Subscribe Donate

Newsroom Type: In the News

Home | Newsroom | In the News

California Governor Criticized for Proposal to Eliminate Health Benefit for Some Disabled Immigrants

SACRAMENTO, Calif. (AP) — California Gov. Gavin Newsom vowed he would not fix the state’s budget deficit by taking away health insurance from low-income adults living in the country without legal permission, calling the state’s policy “something I believe in.”

But Newsom would eliminate an important health benefit for some low-income immigrants with disabilities, angering his allies who are now accusing the second-term governor of breaking his word.

California was one of the first states to give free health insurance to all low-income adults regardless of their immigration status. The multibillion-dollar project, completed in January, made more than 1 million people eligible for California’s Medicaid program, including many people who had never before had health insurance.

Now, just five months later and with California facing an estimated $45 billion deficit, Newsom wants the state to stop paying for caregivers to come to the homes of some disabled people — who are living in the country without legal permission — to help them with cooking, cleaning and other tasks so they can stay out of nursing homes. Everyone else would keep that benefit.

The Newsom administration says this would save about $94 million and impact fewer than 3,000 people out of the more than 15 million who are enrolled in the state’s Medicaid program, known as Medi-Cal. But eliminating the benefit would also keep thousands more from becoming eligible in the future.

Neswom’s proposal “is a betrayal,” said David Kane, an attorney with the Western Center on Law and Poverty. Ronald Coleman Baeza, managing policy director for California Pan-Ethnic Health Network, called it “indefensible” and compared the proposal to a notorious ballot proposition from the 1990s that sought to bar immigrants from accessing government assistance programs.

“I think it could move us back in the sense of treating undocumented as different,” said state Sen. Maria Elena Durazo, a Democrat from Los Angeles who has pushed for the Medicaid expansion for years.

Newsom’s proposal for immigrants would impact a benefit known as in-home supportive services that’s becoming more expensive for the state to provide. The average hourly wage for caregivers has gone up 6% since 2014. And starting this year, with some emergency federal funding provided during the pandemic expired, there have been cost increases of about $200 million.

Once people qualify for the program, they get to hire their own caregiver. It’s often a relative, meaning the program often acts as financial assistance for families.

READ MORE

California could boot thousands of immigrants from program that aids elderly and disabled

In Bell Gardens, Raquel Martinez said she has relied for nearly three years on a program that pays an assistant to help her make it safely to her frequent appointments at the MLK Medical Campus.

Martinez, 65, is blind and has cancer. If she did not have the help of her support worker, Martinez said, she would struggle to navigate the elevators and find the right office. Her assistant also helps her with groceries and other daily tasks such as housekeeping, she said, tending to her 21 hours a week.

“I was in need of a lot of help,” Martinez said in Spanish.

As budget cuts squeeze the state, California could yank such assistance from elderly, blind or otherwise disabled immigrants who have relied on the state’s In-Home Supportive Services program.

IHSS pays assistants who help people with daily tasks such as bathing, laundry or cooking; provide needed care such as injections under the direction of a medical professional; and accompany them to and from doctor’s appointments. It aims to help people remain safely in their own homes, rather than having to move into nursing facilities or suffer without needed care.

Gov. Gavin Newsom has proposed cutting immigrants in the country illegally from the IHSS program, estimating it would save California nearly $95 million as the state stares down a $44.9-billion budget deficit.

The proposed cut has outraged groups that advocate for immigrants and disabled people, which argued it would be a shortsighted move that would jeopardize Californians who need day-to-day support, put them at increased risk of deportation and ultimately drive up costs for the state.

READ MORE

Newsom’s proposed spending cuts spur backlash from affected California groups

Just minutes after Gov. Gavin Newsom unveiled a revised state budget with billions of dollars in spending reductions on Friday, advocates for affected programs began showering reporters with statements of dismay.

The gist of the complaints was that after Newsom and the Legislature had devoted attention and money to expanded health care coverage, prekindergarten education, income supports for the poor, undocumented immigrant assistance, homelessness, climate change and a myriad other left-of-center causes, the new budget would punish their recipients.

Building the California Dream Alliance, a consortium of nearly 60 groups, was among those disappointed with Newsom’s budget, issuing a compendium of comments from its members, including the Western Center on Law and Poverty.

“Although we appreciate the governor maintaining previous expansions and grants, his approach balances the budget on the backs of low-income Californians through over $3 billion in cuts,” Linda Nguy, an associate director of the organization, said. “Instead of considering additional revenue solutions, the governor proposes to cut in-home supportive services for people who were previously excluded from Medi-Cal due to their immigration status, deeper CalWORKs cuts, and continued cuts to housing and homelessness prevention programs.”

While Valley Children’s Executives Earn Millions, Community Benefits Lag

March 22, 2024

As news comes out about Valley Children’s Hospital’s high rate of executive pay, an examination of public records reveals the hospital’s community benefit fund lags other children’s hospitals.

The IRS and hospitals have an understanding. In 2020, an estimated $28 billion in taxes were exempted from nonprofit hospitals, according to Kaiser Family Foundation.

Instead of paying millions of dollars in taxes, state and federal governments require nonprofit hospitals to keep a community benefit fund.

The government knows that hospitals take major losses from patients who can’t pay for their services. Hospitals also provide other services pro bono such as education courses and research.

That can cover anything from health education to scholarships to research grants. Most traditional hospitals send a lion’s share of their community benefits to cover hospital bills for those who can’t pay — called charity care and unreimbursed care.

Valley Children Had a 2% Community Benefit Fund in 2022

In 2022, Valley Children’s entire community benefit fund came in just under $17 million, according to its report filed with the California Department of Health Care Access and Information. That was only 2% of the hospital’s expenses.

That same year, Children’s Hospital Los Angeles spent $440 million on its community benefit fund, or 31% of its expenses. Children’s Hospital Orange County’s $143 million community benefit made up 18% of its expenses.

Rady Children’s Hospital in San Diego spent $85.6 million on its 2022 community benefit fund, or 8.8% of expenses.

For comparison purposes, in 2021, Valley Children’s administrative pay exceeded $20 million and CEO Todd Suntrapak made $5.1 million. That same year, Valley Children’s community benefit fell more in line with other hospitals — its $80 million CBF making up 10.32% of expenses.

But in 2020 the CBF was $12.6 million, or 1.83% of expenses.

Vintage Foster, president of AMF Media Group, a third-party representative for Valley Children’s, said the hospital’s benefit fund was in line with other hospitals.

Foster provided community benefit numbers showing the net community benefit was 13.87% of expenses in fiscal 2021 and 9.88% in fiscal 2020. However, those figures didn’t line up with IRS 990 reports or the hospital’s reported community benefit fund.

Questions to Valley Children’s and Foster to clarify these discrepancies were not answered.

Affordable Care Act Doesn’t Cover Everyone: Western Center for Poverty and Law

A majority of hospital community benefits typically go toward unpaid medical debts.

Of the $269 million community benefit fund from Fresno-based Community Health Systems in 2022, $213 million covered what government-funded insurance didn’t, according to the medical group’s report. The hospital system that year also provided $15 million in charity care.

Children’s hospitals operate differently.

“For Children’s Hospitals, Charity Care trend lower than other hospitals because the percentage of children without health insurance is significantly less than it is for adults,” Foster said.

In contrast, unpaid Medi-Cal costs for Valley Children’s in fiscal year 2022 totaled $85.4 million. Revenue from the California Department of Health Care Service covered the entirety of that cost that year. Charity care totaled $181,952.

But even with the Affordable Care Act, some patients don’t have adequate insurance, said David Kane, an attorney with the Western Center for Poverty and Law.

Western Center and its partners often find patients who should have qualified for charity care.

A Look at Valley Children’s 2022 Community Benefits

Valley Children’s Hospital reported nearly $17 million in community benefit money in fiscal year 2022. (Valley Children’s)
Valley Children’s Hospital reported nearly $17 million in community benefit money in fiscal year 2022. (Valley Children’s)

California law requires access to discounted or even complete coverage for patients making up to 400% of the federal poverty level. In California, that is $4,530 a month for a single person or $9,250 a month for a family of four.

In 2016, St. Agnes requested the amount of required charity care be lessened as more people received insurance and therefore didn’t need the assistance.

Then-Attorney General Xavier Becerra didn’t buy that argument, saying California hospitals’ reported unpaid debt showed an unfilled need in the community. St. Agnes was required to pay out to nonprofits to make up the difference.

Becerra’s office used the hospital-reported “bad debt” as evidence that even federally mandated insurance wasn’t enough to provide for the needs of the community.

In fiscal 2021, Valley Children’s reported $3.7 million in unpaid medical debt, issuing only $181,952 in charity care, or 5% of unpaid medical debt.

Rady Children’s Hospital reported $17.6 million in unpaid debt on its IRS Form 990. But the charity care it reported topped $3.2 million, or 18%.

Of the four California children’s hospitals examined by GV Wire, Valley Children’s was second in charity care.

In 2021, Children’s Hospital of Orange County reported only $52,716 in charity care and $28.8 million in bad debt.

Children’s Hospital of Los Angeles reported $175,661 in charity care and $36.3 million in bad debt.

Hospitals Don’t Receive Much Oversight Into Charity Care: Kaiser Family Foundation

State and federal governments give nonprofit hospitals a lot of leniency for how they spend the money they would otherwise pay to the IRS. But not total leniency.

Kaiser Family Foundation in 2022 reported that “it is possible that some nonprofit hospitals may not expect significant oversight of their charity care practices from government regulators.”

When patients receive their medical bills, hospitals are supposed to inform patients of applications for charity care, said Kane, the attorney with Western Center Poverty and Law. Kane did not speak about Valley Children’s specifically.

He says charity care programs break down because hospitals aren’t incentivized to inform people of their options.

“It’s not because they don’t have the funding available to provide assistance to people who need it. It’s simply because they haven’t implemented the rules properly to screen people, evaluate them, tell them about, those sorts of things,” Kane said.

And hospitals will actively pursue debt collection on patients who may qualify for charity care. Questions about how many Valley Children’s bills have been sold to debt collection agencies went unanswered by the hospital.

A court search in Fresno and Madera counties for two known local medical debt collection agencies did not show legal action on medical bills originating from Valley Children’s.

“There is still a problem with some hospitals not providing this assistance to people who still need it today,” Kane said.

How Does Valley Children’s Spend Its Community Benefit?

Valley Children’s Community Health Needs Assessment identified access to health care and economic insecurity as two of the greatest barriers to healthy living for the community it serves.

Valley Children’s put $11.2 million toward education and research and $5.4 million toward health education, community health improvement, and other non-billing expenditures.

Valley Children’s spokesperson Zara Arboleda said the money for education supports significant training and education to more than 900 physician residents, medical students, and other health profession students —including nurses, pharmacists, social workers, physical therapists, speech therapists, and others.

The hospital also provides education to community-based providers including private practice physicians and school nurses.

“A significant portion of those funds are needed to have the personnel in place to teach future workforce members and to conduct research,” Arboleda said.

Valley Children’s staff and doctors provide education.

Using cumulative IRS 990 data from 2019 to 2021, Valley Children’s spent the least amount on benefits compared to Rady Children’s and the L.A. and Orange County children’s hospitals.

The $38.9 million spent on benefits such as community health improvement services, education for health professionals, and research only accounted for 1.82% of Valley Children’s expenses for those three years.

Valley Children’s did spend the most of the four hospitals in one area — donations to eligible nonprofits. The two biggest donations were $2.8 million to Valley Children’s Medical Group and $1 million to Valley Children’s Healthcare in 2021.

LA Street Vendors Trial Postponed: What Comes Next

Signs, people, various stands and a red food truck line a city sidewalk.Fruit and hot dog vendor Edgar Suy, center, protests on Hollywood Boulevard against the city’s no-vending zones. His sign reads “Just laws regardless of race and color.”
(Leslie Berestein Rojas/LAist)

No trial. At least for now as street vendors involved in a lawsuit against the city of Los Angeles are trying to reach a settlement. The trial was scheduled to begin on Thursday.

Last week, the L.A. City Council voted to do away with no-vending zones. Seven of eight no-vending zones are now OK for vendors to work in. The eighth one in Venice Beach will continue to have restrictions that ban street vending unless it’s tied to first amendment rights.

The street vendors are seeking the reimbursement of any citations paid where the citation was issued for vending in the no-vending zones. They are also asking the city to do away with remaining 500-foot buffer no-vending zones that can be set up around schools, farmers’ markets, and swap meets.

“We hope to reach a resolution on the other regulations we challenge in the lawsuit (mainly the 500-foot buffer zones around schools, swap meets, farmers markets, etc.) and erasure of all of the citations issued for violating these regulations and the no vending zone regulations,” an attorney for the plaintiffs said.

Sidewalk vending was legalized citywide four years ago, but the no-vending zones remained in place until last week.

The lawsuit alleges that no-vending zones conflict with SB 946, the 2018 California law that decriminalized street vending.

Attorney Katie McKeon of Public Counsel, one of the attorneys representing the vendors, said according to the law, “you need to have an objective health, safety or welfare concern that justifies those restrictions or bans. The city has failed to provide any real justification or evidence justifying these bans.”

If no resolution is reached, the trial will continue starting on April 4.

A crowd of people on a city sidewalk hold brightly colored protest signs. Street vendors protesting on Hollywood Boulevard. The blue sign reads, “We are vendors, not criminals” and the orange sign reads, “No barriers to street vending.”
(Leslie Berestein Rojas /  LAist)

On the county level, L.A. County supervisors gave a unanimous final nod last week to two measures that will take effect in early March. The county is not involved in the lawsuit.

One measure applies to street food vendors under the auspices of the county health department, who for years have had trouble obtaining needed county health permits. Until recently, the state’s retail food code was geared toward larger mobile food operations, like food trucks, and not small carts. Health permit fees for these street vendors will range from $309 for “low-risk” vendors selling packaged foods to $1,186 for “high-risk” vendors preparing and selling hot food items. To that end, supervisors approved a related motion from Supervisor Hilda Solis that would make low-income street vendors in unincorporated county areas eligible for a 75% fee subsidy.

The board also voted on a formal plan to regulate street vendors in unincorporated areas. Unlike in the city of Los Angeles, the county so far has not had an official program with which to regulate street vendors in unincorporated county zones, like busy East L.A. The ordinance sets official rules for these vendors, including a $604 annual registration fee. This fee would be subsidized the first year by the county’s Department of Economic Opportunity, and partially subsidized after that.

California should enact reparations to atone for the legacy of slavery. Here’s why / Opinion

UPDATED FEBRUARY 29, 2024 1:47 PM

Too often, conversations over reparations jump straight to the bottom line: Who should be compensated? How much should they be paid? And who pays? But to get the answers to those questions, we must first create a political environment in which reparations are recognized as a moral necessity. That starts with telling a new and authentic story: Why do we need reparations? What are we trying to repair? And how do we all stand to benefit? Indeed, one reason there is now a need for reparations is that throughout our nation’s history, we have been told a false story — one that demonizes Black people in an attempt to justify not only the slave trade, political disenfranchisement and unspeakable horrors committed against Black people, but that continues placing barriers to opportunity and full participation in our society. Through media, books, popular culture and religion, people in power have utilized tropes and stereotypes to relay a message that Black people are less than and deny our full humanity. OPINION We can’t take California where it needs to go if we don’t understand where it’s been. CALIFORNIA’S HISTORIC RECKONING An important step in making reparations fully viable is to develop a curriculum for our public schools that provides students with an accurate historical account of state-sanctioned discrimination and its vestiges, as well as anti-Blackness that continues to impact current systems, policies, practices and outcomes. No shortage of resources can inform this curriculum — from the new documentary “Stamped from the Beginning,” to The 1619 Project Curriculum, to The California Reparations Report, which delves into historical issues like slavery, racial terror, housing segregation and environmental racism. At a moment when conservatives are censoring educators because they fear the impact of honesty, California can play a leading role in declaring that we actually can handle — and benefit from — the truth. This historic accounting must not be limited to classrooms but also explored in our local and state legislatures, houses of worship and other venues where we gather as a community. We must also tend to our public memory with monuments that mark the sins of our past to both educate and declare that these sins will not be repeated. OUR OWN FORGOTTEN HISTORY In California, examples of forgotten or buried history include a majority-Black neighborhood in Palm Springs that was destroyed as families were forced out through eviction, demolition or the burning of their homes in the 1960s. In 1945, Black refrigerator engineer O’Day Short, his wife, Helen, and their 7-year-old daughter and 9-year-old son were murdered just two weeks after police and a vigilante group threatened them for moving into the white neighborhood of Fontana. KKK violence through the 1960s included cross-burnings in Los Angeles, Anaheim and Riverside; more than 100 cases of violence in Kern County in 1922 alone; and the cross-burning and stoning of a Black family’s home in a white Bay Area neighborhood. These and other acts of systemic violence and their repercussions must not be ignored or glossed over.

As we shine a light on our history, we should also take immediate steps to pay reparations now. Willa and Charles Bruce owned a popular lodge, cafe and dance hall on what became known as Bruce’s Beach. In 1924, after several other Black families moved into the neighborhood — and after the KKK failed to drive them out of town — the city of Manhattan Beach, California used eminent domain to destroy the neighborhood, stealing more than two dozen properties. The California Legislature and Gov. Gavin Newsom acted to return the Bruce’s property to their descendants. We hope this will be a precedent-setting act of how we can repair the denial of generational wealth to Black families. Anthony Bruce, center, holds up the property deed to Bruce’s Beach in 2022 as his wife, Sandra, second from right; Kavon Ward, with the Justice for Bruce’s Beach movement, far right; and state and county officials cheer. A unanimous bill passed by the California Legislature cleared the way for the property’s return to descendants of a Black couple that had been driven out of Manhattan Beach in the 1920s. Christina House Los Angeles Times file/TNS GLOBAL EXAMPLES We can also look at the examples of the truth and reconciliation commissions in South Africa and Rwanda to help inform our effort to develop a shared understanding of why reparations are needed and just. In South Africa, one commission investigated “gross human rights violations” under the apartheid regime; developed compensation recommendations for the victims of those abuses; and determined which perpetrators received amnesty in exchange for “full disclosure of all relevant facts” (1,200 individuals were granted amnesty and 5,000 were denied). Following the 1994 Rwandan Genocide, where an estimated 800,000 people were massacred in just 100 days, many Rwandans have participated in The National Unity and Reconciliation Commission’s peace education programs, which examine the origins of division, work to overcome “mutual fear and suspicion” and promote unity. The commission offers age-appropriate curricula for all Rwandans which teach the pursuit of national reconciliation and tasks graduates with training others, and dialogue groups focus on reconciliation and “shared citizenship” between people with diverse identities. THE TIME TO ACT IS NOW We need not wait to take laws off the books that continue to do systemic harm to Black people. The California Task Force offers dozens of policy reforms to end discriminatory harm and suffering, including repealing three-strike sentencing; eliminating legal protections for peace officers who violate civil or constitutional rights; repealing Proposition 209, which prohibits the consideration of race in public education, employment and contracting; removing barrier of proving identity to vote; eliminating barriers to licensure for people with criminal records; eliminating or reducing charges for phone calls within detention centers; repealing crime-free housing policies that ban renting to individuals with a criminal history; and extending the right to vote to people currently incarcerated. As we learn about our shared history, it becomes increasingly clear that reparations are really about repairing our social fabric and shared humanity, and recognizing Black people as equal. We must ensure that we do not repeat past mistakes, compensate for what was lost and reduce barriers to participation — unlocking the potential of a population that has been barred from full participation for 400 years. Michael Tubbs is the founder of End Poverty in California, a senior fellow for the Rosenberg Foundation and a special advisor to Gov. Gavin Newsom. Crystal D. Crawford is executive director of the Western Center on Law & Poverty. Joseph Tomás Mckellar, who also contributed to this piece, is executive director of PICO California, the state’s largest multi-faith, multi-racial community organizing network.

This story was originally published February 29, 2024, 5:00 AM.

 

Fact check: Do all San Diego housing agencies see state tenant protection laws as irrelevant?

February 16, 2024

During a public meeting last November, a top elected official asked the San Diego Housing Commission to explain the findings of an inewsource investigation.

The Housing Commission, which is responsible for managing roughly $300 million in federal Section 8 housing vouchers to help low-income tenants pay rent, is required to ensure rent increases are reasonable before using taxpayer money to pay for them. But officials were approving rent hikes without checking if they exceed the cap in state law, the investigation revealed.

Jeff Davis, the Commission’s then-interim CEO, told elected leaders in that meeting the agency doesn’t think the state’s law protects voucher holders. He said all six public housing agencies in San Diego County, as well as “many, many other California housing authorities,” have been operating the same way.

But that’s not accurate.

Officials with three other public housing agencies — in Carlsbad, Encinitas and National City — say they have been checking to ensure landlords are following the state’s law, the California Tenant Protection Act, which took effect in 2020. The law sets a 10% maximum cap on rent increases within a 12-month period. Some properties are exempt, such as mobile homes, new developments and some single-family homes.

When asked by inewsource, officials with all three agencies said they review the housing characteristics each time a property owner wants to raise the rent on a tenant with a Section 8 voucher. Nonexempt properties are held to the state’s 10% maximum cap, they said.

Carlos Aguirre, director of the National City Housing Authority, said the Tenant Protection Act is a tool to keep rents reasonable. Not complying impacts the overall housing market as well as the agency’s ability to help low-income tenants pay rent.

“There’s an upward pressure on rents,” Aguirre said, adding that landlords are in the market of making a return on their investment. “So that’s a tool for us to make sure that our rents are not increasing to a point where there’s not even a market for Section 8 vouchers in National City.”

Officials with the San Diego Housing Commission, which serves 17,000 families as the region’s largest public housing agency, have viewed the law differently.

They have said they don’t have the authority to limit rent increases for tenants receiving federal assistance. Meanwhile, a pending lawsuit aims to force the agency’s compliance with state law and claw back any public money that was illegally paid to private landlords. The Housing Commission has since announced plans to cap rent hikes for voucher holders, instead billing it as a change in agency policy. But they say that change can’t take effect without approval from the U.S. Department of Housing and Urban Development, which oversees the Section 8 program.

Alternatively, officials in Carlsbad and National City started enforcing the law without approval from HUD. Officials in Oceanside and the county have also recently taken the same steps without HUD approval. inewsource is awaiting Encinitas’ response to the same question.

“Most housing authorities across the state at this point are complying” with state law, said Madeline Howard, a senior attorney with Western Center on Law and Poverty. “So, to the extent that San Diego is saying everybody else is doing a bad job, that’s not true.”

Residential and commercial buildings in National City are shown on, Feb. 14, 2024. (Zoë Meyers/inewsource)

‘That affects the local market.’

Public housing agencies are responsible for managing the federal Section 8 program — one of the most significant safety nets for low-income residents anywhere in the U.S. — and are required to ensure rent increases are in line with the market and adhere to applicable laws.

But when the California Tenant Protection Act took effect in 2020, it set off a yearslong legal debate about whether those state protections extend to federal voucher holders.

Conflicting interpretations of law in state government

In an attempt to settle the debate last summer, California Attorney General Rob Bonta sent a letter to every public housing agency in the state. He said the law clearly protects voucher holders and warned officials to stop approving unlawful rent increases on low-income families the federal program was intended to protect.

Aguirre, the director in National City, said he had no doubt that the Tenant Protection Act applies to Section 8 voucher holders. National City’s housing agency has taken that stance since the law took effect in 2020.

The agency even has a form letter it sends property owners to remind them of the law, informing them of notice requirements and outlining the state’s 10% cap on increases.

“It’s the law,” he said. “They have to abide by it.”

Comparing the cities

The housing authorities in Carlsbad, Encinitas and National City are much smaller, serving far fewer low-income families — about 1,700 combined, a fraction compared to the 17,000 families served in San Diego.

Some properties are exempt from state law, such as mobile homes, new developments and some single-family homes. But in late 2022, National City passed an ordinance extending the state’s cap to include mobile home parks, following complaints from residents.

The National City Housing Authority uses roughly $13 million every year in Section 8 housing vouchers to help about 1,100 low-income families pay rent. Aguirre said almost every landlord in the program asks to raise the rent every year, and six people are tasked with reviewing those requests.

And when a request comes in, Aguirre said his team checks every time whether a property is exempt to ensure compliance with state law before approving it.

“Every Section 8 housing specialist (in National City) is well aware of those exemptions, and our Section 8 manager as well,” Aguirre said, adding that following the law plays an important role in slowing the rise in rent. “If we didn’t call attention to it, then we have this upward pressure that affects the local market.”

Officials in Carlsbad say they have taken the same approach — at least since late 2021, when the agency’s current leadership took over, said Christian Gutierrez, housing services manager.

Carlsbad Village is shown on Feb. 14, 2024. (Zoë Meyers/inewsource) Credit: Zoë Meyers/inewsource

Carlsbad’s housing authority is about half the size of National City’s, serving roughly 500 low-income households with about $8 million to spend every year in federal vouchers. Two people are responsible for reviewing rent increase requests, Gutierrez said.

Any time a landlord wants to raise the rent, officials start by checking the math on any increases over the past 12 months. They also check housing characteristics to see if the property is exempt only if the proposed increase exceeds the state’s 10% cap, Gutierrez said.

Housing officials in Encinitas didn’t start checking compliance until after they received Bonta’s letter last June, according to city spokesperson Lois Yum.

The Encinitas Housing Authority gives out about $1.3 million every year in federal housing vouchers to help roughly 100 households pay rent.

Between January 2020 and November 2023, records show nearly one out of every 12 rent increases for Section 8 voucher holders living in Encinitas exceeded the state’s cap. A couple increases were as high as 35%.

But officials said they took immediate steps to ensure compliance after Bonta’s letter, Yum said. They developed a tool to check the percentage for each increase and started checking housing characteristics to see if the property was exempt.

And for all of the increases that already exceeded the state’s cap, Yum said they have since been adjusted to bring everyone in compliance.

New eligibility rules mean nearly 2 million on Medi-Cal can now save for a rainy day.

FEB. 14, 2024 3 AM PT

Millions of Medi-Cal beneficiaries can now save for a rainy day, keep an inheritance, or hold on to a modest nest egg without losing coverage, thanks to an eligibility change phased in over the past year and a half.

The change also has opened the door for thousands who previously did not qualify for Medi-Cal, the health insurance program for low-income residents that covers over one-third of California’s population.

Until Jan. 1, 3 million Medi-Cal beneficiaries — mainly those who are aged, blind, disabled, in long-term care or in the federal Supplemental Security Income program — faced limits on the value of financial accounts and personal property they could hold and still qualify for coverage. Now, nearly 2 million of them will no longer face these restrictions, putting them on par with the roughly 12 million other Medi-Cal beneficiaries who don’t have asset limits.

They still must be below Medi-Cal’s income threshold, which for most enrollees is currently $1,677 a month for a single adult and $3,450 for a family of four. However, the change will eliminate a lot of paperwork for applicants and the county workers who verify their eligibility.

For a long time, this group of Medi-Cal beneficiaries could have no more than $2,000 in the bank — $3,000 for a married couple — though the home they lived in, as well as one car and certain types of other personal property, were exempt.

“If you had $5,000 in assets, you would have to spend $3,000 on something to prove that you were beneath the limit to qualify,” said Tiffany Huyenh-Cho, a senior attorney at the advocacy group Justice in Aging. “We had people who prepaid rent, spent money on car repairs, bought a new couch or appliances — things to reduce their assets in order to get to the $2,000 limit.”

Now, Huyenh-Cho adds, “you don’t have to remain in deep poverty. You can save for an emergency; you can save for retirement or for a security deposit if you want to move.”

And those who have hoped to leave a little something for their children when they die can now do so, even if they need expensive long-term care.

The first phase of the rule change was implemented in July 2022, when the threshold was raised dramatically to $130,000 for an individual and $195,000 for a two-person household. That was a nonfactor for the vast majority of those concerned; after all, most people with incomes low enough to qualify for Medi-Cal would not have that much saved. For this reason, the total elimination of the so-called asset test ushered in this year is expected to help fewer people financially than the first change did.

Still, there are some people with more than $130,000 in the bank whose savings would have been wiped out in shockingly short order had they needed long-term care in a nursing facility or at home. Now, they can qualify to have Medi-Cal pick up that cost.

Dr. Joanne Shinozaki, a resident of Granada Hills, hired private full-time caregiving last year for her mother, Fujiko, who has dementia. But it cost nearly $11,000 a month, which Shinozaki quickly realized would burn fast through the roughly $200,000 in savings her father had left when he died early last year. Reluctantly, she put her mom in a memory care home, which was less expensive. But after a 10% increase in January, it is now costing $9,000 a month, although that includes food and utilities.

Fujiko Shinozaki, who has dementia, at a memory care home in Agoura Hills.
Fujiko Shinozaki, who has dementia, is currently in a memory care home in Agoura Hills. Thanks to a change in eligibility rules that took effect Jan. 1, she may now qualify for Medi-Cal despite a nest egg her husband left when he died last year.
(Joanne Shinozaki)

Because of the money Shinozaki’s dad left, her mom did not qualify for Medi-Cal under the old rules. Now that money no longer counts against her.

Shinozaki, a veterinarian who quit her job to coordinate her mother’s care, needs to return to work soon. She has applied for Medi-Cal for her mom and is waiting for it to be approved.

“It would mean being able to bring her back to the house where she’s lived since 1988, if she’s well enough to come home,” Shinozaki says. To do that, she will need to get her mom access to caregivers via Medi-Cal’s In-Home Supportive Services program.

Indeed, another benefit of the change in eligibility rules is that it supports the caregiver economy, says Kim Selfon, a Medi-Cal and IHSS policy specialist at Bet Tzedek Legal Services, which provides free legal assistance to people in Los Angeles County.

Advocates who work with Medi-Cal enrollees and applicants say they often have to explain the difference between assets and income.

“I think a lot of people are confused,” says Stephanie Fajuri, program director at the Center for Health Care Rights, an L.A.-based nonprofit that helps people navigate Medi-Cal and Medicare. “They say, ‘What do you mean? I could be making $1 million a year?’ And we say, ‘No, that’s income.’”

So, let’s be clear: Under the new rules, yes, you can have a second house. But if you are renting it out, that’s income — and given today’s rental prices, it will probably disqualify you from full Medi-Cal benefits. You can also keep an investment account regardless of the balance, but distributions from it as well as any interest, dividends and capital gains it generates are also income.

Again, most beneficiaries are unlikely to have a large pool of assets and still have income low enough to qualify for Medi-Cal. But if you suddenly inherit a modest sum — or even a large one — now you can keep it, though it may briefly affect your coverage.

Unfortunately, the 1.1 million Medi-Cal beneficiaries receiving Supplemental Security Income are still subject to an asset test, because different rules apply to them.

Attorney General Bonta, California Legislative Black Caucus Introduce Legislation to Reduce Black Maternal Mortality Through Implicit Bias Training

Monday, February 12, 2024

OAKLAND – California Attorney General Rob Bonta, Assemblymember Lori Wilson (D-Suisun City), Assemblymember Dr. Akilah Weber (D-La Mesa), and members of the California Legislative Black Caucus, today introduced AB 2319 aimed to reduce the alarming and disproportionate maternal mortality rate of Black women and other pregnant persons of color by ensuring successful implementation of Senate Bill 464 (SB 464) (Mitchell), the California Dignity in Pregnancy and Childbirth Act of 2019 (Act). Today’s legislation builds on the California Department of Justice’s (DOJ) investigation to ensure and better equip healthcare facilities to come into full compliance with the Act, the findings of which were announced in DOJ’s Report on Healthcare Facilities and the California Dignity in Pregnancy and Childbirth Act. After DOJ began their investigation, providers’ rate of compliance improved dramatically from below 17% to over 81%. Although many facilities met the requirements of the Act, there is still work to be done to ensure full compliance.

“It is a tragic reality that race continues to be a factor in maternal health and infant mortality rates not just in California, but across this country,” said Attorney General Rob Bonta. “Together, we have made so much progress, and we must continue to address healthcare bias head-on. Today’s legislation does just that; it is designed to make transformational change in a system that has historically failed our mothers and babies, especially those of color. I want to thank the Legislative Black Caucus who worked tirelessly with us on this important legislation to create healthier outcomes for all Californians.”

“Black women in California face alarming disparities in maternal health outcomes. As a Black Mother and as Chair of the California Legislative Black Caucus, the fight to improve these outcomes is personal to me,” said Assemblywoman Lori D. Wilson (D–Suisun City). “I look forward to collaborating with our Attorney General Rob Bonta, Assemblymember Dr. Akilah Weber and other stakeholders to push this accountability measure across the finish line as we seek to make strides in improving Black maternal health outcomes throughout California.”

“The Black maternal morbidity and mortality rate cannot be explained by income or education levels alone. Data suggests what we know, what mothers have been brave enough to share, there is an embedded implicit bias in the maternal health care they receive. Providers ignore symptoms, ignore concerns to the horrible detriment of birthing women. So, sadly when uninformed care doesn’t result in death, it can still result in traumatic birthing experiences for both mother and child,” said Assemblymember Mia Bonta (D-Oakland), who is the newest Chair to the Assembly Health Committee. “California has been proactive in taking the steps to address this bias, but gaps in the process still exist. I am excited to partner with Assemblymember Wilson to address those shortcomings and ensure California is providing high quality healthcare for all women and birthing people so that everyone’s birthing experience concludes in a safe and healthy birth.”

“I stand in full support as a proud principal co-author of the collaborative efforts between the Attorney General and Assemblymember Wilson, Chair of the California Legislative Black Caucus, to fortify the implementation of SB 464, known as the California Dignity in Pregnancy and Childbirth Act,” said Assemblymember Mike A. Gipson (D-Carson). “This measure is fundamental in safeguarding the health and dignity of expectant mothers and their newborns. It is imperative that we redouble our efforts to uphold the principles of dignity and equity in pregnancy and childbirth. Together we can eradicate disparities in maternal care and promote equitable access to quality healthcare for all Californians.”

“California is failing its Black mothers. We have an obligation and moral duty to correct this grave injustice in California’s maternal healthcare. We owe it to our Black mothers to rectify the injustice causing alarming pregnancy-related deaths,” said Assemblymember Dr. Corey A. Jackson (D-Moreno Valley). “I am proud to support Attorney General Rob Bonta and Assemblymember Wilson for continuing this fight against bias and injustice in our healthcare settings. We must meet this moment and solve this issue immediately because lives are literally at stake.”

“The California Dignity in Pregnancy and Childbirth Act was driven by concerns over racial disparities in health care, and the black maternal morbidity and mortality crisis,” said Sandra Poole, Policy Advocate at Western Center on Law & Poverty. “The Act required evidence-based implicit bias training in the healthcare system to address this major factor in racial disparities.  Western Center on Law and Poverty applauds this legislation which would require full compliance with the Act, authorize penalties against non-compliant healthcare facilities, and ensure that healthcare systems are held accountable for providing care that is accessible to all Californians without structural inequities that are determinants of health outcomes.”

“California is a national leader when it comes to reproductive freedom, and we pride ourselves on having the lowest maternal mortality rate of any state in the country—but we still have tremendous work to do to ensure that all Black women and pregnant people in our state have access to quality, equitable, and unbiased care,” said Shannon Olivieri Hovis, Director at Reproductive Freedom for All California. “As a cosponsor of the original legislation requiring implicit bias training for perinatal providers, Reproductive Freedom for All California is proud to join this bill coalition, led by Attorney General Bonta and authored by Assemblymember Wilson and Dr. Weber. We are grateful to AG Bonta for his commitment to ensuring reproductive freedom for all.”

The United States has the highest maternal mortality rate in the developed world — a burden disproportionately borne by communities of color, especially Black women. In California in particular, Black women make up 5% of those pregnant but account for 21% of the total pregnancy-related deaths. This disparity exists across all income levels. Evidence suggests one key cause of this disparity is the implicit bias of healthcare providers. A provider’s level of bias, whether conscious or unconscious, can influence their interactions with patients and their diagnoses and treatment of the patient’s pain, and can undermine patients’ trust and engagement in care.

In August 2021, as part of an inquiry into whether providers were complying with the law, DOJ’s Healthcare Rights and Access Section (HRA) issued letters to California facilities requesting data on their implicit bias training of employees. Of the 242 responding facilities, 201 had not completed or even begun training staff until after receiving DOJ’s letters. Only 41 had begun training their employees in compliance with SB 464, but not a single employee had been fully trained. However, by July 8, 2022, when the investigation concluded, an average of 81.44% of the perinatal care staff in the 242 facilities had completed training.

DOJ’s investigation made clear that setting requirements as part of SB 464 was only the first step to ensuring the training of maternal care providers. Additional steps need to be taken to ensure hospitals and facilities comply with those requirements.

To help reach full compliance and thus help reduce maternal mortality AB 2319 would:

  • Provide clarity on which facilities are mandated to administer anti-bias trainings and which employees need to be trained.
  • Establish firm deadlines by which trainings must be completed to better guide compliance.
  • Confer enforcement powers to the California Department of Public Health and the Attorney General, along with accountability measures.
  • Require compliance data to be posted online so the public is made aware of which facilities have provided anti-bias trainings and which have not.
  • Establish administrative penalties for noncompliant facilities.
  • Add inclusive language to account for nonbinary people and men of transgender experience who also carry children and give birth.

San Diego County starts denying illegal rent increases following inewsource report.

Following an inewsource investigation, the second largest public housing agency in the region says it is, for the first time ever, checking to ensure thousands of low-income tenants have the same protections from excessive rent increases as other California renters.

The San Diego County Housing Authority is now rejecting requests by landlords to raise rent on tenants with a Section 8 housing voucher beyond the state’s 10% maximum cap. The county made the change Dec. 1 to comply with the Tenant Protection Act, a state law that took effect in 2020.

The change, according to the county, was a response to a letter California Attorney General Rob Bonta sent all 96 housing agencies in California last summer. The letter urged officials to stop approving unlawful rent increases on low-income families the federal program was intended to protect.

But the county’s change also came three weeks after an inewsource investigation revealed another agency — the San Diego Housing Commission — has been approving rent hikes for city residents without checking if they exceed the cap in state law. A pending lawsuit filed in November also asks a judge to compel the city’s housing agency to claw back all public funds illegally paid to private landlords.

Officials with the city’s Housing Commission, which serves 17,000 families as the region’s largest public housing agency, contend that the state’s law doesn’t apply to the federal program. Despite taking that stance, officials have since announced plans to cap rent hikes for voucher holders, instead billing it as a change in agency policy. But they say that change can’t take effect without approval from the U.S. Department of Housing and Urban Development, which pays for the Section 8 program.


For perspective:

An individual who lives alone and earns $77,200 or less per year is considered low-income in San Diego. Qualifying residents face up to 15 years on a waitlist for federal housing assistance.


Alternatively, the county changed its policy without approval from HUD. That’s telling, according to an advocacy group suing the city to make the same changes.

“The county took a step in the right direction, which shows the city’s claim about needing HUD approval rings hollow,” said Francine Maxwell, chair of Black Men and Women United San Diego. “There is no reason the city can’t comply with the law.”

Public housing agencies are responsible for managing the federal Section 8 program — one of the most significant safety nets for low-income residents anywhere in the U.S. — and are required to ensure rent increases are reasonable before using taxpayer money to pay for it.

But when the California Tenant Protection Act took effect in 2020, it set off a yearslong legal debate about whether those state protections extend to federal voucher holders.

Conflicting interpretations of law in state government

At the time, officials with the county’s housing authority did not change any policies to check rent increases for compliance and instead told property owners to consult with an attorney to see if the law applies to their units, a county spokesperson said. Tenants who had questions about a rent increase were told to seek help from the Legal Aid Society of San Diego, the largest poverty law firm in San Diego County.

In June, more than three years after the law took effect, Bonta issued his letter insisting that Section 8 voucher holders are protected by state law and urging officials to scrutinize rent increases before approving them for families who can least afford it.

inewsource obtained 107 rent increases the County Housing Authority approved during one week last October. Only 40 showed the original rent and the request, both of which are needed to calculate the increase, and of those, four exceeded the state’s cap.

It’s just a small sample among several thousand requests every year, a snapshot in time, and there’s no way for the public to know whether the rent increases are legal without more data and oversight. It’s possible some of the increases discovered went to properties that are exempt under the Tenant Protection Act, such as mobile homes, new developments and some single-family homes.

The county’s decision to start capping increases at levels set by state law could impact nearly 11,000 families throughout the region who rely on the federal safety net program to pay rent, saving untold millions of dollars in taxpayer money every year.

But some say the county’s move doesn’t go far enough because the agency doesn’t review housing characteristics to determine compliance — that’s data a county spokesperson said the agency doesn’t collect.

County officials instead are relying on a landlord’s word that they have read and understand state law and that their property is exempt. For all other properties, a spokesperson said staff will do the math on rent increase requests and hold those to the 10% cap.

That’s problematic, said Madeline Howard, a senior attorney with Western Center on Law and Poverty, where she works for tenants’ rights and people experiencing homelessness.

“Obviously a landlord could be free to just assert that they’re not covered when they in fact are,” Howard said.

Property owners are already violating the Tenant Protection Act, said Gil Vera, directing attorney with the Legal Aid Society of San Diego.

“It’s not always like a nefarious reason that they’re trying to get around the rent control, but it’s sometimes that they don’t know, especially for smaller landlords,” he said. “So, that is a concern, that someone would self-certify that (the law) doesn’t apply when it does.”