Now at FCA: CMS GUIDE Model

October 5, 2026

A Q&A with Lila Goehring, FCA’s Community Support Navigator & GUIDE Program Care Navigator

Medicare patients living with dementia and their caregivers can now find help through a program called GUIDE. Created by the Center for Medicare & Medicaid Services (CMS),

GUIDE is short for Guiding an Improved Dementia Experience. To qualifying Medicare patients, the program delivers yearly respite grants of $2500, 24/7 dementia-focused telehealth access, and regular contact with an assigned care navigator to build a comprehensive program of care.

FCA’s newest staff member, Lila Goehring, serves as the program’s dedicated care navigator, and we spoke with her to get to know both her and the GUIDE program better.

Walk us through your journey to FCA. What led you here, and what has been a highlight so far?

I’ve always loved stories and making meaningful connections with people in order to learn theirs. I’m from a small town in Ohio, and attended a liberal arts college in Oakland. Both my education and living in the Bay Area exposed me to our incredibly diverse and remarkable community, and also to profound struggles and inequities, like wealth disparity and broken health care systems.

I have always envisioned a career in which I can touch individual lives and see that impact in real time. My time at FCA thus far has absolutely delivered that. In my very first women’s studies class in high school, a beloved teacher said that even one experience of being heard–or simply being listened to–can make all the difference.

What is the role of the care navigator in CMS’s GUIDE program?

As a GUIDE care navigator, I am responsible for monthly check-in calls with members, and the regular contact is vital to developing a solid relationship. I always encourage people to reach out more frequently if things come up.

Together, we come up with a care plan that best fits the needs of the caregiver, and arrange usage of the $2500 respite grant. Because the respite needs to be arranged through GUIDE-approved agencies, I do a lot of communicating between caregivers and the care agencies.I also make clients aware of FCA’s other services, like support groups, counseling services, and online resources. The availability of FCA as a resource, in addition to GUIDE, truly sets our program apart.

How would a provider know if someone is a candidate for GUIDE, and what are the steps of the referral process?

To qualify, caregivers must be caring for someone enrolled in traditional Medicare (not Medicare Advantage), have a dementia diagnosis, and reside at home. The model began on July 1, 2024, and will run for 8 years. It’s okay for members to also be enrolled in Medi-Cal, and many are.

FCA partners with Tembo, a dementia-focused telehealth company who provide 24-hr support to members. If you think a caregiver may qualify for GUIDE, they can visit Tembo’s website and select “Request a Free Consultation” to book an intro call. Tembo will confirm eligibility, conduct a home assessment, and ultimately connect clients to their care navigator–me–to arrange respite. Clients and providers may also reach out directly to me to walk them through this process.

In your previous position, you worked with the senior LGBTQ+ population. How does this experience inform your work?

It’s important to understand the unique challenges of this population–many aren’t connected with family, or lost friends and chosen family members to AIDS. As an LGBTQ+ person myself, I understand the unique role of non-relative caregivers, or complicated familial relationships.

A big challenge faced by the aging LGBTQ+ community is isolation, which we know contributes to cognitive decline. I deeply understand the importance of connection, both for people with dementia and for their caregivers. Some caregivers become very isolated, which is why things like support groups–and time to oneself–are vital to everyone’s health and wellbeing.

What makes working at FCA most rewarding?

I’m honored when caregivers trust me with heavy topics. Any social services work means navigating broken systems, so even a small “win”–like a caregiver enjoying a new support group, or finally being able to practice photography again thanks to a respite grant–makes it all worth it. The heart of our work at FCA is the connections we make with caregivers.

In a way, the GUIDE program is a perfect analogy for FCA’s overall impact: the day-to-day centers around supporting individuals, but also keeps the big picture in mind. At its core, GUIDE is a pilot program aimed to improve the dementia experience. Just as some of my colleagues at FCA work behind the scenes to influence policy or contribute to dementia research, my hope is that GUIDE will move our country’s care system closer to one that actually helps people–and away from what we know doesn’t work.