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Choosing between paying the bills or caring for their families has never been an easy choice for California workers, and COVID-19 health and economic conditions have only exacerbated that dilemma. The federal Families First Coronavirus Response Act temporarily addresses workers’ lack of paid time off in the United States by requiring employers to provide both paid sick days and job-protected paid leave to care for a family member (see Table for more details). While the federal government will provide tax credits to businesses to cover the cost of the required leave policies, the federal law has exemptions that allow some employers to opt out of providing paid time off to workers, many of whom earn low wages, have limited benefits, and are at heighted risk of being exposed to COVID-19.

Workers ineligible for new federal leave laws may be able to rely on California’s family and medical leave laws, but these policies also have limitations that create barriers for workers taking paid time off from work. These barriers are particularly acute for workers with low wages – disproportionately women, Black, and Latinx workers. Finally, some workers may be covered by their employers’ benefits, but workers with low wages are far less likely to have paid time off via workplace benefits. This means that even as state leaders work to stop the spread of COVID-19 and have directed people to stay home, some workers cannot access paid time off to care for themselves or family members and still support their household needs.

How are workers caught in the paid time off gap?

Caught in the Gap: A part-time cashier at a nationwide pharmacy needs several weeks away from work to stay home to care for her spouse who is gravely ill and is under an isolation order, but she is ineligible for federal paid time off because she works for an employer with more than 500 employees. While this worker could use California’s paid family leave, she would not be able to take leave with job security because she works just 20 hours a week, which does not meet the requirements for job-protected leave under California law. Closing the Gap for Workers:

  • Federal policymakers should require large businesses with more than 500 employees who are currently excluded in the Families First Act to provide paid time off. This could reach millions of additional workers in California.
  • State policymakers should extend job protections to all workers who take family and medical leave regardless of the size of the employer, hours worked, or tenure.

Caught in the Gap: A single mom working at a small, local grocery story finds herself without care for her children due to the closure of local schools and day care centers. Her employer has told her that providing her with paid time off to care for her children would be a hardship that would jeopardize the business, and she is not eligible to utilize federal paid leave. California’s paid family leave program is not an option for parents who suddenly find themselves without care for their children due to a public health emergency. Her only option is to apply for unemployment insurance benefits. Closing the Gap for Workers:

  • Federal leaders should limit small-business exemptions to those who would be forced to immediately close if they gave their employees paid time off under this new federal leave program. Currently, the Department of Labor definition of hardship is vague and requires only self-certification by small employers. Small businesses should also be required to submit a simple form to the federal Department of Labor, rather than current practice, which is to self-certify without any documentation.
  • State policymakers should include care for a family member due to the closure of school, child care center, or adult day center during a public health emergency or natural disaster as a reason one can utilize paid family leave.

Caught in the Gap: A worker in the cleaning and maintenance department of a small, rural hospital fears he might have been exposed to COVID-19 when he dropped off groceries for his mother who has since tested positive for the virus. He knows he should self-quarantine for the recommended 14 days, but he only has three days of sick time under California’s paid sick days law and he’s worried about paying his bills. His employer has already informed him that he is considered a health care worker, and they won’t be providing any paid sick days under new federal laws. He could apply for state disability insurance, but he needs medical certification. Unfortunately, even though he works in a hospital, he does not have a primary care doctor, has been unable to schedule an appointment with a new doctor, and is afraid to go to urgent care due to the risk of spreading the virus or increasing his risk of exposure. Closing the Gap for Workers:

  • Federal policymakers should provide health care workers and emergency responders with paid time off to care for themselves or their family. The regulations are overly broad and allow employers to exclude many workers, many of whom have a greater chance of being exposed to COVID-19, and they may need time off, too. Adding to their dilemma and economic hardship, many of these workers likely earn low wages, such as janitors in hospitals and factory workers building medical supplies.
  • State policymakers should increase the minimum required number of paid sick days provided by all employers, which is currently just three days or 24 hours, to the equivalent of two weeks during a public health emergency and seven days when not in a public health emergency. Governor Newsom recently signed an Executive Order expanding paid sick days, but just for essential workers in the food sector who work for large employers currently excluded from federal law.
  • State policymakers should waive medical certification necessary for state disability insurance or paid family leave during a public health emergency to ease the strain on the health care system.

Everyone needs time off to care for themselves or their families, and the COVID-19 pandemic has only heightened the necessity for all workers – crisis or not – to know they can safely keep their jobs and care for the health and well-being of loved ones. State and federal laws create a patchwork of policies to address the need for paid time off but leave notable gaps and workers without a reliable way to care for themselves and others. Both state and federal policymakers should take additional action in the midst of this public health and economic crisis to support California’s workforce in the same way workers show up for the economy every day.


Support for this work is provided by First 5 California. 

Source: Budget Center analysis of federal and California state law and administrative documents.

1 The law doesn’t apply to workers covered under a collective bargaining agreement with certain provisions, to certain public employees, and certain airline employees.

2 Certain employees and certain types of employment are exempt and don’t contribute to state disability insurance. In addition, employers or a majority of employees can opt into voluntary disability plans 

in lieu of state disability insurance and paid family leave with approval from the state.

3 Businesses with fewer than 50 employees can opt out of providing paid sick days or paid leave for workers who need time off to care for family due to a closure of a care facility if it would jeopardize the         

business.

4 Employers can opt to exclude health care workers and emergency responders.

5 The definition of “family member” varies across state and federal laws.

6 May be prorated for part-time work.

7 The 2019-20 budget agreement extended the duration from six weeks to eight, effective July 1, 2020.

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Millions of California workers have lost jobs or seen their work hours significantly cut back as a result of the public health measures that state and local governments have put in place to slow the spread of COVID-19. While necessary to protect the state’s health care system and mitigate the spread of infection, these disruptions seriously threaten the economic stability of a significant share of California workers – and their families. Yet these disruptions do not affect all Californians equally, with a greater burden on California workers with less education, those who are immigrants, and California’s children and adults of color.

To understand who may be most affected, this piece examines the demographics of workers and the families of workers in California industries that are directly and immediately affected by the business slowdown and closures due to the COVID-19 pandemic.

 

In this fact sheet you will learn about:

  1. Who are the State’s Struggling Workers: Many Californians Face High Risk of Economic Devastation from the COVID-19 Business Slowdown
  2. Wage & Educational Disparities: Workers With Low Wages and Less Education Face High Risk of Losing Work
  3. Job Hits Worsen Racial Inequalities: Californians of Color and Their Children Are Particularly Vulnerable to Economic Instability
  4. Impossible Situation for Immigrants: California’s Immigrants Face Financial Crisis, With Millions Left out of Public Support
  5. Opportunities Now & Beyond: Policymakers Can Address Racial and Economic Inequities with COVID-19 Responses

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The federal Supplemental Nutrition and Assistance Program (SNAP) — known as CalFresh in California — is one of the nation’s most powerful antipoverty programs, helping millions of people buy the food they need to support their families and households. Even with a strong economy in 2019, CalFresh provided food assistance to nearly 1 in 10 Californians. Program participation varied across the state’s 53 Congressional districts, but was especially high in the 8th District (R-Cook), 16th District (D-Costa), and 21st District (D-Cox) (see Map 1). CalFresh enrollment will increase dramatically in the coming weeks and months as many across the state lose jobs and income due to the COVID-19 public health and economic crisis.

SNAP is also one of the federal government’s most effective tools in boosting the economy when participants purchase food in their communities. While recent federal legislation responded to the COVID-19 pandemic by enacting temporary provisions in the SNAP program to streamline administration, maintain participation, and provide emergency benefits, more needs to be done. Federal policymakers should take additional actions to help households put food on the table and to boost the economy. Until the public health emergency is over and the economy improves, policymakers should increase SNAP’s maximum benefit and minimum monthly benefit and halt any administrative actions that would limit SNAP food assistance.


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The COVID-19 public health crisis has upended the lives of Californians. Millions of people have experienced serious disruptions to their jobs following social distancing public health recommendations and state and local shelter-in-place orders aimed at slowing the spread of the virus. While necessary to prevent overwhelming the state’s health care system, the business reductions and closures forced by these orders will have a severe economic impact on Californians as well as on regional economies.

This Fact Sheet shows that the major industries most immediately impacted by the COVID-19-related economic shutdown – leisure and hospitality, retail trade, transportation and warehousing, and other services – employ large numbers of Californians in the state’s largest metropolitan areas.1 Without a sufficient federal response to help workers and their families, the shutdown will have a ripple effect throughout local economies as people who lose work will lose income and be forced to cut back on their spending, thus reducing demand for business more broadly.

1 Although many people employed in leisure and hospitality, retail trade, transportation and warehousing, and other services have lost work in recent weeks, there are notable exceptions. For example, within retail trade, grocery stores and pharmacies remain open; within leisure and hospitality, some restaurants have remained in business by providing takeout service instead of in-house service; and within transportation and warehousing, there has been increased demand for jobs supported by online shopping. Due to data limitations for metropolitan areas, it is not possible to present job figures for the industries within these sectors that have been most immediately impacted by the economic shutdown. For these figures at the state level, see The California Industries Hit Hardest by COVID-19 Economic Shutdown: These Industries Employ Millions of Californians.

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The COVID-19 public health crisis has upended the lives of Californians. Millions of people have experienced serious disruptions to their jobs following social distancing public health recommendations and state and local shelter-in-place orders aimed at slowing the spread of the virus. While necessary to prevent overwhelming the state’s health care system, the business reductions and closures forced by these orders will have a severe economic impact on Californians and will hit those with low incomes especially hard.

This Fact Sheet shows that the types of occupations most immediately impacted by the COVID-19-related economic shutdown typically pay low wages, providing annual incomes near or below the poverty line based on the Supplemental Poverty Measure for Los Angeles, even for full-time work.1 This means that the Californians who will bear the brunt of the economic slowdown live paycheck to paycheck even when work is plentiful and are unlikely to have savings to fall back on when their jobs disappear.

1 Although many people employed in these occupations have likely lost work in recent weeks, there are notable exceptions. For example, within transportation and warehousing, there has been increased demand for jobs supported by online shopping.

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The COVID-19 public health crisis has upended the lives of Californians. Millions of people have experienced serious disruptions to their jobs following social distancing public health recommendations and state and local shelter-in-place orders aimed at slowing the spread of the virus. While necessary to prevent overwhelming the state’s health care system, the business reductions and closures forced by these orders will have a severe economic impact on Californians and the state’s economy.

This Fact Sheet shows that the industries most immediately impacted by the COVID-19-related economic shutdown employ several million people in California.1 Without a sufficient federal response to help workers and their families, the shutdown will have a ripple effect throughout the economy as people who lose work will lose income and be forced to cut back on their spending, thus reducing demand for business more broadly.

1Although many people employed in these industries have likely lost work in recent weeks, there are notable exceptions. For example, within transportation and warehousing, there has been increased demand for jobs supported by online shopping.

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In the 1950s and 1960s, policymakers in California and elsewhere began reducing the use of state hospitals to treat people with mental illness – a policy known as “deinstitutionalization.” However, the lack of robust treatment alternatives led to a growing number of people with mental health conditions becoming homeless and, in many cases, incarcerated.1 As a result, prisons and jails have been turned into “America’s…new mental hospitals,” even though it is clear that correctional facilities are highly inappropriate places to house and treat people with mental illness.2

State prisons. Nearly 37,000 people incarcerated at the state level – almost 29% of the total – received mental health treatment in December 2018.3 This was up from about 32,500 – less than 25% of the total – in April 2013. California is projected to spend about $800 million on mental health care in state prisons under Governor Newsom’s proposed 2020-21 state budget. This is more than one-fifth (22%) of total projected health-related spending for state prisoners ($3.6 billion).

County jails. In September 2019, California’s county jails housed 72,806 people on any given day (average daily population).4 Many of these individuals need mental health care. Point-in-time statewide data for September 30, 2019 show that 20,023 people in jail had an open mental health case and 18,020 were receiving psychotropic medication.5 In Los Angeles County, which has the largest jail population in the state, an average of 30% of people in jail on any given day in 2018 — about 5,100 out of roughly 17,000 — “were in mental health housing units and/or prescribed psychotropic medications.”6

While California must continue to improve health care for people who are incarcerated, reforms are also needed to address the connections between mental health and the criminal justice system so that Californians who need mental health treatment receive the appropriate care in a timely manner rather than being confined in state prisons or county jails.

 


For more information on the state’s system, check out “Mental Health in California: Understanding Prevalence, System Connections, Service Delivery, and Funding”.

Support for the Budget Center’s work on behavioral health is provided by the California Health Care Foundation.

1 E. Fuller Torrey, et al., The Treatment of Persons With Mental Illness in Prisons and Jails: A State Survey (Treatment Advocacy Center and National Sheriffs’ Association: April 8, 2014), pp. 11-13; Jen Rushforth, “Guilty by Reason of Insanity: Unforeseen Consequences of California’s Deinstitutionalization Policy,” Themis: Research Journal of Justice Studies and Forensic Science 3 (Spring 2015), pp. 30-35;  Matt Vogel, Katherine D. Stephens, and Darby Siebels, “Mental Illness and the Criminal Justice System,” Sociology Compass 8 (June 2014), pp. 629-630.

2 The quotation is from E. Fuller Torrey, et al., More Mentally Ill Persons Are in Jails and Prisons Than Hospitals: A Survey of the States (Treatment Advocacy Center and National Sheriffs’ Association: May 2010), p. 1. See also Stanford Law School Three Strikes Project, When Did Prisons Become Acceptable Mental Healthcare Facilities? (February 2015).

3 Prison population and expenditure data cited in this paragraph are from the California Department of Corrections and Rehabilitation and the Department of Finance, respectively.

4 Statewide jail population data cited in this paragraph are from the Board of State and Community Corrections.

5 State data do not indicate how many people fall into both categories; the overlap may be substantial. Average daily population data are not directly comparable to point-in-time data. Point-in-time data for several counties were unavailable, so the reported numbers of open mental health cases and people receiving psychotropic medications are likely somewhat low.

6 Stephanie Brooks Holliday, et al., Estimating the Size of the Los Angeles County Jail Mental Health Population Appropriate for Release Into Community Services (RAND Corporation: January 2020).

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As California works to improve access to behavioral health services (mental health and substance use), policymakers should keep in mind the various socioeconomic factors that can contribute to the development of mental health conditions for children, youth, and adults. Research suggests that low levels of household income and mental health conditions are related.1 In addition, experiencing racism and discrimination negatively impacts mental health for multiple racial/ethnic groups, especially for children and adolescents.2 Left unaddressed, chronic stress due to experiencing poverty and/or racism can affect a child’s development and can lead to behavioral problems.3

In California, nearly 1 in 6 adults experience mental illness and 1 in 25 experience a serious mental illness.4

Serious mental illness is more common among Californians with low incomes. In 2015 – the most recent year for which these data are available – about 1 in 11 adults with incomes below the federal poverty line (FPL) had a serious mental illness. The 2015 FPL was $12,331 for a single person and $24,036 for a family of four.

Native American adults experienced the highest rates of serious mental illness in 2015, followed by Black, multiracial, and Latinx adults. White, Pacific Islander, and Asian adults experienced lower rates of serious mental illness.

* KEY TERMS: Mental illness is defined as a mental, behavioral, or emotional disorder that can vary in impact, ranging from no impairment to mild, moderate, and even severe impairment. Serious mental illness is defined as a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities.5

Nearly 1 in 13 California children and youth experience a serious emotional disturbance.

Serious emotional disturbance is most common among children and youth in families with the lowest incomes. In 2015, an estimated 1 in 10 children and youth in families living in poverty experienced a serious emotional disturbance.

Black, Latinx, Native American, and Pacific Islander children experienced the highest rates of serious emotional disturbance (at or near 8%), while rates for multiracial, Asian, and white children were just under 7%.

* KEY TERMS: Serious emotional disturbance applies to children and youth age 17 and under who have, or during the past year have had, a diagnosable mental, behavioral, or emotional disorder resulting in functional impairment that substantially interferes with or limits functioning in family, school, or community activities.6

A greater understanding of the socioeconomic factors can help advance policies that address the racial discrimination and economic disparities many California families face and lead to improved behavioral health outcomes.


For more information on the state’s system, check out “Mental Health in California: Understanding Prevalence, System Connections, Service Delivery, and Funding”.

Support for the Budget Center’s work on behavioral health is provided by the California Health Care Foundation.

1 Jitender Sareen, et al., “Relationship Between Household Income and Mental Disorders,” Archives of General Psychiatry 68 (April 2011), pp. 419–427.

2 Anissa I. Vines, Julia B. Ward, and Kristin Z. Black, “Perceived Racial/Ethnic Discrimination and Mental Health: a Review and Future Directions for Social Epidemiology,” Current Epidemiology Reports 4 (June 2017), pp. 156–165. See also, Aprile D. Benner et al., “Racial/Ethnic Discrimination and Well-Being During Adolescence: A Meta-Analytic Review,” American Psychologist 73 (2018), pp. 855-883.

3 Harvard University Center on the Developing Child, ACEs and Toxic Stress (n.d.). See also American Academy of Pediatrics, American Academy of Pediatrics Recommends Pediatricians Screen for Poverty at Check-ups and Help Eliminate its Toxic Health Effects (March 9, 2016).

4 The prevalence estimates for mental illness and serious emotional disturbance were developed by Dr. Charles Holzer and Dr. Hoang Nguyen using a sociodemographic risk model. For a description of the methodology used to develop these estimates, see page 53 in Mental Health in California: For Too Many, Care Not There.

5 National Institute of Mental Health, Mental Illness (February 2019).

6 Substance Abuse and Mental Health Services Administration, DSM-5 Changes: Implications for Child Serious Emotional Disturbance (June 2016).

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