California Home and Community-Based Services Gap Analysis and Multi-year Roadmap

Mathematica conducted a statewide gap analysis of Medicaid-covered HCBS for the California Department of Health Care Services. Under this project, the Mathematica team employed a mixed-methods approach to identify critical gaps in California’s HCBS programs and service delivery system to meet the needs of beneficiaries. We used quantitative methods to produce a comprehensive profile of current beneficiaries and providers of HCBS and the services they use and provide. We developed a model to estimate demand for HCBS over the next five years, using demographic data, trends in service use by region, and caregiving patterns. We employed qualitative methods, including key informant interviews, focus groups, and listening sessions to gather feedback from an array of interested parties about the challenges with accessing and providing HCBS in California and identified strategies to improve HCBS access and quality. The gap analysis is informing the development of a Multi-year Roadmap which will guide California's transformation to integrated managed long-term services and supports. Findings from the Medi-Cal gap analysis are available to the public in the California Home and Community-Based Services Gap Analysis Report.

To expand the impact of the Medi-Cal gap analysis, the California Department of Aging partnered with Mathematica to expand the analysis to non-Medi-Cal-covered HCBS. Under this project, the Mathematica team expanded this effort and included an accompanying program inventory and analysis of service use and demand for non-Medi-Cal HCBS programs and services.

In addition to the gap analysis and roadmap, Mathematica is supporting the California Department of Health Care Services in calculating and reporting HCBS quality measures. This includes supporting the state in launching the National Core Indicators – Aging and Disabilities survey (NCI-AD) with partner Knowledge Services.