Care in the IE: California’s Inland Empire Faces Growing Challenges in Caring for Aging Population

Overview: California is preparing for a rapidly aging population, with the Inland Empire expected to experience the most growth. However, the region is already struggling with a shortage of resources to care for its elderly population. In addition, Black Americans face unique challenges, many of which are rooted in economic disparities. To address these issues, California is implementing various legislative measures and support programs, but more resources will be needed to effectively support the aging population and ensure equitable access to care.

Mariah Brown

Picture this: more Californians are reaching retirement age, and the state is preparing for a rapidly aging population in the coming decades. To support this shift, California is expanding resources for caregivers and improving nursing facilities. However, the Inland Empire, which will experience much of this growth, is already grappling with a shortage of resources for its aging population. Black Americans, especially Black men, are among the most vulnerable, adding another layer of complexity to the challenges ahead.

As California faces a rapidly aging population, with projections showing that by 2030 one in five residents will be over 65, the state is taking steps to prepare for the growing demand for age-related services. This demographic shift is pushing the state to enhance support systems. The Inland Empire is expected to bear the brunt of this surge, yet it is already struggling with a shortage of resources to care for its elderly. Black elderly individuals in particular face considerable difficulties as they age. Compared to White older adults, African American seniors encounter significant health disparities, such as reduced life expectancies and a greater risk of chronic illnesses like hypertension, diabetes, dementia, stroke, and cancer, according to an analysis from the American Psychological Association. 

The Inland Empire’s Aging Population Will Need a Greater Share of Resources

According to the California Department of Finance, by 2040, the number of residents aged 80 and older is expected to double, reaching nearly 320,000 and the population of 65 and older adults will reach almost one million people in the Inland Empire by 2040.  

The population aged 65 and older is expected to grow more in the Inland Empire than in the state overall by 2040—58% compared to 45% statewide. 

“This demographic shift is putting a lot of pressure on healthcare and in-home care services, which are already stretched thin,” said Shannon McConville, research fellow at Public Policy Institute of Southern California. 

The projected impact of this demographic shift in the Inland Empire is multifaceted.

Economically, there will be a significant increase in healthcare costs, with estimates indicating that spending on long-term care services could rise by 30% in the next 10 years. Socially, the growing elderly population will lead to a higher prevalence of chronic conditions, increased isolation, and greater demand for mental health services. The strain on families and caregivers is also expected to intensify, as many will struggle to balance work responsibilities with caregiving duties.

Long-term care insurance and out-of-pocket expenses are typically designed for institutional care, leaving home care unaffordable for many. This can push people to leave their jobs to care for loved ones, making it hard to cover rent and basic needs without income. 

In-home care is becoming a major solution for California’s growing elderly population, according to Brandi Wolf, policy and research director for SEIU Local 2015.

“Supporting consumers to remain at home allows them to receive professional care while staying connected to their community,” Wolf said. She added that familial care doesn’t compromise quality of care. 

California Grapples with Aging Population Growing 

California’s older adult population is growing quickly, and older adults will make up 25%of the state’s population by 2030. 

In preparation for this population shift, Governor Gavin Newsom called for a Master Plan for Aging (MPA), a 10-year blueprint to build a California for all ages and abilities by 2030. The MPA was created in partnership with older adults, consumers, providers, local officials, private funders, and the Legislature, according to Susan DeMarois, director of the California Department of Aging.

The MPA’s Goal Four: Caregiving That Works, focuses on caregiving, which includes paid family leave, training and virtual care expansion. The CalGrows workforce training and development program is a key initiative under the MPA. CalGrows offers caregivers access to over 600 free online and in-person courses to enhance their skills. Paid direct care workers can qualify for incentive payments for completing these courses and applying their knowledge, but only through August 2024. While unpaid family and friend caregivers can take the courses, they are not eligible for incentives. The courses will remain available to all Californians through September 2024.

Additionally, California supports unpaid caregivers through the Family Caregiver Support Program, offered by Area Agencies on Aging and Caregiver Resource Centers. These programs provide counseling, services like home repairs, respite care, and more, to assist caregivers in supporting their loved ones. 

Caregiving Demands and Skilled Nursing Facilities for Aging Californians

Current data on California’s aging population and in-home care needs, particularly in the Inland Empire, shows a projected 682% increase in the 65 plus population by 2060, the highest growth rate in the state. This will significantly impact long-term care services as the population ages. 

According to the California Department of Aging report, the demand for home care aides and personal care assistants is projected to increase by 47%over the next decade. Currently, there are approximately 25,000 in-home care workers in the Inland Empire, but estimates suggest that this number will need to increase to at least 40,000 to meet future needs.

“Locally, the Inland Empire is not prepared for this rapid growth,” said Ben Jauregui, Inland Empire Health Plan’s manager of Integrated Transitional Care and founding board chair of the Inland Coalition on Aging. “There is a shortage of caregivers, a need for more training, and a need for more supportive services for informal caregivers.”

According to Jauregui, the California Master Plan for Aging identifies “Caregiving That Works” as its fourth goal, to acknowledge the need for improved preparation and support for all caregivers, including paid, unpaid, family and friends. Another proposed solution is the CalGrows program which aims to train caregivers. However, it is a short-term program. 

At the same time, the cost of in-home care is rising, driven by California’s high business expenses and competitive wages in other industries, such as fast food. It might be more appealing for someone to work in fast food at $20 an hour rather than as an In-Home Supportive Services (IHSS) home care provider earning $16, $17 or $18 per hour, according to Jauregui.

“More support is needed in this area,” he said. 

Legislation Considered to Support Family Caregivers

Several bills are currently being discussed to enhance support for family caregivers, including AB 518, which amends the existing paid family leave program to expand eligibility for wage replacement benefits. Currently, workers can receive benefits for caring for a seriously ill family member.

This bill extends coverage to individuals who take time off to care for a seriously ill “designated person,” defined as anyone related by blood or with a relationship equivalent to family. Workers can identify this designated person when filing for benefits. The bill revises relevant definitions and will take effect on Nov. 1, 2024.

Caregivers benefit from existing laws like the California Family Rights Act (CFRA) and Paid Family Leave (PFL), which provide up to 12 weeks of job-protected leave and wage replacement for up to 8 weeks when caring for family members. Additionally, while the state has considered caregiver tax credits, like a proposal offering up to $5,000 in tax relief, comprehensive tax credit legislation hasn’t yet passed. Pending bills, such as AB 1119, aim to further protect caregivers by prohibiting workplace discrimination based on caregiving responsibilities​. 

Black Californians Encounter Distinct Challenges 

In parts of California, rising costs of living and challenges accessing resources for Black Americans remain persistent, at times, leading to poor health outcomes for seniors and added stress for the family caregiver. 

Black Voice News collected data from various counties in California, revealing that Black residents are struggling more than others to keep up with living costs. This issue will significantly affect the elderly, who need expensive care.

In San Bernardino County, the Black population aged 65 and older is projected to increase by 26.4% by 2035. The average annual living cost for a single person in this county is $51,324, and nearly half, 49.6%- of households led by seniors in the area earn less than this amount.   

Projections of California’s elderly Black population (65 years and older) by the year 2035. (Graphic by Alex Reed, Mapping Black California)

By 2035, the Black population aged 65 and older in Riverside County is expected to increase by 39.4%. The average annual living cost for a single person in the county is $54,276, and 41.4%of senior-led households in the region earn less than this amount. With average living costs surpassing $50,000 annually and a substantial portion of senior-led households earning below this threshold, many will struggle to afford basic necessities and healthcare. The growing gap between income and living expenses highlights a critical need for targeted support and resources to ensure that Black seniors can maintain a decent quality of life amidst escalating financial demands.

California’s Inland Empire faces significant challenges as it prepares for a substantial increase in its aging population. The unique struggles faced by Black seniors, including economic disparities and higher costs of living, further complicate the situation. To address these issues, California is implementing various legislative measures and support programs, but the data shows continued efforts and expanded resources will be crucial to effectively support the aging population and ensure equitable access to care.