December 2019 – Public Policy Institute of California

Video: A Conversation with Chief Justice of California Tani G. Cantil-Sakauye

Last Thursday, at a lunchtime event in Sacramento, PPIC president Mark Baldassare talked with Tani Cantil-Sakauye, California’s chief justice and the leader of the state’s judicial branch. Their conversation covered a wide range of challenges and opportunities facing the courts today. In particular, Cantil-Sakauye spoke about civic education, the collaborative courts, and the critical importance of self-evaluation in the judicial branch.

Cantil-Sakauye is known for her efforts to make the courts accessible and understandable to all Californians. She became convinced of the need to educate the public about the judicial branch after the state judiciary was hit hard by budget cuts during the Great Recession. Cantil-Sakauye recalled that state legislators responded to her pleas for adequate funding with “quizzical looks” and questions: “‘What agency are you from? . . .Which chief are you?’ . . . And I thought a civics education initiative might be in order!“

She launched an initiative called the Power of Democracy in 2012: “Judges and lawyers, the president of the California Chamber of Commerce, labor unions, and scholars come together to teach civics to K–12 and also adult students.” In her view, helping Californians understand that “the courts exist for you to press your rights” empowers them to advocate for themselves and their communities.

Asked to name her greatest accomplishments, Cantil-Sakauye pointed to collaboration, civility, and problem solving. “The California judiciary is a collaborative, problem-solving entity,” she said. Indeed, California has led the nation in collaborative courts—community-based courts that specialize in issues such as homelessness, landlord-tenant disputes, domestic violence, veterans, or behavioral health. These courts address underlying problems by connecting people to services and programs that can help get their lives on track. As Cantil-Sakauye put it, “The whole point of a collaborative court is to end recidivism.”

The chief justice is especially proud of the judiciary’s willingness to evaluate itself: “We ask ourselves how we’re doing and we’re honest when we’re not doing well.” A case in point is bail reform. Questions about the efficacy and fairness of bail prompted the chief justice to form a committee to study the issue. After looking at the evidence and hearing from a wide range of stakeholders, the committee unanimously recommended the elimination of cash bail “because it does not serve the purpose of protecting the community or ensuring a person’s return to court.”

The bail reform law signed by Jerry Brown last year is being contested—voters will decide its fate in November. But efforts to improve bail and other aspects of the judicial system will continue. As Cantil-Sakauye put it, “More and more, California courts are becoming social justice centers.”

Providing Safe Drinking Water in the Face of Disasters: Lessons from Lake County

Climate change is already affecting water management across the state. Small rural communities with ongoing drinking water challenges are especially vulnerable to greater extremes brought on by a warming climate. We talked to Jan Coppinger, a special district administrator from Lake County, about how the county’s small water systems have dealt with an especially devastating string of natural disasters.

PPIC: Describe Lake County’s recent water challenges.

JAN COPPINGER: The county is predominantly rural, geographically diverse, and home to a number of small, disadvantaged communities and tribes. As towns in the county were developing, they built small, isolated water systems. We now have almost 100 public water systems, and some are barely getting by. The county tried to encourage consolidation of smaller systems into bigger ones in the late 1980s. Two major consolidations took place at that time: one that merged 41 small suppliers to create the North Lakeport water system—which today is one of our strongest, best water systems—and one that combined 15 systems. The county did feasibility studies on other potential consolidations, but these were met with opposition from local communities, so the issue was dropped altogether until recently.

Over the past several years, a string of natural disasters has kept Lake County in a constant state of emergency. It started with a drought, followed by two massive wildfires, which burned more than 60% of our county. The burn scars made the floods of 2017 and 2019 especially devastating. The 2015 Valley Fire destroyed thousands of homes and eight water systems. One small water supplier—Starview Water System—had 151 customers before the fire and only 14 afterward. Following these disasters, consolidation became a way to get some of the devastated water systems back up and running. We have had success with consolidating and rebuilding nine water systems in the Cobb Mountain area in the last couple of years.

PPIC: Consolidation is a big undertaking. What is the most important lesson from Lake County’s efforts?

JC: It’s a very complicated process, and in most cases, outside technical assistance is needed. We have two other areas now looking at consolidation, and we’re having a hard time identifying which of the small water agencies can take the lead in the process. The agencies are willing but they don’t have the managerial or technical capacity. We have gotten support from the State Water Board and non-profit partners like the Rural Community Assistance Corporation (RCAC) to walk them through it. Financial assistance is another barrier, because consolidation can be expensive. The costs really vary. For the Cobb Mountain project, the feasibility study alone cost $250,000. We’re probably talking around $21 million for the entire consolidation. In that case, we had to bring some of the small systems up to code, and repair significant damage from the fire.

PPIC: How can small systems best prepare for natural disasters and climate change?

JC: Building physical connections to other systems and sharing resources is critical. Small systems need a backup supply to handle disasters—and because sometimes even the backup burns, they may need a backup to the backup. For instance, in the aftermath of the Valley Fire, the county invested $1.7 million to rebuild the Starview Water System, and connect it to other small systems in the Cobb Mountain area. The floods in early 2019 took out the roads, the culverts, and the brand new water system we built.

I never dreamed that entire water systems would burn to the ground. When I describe what has happened to small water systems in our area from these disasters, it really opens people’s eyes. Educating the people running these small systems has helped change minds about consolidation, in Lake County and across the state.

Watch a video of Jan Coppinger and other panelists talk about providing safe drinking water in California

For Many Californians, Poverty Is One Minor Expense Away

Add one extra expense and families living just above the poverty line could fall into poverty. Data from the California Poverty Measure (CPM) show that 7.2 million Californians live near poverty, that is, with just enough resources to meet their basic needs. All told, in 2017 as many Californians lived just above the poverty line as below it, or about 18% in each case. Even a small change, a monthly expense of $250 or less, could push 1.6 million people under the line.

We define “near poverty” to mean having resources worth 1 to 1.5 times the poverty threshold after taxes and necessary expenses. Since the CPM accounts for California’s varied living costs, the range for near poverty differs across regions. In Fresno County, a family of four who rents their home and has $25,900 to $38,900 in resources is near poverty, while in Santa Clara County, the same is true of a family of four with $40,000 to $60,000.

Because the poverty line is a blunt standard, “near poverty” includes families earning just a few dollars above the poverty threshold—even though a few dollars are unlikely to make it easier to make ends meet. This makes it especially important to understand how many Californians are near poverty, and how close those near poverty are to falling into it.

Californians can be pushed into poverty by the smallest expenses. Overall, people near poverty are more likely to be pushed into poverty by a small expense than a large expense. As expenses grow, the total number of people threatened climbs. Three out of four people near poverty, or 5.4 million, are pushed into poverty by an extra $1,000.

Near poverty affects young people more than it does older Californians, and children under 18 are more likely to be near poverty (23.6%) than in poverty (19.3%). Young adults and seniors, however, are more likely to be in poverty. Regional differences in living costs, opportunity levels, and the impact of existing policies and programs are key factors driving this variation.

Without safety net programs, more people, and in particular, more families with children, would face poverty instead of near poverty: resources from programs including CalFresh and the federal and state Earned Income Tax Credits (EITCs) keep 7.1% of Californians out of poverty. Yet almost all people (93%) who move out of poverty via the safety net move into near poverty. This fact has implications for policymakers’ ongoing efforts to help ensure all Californians can meet their basic needs. As the state works to reduce poverty, strategies that promote economic mobility complement investments in programs like the CalEITC and the new Young Child Tax Credit.

Improving Equity in Mental Health Services

California has seen historic declines in the number of residents without health coverage—since 2014, the state’s uninsured rate has decreased from 17.3% to 10.3% percent among adults younger than 65. Expansions in the Medi-Cal program account for most of this expanded coverage; since 2014 enrollment in Medi-Cal has increased more than 50% and now provides coverage to nearly one-third of Californians. However, many challenges remain to ensure that coverage translates into access, particularly in the area of mental health.

Over one million Californians use the state’s public mental health system, which includes services provided through Medi-Cal managed care plans and county mental health plans. For many patients, the system is difficult to navigate. The fragmented delivery system is part of the issue, but there are also concerns that mental health providers are unable to meet the needs of California’s diverse communities—and those needs are notable. In a recent survey, 11.2% of Latinos were identified as likely to have experienced serious psychological distress during the past year.

The disparities in access for underrepresented communities may be reflected by current utilization patterns of county mental health services. Among adult Medi-Cal enrollees, fewer Latinos and Asian/Pacific Islanders use these services than African Americans and whites.

These disparities are similar nationwide—and are likely to be related to a variety of factors. One possibility is the higher share of Latinos and Asian Americans/Pacific Islanders who may experience language barriers, compared to African Americans and whites.

A primary vehicle for reducing these disparities are Cultural Competence Plans, which are intended to guide county mental health plans in meeting the cultural competence and linguistic requirements already mandated by law. Recent legislation seeking to codify these requirements for county mental health plans did not make it past the governor’s desk. But its advancement through the legislature signals growing recognition of the need for communities of color to have access to culturally and linguistically appropriate mental health services. As California’s population becomes more diverse, culturally competent care will become even more important in the coming years.

Covering the Real Costs of College

Faced with the state’s high cost of living, California college students struggle to secure adequate food and housing. Even amid one of the largest and longest economic expansions in state history, 33% of students are housing insecure and 35% have low or very low food security, according to a California Student Aid Commission survey of 150,000 college students. As the state seeks to meet economic demand by producing more students with degrees and certificates, the full cost of college remains a barrier to progress.

Governor Newsom and the legislature have recognized the need to reform state financial aid programs to address the full cost of college. The 2019–20 state budget provided $41 million in ongoing funding to help colleges address food and housing insecurity, $19 million to support rapid rehousing programs, and increased the number of competitive state grants for non-traditional students from 25,750 to 41,000. Additionally, the legislature increased the maximum award amount that students with children pay for non-tuition college costs from $1,672 to about $6,000.

However, broader reform of the state grant aid program remains elusive. Two recent bills sought to expand eligibility for Cal Grants by eliminating current age, time out of high school, and high school GPA requirements. The bills also sought to provide additional non-tuition aid to community college students and students in career education programs. The bills did not make it to a vote; however, they will be re-examined in the next legislative session. Estimated at $2 billion per year, proposed reforms would nearly double the annual cost of the program.

Consequently, the California Student Aid Commission, the agency that distributes financial aid, intends to streamline these proposals to constrain costs while increasing access. Higher education is a vital tool that increases economic and social mobility; ensuring all students have equal access to an affordable education is paramount to modernizing California’s economy. An equitable and financially viable approach to financial aid will be critical if the state’s booming economy slows in coming years.

Better Data for Better California Health Policy

For over a decade, California lawmakers have tried to establish a comprehensive resource on health care costs. Yet a dearth of information still persists among consumers, purchasers, and policymakers. To address this problem, recent legislation allocated $60 million to develop a health care payments database (HPD) for the state. The California Office of Statewide Health Planning and Development (OSHPD) and a stakeholder review committee have held monthly public meetings since March 2019 to guide development.

PPIC is supporting the effort in key ways, in part by describing how an HPD can answer important questions and inform policy decisions. At the November 21 OSHPD Healthcare Payments Data Review Committee, we presented research scenarios that highlight issues facing California policymakers:

How often do patients overpay for prescription drugs?
How does increasing consolidation of health care providers (i.e., hospitals acquiring physician practices) impact costs, quality, and patient outcomes?
What types of housing interventions are most effective for low-income Californians with severe mental illness?
How often do children transition between different types of health insurance coverage and how does it impact their use of preventive services?

We will release our detailed findings in February – including full results from our online survey of California researchers experienced with health care payments data. A sneak peek indicates that these researchers are very enthusiastic about an HPD. Nearly all 50 respondents reported they would likely submit proposals to use the database to investigate topics including: how health care policies impact health outcomes, implications of racial/ethnic disparities and the social determinants of health, as well as health care costs and usage patterns. Researchers also indicated willingness to pay user fees to access the data—an important consideration given that the HPD must be self-sustaining (i.e., not require General Fund support) once in operation.

Several other states operate health care payment databases (often called an All Payer Claims Database or APCD) that support health policy and practice, along with patient decision making. On Colorado’s database, the public can search for prices of common health care services—such as breast biopsies and ultrasounds—across different providers. It also documents how health conditions (i.e., asthma and diabetes) vary over time and across regions, types of insurance, and age groups.

For California’s HPD to be realized, the legislature must act on recommendations from OSHPD and the HPD review committee, due in July 2020. While many hurdles still remain before a California HPD is in operation, substantial investments to support current efforts signal a commitment from the state and stakeholders. By creating the database, the state gains a crucial resource to support evidence-based policymaking. Along with parallel efforts—including the development of a longitudinal database to track student and employment outcomes—California can be one step closer to having the right data to study the state’s most pressing policy issues.

Video: A Path Forward for California’s Freshwater Ecosystems

“The current approach for ecosystem management is not working. We’re proposing an alternative path,” said Jeff Mount, senior fellow at the PPIC Water Policy Center, at a public briefing in Sacramento last week. He described two ways the current path is failing: in preserving the broad economic and social benefits associated with healthy ecosystems and in reversing the long-term downward trend in native biodiversity and ecosystem conditions. “The Endangered Species Act misses all that. It’s emergency room treatment” of a chronic problem, he added.

The event launched a new report that proposes managing more broadly for ecosystem health while still protecting species at risk of extinction. “We need diverse, complex, and varied ecosystems to recover species,” he noted.

A panel of experts brought real-world experience to the discussion. Panelists have worked on a plan to protect habitats for multiple species in the Upper Santa Ana watershed, a program to restore the San Joaquin River, and the effort to remove dams on the Klamath River, among others.

Heather Dyer, an endangered species biologist with the San Bernardino water district, said that in the Upper Santa Ana watershed, a large group of stakeholders is seeking to “reestablish a community of species” rather than solely focusing on one or two endangered species. She noted that improving the health of ecosystems requires planning at larger scales—and with the full landscape of regulators and stakeholders coming together to work things out.

Ali Forsythe of the Sites Reservoir Project noted that the hardest lift for large-scale projects is building trust among diverse stakeholders—especially when the project has had a long history of litigation behind it, as the San Joaquin River restoration did.

Lester Snow, now with the Klamath River Renewal Corporation, raised the issue of urgency for improving the health of the state’s freshwater ecosystems. Noting that the Klamath dam removal is already at the 13-year point with the four dams still standing, he said, “It’s these lead times that I think are killing us. Climate change and the change of our natural resource system are moving faster than we’re responding,” with grave implications for water supply reliability and ecosystem health. “We cannot have two decades of litigation and negotiation to address a problem that is critical today.”

We invite you to watch the event video.

The Democratic Presidential Primary: What Do Californians Care About?

Mark Baldassare, PPIC president and CEO, and director of the PPIC Statewide Survey, participated in a panel on election issues at the Pacific Chapter of the American Association of Public Opinion Research meeting on December 6, 2019 in San Francisco. This post is excerpted from his prepared remarks.

Californians are turning their attention to the March 3 Super Tuesday primary as they play a new role in deciding the next Democratic presidential nominee. This is unfamiliar territory for California’s Democratic primary voters, who have become accustomed to casting ballots in June after other states have already determined the winner of their party’s presidential sweepstakes.

The 2019 PPIC surveys have consistently identified three frontrunners—Joe Biden, Bernie Sanders, and Elizabeth Warren—with no clear favorite. At the same time, likely voters have signaled an openness to considering alternatives. In this context, the debates loom large, and eight in ten likely voters in the September PPIC survey say they are important (41% very, 43% somewhat) in deciding their vote.

What do California’s Democratic primary likely voters most want to hear from the candidates as the stage is being set for a December 19 Democratic debate in Los Angeles? In an open-ended question in the November PPIC survey, the top four issues mentioned are health care (21%), the environment (14%), jobs and the economy (13%), and immigration (12%). Several other issues—such as education, homelessness, housing affordability, gun control, crime, and taxes—are each mentioned by less than one in ten likely voters.

Across demographic groups, likely voters differ on the issues that matter the most. For instance, voters age 45 and older want to hear about health care more often than younger voters do (26% to 13%), while Latinos want to hear about immigration more often than whites do (24% to 5%), and whites want to hear about the environment more often than Latinos do (23% to 4%). Jobs and the economy is the only top issue generating a similar amount of interest across age, education, gender, income, race/ethnic, and regional groups.

The issues of greatest concern also vary according to candidate preference. Biden’s supporters name health care more often (25%), Warren’s supporters mention the environment more often (26%), and Sander’s supporters name immigration more often (22%). By contrast, supporters of the three leading candidates are similarly likely to mention jobs and the economy (13% Sanders, 11% Biden, 7% Warren).

One area of strong consensus? Views of President Trump. In the November PPIC survey, 91% of California Democratic primary likely voters say they disapprove of President Trump and 84% support his impeachment and removal from office.

When asked what’s more important, nominating a candidate who seems most likely to defeat Trump or one whose positions on issues are closest to theirs, 55% want to defeat Trump, while 36% want alignment on positions. Since the May PPIC survey, support for impeachment (65% to 84%) and the importance of nominating an electable candidate (48% to 55%) has risen.

Those who say that electability is most important, compared with those who say policy positions are most important, are more likely to mention health care (25% to 15%) and less likely to name immigration (7% to 18%) as the issue that they most want to hear about in the presidential debates. We find no differences between these two voter groups in the mention of the environment or jobs and the economy. Interestingly, education (11% to 2%) is noted more often among those who say that alignment on the issues is more important to them.

The Los Angeles debate is the next big opportunity for the presidential candidates to connect with California voters whose preferences are still being formed. Many Democratic primary likely voters already report that they are closely following the election news, but the debate could still result in an expanded electorate—and a scrambling of the race—if candidates connect with voters on issues that matter the most to them.

Throughout 2020, PPIC surveys will be monitoring what is likely to be an historic year for voter participation, as Californians engage in a consequential primary and a highly anticipated general election.

Commentary: California Must Stop Relying on the Endangered Species Act to Manage the Environment

This commentary was published on CalMatters on November 5, 2019.

In California, state and federal Endangered Species Acts play an important and often outsized role in regulating water and land management. These powerful laws are also often at the center of conflicts between environmental and economic uses of water.

The state and federal acts have helped prevent the extinction of species and encourage better stewardship of water and the environment. But endangered species protection is often used as a proxy for protecting the environment, something the act are not intended to do. Here’s why we need a better tool.

Under the endangered species acts, state and federal agencies narrowly target regulations to protect listed species from direct harm and loss of critical habitat.

To illustrate, the recent dust-up between the Newsom and Trump administrations over proposed increases in water diversions from the Sacramento-San Joaquin Delta is mostly about actions affecting two endangered fish: Delta smelt and winter-run Chinook salmon.

This narrow focus ignores the fact that it is the ecosystems of the Delta watershed, and the diverse array of social, economic, and environmental benefits, that provide value to all Californians.

But given the narrow mandates of the acts, the arguments and lawsuits tend to focus on just one aspect of these ecosystems: the trade-offs between endangered species and water extraction.

To be clear, society places great value on native biodiversity and rightfully seeks to prevent extinctions. For many, protection of threatened or endangered species is a way to leverage improvements in the overall health of ecosystems.

Unfortunately, that is beyond the scope of the state and federal acts.

To promote healthy ecosystems and protect native biodiversity, California needs a different approach.

A new report by the Public Policy Institute of California’s Water Policy Center recommends that California adopt ecosystem-based management. This doesn’t require major reforms to state or federal endangered species acts. Rather, we recommend a shift in the way these acts are implemented.

Widely used in other countries and in marine fisheries and forest management in the United States, ecosystem-based management emphasizes improving ecosystem condition. The goal is to simultaneously protect native biodiversity while improving other uses of freshwater ecosystems.

It integrates human needs such as water supply and quality, flood risk reduction, hydropower, recreation, and spiritual uses into management objectives and promotes actions that create multiple benefits.

Importantly, this approach is consistent with the acts and other state and federal laws that govern water management. A growing body of research suggests that managing at the ecosystem level, rather than emphasizing the protection of a narrow range of habitat deemed critical, improves the likelihood of recovery of listed species. It also helps head off future endangered species act listings by improving conditions for all native species.

Shifting away from single-species to ecosystem-based management will not be easy. It requires three things:

The state needs to rethink planning and governance processes to include all beneficiaries of freshwater ecosystems, not just advocates for water supply and endangered fish. This includes finding new ways to align agency priorities and permitting rules—now a major obstacle to ecosystem improvement projects.
The state needs to use new tools that go beyond traditional regulatory approaches for environmental water, such as setting minimum flow and water quality standards. One promising approach is to create ecosystem water budgets, which can be stored and traded like a priority water right. This water can be flexibly allocated to improve ecosystem condition, and managed along with habitat changes to maximize benefits.
The state needs to incentivize and institutionalize ecosystem-based management. Given its broad water quality and water right authorities, and its mandate to balance all uses of water, the State Water Board should take the lead.

The board would set the criteria for ecosystem-based management plans and incorporate them into water quality control plans. Where possible, these plans would be supported by negotiated agreements between regulatory agencies, water users, and stakeholder communities.

We don’t need to start from scratch. Elements of ecosystem-based management are being employed throughout the state. For example, the Delta Stewardship Council and the Central Valley Flood Protection Board have plans to simultaneously improve ecosystem condition and human well-being.

A novel ecosystem-based approach to water and species management is being implemented in the Upper Santa Ana Watershed in Southern California. And the Newsom administration’s efforts to develop voluntary agreements for environmental water allocation in the Central Valley take a broad approach to improve ecosystem health.

These nascent efforts are not enough. Changing course will require commitment to new ways of planning and managing. Most importantly, it will require risk-taking and leadership from the water users, state and federal officials and legislators.

This won’t be easy. But the alternative is to keep doing what we’ve been doing, which isn’t working for anyone.