With Philanthropy Leading the Way, States Are Planning for an Aging America

6 min
November 21, 2022
By Wendy Paris and Amy Herr

The master plan movement, now active in more than a dozen states and counting, marks a major, positive shift in how states address aging — and one heavily influenced by philanthropy.

“In a lot of ways, philanthropy is driving these master plans,” said Lindsay Goldman, CEO of Grantmakers in Aging. “A lot of our members have invested in age-friendly communities, and now they’re interested in master plans as a sustainable strategy for those communities and to bring added resources to the field of aging.”

While the phrase “master plan for aging” may sound like just another way to say “endless bureaucracy,” in fact, this approach is making a real difference in how states address aging. As with other aging-related initiatives we’ve covered, such as a push to reframe aging and the expansion of a program to help seniors stay in their homes, funders backing these state-based master plans are working together to leverage their money and diverse talents to amplify their impact.

For these master plans, that generally means joining forces to court a governor or legislator as a champion in each state, position a point person on aging within the state, motivate other agencies — such as the parks department or library — to recognize and address aging as their issue, too, and ultimately, work to route billions of government dollars to the cause. Given the less than 2% of philanthropic funding that goes toward traditional aging-related programs and services, this kind of a high-level, multiyear strategy — drawing on public-sector partnerships and resources — is key to meeting the huge demographic shift before us. Direct giving alone can’t cut it.

The golden state of aging

California, where I live, is the unquestioned leader in the master plan movement. California is also a state that really needs a plan. A quarter of the state’s population — nearly 11 million people — will be “older adults” by 2030. California lacks adequate housing for everyone seeking to age in place, as well as transportation infrastructure, sources of economic security, equitable digital inclusion, and opportunities for meaningful engagement.

The state also has a huge caregiver crisis — a shortage of people able and willing to work as paid caregivers for older adults with multiple needs. That’s something I saw firsthand this past year while working at a caregiving agency as part of a master’s degree in social work program I was completing. At my agency, staff strove to hire caregivers and to keep them in our employ. Our caregivers were mostly women of color, many of them immigrants, often mothers, sometimes working two or three jobs. We paid just above L.A. County’s minimum wage of $15.96/hour, less than the baristas earn at the fancy coffee shop on my corner. (And servers get tips.) While $16+ per hour might be enough to support a family in, say, Mississippi, it doesn’t cover the median rent here in L.A. Many younger office staff also worked second jobs to pay for their lives in L.A.

My field supervisor/boss strove to improve the quality of life for our caregivers and staff, and to create a career ladder. But the money to do so, including for needed interventions and programming, was nowhere to be found.

Now, the state has the dough. Fifty-five million dollars will be available in grant money for “innovation funding” starting this month, and another $100 million in January. These funds are designed to be used for things like caregiver training, retention bonuses, cell phones and other needs. “We would not have one dollar of that without the master plan for aging,” said Susan DeMarois, director of the California Department of Aging. With this money available, my former boss — and others in similar roles — can apply for funds to improve the job skills and prospects of contract caregivers and of staff.

From master plan to moving the money

California began working on its master plan back in 2019, using $200,000 from eight funders to get it going, including West Health, The SCAN Foundation, Metta Fund, Archstone Foundation, and the May and Stanley Smith Charitable Trust. “We paid for consultants, meeting space and other things the state might not have been able to do on its own,” said Amy Herr, director of health policy at West Health.

But in another example of the long-range, strategic thinking that philanthropy can bring to these complicated issues, the work to get this master plan on the state’s agenda started a year earlier. In 2018, West Health had partnered with The Scan Foundation and advocacy groups across California to elevate the issue of aging. During the state’s gubernatorial election that year, they invited candidates to make a pledge to focus on aging as part of their time in office, and funded polling on aging issues and a communications campaign called “We Stand with Seniors.”

Due in part to these efforts, all gubernatorial candidates pledged to focus on aging, and when winner Gavin Newsom started as governor in 2019, he announced his commitment to a California Master Plan for Aging during his first State of the State address. The eight funders then kicked in to support the process.

In 2021, the state released the results of its work drafting a master plan, “California’s Master Plan for Aging,” with five goals and twenty-three strategies to build a “California for All Ages” by 2030. Goals include keeping older adults in their homes, improving economic security and creating 1 million good caregiver jobs. “In the first year or two, it was standing it up. Now we’re entering the implementation phase of some of these exciting initiatives,” DeMarois said.

DeMarois credited the governor — and philanthropy — for California’s leadership role. “We have these incredible, committed, strong and progressive philanthropic partners headquartered here, who started this work. They were very generous not just with financial resources, but also contacts, networks and particular expertise.”

Next up? Learning collaboratives to help other states follow California’s lead

While California is not the only state with a master plan in place, it is leading the charge for far more comprehensive planning and funding than we’ve seen before, and inspiring other states to follow suit. “New York will very likely be next,” Goldman said, pointing to a coalition of 80 organizations across New York State that have mobilized for a master plan, and Gov. Kathy Hochul’s mention of it in her state of the state address. In fact, while I was writing this story, Gov. Hochul signed an executive order to create the state’s first-ever master plan for aging.

In April 2022, West Health led an effort, along with The SCAN Foundation and the May & Stanley Smith Charitable Trust, to give $1 million in combined funding to support a two-year “learning collaborative” aimed at sharing the knowledge gained in California with other states. Ten states are currently participating in the first of a pair of one-year-long cohorts. Another 10 states will join a second cohort in the spring of 2023.

The Center for Health Care Strategies (CHCS), which was the recipient of that funding, is overseeing the collaborative. A policy center that works with Medicaid and state health agencies to improve healthcare delivery, CHCS was started in 1995 with major funding from the Robert Wood Johnson Foundation.

Carrie Graham, the director of long-term services and supports at CHCS and a former consultant on California’s master plan, leads the learning collaborative. “We were out on the road doing presentations on California’s master plan on aging, and a week or two didn’t go by when someone would call us up from another state and say, ‘Will you meet with us? We have all these silos in our state, and they don’t talk to each other.’ We just got all these calls,” she said.

CHCS created two publications or “tools” about creating a master plan, which proved to be incredibly popular. But states needed more hands-on help. “So we said, ‘Why don’t we put together a learning collaborative for states that might be interested?’” Graham said. “California is unusual, and not all states can do the same thing. But they can learn from each other.”

Like pretty much everyone I’ve spoken to, Graham sounded excited about the master plan. “It has done so much for California, which has ended up having historical investment for aging in the budget, which it didn’t have before.”

“This is about all of us”

Master plans bring non-monetary benefits, too. “It’s a way to elevate the issues of older adults and help everyone understand that this is not about a separate agency over here on the side. This is about all of us as we’re aging,” Herr said.

Collaboration among state agencies empowers them to address other crises. During COVID, for example, California found itself with a strong network of agencies ready and able to mobilize together to support older adults, due largely to its proactive approach to convening stakeholders around a master plan. The master plan movement also means that when a state finds itself with a budget windfall, as also occurred in California, it already has spending priorities in place.

All of which is to say, philanthropy is helping make this an exciting time to grow old — or at least to work in the field of aging.


Amy Herr
Director, Health Policy