Shari Horne spends much of her day caring for her husband Hal in their sunny apartment in Orange County’s Laguna Woods, where she was once mayor.
I’m sharing the Hornes’ story in my inaugural column for the California Health Report. Over the next year, I’ll write about health equity and aging, drawing on my personal experiences, as well as those of the people I interview.
For many older adults, especially those with low incomes, mobility is not a luxury. It is the foundation of independence, emotional well-being and dignity. Yet access to basic mobility support varies widely across the state. That gap has serious consequences.
As a physical therapist working in post-acute and long-term care, I see this divide every day.
As a rehabilitation clinician and director working directly with older adults, I see how effective early mobility support can be. Mild losses in leg strength or balance respond well to structured, simple routines when they are addressed early. The greatest need is access.
Several programs across California demonstrate how this access can be expanded.
California, through the Master Plan on Aging, has led the nation in recognizing the unique and increasingly urgent needs of older adults.
But Gov. Newsom’s recently released budget proposal for the 2025-26 fiscal year could cut aging and disability-focused programs. We’ve heard firsthand from older adults, people with disabilities and family caregivers about the challenges in accessing support and affordable housing. Many people feel left behind by the system.
It’s common for people with disabilities to have trouble accessing health care, but this problem is often overlooked. These challenges can affect people as they move from pediatric to adult care, and also as they age.
I’ve seen how disability and health intersect, both in my academic studies and through my own lived experiences as a person with disabilities.
For families like mine, California’s In-Home Supportive Services program is a lifeline.
But the IHSS lifeline is fraying as the cost of living soars. The IHSS pay rate for caregiving has barely inched above minimum wage in most parts of the state. The pay I receive as my father’s caregiver is not enough to support my family, so I have to work a second full time job.
Bonnie Burns was shocked into action the first time she learned that seniors were being coerced into Medicare Advantage plans that either didn’t suit their needs, misled them about costs, or lured them with benefits they wouldn’t actually receive.
A health care advocate for 40 years, Burns was outraged that a health insurance option intended to broaden coverage choices for California elders was instead being misused by unscrupulous marketers to seek profits.
Most older adults want to stay in their homes and communities as they age. To do that, many eventually need assistance with routine and personal care.
But 40 percent of older adults and adults with disabilities in California who need help to stay in their homes report receiving either no help at all or not enough.