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

The state gives a patchwork of solutions, collectively recognized as lengthy-term solutions and supports (LTSS), to assistance address these requires. For a lot of Californians with low incomes, some of these solutions are supplied by way of Medi-Cal, the state’s Medicaid plan. Below CalAIM (California Advancing and Innovating Medi-Cal), the state is placing a lot more duty for provision or coordination of some of these solutions on its contracted Medi-Cal managed care plans.

When a wide variety of approaches could assistance California realize a lot more standardized LTSS advantages and increase the enrollee knowledge, the Division of Well being Care Solutions, which has oversight of Medi-Cal, desires to move toward a delivery technique referred to as statewide Managed Lengthy-Term Solutions and Supports (MLTSS) by 2027.

This report explores some design and style possibilities for implementing MLTSS that policymakers, agency leaders, advocates, and other stakeholders can take into consideration as this function unfolds. The findings are primarily based on investigation of current LTSS in California and other states, a lot more than 20 stakeholder interviews, and input from an advisory committee composed of regulators and topic matter professionals.

The report gives an overview of the challenges of the present technique of supports and describes the prospective advantages of statewide MLTSS. It gives perspectives and lessons discovered that can inform how the technique could be created, an overview of the improvements that a new technique could offer, as effectively as unique scenarios for implementation.