California Medi-Cal Home and Community-Based Services Gap Analysis Report
Evidence | Publications

California Medi-Cal Home and Community-Based Services Gap Analysis Report

Published: Feb 14, 2025
Publisher: California Department of Health Care Services
Health Long-Term Services and Supports Medicaid and CHIP State Health Policy State and Local

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Associated Project

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

Time frame: 2022–2025

Prepared for:

California Health and Human Services (CalHHS)

Key Findings

  • California’s population is aging rapidly, particularly in areas where current access to HCBS is already limited.
  • In rural areas, use of institutional LTSS is higher than in more urban areas. The population of future LTSS users is expected to include a greater number of Hispanics, people ages 85 and older, and females.
  • To meet the needs of a growing population of Medi-Cal members who need HCBS, the number of HCBS providers participating in Medi-Cal must increase.
  • The largest reported areas of workforce needs are for direct care providers.
To identify gaps in availability, accessibility, and delivery of HCBS, DHCS contracted with Mathematica to conduct a mixed-methods analysis of the state’s HCBS programs and service delivery system. To close the gaps and improve access to HCBS, Mathematica will develop a Multi-year Roadmap with recommendations on how to better meet the needs of older adults and people with disabilities enrolled in Medi-Cal. 

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