Report Anticipating Changes in Regional Demand for Nursing Homes By Laurel Beck, Landon Gibson Nov 2, 2016 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.
Report Expanding Health Coverage in California: County Jails as Enrollment Sites By Shannon McConville, Mia Bird May 10, 2016 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.
blog post Immigrants and Health Insurance By Shannon McConville Nov 18, 2015 California has seen large declines in the uninsured rate among noncitizens—a group that includes an estimated 2.6 million people who legally reside in the state, as well as 2.7 million undocumented immigrants.
blog post Big Declines in Number of Uninsured Californians By Shannon McConville Sep 17, 2015 Nearly 2 million more Californians had health insurance coverage in 2014 than in 2013, according to newly released US Census data.
Report Planning for California’s Growing Senior Population By Hans Johnson, Laurel Beck Aug 6, 2015 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.
blog post Focus on Medi-Cal Funding By Shannon McConville Jul 17, 2015 Regardless of how the legislature addresses Med-Cal funding in the special session, the state faces the challenge of establishing a stable and sustainable state funding base for the program.
blog post Undocumented Immigrants and Health Care By Shannon McConville Dec 17, 2014 President Obama’s recent immigration order may result in access to insurance coverage and health care for undocumented immigrants in California.
Report Health Care for California’s Jail Population By Shannon McConville, Mia Bird Jun 18, 2014 The Affordable Care Act (ACA) has created a new opportunity for California to reach and enroll a medically vulnerable population—the jail population—in health insurance coverage. While inmates receive health care services from county jail systems while incarcerated, few have coverage after they are released from custody. Expansion of the state’s Medicaid program (Medi-Cal) under the ACA has extended insurance eligibility to much of the currently uninsured jail population. As a complement to the ACA, California recently signed into law Assembly Bill 720 (AB 720), which facilitates the use of jails as sites of health insurance enrollment. Increasing enrollment levels for the jail population holds the potential to reduce corrections costs, as well as improve public health and safety.
