Supporting Local Multisector Plans for Aging in Rural Communities
By Pauline Delange Martinez
When people think of California, they often imagine it is primarily suburban and urban, picturing Los Angeles and San Francisco. However, more than one in eight Californians ages 65 and older lives in a rural or frontier (fewer than 6 people per square mile) Census code. That’s 804,000 adults—more than the entire populations of Wyoming, Vermont, Alaska or North Dakota.
Rural communities across the United States face many common challenges, including limited resources related to healthcare, housing, transportation, nutrition and social services. And yet, each community has distinct geographies, demographics, resources and challenges. In California, Butte County’s housing and healthcare shortages were severely exacerbated by the 2018 Camp Fire, which destroyed 18,804 buildings and displaced nearly one in five residents. The San Joaquin Valley is the nation’s leading agricultural provider; elders in this region have higher use of avoidable hospitalizations and lower use of planned elective surgeries than do their peers in the rest of California. Riverside County has the largest LGBTQ+ population in the nation and is home to 11 Tribal Nations.
Rural communities in California face unique funding disparities, in part because California counties cover vast geographic areas. This means that rural Census tracks frequently share a county with those that are urban, disqualifying them from targeted national and state funding.
When the California Department of Aging (CDA) launched its statewide Master Plan for Aging (MPA) in 2021, it developed a local playbook to guide communities in developing local MPAs. There was a recognition that to truly implement change, advocacy needs to occur at the state, county and city levels. While many of California’s urban counties have already worked on local plans for aging, rural communities have not had the capacity to invest in this type of work.
To truly implement change, advocacy needs to occur at the state, county and city levels.
To address this need, one of CDA’s philanthropic partners, The SCAN Foundation, in January 2022 launched a two-year Rural MPA Initiative, funding three advocacy coalitions to develop local MPAs covering seven counties. The Diversability Advocacy Network focuses on Shasta, Butte and Glenn counties; the Central Valley Long Term Services and Supports (LTSS) Coalition focuses on Kings and Tulare counties; and the Inland Empire LTSS Coalition focuses on San Bernardino and Riverside counties.
Following the model of the statewide MPA, the coalitions engaged multisectoral leaders to spearhead development of local MPAs. Once these advisory committees were established, their first focus was gathering community input. Focus groups were organized, engaging older adults, adults with disabilities, caregivers and professionals to better understand unmet needs and opportunities.
Participants represented diverse geographies and perspectives. Relationships were formed and expanded with providers and cultural institutions to engage participants representing LGBTQ+, American Indian, Black, Latinx, Hmong and Mien populations, veterans, farmworkers, wildfire survivors, and those who were low-income, unhoused or formerly incarcerated. In some cases, new advocates were identified through the focus groups and invited to join local advisory committees.
Committees also reviewed local area plans, community health assessments, and county-specific transportation and housing reports to inform local MPAs. Thanks to West Health, California’s Data Dashboard for Aging provides an easy resource for communities to compile local demographics and data related to affordable housing, healthcare shortages, LTSS and caregiving.
Today, one year into the Rural MPA Initiative, regional consultants are summarizing themes and key findings from the focus groups. These findings, along with advisory committee recommendations, will be presented to local and statewide leaders to inform policies, programs and funding.
The initiative already is reaping early benefits. Advisory committees continue to grow, engaging elected officials; county and city staff; community-based organizations; healthcare, LTSS, housing and transportation providers. Opportunities to collaborate have emerged naturally. For example, advisory committees identified opportunities to streamline cross-county and cross-agency referrals, and to better coordinate programs addressing food insecurity among older adults in their region.
CDA has been an active partner on the Rural MPA Initiative, meeting quarterly with regional leads. CDA also is intentionally focusing new funding opportunities toward rural, frontier and tribal applicants, recognizing the need to support these communities.
While much work remains, investing in rural communities’ local planning efforts can help. Without this support, county leaders and aging advocates in rural communities are often unequipped to apply for new funding opportunities that could expand services. Rural leaders describe feeling frustrated that the turnaround time for grants is often unrealistic; they have neither staff nor resources to set up and launch new programs in the allotted timeframes.
The SCAN Foundation recognized the need to invest in local plans for aging in rural communities, and other philanthropic institutions are following. In January 2023, The John A. Hartford Foundation funded the National Rural Health Association to lead a national, rural, age-friendly initiative. These types of investments are critical to mitigate health disparities and improve quality of life for millions of older adults and families living in rural communities across the United States.