations seeking to build their internal capacity. This year we rolled out changes to the program aimed at aligning it more closely with our strategic vision, our mission, the principles of our Teams, Training, and Technology approach — our Three Ts of care coordination — and our commitment to reducing health disparities.
We awarded six grants in the fall and will begin accepting new requests for proposals in July. Beyond awarding grant dollars, we are continuing our partnership with Catchafire, a nonprofit that matches professionals willing to donate their time with nonprofit groups seeking those skills.
On behalf of all of us at Archstone Foundation, I wish you joy and harmony in the new year. Please continue to reach out to share your thoughts and ideas for improving the lives of older Californians and their caregivers. We invite you to bookmark our blog and check back often in 2024 for updates on our strategic plan and thought-provoking discussions to achieve a happier and healthier future for us all.
