Fostering innovation and increasing services that support aging in place at scale. 

Central Texas has one of the fastest growing aging populations in the country and it is predicted to double over the next 20 years. As we age, we become more vulnerable to chronic conditions and functional disabilities that make it challenging for us to remain safe and independent in our homes and connected to our communities. 

Most older adults desire to remain living in their home, and support services are critical in helping them to achieve this goal. To meet the growing demand, St. David’s Foundation is working to foster innovation and increase services that support aging in place at a large scale appropriate for our five-county region. 

Older adults have a vital role to play in the community. The future is shaped through the wisdom and experience of our elders. In return, aging adults need access to services that enable them to remain safe and independent in their homes and connected to their communities.  

Overall, we aim to help older adults live safely and independently in their homes as they age. We do this by increasing funding for core services for low-income older adults, fostering multi-sector community engagement to improve the lives of older adults and family caregivers, and conducting community-based research to assess needs and inform strategy. 

The Issue 

Central Texas has an inadequate supply of services for older adults. The care older adults receive should be of high-quality and, for those at the end of their life, it should enable them to have a better death. 

In Central Texas, an estimated 48,334 older adults 65+ are living under 200% Federal Poverty Level. While the poorest older adults can qualify for Medicaid, the process of navigating benefits can be complicated, and services are often unavailable. 

Additionally, older adults just over the Medicaid threshold do not qualify for assistance and are particularly vulnerable to being left unserved. Older adults living in rural areas are disproportionately affected by having less access to services, limited transportation options, and increased social isolation. 

Finally, older adults of color have experienced structural inequities that have often led to less wealth accumulation. They also often live in areas with a historical lack of economic and social investment. Therefore, the Foundation is particularly invested in supporting underserved communities of color. 

Our Approach 

The Foundation will seek to improve conditions in Central Texas for older adults by activating the following strategies: 

Directly funding services and supporting the health of organizations providing services. This approach includes programmatic and capacity building grants in six key funding areas: 

• Core services for vulnerable homebound older adults; 
• Resources and education for family caregivers; 
• Adult day health centers;
• Programs that reduce social isolation;
• Palliative care and end-of-life planning;
• Workforce development of highly-skilled geriatric social workers. 

Bringing services to scale in ways beyond grantmaking. Specifically, the Foundation will use the following approaches: 

• Build evidence for new models by piloting and evaluating innovative services in Central Texas and demonstrating the “double impact” of intergenerational approaches 
• Lead new payment models and public system improvement by advocating to MCOs and legislators on the cost effectiveness of adopting evidence-based services, advocating for increased appropriations for Medicaid services for older adults, and engaging local organizations to advocate for supportive aging policies 
• Engage and activate community around aging issues.