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PPIC Statewide Survey: Californians and Their Government (May 2022)

May 26, 2022

Every California voter has received a June 7 primary ballot in the mail and they have been weighing their election choices in the midst of disturbing news and unsettling circumstances. Inflation continues to take a daily toll on consumers and dampens their economic outlook. Russia's invasion of Ukraine has turned into a deadly and protracted military conflict. The latest omicron variant is resulting in yet another surge in COVID cases. And Californians are being asked to conserve water in response to the drought while bracing themselves for wildfire season. The one bright spot is Governor Newsom's May revision, which includes a record-setting surplus of revenues available for the state budget.This report highlights key findings of a statewide survey on state and national issues that was conducted from May 12 to 22 by the Public Policy Institute of California.

Immigration Legal Services in California: A Time for Bold Action (2022 Update)

May 6, 2022

Recognizing the intensifying legal service needs of immigrant communities and legal service providers, GCIR and the California Immigrant Integration Initiative (CIII) launched a study in 2019 to understand the capacity of immigration legal services in California and generate recommendations for strategic philanthropic investment. This 2022 update is a supplement to the 2019-20 findings and recommendations and offers recommendations to strengthen immigration legal services in California for immigrants and asylum seekers. The report draws from 20 interviews with executive-level staff from legal service organizations and 80 responses to an online survey of a broad range of immigration legal service providers across the state.

Gun Violence in California by the Numbers 2022

May 5, 2022

WE ALL DESERVE TO FEEL SECURE WHERE WE LIVE, WORK AND PLAY; but in reality with thousands of Californians killed or injured from gun violence every year there is much work to be done.

Food Insecurity Among Undocumented Immigrants in California and Exclusion from Nutrition Assistance Programs

April 29, 2022

California is home to the largest economy in the United States–and our nation's highest rate of poverty. That experience of deep hardship in the face of great prosperity holds true for many California immigrants. An estimated 11 million immigrants–including approximately 2.3 million undocumented immigrants–contribute to the rich diversity of the Golden State.The COVID-19 pandemic has exacerbated hardship and driven inequitable outcomes for immigrants across California. But hardships such as poverty and food insecurity persisted well before this public health emergency. Exclusionary policies continue to perpetuate poverty and food insecurity, inflicting harm on California's immigrant communities and the state at large.This brief draws on quantitative data and community voices to provide a novel, state-specific analysis of food insecurity and poverty among undocumented immigrants in California. These findings are essential to advance evidence-based policies that can make California a more equitable, inclusive place for all who call it home.

CalAIM Community Supports: Promoting Independent Living Among Older Adults and People with Disabilities

April 26, 2022

Through CalAIM (California Advancing and Innovating Medi-Cal), a multiyear initiative to transform the Medi-Cal program, managed care plans now have the option to offer any of 14 Community Supports that provide person-centered services to address a variety of social drivers of health. Several of these Community Supports could help older adults and people with disabilities remain in their own homes, participate in their communities, and live independently in the setting of their choice.To support understanding and increased uptake of these services over time, this report provides an overview of and evidence summary for six Community Supports most relevant to supporting independent living for older adults and people with disabilities, including:Respite Services. Short-term services aimed at providing relief to caregivers of those who require occasional or temporary assistance or supervision.Nursing Facility Transition / Diversion to Assisted Living Facilities. Services that help people remain in the community by facilitating transitions from a nursing facility back into a home-like, community setting or prevent nursing facility admissions for those with imminent need.Community Transition Services / Nursing Facility Transition to a Home. Nonrecurring support, including setup expenses, to avoid further institutionalization and help people remain in the community as they return home from a licensed nursing facility.Personal Care and Homemaker Services. Supports for people needing assistance with daily activities, such as bathing, dressing, cooking, eating, and personal hygiene.Environmental Accessibility Adaptations (Home Modifications). Physical adaptations to a home when necessary to ensure health, welfare, and safety, or promote greater independence at home through improved functionality and mobility.Medically Supportive Food / Meals / Medically Tailored Meals. Meal services to help people achieve their nutritional goals at critical times (such as after a hospital or nursing facility stay) to regain and maintain their health.

Health Care Access among California’s Farmworkers

April 25, 2022

Recent federal and state policies may have improved access to health insurance for farmworkers, who are important contributors to California's economy and an essential link in the food supply chain. The Affordable Care Act (ACA) included an expansion of Medi-Cal to most low-income adults, and a mandate requiring companies with at least 50 workers to offer employer health insurance. California also expanded Medi-Cal to young undocumented immigrants, and will soon extend it to older individuals. This report investigates whether these policies coincided with better insurance coverage or reduced barriers to health care for immigrant farmworkers.Farmworkers are aging and more likely to settle in the US with family; thus, their health care needs—and those of their families and children—will likely grow. Cost or lack of insurance are the most salient barriers to health care for farmworkers; few farmworkers note barriers related to immigration status, although being undocumented is a strong predictor of lacking health insurance. Many documented farmworkers have enrolled in Medi-Cal following the ACA expansion, which has increased coverage rates and lowered cost and insurance barriers to health care. Undocumented farmworkers have not fared as well in these areas. Employer health insurance coverage for farmworkers did not change detectably with the rollout of the ACA employer mandate, regardless of a farmworker's documentation status or whether the worker was a direct hire versus a contractor. These findings take on special importance during the coronavirus pandemic. Farmworkers have continued to work during the public health emergency. Yet with California's high cost of housing, many farmworkers live in crowded conditions, making it difficult to remain socially distant from other household members. Although emergency Medi-Cal covers COVID-19 treatment regardless of immigration status, long COVID and resulting disability may threaten farmworkers' health and livelihoods.

State Constitutions and Abortion Rights: Building Protections for Reproductive Autonomy

April 22, 2022

This report outlines 11 states in which high courts have recognized that their state constitutions protect abortion rights and access independently from and more strongly than the U.S. Constitution or have struck down restrictions that were upheld by the U.S. Supreme Court. The analysis considers how this jurisprudence can expand and shape efforts to secure reproductive rights.

Investing in Primary Care: Why It Matters for Californians with Commercial Coverage

April 19, 2022

Decades of research have shown that increased investments in primary care lead to higher-quality and more equitable care as well as lower costs. However, there were few data on the level of primary care investment specifically in the California health care market. This first-of-its-kind study, Investing in Primary Care: Why It Matters for Californians with Commercial Coverage, measures primary care spending, as a proportion of overall spending, among eight health plans and their product offerings, covering 80% of commercially insured adults in California (13.9 million). The study also took a deeper look at the primary care spending of 180 separate provider organizations, comprising 8.5 million adults enrolled in HMO plans, or nearly half of California's commercially insured adults.To measure the impact of primary care investment on care quality, researchers compared provider organizations on measures including the share of members who received recommended breast cancer, cervical cancer, and colorectal cancer screenings; received appropriate medications; and who had their diabetes care goals met. 

PPIC Statewide Survey: Californians and Their Government (March 2022)

March 24, 2022

The world order was upended when the Russian military invaded Ukraine, an action that has caused widespread death and destruction. In response, the international community imposed harsh economic sanctions on the Russian government. Californians felt the shock waves through rising prices at the gasoline pump that added further fuel to inflation fears. In recent weeks, COVID-19 cases have plummeted and the omicron surge has given way to an easing of mask and vaccination restrictions. Meanwhile, statewide and legislative candidates for the California June primary made their plans known by the March 11 deadline. This report presents the key findings of a statewide survey on state and national issues conducted by the Public Policy Institute of California from March 6 to 17, 2022.

Big Gifts for Little Learners: Making the Case for Philanthropic Investment From Pregnancy Through Preschool

March 21, 2022

The San Francisco Bay Area is home to some of the wealthiest counties and most generous donors in the country. But how do those individuals choose where to spend their philanthropic dollars?In our 2021 survey of Bay Area donors, which included both affluent individuals and foundations, 40% of respondents said that when considering causes or groups to give to, demonstrated impact would lead them to choose one cause or group over others.In some ways it is surprising, then, that only 15% of donors said they give to early care and learning -- an area with robust research demonstrating positive impact on the children supported (including permanent increases in children's IQ and better health outcomes) as well as on their families and the broader community (e.g., gains in maternal workforce participation).

Medi-Cal and Opportunities for Health Tech in Home-Based Medical Care

March 9, 2022

For people living with complex health needs, the usual model of going to the clinic or hospital for care does not always work well. Home-based medical care programs have been designed to fill this gap, providing better care to people living with multiple chronic conditions, functional limitations, and often social risk factors who have difficulty accessing care in traditional settings.This group, which includes seniors as well as younger people living with physical, mental, or developmental disabilities, is large. The state's Medicaid program, Medi-Cal, plays an outsized role in covering their care. Although Medi-Cal covers one in three Californians, it covers more than 50% of those living with a disability. In fact, there are 2.3 million seniors and people with disabilities covered by Medi-Cal, who represent roughly one in three Medi-Cal enrollees.Growing demand from consumers and their caregivers and a favorable policy environment create an opportunity for entrepreneurs and safety-net plans and providers to work together to improve access to these innovative models. This report explores opportunities for innovation, challenges, current policies, and implications for innovators. For this landscape report, the author interviewed a range of stakeholders to understand their perspectives and approaches to home-based medical care in an effort to showcase different models in California's health ecosystem.Readers should note this landscape overview is not intended to be exhaustive, nor is it an endorsement of the companies included. Finally, because solutions landscapes can evolve quickly, this brief may not fully reflect the current market.

Can You Verify? Addressing Work Authorization Restrictions As Obstacles to Workforce Development Equity for Immigrant Workers

March 9, 2022

This year, the Governor proposed over $250 million in funding for workforce development specifically intended to benefit immigrant communities. These investments include job training, support services, "earn and learn" opportunities, and more—promising, welcome, and necessary funding for our communities to gain better jobs in the workforce. But what does our current public workforce development system look like, especially for undocumented immigrant workers? Our latest research on workforce development, building off of our prior work, investigates how work authorization requirements may create unnecessary barriers for California's undocumented immigrant workforce when attempting to access public workforce services and resources. This report is the first-ever empirical analysis of the discrepancies in local workforce boards' policies and practices related to immigrant access to workforce development services. It offers new insights through original survey data collected from California's 45 local workforce development boards, COVID-19 and industry data on immigrant workers, and strategic recommendations that the California Workforce Development Board can implement to better support undocumented immigrant workers and remove exclusionary, and unneccesary, restrictions.