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"content": "\u003cp>Uber wants to get you from your home to your doctor's office -- and you won't even need to open the Uber app. The company announced Thursday that it's teaming up with health care organizations to provide transportation for patients going to and from medical appointments. \u003c/p>\n\u003cp>The rides can be scheduled for patients through doctor's offices, by receptionists or other staffers. And they can be booked for immediate pickup or up to 30 days in advance. That means patients without a smartphone -- who wouldn't be able to use Uber otherwise -- can become Uber customers.\u003c/p>\n\u003cp>Instead of operating through an app, Uber Health will send its passengers' ride information through an SMS text message. The company also plans to introduce the option for passengers to receive a call with trip details to their landline instead. Drivers will still use the Uber smartphone app to pick up these passengers. \u003c/p>\n\u003cp>\"Transportation barriers are the greatest for vulnerable populations,\" says Chris Weber, the general manager of Uber Health. \"This service will provide reliable, comfortable transportation for patients.\" \u003c/p>\n\u003cp>Transportation is, indeed, a barrier to good health care. Affordable access to a vehicle is consistently associated with increased access to medical care, according to \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265215/\" target=\"_blank\">a study\u003c/a>. Around 3.6 million Americans miss doctor's appointments or delay medical care due to a lack of transportation every year, according to the \u003ca href=\"http://www.ncsl.org/research/transportation/non-emergency-medical-transportation-a-vital-lifeline-for-a-healthy-community.aspx\" target=\"_blank\">National Conference of State Legislatures\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>To meet the medical privacy standards outlined in the federal HIPAA law, drivers won't know which of their passengers are using Uber Health. Like a typical Uber ride, only a passenger's name, pickup and drop-off addresses will be given to the driver. So Uber drivers won't be able to opt into the health service the same way that they opt into Uber Eats, a food delivery service.\u003c/p>\n\u003cp>Peter Whorley, who drives a Honda Odyssey minivan for Uber in Fort Lauderdale, Florida, often picks up passengers who need the extra space, including patients traveling to and from doctor's offices.\u003c/p>\n\u003cp>\"I just picked up someone with back surgery the other day,\" he says. \"I like to help people, if they need extra assistance, I personally don't have that problem. But some people might be squeamish, and not want to.\"\u003c/p>\n\u003cp>Whorley, who has been driving for Uber for more than two years, is more skeptical about picking up people without smartphones. He thinks location tracking on smartphones is vital to the efficiency of the ride-hailing service. \"When you're a good passenger, you should be able to have your phone out to communicate with your driver,\" he says.\u003c/p>\n\u003cp>Uber's Weber says that because health care providers will use their best discretion in scheduling the rides, they won't call Ubers for people in need of urgent medical attention. \"It's not a replacement to ambulances,\" he says, but a reliable means of transportation to non-urgent medical services that he hopes will curb missed appointments. \u003c/p>\n\u003cp>One hundred health care organizations in the U.S., including hospitals, clinics, rehab centers, senior care facilities, home care centers, and physical therapy centers have already used Uber Health's test program. The service will be rolled out to health care organizations gradually. \u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Uber wants to get you from your home to your doctor's office -- and you won't even need to open the Uber app. The company announced Thursday that it's teaming up with health care organizations to provide transportation for patients going to and from medical appointments. \u003c/p>\n\u003cp>The rides can be scheduled for patients through doctor's offices, by receptionists or other staffers. And they can be booked for immediate pickup or up to 30 days in advance. That means patients without a smartphone -- who wouldn't be able to use Uber otherwise -- can become Uber customers.\u003c/p>\n\u003cp>Instead of operating through an app, Uber Health will send its passengers' ride information through an SMS text message. The company also plans to introduce the option for passengers to receive a call with trip details to their landline instead. Drivers will still use the Uber smartphone app to pick up these passengers. \u003c/p>\n\u003cp>\"Transportation barriers are the greatest for vulnerable populations,\" says Chris Weber, the general manager of Uber Health. \"This service will provide reliable, comfortable transportation for patients.\" \u003c/p>\n\u003cp>Transportation is, indeed, a barrier to good health care. Affordable access to a vehicle is consistently associated with increased access to medical care, according to \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265215/\" target=\"_blank\">a study\u003c/a>. Around 3.6 million Americans miss doctor's appointments or delay medical care due to a lack of transportation every year, according to the \u003ca href=\"http://www.ncsl.org/research/transportation/non-emergency-medical-transportation-a-vital-lifeline-for-a-healthy-community.aspx\" target=\"_blank\">National Conference of State Legislatures\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>To meet the medical privacy standards outlined in the federal HIPAA law, drivers won't know which of their passengers are using Uber Health. Like a typical Uber ride, only a passenger's name, pickup and drop-off addresses will be given to the driver. So Uber drivers won't be able to opt into the health service the same way that they opt into Uber Eats, a food delivery service.\u003c/p>\n\u003cp>Peter Whorley, who drives a Honda Odyssey minivan for Uber in Fort Lauderdale, Florida, often picks up passengers who need the extra space, including patients traveling to and from doctor's offices.\u003c/p>\n\u003cp>\"I just picked up someone with back surgery the other day,\" he says. \"I like to help people, if they need extra assistance, I personally don't have that problem. But some people might be squeamish, and not want to.\"\u003c/p>\n\u003cp>Whorley, who has been driving for Uber for more than two years, is more skeptical about picking up people without smartphones. He thinks location tracking on smartphones is vital to the efficiency of the ride-hailing service. \"When you're a good passenger, you should be able to have your phone out to communicate with your driver,\" he says.\u003c/p>\n\u003cp>Uber's Weber says that because health care providers will use their best discretion in scheduling the rides, they won't call Ubers for people in need of urgent medical attention. \"It's not a replacement to ambulances,\" he says, but a reliable means of transportation to non-urgent medical services that he hopes will curb missed appointments. \u003c/p>\n\u003cp>One hundred health care organizations in the U.S., including hospitals, clinics, rehab centers, senior care facilities, home care centers, and physical therapy centers have already used Uber Health's test program. The service will be rolled out to health care organizations gradually. \u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cstrong>Updated March 1 at 9:40 a.m.\u003c/strong>\u003c/p>\n\u003cp>Walmart and Dick’s Sporting Goods said Wednesday they won’t sell guns to customers under 21, and both are putting new restrictions on ammunition sales.\u003c/p>\n\u003cp>Kroger Co. announced Thursday that its Fred Meyer stores would also stop selling guns and ammunition to people under age 21.\u003c/p>\n\u003cp>Dick’s Sporting Goods, one of the largest sports retailers in the U.S., announced it is immediately ending its sales of military-style semi-automatic rifles and is requiring all customers to be older than 21 to buy a firearm at its stores. Additionally, the company no longer will sell high-capacity magazines. \u003c/p>\n\u003cp>Walmart, which ended sales of modern sporting rifles such as AR-15s in 2015, has \u003ca href=\"https://news.walmart.com/2018/02/28/walmart-statement-on-firearms-policy\" target=\"_blank\" rel=\"noopener\">announced \u003c/a>that it is raising the minimum age for purchasing firearms and ammunition from 18 to 21. The company notes that it does not sell bump stocks, high-capacity magazines and similar accessories.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Walmart is also removing items from its website “resembling assault-style rifles, including nonlethal airsoft guns and toys” —\u003cbr>\n like the air gun Tamir Rice \u003ca href=\"https://www.npr.org/2015/11/20/456626171/for-family-of-tamir-rice-an-inauspicious-anniversary\" target=\"_blank\" rel=\"noopener\">was playing with\u003c/a> when he was shot by a Cleveland police officer who thought the 12-year-old was armed. \u003c/p>\n\u003cp>Dick’s Sporting Goods CEO Ed Stack announced the firm’s decision on ABC’s “Good Morning America” on Wednesday, the same day that survivors of the shooting at Marjory Stoneman Douglas High School \u003ca href=\"https://www.npr.org/2018/02/28/589355178/stoneman-douglas-students-head-back-to-school\" target=\"_blank\" rel=\"noopener\">returned to class\u003c/a>. Stack said the 19-year-old gunman allegedly behind that massacre, which claimed 17 lives and wounded many more in Parkland, Fla., had purchased a firearm from the retailer last November.\u003c/p>\n\u003cp>While that the weapon — a shotgun — was not used in the shooting, the CEO said the revelation deeply affected Stack and his colleagues at Dick’s.\u003c/p>\n\u003cp>“We did everything by the book. We did everything that the law required, and still he was able to buy a gun,” Stack said. “When we looked at that, we said the systems that are in place across the board just aren’t effective enough to keep us from selling a gun like that.\u003c/p>\n\u003cp>“And so we’ve decided we’re not going to sell the assault-type rifles any longer.”\u003c/p>\n\u003cp>https://twitter.com/DICKS/status/968830988246765568\u003c/p>\n\u003cp>The company, which operates more than 715 locations, already had pulled assault-style weapons from Dick’s stores after the 2012 Sandy Hook shooting; now it will also stop selling the weapons at its subsidiary Field & Stream stores.\u003c/p>\n\u003cp>Stack said the decision to eliminate assault-style rifles is permanent.\u003c/p>\n\u003cp>“Our thoughts and prayers are with all of the victims and their loved ones,” the company said in a \u003ca href=\"http://pressroom.dicks.com/press-information/media-statements.aspx?camp=sns::20180227:CS2015:am:end:&utm_medium=Social%20DSG&utm_source=&utm_campaign=CS2015&utm_term=&utm_content=20180227\" target=\"_blank\" rel=\"noopener\">statement issued\u003c/a> Wednesday. “But thoughts and prayers are not enough. We have tremendous respect and admiration for the students organizing and making their voices heard regarding gun violence in schools and elsewhere in our country.\u003c/p>\n\u003cp>“We have heard you. The nation has heard you. … The systems in place are not effective to protect our kids and our citizens.”\u003c/p>\n\u003cp>The statement asserted the company’s support for the Second Amendment but continued, “we have to help solve the problem that’s in front of us. Gun violence is an epidemic.”\u003c/p>\n\u003cp>In addition to changing its own policies, the company issued a plea to elected officials to enact “common-sense gun reform,” specifically calling for the following regulations:\u003c/p>\n\u003cul>\n\u003cli>Ban assault-style firearms\u003c/li>\n\u003cli>Raise the minimum age to purchase firearms to 21\u003c/li>\n\u003cli>Ban high-capacity magazines, as well as bump stocks — gun accessories that allow semi-automatic rifles to operate like fully automatic weapons\u003c/li>\n\u003cli>Require universal background checks that include relevant mental health information and previous interactions with the law\u003c/li>\n\u003cli>Ensure a complete universal database of those banned from buying firearms\u003c/li>\n\u003cli>Close the private sale and gun show loopholes that waive background checks\u003c/li>\n\u003c/ul>\n\u003cp>With their moves, Dick’s and Walmart join a host of major companies that made changes in reaction to the Parkland shooting. As \u003ca href=\"https://www.npr.org/sections/thetwo-way/2018/02/23/588233273/one-by-one-companies-cut-ties-with-nra\" target=\"_blank\" rel=\"noopener\">NPR’s Amy Held reported\u003c/a> last week, many other high-profile companies — from MetLife Insurance and First National Bank of Omaha to Symantec and Hertz — have ended their corporate partnerships with the National Rifle Association.\u003c/p>\n\u003cp>Those moves have not been without controversy.\u003c/p>\n\u003cp>Earlier this week, for instance, Georgia Lt. Gov. Casey Cagle threatened to “\u003ca href=\"https://www.npr.org/sections/thetwo-way/2018/02/27/589047224/georgias-lt-gov-threatens-to-kill-tax-break-for-delta-airlines-amid-nra-spat\" target=\"_blank\" rel=\"noopener\">kill any tax legislation\u003c/a> that benefits” Delta Air Lines after the company ended its own relationship with the NRA. Delta, which is based in Atlanta, had announced two days earlier that “we will be requesting that the NRA remove our information from their website” — a decision Cagle described as an attack on conservatives.\u003c/p>\n\u003cp>Asked about the potential for pushback among gun rights advocates, Stack acknowledged the move “isn’t going to make everyone happy. But when we look at what those kids and the parents and the heroes in the school, what they did, our view was: If the kids can be brave enough to organize like this, we can be brave enough to get these [firearms] out of here.”\u003c/p>\n\u003cp>“We’re staunch supporters of the Second Amendment,” he added. “I’m a gun owner myself. We’ve just decided that based on what’s happened and with these guns, we don’t want to be part of this story.” \u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Walmart is also removing items from its website “resembling assault-style rifles, including nonlethal airsoft guns and toys” —\u003cbr>\n like the air gun Tamir Rice \u003ca href=\"https://www.npr.org/2015/11/20/456626171/for-family-of-tamir-rice-an-inauspicious-anniversary\" target=\"_blank\" rel=\"noopener\">was playing with\u003c/a> when he was shot by a Cleveland police officer who thought the 12-year-old was armed. \u003c/p>\n\u003cp>Dick’s Sporting Goods CEO Ed Stack announced the firm’s decision on ABC’s “Good Morning America” on Wednesday, the same day that survivors of the shooting at Marjory Stoneman Douglas High School \u003ca href=\"https://www.npr.org/2018/02/28/589355178/stoneman-douglas-students-head-back-to-school\" target=\"_blank\" rel=\"noopener\">returned to class\u003c/a>. Stack said the 19-year-old gunman allegedly behind that massacre, which claimed 17 lives and wounded many more in Parkland, Fla., had purchased a firearm from the retailer last November.\u003c/p>\n\u003cp>While that the weapon — a shotgun — was not used in the shooting, the CEO said the revelation deeply affected Stack and his colleagues at Dick’s.\u003c/p>\n\u003cp>“We did everything by the book. We did everything that the law required, and still he was able to buy a gun,” Stack said. “When we looked at that, we said the systems that are in place across the board just aren’t effective enough to keep us from selling a gun like that.\u003c/p>\n\u003cp>“And so we’ve decided we’re not going to sell the assault-type rifles any longer.”\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>The company, which operates more than 715 locations, already had pulled assault-style weapons from Dick’s stores after the 2012 Sandy Hook shooting; now it will also stop selling the weapons at its subsidiary Field & Stream stores.\u003c/p>\n\u003cp>Stack said the decision to eliminate assault-style rifles is permanent.\u003c/p>\n\u003cp>“Our thoughts and prayers are with all of the victims and their loved ones,” the company said in a \u003ca href=\"http://pressroom.dicks.com/press-information/media-statements.aspx?camp=sns::20180227:CS2015:am:end:&utm_medium=Social%20DSG&utm_source=&utm_campaign=CS2015&utm_term=&utm_content=20180227\" target=\"_blank\" rel=\"noopener\">statement issued\u003c/a> Wednesday. “But thoughts and prayers are not enough. We have tremendous respect and admiration for the students organizing and making their voices heard regarding gun violence in schools and elsewhere in our country.\u003c/p>\n\u003cp>“We have heard you. The nation has heard you. … The systems in place are not effective to protect our kids and our citizens.”\u003c/p>\n\u003cp>The statement asserted the company’s support for the Second Amendment but continued, “we have to help solve the problem that’s in front of us. Gun violence is an epidemic.”\u003c/p>\n\u003cp>In addition to changing its own policies, the company issued a plea to elected officials to enact “common-sense gun reform,” specifically calling for the following regulations:\u003c/p>\n\u003cul>\n\u003cli>Ban assault-style firearms\u003c/li>\n\u003cli>Raise the minimum age to purchase firearms to 21\u003c/li>\n\u003cli>Ban high-capacity magazines, as well as bump stocks — gun accessories that allow semi-automatic rifles to operate like fully automatic weapons\u003c/li>\n\u003cli>Require universal background checks that include relevant mental health information and previous interactions with the law\u003c/li>\n\u003cli>Ensure a complete universal database of those banned from buying firearms\u003c/li>\n\u003cli>Close the private sale and gun show loopholes that waive background checks\u003c/li>\n\u003c/ul>\n\u003cp>With their moves, Dick’s and Walmart join a host of major companies that made changes in reaction to the Parkland shooting. As \u003ca href=\"https://www.npr.org/sections/thetwo-way/2018/02/23/588233273/one-by-one-companies-cut-ties-with-nra\" target=\"_blank\" rel=\"noopener\">NPR’s Amy Held reported\u003c/a> last week, many other high-profile companies — from MetLife Insurance and First National Bank of Omaha to Symantec and Hertz — have ended their corporate partnerships with the National Rifle Association.\u003c/p>\n\u003cp>Those moves have not been without controversy.\u003c/p>\n\u003cp>Earlier this week, for instance, Georgia Lt. Gov. Casey Cagle threatened to “\u003ca href=\"https://www.npr.org/sections/thetwo-way/2018/02/27/589047224/georgias-lt-gov-threatens-to-kill-tax-break-for-delta-airlines-amid-nra-spat\" target=\"_blank\" rel=\"noopener\">kill any tax legislation\u003c/a> that benefits” Delta Air Lines after the company ended its own relationship with the NRA. Delta, which is based in Atlanta, had announced two days earlier that “we will be requesting that the NRA remove our information from their website” — a decision Cagle described as an attack on conservatives.\u003c/p>\n\u003cp>Asked about the potential for pushback among gun rights advocates, Stack acknowledged the move “isn’t going to make everyone happy. But when we look at what those kids and the parents and the heroes in the school, what they did, our view was: If the kids can be brave enough to organize like this, we can be brave enough to get these [firearms] out of here.”\u003c/p>\n\u003cp>“We’re staunch supporters of the Second Amendment,” he added. “I’m a gun owner myself. We’ve just decided that based on what’s happened and with these guns, we don’t want to be part of this story.” \u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "America's Emperor, San Francisco's Treasure: Who Was Emperor Norton?",
"headTitle": "America’s Emperor, San Francisco’s Treasure: Who Was Emperor Norton? | KQED",
"content": "\u003cp>If you’ve taken a walking tour of San Francisco, there’s a good chance you’ve heard the name Emperor Norton.\u003c/p>\n\u003cp>That was how Bay Curious listener and Oakland resident Jennifer Jacobs first learned about the beloved San Francisco eccentric after she moved to the Bay Area from Michigan in 1999.\u003c/p>\n\u003cp>“I was just like, ‘Wow, this is a whole other world. They have their own emperor here in San Francisco,’ ” Jennifer says.\u003cbr>\n[baycuriouspodcastinfo]\u003cbr>\nEver since, Jennifer has wanted to know more. Who was Emperor Norton? How was he seen in his own time? And why is he still remembered and revered today, almost 140 years after his death?\u003c/p>\n\u003cp>Not much is known about Emperor Norton’s early life, according to John Lumea, president of the \u003ca href=\"http://www.emperorsbridge.org/\" target=\"_blank\" rel=\"noopener\">Emperor’s Bridge Campaign\u003c/a>, which focuses on researching Norton’s life and sharing it with the public.\u003c/p>\n\u003cp>Here’s what we do know.\u003c/p>\n\u003ch3>The rise and fall of a Gold Rush businessman\u003c/h3>\n\u003cp>Emperor Norton was born Joshua Abraham Norton in 1818 to Jewish parents in present-day London. At age 2, he moved with his parents to South Africa, where his dad set up a successful ship supplies business.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>At 21, with help from his father, Norton opened his own ship supplies business, but it went bankrupt within 18 months. Things went from bad to worse over the next few years, and by 1848, both of Norton’s parents and two of his siblings had died.\u003c/p>\n\u003cp>The following year, Norton left South Africa, and after a short stop in South America, landed in San Francisco in late 1849.\u003c/p>\n\u003cp>Norton arrived in a lawless, Wild West version of San Francisco. The Gold Rush transformed a small town of a few hundred people to a bustling metropolis of 25,000 within a few years.\u003c/p>\n\u003cp>It was also a town of constant rebirth. People were making and losing their fortunes in the blink of an eye. The city was almost \u003ca href=\"https://thebolditalic.com/5-times-san-francisco-was-almost-destroyed-the-bold-italic-san-francisco-697dcf1177b8\" target=\"_blank\" rel=\"noopener\">destroyed by fires\u003c/a> seven times between 1849 and 1851.\u003c/p>\n\u003cp>Norton, who had already built and lost a business in South Africa, fit right into this boom-and-bust town. He established himself as a successful businessman selling commodities like rice and flour. He invested in real estate, erecting buildings on three of the four corners of Sansome and Jackson streets — one of the most popular intersections in town — plus plots in North Beach and a lucrative waterfront property.\u003c/p>\n\u003cfigure id=\"attachment_10981646\" class=\"wp-caption alignright\" style=\"max-width: 900px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-10981646\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2016/06/Ship-in-the-Bay.jpg\" alt=\"\" width=\"900\" height=\"723\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2016/06/Ship-in-the-Bay.jpg 900w, https://ww2.kqed.org/app/uploads/sites/10/2016/06/Ship-in-the-Bay-400x321.jpg 400w, https://ww2.kqed.org/app/uploads/sites/10/2016/06/Ship-in-the-Bay-800x643.jpg 800w\" sizes=\"(max-width: 900px) 100vw, 900px\">\u003cfigcaption class=\"wp-caption-text\">The San Francisco waterfront in 1851. (San Francisco Maritime Museum National Historical Park)\u003c/figcaption>\u003c/figure>\n\u003cp>“He made a great amount of money and was very influential,” Lumea says of Norton’s early days in the city. “He was in with all the right people, attended all the right clubs and all the right restaurants.”\u003c/p>\n\u003cp>Riding high, Norton planned his next business move. With a rice famine underway in China, Norton was presented with a chance to corner the rice market by buying up a shipload of Peruvian rice. Expecting rice prices to soar, Norton went in with a couple of business partners in 1852 and staked $25,000 on the venture.\u003c/p>\n\u003cp>And then it all went wrong.\u003c/p>\n\u003cp>“Within a [few] days, ship after ship after ship of rice comes in, and so the bottom falls out of the market,” Lumea says. “This idea, which at one point seemed so great, now isn’t so great.”\u003c/p>\n\u003cp>The deal, and the subsequent years of legal wrangling, ruined Norton. By the time Norton was 38, in 1856, he was bankrupt for the second time.\u003c/p>\n\u003ch3>An imperial transformation\u003c/h3>\n\u003cp>After his financial ruin, Norton went quiet for a few years. He moved out of his prestigious home, and fell out of favor with some members of the social elite.\u003c/p>\n\u003cp>He re-emerged on Sept. 17, 1859, on the pages on the San Francisco Evening Bulletin newspaper. Earlier in the day, he had walked into the paper’s offices and presented the editor with a short notice he asked to have published in that day’s edition.\u003c/p>\n\u003cp>“At the peremptory request of a large majority of the citizens of these United States, I, Joshua Norton, formerly of Algoa Bay, Cape of Good Hope, and now for the last nine years and ten months past of San Francisco, California, declare and proclaim myself Emperor of these United States,” the notice began.\u003c/p>\n\u003cfigure id=\"attachment_11652849\" class=\"wp-caption aligncenter\" style=\"max-width: 411px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/RS29665_First-Norton-Proclamation-qut.jpg\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11652849 size-full\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/RS29665_First-Norton-Proclamation-qut.jpg\" alt=\"The proclamation in the September 17, 1859, edition of the San Francisco Evening Bulletin that transformed Joshua Abraham Norton into Emperor Norton.\" width=\"411\" height=\"481\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29665_First-Norton-Proclamation-qut.jpg 411w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29665_First-Norton-Proclamation-qut-160x187.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29665_First-Norton-Proclamation-qut-240x281.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29665_First-Norton-Proclamation-qut-375x439.jpg 375w\" sizes=\"(max-width: 411px) 100vw, 411px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The proclamation in the September 17, 1859, edition of the San Francisco Evening Bulletin that transformed Joshua Abraham Norton into Emperor Norton. \u003ccite>(San Francisco Public Library)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At age 41, three years after losing everything, Norton christened himself Emperor of the United States. When France’s Napoleon III invaded Mexico in 1861, Norton added “Protector of Mexico” to his imperial title.\u003c/p>\n\u003cp>This astonishing transformation has always fascinated Bay Curious listener Jacobs.\u003c/p>\n\u003cp>“I majored in psychology, so I couldn’t help thinking he must have had some kind of a nervous breakdown or something happened in those few years,” she says. “I was thinking schizophrenia or bipolar disorder maybe.”\u003c/p>\n\u003cp>There are no sure answers about Norton’s mental health before or after his imperial declaration, but some people think his money troubles led him into a deep depression and that becoming Emperor Norton was a coping mechanism.\u003c/p>\n\u003cfigure id=\"attachment_11652931\" class=\"wp-caption alignleft\" style=\"max-width: 400px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11652931\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/bike.jpg\" alt=\"A snarky caption is scrawled below this image of Norton on a bicycle.\" width=\"400\" height=\"552\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2018/02/bike.jpg 522w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/bike-160x221.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/bike-240x331.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/bike-375x517.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/bike-520x717.jpg 520w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003cfigcaption class=\"wp-caption-text\">A snarky caption is scrawled below this image of Norton on a bicycle. \u003ccite>(California State Library)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“There’s a sense in which the persona of the Emperor actually saved him in a way,” Lumea says.\u003c/p>\n\u003cp>Later in his declaration, Norton called on representatives of all the states to assemble the following February to establish his empire and “to make such alterations in the existing laws of the Union to ameliorate the evils under which the country is laboring.”\u003c/p>\n\u003cp>Unsurprisingly, nobody showed up.\u003c/p>\n\u003cp>But that didn’t stop Norton. He had declared himself emperor. And he was going to act like it for the next 20 years.\u003c/p>\n\u003ch3>Emperor of the United States, Protector of Mexico\u003c/h3>\n\u003cp>Norton continued issuing imperial proclamations on items big, like calling for the end of presidential elections, and small, like chastising the skating rink operator who wouldn’t let him use a pair of skates.\u003c/p>\n\u003cp>Even though he was Emperor of the United States, his proclamations were often very local in nature. He didn’t hesitate to call out San Francisco’s police and elected officials. Perhaps his most well-known proclamations were the ones calling for the construction of a bridge connecting Oakland and San Francisco through Yerba Buena Island — what we recognize today as the Bay Bridge.\u003c/p>\n\u003cp>[gallery type=\"rectangular\" ids=\"11652859,11652858,11652857,11652856\"]\u003c/p>\n\u003cp>Norton also adopted an imperial wardrobe. He started with either a blue or gray military jacket, switching between the two early in his “reign” to maintain his neutrality in the ongoing Civil War.\u003c/p>\n\u003cp>After the war, he settled on a blue officer’s jacket furnished with large, fringed, golden shoulder epaulets. His balding head was almost always covered with a hat, most often a small military kepi or a garish beaver fur top hat with a cascade of colorful feathers pinned to the front.\u003c/p>\n\u003cp>Being emperor did not pay very well. Norton spent most of his reign subsisting off the generosity of the public and the support of a few wealthy friends from his high society days.\u003c/p>\n\u003cp>In 1870, with the newly-completed transcontinental railroad bringing more tourists to San Francisco from across the country, Norton helped fill his coffers by selling “imperial bonds” for 50 cents each.\u003c/p>\n\u003cfigure id=\"attachment_11652847\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/Emperor_Joshua_A._Norton_I.jpg\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-11652847\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/Emperor_Joshua_A._Norton_I-800x1212.jpg\" alt=\"Emperor Norton in his traditional imperial outfit around 1875.\" width=\"800\" height=\"1212\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2018/02/Emperor_Joshua_A._Norton_I-800x1212.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/Emperor_Joshua_A._Norton_I-160x242.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/Emperor_Joshua_A._Norton_I-240x364.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/Emperor_Joshua_A._Norton_I-375x568.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/Emperor_Joshua_A._Norton_I-520x788.jpg 520w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/Emperor_Joshua_A._Norton_I.jpg 866w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Emperor Norton in his traditional imperial outfit around 1875. \u003ccite>(Bancroft Library, UC Berkeley)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>He didn’t need much money. His lodgings on Commercial Street cost him only 50 cents a night, and he spent most of his day reading the newspapers, talking with other forty-niners in Portsmouth Square and writing proclamations at the Mechanics’ Institute Library on Post Street.\u003c/p>\n\u003cp>For lunch, Norton could go to almost any tavern in town and for the price of a drink, no more than 25 cents, get access to a full lunch spread of salmon, roast beef, tomatoes and more.\u003c/p>\n\u003cp>“He really makes himself part of the life of the city,” Lumea says. “He goes to political meetings. He goes to the theater. He goes to the saloons. He makes himself a public presence. He’s in the streets.”\u003c/p>\n\u003cp>The city’s newspapers saw Norton as a bit of a buffoon and regularly published fake proclamations with his name attached. So, in 1870, he started publishing his genuine proclamations almost exclusively in an African-American-owned and operated abolitionist weekly, The Pacific Appeal.\u003c/p>\n\u003cp>[gallery type=\"slideshow\" ids=\"11652840,11652839,11652838,11652837,11652836,11652835,11652834,11652833,11652832,11652831,11652830,11652829,11652828,11652827,11652826,11652825,11652824\"]\u003c/p>\n\u003cp>Many of Norton’s proclamations, especially those in The Pacific Appeal, were surprisingly progressive for his time.\u003c/p>\n\u003cp>“He’s talking about how African-Americans should have the right to attend public schools, ride public streetcars. How the Chinese should be able to have their testimony heard in court,” Lumea says. Norton also argued for the rights of Native Americans and against political corruption.\u003c/p>\n\u003cp>“So he’s really making himself into an early champion of the values of fairness and tolerance and the common good that really later become a great symbol of San Francisco,” Lumea says.\u003c/p>\n\u003ch3>‘Le roi est mort’\u003c/h3>\n\u003cp>Jan. 8, 1880, was a cold and rainy night in San Francisco. Norton left his room on Commercial Street to walk the few short blocks to a debate at the Academy of Natural Sciences.\u003c/p>\n\u003cp>On his way there, he collapsed on the street and died of a suspected stroke.\u003c/p>\n\u003cfigure id=\"attachment_11652860\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/4436597737_cae5796fb3_o-1.jpg\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-11652860\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/4436597737_cae5796fb3_o-1-800x1067.jpg\" alt=\"Emperor Norton's grave, which was moved from the Masonic Cemetery in San Francisco to Colma.\" width=\"800\" height=\"1067\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2018/02/4436597737_cae5796fb3_o-1-800x1067.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/4436597737_cae5796fb3_o-1-160x213.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/4436597737_cae5796fb3_o-1-1020x1360.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/4436597737_cae5796fb3_o-1-1180x1573.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/4436597737_cae5796fb3_o-1-960x1280.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/4436597737_cae5796fb3_o-1-240x320.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/4436597737_cae5796fb3_o-1-375x500.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/4436597737_cae5796fb3_o-1-520x693.jpg 520w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/4436597737_cae5796fb3_o-1.jpg 1536w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Emperor Norton’s grave, which was moved from the Masonic Cemetery in San Francisco to Colma. \u003ccite>(Joshua Neff/Flickr)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Ten thousand people came to Norton’s funeral. The headline of his obituary in the San Francisco Chronicle read, “Le roi est mort.”\u003c/p>\n\u003cp>Norton died with just a few dollars in his pockets and would have been sent to a pauper’s grave, if not for the intercession of his old friends in business, who paid for a fancy rosewood coffin adorned with silver and a burial plot in the Masonic Cemetery.\u003c/p>\n\u003cp>“Even though often in the official world of journalism or politics he was somewhat seen as a figure of ridicule,” Lumea says, “to the people in the streets who saw him on a day-to-day basis for 20 years, he was known as a very kind person.”\u003c/p>\n\u003ch3>Norton at 200\u003c/h3>\n\u003cp>Almost 140 years after his death, Norton continues to captivate San Francisco.\u003c/p>\n\u003cp>Lumea started the Emperor’s Bridge Campaign in 2013 to try to get the Bay Bridge renamed for Emperor Norton, in recognition of him publishing the idea decades before it came to be. The Board of Supervisors designated February 2018 as \u003ca href=\"https://twitter.com/EmperorsBridge/status/960568176013541376\" target=\"_blank\" rel=\"noopener\">“Emperor Norton Month,”\u003c/a> and City Hall and Coit Tower were lit up gold on Feb. 4, 2018, in honor of Norton’s 200th birthday.\u003c/p>\n\u003cp>“Nobody really encompasses the spirit of San Francisco better than Emperor Norton,” says Joseph Amster, one of two men who walk the streets of San Francisco as official Emperor Norton impersonators.\u003c/p>\n\u003cp>Amster and his fellow Norton, Rick Saber, both showed up in full imperial regalia at Norton’s 200th birthday party in February at one of Norton’s favorite spots, the Mechanics’ Institute Library.\u003c/p>\n\u003cfigure id=\"attachment_11652852\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/RS29664_DSC_1504-qut.jpg\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-11652852\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/RS29664_DSC_1504-qut-800x530.jpg\" alt=\"Jennifer Jacobs stands with Rick Saber (L) and Joseph Amster (R), two official Emperor Norton impersonators at Emperor Norton's 200th birthday party at the Mechanics' Institute in San Francisco on Feb. 7, 2018.\" width=\"800\" height=\"530\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29664_DSC_1504-qut-800x530.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29664_DSC_1504-qut-160x106.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29664_DSC_1504-qut-1020x676.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29664_DSC_1504-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29664_DSC_1504-qut-1180x782.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29664_DSC_1504-qut-960x636.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29664_DSC_1504-qut-240x159.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29664_DSC_1504-qut-375x248.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29664_DSC_1504-qut-520x345.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jennifer Jacobs stands with Rick Saber (L) and Joseph Amster (R), two official Emperor Norton impersonators, at Emperor Norton’s 200th birthday party at the Mechanics’ Institute Library in San Francisco on Feb. 7, 2018. \u003ccite>(Ryan Levi/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Guests came dressed in their 19th century finest, from Wild West leather chaps to Victorian dresses, to honor Norton. Kazuo Sayama came all the way from Japan to attend the party. He first learned about Norton decades ago while he was doing research for a book about San Francisco, and he was so enthralled by his story that he dedicated an entire book to just Norton and is working on a second.\u003c/p>\n\u003cp>“You have so many presidents,” Sayama says of the United States, “but no emperor in history. But people admire him as emperor.”\u003c/p>\n\u003cp>For many at the party and across the city, Norton represents the best of the Bay Area: an advocate of fairness and tolerance, a kind person and a bit of an oddball.\u003c/p>\n\u003cp>“He’s kind of a symbol of why this isn’t New York or why this isn’t Florida or why this isn’t Seattle,” says Tito Young, who came to the party dressed as a Wild West cowboy in brown leather chaps. “I think there’s something wonderfully eccentric about this gentleman, which I can very much identify with.”\u003cbr>\n[baycuriousbug]\u003cbr>\n“I’m glad there’s a strong personality in my family tree,” says Julie Driver, Norton’s great-great-great-great-niece. She lives in Ontario, Canada, and learned about her famous relative from her dad. “He found a way to make a name for himself after he lost his fortune, and I think that’s something that we should learn from.”\u003c/p>\n\u003cp>Bay Curious listener Jennifer Jacobs was blown away by the sustained love and attention the city continues to give Emperor Norton, and she can’t imagine it happening in any other city.\u003c/p>\n\u003cp>“San Francisco is a quirky town in a lot of ways,” she says, “and he kind of embodies that.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>[baycuriousquestion]\u003c/p>\n\n",
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"excerpt": "Almost 140 years after his death, the beloved eccentric is still celebrated and revered in San Francisco. So who was he?",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>If you’ve taken a walking tour of San Francisco, there’s a good chance you’ve heard the name Emperor Norton.\u003c/p>\n\u003cp>That was how Bay Curious listener and Oakland resident Jennifer Jacobs first learned about the beloved San Francisco eccentric after she moved to the Bay Area from Michigan in 1999.\u003c/p>\n\u003cp>“I was just like, ‘Wow, this is a whole other world. They have their own emperor here in San Francisco,’ ” Jennifer says.\u003cbr>\n\u003c/p>\u003cp>\u003caside class=\"alignleft utils-parseShortcode-shortcodes-__bayCuriousPodcastShortcode__bayCurious\">\u003cimg src=https://cdn.kqed.org/wp-content/uploads/2023/02/bayCuriousLogo.png alt=\"Bay Curious Podcast\" loading=\"lazy\" />\n \u003ca href=\"/news/series/baycurious\">Bay Curious\u003c/a> is a podcast that answers your questions about the Bay Area.\n Subscribe on \u003ca href=\"https://itunes.apple.com/us/podcast/bay-curious/id1172473406\" target=\"_blank\" rel=\"noopener noreferrer\">Apple Podcasts\u003c/a>,\n \u003ca href=\"http://www.npr.org/podcasts/500557090/bay-curious\" target=\"_blank\" rel=\"noopener noreferrer\">NPR One\u003c/a> or your favorite podcast platform.\u003c/aside>\u003c/p>\u003cp>\u003cbr>\nEver since, Jennifer has wanted to know more. Who was Emperor Norton? How was he seen in his own time? And why is he still remembered and revered today, almost 140 years after his death?\u003c/p>\n\u003cp>Not much is known about Emperor Norton’s early life, according to John Lumea, president of the \u003ca href=\"http://www.emperorsbridge.org/\" target=\"_blank\" rel=\"noopener\">Emperor’s Bridge Campaign\u003c/a>, which focuses on researching Norton’s life and sharing it with the public.\u003c/p>\n\u003cp>Here’s what we do know.\u003c/p>\n\u003ch3>The rise and fall of a Gold Rush businessman\u003c/h3>\n\u003cp>Emperor Norton was born Joshua Abraham Norton in 1818 to Jewish parents in present-day London. At age 2, he moved with his parents to South Africa, where his dad set up a successful ship supplies business.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>At 21, with help from his father, Norton opened his own ship supplies business, but it went bankrupt within 18 months. Things went from bad to worse over the next few years, and by 1848, both of Norton’s parents and two of his siblings had died.\u003c/p>\n\u003cp>The following year, Norton left South Africa, and after a short stop in South America, landed in San Francisco in late 1849.\u003c/p>\n\u003cp>Norton arrived in a lawless, Wild West version of San Francisco. The Gold Rush transformed a small town of a few hundred people to a bustling metropolis of 25,000 within a few years.\u003c/p>\n\u003cp>It was also a town of constant rebirth. People were making and losing their fortunes in the blink of an eye. The city was almost \u003ca href=\"https://thebolditalic.com/5-times-san-francisco-was-almost-destroyed-the-bold-italic-san-francisco-697dcf1177b8\" target=\"_blank\" rel=\"noopener\">destroyed by fires\u003c/a> seven times between 1849 and 1851.\u003c/p>\n\u003cp>Norton, who had already built and lost a business in South Africa, fit right into this boom-and-bust town. He established himself as a successful businessman selling commodities like rice and flour. He invested in real estate, erecting buildings on three of the four corners of Sansome and Jackson streets — one of the most popular intersections in town — plus plots in North Beach and a lucrative waterfront property.\u003c/p>\n\u003cfigure id=\"attachment_10981646\" class=\"wp-caption alignright\" style=\"max-width: 900px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-10981646\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2016/06/Ship-in-the-Bay.jpg\" alt=\"\" width=\"900\" height=\"723\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2016/06/Ship-in-the-Bay.jpg 900w, https://ww2.kqed.org/app/uploads/sites/10/2016/06/Ship-in-the-Bay-400x321.jpg 400w, https://ww2.kqed.org/app/uploads/sites/10/2016/06/Ship-in-the-Bay-800x643.jpg 800w\" sizes=\"(max-width: 900px) 100vw, 900px\">\u003cfigcaption class=\"wp-caption-text\">The San Francisco waterfront in 1851. (San Francisco Maritime Museum National Historical Park)\u003c/figcaption>\u003c/figure>\n\u003cp>“He made a great amount of money and was very influential,” Lumea says of Norton’s early days in the city. “He was in with all the right people, attended all the right clubs and all the right restaurants.”\u003c/p>\n\u003cp>Riding high, Norton planned his next business move. With a rice famine underway in China, Norton was presented with a chance to corner the rice market by buying up a shipload of Peruvian rice. Expecting rice prices to soar, Norton went in with a couple of business partners in 1852 and staked $25,000 on the venture.\u003c/p>\n\u003cp>And then it all went wrong.\u003c/p>\n\u003cp>“Within a [few] days, ship after ship after ship of rice comes in, and so the bottom falls out of the market,” Lumea says. “This idea, which at one point seemed so great, now isn’t so great.”\u003c/p>\n\u003cp>The deal, and the subsequent years of legal wrangling, ruined Norton. By the time Norton was 38, in 1856, he was bankrupt for the second time.\u003c/p>\n\u003ch3>An imperial transformation\u003c/h3>\n\u003cp>After his financial ruin, Norton went quiet for a few years. He moved out of his prestigious home, and fell out of favor with some members of the social elite.\u003c/p>\n\u003cp>He re-emerged on Sept. 17, 1859, on the pages on the San Francisco Evening Bulletin newspaper. Earlier in the day, he had walked into the paper’s offices and presented the editor with a short notice he asked to have published in that day’s edition.\u003c/p>\n\u003cp>“At the peremptory request of a large majority of the citizens of these United States, I, Joshua Norton, formerly of Algoa Bay, Cape of Good Hope, and now for the last nine years and ten months past of San Francisco, California, declare and proclaim myself Emperor of these United States,” the notice began.\u003c/p>\n\u003cfigure id=\"attachment_11652849\" class=\"wp-caption aligncenter\" style=\"max-width: 411px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/RS29665_First-Norton-Proclamation-qut.jpg\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11652849 size-full\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/RS29665_First-Norton-Proclamation-qut.jpg\" alt=\"The proclamation in the September 17, 1859, edition of the San Francisco Evening Bulletin that transformed Joshua Abraham Norton into Emperor Norton.\" width=\"411\" height=\"481\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29665_First-Norton-Proclamation-qut.jpg 411w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29665_First-Norton-Proclamation-qut-160x187.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29665_First-Norton-Proclamation-qut-240x281.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29665_First-Norton-Proclamation-qut-375x439.jpg 375w\" sizes=\"(max-width: 411px) 100vw, 411px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The proclamation in the September 17, 1859, edition of the San Francisco Evening Bulletin that transformed Joshua Abraham Norton into Emperor Norton. \u003ccite>(San Francisco Public Library)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At age 41, three years after losing everything, Norton christened himself Emperor of the United States. When France’s Napoleon III invaded Mexico in 1861, Norton added “Protector of Mexico” to his imperial title.\u003c/p>\n\u003cp>This astonishing transformation has always fascinated Bay Curious listener Jacobs.\u003c/p>\n\u003cp>“I majored in psychology, so I couldn’t help thinking he must have had some kind of a nervous breakdown or something happened in those few years,” she says. “I was thinking schizophrenia or bipolar disorder maybe.”\u003c/p>\n\u003cp>There are no sure answers about Norton’s mental health before or after his imperial declaration, but some people think his money troubles led him into a deep depression and that becoming Emperor Norton was a coping mechanism.\u003c/p>\n\u003cfigure id=\"attachment_11652931\" class=\"wp-caption alignleft\" style=\"max-width: 400px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11652931\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/bike.jpg\" alt=\"A snarky caption is scrawled below this image of Norton on a bicycle.\" width=\"400\" height=\"552\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2018/02/bike.jpg 522w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/bike-160x221.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/bike-240x331.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/bike-375x517.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/bike-520x717.jpg 520w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003cfigcaption class=\"wp-caption-text\">A snarky caption is scrawled below this image of Norton on a bicycle. \u003ccite>(California State Library)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“There’s a sense in which the persona of the Emperor actually saved him in a way,” Lumea says.\u003c/p>\n\u003cp>Later in his declaration, Norton called on representatives of all the states to assemble the following February to establish his empire and “to make such alterations in the existing laws of the Union to ameliorate the evils under which the country is laboring.”\u003c/p>\n\u003cp>Unsurprisingly, nobody showed up.\u003c/p>\n\u003cp>But that didn’t stop Norton. He had declared himself emperor. And he was going to act like it for the next 20 years.\u003c/p>\n\u003ch3>Emperor of the United States, Protector of Mexico\u003c/h3>\n\u003cp>Norton continued issuing imperial proclamations on items big, like calling for the end of presidential elections, and small, like chastising the skating rink operator who wouldn’t let him use a pair of skates.\u003c/p>\n\u003cp>Even though he was Emperor of the United States, his proclamations were often very local in nature. He didn’t hesitate to call out San Francisco’s police and elected officials. Perhaps his most well-known proclamations were the ones calling for the construction of a bridge connecting Oakland and San Francisco through Yerba Buena Island — what we recognize today as the Bay Bridge.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Norton also adopted an imperial wardrobe. He started with either a blue or gray military jacket, switching between the two early in his “reign” to maintain his neutrality in the ongoing Civil War.\u003c/p>\n\u003cp>After the war, he settled on a blue officer’s jacket furnished with large, fringed, golden shoulder epaulets. His balding head was almost always covered with a hat, most often a small military kepi or a garish beaver fur top hat with a cascade of colorful feathers pinned to the front.\u003c/p>\n\u003cp>Being emperor did not pay very well. Norton spent most of his reign subsisting off the generosity of the public and the support of a few wealthy friends from his high society days.\u003c/p>\n\u003cp>In 1870, with the newly-completed transcontinental railroad bringing more tourists to San Francisco from across the country, Norton helped fill his coffers by selling “imperial bonds” for 50 cents each.\u003c/p>\n\u003cfigure id=\"attachment_11652847\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/Emperor_Joshua_A._Norton_I.jpg\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-11652847\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/Emperor_Joshua_A._Norton_I-800x1212.jpg\" alt=\"Emperor Norton in his traditional imperial outfit around 1875.\" width=\"800\" height=\"1212\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2018/02/Emperor_Joshua_A._Norton_I-800x1212.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/Emperor_Joshua_A._Norton_I-160x242.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/Emperor_Joshua_A._Norton_I-240x364.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/Emperor_Joshua_A._Norton_I-375x568.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/Emperor_Joshua_A._Norton_I-520x788.jpg 520w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/Emperor_Joshua_A._Norton_I.jpg 866w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Emperor Norton in his traditional imperial outfit around 1875. \u003ccite>(Bancroft Library, UC Berkeley)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>He didn’t need much money. His lodgings on Commercial Street cost him only 50 cents a night, and he spent most of his day reading the newspapers, talking with other forty-niners in Portsmouth Square and writing proclamations at the Mechanics’ Institute Library on Post Street.\u003c/p>\n\u003cp>For lunch, Norton could go to almost any tavern in town and for the price of a drink, no more than 25 cents, get access to a full lunch spread of salmon, roast beef, tomatoes and more.\u003c/p>\n\u003cp>“He really makes himself part of the life of the city,” Lumea says. “He goes to political meetings. He goes to the theater. He goes to the saloons. He makes himself a public presence. He’s in the streets.”\u003c/p>\n\u003cp>The city’s newspapers saw Norton as a bit of a buffoon and regularly published fake proclamations with his name attached. So, in 1870, he started publishing his genuine proclamations almost exclusively in an African-American-owned and operated abolitionist weekly, The Pacific Appeal.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Many of Norton’s proclamations, especially those in The Pacific Appeal, were surprisingly progressive for his time.\u003c/p>\n\u003cp>“He’s talking about how African-Americans should have the right to attend public schools, ride public streetcars. How the Chinese should be able to have their testimony heard in court,” Lumea says. Norton also argued for the rights of Native Americans and against political corruption.\u003c/p>\n\u003cp>“So he’s really making himself into an early champion of the values of fairness and tolerance and the common good that really later become a great symbol of San Francisco,” Lumea says.\u003c/p>\n\u003ch3>‘Le roi est mort’\u003c/h3>\n\u003cp>Jan. 8, 1880, was a cold and rainy night in San Francisco. Norton left his room on Commercial Street to walk the few short blocks to a debate at the Academy of Natural Sciences.\u003c/p>\n\u003cp>On his way there, he collapsed on the street and died of a suspected stroke.\u003c/p>\n\u003cfigure id=\"attachment_11652860\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/4436597737_cae5796fb3_o-1.jpg\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-11652860\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/4436597737_cae5796fb3_o-1-800x1067.jpg\" alt=\"Emperor Norton's grave, which was moved from the Masonic Cemetery in San Francisco to Colma.\" width=\"800\" height=\"1067\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2018/02/4436597737_cae5796fb3_o-1-800x1067.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/4436597737_cae5796fb3_o-1-160x213.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/4436597737_cae5796fb3_o-1-1020x1360.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/4436597737_cae5796fb3_o-1-1180x1573.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/4436597737_cae5796fb3_o-1-960x1280.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/4436597737_cae5796fb3_o-1-240x320.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/4436597737_cae5796fb3_o-1-375x500.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/4436597737_cae5796fb3_o-1-520x693.jpg 520w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/4436597737_cae5796fb3_o-1.jpg 1536w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Emperor Norton’s grave, which was moved from the Masonic Cemetery in San Francisco to Colma. \u003ccite>(Joshua Neff/Flickr)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Ten thousand people came to Norton’s funeral. The headline of his obituary in the San Francisco Chronicle read, “Le roi est mort.”\u003c/p>\n\u003cp>Norton died with just a few dollars in his pockets and would have been sent to a pauper’s grave, if not for the intercession of his old friends in business, who paid for a fancy rosewood coffin adorned with silver and a burial plot in the Masonic Cemetery.\u003c/p>\n\u003cp>“Even though often in the official world of journalism or politics he was somewhat seen as a figure of ridicule,” Lumea says, “to the people in the streets who saw him on a day-to-day basis for 20 years, he was known as a very kind person.”\u003c/p>\n\u003ch3>Norton at 200\u003c/h3>\n\u003cp>Almost 140 years after his death, Norton continues to captivate San Francisco.\u003c/p>\n\u003cp>Lumea started the Emperor’s Bridge Campaign in 2013 to try to get the Bay Bridge renamed for Emperor Norton, in recognition of him publishing the idea decades before it came to be. The Board of Supervisors designated February 2018 as \u003ca href=\"https://twitter.com/EmperorsBridge/status/960568176013541376\" target=\"_blank\" rel=\"noopener\">“Emperor Norton Month,”\u003c/a> and City Hall and Coit Tower were lit up gold on Feb. 4, 2018, in honor of Norton’s 200th birthday.\u003c/p>\n\u003cp>“Nobody really encompasses the spirit of San Francisco better than Emperor Norton,” says Joseph Amster, one of two men who walk the streets of San Francisco as official Emperor Norton impersonators.\u003c/p>\n\u003cp>Amster and his fellow Norton, Rick Saber, both showed up in full imperial regalia at Norton’s 200th birthday party in February at one of Norton’s favorite spots, the Mechanics’ Institute Library.\u003c/p>\n\u003cfigure id=\"attachment_11652852\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/RS29664_DSC_1504-qut.jpg\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-11652852\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/RS29664_DSC_1504-qut-800x530.jpg\" alt=\"Jennifer Jacobs stands with Rick Saber (L) and Joseph Amster (R), two official Emperor Norton impersonators at Emperor Norton's 200th birthday party at the Mechanics' Institute in San Francisco on Feb. 7, 2018.\" width=\"800\" height=\"530\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29664_DSC_1504-qut-800x530.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29664_DSC_1504-qut-160x106.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29664_DSC_1504-qut-1020x676.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29664_DSC_1504-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29664_DSC_1504-qut-1180x782.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29664_DSC_1504-qut-960x636.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29664_DSC_1504-qut-240x159.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29664_DSC_1504-qut-375x248.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29664_DSC_1504-qut-520x345.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jennifer Jacobs stands with Rick Saber (L) and Joseph Amster (R), two official Emperor Norton impersonators, at Emperor Norton’s 200th birthday party at the Mechanics’ Institute Library in San Francisco on Feb. 7, 2018. \u003ccite>(Ryan Levi/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Guests came dressed in their 19th century finest, from Wild West leather chaps to Victorian dresses, to honor Norton. Kazuo Sayama came all the way from Japan to attend the party. He first learned about Norton decades ago while he was doing research for a book about San Francisco, and he was so enthralled by his story that he dedicated an entire book to just Norton and is working on a second.\u003c/p>\n\u003cp>“You have so many presidents,” Sayama says of the United States, “but no emperor in history. But people admire him as emperor.”\u003c/p>\n\u003cp>For many at the party and across the city, Norton represents the best of the Bay Area: an advocate of fairness and tolerance, a kind person and a bit of an oddball.\u003c/p>\n\u003cp>“He’s kind of a symbol of why this isn’t New York or why this isn’t Florida or why this isn’t Seattle,” says Tito Young, who came to the party dressed as a Wild West cowboy in brown leather chaps. “I think there’s something wonderfully eccentric about this gentleman, which I can very much identify with.”\u003cbr>\n\u003c/p>\u003cp>\u003caside class=\"alignleft utils-parseShortcode-shortcodes-__bayCuriousPodcastShortcode__bayCurious\">\u003cimg src=https://cdn.kqed.org/wp-content/uploads/2023/02/bayCuriousLogo.png alt=\"Bay Curious Podcast\" loading=\"lazy\" />\n What do you wonder about the Bay Area, its culture or people that you want KQED to investigate?\n \u003ca href=\"/news/series/baycurious\">Ask Bay Curious.\u003c/a>\u003c/aside>\u003c/p>\u003cp>\u003cbr>\n“I’m glad there’s a strong personality in my family tree,” says Julie Driver, Norton’s great-great-great-great-niece. She lives in Ontario, Canada, and learned about her famous relative from her dad. “He found a way to make a name for himself after he lost his fortune, and I think that’s something that we should learn from.”\u003c/p>\n\u003cp>Bay Curious listener Jennifer Jacobs was blown away by the sustained love and attention the city continues to give Emperor Norton, and she can’t imagine it happening in any other city.\u003c/p>\n\u003cp>“San Francisco is a quirky town in a lot of ways,” she says, “and he kind of embodies that.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Protesters Surround San Francisco ICE Office After Immigration Arrests",
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"content": "\u003cp>\u003cstrong>Update, March 1, 12:40 p.m: \u003c/strong>San Francisco officials have announced that the city will spend an additional $3.5 million annually on legal services for detained immigrants, through the Public Defender's Office and local nonprofits. That's more money than initially suggested by Supervisor Sandra Lee Fewer, who worked with Mayor Mark Farrell and others on the funding plan.\u003c/p>\n\u003cp>The additional resources bring total annual city spending for immigrant legal aid to more than $11 million. In addition, Farrell and San Francisco Assemblyman Phil Ting are advocating for $7 million in state funding to provide legal representation for all immigrants detained in Northern California. A majority of detained immigrants lack legal representation, according to city officials.\u003c/p>\n\u003cp>\u003cstrong>Original story:\u003c/strong>\u003c/p>\n\u003cp>More than 200 protesters surrounded the offices of U.S. Immigration and Customs Enforcement in downtown San Francisco Wednesday and closed the area to traffic, after \u003ca href=\"https://ww2.kqed.org/news/2018/02/27/advocates-confirm-23-immigrants-arrested-in-northern-california-operation/\" target=\"_blank\" rel=\"noopener\">the federal agency arrested more than 150 people\u003c/a> in Northern and Central California this week.\u003c/p>\n\u003cp>About half of the immigrants arrested since Sunday have criminal backgrounds, according to an ICE statement, which said the agency is targeting people it considers a threat to public safety. But protesters denounced the operation as a move that terrorizes communities and separates families.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[contextly_sidebar id=\"sDH8fHn25tck1dSHHSP43D8YIpDYin5G\"]\u003c/p>\n\u003cp>UC Berkeley graduate Juan Prieto went to the protest to demand that ICE ensure detainees are treated fairly and are given access to immigration attorneys. Prieto, a recipient of Deferred Action for Childhood Arrivals, or DACA, protection, was one of 10 protesters who linked arms and blocked the intersection of Sansome and Washington streets for four hours.\u003c/p>\n\u003cp>[audio src=\"https://www.kqed.org/.stream/anon/radio/RDnews/2018/03/20180301romero.mp3\" title=\"Protesters Surround San Francisco ICE Office After Immigration Arrests\" program=\"KQED News\" image=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/RS29672_alt_694.jpg\"]\u003c/p>\n\u003cp>\"Sharing a post on Facebook is no longer enough to protect the undocumented community. They need to get to the streets and shut down ICE,\" said Prieto, 25, whose younger brother is a U.S. citizen while other relatives are undocumented.\u003c/p>\n\u003cp>\"I need to set an example for my family that we don't need to be afraid. We need to be bolder,\" he said.\u003c/p>\n\u003cfigure id=\"attachment_11652916\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-11652916 size-full\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/RS29666_IMG_8268-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29666_IMG_8268-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29666_IMG_8268-qut-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29666_IMG_8268-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29666_IMG_8268-qut-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29666_IMG_8268-qut-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29666_IMG_8268-qut-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29666_IMG_8268-qut-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29666_IMG_8268-qut-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29666_IMG_8268-qut-520x390.jpg 520w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Juan Prieto, 25, links arms with Cristian Alejandre, 23, to block the intersection of Sansome and Washington streets on Feb. 28, 2018. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>While protester Rosa Alvarado said she wants to protect undocumented immigrants who are otherwise law-abiding, she welcomes immigration enforcement targeting criminal activity.\u003c/p>\n\u003cp>\"We don't need that here. We already have a lot of problems with drugs and homelessness,\" said Alvarado, adding that she frequently sees drug sales on the streets of her Tenderloin neighborhood.\u003c/p>\n\u003cfigure id=\"attachment_11652924\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-11652924 size-full\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/RS29673_407-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29673_407-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29673_407-qut-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29673_407-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29673_407-qut-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29673_407-qut-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29673_407-qut-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29673_407-qut-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29673_407-qut-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29673_407-qut-520x390.jpg 520w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Protesters gathered by the entrance to ICE offices on 630 Sansome St. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>San Francisco Supervisor Sandra Lee Fewer said the city is announcing Thursday that it will hire four more attorneys to represent detained immigrants through the Public Defender's Office. The city is also giving an additional $1.5 million to local nonprofit immigrant rights groups so they can conduct education campaigns and provide legal aid, she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We are not going to sit by idly. San Francisco is going to put money where their values are,\" said Fewer, who represents the Richmond district and is the granddaughter of immigrants.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Update, March 1, 12:40 p.m: \u003c/strong>San Francisco officials have announced that the city will spend an additional $3.5 million annually on legal services for detained immigrants, through the Public Defender's Office and local nonprofits. That's more money than initially suggested by Supervisor Sandra Lee Fewer, who worked with Mayor Mark Farrell and others on the funding plan.\u003c/p>\n\u003cp>The additional resources bring total annual city spending for immigrant legal aid to more than $11 million. In addition, Farrell and San Francisco Assemblyman Phil Ting are advocating for $7 million in state funding to provide legal representation for all immigrants detained in Northern California. A majority of detained immigrants lack legal representation, according to city officials.\u003c/p>\n\u003cp>\u003cstrong>Original story:\u003c/strong>\u003c/p>\n\u003cp>More than 200 protesters surrounded the offices of U.S. Immigration and Customs Enforcement in downtown San Francisco Wednesday and closed the area to traffic, after \u003ca href=\"https://ww2.kqed.org/news/2018/02/27/advocates-confirm-23-immigrants-arrested-in-northern-california-operation/\" target=\"_blank\" rel=\"noopener\">the federal agency arrested more than 150 people\u003c/a> in Northern and Central California this week.\u003c/p>\n\u003cp>About half of the immigrants arrested since Sunday have criminal backgrounds, according to an ICE statement, which said the agency is targeting people it considers a threat to public safety. But protesters denounced the operation as a move that terrorizes communities and separates families.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Sharing a post on Facebook is no longer enough to protect the undocumented community. They need to get to the streets and shut down ICE,\" said Prieto, 25, whose younger brother is a U.S. citizen while other relatives are undocumented.\u003c/p>\n\u003cp>\"I need to set an example for my family that we don't need to be afraid. We need to be bolder,\" he said.\u003c/p>\n\u003cfigure id=\"attachment_11652916\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-11652916 size-full\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/RS29666_IMG_8268-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29666_IMG_8268-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29666_IMG_8268-qut-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29666_IMG_8268-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29666_IMG_8268-qut-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29666_IMG_8268-qut-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29666_IMG_8268-qut-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29666_IMG_8268-qut-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29666_IMG_8268-qut-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29666_IMG_8268-qut-520x390.jpg 520w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Juan Prieto, 25, links arms with Cristian Alejandre, 23, to block the intersection of Sansome and Washington streets on Feb. 28, 2018. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>While protester Rosa Alvarado said she wants to protect undocumented immigrants who are otherwise law-abiding, she welcomes immigration enforcement targeting criminal activity.\u003c/p>\n\u003cp>\"We don't need that here. We already have a lot of problems with drugs and homelessness,\" said Alvarado, adding that she frequently sees drug sales on the streets of her Tenderloin neighborhood.\u003c/p>\n\u003cfigure id=\"attachment_11652924\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-11652924 size-full\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/RS29673_407-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29673_407-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29673_407-qut-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29673_407-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29673_407-qut-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29673_407-qut-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29673_407-qut-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29673_407-qut-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29673_407-qut-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2018/02/RS29673_407-qut-520x390.jpg 520w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Protesters gathered by the entrance to ICE offices on 630 Sansome St. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>San Francisco Supervisor Sandra Lee Fewer said the city is announcing Thursday that it will hire four more attorneys to represent detained immigrants through the Public Defender's Office. The city is also giving an additional $1.5 million to local nonprofit immigrant rights groups so they can conduct education campaigns and provide legal aid, she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We are not going to sit by idly. San Francisco is going to put money where their values are,\" said Fewer, who represents the Richmond district and is the granddaughter of immigrants.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Too Late To Operate? Surgery Near End Of Life Is Common, Costly",
"title": "Too Late To Operate? Surgery Near End Of Life Is Common, Costly",
"headTitle": "The California Report | KQED News",
"content": "\u003cp>At 87, Maxine Stanich cared more about improving the quality of her life than prolonging it.\u003c/p>\n\u003cp>She suffered from a long list of health problems, including heart failure and chronic lung disease that could leave her gasping for breath.\u003c/p>\n\u003cp>When her time came she wanted to die a natural death, Stanich told her daughter, and she signed a \"do not resuscitate\" directive, or DNR, ordering doctors not to revive her should her heart stop.\u003c/p>\n\u003cp>Yet a trip to a San Francisco emergency room for shortness of breath in 2008 led Stanich to get a defibrillator implanted in her chest — a medical device to keep her alive by delivering a powerful shock to her heart if it started beating irregularly.\u003c/p>\n\u003cp>At the time, Stanich didn't fully grasp what she had agreed to, even though she signed a document granting permission for the procedure, said her daughter, Susan Giaquinto.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That clarity came only during a subsequent visit to a different hospital, when a surprised ER doctor saw the defibrillator protruding from Stanich's thin chest. It was the first time a doctor clearly explained what the defibrillator would mean for Stanich, said Giaquinto, who accompanied her mother on both hospital trips.\u003c/p>\n\u003cp>To Stanich's horror, the ER doctor explained that the device wouldn't allow Stanich to slip away painlessly. Instead, the defibrillator would give her a jolt \"so strong that it will knock her across the room,\" Giaquinto said.\u003c/p>\n\u003cp>Surgery like Stanich's defibrillator implantation has become all too common among those near the end of life, experts say. Nearly \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61268-3/fulltext\" target=\"_blank\" rel=\"noopener\">1 in 3 Medicare patients\u003c/a> undergoes an operation in the year before death, even though the evidence shows that many are more likely to be harmed than to benefit from it.\u003c/p>\n\u003cfigure id=\"attachment_11652868\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-11652868\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/rita-redberg-toned-41-f9f41542571d59b90321a2c978b286c7de516c4d-e1519866638109.jpg\" alt=\"Dr. Rita Redberg, director of women's cardiovascular services at the University of California, San Francisco's cardiology division, tends to her mother, Mae Redberg, in Mae's apartment in New York City.\" width=\"1920\" height=\"1440\">\u003cfigcaption class=\"wp-caption-text\">Dr. Rita Redberg, director of women's cardiovascular services at the University of California, San Francisco's cardiology division, tends to her mother, Mae Redberg, in Mae's apartment in New York City. \u003ccite>(Yana Paskova/Kaiser Health News)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The practice is driven by financial incentives that reward doctors for doing procedures, as well as a medical culture in which patients and doctors are reluctant to talk about how surgical interventions should be prescribed more judiciously, said \u003ca href=\"http://profiles.ucsf.edu/rita.redberg\" target=\"_blank\" rel=\"noopener\">Dr. Rita Redberg\u003c/a>, a cardiologist who treated Stanich when she sought care at the second hospital a week after her defibrillator was implanted.\u003c/p>\n\u003cp>\"We have a culture that believes in very aggressive care,\" said Redberg, who specializes in heart disease in women at the University of California, San Francisco. \"We are often not considering the chance of benefit and chance of harm, and how that changes when you get older. We also fail to have conversations about what patients value most.\"\u003c/p>\n\u003cp>While surgery can be lifesaving for younger people, operating on frail, older patients rarely helps them live longer or returns the quality of life they once enjoyed, according to \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4492901/pdf/nihms647215.pdf\" target=\"_blank\" rel=\"noopener\">a 2016 paper\u003c/a> in \u003cem>Annals of Surgery.\u003c/em>\u003c/p>\n\u003cp>The cost of these surgeries — typically paid for by Medicare, the government health insurance program for people over 65 — involve more than money, said Dr. Amber Barnato, a professor at the Dartmouth Institute for Health Policy and Clinical Practice. Older patients who undergo surgery within a year of death spent 50 percent more time in the hospital than others, and nearly twice as many days in intensive care.\u003c/p>\n\u003cp>And while some robust octogenarians have many years ahead of them, studies show that surgery is also common among those who are far more frail.\u003c/p>\n\u003cp>Eighteen percent of Medicare patients have surgery in their final month of life and 8 percent in their final week, according to a \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61268-3/fulltext\" target=\"_blank\" rel=\"noopener\">2011 study \u003c/a>in \u003cem>The Lancet.\u003c/em>\u003c/p>\n\u003cp>More than 12 percent of defibrillators were implanted in people older than 80, \u003ca href=\"https://academic.oup.com/europace/article/17/2/174/569259\" target=\"_blank\" rel=\"noopener\">according to a 2015 study.\u003c/a> Doctors implant about 158,000 of the devices each year, according to the American College of Cardiology. The total \u003ca href=\"https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Inpatient2015.html\" target=\"_blank\" rel=\"noopener\">cost\u003c/a> of the procedure runs about $60,000.\u003c/p>\n\u003cp>Procedures performed in the elderly range from major operations require lengthy recoveries compared to relatively minor surgery performed in a doctor's office, such as the removal of nonfatal skin cancers that would likely never cause any problems.\u003c/p>\n\u003cp>Research led by Dr. Eleni Linos has shown that people with limited life expectancies \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1111/jgs.14202/abstract\" target=\"_blank\" rel=\"noopener\">are treated for nonfatal skin cancers as aggressively as younger patients\u003c/a>. Among patients with a nonfatal skin cancer and a limited time to live, 70 percent underwent surgery, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23699934\" target=\"_blank\" rel=\"noopener\">according to\u003c/a> her 2013 study in \u003cem>JAMA Internal Medicine\u003c/em>.\u003c/p>\n\u003cp>\u003cstrong>When less is more\u003c/strong>\u003c/p>\n\u003cp>Surgery poses serious risks for older people, who weather anesthesia poorly and whose skin takes longer to heal. Among seniors who undergo urgent or emergency abdominal surgery, 20 percent die within 30 days, \u003ca href=\"https://jamanetwork.com/journals/jamasurgery/article-abstract/2599170\" target=\"_blank\" rel=\"noopener\">studies show.\u003c/a>\u003c/p>\n\u003cp>With diminished mental acuity and an old-fashioned respect for the medical profession, some aging patients are vulnerable to unwanted interventions. Stanich agreed to a pacemaker defibrillator simply because her doctor suggested it, Giaquinto said. Many people of Stanich's generation \"thought doctors were God ... They never questioned doctors — ever.\"\u003c/p>\n\u003cp>According to the University of Michigan's National Poll on Healthy Aging, published Wednesday, more than half of adults ages 50 to 80 said doctors often recommend unnecessary tests, medications or procedures. Yet half of those who'd been told they needed an X-ray or other test – but weren't sure they needed it – went on to have the procedure anyway.\u003c/p>\n\u003cp>Dr. Margaret Schwarze, a surgeon and associate professor at the University of Wisconsin School of Medicine and Public Health, said that older patients often don't feel the financial pain of surgery because insurance pays most of the cost.\u003c/p>\n\u003cp>When a surgeon offers to \"fix\" the heart valve in a person with multiple diseases, for example, the patient may assume that surgery will \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/25749396\" target=\"_blank\" rel=\"noopener\">fix all of her medical problems,\u003c/a> Schwarze said. \"With older patients with lots of chronic illnesses, we're not really fixing anything.\"\u003c/p>\n\u003cp>Even as a doctor, Redberg said, she struggles to prevent other doctors from performing too many procedures on her 92-year-old mother, Mae, who lives in New York City.\u003c/p>\n\u003cp>Redberg said doctors recently treated her mother for melanoma — the most serious type of skin cancer. After the cancer was removed from her leg, Redberg's mother was urged by a doctor to undergo an additional surgery to cut away more tissue and nearby lymph nodes, which can harbor cancerous cells.\u003c/p>\n\u003cp>\"Every time she went in, the dermatologist wanted to refer her to a surgeon,\" Redberg said. \"Medicare would have been happy to pay for it.\"\u003c/p>\n\u003cp>But her mother often has problems with wound healing, she said, and recovery would likely have taken three months. When Redberg pressed a surgeon about the benefits, he said the procedure could reduce the chances of cancer coming back within three to five years.\u003c/p>\n\u003cp>Redberg said her mother laughed and said, \"I'm not interested in doing something that will help me in three to five years. I doubt I'll be here.\"\u003c/p>\n\u003cp>\u003cstrong>Finding solutions\u003c/strong>\u003c/p>\n\u003cp>The momentum of hospital care can make people feel as if they're on a moving train and can't jump off.\u003c/p>\n\u003cp>The rush of medical decisions \"doesn't allow time to deliberate or consider the patients' overall health or what their goals and values might be,\" said Dr. Jacqueline Kruser, an instructor in pulmonary and critical care medicine and medical social sciences at the Northwestern University Feinberg School of Medicine.\u003c/p>\n\u003cp>Many hospitals and health systems are developing \"decision aids,\" easy-to-understand written \u003ca href=\"http://centerforinnovation.mayo.edu/decision-aids/\" target=\"_blank\" rel=\"noopener\">materials and videos\u003c/a> to help patients make more informed medical choices, giving them time to develop more realistic expectations.\u003c/p>\n\u003cp>After Kaiser Permanente Washington introduced the tools relating to joint replacement, the number of patients choosing to have hip replacement surgery fell 26 percent, while knee replacements declined 38 percent, \u003ca href=\"https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2011.0686\" target=\"_blank\" rel=\"noopener\">according to a 2012 study\u003c/a> in the journal \u003cem>Health Affairs.\u003c/em> (Kaiser Permanente isn't affiliated with Kaiser Health News, which is an editorially independent program of the Kaiser Family Foundation.)\u003c/p>\n\u003cp>In research findings \u003ca href=\"https://jamanetwork.com/journals/jamasurgery/article-abstract/2599170\" target=\"_blank\" rel=\"noopener\">published last year\u003c/a> in \u003cem>JAMA Surgery\u003c/em> and the \u003ca href=\"http://www.jpsmjournal.com/article/S0885-3924(16)31228-3/pdf\" target=\"_blank\" rel=\"noopener\">Journal of Pain and Symptom Management,\u003c/a> Schwarze, Kruser and colleagues suggested creating narratives to illustrate surgical risks, rather than relying on statistics.\u003c/p>\n\u003cp>Instead of telling patients that surgery carries a 20 percent risk of stroke, for example, doctors should lay out the best, worst and most likely outcomes.\u003c/p>\n\u003cp>In the best-case scenario, a patient might spend weeks in the hospital after surgery, living the rest of her life in a nursing home. In the worst case, the same patient dies after several weeks in intensive care. In the most likely scenario, the patient survives just two to three months after surgery.\u003c/p>\n\u003cp>\"If someone says they can't tolerate the best-case scenario — which involves them being in a nursing home — then maybe we shouldn't be doing this,\" Schwarze said.\u003c/p>\n\u003cp>Maxine Stanich died in 2010, just after her 90th birthday. Although Redberg had deactivated the defibrillator at Stanich's request, it remained in her chest.\u003c/p>\n\u003chr>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ca href=\"https://khn.org/about-us\" target=\"_blank\" rel=\"noopener\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem> is a nonprofit news service covering health issues. You can follow Liz Szabo on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/LizSzabo\" target=\"_blank\" rel=\"noopener\">\u003cem>@LizSzabo\u003c/em>\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Too+Late+To+Operate%3F+Surgery+Near+End+Of+Life+Is+Common%2C+Costly&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>At 87, Maxine Stanich cared more about improving the quality of her life than prolonging it.\u003c/p>\n\u003cp>She suffered from a long list of health problems, including heart failure and chronic lung disease that could leave her gasping for breath.\u003c/p>\n\u003cp>When her time came she wanted to die a natural death, Stanich told her daughter, and she signed a \"do not resuscitate\" directive, or DNR, ordering doctors not to revive her should her heart stop.\u003c/p>\n\u003cp>Yet a trip to a San Francisco emergency room for shortness of breath in 2008 led Stanich to get a defibrillator implanted in her chest — a medical device to keep her alive by delivering a powerful shock to her heart if it started beating irregularly.\u003c/p>\n\u003cp>At the time, Stanich didn't fully grasp what she had agreed to, even though she signed a document granting permission for the procedure, said her daughter, Susan Giaquinto.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That clarity came only during a subsequent visit to a different hospital, when a surprised ER doctor saw the defibrillator protruding from Stanich's thin chest. It was the first time a doctor clearly explained what the defibrillator would mean for Stanich, said Giaquinto, who accompanied her mother on both hospital trips.\u003c/p>\n\u003cp>To Stanich's horror, the ER doctor explained that the device wouldn't allow Stanich to slip away painlessly. Instead, the defibrillator would give her a jolt \"so strong that it will knock her across the room,\" Giaquinto said.\u003c/p>\n\u003cp>Surgery like Stanich's defibrillator implantation has become all too common among those near the end of life, experts say. Nearly \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61268-3/fulltext\" target=\"_blank\" rel=\"noopener\">1 in 3 Medicare patients\u003c/a> undergoes an operation in the year before death, even though the evidence shows that many are more likely to be harmed than to benefit from it.\u003c/p>\n\u003cfigure id=\"attachment_11652868\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-11652868\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/02/rita-redberg-toned-41-f9f41542571d59b90321a2c978b286c7de516c4d-e1519866638109.jpg\" alt=\"Dr. Rita Redberg, director of women's cardiovascular services at the University of California, San Francisco's cardiology division, tends to her mother, Mae Redberg, in Mae's apartment in New York City.\" width=\"1920\" height=\"1440\">\u003cfigcaption class=\"wp-caption-text\">Dr. Rita Redberg, director of women's cardiovascular services at the University of California, San Francisco's cardiology division, tends to her mother, Mae Redberg, in Mae's apartment in New York City. \u003ccite>(Yana Paskova/Kaiser Health News)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The practice is driven by financial incentives that reward doctors for doing procedures, as well as a medical culture in which patients and doctors are reluctant to talk about how surgical interventions should be prescribed more judiciously, said \u003ca href=\"http://profiles.ucsf.edu/rita.redberg\" target=\"_blank\" rel=\"noopener\">Dr. Rita Redberg\u003c/a>, a cardiologist who treated Stanich when she sought care at the second hospital a week after her defibrillator was implanted.\u003c/p>\n\u003cp>\"We have a culture that believes in very aggressive care,\" said Redberg, who specializes in heart disease in women at the University of California, San Francisco. \"We are often not considering the chance of benefit and chance of harm, and how that changes when you get older. We also fail to have conversations about what patients value most.\"\u003c/p>\n\u003cp>While surgery can be lifesaving for younger people, operating on frail, older patients rarely helps them live longer or returns the quality of life they once enjoyed, according to \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4492901/pdf/nihms647215.pdf\" target=\"_blank\" rel=\"noopener\">a 2016 paper\u003c/a> in \u003cem>Annals of Surgery.\u003c/em>\u003c/p>\n\u003cp>The cost of these surgeries — typically paid for by Medicare, the government health insurance program for people over 65 — involve more than money, said Dr. Amber Barnato, a professor at the Dartmouth Institute for Health Policy and Clinical Practice. Older patients who undergo surgery within a year of death spent 50 percent more time in the hospital than others, and nearly twice as many days in intensive care.\u003c/p>\n\u003cp>And while some robust octogenarians have many years ahead of them, studies show that surgery is also common among those who are far more frail.\u003c/p>\n\u003cp>Eighteen percent of Medicare patients have surgery in their final month of life and 8 percent in their final week, according to a \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61268-3/fulltext\" target=\"_blank\" rel=\"noopener\">2011 study \u003c/a>in \u003cem>The Lancet.\u003c/em>\u003c/p>\n\u003cp>More than 12 percent of defibrillators were implanted in people older than 80, \u003ca href=\"https://academic.oup.com/europace/article/17/2/174/569259\" target=\"_blank\" rel=\"noopener\">according to a 2015 study.\u003c/a> Doctors implant about 158,000 of the devices each year, according to the American College of Cardiology. The total \u003ca href=\"https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Inpatient2015.html\" target=\"_blank\" rel=\"noopener\">cost\u003c/a> of the procedure runs about $60,000.\u003c/p>\n\u003cp>Procedures performed in the elderly range from major operations require lengthy recoveries compared to relatively minor surgery performed in a doctor's office, such as the removal of nonfatal skin cancers that would likely never cause any problems.\u003c/p>\n\u003cp>Research led by Dr. Eleni Linos has shown that people with limited life expectancies \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1111/jgs.14202/abstract\" target=\"_blank\" rel=\"noopener\">are treated for nonfatal skin cancers as aggressively as younger patients\u003c/a>. Among patients with a nonfatal skin cancer and a limited time to live, 70 percent underwent surgery, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23699934\" target=\"_blank\" rel=\"noopener\">according to\u003c/a> her 2013 study in \u003cem>JAMA Internal Medicine\u003c/em>.\u003c/p>\n\u003cp>\u003cstrong>When less is more\u003c/strong>\u003c/p>\n\u003cp>Surgery poses serious risks for older people, who weather anesthesia poorly and whose skin takes longer to heal. Among seniors who undergo urgent or emergency abdominal surgery, 20 percent die within 30 days, \u003ca href=\"https://jamanetwork.com/journals/jamasurgery/article-abstract/2599170\" target=\"_blank\" rel=\"noopener\">studies show.\u003c/a>\u003c/p>\n\u003cp>With diminished mental acuity and an old-fashioned respect for the medical profession, some aging patients are vulnerable to unwanted interventions. Stanich agreed to a pacemaker defibrillator simply because her doctor suggested it, Giaquinto said. Many people of Stanich's generation \"thought doctors were God ... They never questioned doctors — ever.\"\u003c/p>\n\u003cp>According to the University of Michigan's National Poll on Healthy Aging, published Wednesday, more than half of adults ages 50 to 80 said doctors often recommend unnecessary tests, medications or procedures. Yet half of those who'd been told they needed an X-ray or other test – but weren't sure they needed it – went on to have the procedure anyway.\u003c/p>\n\u003cp>Dr. Margaret Schwarze, a surgeon and associate professor at the University of Wisconsin School of Medicine and Public Health, said that older patients often don't feel the financial pain of surgery because insurance pays most of the cost.\u003c/p>\n\u003cp>When a surgeon offers to \"fix\" the heart valve in a person with multiple diseases, for example, the patient may assume that surgery will \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/25749396\" target=\"_blank\" rel=\"noopener\">fix all of her medical problems,\u003c/a> Schwarze said. \"With older patients with lots of chronic illnesses, we're not really fixing anything.\"\u003c/p>\n\u003cp>Even as a doctor, Redberg said, she struggles to prevent other doctors from performing too many procedures on her 92-year-old mother, Mae, who lives in New York City.\u003c/p>\n\u003cp>Redberg said doctors recently treated her mother for melanoma — the most serious type of skin cancer. After the cancer was removed from her leg, Redberg's mother was urged by a doctor to undergo an additional surgery to cut away more tissue and nearby lymph nodes, which can harbor cancerous cells.\u003c/p>\n\u003cp>\"Every time she went in, the dermatologist wanted to refer her to a surgeon,\" Redberg said. \"Medicare would have been happy to pay for it.\"\u003c/p>\n\u003cp>But her mother often has problems with wound healing, she said, and recovery would likely have taken three months. When Redberg pressed a surgeon about the benefits, he said the procedure could reduce the chances of cancer coming back within three to five years.\u003c/p>\n\u003cp>Redberg said her mother laughed and said, \"I'm not interested in doing something that will help me in three to five years. I doubt I'll be here.\"\u003c/p>\n\u003cp>\u003cstrong>Finding solutions\u003c/strong>\u003c/p>\n\u003cp>The momentum of hospital care can make people feel as if they're on a moving train and can't jump off.\u003c/p>\n\u003cp>The rush of medical decisions \"doesn't allow time to deliberate or consider the patients' overall health or what their goals and values might be,\" said Dr. Jacqueline Kruser, an instructor in pulmonary and critical care medicine and medical social sciences at the Northwestern University Feinberg School of Medicine.\u003c/p>\n\u003cp>Many hospitals and health systems are developing \"decision aids,\" easy-to-understand written \u003ca href=\"http://centerforinnovation.mayo.edu/decision-aids/\" target=\"_blank\" rel=\"noopener\">materials and videos\u003c/a> to help patients make more informed medical choices, giving them time to develop more realistic expectations.\u003c/p>\n\u003cp>After Kaiser Permanente Washington introduced the tools relating to joint replacement, the number of patients choosing to have hip replacement surgery fell 26 percent, while knee replacements declined 38 percent, \u003ca href=\"https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2011.0686\" target=\"_blank\" rel=\"noopener\">according to a 2012 study\u003c/a> in the journal \u003cem>Health Affairs.\u003c/em> (Kaiser Permanente isn't affiliated with Kaiser Health News, which is an editorially independent program of the Kaiser Family Foundation.)\u003c/p>\n\u003cp>In research findings \u003ca href=\"https://jamanetwork.com/journals/jamasurgery/article-abstract/2599170\" target=\"_blank\" rel=\"noopener\">published last year\u003c/a> in \u003cem>JAMA Surgery\u003c/em> and the \u003ca href=\"http://www.jpsmjournal.com/article/S0885-3924(16)31228-3/pdf\" target=\"_blank\" rel=\"noopener\">Journal of Pain and Symptom Management,\u003c/a> Schwarze, Kruser and colleagues suggested creating narratives to illustrate surgical risks, rather than relying on statistics.\u003c/p>\n\u003cp>Instead of telling patients that surgery carries a 20 percent risk of stroke, for example, doctors should lay out the best, worst and most likely outcomes.\u003c/p>\n\u003cp>In the best-case scenario, a patient might spend weeks in the hospital after surgery, living the rest of her life in a nursing home. In the worst case, the same patient dies after several weeks in intensive care. In the most likely scenario, the patient survives just two to three months after surgery.\u003c/p>\n\u003cp>\"If someone says they can't tolerate the best-case scenario — which involves them being in a nursing home — then maybe we shouldn't be doing this,\" Schwarze said.\u003c/p>\n\u003cp>Maxine Stanich died in 2010, just after her 90th birthday. Although Redberg had deactivated the defibrillator at Stanich's request, it remained in her chest.\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://khn.org/about-us\" target=\"_blank\" rel=\"noopener\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem> is a nonprofit news service covering health issues. You can follow Liz Szabo on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/LizSzabo\" target=\"_blank\" rel=\"noopener\">\u003cem>@LizSzabo\u003c/em>\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Too+Late+To+Operate%3F+Surgery+Near+End+Of+Life+Is+Common%2C+Costly&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Hope Hicks to Resign as White House Communications Director",
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"content": "\u003cp>\u003cstrong>Updated at 7:08 p.m. ET\u003c/strong>\u003c/p>\n\u003cp>White House communications director Hope Hicks, President Trump's longest-serving aide, is resigning and will depart in the next few weeks, the White House says.\u003c/p>\n\u003cp>In a White House that has \u003ca href=\"https://www.npr.org/2018/01/19/578858897/turnover-in-trumps-white-house-is-record-setting-and-it-isn-t-even-close\">set records for staff turnover\u003c/a> (and it isn't even close), the departure of Hicks still came as a shock. \u003c/p>\n\u003cp>Hicks, who has been working with the president for three years, managed to stay in his orbit even after many others had been pushed out. President Trump called Hicks \"outstanding.\"\u003c/p>\n\u003cp>\"She is as smart and thoughtful as they come, a truly great person,\" Trump said in a statement on Wednesday. \"I will miss having her by my side but when she approached me about pursuing other opportunities, I totally understood. I am sure we will work together again in the future.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>News of Hicks' departure followed a day after she testified for hours before a closed session of the House intelligence committee as part of its Russia probe, \u003ca href=\"https://www.nytimes.com/2018/02/27/us/politics/hope-hicks-house-intelligence-committee-testimony.html\">reportedly admitting\u003c/a> to telling \"white lies\" on behalf of the president, though not in matters material to the investigation. Lawmakers are investigating Russia's interference in the 2016 presidential election and whether any Trump campaign associates aided that effort. The White House has repeatedly denied any such collusion. \u003c/p>\n\u003cp>[contextly_sidebar id=\"raXUonWHyQrHnTcQxXmYq5yhtIKWUWeY\"]\u003c/p>\n\u003cp>Earlier this month Hicks was deeply involved in the White House's botched handling of domestic abuse allegations against a former top aide to the president. But a White House official insists Hicks' decision to resign wasn't related to either of those matters.\u003c/p>\n\u003cp>Another person close to Hicks told NPR the resignation has been in the works for weeks.\u003c/p>\n\u003cp>In a White House full of big personalities, the 29-year-old former teen fashion model has had a knack for maintaining a low profile; that is, until recently. She was often photographed with other White House aides but rarely went on the record and almost never spoke before microphones.\u003c/p>\n\u003cp>\"I think it's a skill ... to avoid being in the press,\" Dana Perino, who served as White House press secretary during the George W. Bush administration, told NPR in August. \"She is a true communications professional in that she doesn't seek the limelight.\"\u003c/p>\n\u003cp>That skill, along with her apparently unwavering loyalty, helped keep her in the president's good graces. That loyalty was once again on display in a quote circulated by the White House announcing her departure. \u003c/p>\n\u003cp>\"There are no words to adequately express my gratitude to President Trump,\" Hicks said in the statement. \"I wish the President and his administration the very best as he continues to lead our country.\"\u003c/p>\n\u003cp>[contextly_sidebar id=\"pzTMmi1EJYaqwylxqWOMHdsw9v4anG0d\"]\u003c/p>\n\u003cp>Hicks joined the Trump organization in 2014 — recruited by Ivanka Trump, who was impressed by work Hicks had done for her clothing line while working at a New York public relations firm. Hicks was then pulled into the Trump campaign before there even was a campaign, becoming de facto press secretary while initially she continued doing work for the Trump Organization. \u003c/p>\n\u003cp>\"She really understood the president's brand, that he's a mogul, that he's a magnet,\" said Sam Nunberg, who served as an adviser to Trump from 2011 to mid-2015. \"And she said to me that people in the primary states were going to view him as a president because they watched him on \u003cem>The Apprentice. \u003c/em>Which was true.\u003cem>\"\u003c/em>\u003c/p>\n\u003cp>Hicks was serving as the White House's director of strategic communications, an unusual role where she essentially functioned as a gatekeeper to the president, when she was \u003ca href=\"https://www.npr.org/2017/08/16/543901998/hope-hicks-named-interim-white-house-communications-director\">named interim communications director\u003c/a> in August. That followed the days-long tenure of Anthony Scaramucci and the departure of multiple other communications directors — Sean Spicer, who had also been press secretary; Mike Dubke; and Jason Miller, who served during the transition. \u003c/p>\n\u003cp>Nunberg predicted at the time of her promotion that Hicks would be with Trump \"to the very end.\" \u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Even so, on Wednesday, the aide who was so close to Trump she was often described as being like family said she, too, would leave. \u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Hope+Hicks+To+Resign+As+White+House+Communications+Director&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "Hicks has worked for President Trump for three years, remaining a close aide even as many others were pushed out. \"I am sure we will work together again in the future,\" the president said.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Updated at 7:08 p.m. ET\u003c/strong>\u003c/p>\n\u003cp>White House communications director Hope Hicks, President Trump's longest-serving aide, is resigning and will depart in the next few weeks, the White House says.\u003c/p>\n\u003cp>In a White House that has \u003ca href=\"https://www.npr.org/2018/01/19/578858897/turnover-in-trumps-white-house-is-record-setting-and-it-isn-t-even-close\">set records for staff turnover\u003c/a> (and it isn't even close), the departure of Hicks still came as a shock. \u003c/p>\n\u003cp>Hicks, who has been working with the president for three years, managed to stay in his orbit even after many others had been pushed out. President Trump called Hicks \"outstanding.\"\u003c/p>\n\u003cp>\"She is as smart and thoughtful as they come, a truly great person,\" Trump said in a statement on Wednesday. \"I will miss having her by my side but when she approached me about pursuing other opportunities, I totally understood. I am sure we will work together again in the future.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>News of Hicks' departure followed a day after she testified for hours before a closed session of the House intelligence committee as part of its Russia probe, \u003ca href=\"https://www.nytimes.com/2018/02/27/us/politics/hope-hicks-house-intelligence-committee-testimony.html\">reportedly admitting\u003c/a> to telling \"white lies\" on behalf of the president, though not in matters material to the investigation. Lawmakers are investigating Russia's interference in the 2016 presidential election and whether any Trump campaign associates aided that effort. The White House has repeatedly denied any such collusion. \u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Earlier this month Hicks was deeply involved in the White House's botched handling of domestic abuse allegations against a former top aide to the president. But a White House official insists Hicks' decision to resign wasn't related to either of those matters.\u003c/p>\n\u003cp>Another person close to Hicks told NPR the resignation has been in the works for weeks.\u003c/p>\n\u003cp>In a White House full of big personalities, the 29-year-old former teen fashion model has had a knack for maintaining a low profile; that is, until recently. She was often photographed with other White House aides but rarely went on the record and almost never spoke before microphones.\u003c/p>\n\u003cp>\"I think it's a skill ... to avoid being in the press,\" Dana Perino, who served as White House press secretary during the George W. Bush administration, told NPR in August. \"She is a true communications professional in that she doesn't seek the limelight.\"\u003c/p>\n\u003cp>That skill, along with her apparently unwavering loyalty, helped keep her in the president's good graces. That loyalty was once again on display in a quote circulated by the White House announcing her departure. \u003c/p>\n\u003cp>\"There are no words to adequately express my gratitude to President Trump,\" Hicks said in the statement. \"I wish the President and his administration the very best as he continues to lead our country.\"\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Hicks joined the Trump organization in 2014 — recruited by Ivanka Trump, who was impressed by work Hicks had done for her clothing line while working at a New York public relations firm. Hicks was then pulled into the Trump campaign before there even was a campaign, becoming de facto press secretary while initially she continued doing work for the Trump Organization. \u003c/p>\n\u003cp>\"She really understood the president's brand, that he's a mogul, that he's a magnet,\" said Sam Nunberg, who served as an adviser to Trump from 2011 to mid-2015. \"And she said to me that people in the primary states were going to view him as a president because they watched him on \u003cem>The Apprentice. \u003c/em>Which was true.\u003cem>\"\u003c/em>\u003c/p>\n\u003cp>Hicks was serving as the White House's director of strategic communications, an unusual role where she essentially functioned as a gatekeeper to the president, when she was \u003ca href=\"https://www.npr.org/2017/08/16/543901998/hope-hicks-named-interim-white-house-communications-director\">named interim communications director\u003c/a> in August. That followed the days-long tenure of Anthony Scaramucci and the departure of multiple other communications directors — Sean Spicer, who had also been press secretary; Mike Dubke; and Jason Miller, who served during the transition. \u003c/p>\n\u003cp>Nunberg predicted at the time of her promotion that Hicks would be with Trump \"to the very end.\" \u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Even so, on Wednesday, the aide who was so close to Trump she was often described as being like family said she, too, would leave. \u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Hope+Hicks+To+Resign+As+White+House+Communications+Director&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Health Care Revamp At The L.A. County Jails",
"title": "Health Care Revamp At The L.A. County Jails",
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"content": "\u003cp>Michael Callahan, an outgoing 43-year-old carpenter, landed in a Los Angeles County jail last September because of what he said were “bad decisions and selling drugs.”\u003c/p>\n\u003cp>He had uncontrolled diabetes and high blood pressure when he arrived, but his health was the last thing on his mind. Consumed by a meth addiction, he hadn’t taken his medications for months. “When I got here, I was a wreck,” said Callahan, who is stocky and covered in tattoos. “My legs were so swollen that if I bumped them they would break open.”\u003c/p>\n\u003cp>By January, however, his diabetes was improving and his blood pressure had dropped. Now, he takes his medications daily and sees a doctor every two months. Even as he counts the days until his release this summer, Callahan knows he is getting much-needed medical care. “I’m where I need to be, not where I want to be,” he said.\u003c/p>\n\u003cp>Callahan’s situation is counterintuitive: He may end up leaving jail healthier than when he arrived. Officials at the Los Angeles County Department of Health Services hope to see more cases like his as they embark on an ambitious effort to improve health care for jail inmates. Their project follows decades of complaints, lawsuits and reports of poor medical and mental health care at the Los Angeles County jails, which house about 18,000 inmates on any given day.\u003c/p>\n\u003cp>The county’s overhaul is designed to raise the quality of health care behind bars and better equip inmates to manage their health after they are released. But the challenges are enormous – the population is disproportionately sick, and the jails weren’t designed to be medical facilities.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The innovative effort at one of the nation’s biggest jail systems is based on a logical premise: Inmates don’t stay in jail for long – the average stay is just 60 days – so it’s a crucial opportunity to diagnose and begin treating their diseases.\u003c/p>\n\u003cp>“People are there for just a blip in time, days, weeks, months … and they’re returning back to the community,” said Mark Ghaly, director of community health for the county Department of Health Services. “What happens in the jail matters.”\u003c/p>\n\u003cp>The county health agency took over medical care in the jails from the LA County Sheriff’s Department in 2015 and started revamping the system in earnest last year.\u003c/p>\n\u003cfigure id=\"attachment_362814\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-362814\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2018/02/jail-health-1_preview-800x534.jpeg\" alt=\"The health clinic at a Los Angeles County jail on January 17, 2018. Inmates wait on a bench to get medications or see medical providers.\" width=\"800\" height=\"534\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-1_preview-800x534.jpeg 800w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-1_preview-160x107.jpeg 160w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-1_preview-768x513.jpeg 768w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-1_preview-1020x681.jpeg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-1_preview-1180x788.jpeg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-1_preview-960x641.jpeg 960w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-1_preview-240x160.jpeg 240w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-1_preview-375x250.jpeg 375w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-1_preview-520x347.jpeg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The health clinic at a Los Angeles County jail on January 17, 2018. Inmates wait on a bench to get medications or see medical providers. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The main health clinic at the Men’s Central Jail in downtown Los Angeles is located just inside a large metal gate. Inmates there and at all the LA county jails can get a wide variety of medical and behavioral care. “It’s a giant health system and it’s complex,” said Margarita Pereyda, chief medical officer of correctional health services for LA County. “We are a hybrid between a hospital and an ER and an outpatient kind of environment.”\u003c/p>\n\u003cp>Part of the plan is to make clinics inside the jails more like ones on the outside. That means assigning inmates to primary care doctors to manage their chronic diseases and getting them appointments and medications quickly. It also means expanding treatment for mental health and substance abuse and referring those who need advanced medical or behavioral care to specialists who work for the county.\u003c/p>\n\u003cp>It’s a monumental job: Nearly half of all inmates have at least one chronic disease, including about 450 who have HIV and 900 with diabetes. About two-thirds of inmates are addicted to drugs or alcohol, and about a quarter have serious mental illnesses.\u003c/p>\n\u003cp>“Very few people have chronic illness under good control,” Ghaly said. ”The jails have largely become treatment facilities.”\u003c/p>\n\u003cp>To improve inmates’ access to care, county officials launched a physician recruitment effort this month. They released a series of online videos featuring medical providers with the slogan “\u003ca href=\"https://missionpossible.lacounty.gov/\" target=\"_blank\" rel=\"noopener\">Mission Possible\u003c/a>.” As an incentive, they are offering to pay up to $120,000 in medical school debt for each of the new hires who need it. That strategy has been used to lure doctors to low-income communities around the United States.\u003c/p>\n\u003cp>Esther Lim, who directs the jails project at the American Civil Liberties Union of Southern California, said she is optimistic care will improve, but she still hears daily from inmates about delays in appointments and medications. And, she said, people are still dying inside the LA County jails – an average of 25 each year, according to the health department.\u003c/p>\n\u003cp>“It’s an indication that there is something wrong, that the delivery of medical care is still poor,” Lim said. Overcrowding can result in inmates’ health being neglected and deteriorating over time, she said. County health officials acknowledge the situation is not going to change overnight. The county is “making some great headway,” but “there are some things that you can change more quickly than others,” said Ed Matzen, clinical nursing director for the jails.\u003c/p>\n\u003cfigure id=\"attachment_362816\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-362816\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2018/02/jail-health-17_preview-800x534.jpeg\" alt=\"Public health nurse Martha Tadesse speaks with a patient at a Los Angeles County jail on January 17, 2018.\" width=\"800\" height=\"534\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-17_preview-800x534.jpeg 800w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-17_preview-160x107.jpeg 160w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-17_preview-768x513.jpeg 768w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-17_preview-1020x681.jpeg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-17_preview-1180x788.jpeg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-17_preview-960x641.jpeg 960w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-17_preview-240x160.jpeg 240w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-17_preview-375x250.jpeg 375w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-17_preview-520x347.jpeg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Public health nurse Martha Tadesse speaks with a patient at a Los Angeles County jail on January 17, 2018. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Lello Tesema, a primary care physician and director of population health for the county jails, said many of her patients have gone without care on the outside for a long time. As soon as she gets a new patient, Tesema takes a medical and personal history. Then she creates a plan with the patient, knowing she only has a limited amount of time to implement it.\u003c/p>\n\u003cp>One early morning in January, Tesema examined Callahan, the carpenter, on an exam table in a room just off a busy corridor around the corner from his dorm-style cell. She said the swelling in his legs had diminished and his blood sugar level was looking good. “We’re moving in the right direction,” she told him. On the way back to his bunk, Callahan stopped at a window to pick up a pill for his diabetes.\u003c/p>\n\u003cp>Tesema said she worries about the health of her patients after they get out of jail even though they leave with a referral to a county clinic and 30 days’ worth of medication – up from three days in the past. “Often I see patients come back and a lot of the successes that happened while they were here end up diminishing after they leave,” she said.\u003c/p>\n\u003cp>Tesema and other medical providers in the jail must manage the inherent tension between safety and medical care. Sometimes, doctors have to see patients in their cells or treat them when they are handcuffed, Tesema said.\u003c/p>\n\u003cp>Jason Wolak, a captain in the medical services bureau of the Sheriff’s Department, said deputies are making an effort to get more inmates to medical appointments. “We’re the Uber for medical,” he said. He added that the Sheriff’s Department needs more staff, especially for transporting inmates to outside specialists or to the county-run hospitals.\u003c/p>\n\u003cp>Since patients also are going to court, attending classes or meeting with their lawyers, scheduling medical visits can be a challenge, Ghaly said. “There’s a high no-show rate to appointments.”\u003c/p>\n\u003cp>Pereyda said the new system for providing care at the jails depends on current doctors changing their mindset – things as simple as calling people patients rather than inmates.\u003c/p>\n\u003cp>“We can figure out the logistics and we can figure out the resources, but shifting the way people think and act is going to be our biggest challenge,” she said. Hiring new doctors who believe in the mission of health care behind bars will help, she added.\u003c/p>\n\u003cp>Among some inmates, attitudes about their own health are already beginning to shift.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Callahan said he’s determined to stay sober and continue monitoring his health when he gets out. “I’m 43 years old and that’s not the age to be screwing around with diabetes,” he said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Michael Callahan, an outgoing 43-year-old carpenter, landed in a Los Angeles County jail last September because of what he said were “bad decisions and selling drugs.”\u003c/p>\n\u003cp>He had uncontrolled diabetes and high blood pressure when he arrived, but his health was the last thing on his mind. Consumed by a meth addiction, he hadn’t taken his medications for months. “When I got here, I was a wreck,” said Callahan, who is stocky and covered in tattoos. “My legs were so swollen that if I bumped them they would break open.”\u003c/p>\n\u003cp>By January, however, his diabetes was improving and his blood pressure had dropped. Now, he takes his medications daily and sees a doctor every two months. Even as he counts the days until his release this summer, Callahan knows he is getting much-needed medical care. “I’m where I need to be, not where I want to be,” he said.\u003c/p>\n\u003cp>Callahan’s situation is counterintuitive: He may end up leaving jail healthier than when he arrived. Officials at the Los Angeles County Department of Health Services hope to see more cases like his as they embark on an ambitious effort to improve health care for jail inmates. Their project follows decades of complaints, lawsuits and reports of poor medical and mental health care at the Los Angeles County jails, which house about 18,000 inmates on any given day.\u003c/p>\n\u003cp>The county’s overhaul is designed to raise the quality of health care behind bars and better equip inmates to manage their health after they are released. But the challenges are enormous – the population is disproportionately sick, and the jails weren’t designed to be medical facilities.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The innovative effort at one of the nation’s biggest jail systems is based on a logical premise: Inmates don’t stay in jail for long – the average stay is just 60 days – so it’s a crucial opportunity to diagnose and begin treating their diseases.\u003c/p>\n\u003cp>“People are there for just a blip in time, days, weeks, months … and they’re returning back to the community,” said Mark Ghaly, director of community health for the county Department of Health Services. “What happens in the jail matters.”\u003c/p>\n\u003cp>The county health agency took over medical care in the jails from the LA County Sheriff’s Department in 2015 and started revamping the system in earnest last year.\u003c/p>\n\u003cfigure id=\"attachment_362814\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-362814\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2018/02/jail-health-1_preview-800x534.jpeg\" alt=\"The health clinic at a Los Angeles County jail on January 17, 2018. Inmates wait on a bench to get medications or see medical providers.\" width=\"800\" height=\"534\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-1_preview-800x534.jpeg 800w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-1_preview-160x107.jpeg 160w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-1_preview-768x513.jpeg 768w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-1_preview-1020x681.jpeg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-1_preview-1180x788.jpeg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-1_preview-960x641.jpeg 960w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-1_preview-240x160.jpeg 240w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-1_preview-375x250.jpeg 375w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-1_preview-520x347.jpeg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The health clinic at a Los Angeles County jail on January 17, 2018. Inmates wait on a bench to get medications or see medical providers. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The main health clinic at the Men’s Central Jail in downtown Los Angeles is located just inside a large metal gate. Inmates there and at all the LA county jails can get a wide variety of medical and behavioral care. “It’s a giant health system and it’s complex,” said Margarita Pereyda, chief medical officer of correctional health services for LA County. “We are a hybrid between a hospital and an ER and an outpatient kind of environment.”\u003c/p>\n\u003cp>Part of the plan is to make clinics inside the jails more like ones on the outside. That means assigning inmates to primary care doctors to manage their chronic diseases and getting them appointments and medications quickly. It also means expanding treatment for mental health and substance abuse and referring those who need advanced medical or behavioral care to specialists who work for the county.\u003c/p>\n\u003cp>It’s a monumental job: Nearly half of all inmates have at least one chronic disease, including about 450 who have HIV and 900 with diabetes. About two-thirds of inmates are addicted to drugs or alcohol, and about a quarter have serious mental illnesses.\u003c/p>\n\u003cp>“Very few people have chronic illness under good control,” Ghaly said. ”The jails have largely become treatment facilities.”\u003c/p>\n\u003cp>To improve inmates’ access to care, county officials launched a physician recruitment effort this month. They released a series of online videos featuring medical providers with the slogan “\u003ca href=\"https://missionpossible.lacounty.gov/\" target=\"_blank\" rel=\"noopener\">Mission Possible\u003c/a>.” As an incentive, they are offering to pay up to $120,000 in medical school debt for each of the new hires who need it. That strategy has been used to lure doctors to low-income communities around the United States.\u003c/p>\n\u003cp>Esther Lim, who directs the jails project at the American Civil Liberties Union of Southern California, said she is optimistic care will improve, but she still hears daily from inmates about delays in appointments and medications. And, she said, people are still dying inside the LA County jails – an average of 25 each year, according to the health department.\u003c/p>\n\u003cp>“It’s an indication that there is something wrong, that the delivery of medical care is still poor,” Lim said. Overcrowding can result in inmates’ health being neglected and deteriorating over time, she said. County health officials acknowledge the situation is not going to change overnight. The county is “making some great headway,” but “there are some things that you can change more quickly than others,” said Ed Matzen, clinical nursing director for the jails.\u003c/p>\n\u003cfigure id=\"attachment_362816\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-362816\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2018/02/jail-health-17_preview-800x534.jpeg\" alt=\"Public health nurse Martha Tadesse speaks with a patient at a Los Angeles County jail on January 17, 2018.\" width=\"800\" height=\"534\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-17_preview-800x534.jpeg 800w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-17_preview-160x107.jpeg 160w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-17_preview-768x513.jpeg 768w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-17_preview-1020x681.jpeg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-17_preview-1180x788.jpeg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-17_preview-960x641.jpeg 960w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-17_preview-240x160.jpeg 240w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-17_preview-375x250.jpeg 375w, https://ww2.kqed.org/app/uploads/sites/27/2018/02/jail-health-17_preview-520x347.jpeg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Public health nurse Martha Tadesse speaks with a patient at a Los Angeles County jail on January 17, 2018. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Lello Tesema, a primary care physician and director of population health for the county jails, said many of her patients have gone without care on the outside for a long time. As soon as she gets a new patient, Tesema takes a medical and personal history. Then she creates a plan with the patient, knowing she only has a limited amount of time to implement it.\u003c/p>\n\u003cp>One early morning in January, Tesema examined Callahan, the carpenter, on an exam table in a room just off a busy corridor around the corner from his dorm-style cell. She said the swelling in his legs had diminished and his blood sugar level was looking good. “We’re moving in the right direction,” she told him. On the way back to his bunk, Callahan stopped at a window to pick up a pill for his diabetes.\u003c/p>\n\u003cp>Tesema said she worries about the health of her patients after they get out of jail even though they leave with a referral to a county clinic and 30 days’ worth of medication – up from three days in the past. “Often I see patients come back and a lot of the successes that happened while they were here end up diminishing after they leave,” she said.\u003c/p>\n\u003cp>Tesema and other medical providers in the jail must manage the inherent tension between safety and medical care. Sometimes, doctors have to see patients in their cells or treat them when they are handcuffed, Tesema said.\u003c/p>\n\u003cp>Jason Wolak, a captain in the medical services bureau of the Sheriff’s Department, said deputies are making an effort to get more inmates to medical appointments. “We’re the Uber for medical,” he said. He added that the Sheriff’s Department needs more staff, especially for transporting inmates to outside specialists or to the county-run hospitals.\u003c/p>\n\u003cp>Since patients also are going to court, attending classes or meeting with their lawyers, scheduling medical visits can be a challenge, Ghaly said. “There’s a high no-show rate to appointments.”\u003c/p>\n\u003cp>Pereyda said the new system for providing care at the jails depends on current doctors changing their mindset – things as simple as calling people patients rather than inmates.\u003c/p>\n\u003cp>“We can figure out the logistics and we can figure out the resources, but shifting the way people think and act is going to be our biggest challenge,” she said. Hiring new doctors who believe in the mission of health care behind bars will help, she added.\u003c/p>\n\u003cp>Among some inmates, attitudes about their own health are already beginning to shift.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Callahan said he’s determined to stay sober and continue monitoring his health when he gets out. “I’m 43 years old and that’s not the age to be screwing around with diabetes,” he said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "10 Things to Know About the Big, Snowy Storm Hitting California",
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"content": "\u003cp>\u003cstrong>1. What's different about this storm?\u003c/strong> Unlike most of the storms we've seen this winter, which have been either warm and wet or cold but dry, this is a cold weather system that will pull in a decent amount of moisture from the Pacific and dump lots of snow -- 5 feet or more at the highest elevations -- throughout California's mountains from late Wednesday through late Saturday. As much as a foot may fall in the northern Sierra foothills, and snow may even accumulate at the northern end of the Sacramento Valley. High winds will create blizzard conditions. The National Weather Service office in Sacramento says \"travel over the mountains is highly discouraged\" during the tempest.\u003c/p>\n\u003cp>\u003cstrong>2. When will it hit?\u003c/strong> Rain will begin sweeping over the Bay Area early Wednesday evening, with rain reaching the South Bay by midnight. Models suggest snow will begin falling in the northern and central Sierra by midafternoon.\u003c/p>\n\u003cp>\u003cstrong>3. Where will it hit? \u003c/strong>Virtually all of California except the state's southeastern corner is in for some rain or snow between Wednesday and Saturday.\u003c/p>\n\u003cp>https://twitter.com/SFmeteorologist/status/968539326576406528\u003c/p>\n\u003cp>\u003cstrong>4. How much rain?\u003c/strong> Most of the Bay Area is forecast to get between 1 and 2 inches of rain by Saturday afternoon. The usual suspects -- the higher elevations in Sonoma and Marin counties and the Santa Cruz Mountains -- could get 3 to 4 inches of rain during that period.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>5. How much snow?\u003c/strong> Up to 4 feet in the Siskiyous, Trinity Alps and other ranges of far Northern California; up to 4 feet at Mount Lassen and in the higher elevations of the northern Sierra; from 5 to 7 feet in the highest reaches of the central Sierra, including all the main highway passes, with between 1 and 3 feet at the 6,000-foot elevation, including Lake Tahoe; and as much as 3 feet in the southern Sierra.\u003c/p>\n\u003cp>https://twitter.com/NWSSacramento/status/968476085619953664\u003c/p>\n\u003cp>\u003cstrong>6. Wind?\u003c/strong> The forecast calls for 15 to 30 mph winds on Wednesday night and early Thursday in most Bay Area locales, gusting to 40 mph on the coast and 50 mph over higher terrain. Gusts over Sierra Nevada ridges could top 100 mph.\u003c/p>\n\u003cp>\u003cstrong>7. Will all that snow help build up our meager snowpack?\u003c/strong> Yes. But bear in mind that going into this week, the statewide mountain snowpack was near its lowest level ever -- less than 20 percent of the average snow-water equivalent for late February. The cold, relatively dry storm that dropped more than a foot of snow on some locations earlier this week improved things a little, moving \u003ca href=\"http://cdec.water.ca.gov/cgi-progs/snow/DLYSWEQ\">the snow-water equivalent\u003c/a> up to 23 percent of average. If the incoming storm is as wet as expected, dropping the equivalent of 5 to 6 inches of water over the Sierra crest, the snowpack could be between 40 and 50 percent by the beginning of next week.\u003c/p>\n\u003cp>\u003cstrong>8. Travel impacts?\u003c/strong> We'll see enough rain around the Bay Area to create the usual problems with ponding and standing water on roadways. The standard advice is to slow down -- but we're not holding our breath that most of us will actually do that. Traveling in the mountains will be another matter. Winter storm warnings are in place for virtually all mountain areas in the northern two-thirds of the state. The National Weather Service office in Sacramento puts it succinctly: \u003cem>\u003cstrong>\"Travel over the mountains is highly discouraged, as conditions will be extremely hazardous.\"\u003c/strong>\u003c/em> That advisory holds for the duration of the warning period, which in many locations will last through Saturday night.\u003c/p>\n\u003cp>https://twitter.com/NWSSacramento/status/968883126196932609\u003c/p>\n\u003cp>\u003cstrong>9. What about the impact in Southern California?\u003c/strong> The storm could bring parts of the Los Angeles area more than an inch of rain. The biggest concern is in the area near Santa Barbara and Montecito, where extremely heavy rain on Jan. 9 over the region burned in the Thomas Fire unleashed a debris flow that killed 21 people. \u003c/p>\n\u003cp>The current forecast anticipates heavy rain over vulnerable parts of multiple burn areas, prompting Santa Barbara County officials to \u003ca href=\"https://ww2.kqed.org/news/2018/03/01/mudslide-fears-prompt-mandatory-evacuations-for-montecito-other-burn-areas/\" rel=\"noopener\" target=\"_blank\">issue mandatory evacuation orders\u003c/a> for residents near the Thomas, Sherpa and Whittier fire burn areas. Officials said residents should evacuate by 6:00 p.m. Thursday.\u003c/p>\n\u003cp>https://twitter.com/NWSLosAngeles/status/968818168734076931\u003c/p>\n\u003cp>\u003cstrong>10. What's next?\u003c/strong> After the main burst of snow and rain Wednesday and Thursday, showers are forecast through Saturday in lower elevations, including the Bay Area. In the mountains, a second wave of snow is forecast Friday night. Dry, cold weather is forecast after the rain departs. Forecast models suggest we'll see more rain as early as next Tuesday.\u003c/p>\n\u003cp>\u003cstrong>Further reading: \u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>San Jose Mercury News:\u003c/strong> \u003ca href=\"https://www.mercurynews.com/2018/02/27/largest-storm-of-the-year-to-bring-up-to-seven-feet-of-snow-to-sierra-nevada/\" target=\"_blank\" rel=\"noopener\">'Largest storm of the year' to bring up to 7 feet of snow to Sierra Nevada\u003c/a>\u003c/li>\n\u003cli>\u003cstrong>San Francisco Chronicle\u003c/strong> \u003ca href=\"https://www.sfgate.com/weather/article/Sierra-weather-snow-biggest-storm-year-2018-12713904.php\" target=\"_blank\" rel=\"noopener\">Storm taking aim at Sierra could be one of fiercest in years\u003c/a>\u003c/li>\n\u003cli>\u003cstrong>Tahoe Daily Snow\u003c/strong>: \u003ca href=\"http://opensnow.com/dailysnow/tahoe/post/10710\" target=\"_blank\" rel=\"noopener\">Here we go ... \u003c/a>\u003c/li>\n\u003cli>\u003cstrong>California Weather Blog:\u003c/strong> \u003ca href=\"http://weatherwest.com/archives/6119\" target=\"_blank\" rel=\"noopener\">Much-needed Sierra Nevada snowfall on the way! But a March miracle? Not so fast\u003c/a>\u003c/li>\n\u003cli>\u003cstrong>National Weather Service:\u003c/strong> \u003ca href=\"https://www.weather.gov/mtr/\" target=\"_blank\" rel=\"noopener\">San Francisco Bay Area\u003c/a>\u003c/li>\n\u003cli>N\u003cstrong>ational Weather Service:\u003c/strong> \u003ca href=\"https://www.weather.gov/sto/\" target=\"_blank\" rel=\"noopener\">Sacramento\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post has been updated.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>1. What's different about this storm?\u003c/strong> Unlike most of the storms we've seen this winter, which have been either warm and wet or cold but dry, this is a cold weather system that will pull in a decent amount of moisture from the Pacific and dump lots of snow -- 5 feet or more at the highest elevations -- throughout California's mountains from late Wednesday through late Saturday. As much as a foot may fall in the northern Sierra foothills, and snow may even accumulate at the northern end of the Sacramento Valley. High winds will create blizzard conditions. The National Weather Service office in Sacramento says \"travel over the mountains is highly discouraged\" during the tempest.\u003c/p>\n\u003cp>\u003cstrong>2. When will it hit?\u003c/strong> Rain will begin sweeping over the Bay Area early Wednesday evening, with rain reaching the South Bay by midnight. Models suggest snow will begin falling in the northern and central Sierra by midafternoon.\u003c/p>\n\u003cp>\u003cstrong>3. Where will it hit? \u003c/strong>Virtually all of California except the state's southeastern corner is in for some rain or snow between Wednesday and Saturday.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>\u003cstrong>4. How much rain?\u003c/strong> Most of the Bay Area is forecast to get between 1 and 2 inches of rain by Saturday afternoon. The usual suspects -- the higher elevations in Sonoma and Marin counties and the Santa Cruz Mountains -- could get 3 to 4 inches of rain during that period.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>5. How much snow?\u003c/strong> Up to 4 feet in the Siskiyous, Trinity Alps and other ranges of far Northern California; up to 4 feet at Mount Lassen and in the higher elevations of the northern Sierra; from 5 to 7 feet in the highest reaches of the central Sierra, including all the main highway passes, with between 1 and 3 feet at the 6,000-foot elevation, including Lake Tahoe; and as much as 3 feet in the southern Sierra.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>\u003cstrong>6. Wind?\u003c/strong> The forecast calls for 15 to 30 mph winds on Wednesday night and early Thursday in most Bay Area locales, gusting to 40 mph on the coast and 50 mph over higher terrain. Gusts over Sierra Nevada ridges could top 100 mph.\u003c/p>\n\u003cp>\u003cstrong>7. Will all that snow help build up our meager snowpack?\u003c/strong> Yes. But bear in mind that going into this week, the statewide mountain snowpack was near its lowest level ever -- less than 20 percent of the average snow-water equivalent for late February. The cold, relatively dry storm that dropped more than a foot of snow on some locations earlier this week improved things a little, moving \u003ca href=\"http://cdec.water.ca.gov/cgi-progs/snow/DLYSWEQ\">the snow-water equivalent\u003c/a> up to 23 percent of average. If the incoming storm is as wet as expected, dropping the equivalent of 5 to 6 inches of water over the Sierra crest, the snowpack could be between 40 and 50 percent by the beginning of next week.\u003c/p>\n\u003cp>\u003cstrong>8. Travel impacts?\u003c/strong> We'll see enough rain around the Bay Area to create the usual problems with ponding and standing water on roadways. The standard advice is to slow down -- but we're not holding our breath that most of us will actually do that. Traveling in the mountains will be another matter. Winter storm warnings are in place for virtually all mountain areas in the northern two-thirds of the state. The National Weather Service office in Sacramento puts it succinctly: \u003cem>\u003cstrong>\"Travel over the mountains is highly discouraged, as conditions will be extremely hazardous.\"\u003c/strong>\u003c/em> That advisory holds for the duration of the warning period, which in many locations will last through Saturday night.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>\u003cstrong>9. What about the impact in Southern California?\u003c/strong> The storm could bring parts of the Los Angeles area more than an inch of rain. The biggest concern is in the area near Santa Barbara and Montecito, where extremely heavy rain on Jan. 9 over the region burned in the Thomas Fire unleashed a debris flow that killed 21 people. \u003c/p>\n\u003cp>The current forecast anticipates heavy rain over vulnerable parts of multiple burn areas, prompting Santa Barbara County officials to \u003ca href=\"https://ww2.kqed.org/news/2018/03/01/mudslide-fears-prompt-mandatory-evacuations-for-montecito-other-burn-areas/\" rel=\"noopener\" target=\"_blank\">issue mandatory evacuation orders\u003c/a> for residents near the Thomas, Sherpa and Whittier fire burn areas. Officials said residents should evacuate by 6:00 p.m. Thursday.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>\u003cstrong>10. What's next?\u003c/strong> After the main burst of snow and rain Wednesday and Thursday, showers are forecast through Saturday in lower elevations, including the Bay Area. In the mountains, a second wave of snow is forecast Friday night. Dry, cold weather is forecast after the rain departs. Forecast models suggest we'll see more rain as early as next Tuesday.\u003c/p>\n\u003cp>\u003cstrong>Further reading: \u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>San Jose Mercury News:\u003c/strong> \u003ca href=\"https://www.mercurynews.com/2018/02/27/largest-storm-of-the-year-to-bring-up-to-seven-feet-of-snow-to-sierra-nevada/\" target=\"_blank\" rel=\"noopener\">'Largest storm of the year' to bring up to 7 feet of snow to Sierra Nevada\u003c/a>\u003c/li>\n\u003cli>\u003cstrong>San Francisco Chronicle\u003c/strong> \u003ca href=\"https://www.sfgate.com/weather/article/Sierra-weather-snow-biggest-storm-year-2018-12713904.php\" target=\"_blank\" rel=\"noopener\">Storm taking aim at Sierra could be one of fiercest in years\u003c/a>\u003c/li>\n\u003cli>\u003cstrong>Tahoe Daily Snow\u003c/strong>: \u003ca href=\"http://opensnow.com/dailysnow/tahoe/post/10710\" target=\"_blank\" rel=\"noopener\">Here we go ... \u003c/a>\u003c/li>\n\u003cli>\u003cstrong>California Weather Blog:\u003c/strong> \u003ca href=\"http://weatherwest.com/archives/6119\" target=\"_blank\" rel=\"noopener\">Much-needed Sierra Nevada snowfall on the way! But a March miracle? Not so fast\u003c/a>\u003c/li>\n\u003cli>\u003cstrong>National Weather Service:\u003c/strong> \u003ca href=\"https://www.weather.gov/mtr/\" target=\"_blank\" rel=\"noopener\">San Francisco Bay Area\u003c/a>\u003c/li>\n\u003cli>N\u003cstrong>ational Weather Service:\u003c/strong> \u003ca href=\"https://www.weather.gov/sto/\" target=\"_blank\" rel=\"noopener\">Sacramento\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post has been updated.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Seven San Francisco police officers fired some 65 rounds at a homicide suspect on Feb. 17 after he shot a handgun twice from inside a parked RV, according to a description of the incident, \u003ca href=\"http://sanfranciscopolice.org/article/notes-used-during-presentation-february-27-2018-town-hall-address-february-17th-2018-officer\" target=\"_blank\" rel=\"noopener\">released Tuesday night along with videos\u003c/a> from the officers' body cameras.\u003c/p>\n\u003cp>No one was hit by the gunfire.\u003c/p>\n\u003cp>The chain of events that led to the shootout began the evening of Feb. 16, when police responded to reports of gunshots in the northwest corner of the Haight-Ashbury district, bordering Golden Gate Park and south of the Panhandle. They found two people suffering from apparent gunshot wounds. One was pronounced dead at the scene.\u003c/p>\n\u003cp>Police linked the homicide and a nearby carjacking to the same suspect, identified as Joel Armstrong.\u003c/p>\n\u003cp>Nearly six hours later, just after midnight Feb. 17, officers in the city's Design District, north of Potrero Hill, noticed the stolen car parked behind an RV on Alameda Street between De Haro and Rhode Island streets.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>An officer \"peered into a window of the RV\" and saw Armstrong, according to the Police Department's description of the incident. \u003ca href=\"https://vimeo.com/257802564\" target=\"_blank\" rel=\"noopener\">One\u003c/a> of seven body-camera \u003ca href=\"https://vimeo.com/sfpd\" target=\"_blank\" rel=\"noopener\">videos\u003c/a> released by the Police Department shows an officer rush back to his colleagues after looking in the window.\u003c/p>\n\u003cp>\"Hey, we got him! We got him,\" the officer says. \"He's in there! He's in there!\"\u003c/p>\n\u003cp>The body-camera footage shows several officers assembling behind the RV. They ordered people out of the vehicle -- police say three occupants emerged, including a woman with a large barking dog visible on the videos. The officers ordered her to stay down and hold the dog while they continued to call out Armstrong.\u003c/p>\n\u003cp>Then two shots the Police Department says were fired from inside the RV rang out. Video shows officers scrambling for cover and beginning to fire. One fell, then another tripped over him. They both continued firing.\u003c/p>\n\u003cp>A total of seven officers unleashed a fusillade from handguns and assault rifles at the RV for more than 10 seconds. The woman with the dog appeared to still be near the vehicle, though her figure is redacted in the video.\u003c/p>\n\u003cp>Police then moved back and continued to order Armstrong out.\u003c/p>\n\u003cp>Armstrong, 31, surrendered at 2:15 a.m. He's charged with murder, eight counts of attempted murder, carjacking, being a felon in possession of a firearm, discharge of a firearm and receiving stolen property, according to the Police Department.\u003c/p>\n\u003cp>The department identified the officers who fired their weapons as Glennon Griffin, Anthony Sharron, Robby Wilkom, Matthew Nazar, Gregory Buhagiar, Steven Oesterich and Christopher Cotter.\u003c/p>\n\u003cp>Police homicide and internal affairs investigations into the incident are ongoing. The District Attorney's Office and Department of Police Accountability are also investigating.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>SFPD Commander Greg McEachern told the \u003ca href=\"http://www.sfexaminer.com/sfpd-release-footage-officers-firing-65-rounds-shootout/\" target=\"_blank\" rel=\"noopener\">San Francisco Examiner\u003c/a> at a Tuesday night meeting about the shooting that officers would be interviewed \"to determine why they shot the number of shots that they fired.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Seven San Francisco police officers fired some 65 rounds at a homicide suspect on Feb. 17 after he shot a handgun twice from inside a parked RV, according to a description of the incident, \u003ca href=\"http://sanfranciscopolice.org/article/notes-used-during-presentation-february-27-2018-town-hall-address-february-17th-2018-officer\" target=\"_blank\" rel=\"noopener\">released Tuesday night along with videos\u003c/a> from the officers' body cameras.\u003c/p>\n\u003cp>No one was hit by the gunfire.\u003c/p>\n\u003cp>The chain of events that led to the shootout began the evening of Feb. 16, when police responded to reports of gunshots in the northwest corner of the Haight-Ashbury district, bordering Golden Gate Park and south of the Panhandle. They found two people suffering from apparent gunshot wounds. One was pronounced dead at the scene.\u003c/p>\n\u003cp>Police linked the homicide and a nearby carjacking to the same suspect, identified as Joel Armstrong.\u003c/p>\n\u003cp>Nearly six hours later, just after midnight Feb. 17, officers in the city's Design District, north of Potrero Hill, noticed the stolen car parked behind an RV on Alameda Street between De Haro and Rhode Island streets.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>An officer \"peered into a window of the RV\" and saw Armstrong, according to the Police Department's description of the incident. \u003ca href=\"https://vimeo.com/257802564\" target=\"_blank\" rel=\"noopener\">One\u003c/a> of seven body-camera \u003ca href=\"https://vimeo.com/sfpd\" target=\"_blank\" rel=\"noopener\">videos\u003c/a> released by the Police Department shows an officer rush back to his colleagues after looking in the window.\u003c/p>\n\u003cp>\"Hey, we got him! We got him,\" the officer says. \"He's in there! He's in there!\"\u003c/p>\n\u003cp>The body-camera footage shows several officers assembling behind the RV. They ordered people out of the vehicle -- police say three occupants emerged, including a woman with a large barking dog visible on the videos. The officers ordered her to stay down and hold the dog while they continued to call out Armstrong.\u003c/p>\n\u003cp>Then two shots the Police Department says were fired from inside the RV rang out. Video shows officers scrambling for cover and beginning to fire. One fell, then another tripped over him. They both continued firing.\u003c/p>\n\u003cp>A total of seven officers unleashed a fusillade from handguns and assault rifles at the RV for more than 10 seconds. The woman with the dog appeared to still be near the vehicle, though her figure is redacted in the video.\u003c/p>\n\u003cp>Police then moved back and continued to order Armstrong out.\u003c/p>\n\u003cp>Armstrong, 31, surrendered at 2:15 a.m. He's charged with murder, eight counts of attempted murder, carjacking, being a felon in possession of a firearm, discharge of a firearm and receiving stolen property, according to the Police Department.\u003c/p>\n\u003cp>The department identified the officers who fired their weapons as Glennon Griffin, Anthony Sharron, Robby Wilkom, Matthew Nazar, Gregory Buhagiar, Steven Oesterich and Christopher Cotter.\u003c/p>\n\u003cp>Police homicide and internal affairs investigations into the incident are ongoing. The District Attorney's Office and Department of Police Accountability are also investigating.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>SFPD Commander Greg McEachern told the \u003ca href=\"http://www.sfexaminer.com/sfpd-release-footage-officers-firing-65-rounds-shootout/\" target=\"_blank\" rel=\"noopener\">San Francisco Examiner\u003c/a> at a Tuesday night meeting about the shooting that officers would be interviewed \"to determine why they shot the number of shots that they fired.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>In past election years, Democrats have suffered from a shortage of serious candidates running for congressional seats held by Republicans. This year, they have the opposite problem: Too \u003cem>many\u003c/em> serious candidates in districts Democrats are targeting.\u003c/p>\n\u003cp>Some Democratic Party insiders say if they don’t address the problem soon, it could cost them control of the House of Representatives. And time is running out.\u003c/p>\n\u003cp>The issue played out at the California Democratic Party convention in San Diego last weekend. Many congressional candidates in districts targeted for being flipped from red to blue failed to win the 60 percent vote from delegates needed to get an official party endorsement.\u003c/p>\n\u003cp>When all the ballots were counted, no candidates were able to win the party’s endorsement in two targeted districts now held by Republicans.\u003c/p>\n\u003cp>That “stamp of approval” can be critical to challengers, especially if they’ve never run for office before and aren’t well known.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It’s very problematic for Democrats,” says political strategist Katie Merrill. She’s especially worried about three seats now held by Republicans: CD-39, where incumbent Ed Royce is retiring; CD-48, where Republican Dana Rohrabacher looks vulnerable; and CD-49, which Darrell Issa barely held onto in 2016.\u003c/p>\n\u003cp>Merrill notes that with several serious Democrats running in those seats, “polling has already shown that it’s possible for two Republicans to get through to the general election in November. So these candidates are going to have to take a hard look at why they decided to run in the first place.”\u003c/p>\n\u003cp>Before the Democrats’ convention, party chair Eric Bauman said, “We’ve been activity engaged with some candidates trying to help them look at some alternative offices they might seek.” That said, Bauman added, “I will not ever tell a candidate they don’t have a right to run or it’s not their time to run because I think that’s offensive. But I continue to talk to them about the greater good here.”\u003c/p>\n\u003cp>In order to take back the House of Representatives in November, Democrats need a net pickup of 24 seats. The Democratic Congressional Campaign Committee is counting on at least two of those takeaways coming in California.\u003c/p>\n\u003cp>DCCC regional spokesman Andrew Godinich says they’re “evaluating the landscape,” which they acknowledge is somewhat littered with Democratic candidates.\u003c/p>\n\u003cp>“Working alongside grass-roots activists and the California Democratic Party, the DCCC is keeping all options on the table to ensure that voters have a Democrat on the ballot this November,” Godinich said. However, it can be difficult to convince someone who’s been running and raising money for a year to give up 14 weeks before the June election.\u003c/p>\n\u003cp>Sharpening the Democrats’ focus is what happened in 2012, when Redlands Mayor Pete Aguilar failed to make the top two in the June primary after four Democrats split the vote, leaving two Republicans to face off in November. Having learned their lesson, Aguilar came back to win the seat two years later.\u003c/p>\n\u003cp>Democratic consultant Katie Merrill says that the sheer number of candidates running, especially in Southern California, is jeopardizing the thing Democrats need to do to put a major speed bump in Donald Trump’s pathway.\u003c/p>\n\u003cp>“If we don’t have those three seats — even a chance at winning them in the general election in California — we’re not going to take back the House,” Merrill said. “These candidates are going to take a very hard look at why they’re running.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In other words, the Democratic Day of Reckoning is coming sooner rather than later.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In past election years, Democrats have suffered from a shortage of serious candidates running for congressional seats held by Republicans. This year, they have the opposite problem: Too \u003cem>many\u003c/em> serious candidates in districts Democrats are targeting.\u003c/p>\n\u003cp>Some Democratic Party insiders say if they don’t address the problem soon, it could cost them control of the House of Representatives. And time is running out.\u003c/p>\n\u003cp>The issue played out at the California Democratic Party convention in San Diego last weekend. Many congressional candidates in districts targeted for being flipped from red to blue failed to win the 60 percent vote from delegates needed to get an official party endorsement.\u003c/p>\n\u003cp>When all the ballots were counted, no candidates were able to win the party’s endorsement in two targeted districts now held by Republicans.\u003c/p>\n\u003cp>That “stamp of approval” can be critical to challengers, especially if they’ve never run for office before and aren’t well known.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It’s very problematic for Democrats,” says political strategist Katie Merrill. She’s especially worried about three seats now held by Republicans: CD-39, where incumbent Ed Royce is retiring; CD-48, where Republican Dana Rohrabacher looks vulnerable; and CD-49, which Darrell Issa barely held onto in 2016.\u003c/p>\n\u003cp>Merrill notes that with several serious Democrats running in those seats, “polling has already shown that it’s possible for two Republicans to get through to the general election in November. So these candidates are going to have to take a hard look at why they decided to run in the first place.”\u003c/p>\n\u003cp>Before the Democrats’ convention, party chair Eric Bauman said, “We’ve been activity engaged with some candidates trying to help them look at some alternative offices they might seek.” That said, Bauman added, “I will not ever tell a candidate they don’t have a right to run or it’s not their time to run because I think that’s offensive. But I continue to talk to them about the greater good here.”\u003c/p>\n\u003cp>In order to take back the House of Representatives in November, Democrats need a net pickup of 24 seats. The Democratic Congressional Campaign Committee is counting on at least two of those takeaways coming in California.\u003c/p>\n\u003cp>DCCC regional spokesman Andrew Godinich says they’re “evaluating the landscape,” which they acknowledge is somewhat littered with Democratic candidates.\u003c/p>\n\u003cp>“Working alongside grass-roots activists and the California Democratic Party, the DCCC is keeping all options on the table to ensure that voters have a Democrat on the ballot this November,” Godinich said. However, it can be difficult to convince someone who’s been running and raising money for a year to give up 14 weeks before the June election.\u003c/p>\n\u003cp>Sharpening the Democrats’ focus is what happened in 2012, when Redlands Mayor Pete Aguilar failed to make the top two in the June primary after four Democrats split the vote, leaving two Republicans to face off in November. Having learned their lesson, Aguilar came back to win the seat two years later.\u003c/p>\n\u003cp>Democratic consultant Katie Merrill says that the sheer number of candidates running, especially in Southern California, is jeopardizing the thing Democrats need to do to put a major speed bump in Donald Trump’s pathway.\u003c/p>\n\u003cp>“If we don’t have those three seats — even a chance at winning them in the general election in California — we’re not going to take back the House,” Merrill said. “These candidates are going to take a very hard look at why they’re running.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In other words, the Democratic Day of Reckoning is coming sooner rather than later.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>The Anti-Defamation League has identified 1,986 anti-Semitic incidents in its \u003ca href=\"https://www.adl.org/education/resources/reports/2017-audit-of-anti-semitic-incidents#major-findings\">2017 Audit of Anti-Semitic Incidents\u003c/a>. That's up from 1,267 in 2016, marking the highest single-year increase since the organization released its first audit in 1979.\u003c/p>\n\u003cp>The annual audit tracks incidents of vandalism, harassment or assault reported to the ADL by law enforcement, media and victims. All reported incidents are assessed by ADL staff members for credibility by seeking independent verification.\u003c/p>\n\u003cp>\"A confluence of events in 2017 led to a surge in attacks on our community — from bomb threats, cemetery desecrations, white supremacists marching in Charlottesville, and children harassing children at school,\" said CEO and National Director Jonathan A. Greenblatt in \u003ca href=\"https://www.adl.org/news/press-releases/anti-semitic-incidents-surged-nearly-60-in-2017-according-to-new-adl-report\">a statement\u003c/a>.\u003c/p>\n\u003cp>\"These incidents came at a time when we saw a rising climate of incivility, the emboldening of hate groups and widening divisions in society.\"\u003c/p>\n\u003cp>[contextly_sidebar id=\"aYyeArl7ESyPuFx6gfzxjHQyHYSrTR6T\"]\u003c/p>\n\u003cp>In previous audits, the largest number of incidents occurred in public areas, such as parks and streets. In 2017, K-12 schools surpassed public areas as the locations with the highest number of anti-Semitic incidents.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>There were 457 incidents in K-12 schools: a dramatic increase of 94 percent from the previous year. On college campuses, there were 204 incidents: an 89 percent increase.\u003c/p>\n\u003cp>For the first time since 2010, an incident occurred in every U.S. state. New York, California and New Jersey were states with the highest numbers of incidents, which the ADL attributes to their large Jewish populations.\u003c/p>\n\u003cp>Vandalism saw the highest increase in terms of types of incidents. There were 952 incidents reported — an 86 percent increase from 2016. The surge in anti-Semitic acts of vandalism is particularly upsetting, says the ADL, \"because it indicates that the perpetrators feel emboldened enough to break the law.\"\u003c/p>\n\u003cp>Physical assaults were down by 47 percent, from 36 instances in 2016 to 19 in 2017.\u003c/p>\n\u003cp>There were 1,015 incidents of harassment in 2017; 163 of these were part of a spree of\u003ca href=\"https://www.npr.org/sections/thetwo-way/2017/02/27/517539505/bomb-threats-made-against-jewish-community-centers-in-11-states\"> bomb threats made against Jewish institutions\u003c/a>. Those organizations were subject to 342 total anti-Semitic incidents in 2017 — an increase of 101 percent over the 170 incidents recorded in 2016.\u003c/p>\n\u003cp>The ADL doesn't include instances of discrimination, such as a Jewish worker not receiving an accommodation for Rosh Hashanah, or general expressions of hateful ideologies in their audit.\u003c/p>\n\u003cp>[contextly_sidebar id=\"ap56ArQjT7fvYPv85Dy0hAe9AEo1E2Lr\"]\u003c/p>\n\u003cp>An \"incident\" in this audit doesn't necessarily mean a single act of anti-Semitism. For instance, 170 Jewish tombstones were overturned in a Missouri cemetery in February 2017, and the act was counted as one incident by the ADL.\u003c/p>\n\u003cp>\"This family is all family. These stones are all our stones. No matter who's here, they're my family. They're Jews who have been desecrated,\" Jody Serkes, who had family members buried in the cemetery, \u003ca href=\"https://www.npr.org/2017/02/21/516488403/headstones-vandalized-at-jewish-cemetery-in-missouri\">told NPR last year\u003c/a>.\u003c/p>\n\u003cp>\"You know, people have permission now,\" Serkes continued, speaking on the climate of ignorance and fear she believed President Trump had allowed. \"They think in their minds their ignorance and fear is permission to be angry about anything.\"\u003c/p>\n\u003cp>An ADL \u003ca href=\"https://www.adl.org/news/press-releases/anti-semitic-incidents-surged-nearly-60-in-2017-according-to-new-adl-report\">press release\u003c/a> noted that one \"bright spot\" in this was the response of Muslims and Christians who raised thousands of dollars to help repair the damaged tombstones.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"If we expect law enforcement officials and community members to take these incidents seriously, we must take them seriously — and report them, both to ADL and to the police,\" the press release said.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Anti-Semitic+Incidents+See+Largest+Single-Year+Increase+On+Record%2C+Audit+Finds&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Anti-Defamation League has identified 1,986 anti-Semitic incidents in its \u003ca href=\"https://www.adl.org/education/resources/reports/2017-audit-of-anti-semitic-incidents#major-findings\">2017 Audit of Anti-Semitic Incidents\u003c/a>. That's up from 1,267 in 2016, marking the highest single-year increase since the organization released its first audit in 1979.\u003c/p>\n\u003cp>The annual audit tracks incidents of vandalism, harassment or assault reported to the ADL by law enforcement, media and victims. All reported incidents are assessed by ADL staff members for credibility by seeking independent verification.\u003c/p>\n\u003cp>\"A confluence of events in 2017 led to a surge in attacks on our community — from bomb threats, cemetery desecrations, white supremacists marching in Charlottesville, and children harassing children at school,\" said CEO and National Director Jonathan A. Greenblatt in \u003ca href=\"https://www.adl.org/news/press-releases/anti-semitic-incidents-surged-nearly-60-in-2017-according-to-new-adl-report\">a statement\u003c/a>.\u003c/p>\n\u003cp>\"These incidents came at a time when we saw a rising climate of incivility, the emboldening of hate groups and widening divisions in society.\"\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In previous audits, the largest number of incidents occurred in public areas, such as parks and streets. In 2017, K-12 schools surpassed public areas as the locations with the highest number of anti-Semitic incidents.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>There were 457 incidents in K-12 schools: a dramatic increase of 94 percent from the previous year. On college campuses, there were 204 incidents: an 89 percent increase.\u003c/p>\n\u003cp>For the first time since 2010, an incident occurred in every U.S. state. New York, California and New Jersey were states with the highest numbers of incidents, which the ADL attributes to their large Jewish populations.\u003c/p>\n\u003cp>Vandalism saw the highest increase in terms of types of incidents. There were 952 incidents reported — an 86 percent increase from 2016. The surge in anti-Semitic acts of vandalism is particularly upsetting, says the ADL, \"because it indicates that the perpetrators feel emboldened enough to break the law.\"\u003c/p>\n\u003cp>Physical assaults were down by 47 percent, from 36 instances in 2016 to 19 in 2017.\u003c/p>\n\u003cp>There were 1,015 incidents of harassment in 2017; 163 of these were part of a spree of\u003ca href=\"https://www.npr.org/sections/thetwo-way/2017/02/27/517539505/bomb-threats-made-against-jewish-community-centers-in-11-states\"> bomb threats made against Jewish institutions\u003c/a>. Those organizations were subject to 342 total anti-Semitic incidents in 2017 — an increase of 101 percent over the 170 incidents recorded in 2016.\u003c/p>\n\u003cp>The ADL doesn't include instances of discrimination, such as a Jewish worker not receiving an accommodation for Rosh Hashanah, or general expressions of hateful ideologies in their audit.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>An \"incident\" in this audit doesn't necessarily mean a single act of anti-Semitism. For instance, 170 Jewish tombstones were overturned in a Missouri cemetery in February 2017, and the act was counted as one incident by the ADL.\u003c/p>\n\u003cp>\"This family is all family. These stones are all our stones. No matter who's here, they're my family. They're Jews who have been desecrated,\" Jody Serkes, who had family members buried in the cemetery, \u003ca href=\"https://www.npr.org/2017/02/21/516488403/headstones-vandalized-at-jewish-cemetery-in-missouri\">told NPR last year\u003c/a>.\u003c/p>\n\u003cp>\"You know, people have permission now,\" Serkes continued, speaking on the climate of ignorance and fear she believed President Trump had allowed. \"They think in their minds their ignorance and fear is permission to be angry about anything.\"\u003c/p>\n\u003cp>An ADL \u003ca href=\"https://www.adl.org/news/press-releases/anti-semitic-incidents-surged-nearly-60-in-2017-according-to-new-adl-report\">press release\u003c/a> noted that one \"bright spot\" in this was the response of Muslims and Christians who raised thousands of dollars to help repair the damaged tombstones.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"If we expect law enforcement officials and community members to take these incidents seriously, we must take them seriously — and report them, both to ADL and to the police,\" the press release said.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Anti-Semitic+Incidents+See+Largest+Single-Year+Increase+On+Record%2C+Audit+Finds&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"title": "Investigators Fail to Find Cause of Smoky Metal Yard Fire in Richmond",
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"content": "\u003cp>The cause of a major fire at a metal recycling facility in Richmond that sent high levels of toxic smoke into the air last month may never be known.\u003c/p>\n\u003cp>Investigators have spent weeks interviewing employees of the Sims Metal Management site and sifting through large amounts of burned debris, but in the end they could not find conclusive evidence of what exactly sparked the Jan. 30 blaze, according to Inspector Eric Govan of the Richmond Fire Department.\u003c/p>\n\u003cp>While the department has ruled out arson, the cause of the fire has officially been categorized as undetermined, Govan said.\u003c/p>\n\u003cp>[contextly_sidebar id=”i65DUFxnOrhqPlkRNBkTnrzSqwrfmAHo”]\u003c/p>\n\u003cp>The \u003ca href=\"https://ww2.kqed.org/news/2018/01/31/smoke-from-scrap-metal-yard-fire-in-richmond-may-have-violated-local-air-standards/\" target=\"_blank\" rel=\"noopener\">blaze\u003c/a> ignited a 20-foot-tall pile made up of refrigerators, stoves, dishwashers and office furniture, burning debris for about 11 hours.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I went into the center of this pile,” Govan said. “Everything was burned.”\u003c/p>\n\u003cp>So much of the material was charred it was impossible to find out what heat source led the debris to catch fire, Govan said.\u003c/p>\n\u003cp>In the coming weeks the department plans to issue an investigative report that could include a set of recommendations aimed at preventing another large blaze at the facility.\u003c/p>\n\u003cp>\u003cstrong>Fire Reveals Weaknesses in Emergency Communication\u003c/strong>\u003c/p>\n\u003cp>The fire prompted a set of alerts ordering residents to stay indoors. In the days after the fire, residents and the city’s mayor, Tom Butt, a longtime critic of Contra Costa County’s community warning system, complained that the shelter-in-place alerts were too slow and confusing.\u003c/p>\n\u003cp>There was a 40-minute lag between the time Richmond fire officials asked the county to initiate a community alert and the time it was issued. That lapse prompted a meeting on Feb. 8 between Richmond city officials and the Contra Costa County Sheriff’s Office.\u003c/p>\n\u003cp>During that discussion county officials emphasized that not just any member of the Fire Department could initiate an alert request — that only an “incident commander” could do so. During the next emergency, Richmond Fire Chief Adrian Sheppard says his department will follow those rules.\u003c/p>\n\u003cp>Other weaknesses in the emergency response came up in that meeting: Unlike other local cities, Richmond does not use Nixle, the free online service utilized by local governments around the country to help warn their residents of emergencies. And if a Spanish-speaking resident wants to sign up to receive one of the county alerts, they must navigate through a set of prompts in English.\u003c/p>\n\u003cp>The Contra Costa County Sheriff’s Office would not respond to request for comment on the warning system other than to refer back to a \u003ca href=\"http://www.cocosheriff.org/civicax/filebank/blobdload.aspx?blobid=22877\" target=\"_blank\" rel=\"noopener\">statement\u003c/a> issued in response to Mayor Butt’s criticism, defending the program.\u003c/p>\n\u003cp>Residents also wanted to know why the alert system did not use the sirens the county regularly tests. Sheppard later revealed that fire officials were concerned the sound of the sirens would prompt people to flee their homes when the department wanted them inside because of the smoke.\u003c/p>\n\u003cp>The fire has prompted Richmond to consider placing Sims under the same regulations the city uses to oversee the Chevron refinery. The City Council voted last week to look into expanding its industrial safety ordinance to cover the facility as the city reviews \u003ca href=\"https://ww2.kqed.org/news/2018/02/05/richmond-launches-review-of-metal-yard-that-went-up-in-flames/\" target=\"_blank\" rel=\"noopener\">whether Sims is complying\u003c/a> with rules governing its work near the Port of Richmond.\u003c/p>\n\u003cp>At that council hearing, Sheppard acknowledged weaknesses in the city’s inspection system after revealing that Sims had not been inspected in several years.\u003c/p>\n\u003cp>Sheppard told the council he believes the last time the facility was inspected was in 2015.\u003c/p>\n\u003cp>“The honest answer is, it fell through the cracks,” Sheppard said. “Maybe the inspection was done and it wasn’t documented. I can’t tell you definitively whether or not it was inspected. I can just tell you that we have a process improvement plan in place.”\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/news/2018/02/12/richmond-fire-released-range-of-toxic-chemicals-into-air-reports-show/\" target=\"_blank\" rel=\"noopener\">Tests\u003c/a> of air captured at the site of the fire found elevated levels of several industrial chemicals, including at least two human carcinogens.\u003c/p>\n\u003cp>The Bay Area Air Quality Management District is investigating the fire. It issued two notices of violation against Sims, one for public nuisance and another for illegal open burning.\u003c/p>\n\u003cp>\u003cstrong>Sims Says It’s Becoming Safer\u003c/strong>\u003c/p>\n\u003cp>The blaze is prompting the company to do a better job of preparing for fire risks in the future, according to Sims spokeswoman Jill Rodby. The facility is buying a compressed-air foam system so company crews can put foam on a fire before firefighters arrive on scene.\u003c/p>\n\u003cp>During the fire, crews from the Chevron, Shell and Dow Chemical plants brought in 15,000 gallons of foam to help firefighters put out the blaze. That was on top of the 2 million gallons of water the Fire Department used.\u003c/p>\n\u003cp>Company crews now monitor the facility’s stockpiles 24 hours a day, according to Mike Holmes, a Sims division manager.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We’ve been in the community. We’re neighbors,” Rodby said. “We have never ever wanted to harm anybody in the community. When something like this happens, it breaks your heart.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The cause of a major fire at a metal recycling facility in Richmond that sent high levels of toxic smoke into the air last month may never be known.\u003c/p>\n\u003cp>Investigators have spent weeks interviewing employees of the Sims Metal Management site and sifting through large amounts of burned debris, but in the end they could not find conclusive evidence of what exactly sparked the Jan. 30 blaze, according to Inspector Eric Govan of the Richmond Fire Department.\u003c/p>\n\u003cp>While the department has ruled out arson, the cause of the fire has officially been categorized as undetermined, Govan said.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The \u003ca href=\"https://ww2.kqed.org/news/2018/01/31/smoke-from-scrap-metal-yard-fire-in-richmond-may-have-violated-local-air-standards/\" target=\"_blank\" rel=\"noopener\">blaze\u003c/a> ignited a 20-foot-tall pile made up of refrigerators, stoves, dishwashers and office furniture, burning debris for about 11 hours.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I went into the center of this pile,” Govan said. “Everything was burned.”\u003c/p>\n\u003cp>So much of the material was charred it was impossible to find out what heat source led the debris to catch fire, Govan said.\u003c/p>\n\u003cp>In the coming weeks the department plans to issue an investigative report that could include a set of recommendations aimed at preventing another large blaze at the facility.\u003c/p>\n\u003cp>\u003cstrong>Fire Reveals Weaknesses in Emergency Communication\u003c/strong>\u003c/p>\n\u003cp>The fire prompted a set of alerts ordering residents to stay indoors. In the days after the fire, residents and the city’s mayor, Tom Butt, a longtime critic of Contra Costa County’s community warning system, complained that the shelter-in-place alerts were too slow and confusing.\u003c/p>\n\u003cp>There was a 40-minute lag between the time Richmond fire officials asked the county to initiate a community alert and the time it was issued. That lapse prompted a meeting on Feb. 8 between Richmond city officials and the Contra Costa County Sheriff’s Office.\u003c/p>\n\u003cp>During that discussion county officials emphasized that not just any member of the Fire Department could initiate an alert request — that only an “incident commander” could do so. During the next emergency, Richmond Fire Chief Adrian Sheppard says his department will follow those rules.\u003c/p>\n\u003cp>Other weaknesses in the emergency response came up in that meeting: Unlike other local cities, Richmond does not use Nixle, the free online service utilized by local governments around the country to help warn their residents of emergencies. And if a Spanish-speaking resident wants to sign up to receive one of the county alerts, they must navigate through a set of prompts in English.\u003c/p>\n\u003cp>The Contra Costa County Sheriff’s Office would not respond to request for comment on the warning system other than to refer back to a \u003ca href=\"http://www.cocosheriff.org/civicax/filebank/blobdload.aspx?blobid=22877\" target=\"_blank\" rel=\"noopener\">statement\u003c/a> issued in response to Mayor Butt’s criticism, defending the program.\u003c/p>\n\u003cp>Residents also wanted to know why the alert system did not use the sirens the county regularly tests. Sheppard later revealed that fire officials were concerned the sound of the sirens would prompt people to flee their homes when the department wanted them inside because of the smoke.\u003c/p>\n\u003cp>The fire has prompted Richmond to consider placing Sims under the same regulations the city uses to oversee the Chevron refinery. The City Council voted last week to look into expanding its industrial safety ordinance to cover the facility as the city reviews \u003ca href=\"https://ww2.kqed.org/news/2018/02/05/richmond-launches-review-of-metal-yard-that-went-up-in-flames/\" target=\"_blank\" rel=\"noopener\">whether Sims is complying\u003c/a> with rules governing its work near the Port of Richmond.\u003c/p>\n\u003cp>At that council hearing, Sheppard acknowledged weaknesses in the city’s inspection system after revealing that Sims had not been inspected in several years.\u003c/p>\n\u003cp>Sheppard told the council he believes the last time the facility was inspected was in 2015.\u003c/p>\n\u003cp>“The honest answer is, it fell through the cracks,” Sheppard said. “Maybe the inspection was done and it wasn’t documented. I can’t tell you definitively whether or not it was inspected. I can just tell you that we have a process improvement plan in place.”\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/news/2018/02/12/richmond-fire-released-range-of-toxic-chemicals-into-air-reports-show/\" target=\"_blank\" rel=\"noopener\">Tests\u003c/a> of air captured at the site of the fire found elevated levels of several industrial chemicals, including at least two human carcinogens.\u003c/p>\n\u003cp>The Bay Area Air Quality Management District is investigating the fire. It issued two notices of violation against Sims, one for public nuisance and another for illegal open burning.\u003c/p>\n\u003cp>\u003cstrong>Sims Says It’s Becoming Safer\u003c/strong>\u003c/p>\n\u003cp>The blaze is prompting the company to do a better job of preparing for fire risks in the future, according to Sims spokeswoman Jill Rodby. The facility is buying a compressed-air foam system so company crews can put foam on a fire before firefighters arrive on scene.\u003c/p>\n\u003cp>During the fire, crews from the Chevron, Shell and Dow Chemical plants brought in 15,000 gallons of foam to help firefighters put out the blaze. That was on top of the 2 million gallons of water the Fire Department used.\u003c/p>\n\u003cp>Company crews now monitor the facility’s stockpiles 24 hours a day, according to Mike Holmes, a Sims division manager.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We’ve been in the community. We’re neighbors,” Rodby said. “We have never ever wanted to harm anybody in the community. When something like this happens, it breaks your heart.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"soldout": {
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"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
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