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key takeaway

California’s 2023-24 budget includes $78.4 million for permanent family fee reform, eliminating fees for families below 75% of the state median income and capping fees at 1% for other families.

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The 2023-24 enacted state budget package included several key policy advances for early learning and care. These advances will help to expand access to early learning programs in California and temporarily boost rates for providers. Family fee reform represents one of these significant steps forward. Specifically, the 2023-24 budget includes $78.4 million for permanent family fee reform beginning October 1, 2023. Under the new family fee structure: 

  • Families below 75% of the state median income (SMI) will no longer pay a fee for subsidized child care;
  • Families at or above 75% of the SMI will have fees capped at 1% of their monthly income; and
  • Family fees owed before October 1, 2023 will be waived. 1Costs for waiving past due family fees were addressed in two early action bills — Assembly Bill 100 and Assembly Bill 110 — and are therefore not a part of the 2023-24 enacted budget allocation for family fee reform.

An earlier report co-published with Parent Voices highlighted Parent Voices’ proposed fee schedule and how much families would have paid under the family fee schedule approved prior to the enacted state budget (referred to as the “original schedule”) and how much they would have saved with Parent Voices’ proposed fee schedule. Since this analysis, the California Department of Social Services (CDSS) has confirmed the new family fee schedule for 2023-24 (referred to as the “new schedule”). Most principles proposed by Parent Voices were included in the new schedule, with the exception of two key differences: 1) CDSS did not eliminate part-time family fees; 2) the new schedule does not incorporate the sliding scale (based on income) proposed by Parent Voices.  

Under the new schedule, families earning between 75% and 85% of SMI will pay no more than 1% of their monthly income in fees. The exact percentage differs slightly based on family size. The table below shows how much of a family’s income was spent on family fees under the original schedule compared to how much will be spent under the new schedule for families at 75% SMI, by household size.

With the new family fee schedule, in some cases, families will recoup nearly 10% of their annual income. The chart below shows the amount of money a two-person family would have paid in fees with the original schedule and how much they will pay with the new schedule. The corresponding table shows how much a family of two will save with the new family fee schedule.

The thousands of dollars saved annually by many families across California will support them with paying for basic needs such as food, rent, and utilities. Given the dramatic increase in poverty across California, as a result of the expiration of temporary federal aid enacted to address the economic effects of the pandemic, family fee reform is a much-needed policy change to provide families, particularly families of color with low incomes, with the resources they need to thrive. 

Banner photo by Allison Shelley for EDUimages.

  • 1
    Costs for waiving past due family fees were addressed in two early action bills — Assembly Bill 100 and Assembly Bill 110 — and are therefore not a part of the 2023-24 enacted budget allocation for family fee reform.

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key takeaway

More than 6 in 10 households in California earning less than $35,000 had difficulty paying for basic expenses from March to mid-July of 2023.

All Californians should be able to put food on the table, keep themselves and their families safely housed, and thrive in their communities. However, high costs of living, inflation, and the end of pandemic-era supports, such as CalFresh emergency food benefits and the expanded federal Child Tax Credit, put a strain on the ability of Californians to make ends meet.

Not everyone bears these challenges equally. Californians with the lowest incomes are hit the hardest when basic costs go up. More than 6 in 10 households in California earning less than $35,000 had difficulty paying for basic expenses such as food, housing, and medical costs from March to mid-July of this year.

A bar chart showing the share of households reporting difficulty paying for basic expenses where Californians with low incomes were the most likely to struggle to pay for basic expenses from March to July of 2023.

Black, Latinx, and other Californians of color were more likely to struggle paying for basic expenses. Past racist policies and ongoing discrimination have made Californians of color more likely to have low incomes. For example, more than half (54%) of Black Californians reported facing difficulty paying for essential needs like food and housing. Additionally, LGBTQ+ individuals in the state disproportionately struggle to afford basic expenses.

A bar chart showing the share of households reporting difficulty paying for basic expenses where Black, Latinx, and other Californians of color were most likely to struggle paying for basic expenses.

Many California households with children are also struggling to pay for basic expenses. This is even more pronounced in households with low incomes. Overall, almost half of all California households with children (46%) struggled to pay for basic expenses between March and mid-July, compared to 35% of households without children. Among households with incomes under $35,000, over half (59%) of those without kids struggled paying for basic necessities. And while that share is very high, it’s even higher for households with low incomes and children — 71%, or 12 percentage points higher.

A bar chart showing the share of households reporting difficulty paying for basic expenses where households with children, especially those with low incomes, were more likely to struggle paying for basic expenses.

Millions of Californians are struggling to make ends meet every day. This is especially true for those with low incomes, Black, Latinx, and other Californians of color, and households with children. Pandemic-era supports that helped families and individuals pay for basic needs in recent years have expired. However, inflation and the high cost of living relative to workers’ earnings continue to strain families’ budgets. This points to the urgent need for policymakers to further invest in resources to ensure that all Californians can thrive. This includes affordable housing, affordable health care, and a strong safety net. In a state as wealthy as California, policymakers have the tools to build communities where all can share in our state’s prosperity.

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Key Takeaway

Over 50% of eligible students do not participate in SNAP, and the complexity of the rules is a major contributor.

All Californians should have the opportunity to pursue higher education without sacrificing their basic needs. However, food insecurity among college students is an ongoing problem. For example, a 2019 survey of California community college students revealed that over half had trouble paying for their meals.

Over 50% of Eligible College Students Don’t Participate in SNAP

While there are safety net programs in place, such as the Supplemental Nutrition Assistance Program (SNAP) — or CalFresh, as it is known in California — to help people put food on the table, people who are enrolled in college at least half-time face significantly more complex rules to qualify.

A recent government report estimated that over 50% of eligible students did not participate in SNAP. The report pointed to the complexity of student-specific eligibility rules as a likely contributor to low enrollment rates. To qualify, students enrolled at least half-time must meet the regular income eligibility criteria and also meet one of eight additional requirements.1Under SNAP/CalFresh, people are considered students if they are enrolled in an institution of higher education at least half-time, are between the ages of 18 and 49, and are deemed mentally and physically fit. Students who are enrolled less than half-time are not classified as “students” under CalFresh. These students only have to meet the regular income eligibility criteria to receive benefits. Four of these requirements are geared toward parents or caretakers. The other four require that students:

  • Be in their final semester.
  • Work at least 20 hours a week.
  • Participate in work study, or enroll in an employment training program.

If they do not meet these requirements, they cannot receive CalFresh regardless of their income or needs.

A stacked bar chart showing the community college enrollment by age in the fall of 2022 where nearly three-quarters of students enrolled at least half-time are under the age of 25.

CalFresh Requirements Need to Be Simplified for College Students

Given the increasingly high costs of attending college, students with low incomes face a significant disadvantage and a higher likelihood of experiencing food insecurity. In fact, within the California Community Colleges (CCC) system, which serves high percentages of people of color and people with low incomes, over half of all students are enrolled at least half-time. Therefore, these students would need to meet the burdensome requirements to access CalFresh. Nearly three-quarters of these students are under the age of 25, which makes them less likely to meet requirements geared toward parents and families. This suggests that most students in need of food assistance would have to take on jobs on top of their heavy course loads. This could significantly impact their ability to meet their educational goals.

Under federal COVID-19 relief policies, additional exemption criteria were granted to allow more students to receive CalFresh. The expansion allowed students eligible for federal or state work study, regardless of whether they participated, or those with $0 in expected family contributions to qualify for CalFresh if they met the regular income requirements. As a result, student applications for CalFresh more than quadrupled in 2021.2Aaron Kunst, Andrew Cheyne, Becky Silva, and Ruben E. Canedo, CalFresh for College Students: Equitable and Just Access (California Association of Food Banks, March 2022), 4, https://www.cafoodbanks.org/wp-content/uploads/2022/03/College-CalFresh-WhitePaper-final-March2022.pdf. However, these federal exemptions ended in June 2023. Students who qualified for CalFresh via these exemptions will no longer be eligible at their renewal date.

Policymakers Can Ensure College Students Have Better Access to Food Assistance

College students should have the same opportunity as any other Californian to access CalFresh. Policymakers have a responsibility to support college students in meeting their educational goals to ensure a skilled workforce in California.

Federal policymakers can help reduce student hunger by:

  • Reinstating COVID-19 expansions to SNAP.
  • Completely removing the additional red tape that students face to put students on equal footing with everyone else.

In the meantime, state policymakers can continue to support students by investing in administrative support and ensuring that the program is accessible to all eligible students.


Support for this report was provided by the Hilton Foundation.

  • 1
    Under SNAP/CalFresh, people are considered students if they are enrolled in an institution of higher education at least half-time, are between the ages of 18 and 49, and are deemed mentally and physically fit. Students who are enrolled less than half-time are not classified as “students” under CalFresh. These students only have to meet the regular income eligibility criteria to receive benefits.
  • 2
    Aaron Kunst, Andrew Cheyne, Becky Silva, and Ruben E. Canedo, CalFresh for College Students: Equitable and Just Access (California Association of Food Banks, March 2022), 4, https://www.cafoodbanks.org/wp-content/uploads/2022/03/College-CalFresh-WhitePaper-final-March2022.pdf.

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key takeaway

Nearly six in 10 Californians say that recent price increases have caused hardship. Strengthening the state’s refundable income tax credits is a proven way policymakers can improve Californians’ economic security.

Every Californian deserves to be able to put food on the table, pay the rent, and support their families. But millions of people across California struggle to make ends meet every day. Although inflation has slowed in recent months, the cost of basic needs like food and housing remain high and continue to strain family budgets.

Nearly six in 10 Californians say that price increases have caused hardship. Additionally, nearly half — including 63% of low-income Californians — say that their housing costs are placing a financial strain on them and their families. On top of this, the number of Californians living in poverty has likely risen because policymakers let pandemic supports expire. This includes emergency food assistance and expansions of the federal Earned Income Tax Credit (EITC) and Child Tax Credit.

A key and proven way policymakers can improve Californians’ economic security is by strengthening the state’s refundable income tax credits. These tax credits provide tax refunds to people with low incomes. California’s largest of such credits — the California Earned Income Tax Credit (CalEITC) — helps millions of Californians with low incomes meet basic needs each year.

Last year, the CalEITC put over $700 million back in the pockets of workers with low incomes and their families. So far this year, it’s provided well over $800 million. These dollars help families and individuals. Additionally, it supports local businesses, jobs, and economies by boosting the spending power of tax credit recipients. Research on the expanded federal Child Tax Credit as well as the federal EITC shows that the vast majority of families with low incomes spend their credits on basic household needs, with food being the most common expense.

Increasing the amount of cash provided through the CalEITC is a simple, effective way for state policymakers to help more Californians in working families make ends meet while also supporting local businesses and jobs. This investment is especially imperative now that federal pandemic supports have expired. This expiration makes it more difficult for many Californians to make ends meet. Tens of thousands of households in every legislative district across the state currently benefit from the CalEITC. Further investments in the credit could inject significant resources into their communities.

Assembly District Order

Assembly DistrictAssemblymemberPartyNumber of Households Benefitting from the CalEITC Tax Year 2021Amount of CalEITC Credits Going to Households Tax Year 2021
1Megan DahleRepublican38,800$7,307,300
2Jim WoodDemocrat40,900$7,511,700
3James GallagherRepublican44,900$9,364,300
4Cecilia M. Aguiar-CurryDemocrat34,700$6,171,900
5Joe PattersonRepublican27,500$4,552,000
6Kevin McCartyDemocrat45,200$9,098,200
7Josh HooverRepublican39,300$7,274,100
8Jim PattersonRepublican40,900$7,736,200
9Heath FloraRepublican39,700$7,596,200
10Stephanie NguyenDemocrat49,000$10,131,400
11Lori D. WilsonDemocrat38,300$7,196,200
12Damon ConnollyDemocrat27,100$4,651,000
13Carlos VillapuduaDemocrat48,400$11,172,200
14Buffy WicksDemocrat30,400$5,364,700
15Timothy S. GraysonDemocrat38,000$7,510,100
16Rebecca Bauer-KahanDemocrat16,900$2,438,600
17Matt HaneyDemocrat31,200$5,287,000
18Mia BontaDemocrat37,500$7,570,200
19Philip Y. TingDemocrat27,400$3,949,300
20Liz OrtegaDemocrat35,700$6,276,200
21Diane PapanDemocrat20,700$3,417,000
22Juan AlanisRepublican47,900$10,521,200
23Marc BermanDemocrat15,300$2,272,100
24Alex LeeDemocrat24,900$3,892,500
25Ash KalraDemocrat39,700$7,222,400
26Evan LowDemocrat19,700$3,151,700
27Esmeralda Z. SoriaDemocrat61,500$14,809,700
28Gail PellerinDemocrat22,000$3,498,000
29Robert RivasDemocrat51,100$11,484,600
30Dawn AddisDemocrat31,600$5,232,100
31Dr. Joaquin ArambulaDemocrat65,800$17,041,200
32Vince FongRepublican47,100$10,464,000
33Devon J. MathisRepublican60,800$15,246,800
34Tom LackeyRepublican49,300$11,402,400
35Jasmeet Kaur BainsDemocrat67,500$17,022,400
36Eduardo GarciaDemocrat60,100$14,462,800
37Gregg HartDemocrat40,700$8,009,800
38Steve BennettDemocrat46,200$9,110,500
39Juan CarrilloDemocrat60,500$15,277,800
40Pilar SchiavoDemocrat40,600$6,916,900
41Chris R. HoldenDemocrat35,500$6,024,500
42Jacqui IrwinDemocrat28,700$4,279,200
43Luz M. RivasDemocrat64,000$13,048,000
44Laura FriedmanDemocrat42,500$6,309,100
45James C. RamosDemocrat61,900$14,078,900
46Jesse GabrielDemocrat50,500$9,333,600
47Greg WallisRepublican48,200$9,378,200
48Blanca E. RubioDemocrat53,200$9,508,500
49Mike FongDemocrat53,200$8,654,500
50Eloise Gómez ReyesDemocrat54,200$10,656,200
51Rick Chavez ZburDemocrat36,900$5,207,900
52Wendy CarrilloDemocrat59,200$11,011,300
53Freddie RodriguezDemocrat55,300$10,734,700
54Miguel SantiagoDemocrat63,600$13,057,200
55Isaac G. BryanDemocrat44,900$8,402,600
56Lisa CalderonDemocrat52,600$9,400,700
57Reginald B. Jones-Sawyer, Sr.Democrat70,400$17,673,400
58Sabrina CervantesDemocrat52,000$10,111,000
59Phillip ChenRepublican33,300$5,400,700
60Dr. Corey A. JacksonDemocrat55,600$12,396,800
61Tina S. McKinnorDemocrat53,000$10,988,700
62Anthony RendonDemocrat57,800$12,008,900
63Bill EssayliRepublican42,100$7,895,700
64Blanca PachecoDemocrat56,500$10,634,100
65Mike A. GipsonDemocrat63,300$14,612,200
66Al MuratsuchiDemocrat29,300$4,855,700
67Sharon Quirk-SilvaDemocrat48,200$8,547,200
68Avelino ValenciaDemocrat57,300$10,921,900
69Josh Lowenthal Democrat48,500$9,086,200
70Tri TaRepublican55,200$9,556,700
71Kate A. SanchezRepublican31,900$5,182,500
72Diane B. DixonRepublican29,700$4,467,900
73Cottie Petrie-NorrisDemocrat32,700$5,280,000
74Laurie DaviesRepublican37,200$6,207,900
75Marie WaldronRepublican35,400$6,434,400
76Brian MaienscheinDemocrat32,500$5,614,400
77Tasha BoernerDemocrat25,500$3,542,300
78Christopher M. WardDemocrat38,200$5,977,400
79Dr. Akilah Weber, M.D.Democrat57,100$11,188,500
80David A. AlvarezDemocrat65,000$12,615,700

Notes: Number of households is rounded to the nearest hundred. It reflects those receiving the CalEITC in tax year 2021 as of 12/31/22. Just over 49,000 households that received the CalEITC (1.4%) filed taxes from zip codes outside of California. These households are not included in this analysis. Another 48,000 households that received the CalEITC & filed taxes from within California (1.3%) are not included in this analysis. They could not be matched to an Assembly or Senate district or because FTB did not report the zip code from which they filed in order to meet confidentiality standards. 

Source: Budget Center analysis of Franchise Tax Board data

Senate District Order

Senate DistrictSenatorPartyNumber of Households Benefiting from the CalEITC
Tax Year 2021
Amount of CalEITC Credits Going to Households
Tax Year 2021
1Brian Dahle Republican94,100$17,456,600
2Mike McGuireDemocrat70,100$12,915,800
3Bill DoddDemocrat72,700$12,736,000
4Marie Alvarado-GilDemocrat88,500$17,803,500
5Susan Talamantes EggmanDemocrat99,100$21,230,400
6Roger W. NielloRepublican84,200$15,812,600
7Steven M. GlazerDemocrat56,500$10,301,400
8Angelique V. AshbyDemocrat87,700$17,980,800
9Nancy SkinnerDemocrat84,300$15,805,000
10Aisha WahabDemocrat57,300$9,389,700
11Scott D. WienerDemocrat57,500$9,073,100
12Shannon GroveRepublican97,400$21,370,000
13Josh BeckerDemocrat37,900$6,036,700
14Anna M. CaballeroDemocrat158,700$39,116,600
15Dave CorteseDemocrat56,800$9,870,400
16Melissa HurtadoDemocrat122,900$30,957,300
17John LairdDemocrat69,300$12,383,700
18Steve PadillaDemocrat144,600$30,670,200
19Monique LimónDemocrat86,700$16,999,400
20Caroline MenjivarDemocrat139,000$26,503,300
21Scott WilkRepublican109,500$25,102,600
22Susan RubioDemocrat141,700$25,980,200
23Rosilicie Ochoa BoghRepublican133,900$28,638,200
24Benjamin Allen Democrat65,100$9,310,900
25Anthony J. PortantinoDemocrat85,000$13,519,600
26María Elena DurazoDemocrat125,900$24,237,900
27Henry I. Stern Democrat74,600$12,569,600
28Lola Smallwood-CuevasDemocrat106,400$22,981,400
29Josh NewmanDemocrat88,900$15,325,300
30Bob ArchuletaDemocrat107,900$19,269,800
31Richard D. RothDemocrat141,900$28,535,500
32Kelly SeyartoRepublican96,400$17,757,800
33Lena A. GonzalezDemocrat124,500$27,371,400
34Thomas J. UmbergDemocrat115,500$21,410,800
35Steven BradfordDemocrat122,900$26,426,700
36Janet NguyenRepublican83,500$13,528,800
37Dave MinDemocrat68,800$11,102,800
38Catherine BlakespearDemocrat66,600$10,406,900
39Toni G. Atkins Democrat93,900$15,232,500
40Brian W. JonesRepublican78,500$13,860,400

Notes: Number of households is rounded to the nearest hundred. This reflects those receiving the CalEITC in tax year 2021 as of 12/31/22. Just over 49,000 households that received the CalEITC (1.4%) filed taxes from zip codes outside of California. These households are not included in this analysis. Another 48,000 households that received the CalEITC and filed taxes from within California (1.3%) are not included in this analysis. They could not be matched to an Assembly or Senate district or because FTB did not report the zip code from which they filed in order to meet confidentiality standards.

Source: Budget Center analysis of Franchise Tax Board data

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key takeaway

California has the largest LGBTQ+ population in the US, with about 1 in 10 adults identifying as LGBTQ+.

Californians of all genders and sexual orientations are important members of families, schools, workplaces, and communities throughout the state. About 1 in 10 California adults identify as LGBTQ+, according to data from the US Census Bureau’s Household Pulse Survey.1Budget Center analysis of US Census Bureau, Household Pulse Survey data for July 2021 to June 2023. California has by far the largest LGBTQ+ population of any state in the US. Specifically, about 2.7 million adult residents identify as lesbian, gay, bisexual, or transgender.2Budget Center analysis of US Census Bureau, Household Pulse Survey data for July 2021 to June 2023. These data likely underestimate the true population of LGBTQ+ Californians since they do not allow for the clear identification of other non-cisgender, non-straight identities such as non-binary, two-spirit, pansexual, and asexual. See notes on the limitations of the Household Pulse Survey data in Kayla Kitson and Adriana Ramos-Yamamoto, State Leaders Should Prioritize LGBTQ+ Californians’ Mental Health (California Budget & Policy Center, May 2022).

Families that include LGBTQ+ individuals live in every region of the state. Around 46,000 California children under age 18 lived with same-sex parents in 2021, according to Census Bureau American Community Survey data.3Budget Center analysis of US Census Bureau, American Community Survey public-use microdata downloaded from IPUMS USA (University of Minnesota, www.ipums.org). Additionally, California is home to about 49,000 youth ages 13 to 17 who identify as transgender, according to estimates from the UCLA Williams Institute.4Jody Herman, Andrew Flores, and Kathryn O’Neill, How Many Adults and Youth Identify as Transgender in the United States? (UCLA Williams Institute, June 2022).

LGBTQ+ community activists in California and throughout the US have been key leaders driving progress in multiple areas of public concern. Activists’ strategies to push for equal rights to marriage for gay and lesbian couples have been held up as a model for advancing civil rights struggles.5Molly Ball, “What Other Activists Can Learn From the Fight for Gay Marriage,” The Atlantic (July 14, 2015); John Kowal, The Improbable Victory of Marriage Equality (Brennan Center for Justice, September 29, 2015); Josh Zeitz, “The Making of the Marriage Equality Revolution,” Politico Magazine (April 28, 2015).

In the health arena, advocacy campaigns by HIV/AIDS activists from LGBTQ+ communities directly led the federal government to establish accelerated approval processes for life-threatening diseases without effective treatments. which made possible the rapid review and approval of newly developed vaccines and drugs during the COVID-19 pandemic.6Lillian Brown, Matthew Spinelli, and Monica Gandhi, “The Interplay Between HIV and COVID-19: Summary of the Data and Responses to Date,” Current Opinion in HIV and AIDS 16, no. 1 (January 2021): 63-73; Anthony Fauci, “Victories Against AIDS Have Lessons for COVID-19,” Nature 600, no. 9 (November 2021).

LGBTQ+ Californians make up a substantial share of the state’s population and play important roles in families and communities. Policymakers should pay attention to the needs of LGBTQ+ Californians. Specifically, they should consider the impact of public policies on LGBTQ+ individuals and their families and communities.

A graphic that shows that about 1 in 10 California adults identify as LGBTQ+.

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key takeaway

LGBTQ+ Californians — who make up about 1 in 10 adults in the state — are more likely to experience economic hardship than other Californians.

California should be a place where everyone — regardless of gender identity or sexual orientation — can afford to support themselves and their families. Many Californians struggle with the high costs of living in the state. They face uncertainty over whether they will be able to make their next housing payment, keep enough food on the table, and pay for their health expenses.

LGBTQ+ Californians — who make up about 1 in 10 adults in the state — are more likely than other Californians to have a hard time covering the basics. Around 2 in 5 LGBTQ+ adults in the state had difficulty paying for usual household expenses, according to data from the US Census Bureau’s Household Pulse Survey collected between July 2021 and June 2023.1Based on Budget Center analysis of Household Pulse Survey data. These data likely exclude some LGBTQ+ Californians since they do not allow for the clear identification of other non-cisgender, non-straight identities such as nonbinary, two-spirit, pansexual, and asexual. See notes on the limitations of the Household Pulse Survey data in Kayla Kitson and Adriana Ramos-Yamamoto, State Leaders Should Prioritize LGBTQ+ Californians’ Mental Health (California Budget & Policy Center: May 2022). Broken down by gender identity and sexual orientation, about 47% of transgender Californians and 38% of lesbian, gay, or bisexual Californians had difficulty covering their expenses.2Note that LGBTQ+ gender identity and sexual orientation categories are not mutually exclusive; for example, transgender individuals may identify as lesbian, gay, bisexual, or straight.

A comparative column chart showing the share of LGBTQ+ adults in California reporting difficulty paying for basic expenses from July 2021 to June 2023 where LGBTQ+ Californians are more likely to have trouble paying for basic expenses.

Barriers to Economic Stability

Many LGBTQ+ people face barriers to economic stability, including employment and housing discrimination, a lack of family support, and mental health concerns.3Harvard T.H. Chan School of Public Health, Robert Wood Johnson Foundation, and National Public Radio, Discrimination in America: Experiences and Views of LGBTQ Americans (November 2017), 1; Kitson and Ramos-Yamamoto, State Leaders Should Prioritize LGBTQ+ Californians’ Mental Health. And while California is far ahead of many other states in enacting legal protections for LGBTQ+ individuals and families, the degree of social acceptance of LGBTQ+ people varies across the state, which likely impacts their economic as well as social well-being.4Snapshot: LGBTQ Equality By State,” Movement Advancement Project (webpage), accessed March 31, 2023 ; The Williams Institute, The LGBT Divide in California: A look at the socioeconomic well-being of LGBT people in California (June 2015).

Other intersecting identities — such as race and ethnicity, age, and ability — may make some LGBTQ+ people more susceptible to financial insecurity. For example, LGBTQ+ Californians of color are more likely to face barriers to economic security than both white LGBTQ+ Californians and non-LGBTQ+ Californians of color. LGBTQ+ youth and young adults are more likely to experience homelessness due to an unaccepting family environment, which can result in lasting adverse health, educational, and economic outcomes.5LGBTQ+,” youth.gov (webpage), accessed March 31, 2023.

Inclusive Policies for LGBTQ+ Californians

State leaders should ensure that policies aiming to reduce economic hardship take into account the unique challenges faced by LGBTQ+ Californians and that supports are available and accessible to address the needs of these communities. Policymakers at all levels of government should also take steps to improve data collection methods to make sure that LGBTQ+ individuals — and the many identities underneath the LGBTQ+ umbrella — are represented. Having reliable and accurate data on the challenges that different LGBTQ+ communities are facing is vital in order to inform the most effective policy solutions to address these challenges.

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key takeaway

State policymakers must continue to invest in the health workforce in order to meet the needs of Californians. This includes investments in community-led efforts to promote health, such as community health workers and promotores de salud.

Access to health care services is important for everyone’s health and well-being. The state’s workforce must meet the needs of Californians to achieve equitable access to timely and culturally competent health services. While state policymakers have made considerable investments in recent years to bolster the health workforce, investments in various health workforce areas still fall short.

Investments to Increase Provider Participation in Medi-Cal Are Critical

More than 15 million Californians with modest incomes — nearly half of whom are Latinx — receive free or low-cost health care through Medi-Cal (California’s Medicaid program). In order to better support the millions of Californians who rely on the state’s health safety net, policymakers have taken steps to increase provider participation in Medi-Cal.

Specifically, this year’s 2023-24 budget includes $237.4 million to increase Medi-Cal provider rates effective January 1, 2024. Rate increases are targeted to:

  • primary care, which includes nurse practitioners and physical assistants,
  • maternity care (i.e., obstetrics/gynecology physicians and doulas),
  • and non-specialty mental health services, such as for mental health evaluation and treatment.

The governor’s administration also plans for additional Medi-Cal provider rate increases in future years for hospital outpatient procedures and services, family planning services, emergency physician services, and more.

related resource

See our Report: Californians Need State Leaders to Make Health Care More Affordable to learn how state leaders can use revenues to make progress on health care affordability.

Policymakers Should Also Invest in Community-Led Efforts to Promote Health 

California is home to people with diverse cultural and ethnic backgrounds. Therefore, policymakers should invest in workforce strategies that leverage community-led efforts to improve health. This includes investing in community health workers and promotores de salud, frontline public health workers who are trusted members of their communities. They serve as liaisons between the community and health and social service providers in order to facilitate access to services and improve service delivery. Community health workers and promotores provide services in a way that is linguistically and culturally responsive to the needs of the communities they serve.

State leaders have taken initial steps to integrate community health workers and promotores into the Medi-Cal workforce. For instance, state leaders established a community health worker benefit within the Medi-Cal program in July 2022. This allows these workers to be paid for providing services to Medi-Cal enrollees. These services include:

  • health education to help patients manage chronic health conditions,
  • and health navigation to assist people access health care services.

Additional ongoing investments are needed to develop a strong pipeline of community health workers and also to ensure that workers are paid fair wages.

State Policymakers Should Increase Health Workforce Opportunities for Youth

Youth and young adults have tremendous power to improve health outcomes within their communities — both in the immediate and long term. Examples of youth supporting youth are peer-to-peer programs in school settings and peer support specialists. Research shows that peer-to-peer supports help improve mental health outcomes, decrease substance use, and reduce hospital admission rates. Policymakers should invest in peer support programs that lead to meaningful career pathways for youth and young adults. Particularly, for individuals disconnected from school or employment.

Meeting the health needs of Californians will require significant long-term investment in youth workforce development programs. In 2019, the California Future Health Workforce Commission developed a strategic plan for addressing health workforce gaps. According to a recent progress report, policymakers have made progress on many of the priority recommendations. However, state leaders can do more to recruit and train students from rural areas and other historically underserved communities to practice in community health centers.

Bottom line: State policymakers must continue to build a health workforce that meets the needs of Californians. Policymakers should also invest in efforts to make sure that the health workforce better reflects the diversity of all Californians. This includes their race/ethnicity, disability status, gender identity, and sexual orientation. Doing so will require sustained, ongoing investment.

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key takeaway

Homelessness among Latinx Californians has increased by 22% since 2020, more than three times the overall state increase of 6.2% over the same period.

Every Californian deserves a safe and stable place to call home. Yet, more Californians are pushed into homelessness faster than our systems can house them. From 2020 to 2022, the total number of unhoused Latinx Californians increased by 22% — a trend reflected in a rise in both sheltered and unsheltered homelessness. Overall, California’s total unhoused population during the same point-in-time counts increased by 6.2%. This increase mainly reflected a rise in sheltered populations.

A column chart showing the the number of Californians experiencing homelessness at a point-in-time in 2020 and 2022 where Latinx Californians experiencing homelessness rose by 22%, which is more than three times the overall state increase.

The sharp increase in unhoused Latinx Californians likely results from the inequitable compounding effects of the pandemic which exacerbated the economic and housing insecurity many communities of color already faced. Latinx Californians experienced high rates of housing hardship and unemployment and disproportionately worked in essential, low-wage occupations.1Aureo Dias Mesquita and Sara Kimberlin, Who is Experiencing Housing Hardship in California? (California Budget & Policy Center, May 2022); Sara Kimberlin and Alissa Anderson, In Good Times and Bad, California’s Black and Latinx Workers Bear the Burden of Unemployment (California Budget & Policy Center, December 2022); Sarah Thomason and Annette Bernhardt, Front-line Essential Jobs in California: A Profile of Job and Worker Characteristics (UC Berkeley Labor Center, May 2020). They also confronted higher rates of COVID-19 infections and deaths during the first year of the pandemic, before COVID-19 vaccines and treatments were available.2Adriana Ramos-Yamamoto and Monica Davalos, Confronting Racism, Overcoming COVID-19, and Advancing Health Equity (California Budget & Policy Center, February 2021). Combined, the pandemic’s deep economic and health ramifications made families and individuals more susceptible to not being able to afford their homes.

While all unhoused populations are generally undercounted, research shows that unhoused Latinx individuals are specifically underreported due to distinctive factors. Stronger reliance on social networks, lower utilization of homeless and public services due to information and service gaps, language barriers and mistrust, and increased likelihood of residing in nontraditional homelessness spaces or overcrowded housing means they are less likely to be captured in standardized counts.3Melissa Chinchilla et al., Increasing Latino Homelessness— What’s Happening, Why, and What to Do About It (National Alliance to End Homelessness and the Homelessness Research Institute, January 2023); Melissa Chinchilla, Stemming the Rise of Latino Homelessness: Lessons From Los Angeles County (UCLA Latino Policy & Politics Initiative, 2019). Therefore, the trending increase in Latinx homelessness may signify an even larger, unseen need among this community.

As many Californians continue to struggle to stay in their homes or exit homelessness, policymakers need to keep investing in the evidence-based solutions that we know can end homelessness. These solutions require at-scale, ongoing investments in California’s homelessness response systems and expanding the stock of affordable housing. Without this, the stark racial disparities we already see in our state’s unhoused population will continue to grow alongside Californians who are pushed into homelessness daily because they cannot afford to stay in their homes.

Policy solutions should also be rooted in equitable interventions that build community trust and integrate culturally and linguistically competent practices. Ending homelessness for all Californians is possible if policymakers use the levers at their disposal to ensure everyone has a place to call home.

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