In order to obtain long-term services and supports, many middle-income people “spend down” their assets until they qualify for Medicaid. Is there a social insurance alternative to this system?  Kristina Bas Hamilton works for UDW, which will co-sponsor, with the Academy and Caring Across Generations, a virtual forum on Strengthening California’s Care Infrastructure:  Poverty, Inequality, and Universal Long-Term Care. The forum will bring together legislators, government officials, and advocates to discuss the caregiving crisis and stakeholder’s recommendation to adopt a social insurance-based program for long term services and supports (LTSS).

Q: How can this forum help in your efforts to improve life for low-income elders, people with disabilities, and the direct care workforce?

A: The forum, ideally, will capture the imagination of legislators and the administration as they go into the final stages of developing California’s Master Plan for Aging. We will begin the forum with a family caregiver telling her story about the financial hardship experienced by her family paying out of pocket for services needed for an aging parent. It will then segue into a discussion among panelists about the lack of access and affordability of LTSS, issues facing caregivers, and the proposal to create a new LTSS social insurance program. California Senate President pro tempore Toni Atkins will participate as a panelist along with Kim McCoy Wade, Director of the California Department of Aging, and distinguished advocates and experts in the field. Our goal is for this to be more than just another conversation between policy wonks who already agree with each other. We want to attract the attention of members of the Legislature and Administration and the press.

Last year, when Governor Gavin Newsom issued an executive order mandating the creation of a state Master Plan for Aging (MPA), I was honored to be appointed to the MPA Stakeholder Advisory Committee and LTSS Subcommittee. The subcommittee released a stakeholder report with extensive recommendations, including “advancing a statewide public LTSS benefit to help the ‘forgotten middle’ avoid spending down to poverty when LTSS becomes a need”. The report was supposed to be issued in March, but the COVID 19 pandemic disrupted timing of its release.  The report was eventually released in May, and is available online.  However, the state has been in crisis for months, not only with COVID, but also with the terrible wildfires, homelessness and other issues. There’s a lot dominating the attention of the administration and the legislature right now.

My goal with the forum is to get LTSS financing back on the radar again. Lack of affordable and available LTSS contributes to increasing rates of poverty and homelessness among seniors and people with disabilities. A social insurance program for LTSS – and ultimately for Universal Family Care -would help alleviate poverty, economic inequality, and homelessness. Now is the time to make our case.

More about Kristina Bas Hamilton

Kristina Bas Hamilton is the legislative director for UDW/AFSCME Local 3930, which represents approximately 118,000 home care workers in California.  UDW members provide critical services through the state’s In-Home Supportive Services program (IHSS), which allow over half a million seniors and people with disabilities to remain in their homes with dignity and independence. Kristina Bas Hamilton holds a Master of Labor and Industrial Relations degree from Rutgers University – New Brunswick. She has been a Member of the Academy since 2019.


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