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Chosen Family: Expanding Paid Family Leave for Diverse Communities

May 2025 | By Hannah Orbach-Mandel

what is chosen family?

Chosen family refers to individuals who love and support each other like a family might, but do so by choice rather than based on biological or legal bonds.

All California workers should be able to care for their loved ones when they are ill without worrying about their next paycheck. However, many Californians have close relationships with extended or chosen family members who are not currently covered by the state’s paid family leave program. Although the program is funded entirely by worker contributions, some workers – especially those who are LGTBTQ+ and immigrants – are excluded from taking leave for their loved ones.

Policymakers can make the state’s paid family leave program more inclusive and accessible to all workers by expanding the definition of family to include a designated, or chosen, family member.

1. California’s Current Definition of Family Excludes Millions

Approximately 10% of Californians live with someone who isn’t currently included in California’s definition of family. Workers in California can currently take paid family leave to care for a sick family member if that family member is a: grandparent, grandchild, sibling, parent-in-law, parent, child, spouse, or registered domestic partner. However, around 3.5 million Californians, or 10% of the population, live in households with someone not included in this definition, such as an unmarried partner or other relative, meaning they are unable to take paid leave to care for these individuals because of the state’s definition of family. This is especially the case for immigrants, who make up 28% of the state population and are more likely to live in multigenerational households.

Additionally, there are about 2.7 million (or 1 in 10) LGBTQ+ individuals in California, which is the most in the US. Members of the LGBTQ+ community tend to rely on chosen family, or people outside of the traditional family definition, who are not currently covered by California’s paid family leave program to care for them when they are sick. That means these individuals’ chosen family, who pay a certain percentage of their paycheck every month into the state’s paid family leave fund, are not able to care for them in their time of need.

Expanding Paid Leave Means Recognizing All Families

Dannie is a transgender person in California whose biological family did not support him coming out as transgender. He found a chosen mom in Yvette at a critical time in his life. He shared the impact on him when Yvette was not able to take paid leave to care for him:

“I was not okay and I did not have anyone there for me. If Yvette had been able to take time off from the very beginning, she never would have allowed it to get as bad as it did where I was admitted to the hospital for a week. I should be able to say ‘Yvette I need you. Yvette I am really scared.’ Yvette couldn’t be there because she couldn’t take time off work because I am not blood family. This is a really big gap that needs to be filled in order for our community to not only live a healthy life, but to live a long-lasting life.” – Dannie

Policymakers should expand paid family leave in California so that people like Dannie can rely on their chosen family when they need to.

2. There is National Precedent for Expanding the Definition of Family

Seven states have more inclusive family definitions than California. While California was the first state in the country to enact a paid family leave program in 2004, other states have since established their own programs that are more inclusive. Washington, New Jersey, Oregon, Connecticut, Colorado, Minnesota, and Maine all include people who are related to the worker by blood or affinity (chosen family) in their definition of a family member.

3. Making Paid Family Leave More Inclusive Maintains Program Stability

There is minimal impact on states’ paid family leave disbursement funds. Washington expanded their definition of a family member in 2021 to include chosen family members. In that time, only 0.22% of claims filed for paid family leave have been used for a chosen family member. Colorado started their paid family leave program for chosen family members in 2024, and Connecticut’s program began in 2022. Since Colorado’s program expanded to include chosen family members, 495 people have taken paid family leave for a chosen family member, which represents just 2.5% of total caregiving claims. In Connecticut, 926 people, or 2.4% of total caregiving claims, have used the state’s paid leave program for a chosen family member. Although an expanded family definition has an immense and meaningful impact on the lives of those individuals who do not fit under the traditional family definition, the actual impact on a state’s paid family leave disbursement fund is very small.

4. Including a Designated Family Member Does Not Strain State Funds

When Washington expanded their definition of a family member to include a chosen family member, language was included in the policy that if over 500 individuals filed claims for expanded family members, a reimbursement from the state’s General Fund would be triggered. This was to ensure that the paid family leave fund would remain solvent even with the anticipated increase in the number of claims filed. However, that number was not met in 2021 or 2022 (a total of 686 claims were filed from July 25, 2021 to March 30, 2023), so $0 have been needed to reimburse the fund from the General Fund, further suggesting that adding a chosen family member will not strain a state’s disability insurance fund.

5. Current Contribution Rates Support Expanded Definition of Family Leave

Currently, workers in California pay 1.2% of their wages to the State Disability Insurance fund to pay for the state’s paid family leave and disability insurance programs. Data from Washington point to expanded family member claims having no impact on payroll contribution rates in the years after expansion. The Washington example suggests that expanding the definition of family to include a chosen family member would have a negligible, or zero, impact on current contribution rates in California.

California workers provide 100% of the funding for the state’s disability insurance fund, which provides payments for paid family leave benefits. However, many workers are blocked from accessing paid family leave for their family because they do not fit the strict definition of family used in the state — this is especially true for LGBTQ+ Californians and immigrant communities. California can ensure equitable access to paid family leave and catch up to other states’ more inclusive policies by expanding their family definition to include a designated chosen family member.

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key takeaway

Cutting Medi-Cal funding would deepen racial and gender health disparities, putting the well-being of women of color at risk. Women of color already face systemic barriers to health care due to racism and sexism, leading to poorer health outcomes and shorter life expectancies. Policymakers should strengthen Medi-Cal to ensure equitable access to health care.

Medi-Cal, Californian’s Medicaid program, is a lifeline that provides free or low-cost health coverage for over one-third of California’s population. Access to health care leads to better health outcomes and a more effective health care system and benefits communities.

Right now, Congressional Republicans are actively pushing federal budget and policy proposals that threaten the program by cutting its funding in favor of tax breaks for the wealthy. Such cuts would be harmful for millions of Californians, but for women of color, including multi-race, Latinx, Black, and Asian and Pacific Islander women, who are already facing significant health disparities due to historic and ongoing racism and sexism, these cuts would be devastating.

Women of color are vital in creating a vibrant and economically strong California. They are the backbone of prosperous communities and the strong workforce that propelled California into becoming the fifth largest economy in the world. When women of color thrive, their communities thrive.

Without access to health coverage, women of color would face impossible choices between paying rent, putting food on the table, and getting the care they need to stay healthy. For many, Medi-Cal is the only way to access vital health services, from primary care to mental health supports. Cutting funding for Medi-Cal means taking critical care away from people who already face long-standing barriers to care, such as:

  • Lack of health coverage,
  • Limited access to transportation to get to appointments,
  • Limited health care resources,
  • Lack of culturally competent and linguistically appropriate care, or
  • Other forms of discrimination.

These barriers to care are rooted in structural racism and sexism, which have driven policy decisions that systematically deny women of color equitable access to quality care and resources. Cutting funding for Medicaid would worsen these racial inequities and put the health and well-being of women of color at risk.

Key Terms

1. Women of Color Face High Barriers to Mental and Overall Health

Centuries of racism, sexism, and economic exclusion have created disparities in health outcomes. Almost 30% of Native American women in California are in fair or poor health, and over 20% have experienced serious psychological distress in the past year. Multi-race, Latinx, Black, and Asian and Pacific Islander women all also report experiencing worse health outcomes than average in California. These racial and ethnic disparities can be attributed to a history of racism and sexism in health care. Unfortunately, these disparities will only worsen if cuts are made to Medicaid programs that provide health care for individuals in the state.

2. Native American and Black Women Have Shortest Life Expectancies

Life expectancy is a useful measure of population health, and can indicate underlying racial, ethnic, and gender disparities in health care and economic and social inequities. In California, the average life expectancy for a woman is just under 84 years. However, Native American and Black women have significantly shorter life expectancies, at 79 and 77 years respectively. This is a profound injustice. The disparities seen in women of color in California signal that Native American and Black women especially are facing barriers to accessing health care as well as racism and discrimination that can contribute to lower quality of care. Medi-Cal saves lives and proposed cuts would take critical care away from those who need it most, further worsening disparities that are already present for women of color in California.

3. There Are Significant Racial Gaps in Access to Health Insurance

While access to health coverage in California has improved for all racial/ethnic groups over the last decade, women of color continue to face barriers to health insurance coverage. Latinx, Native American, and Pacific Islander women all face the highest barriers to accessing health insurance in the state. Almost 15% of Latinx women in California did not have health insurance between 2018 and 2022. These disparities in health coverage highlight the profound and enduring impact of racism and sexism, which blocks women of color from equal access to health care.

Health care is critical for individuals and families to thrive, pursue education, and contribute to their communities. Systemic barriers in the health care system have contributed to these racial and ethnic disparities, and cuts to Medicaid would only increase the number of people without this critical care.

4. Multi-Racial Women Are Delaying Receiving Critical Care at High Rates

No one should ever have to skip or delay health care, but a large portion of women, and especially women of color, are delaying medical care or getting prescriptions. Nearly 1 in 3 multi-racial women delayed receiving medical care between 2018 and 2022, a significantly higher amount than the statewide average (26%).

Forgoing preventive care or treatment for health conditions is harmful to health and well-being. Avoiding or delaying care also threatens the ability of women to thrive in the state. The reasons women are delaying care are many, such as lack of time due to caregiving responsibilities, but point to systemic obstacles as well as racism and sexism in the health care industry. Cutting funding for Medicaid would increase the cost of health care for millions of Californians and cause even more women to delay receiving critical care.

5. Adequate Prenatal Care Is an Area of Concern for Women of Color

Prenatal care refers to the health care a woman receives during pregnancy to help ensure a healthy pregnancy for both the mother and fetus. Yet, women of color and specifically, Black, Latinx, multi-racial, Native American, and Pacific Islander women all report receiving less adequate prenatal care than the statewide average. The starkest disparity is for Pacific Islander women where nearly 3 in 5 women report receiving adequate prenatal care, or in other words, nearly 2 in 5 women do not receive adequate prenatal care. Barriers to receiving adequate prenatal care impact the health of the birthing parent, the child, and the family. Action should be taken to increase access to adequate prenatal care, not cuts that would take care away.

Policymakers should protect Medi-Cal. Women of color in California are already bearing the brunt of years of racism and sexism that have led to stark disparities in health outcomes. Cutting Medi-Cal would take critical care away from millions of women of color who rely on Medi-Cal to stay healthy. Rather than deepening these inequities, state and federal policymakers should strengthen Medi-Cal to better meet the needs of women of color. The well-being of women of color, their communities, and the future of California depends on it.

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key takeaway

California’s vast wealth contrasts sharply with deep income inequality, leaving over a quarter of residents unable to meet basic needs without safety net support. Strengthening safety net programs is crucial to reducing poverty and ensuring all Californians can thrive.

California is home to vast wealth and has the 5th largest economy in the world. However, increasing poverty levels and deep income inequality make clear that not all Californians have access to this wealth. With the highest poverty rate in the nation, millions of Californians, many of whom are employed, rely on the state’s wide array of safety net programs to provide essentials like food, housing, and health care to meet their basic needs.

The COVID-19 pandemic exacerbated hardship for Californians with low incomes, but expansions in safety net programs showed promising progress in closing many long-standing gaps. As those expansions have concluded, the scars left by the pandemic are being highlighted. A recent study shows that persistently high inflation has disproportionately hit low-income Californians the hardest as prices for necessities, which make up the majority of their budget, have increased more than the average good.

While measures of poverty are concerning, they underestimate true need. According to MIT researchers, to make ends meet in 2024, a single adult in California would need an hourly wage of $27.32, or about $57,000 in annual income, and a family of two adults with two children would need wages between $33.26 and $49.10, or between $69,000 and $102,000 annually. These estimates suggest that families in California need incomes well over 200% of the federal poverty level (FPL), or $30,000 for a family of one and $62,000 for a family of four, to meet their basic needs. As of 2023, over a quarter of Californians lived below 200% of FPL.

Reducing poverty and ensuring all Californians have sufficient resources to thrive requires a strong social safety net. The charts below paint a picture of who participates and is most affected by the safety net, where funding comes from, and how income thresholds interact with assistance amounts. An overview of some of California’s most utilized safety net programs shows that scope and income restrictions limit the impact and reach of these vital supports.

1. Participation in Safety Net Programs Does Not Fully Capture Need in the State

Millions of Californians participate in safety net programs. However, many people in need face barriers in accessing these programs due to the narrow eligibility criteria, income limits, and other bureaucratic red tape. Medi-Cal is the only program where participation exceeds the number of Californians under the 200% FPL, which is likely due to its relatively high-income eligibility for children and recent eligibility expansions. In contrast, CalFresh, the largest food assistance program in California, and the Earned Income Tax Credits (CalEITC and Federal EITC) only reach about half of Californians in need. Programs like the California Work Opportunity and Responsibility to Kids (CalWORKs), Supplemental Security Income/State Supplementary Payment (SSI/SSP) programs, and the Young Child Tax Credit (YCTC) are even more narrowly focused, serving only about a tenth of the population in need.

While some participants can receive assistance from multiple programs, the narrow eligibility scopes do not guarantee this. In fact, many Californians are excluded entirely or can only access very limited aid in times of need.

2. Strong Public Supports Help Reduce Poverty Among Communities of Color

Discriminatory policies and systemic racism have historically blocked Californians of color from accessing economic opportunities in California. Safety net programs serve as a mechanism to level the playing fields for these communities and close the gap created by the barriers placed before them. An overwhelming majority of the programs displayed below serve mainly Black and brown Californians, communities that face disproportionately high poverty rates.

Programs like CalWORKs play a crucial role in ensuring that these families and children have the ability to afford basic needs. Proposed cuts to and limitations imposed on these programs are particularly harmful to Californians of color and reinforce the negative impact of historic racist policies. The end of pandemic-era policies – which temporarily expanded many of these programs – demonstrates the real harm to Black and Latinx Californians and the increased hardship they face when California reduces funding for the safety net.

3. California Safety Net Program Rely on Both State and Federal Funding

California has led the nation in many ways strengthening its safety net. Federal dollars play a large role in supporting many of these vital services. Consequently, this means that many safety net programs are subject to federal regulations and susceptible to restrictions and cuts. CalWORKs, CalFresh, SSI/SSP, and Medi-Cal all received funding from both the state and federal government, with Medi-Cal receiving almost two-thirds (64.4%) of all federal funding that flows through the state budget.

In recent years, safety net programs, like TANF and SNAP — the federal names for CalWORKs and CalFresh — have been used as bargaining chips for conservative federal budget deals and have been put at risk of cuts and restrictions. California has historically invested large sums of state dollars beyond what is required to allow for eligibility flexibilities, as demonstrated by the creation of the California Food Assistance Program (CFAP) that extends CalFresh to certain non-citizens. However, if federal safety net funding is reduced, the state would need to backfill billions of dollars to maintain services, potentially jeopardizing these programs and limiting their impact.

4. Complex Income Requirements May Limit Programs’ Impact

Safety net programs, such as tax credits and cash/in-kind assistance, have specific income requirements that determine eligibility and the amount of aid provided. In many cases, assistance is inversely proportional to income, with those with the lowest incomes receiving the most help. However, both state and federal tax credits phase in and out at different income levels, with most phasing out at relatively low incomes. In the case of the Child Tax Credit (CTC), families with zero earnings are entirely excluded while high earners can receive the full credit.

Programs such as CalFresh, CalWORKs, Medi-Cal, and SSI/SSP have varying income thresholds depending on household size, typically offering more support to those with lower incomes. CalFresh generally serves households with incomes up to 200% of the federal poverty level, but the eligibility limits for other non-tax credit programs are much lower. This creates a challenge for individuals who earn too much to qualify for safety net programs but still struggle to meet basic needs, illustrating a clear gap where increasing income can push people out of eligibility without significantly improving their financial situation.

5. Safety Net Programs Provide Limited Assistance to Californians in Need

The amounts of assistance provided, along with income eligibility restrictions, highlight the gaps in California’s safety net. While the chart below shows the maximum aid available to program participants, not all households qualify for the full amount. For instance, the SSI/SSP program offers a higher maximum monthly aid than the other programs, but only families with zero earnings would receive the full amount, putting their income level well below what is needed to meet their basic needs.

Other programs follow a similar structure where cash or in-kind benefits are not added on top of earnings but are instead limited based on earning levels. In many cases, the bureaucratic process to apply for aid is cumbersome and discourages income-eligible Californians from accessing these programs. This is especially true considering that the assistance amounts are often insufficient to compensate for the costs of missing work to attend appointments or completing other steps of the application process, further discouraging participation.

Safety net programs are vital in ensuring that the most vulnerable Californians are given the opportunity to overcome systemic barriers stemming from discriminatory policies. The new Trump administration and Republican control of Congress promised to cut these programs and have the ability to further disadvantage already marginalized communities. In addition, income limits and restrictions imposed on programs limit the reach and impact these programs have on the most vulnerable Californians. However, pandemic-era policies, historic Medi-Cal expansions, and other wins in the safety net have proven that California policymakers have the ability to curb harm and enact policies that can significantly improve the well-being of all Californians.

Alissa Anderson and Kayla Kitson contributed to this publication.

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Affordable health care is essential for everyone to be healthy and thrive. Having health insurance coverage helps lower out-of-pocket expenses and ensures access to preventive care, which in turn supports workforce participation and education. While California has made great strides in lowering the uninsured rate and expanding health care access, policymakers can take further action to protect progress and achieve universal health care coverage.

1. Medi-Cal Covers Over a Third of the State’s Population

Medi-Cal, California’s Medicaid program, provides free or low-cost health care to over one-third of the state’s population. The program covers a wide range of services to Californians with modest incomes, and many children, seniors, people with disabilities, and pregnant individuals rely on it. Medi-Cal plays a crucial role in promoting health equity, with about half of its beneficiaries being Latinx Californians, who often face low-wage employment and limited access to employer-sponsored health plans. For those who earn too much to qualify for Medi-Cal, Covered California — the state’s health insurance marketplace established through the Affordable Care Act — serves as a vital resource, helping individuals and families find affordable health coverage. Nearly 1.8 million Californians purchase their insurance through this state marketplace.

2. California’s Uninsured Rate Reached a Historic Low in 2023

California has made substantial progress in expanding access to health coverage over the past decade. Key drivers of this success include the federal Affordable Care Act and more recent state initiatives, such as expanding full-scope Medi-Cal to income-eligible Californians who are undocumented. As a result, the uninsured rate dropped to 6.4% in 2023, matching the record low of 6.4% in 2022. These gains reflect a major shift from a decade ago when over 17% of Californians lacked health coverage, underscoring the state's commitment to improving health care access for all.

3. American Indian or Alaska Native Californians Have the Highest Uninsured Rate

Despite California’s overall progress in expanding health coverage, significant racial disparities persist. American Indian or Alaska Native Californians face the highest uninsured rate among all racial and ethnic groups in the state. The racial disparities in health coverage highlight the profound and enduring impact of racism, which blocks Californians of color from equal access to health care. Addressing the racial disparities in health coverage requires targeted outreach and education efforts along with other antiracist policy actions to improve health and well-being for Californians of color.

4. Too Many Californians Lost Medi-Cal Coverage Due to Paperwork Challenges

When California resumed Medi-Cal renewals in 2023, after pausing them during the pandemic, many Californians were disenrolled from Medi-Cal. This process, known as the "unwinding period," marked the end of the federal policy that temporarily paused routine renewals.1A provision in the federal Families First Coronavirus Response Act passed in March 2020 required states to provide continuous coverage for Medicaid beneficiaries in exchange for enhanced federal funding during the federally declared Public Health Emergency (PHE). The Consolidated Appropriations Act of 2023, which federal policymakers passed in December 2022, delinked the continuous coverage provision from the PHE, thereby ending this provision on March 31, 2023. Over 1.8 million Californians lost Medi-Cal coverage from June 2023 to July 2024.2The California Department of Health Care Services publishes interactive dashboards detailing statewide and county-level demographic data on Medi-Cal application processing, enrollments, redeterminations, and renewal outcomes. The majority of disenrollments (85.2%) were due to challenges with the renewal paperwork. Completing the renewal process often involves complex paperwork and documentation requirements, which can be challenging to navigate. Additionally, many Californians have experienced extended call wait times when attempting to contact county Medi-Cal workers regarding their application. The high disenrollment rate underscores the need to further streamline the renewal process as well as permanently enact policies that build upon lessons learned during the pandemic.

5. Many Californians Could Lose Health Coverage if Premium Tax Credits Expire

Enhanced premium tax credits from recent federal policy actions have significantly improved health care affordability for many Covered California enrollees. However, these credits are set to expire at the end of 2025, which would lead to steep increases in monthly premiums. About 2.4 million Californians in the individual market would face higher health insurance premiums if Congress does not extend the expanded federal subsidies, according to the UC Berkeley Labor Center. The loss of these tax credits means that average premiums could rise by 63% for Covered California enrollees, and communities of color will be disproportionately impacted. Premiums will increase by 76% for Latinx enrollees, 67% for Black enrollees, and 71% for Asian enrollees, compared to a 57% increase for white enrollees. Overall, without these federal subsidies, an estimated 138,000 to 183,000 Covered California enrollees would disenroll.

Looking Ahead, Policymakers Can Take Action to Strengthen Health Coverage

While California has made substantial progress, challenges remain in ensuring health coverage for everyone. By addressing gaps in coverage, particularly for historically underserved communities, state leaders can continue leading the nation in advancing health equity and improving well-being for all Californians.

Key policy recommendations include:

Poverty & Inequality
  • 1
    A provision in the federal Families First Coronavirus Response Act passed in March 2020 required states to provide continuous coverage for Medicaid beneficiaries in exchange for enhanced federal funding during the federally declared Public Health Emergency (PHE). The Consolidated Appropriations Act of 2023, which federal policymakers passed in December 2022, delinked the continuous coverage provision from the PHE, thereby ending this provision on March 31, 2023.
  • 2
    The California Department of Health Care Services publishes interactive dashboards detailing statewide and county-level demographic data on Medi-Cal application processing, enrollments, redeterminations, and renewal outcomes.

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key takeaway

California’s homeless population is aging rapidly, with adults 50+ making up nearly 40% of those needing shelter. Without swift and intentional policy action, California faces a future with a growing number of unhoused older adults as the state’s population ages.

Every Californian deserves an affordable, dignified, and accessible home, regardless of their age, ability, race, gender, or economic status. Yet thousands of Californians — increasingly composed of older adults age 50 and over — continue to fall into homelessness faster than our systems can house them. During the course of the 2022-23 fiscal year, local California homeless service providers made contact with over 215,000 adults without children needing to find a home or search for other life-sustaining services — and even more were likely served by the end of 2023.1Adults without children, also referred to as single adults, are categorized by the US Department of Housing and Urban Development as being age 25 and over. This includes sole individuals, adult couples with no children, groups of adults, and may capture noncustodial parents. Sole individuals ages 18 to 24 are considered unaccompanied  youth. The terms homeless and unhoused are also used interchangeably. Of these, 85,310 — nearly 40% — were adults age 50 and over. While experiencing homelessness at any age is severely destructive to an individual’s well-being, older adults are the fastest-growing population experiencing homelessness and the largest share of individuals who are encountering homelessness for the first time in their lives. Without swift and intentional policy action, California faces a future with a growing number of unhoused older adults as the state’s population ages.

Understanding the diverse characteristics, circumstances, and tailored interventions unhoused older Californians need is key to effectively addressing their housing needs and solving homelessness across the state.

“Older adults” refers to individuals who are age 50 and over. This determination was made to parallel current research on older adults at risk of or experiencing homelessness. It also acknowledges the increased physical and behavioral health vulnerabilities that are being experienced by unhoused individuals aged 50 and over which have been traditionally seen in older populations and require tailored interventions.

1. Older Californians Are a Large Share of the Unhoused Population

Unhoused Californians age 50 and over comprised 40% of adult-only households who connected with the homelessness response system in the 2022-23 fiscal year. Yet older adults account for only 34% of the state’s entire population.

Research identifies two main cohorts that are driving the growth in older adult homelessness:

Prolonged economic hardship and insufficient wages have also prevented many from building savings or retirement accounts, leading to economic insecurity among older Californians. Adults without children are also ineligible for many cash-based safety net programs as they typically target people with children.2For more on the shortfalls of safety net programs for low-income non-elderly adults see: Joseph Llobrera et al., A Frayed and Fragmented System of Supports for Low-Income Adults Without Minor Children (Center on Budget and Policy Priorities, January 28, 2021), https://www.cbpp.org/research/a-frayed-and-fragmented-system-of-supports-for-low-income-adults-without-minor-children#state-general-assistance-programs-provide-cbpp-anchor. 

Available programs often have minimal benefit amounts that are even lower for adults without dependents. Some program benefits vary by county (particularly for General Assistance/General Relief), have time restrictions, strict asset limits, and may require an age threshold or a physical/developmental disability. Nationally, inadequate rental assistance funding also prevents more than 4 in 5 low-income, non-elderly adult households without children from obtaining the support they qualify for.3General Assistance/General Relief which is a state-mandated program that counties must offer to indigent adults. Each California county administers and fully funds its own program and sets their own benefits, payment levels, and eligibility requirements. Regardless of the circumstances leading to homelessness for older adults, it is clear that there is an urgent need for amplified, targeted safety net and housing interventions at various points to ensure aging Californians can remain in their homes.

2. Stark Racial Disparities Persist in California’s Unhoused Older Adult Population

Older Black, Indigenous, and Pacific Islander Californians disproportionately experience homelessness in California. While Black Californians age 50 and older make up roughly 5.4% of the state’s population, they comprised over 1 in 4 (26%) older adults who made contact with homeless service providers in the 2022-23 fiscal year. Disparities are also evident within Indigenous and Pacific Islander communities, with Indigenous individuals being almost six times as likely and Pacific Islanders twice as likely to connect with the homelessness response system. Separate data from the state’s point-in-time counts reflect homelessness increased among Latinx Californians across the whole population, which captures older adults as well.

The stark racial disparities parallel the broader racial disparities observed in California's unhoused population, underscoring that people of color bear the disproportionate and harmful impacts of homelessness. These disparities reflect the enduring effects of intentional racist policies that created educational, housing, economic, and health barriers for people of color — all of which directly affect an individual’s ability to obtain and sustain stable housing, especially at older ages.

Racist institutionalized practices, such as redlining, government-sanctioned displacement, and predatory practices, have placed generations in positions that make it harder to obtain housing and economic security.4For more see: Danyelle Solomon, Connor Maxwell, and Abril Castro, Systemic Inequality: Displacement, Exclusion, and Segregation: How America's Housing System Undermines Wealth Building in Communities of Color (Center for American Progress, August 7, 2019),  https://www.americanprogress.org/article/systemic-inequality-displacement-exclusion-segregation/ and California Department of Justice, California Task Force to Study and Develop Reparation Proposals for African Americans, The California Reparations Report (2023), https://oag.ca.gov/ab3121/report.

Discriminatory practices have also caused Black and other communities of color to face the highest risk of justice system involvement, familial disruptions, and traumatic experiences which can cause and exacerbate homelessness throughout a lifetime.

3. Most Unhoused Older Adults Have a Disabling Condition

Most older adults experiencing homelessness reported having a disabling condition (72%) in the 2022-23 fiscal year. Disabling conditions include physical, mental, or emotional impairments that are long continuing, significantly impeding an individual’s ability to live independently, and could be improved with housing. It also captures people with developmental disabilities. Research demonstrates many unhoused individuals experience health conditions and mobility limitations prematurely, often decades before housed adults of the same age. The striking differences reflect the detrimental health effects experiencing homelessness has on the lives of Californians, especially as they age. This pivotal factor underscores the need for policy interventions to be both accessible and tailored to the diverse demographic of older adults starting at age 50.

Unhoused Californians face steep barriers to medical access, face daily safety concerns, and often have limited access to basic necessities such as consistent meals, proper medication storage, and sanitation. Even temporary homeless shelters are often not equipped to accommodate older individuals with complex medical or mobility conditions. Combined, the lack of access to care, medical support, and appropriate housing exacerbates negative health outcomes. Experiencing homelessness ultimately limits the opportunity to live a long, healthy life and reach older ages, which is reflected by higher mortality rates in unhoused populations when compared to their housed counterparts.

Ensuring older unhoused Californians with disabilities have appropriate housing and care is largely achievable through scaling supportive housing. This effective, evidence-based intervention combines robust housing interventions with wraparound supportive services to meet the medical, physical, and behavioral health needs of unhoused Californians with disabling conditions.

4. Most Unhoused Older Adults Have an Income Source —  But It's Not Enough

Most unhoused older adults who made contact with homeless service providers in the 2022-23 fiscal year reported having at least one source of income. These older adults had a median total monthly income of $1,000 —  an amount that cannot cover fair market rent for a studio apartment in nearly 70% of the state’s counties, let alone other basic living expenses like food, utilities, and transportation.

The top three reported income sources were Supplemental Security Income (SSI) (median = $1,037), Social Security Disability Insurance (SSDI) (median = $1,040), and General Assistance (median = $221). All of which reflect the very low incomes and high rates of disabling conditions among the unhoused older adult population. Additionally, nearly 25% of individuals with an income source reported having income from work.

The limited state and federal aid available to adults without children, low-income seniors, and people with disabilities cannot cover the high cost of housing and other basic needs in California creating vulnerabilities that can lead to homelessness. Benefit amounts are insufficient and often have strict asset limits, placing Californians who depend on these supports in severe economic hardship. In 2022, only 24 housing units were affordable and available for every 100 extremely low-income renter households, which older adults on fixed incomes often fall into. The misalignment between safety net income supports and housing costs highlights the urgent need for significant investments in accessible, affordable housing and cash supports to prevent homelessness among older adults.

5. High Housing Costs Drive Homelessness Among Older Californians

The severe shortage of affordable housing in California, leading to skyrocketing housing costs, is the primary factor pushing older adults into homelessness. In 2022, over half (52%) of all older adult California renters were housing cost-burdened, paying more than 30% of their total income in rent, and nearly 1 in 3 (29%) were severely cost-burdened, paying more than 50% of their income in rent. Older Black California renters faced the highest rates, with over 60% paying unaffordable housing costs. Older Californians of color broadly are especially vulnerable to housing insecurity as they are more likely to be renters and consequently do not have home equity to potentially fall back on. Nearly half (45.7%) of older Black Californians are renters, followed by older Latinx (37.1%), other Californians of color (29.6%), and Asian Californians (26.1%).

The increased share of Californians of color in renter households reflects discriminatory policies that have perpetuated the racial wealth gap and limited access to housing and other opportunities, leading to adverse outcomes in later life. As housing costs comprise a significant portion of their income, older adult renters — especially those with low or fixed incomes — are left with fewer resources for essentials like transportation, medicine, and food. This precarious situation can be the tipping point into homelessness due to minor financial setbacks, medical expenses, or rent hikes. Ultimately, California’s housing shortage places older renters in situations where they have to pay more than they can afford, exacerbating housing and economic insecurity.

Policymakers Can Ensure All Older Adults Have a Home

Older Californians are neighbors, parents, grandparents, and invaluable members of our communities who deserve access to an affordable, accessible, and dignified place to call home, regardless of their background or ability. As state and federal policymakers consider choices that will affect California’s unhoused and vulnerable communities, it is important to understand the unique housing, economic, and health conditions older unhoused adults face. By doing so, policymakers can act on proven policies and interventions that can help solve homelessness among older adults, including:

  • Increasing affordable rental housing and supportive housing to ensure that all Californians have access to an affordable home that is designed to meet the needs of diverse types of households, including older adults, single workers, and people with disabilities.
  • Expanding and targeting additional financial support for Californians without dependents, low incomes, and disabilities through boosting Supplemental Security Income/State Supplementary Payment, General Assistance, and refundable tax credits.
  • Directing resources for rental assistance and homelessness services, including emergency and shallow rental subsidies, housing vouchers, and rapid-rehousing efforts to ensure people can remain in their homes during times of financial crisis or quickly exit homelessness.
  • Continuing to strengthen California's aging network and initiatives to connect housing and healthcare systems by leveraging efforts such as CalAIM housing supports and California’s Master Plan on Aging.
  • Protecting renters through expanding, enforcing, and funding legal aid and eviction protections.

Policymakers can work towards a California where experiencing homelessness is a brief and rare occurrence, and where everyone has a safe and stable home.

Poverty & Inequality
  • 1
    Adults without children, also referred to as single adults, are categorized by the US Department of Housing and Urban Development as being age 25 and over. This includes sole individuals, adult couples with no children, groups of adults, and may capture noncustodial parents. Sole individuals ages 18 to 24 are considered unaccompanied  youth. The terms homeless and unhoused are also used interchangeably.
  • 2
    For more on the shortfalls of safety net programs for low-income non-elderly adults see: Joseph Llobrera et al., A Frayed and Fragmented System of Supports for Low-Income Adults Without Minor Children (Center on Budget and Policy Priorities, January 28, 2021), https://www.cbpp.org/research/a-frayed-and-fragmented-system-of-supports-for-low-income-adults-without-minor-children#state-general-assistance-programs-provide-cbpp-anchor.
  • 3
    General Assistance/General Relief which is a state-mandated program that counties must offer to indigent adults. Each California county administers and fully funds its own program and sets their own benefits, payment levels, and eligibility requirements.
  • 4
    For more see: Danyelle Solomon, Connor Maxwell, and Abril Castro, Systemic Inequality: Displacement, Exclusion, and Segregation: How America's Housing System Undermines Wealth Building in Communities of Color (Center for American Progress, August 7, 2019),  https://www.americanprogress.org/article/systemic-inequality-displacement-exclusion-segregation/ and California Department of Justice, California Task Force to Study and Develop Reparation Proposals for African Americans, The California Reparations Report (2023), https://oag.ca.gov/ab3121/report.

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key takeaway

California’s universal school meal program ensures all students have access to nutritious meals at school regardless of family income. This program combats childhood hunger, simplifies administration for schools, and has inspired similar initiatives in other states.

No child in California should go hungry. While families across the country face significant price increases in groceries and other basic needs, California schools have played a central role in making sure that children have access to nutritious meals regardless of their families’ income level. 

In the 2022-23 school year, California became the first state to provide free school meals to any child regardless of whether they were eligible for the free or reduced-price meals as defined by the federal government. Since then, seven other states have passed similar policies, recognizing the benefits universal school meals provide to families and schools. 

California policymakers should continue to protect universal school meal programs to support children’s health and well-being. Limiting free school lunches to families who meet a certain income threshold would be harmful to children’s health and would also increase the administrative burden for schools.

WHat is food insecurity?

Food insecurity is a household-level economic and social condition of limited or uncertain access to adequate food. In contrast, food security is when all people have access to enough food for an active, healthy life at all times.

1. Reverting to the Federal School Meal Program Would Exclude Many Families Facing Food Insecurity

The California Universal School Meals Program (UMP) has expanded access to school meals to all children, well beyond what the federal government requires. The National School Lunch Program (NSLP) and School Breakfast Program (SBP), the two federally funded school meal programs, cap income eligibility at 130% and 185% of the federal poverty line (FPL), respectively. In California, that would mean that a family of four must have a total income of at most $39,000 for the children to qualify for free school meals and at most $55,500 to qualify for reduced-price meals in the current school year. However, 44% of food-insecure families in California had incomes above 185% of the FPL in 2022.1Based on Budget Center analysis of US Census Bureau, Current Population Survey for 2022 downloaded from IPUMS. As shown in the chart below, families with incomes above the threshold experience varying degrees of food insecurity.

2. The California Universal Meals Program Can Help Reduce Child Hunger

Income is not a perfect measure of whether a child is food insecure because family circumstances can change, and often do, particularly in a state with a high cost of living like California. In a 2022 survey, parents reported that the UMP has saved them money and time as well as reduced family stress. The UMP has ensured that no child has to worry about where their next meal will come from, regardless of their family situation.

3. School Meals Support Children’s Health and Learning

School meals promote good nutrition and improve health and learning, according to research. Children who participate in school meal programs are more likely to consume fruits, vegetables, and milk at breakfast and lunch, reducing the risk of nutrient deficiencies which can be harmful to health. These programs are also instrumental in supporting students’ health and well-being, with studies showing that free or reduced-price school lunches help lower rates of poor health and obesity. In addition, research shows that school meal programs help students learn and succeed in school through improved attendance, student behavior, academic performance, and long-term educational attainment.

4. The Universal School Meals Program Reduces Stigma Around Free Meals

Moving away from a means-tested approach reduces stigma around free meals, which helps the program reach more students. Research has shown that reducing the stigma associated with means-tested programs increases participation. The UMP has been successful in increasing breakfast and lunch participation as well as reducing the stigma around free school meals and unpaid meal debt. When food access is not tied to poverty status, students are less likely to shy away from grabbing a meal if they need one.

5. The Universal Meals Program Reduces Administrative Burden On Schools

The UMP reduces meal debt by making all school meals free to students. Schools are required to take on extra administrative tasks to account for meal debt, which, according to the California Department of Education (CDE), include collecting and documenting:

  • Evidence of efforts to collect unpaid meal charges in accordance with the CDE or local unpaid meal charge policy; 
  • Financial documentation showing when the unpaid meal charges became an operating loss; and 
  • Documentation showing when the repayment plan was agreed to by all parties.

Additionally, meal debt is an operating loss for schools. Thus, without UMP, school districts would likely face challenges with both the financial and administrative burdens of increased meal debt.

The UMP requires high-poverty schools to participate in the Community Eligibility Provision (CEP), which significantly reduces school meal administrative burden. CEP is a federal program that provides alternate meal counting and collection procedures. Namely, CEP schools do not collect meal applications, do not conduct verification activities, and do not classify meals as free, reduced-price, or paid. As a result, school meal administration is far less burdensome and many overhead costs are eliminated. Before the UMP requirement, only 24 percent of schools participated in CEP. 

what is meal debt?

Meal debt occurs when students who are not certified to receive free school meals do not have enough cash in hand or in their school meals account to pay for their meals or for the “reduced-price” copayment. School districts set their own policy for unpaid school meal fees.

As of the 2022-23 school year, participation increased to 51 percent, prompted by the onset of UMP. However, as part of the CEP application, California schools must calculate an identified student percentage (ISP) reflecting the proportion of students that are directly certified for meals at no cost on the basis of their participation in safety net programs (i.e., CalFresh and CalWORKs) and other characteristics (such as foster youth). Some California schools face challenges with correctly calculating the ISP and are therefore not able to fully maximize the federal benefit.  Therefore, with UMP and its associated CEP participation requirement, more schools may benefit from the administrative efficiency that comes with program participation but additional technical assistance from CDE could ensure schools maximize benefits from CEP participation.

California should continue to lead the way in making sure any child who needs a meal can obtain one. The California Universal School Meals Program not only supports family and child well-being and effective school administration, but it also may promote cost savings if the state can maximize the number of meals federally reimbursed at the free rate. State policymakers should continue investing in this program to maximize federal reimbursements and ensure all children have access to high-quality nutritious meals. By making sure all children receive proper nutrition at school, state leaders can help alleviate food insecurity and support children’s health and well-being.

Poverty & Inequality
  • 1
    Based on Budget Center analysis of US Census Bureau, Current Population Survey for 2022 downloaded from IPUMS.

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