At last week’s 2026 OPEN MINDS Aging Services & Supports Summit, Sarah Steenhausen, Deputy Director of Policy, Research & Equity of the California Department of Aging, mentioned the ‘crisis’ that was upon us. She was referring to the need for aging consumers to ‘impoverish themselves’ to get access to needed services.

Ms. Steenhausen referenced two related policy issues. First, Medicare offers time-limited coverage supporting home-based services for people whose activities of daily living are diminished by a health conditions. And second, Medicaid does not fill that gap – with a long-term care benefit largely limited to skilled nursing facility services with a ‘spend down’ requirement.

But the crisis isn’t limited to consumers. State budgets are sagging under the…