Why MPAs Are Critical to Equitably Meeting the Needs of Aging Communities

ASA is partnering with West Health, The SCAN Foundation and The John A. Hartford Foundation on a series of posts, virtual and On Aging programming to foster Multisector Plans for Aging across the country. This is the fourth in the blog post series.

Please tune in on Nov. 7 to the Future Proof Live: Centering Equity and Family Caregivers in State Multisector Plans for Aging.

In the aftermath of the COVID-19 pandemic, states have an opportunity to rebuild their systems serving elders to better serve all older adults and people with disabilities. This massive feat must begin with a plan.

Multisector Plans for Aging—also known as master plans, strategic plans or aging-well plans—offer a powerful tool for communities to better meet older adults’ long-term services and supports (LTSS) needs. Creating these plans provides a state-specific blueprint that:

  • Includes planning for 10 or more years
  • Is often led by a governor with other executive and legislative leaders
  • Is developed to guide the restructuring of state and local policy, programs and funding toward aging well in the community.

Already many states nationwide are engaged to some degree with multisector plans to prepare for an aging population. Each state’s plan is unique and crafted to fit the needs of its aging population and align with its priority areas on aging (e.g., strengthening LTSS, designing age-friendly communities, addressing health disparities, and increasing financial security for older adults). Plans also have the potential in coming years to cover the needs of older adults, people with disabilities, and family caregivers.

An Innovative and Important Tool

These plans have received increased recognition over the years, with the most recent and notable feature appearing in the 2023 AARP LTSS State Scorecard. This Scorecard is a compilation of state data and analyses that provides a comprehensive picture of how states support older adults, people with physical disabilities and family caregivers through their LTSS.

The latest iteration released this past September examines whether or not states have developed Multisector Plans for Aging. Using April 2023 data from the SCAN Foundation, the Scorecard offers full credit to states with developed or implemented plans, and partial credit to states with legislation or executive orders for such plans. Eight states earned credit for their Multisector Plans for Aging: California, Colorado, Massachusetts, Missouri, North Carolina, New York, Utah and Vermont.

This is all part of the Scorecard’s effort to spotlight innovation in LTSS. The Scorecard highlights six innovation practices, and it is notable that all four of the states that stand out for having implemented the most innovative practices have a Multisector Plan for Aging (Colorado, California, Missouri and New York).

According to the Scorecard, “This suggests it is possible that the focus on systemic improvement and the type of coalitions required to develop a Multisector Plan for Aging are also associated with the commitment and capacity to innovate overall.”

While not reflected in the Scorecard, several states are engaged in learning collaboratives to share best practices. Additionally, the Scorecard only credited states with plans recognized by the SCAN Foundation and doesn’t include those that have developed plans but the plans don’t meet that criteria.

Addressing Inequities

Multisector Plans for Aging acknowledge that LTSS do not exist in a vacuum. Instead, an individual’s LTSS experience is influenced by social, economic, environmental and behavioral factors.

The current U.S. LTSS ecosystem is a complex web of institutions, services and providers. At both federal and state levels, LTSS systems operate in silos, where various components do not effectively collaborate. This degree of fragmentation lowers the quality of care and increases financial burden and emotional distress for older adults and those living with a disability. Ultimately it leads to poor health and quality of life.

‘At federal and state levels, LTSS systems operate in silos.’

These adverse outcomes tend to be more pronounced for racially and ethnically diverse older adults, who, on top of navigating the system’s complexities, also face systemic inequities in their pursuit to age in good health.

A key principle in the Scorecard notes that a high-performing LTSS system must center equity to optimize care access, delivery, and outcomes for all older adults and their families. As states explore opportunities to strengthen their aging and LTSS systems, centering equity as a tenet of their Multisector Plans for Aging is key to addressing racial and ethnic disparities. California's plan offers an example of how equity can be embedded in key components of a state’s aging plan to drive equitable aging policies and programs.

Engaging the Community

Cross-sector involvement in these plans requires engaging key components of the LTSS system to understand and address the root causes of the current challenges faced by older adults, people with disabilities, caregivers and families. Moreover, the collaborative nature of these plans has the potential to drive innovation and propel solutions that are people-first and grounded in evidence-based practices. In underserved communities, innovation can improve access to and quality of LTSS, enhancing the well-being of individuals and communities.

Family caregivers—including friends and neighbors—form the bedrock of LTSS, enabling older adults and people with disabilities to get the care and support they need as they age. States should ensure that their plans reflect the voices, experiences and recommendations of family caregivers, given their vital role in LTSS systems.

In their Multisector Plans for Aging, states should integrate and strengthen support for family caregivers through strategies, including protecting their financial security and well-being while caring for older adults and people with disabilities.

While the promise of a multisector plan is clear, there is no doubt that the true success of each state plan lies in its implementation. Nonetheless, comprehensive, multisector aging plans have the power to secure transformative change in state LTSS systems. These plans offer states an opportunity to embrace a unified and holistic approach to rebuilding their LTSS system centered on equity and collaboration to achieve a lasting impact on the lives of Americans.

Edem Hado, MPH, is a senior strategic policy advisor on the family, home and community team in AARP’s Public Policy Institute, focused on advancing equitable policies in LTSS and caregiving.

To Learn More About the Multisector Plan for Aging Movement

Visit the new Multisector Plan for Aging website to learn about the latest state action on MPAs. This website serves as a hub for involvement opportunities, including an interactive map showing state progress on MPAs and links to helpful resources such as articles, event recordings, and toolkits.