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Anticipating Changes in Regional Demand for Nursing Homes

By Laurel Beck, Landon Gibson

California’s nursing homes provide a major source of personal and medical care for the state’s most vulnerable residents—the elderly and the disabled. By 2030 the state’s 65-and-over population will grow by 87 percent. The number of people requiring skilled nursing care could increase by 32,000, far outstripping current capacities. We find that there will be significant disparities in regional growth rates across racial/ethnic groups and in regions’ abilities to absorb higher numbers of patients. Specifically:

  • The Bay Area and the Inland Empire have the largest discrepancies between existing nursing home capacity and projected demand in 2030; Los Angeles and Northern California (excluding the Bay Area) have the smallest.
  • Regional growth rates in the 65-and-over population vary widely within racial/ethnic groups. For example, rates among Latinos range from 159 percent on the state’s Southern Border (Imperial and San Diego Counties) to 193 percent in the Inland Empire; among Asians they range from 93 percent in the Central Coast to 212 percent in Northern California (excluding the Bay Area).

In order to meet the growing and changing demands for senior care at the statewide and regional levels, policymakers will need to address ways to increase nursing home capacity. These solutions must also include recruiting and training health workers who can provide effective, culturally competent care, whether in skilled nursing facilities or home- and community-based settings.


Income Inequality and the Safety Net in California

By Caroline Danielson, Sarah Bohn

Income inequality has been growing for decades, in California and the nation as a whole. In recent years, inequality—and the role of policy in addressing it—has become a major focus of public debate. This report documents the polarization of incomes across the state and shows how social safety net programs mitigate inequality.


Expanding Health Coverage in California: County Jails as Enrollment Sites

By Shannon McConville, Mia Bird

In 2014, the first year of Affordable Care Act (ACA) implementation, the number of Californians with health insurance increased substantially. However, millions of state residents continue to lack comprehensive health coverage, and those who remain uninsured are likely more difficult to enroll through traditional strategies.

In this report, we find that uninsured rates are highest for young men and for those with low levels of education, income, and employment. The prevalence of these same characteristics among correctional populations suggests that the justice system—and, in particular, county jails—may offer points of contact for many uninsured individuals who would otherwise be hard to reach.

Outreach and enrollment efforts aimed at local jail populations are set within the policy context of California’s 2011 Public Safety Realignment, which created incentives and resources for local corrections agencies to improve reentry outcomes. With expansions in access to health insurance coverage under the ACA, nearly all counties are establishing programs to provide enrollment assistance to jail inmates as part of a more comprehensive reentry strategy. But resources and capacity are limited, so it is important to identify effective models to maximize the potential of county correctional systems as sites of insurance enrollment.

Statewide Survey

PPIC Statewide Survey: Californians and Education

By Mark Baldassare, Lunna Lopes, Dean Bonner, David Kordus

Some findings of the current survey:

  • Most Californians say that state funding for local schools is inadequate; solid majorities favor a Proposition 30 income tax increase extension and state and local school bonds.
  • Democrats and Republicans are divided on the Common Core standards. Still, a majority of Californians are confident that Common Core will help prepare students for college and careers.
  • While few Californians have heard of the Local Control Funding Formula, a solid majority are supportive after being read a short description of the policy.
  • Californians are concerned about preschool affordability; most favor using some of the state budget surplus to fund early childhood education programs.

All Adults [PDF]
Likely Voters [PDF]

Time Trends:
All Adults [PDF]
Likely Voters [PDF]

The survey was supported with funding from the S. D. Bechtel, Jr. Foundation, The Dirk and Charlene Kabcenell Foundation, the LA Partnership for Early Childhood Investment, the Silver Giving Foundation, and the Stuart Foundation.

Statewide Survey

PPIC Statewide Survey: Californians and Their Government

By Mark Baldassare, Lunna Lopes, Dean Bonner, David Kordus

Some findings of the current survey:

  • Californians are much more likely than adults nationwide to view global climate change as a very serious problem.
  • Two in three Californians say the state is divided into haves and have-nots.
  • Slightly more than half (54%) favor providing health care coverage for undocumented immigrants in California.
  • Half prioritize new ideas and a different approach over experience and a proven record in a presidential candidate.

Job Approval Ratings:
President Obama [PDF]
Governor Brown [PDF]
California State Legislature [PDF]
U.S. Congress [PDF]

Time Trends of Job Approval Ratings:
President Obama [XLS]
Governor Brown [XLS]
California State Legislature [XLS]
U.S. Congress [XLS]

Mood of Californians:
General Direction of Things in California [PDF]
Economic Outlook for California [PDF]

Time Trends for the Mood of Californians:
General Direction of Things in California [XLS]
Economic Outlook for California [XLS]

This survey was supported with funding from The James Irvine Foundation.


Planning for California’s Growing Senior Population

By Hans Johnson, Laurel Beck

California’s senior population is entering a period of rapid growth. By 2030, as the Baby Boom generation reaches retirement age, the over-65 population will grow by four million people. It will also become much more racially and ethnically diverse, with the fastest growth among Latinos and Asians. Many more seniors are likely to be single and/or childless—suggesting an increased number of people living alone. All of these changes will have a significant impact on senior support services.

We project that by 2030 slightly more than one million seniors will require some assistance with self-care, and that the demand for nursing home care will begin to increase after decades of decline. These changes will have direct budget implications for the Medi-Cal and In-Home Supportive Services (IHSS) programs, both of which pay for care and services for low-income seniors. The state will need additional resources, including nursing care facilities and health care professionals, especially those who provide home- and community-based services. California’s community college system will be critical in training workers to meet the state’s health care workforce needs for the growing and changing senior population.

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