2011 California Policy Priorities

2011 California Policy Priorities

Southeast Asian refugees constitute the largest group of refugees to ever resettle in the United States.¹ In the aftermath of the Vietnam War and surrounding atrocities, millions refugees escaping war and persecution in Cambodia, Laos and Vietnam were resettled in the U.S. Today, California is home to the largest Southeast Asian American population in the nation, with a community of over 700,000 who contribute greatly to all facets of California.

The following policy issues are those that the Southeast Asia Resource Action Center (SEARAC), in cooperation with locally based community organizations and leaders across the state, has identified as having significant impact on Southeast Asian American (SEAA) communities. As such, these priorities will serve as a guide for SEARAC’s California policy work in 2011. In addition, as a national organization based out of Washington, DC, SEARAC has also identified national policy priorities which can be found here.

While the following policy priorities and recommendations are tailored to SEAA communities, they are also issues that affect the broader American population and communities across the U.S.

Health Care Reform Implementation

The passage of the Patient Protection and Affordable Care Act (ACA) significantly affects the country’s health care delivery system. Specifically, for Southeast Asian Americans, where nearly 1 in 5 individuals are uninsured,² ACA will improve access to health insurance and preventative care. While ACA made significant changes and improvements to the current health care system, the law requires California and other state governments to play an important role in implementing significant portions of reform—including expanding coverage through Medicaid, establishing a State Health Insurance Exchange market, and training a larger workforce to meet the growing demand for healthcare.

In addition, with the passage of AB 1602 (Perez) and SB 900 (Alquist) in Fall 2010, California became the first state in the country to establish the guidelines for its Health Insurance Exchange. These new provisions create a marketplace for consumers and small businesses to compare and choose health insurance plans suitable to their needs. While the passage of several initial guidelines is a significant step forward in implementing ACA, the success of health care reform will heavily depend on California’s ability to create policies that are accountable to California’s diverse population.

Health Care Reform Implementation Recommendations

• As the State implements AB 1602 & SB 900, the Department of Health Care Services must create tools to help limited-English proficient consumers navigate their health care options under the new Health Insurance Exchange.
• The State should develop concrete strategies to utilize millions of dollars in federal grants for the purpose of developing a culturally and linguistically competent workforce
• More recommendations regarding ACA found below.

Social Programs

In the past two years, Californians have endured dramatic budget cuts to the State’s social programs. Unfortunately, the California budget deficit continues to grow and the risk of further cuts to resources for low income families and elders remains a concern to many Southeast Asian Americans.  Cuts to programs like SSI/SSP, Medi-Cal, the Cash Assistance Program for Immigrants (CAPI), and California Food Assistance Program (CFAP) exacerbate financial burdens and health risks to low-income families, many of whom are on fixed incomes and have no other means of sustenance.

Social Programs Recommendations

• Ensure that further cuts to health and human services programs that aid low-income, disabled and elder populations are limited and among the last programs to be compromised in upcoming budget cycles.
• Policy makers must work collaboratively with community based organizations to ensure that when cuts are unavoidable, programs are carefully amended to limit the negative effects on vulnerable beneficiaries, like the disabled and elderly.

Aging and Long-Term Care  

Many Southeast Asian American elders age with a wide range of challenges and face numerous barriers to attaining quality long term care.  Approximately 90% of SEAA elders aged 65 or older live at home as opposed to institutional alternatives.³ In addition, there are high rates of disability among SEAA elders, many of whom have endured war and trauma. 68% of Cambodian, 71.2% of Hmong, 63.4% of Laotian and 57.5% of Vietnamese American elders in California have a disability.⁴ Because of the high proportion of SEAA elders living at home and their high rates of disability, in-home and community based care policies and programs are essential to maintaining the independence and quality of life of elders. One study found that not only do these home and community based care alternatives maintain elders’ independence and keep families together, they are also more cost effective and beneficial for the health of elders when compared to institutionalized care.⁵ Despite the fact that these services are vitally important and have proven to be more cost-effective, they have been targeted for significant reductions.

Aging and Long-Term Care Recommendations

• Reject the elimination of In-Home Supportive Services to thousands of elders and other disabled individuals.
• Ensure adequate resources for programs and services that support the ability of elders to maintain independent lifestyles in their homes and their communities.
• Ensure that resources provided by The Patient Protection and Affordable Care Act are used to preserve and improve existing community-based or in-home care programs.
• Ensure community-based aging services are accountable to diverse aging communities by developing culturally and linguistically appropriate programs.

Language Access and Disaggregated Data for State Programs

Language access to a wide range of State programs is a barrier for many Southeast Asian Americans. 83.3% of Hmong, 82% of Cambodians, 79% of Laotians and 75% of Vietnamese American elders are limited English proficient (LEP) speakers, many of whom also have limited literacy even in their native languages.⁶ Language accessible resources and services are vital to ensuring the well being of this population. In addition, the lack of accessible data regarding Southeast Asian American communities hinders policy makers and community leaders’ ability to effectively and efficiently address needs in the community. Frequently, existing data simply characterizes the Asian American community as a homogenous group, which masks existing disparities experienced by diverse ethnic subgroups within in the Asian American community.

 Language Access and Disaggregated Data Recommendations

• Improve and support adequate language resources and services to ensure that accessibility and appropriateness of services.
• Utilize the Patient Protection and Affordable Care Act’s (ACA) expanded funding for health information technology to establish a data collection system that disaggregates ethnic health data.
• State agencies should develop disaggregated data collection mechanisms to improve the efficiency and effectiveness of existing programs regardless of whether funding is made available through the ACA.