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"content": "\u003cp>Gov. Gavin Newsom is an unlikely champion of California’s down and out. Yet the wine entrepreneur, who built his political career and fortune with help from the state’s wealthy elite, campaigned on a promise to address California’s disparities — and do so boldly.\u003c/p>\n\u003cp>From his \u003ca href=\"https://www.gov.ca.gov/2019/01/07/newsom-inaugural-address/\">first day in office\u003c/a> in January 2019, Newsom called the manifestations of California’s inequality — homelessness, poverty and rising costs — “moral imperatives,” not just policy priorities. “So long as they persist, each and every one of us is diminished,” he declared.\u003c/p>\n\u003cp>Those inequalities persisted and were laid bare by two years of the COVID-19 pandemic, a tumultuous time that saw the governor overcome a Republican-led effort to recall him from office last September.[pullquote size=\"medium\" align=\"right\" citation=\"Chris Hoene, director, California Budget and Policy Center\"]‘If the comparison is where we were when he took over as governor, and where we are today, he’s facing a ton of headwinds. And the urgency and the need drives expectations about him doing more.’[/pullquote]Now with the pandemic receding, the economy rebounding and no major political opposition standing in his way to reelection this year, Newsom has the opportunity to return to his original priority of reducing the stain\u003cstrong> \u003c/strong>of poverty on the state.\u003c/p>\n\u003cp>He is expected to address the issue today in the final State of the State speech of his first term. ”There is going to be an explicit callout on inequality, and the stakes,” said an aide, who spoke only if not named because they were not authorized to give a preview of the speech. “One of the themes of the speech is going to be democracy, and tying that to how unchecked inequality undermines democracy.”\u003c/p>\n\u003cp>Some experts and advocates say Newsom’s efforts to close the economic divide may determine his legacy — and help set him apart from his predecessor and fellow Democrat, Jerry Brown, who insisted state government could only go so far \u003ca href=\"https://www.wsj.com/articles/the-mixed-ledger-of-jerry-brown-11544803128\">in closing the divide between rich and poor\u003c/a>.\u003c/p>\n\u003cp>“If the comparison is past governors in California, he’s trying to do a lot,” said Chris Hoene, director of the \u003ca href=\"https://calbudgetcenter.org/\">California Budget and Policy Center\u003c/a>, a nonprofit that researches policy affecting lower-income Californians. “If the comparison is where we were when he took over as governor, and where we are today, he’s facing a ton of headwinds. And the urgency and the need drives expectations about him doing more.”\u003c/p>\n\u003cp>Nationally, the jobs recovery is in full swing, and though California has lagged other states, it could at last see improvements as mask mandates loosen and the economy returns more to normal. The pandemic — and record state budget surpluses — have given Newsom the opportunity to address the state’s inequalities. The Democratic leaders of the state Assembly and Senate leaders also say they want to use the budget to \u003ca href=\"https://calmatters.org/politics/2022/01/california-legislature-what-to-expect-in-2022/\">create a more inclusive recovery and more equitable economy\u003c/a>.\u003c/p>\n\u003cp>But Assembly GOP leader James Gallagher of Yuba City said it’s the policies of Democrats that are driving inequality.\u003c/p>\n\u003cp>“We have a huge surplus because the wealthiest are doing so well,” he said. “That doesn’t tell the story of the middle- and low-income earners in this state.”\u003c/p>\n\u003cp>For instance, he said working families are getting hammered by the state’s high cost of gasoline, \u003ca href=\"https://gasprices.aaa.com/state-gas-price-averages/\">which according to AAA\u003c/a> has now topped an average of $5 a gallon — an increase \u003ca href=\"https://twitter.com/CNBCnow/status/1500616012936404998?s=20&t=rVWBoDfE4mpwCbhd1sf3aA\">accelerated by the Ukraine war\u003c/a>, although Gallagher and other \u003ca href=\"https://twitter.com/SenateRepCaucus/status/1500855328396640257?s=20&t=PuXYRJdx071mxt-zKe53Xw\">Republicans also blame the state’s gas tax\u003c/a>, which Democrats \u003ca href=\"https://www.latimes.com/politics/la-pol-sac-gas-tax-signing-20170428-story.html\">raised in 2017 \u003c/a>under Brown to repair roads and bridges and expand mass transit. Newsom has proposed putting off a scheduled July increase, but he has \u003ca href=\"https://calmatters.org/politics/2022/02/california-legislators-debates-preview/\">met resistance\u003c/a> from his own party in the Legislature. The climate change agenda of California Democrats also has driven up the cost of utilities, further deepening inequality, Gallagher said.\u003c/p>\n\u003cp>“I think he genuinely cares about this issue, but I think that his policies — the policies of either he, or Democrats in the Legislature — have made the problem worse,” Gallagher said. “The other problem is that the governor has a lack of follow-through. He’s big on pronouncements and announcing new programs, but pretty short on implementation and results.”\u003c/p>\n\u003ch2>What’s Newsom’s record?\u003c/h2>\n\u003cp>In his State of the State speech last year, Newsom returned to the \u003ca href=\"https://www.gov.ca.gov/2021/03/09/governor-newsom-delivers-state-of-the-state-address-charting-californias-path-to-a-brighter-future/\">theme of inequality\u003c/a>, indicating his belief the pandemic was “widening gaps between the haves and the have-nots.” “California’s most acute preexisting condition remains income inequality,” he said.\u003c/p>\n\u003cp>In his three years in office, he has pushed through several significant initiatives:\u003c/p>\n\u003cul>\n\u003cli>Steadily expanding Medi-Cal coverage to include undocumented people until they turn 26 and once they turn 50, and in his \u003ca href=\"https://calmatters.org/politics/2022/01/california-budget-newsom/\">January budget\u003c/a> proposing covering those previously excluded. But the expansion would still leave several hundred thousand undocumented immigrants \u003ca href=\"https://calmatters.org/health/2022/02/medi-cal-expansion-immigrants/\">unable to qualify\u003c/a> because they earn above the program’s annual income thresholds.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>In 2019, expanding the state’s earned income tax credit and the young child tax credit to help boost the wages of low-paid workers and families.\u003cstrong> \u003c/strong>In 2020, he signed a law allowing anyone with an individual taxpayer identification number to qualify for the expanded earned income tax credit. That made \u003ca href=\"https://calmatters.org/economy/2020/12/tax-credits-undocumented-workers-california-law/\">undocumented workers\u003c/a> eligible to receive hundreds, or thousands, of dollars each year. Last year, he \u003ca href=\"https://calmatters.org/california-divide/2021/02/california-600-stimulus-checks-undocumented-workers/\">signed a measure\u003c/a> giving $600 one-time payments to those who receive the state’s earned income tax credit, along with an extra $600 for certain undocumented taxpayers not eligible for some federal aid.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>During the pandemic, expanding eligibility for several safety net programs, including food assistance, allowing for more people to participate. In particular, the state \u003ca href=\"https://calfresh.guide/temporary-reporting-and-recertification-changes-because-of-covid-19/\">paused the recertification process\u003c/a> in the state’s CalFresh program, which provides food benefits to some 2.6 million lower-income households. And the state last year created a \u003ca href=\"https://edsource.org/2021/free-school-meals-here-to-stay-in-california/658564\">universal free school meals program\u003c/a>, doing away with a previous income requirement.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>When taking office, \u003ca href=\"https://calmatters.org/economy/2019/01/newsom-paid-family-leave-proposal-analyzed/\">announcing plans\u003c/a> to assist working parents with a six-month, paid family leave program. He has so far extended the program to eight weeks per parent. In 2020, he signed a bill expanding unpaid family leave to include smaller employers, but in 2021 vetoed a bill intended to extend the program to \u003ca href=\"https://calmatters.org/politics/2021/07/california-paid-family-leave/\">lower-income workers\u003c/a>. The governor also has made progress on his goals to expand preschool, with a plan to provide universal transitional kindergarten for 4-year-olds by 2025.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>Experts and activists say making higher education more affordable is important to reducing inequality in the state. Last year, the administration eliminated age and time-out-of-high-school requirements for Cal Grant scholarships to community colleges. But the governor \u003ca href=\"https://calmatters.org/education/higher-education/2021/10/cal-grant-expansion-veto/\">vetoed a bill\u003c/a> that would have made Cal Grants more broadly available. Lawmakers last year also signaled the intent to expand a scholarship for middle-class students in the state, as well as more slots in public universities for California students, though \u003ca href=\"https://calmatters.org/education/2021/06/california-college-budget/\">lawmakers must agree this year\u003c/a> to fund those promises.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>The governor’s efforts with economic recovery, trying to \u003ca href=\"https://opr.ca.gov/economic-development/just-transition/cerf.html#regions\">target funds regionally\u003c/a>, could help the Central Valley and other parts of the state that are struggling. Such work might not be easy; a legislative effort to retrain oil workers already has sparked a \u003ca href=\"https://calmatters.org/california-divide/2022/02/just-transition-bill-for-oil-industry-workers-exposes-labor-rift/\">political fight\u003c/a> among some of the state’s labor unions.\u003c/li>\n\u003c/ul>\n\u003cp>Still, advocates say the state could be doing more to shrink the economic divide.\u003c/p>\n\u003ch2>What do the numbers show?\u003c/h2>\n\u003cp>While recessions \u003ca href=\"https://calmatters.org/california-divide/ca-divide-economic-inequality/2022/02/california-income-inequality/\">tend to widen income disparities\u003c/a> between rich and poor, earnings have increased for lower-income workers while unprecedented government relief kept millions from falling into poverty. That’s despite the sharp downturn in 2020, and the disproportionate number of pandemic-related job losses hitting lower-wage sectors. During the recovery, some of the biggest gains are in the leisure and hospitality sectors, according to \u003ca href=\"https://www.ppic.org/person/sarah-bohn/\">Sarah Bohn\u003c/a>, vice president and policy research chair with the Public Policy Institute of California.\u003c/p>\n\u003cp>“Wages are picking up the most at the low end of the spectrum, even though we’re still in a recovery period with elevated unemployment,” Bohn said. “It might be that inequality is actually decreasing during the pandemic — which is kind of crazy, and we’ll know more soon — but when you just look at the wage statistics, the sectors that are lowest paid have the highest increase in wages.”\u003c/p>\n\u003cp>Nationally, data from the \u003ca href=\"https://www.atlantafed.org/chcs/wage-growth-tracker\">Federal Reserve Bank of \u003c/a>\u003ca href=\"https://www.atlantafed.org/chcs/wage-growth-tracker\">Atlanta \u003c/a>shows typical wages for the bottom 25% of earners growing faster than for those of other income groups. Meanwhile the Biden administration has highlighted research from two influential UC Berkeley economists underscoring that economic growth has been broadly shared since he took office in January 2021.\u003c/p>\n\u003cp>In California, income inequality statistics for 2020 are not yet available, but the trend has been one of dramatic widening over the long run, with the modern economy placing a premium on highly educated workers. Analyzing pretax income and including cash from some safety net programs, the PPIC found income growth for the bottom 10% of families in California lagging significantly behind the top 10% from 1980 to 2019.\u003c/p>\n\u003cp>\u003ca href=\"https://inequality.stanford.edu/about/people/david-grusky\">David Grusky\u003c/a>, director of the Stanford Center on Poverty and Inequality, said that while incomes may be increasing on the bottom end, those with higher incomes were less interrupted by job losses and many saw a significant rise in the value of their assets.\u003c/p>\n\u003cp>“Those people who had money in the stock market fared well, and those are the people who are well off,” he said.\u003c/p>\n\u003cp>With its highest earners doing well, and a major boost in federal aid, California’s budget has been flush with surpluses during the pandemic. And Congress last year passed President Biden’s American Rescue Plan, which California has used to address some of its longstanding inequities. Newsom and legislators have invested billions in homelessness programs, affordable housing, aid to undocumented immigrants and its youth mental health system.\u003c/p>\n\u003cp>The youth mental health system reforms are “transformational and are expected to be permanent,” said \u003ca href=\"https://www.cbpp.org/about/our-staff/ed-lazere\">Ed Lazere\u003c/a>, a researcher who tracks state fiscal policy at the Center on Budget and Policy Priorities in Washington, D.C.\u003c/p>\n\u003ch2>Focus on homelessness\u003c/h2>\n\u003cp>In many ways, much of Newsom’s political career has been defined by one of the most visible manifestations of the state’s extremes — homelessness. He garnered political attention and notoriety from activists with his Care Not Cash initiative as a San Francisco supervisor, a measure intended to cut general assistance programs for the unhoused in exchange for housing and other services. He often walked through the city’s Tenderloin, where he saw homelessness for himself.[aside postID=\"news_11901253,news_11907155,news_11906414\" label=\"Related Posts\"]In 2020, just before COVID, Newsom dedicated his \u003ca href=\"https://www.gov.ca.gov/2020/02/19/governor-newsom-delivers-state-of-the-state-address-on-homelessness/\">State of the State\u003c/a> address solely to the subject. During the pandemic, his administration \u003ca href=\"https://calmatters.org/housing/homeless/2021/05/newsom-end-homelessness-pandemic-lessons/\">converted dozens of run-down motels into shelters\u003c/a> and housing for unhoused people. Last year, he and the Legislature allocated $12 billion to homelessness programs. He’s proposing another $2 billion in the 2022-23 budget. He’s also moving ahead with an ambitious plan to \u003ca href=\"https://calmatters.org/housing/homeless/2021/11/california-homeless-camps-clearing-plan/\">clear homeless encampments\u003c/a> and offer services to people living in them. And last week, \u003ca href=\"https://calmatters.org/health/2022/03/newsom-california-mental-illness-treatment/\">Newsom outlined a plan to allow courts\u003c/a> to force some unhoused individuals with serious mental illness and substance use disorders into treatment, while also providing some services.\u003c/p>\n\u003cp>After all that, \u003ca href=\"https://calmatters.org/housing/homeless/2022/03/california-homeless-count/\">homelessness remains\u003c/a> one of the biggest problems facing his administration. Two-thirds of voters \u003ca href=\"https://escholarship.org/uc/item/6ft4h17c\">in a February poll from UC Berkeley’s Institute of Governmental Studies\u003c/a> said he’s doing a poor or very poor job on the issue, contributing to a lower approval rating than before the recall election last September. And \u003ca href=\"https://calmatters.org/newsletters/whatmatters/2022/02/california-crime-homelessness/\">along with public perception of rising crime\u003c/a>, it may be what gets in the way of a smooth path to a second term in this year’s election.\u003c/p>\n\u003cp>At the same time, Californians care about inequality: In a \u003ca href=\"https://www.ppic.org/publication/ppic-statewide-survey-californians-and-their-economic-well-being-november-2021/\">November survey by the PPIC\u003c/a>, 69% said the gap between rich and poor is growing in their region, and 76% supported increasing government funding so child care is available to more lower-income working parents. And how Newsom decides to lead on inequality will matter politically in Sacramento given the number of moderate Democrats and legislators finding themselves in new districts untested by voters, many of whom could be unlikely to support riskier policies without a push from the governor.\u003c/p>\n\u003cp>Those who advocate for those policies will be watching: “It does seem like Newsom is treating a commitment to reducing poverty as one of his key legacy commitments, and so that’s wonderful,” said Grusky of Stanford. But, he said, “we can do, and should do, even more.”\u003c/p>\n\u003cp>\u003cem>This article is part of the\u003c/em>\u003ca href=\"https://calmatters.org/projects/california-divide/\">\u003cem> California Divide\u003c/em>\u003c/a>\u003cem> project, a collaboration among newsrooms examining income inequality and economic survival in California.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "With the pandemic receding, the economy rebounding and no major political opposition standing in his way to reelection, Gov. Newsom has the opportunity to return to his original priority of reducing the stain of poverty on the state.",
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"title": "Gavin Newsom Has a Chance to Address California's Inequality. Will He Take It? | KQED",
"description": "With the pandemic receding, the economy rebounding and no major political opposition standing in his way to reelection, Gov. Newsom has the opportunity to return to his original priority of reducing the stain of poverty on the state.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Gov. Gavin Newsom is an unlikely champion of California’s down and out. Yet the wine entrepreneur, who built his political career and fortune with help from the state’s wealthy elite, campaigned on a promise to address California’s disparities — and do so boldly.\u003c/p>\n\u003cp>From his \u003ca href=\"https://www.gov.ca.gov/2019/01/07/newsom-inaugural-address/\">first day in office\u003c/a> in January 2019, Newsom called the manifestations of California’s inequality — homelessness, poverty and rising costs — “moral imperatives,” not just policy priorities. “So long as they persist, each and every one of us is diminished,” he declared.\u003c/p>\n\u003cp>Those inequalities persisted and were laid bare by two years of the COVID-19 pandemic, a tumultuous time that saw the governor overcome a Republican-led effort to recall him from office last September.\u003c/p>\u003c/div>",
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"content": "‘If the comparison is where we were when he took over as governor, and where we are today, he’s facing a ton of headwinds. And the urgency and the need drives expectations about him doing more.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Now with the pandemic receding, the economy rebounding and no major political opposition standing in his way to reelection this year, Newsom has the opportunity to return to his original priority of reducing the stain\u003cstrong> \u003c/strong>of poverty on the state.\u003c/p>\n\u003cp>He is expected to address the issue today in the final State of the State speech of his first term. ”There is going to be an explicit callout on inequality, and the stakes,” said an aide, who spoke only if not named because they were not authorized to give a preview of the speech. “One of the themes of the speech is going to be democracy, and tying that to how unchecked inequality undermines democracy.”\u003c/p>\n\u003cp>Some experts and advocates say Newsom’s efforts to close the economic divide may determine his legacy — and help set him apart from his predecessor and fellow Democrat, Jerry Brown, who insisted state government could only go so far \u003ca href=\"https://www.wsj.com/articles/the-mixed-ledger-of-jerry-brown-11544803128\">in closing the divide between rich and poor\u003c/a>.\u003c/p>\n\u003cp>“If the comparison is past governors in California, he’s trying to do a lot,” said Chris Hoene, director of the \u003ca href=\"https://calbudgetcenter.org/\">California Budget and Policy Center\u003c/a>, a nonprofit that researches policy affecting lower-income Californians. “If the comparison is where we were when he took over as governor, and where we are today, he’s facing a ton of headwinds. And the urgency and the need drives expectations about him doing more.”\u003c/p>\n\u003cp>Nationally, the jobs recovery is in full swing, and though California has lagged other states, it could at last see improvements as mask mandates loosen and the economy returns more to normal. The pandemic — and record state budget surpluses — have given Newsom the opportunity to address the state’s inequalities. The Democratic leaders of the state Assembly and Senate leaders also say they want to use the budget to \u003ca href=\"https://calmatters.org/politics/2022/01/california-legislature-what-to-expect-in-2022/\">create a more inclusive recovery and more equitable economy\u003c/a>.\u003c/p>\n\u003cp>But Assembly GOP leader James Gallagher of Yuba City said it’s the policies of Democrats that are driving inequality.\u003c/p>\n\u003cp>“We have a huge surplus because the wealthiest are doing so well,” he said. “That doesn’t tell the story of the middle- and low-income earners in this state.”\u003c/p>\n\u003cp>For instance, he said working families are getting hammered by the state’s high cost of gasoline, \u003ca href=\"https://gasprices.aaa.com/state-gas-price-averages/\">which according to AAA\u003c/a> has now topped an average of $5 a gallon — an increase \u003ca href=\"https://twitter.com/CNBCnow/status/1500616012936404998?s=20&t=rVWBoDfE4mpwCbhd1sf3aA\">accelerated by the Ukraine war\u003c/a>, although Gallagher and other \u003ca href=\"https://twitter.com/SenateRepCaucus/status/1500855328396640257?s=20&t=PuXYRJdx071mxt-zKe53Xw\">Republicans also blame the state’s gas tax\u003c/a>, which Democrats \u003ca href=\"https://www.latimes.com/politics/la-pol-sac-gas-tax-signing-20170428-story.html\">raised in 2017 \u003c/a>under Brown to repair roads and bridges and expand mass transit. Newsom has proposed putting off a scheduled July increase, but he has \u003ca href=\"https://calmatters.org/politics/2022/02/california-legislators-debates-preview/\">met resistance\u003c/a> from his own party in the Legislature. The climate change agenda of California Democrats also has driven up the cost of utilities, further deepening inequality, Gallagher said.\u003c/p>\n\u003cp>“I think he genuinely cares about this issue, but I think that his policies — the policies of either he, or Democrats in the Legislature — have made the problem worse,” Gallagher said. “The other problem is that the governor has a lack of follow-through. He’s big on pronouncements and announcing new programs, but pretty short on implementation and results.”\u003c/p>\n\u003ch2>What’s Newsom’s record?\u003c/h2>\n\u003cp>In his State of the State speech last year, Newsom returned to the \u003ca href=\"https://www.gov.ca.gov/2021/03/09/governor-newsom-delivers-state-of-the-state-address-charting-californias-path-to-a-brighter-future/\">theme of inequality\u003c/a>, indicating his belief the pandemic was “widening gaps between the haves and the have-nots.” “California’s most acute preexisting condition remains income inequality,” he said.\u003c/p>\n\u003cp>In his three years in office, he has pushed through several significant initiatives:\u003c/p>\n\u003cul>\n\u003cli>Steadily expanding Medi-Cal coverage to include undocumented people until they turn 26 and once they turn 50, and in his \u003ca href=\"https://calmatters.org/politics/2022/01/california-budget-newsom/\">January budget\u003c/a> proposing covering those previously excluded. But the expansion would still leave several hundred thousand undocumented immigrants \u003ca href=\"https://calmatters.org/health/2022/02/medi-cal-expansion-immigrants/\">unable to qualify\u003c/a> because they earn above the program’s annual income thresholds.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>In 2019, expanding the state’s earned income tax credit and the young child tax credit to help boost the wages of low-paid workers and families.\u003cstrong> \u003c/strong>In 2020, he signed a law allowing anyone with an individual taxpayer identification number to qualify for the expanded earned income tax credit. That made \u003ca href=\"https://calmatters.org/economy/2020/12/tax-credits-undocumented-workers-california-law/\">undocumented workers\u003c/a> eligible to receive hundreds, or thousands, of dollars each year. Last year, he \u003ca href=\"https://calmatters.org/california-divide/2021/02/california-600-stimulus-checks-undocumented-workers/\">signed a measure\u003c/a> giving $600 one-time payments to those who receive the state’s earned income tax credit, along with an extra $600 for certain undocumented taxpayers not eligible for some federal aid.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>During the pandemic, expanding eligibility for several safety net programs, including food assistance, allowing for more people to participate. In particular, the state \u003ca href=\"https://calfresh.guide/temporary-reporting-and-recertification-changes-because-of-covid-19/\">paused the recertification process\u003c/a> in the state’s CalFresh program, which provides food benefits to some 2.6 million lower-income households. And the state last year created a \u003ca href=\"https://edsource.org/2021/free-school-meals-here-to-stay-in-california/658564\">universal free school meals program\u003c/a>, doing away with a previous income requirement.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>When taking office, \u003ca href=\"https://calmatters.org/economy/2019/01/newsom-paid-family-leave-proposal-analyzed/\">announcing plans\u003c/a> to assist working parents with a six-month, paid family leave program. He has so far extended the program to eight weeks per parent. In 2020, he signed a bill expanding unpaid family leave to include smaller employers, but in 2021 vetoed a bill intended to extend the program to \u003ca href=\"https://calmatters.org/politics/2021/07/california-paid-family-leave/\">lower-income workers\u003c/a>. The governor also has made progress on his goals to expand preschool, with a plan to provide universal transitional kindergarten for 4-year-olds by 2025.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>Experts and activists say making higher education more affordable is important to reducing inequality in the state. Last year, the administration eliminated age and time-out-of-high-school requirements for Cal Grant scholarships to community colleges. But the governor \u003ca href=\"https://calmatters.org/education/higher-education/2021/10/cal-grant-expansion-veto/\">vetoed a bill\u003c/a> that would have made Cal Grants more broadly available. Lawmakers last year also signaled the intent to expand a scholarship for middle-class students in the state, as well as more slots in public universities for California students, though \u003ca href=\"https://calmatters.org/education/2021/06/california-college-budget/\">lawmakers must agree this year\u003c/a> to fund those promises.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>The governor’s efforts with economic recovery, trying to \u003ca href=\"https://opr.ca.gov/economic-development/just-transition/cerf.html#regions\">target funds regionally\u003c/a>, could help the Central Valley and other parts of the state that are struggling. Such work might not be easy; a legislative effort to retrain oil workers already has sparked a \u003ca href=\"https://calmatters.org/california-divide/2022/02/just-transition-bill-for-oil-industry-workers-exposes-labor-rift/\">political fight\u003c/a> among some of the state’s labor unions.\u003c/li>\n\u003c/ul>\n\u003cp>Still, advocates say the state could be doing more to shrink the economic divide.\u003c/p>\n\u003ch2>What do the numbers show?\u003c/h2>\n\u003cp>While recessions \u003ca href=\"https://calmatters.org/california-divide/ca-divide-economic-inequality/2022/02/california-income-inequality/\">tend to widen income disparities\u003c/a> between rich and poor, earnings have increased for lower-income workers while unprecedented government relief kept millions from falling into poverty. That’s despite the sharp downturn in 2020, and the disproportionate number of pandemic-related job losses hitting lower-wage sectors. During the recovery, some of the biggest gains are in the leisure and hospitality sectors, according to \u003ca href=\"https://www.ppic.org/person/sarah-bohn/\">Sarah Bohn\u003c/a>, vice president and policy research chair with the Public Policy Institute of California.\u003c/p>\n\u003cp>“Wages are picking up the most at the low end of the spectrum, even though we’re still in a recovery period with elevated unemployment,” Bohn said. “It might be that inequality is actually decreasing during the pandemic — which is kind of crazy, and we’ll know more soon — but when you just look at the wage statistics, the sectors that are lowest paid have the highest increase in wages.”\u003c/p>\n\u003cp>Nationally, data from the \u003ca href=\"https://www.atlantafed.org/chcs/wage-growth-tracker\">Federal Reserve Bank of \u003c/a>\u003ca href=\"https://www.atlantafed.org/chcs/wage-growth-tracker\">Atlanta \u003c/a>shows typical wages for the bottom 25% of earners growing faster than for those of other income groups. Meanwhile the Biden administration has highlighted research from two influential UC Berkeley economists underscoring that economic growth has been broadly shared since he took office in January 2021.\u003c/p>\n\u003cp>In California, income inequality statistics for 2020 are not yet available, but the trend has been one of dramatic widening over the long run, with the modern economy placing a premium on highly educated workers. Analyzing pretax income and including cash from some safety net programs, the PPIC found income growth for the bottom 10% of families in California lagging significantly behind the top 10% from 1980 to 2019.\u003c/p>\n\u003cp>\u003ca href=\"https://inequality.stanford.edu/about/people/david-grusky\">David Grusky\u003c/a>, director of the Stanford Center on Poverty and Inequality, said that while incomes may be increasing on the bottom end, those with higher incomes were less interrupted by job losses and many saw a significant rise in the value of their assets.\u003c/p>\n\u003cp>“Those people who had money in the stock market fared well, and those are the people who are well off,” he said.\u003c/p>\n\u003cp>With its highest earners doing well, and a major boost in federal aid, California’s budget has been flush with surpluses during the pandemic. And Congress last year passed President Biden’s American Rescue Plan, which California has used to address some of its longstanding inequities. Newsom and legislators have invested billions in homelessness programs, affordable housing, aid to undocumented immigrants and its youth mental health system.\u003c/p>\n\u003cp>The youth mental health system reforms are “transformational and are expected to be permanent,” said \u003ca href=\"https://www.cbpp.org/about/our-staff/ed-lazere\">Ed Lazere\u003c/a>, a researcher who tracks state fiscal policy at the Center on Budget and Policy Priorities in Washington, D.C.\u003c/p>\n\u003ch2>Focus on homelessness\u003c/h2>\n\u003cp>In many ways, much of Newsom’s political career has been defined by one of the most visible manifestations of the state’s extremes — homelessness. He garnered political attention and notoriety from activists with his Care Not Cash initiative as a San Francisco supervisor, a measure intended to cut general assistance programs for the unhoused in exchange for housing and other services. He often walked through the city’s Tenderloin, where he saw homelessness for himself.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>In 2020, just before COVID, Newsom dedicated his \u003ca href=\"https://www.gov.ca.gov/2020/02/19/governor-newsom-delivers-state-of-the-state-address-on-homelessness/\">State of the State\u003c/a> address solely to the subject. During the pandemic, his administration \u003ca href=\"https://calmatters.org/housing/homeless/2021/05/newsom-end-homelessness-pandemic-lessons/\">converted dozens of run-down motels into shelters\u003c/a> and housing for unhoused people. Last year, he and the Legislature allocated $12 billion to homelessness programs. He’s proposing another $2 billion in the 2022-23 budget. He’s also moving ahead with an ambitious plan to \u003ca href=\"https://calmatters.org/housing/homeless/2021/11/california-homeless-camps-clearing-plan/\">clear homeless encampments\u003c/a> and offer services to people living in them. And last week, \u003ca href=\"https://calmatters.org/health/2022/03/newsom-california-mental-illness-treatment/\">Newsom outlined a plan to allow courts\u003c/a> to force some unhoused individuals with serious mental illness and substance use disorders into treatment, while also providing some services.\u003c/p>\n\u003cp>After all that, \u003ca href=\"https://calmatters.org/housing/homeless/2022/03/california-homeless-count/\">homelessness remains\u003c/a> one of the biggest problems facing his administration. Two-thirds of voters \u003ca href=\"https://escholarship.org/uc/item/6ft4h17c\">in a February poll from UC Berkeley’s Institute of Governmental Studies\u003c/a> said he’s doing a poor or very poor job on the issue, contributing to a lower approval rating than before the recall election last September. And \u003ca href=\"https://calmatters.org/newsletters/whatmatters/2022/02/california-crime-homelessness/\">along with public perception of rising crime\u003c/a>, it may be what gets in the way of a smooth path to a second term in this year’s election.\u003c/p>\n\u003cp>At the same time, Californians care about inequality: In a \u003ca href=\"https://www.ppic.org/publication/ppic-statewide-survey-californians-and-their-economic-well-being-november-2021/\">November survey by the PPIC\u003c/a>, 69% said the gap between rich and poor is growing in their region, and 76% supported increasing government funding so child care is available to more lower-income working parents. And how Newsom decides to lead on inequality will matter politically in Sacramento given the number of moderate Democrats and legislators finding themselves in new districts untested by voters, many of whom could be unlikely to support riskier policies without a push from the governor.\u003c/p>\n\u003cp>Those who advocate for those policies will be watching: “It does seem like Newsom is treating a commitment to reducing poverty as one of his key legacy commitments, and so that’s wonderful,” said Grusky of Stanford. But, he said, “we can do, and should do, even more.”\u003c/p>\n\u003cp>\u003cem>This article is part of the\u003c/em>\u003ca href=\"https://calmatters.org/projects/california-divide/\">\u003cem> California Divide\u003c/em>\u003c/a>\u003cem> project, a collaboration among newsrooms examining income inequality and economic survival in California.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cb>Nova Ukraine\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Ostap Korkuna has a full-time job in tech, but since the Russian invasion of Ukraine on Feb. 24, he’s been spending most of his time coordinating humanitarian aid to his home country. Korkuna is the co-chair and director of Nova Ukraine, a non-profit run entirely by volunteers. Right now, he said, they are trying to secure planes to transport medical supplies for injured civilians and soldiers in Ukraine.\u003c/span>\u003c/p>\n\u003cp>\u003cb>Former Sen. Barbara Boxer\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">“My heart is breaking as I watch this war unfold,” said \u003c/span>\u003cb>former Sen. Barbara Boxer,\u003c/b>\u003cspan style=\"font-weight: 400\"> D-CA (1993-2017). As the second week of Russia’s war on Ukraine unfolds, American and Californian support for Ukraine grew. Boxer shares her perspective on the war, sanctions against Russia, and whether Russian President Vladimir Putin can prevail. \u003c/span>\u003c/p>\n\u003cp>\u003cb>This Week in California News and Politics\u003c/b>\u003cspan style=\"font-weight: 400\">\u003cbr>\n\u003c/span>\u003cspan style=\"font-weight: 400\">This week, President Biden gave his first State of the Union, which was heavily focused on the crisis in Ukraine as well as plans for learning to live with COVID. We analyze what Biden’s priorities mean for California in addition to other news of the week\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Guests:\u003c/span>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Saul Gonzalez, KQED’s The California Report co-host\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Scott Shafer, KQED politics and government senior editor\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Something Beautiful: West Oakland Mural Project\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">This week’s look at Something Beautiful is a public art installation by the West Oakland Mural Project which highlights the vital role women played in the revolutionary Black Panther Party. \u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cb>Nova Ukraine\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Ostap Korkuna has a full-time job in tech, but since the Russian invasion of Ukraine on Feb. 24, he’s been spending most of his time coordinating humanitarian aid to his home country. Korkuna is the co-chair and director of Nova Ukraine, a non-profit run entirely by volunteers. Right now, he said, they are trying to secure planes to transport medical supplies for injured civilians and soldiers in Ukraine.\u003c/span>\u003c/p>\n\u003cp>\u003cb>Former Sen. Barbara Boxer\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">“My heart is breaking as I watch this war unfold,” said \u003c/span>\u003cb>former Sen. Barbara Boxer,\u003c/b>\u003cspan style=\"font-weight: 400\"> D-CA (1993-2017). As the second week of Russia’s war on Ukraine unfolds, American and Californian support for Ukraine grew. Boxer shares her perspective on the war, sanctions against Russia, and whether Russian President Vladimir Putin can prevail. \u003c/span>\u003c/p>\n\u003cp>\u003cb>This Week in California News and Politics\u003c/b>\u003cspan style=\"font-weight: 400\">\u003cbr>\n\u003c/span>\u003cspan style=\"font-weight: 400\">This week, President Biden gave his first State of the Union, which was heavily focused on the crisis in Ukraine as well as plans for learning to live with COVID. We analyze what Biden’s priorities mean for California in addition to other news of the week\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Guests:\u003c/span>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Saul Gonzalez, KQED’s The California Report co-host\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Scott Shafer, KQED politics and government senior editor\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Something Beautiful: West Oakland Mural Project\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">This week’s look at Something Beautiful is a public art installation by the West Oakland Mural Project which highlights the vital role women played in the revolutionary Black Panther Party. \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Newsom Says He Won't Intervene to Stop Oakland Schools From Permanently Closing",
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"content": "\u003cp>In an interview with KQED, Gov. Gavin Newsom said the state should not get involved in the Oakland school board's recent controversial decision to close, merge or shrink 11 schools over the next two years — a decision that's been met with fury from local families and educators.\u003c/p>\n\u003cp>The board said they needed to take the action because they have too many schools for a dwindling number of students, citing a need for cost-cutting measures to help solve a structural deficit. OUSD is still paying $30 million in debt to the state from a loan given decades ago to head off bankruptcy. [aside postID=\"news_11905982\" label=\"More on the Oakland school closure fight\"]\u003c/p>\n\u003cp>Two Oakland educators, Moses Omolade and Maurice André San-Chez, went on \u003ca href=\"https://www.kqed.org/news/11905982/how-dare-you-oakland-school-closure-decision-inspires-new-opposition-efforts\">hunger strikes\u003c/a> to protest the decision. They said one of the conditions of ending their strike was that Newsom meet with them.\u003c/p>\n\u003cp>In his talk with KQED, Newsom disclosed that his chief of staff met with the hunger strikers last week.\u003c/p>\n\u003cp>Omolade and San-Chez agreed to end their hunger strike in mid-February after the district called a special board meeting, where it ultimately decided to move forward with the closures.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The governor visited Redwood City on Wednesday\u003ca href=\"https://www.grants.ca.gov/grants/encampment-resolution-funding-program/\"> to bring attention to his Encampment Resolution Funding Program\u003c/a>, which is doling out $50 million to counties that have plans to eliminate specific encampments.\u003c/p>\n\u003cp>While getting his hands dirty cleaning up a roadside encampment, Newsom previewed his upcoming conservatorship proposal, talked about his view on the Oakland school closures, and more, in this interview with KQED's Kate Wolffe.\u003c/p>\n\u003cp>\u003cem>This interview has been edited for length and clarity.\u003c/em>\u003c/p>\n\u003ch2>On the Oakland hunger strikers, who were protesting the closure and merging of 11 schools in the district\u003c/h2>\n\u003cp>I so appreciate their advocacy, and compassion for the community, and their advocacy on behalf of the school system and the communities the school system serves.\u003c/p>\n\u003cp>These local decisions are local decisions.\u003c/p>\n\u003cp>I remember in San Francisco when I was mayor, I think when I was supervisor, even prior, there were some schools that had to close. They’re deeply emotional, difficult decisions. I don't deny that.\u003c/p>\n\u003cp>But if the state is going to get involved in deciding that, then we should be running all the school systems, and that's not something you want, I don't think anyone wants. We've got to provide that local accountability, local framework. That's why school boards are essential and critical and public engagement, parental engagement, is critical and essential as well. But I deeply understand how emotional it is. I don't know the details of the decision. I just don't.\u003c/p>\n\u003cp>As a mayor in the past, I understand those local decisions need to be made and stay local. But at the state level, I know what we are doing, which is providing unprecedented support for our schools and record-breaking per-pupil investments that should provide more flexibility to Oakland [Unified] School District than they've ever had in their history to address some of their financial challenges.\u003c/p>\n\u003ch2>On efforts to resolve encampments in the state\u003c/h2>\n\u003cp>The last two years, we all know what happened. We didn't just have a pandemic, but we had stasis. And the CDC had specific, very explicit guidelines that said don't touch the encampments because of COVID.\u003c/p>\n\u003cfigure id=\"attachment_11906665\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-11906665 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6076-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6076-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6076-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6076-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6076-1536x1152.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6076-2048x1536.jpg 2048w, https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6076-1920x1440.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Gov. Newsom helps to clean up an encampment in Redwood City on Feb. 23, 2022. \u003ccite>(Kate Wolffe, KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>So the entire year 2020, I think there were two dozen encampments cleaned up the entire year by the state of California. We've done 431 just in the last few months. So we've got all this residual stress that has exacerbated conditions on the street more visible than it's ever been. And I recognize that. And now there's no excuse.\u003c/p>\n\u003ch2>On the importance of addressing homeless encampments locally\u003c/h2>\n\u003cp>If you're a local elected official, you step up. If this is the crisis that it is and you have identified as such, then get out here — act like it.\u003c/p>\n\u003cp>I'm serious. We're doing our part. Now you can come out and follow up, do your part. If you need help, identify specifically, what specific help do you need?\u003c/p>\n\u003cp>[When I was mayor,] the state of California was nowhere to be found on homelessness. Nowhere. When I was mayor, we didn't get a dollar. There was no strategy plan, no accountability. No one, ever. I mean, the last thing I ever thought about was calling Arnold Schwarzenegger or Gray Davis. It's completely, radically changed.\u003c/p>\n\u003cp>When I got here there was no plan. There was no accountability and there was no playbook. And there was half a billion dollars that the last administration threw out at the last minute. Now we have $14 billion. We have a plan, we have strategies, we actually have accountability plans, including this Encampment Resolution grant.\u003c/p>\n\u003ch2>On the challenges of resolving encampments\u003c/h2>\n\u003cp>(\u003cem>Note: At the particular encampment that Newsom was cleaning in Redwood City, Caltrans said no residents accepted a shelter bed.\u003c/em>)\u003c/p>\n\u003cp>We’re going to have to keep meeting people where they are. You don't give up. I mean, of course, that's the case. What I think, look, I mean, this is not my first encampment, this is not my first effort. I reject the fatalism that, well, because \"in this circumstance, that circumstance, we weren't successful in encouraging people to get the support and services they need\" that we give up. That just means keep working at it.\u003c/p>\n\u003cfigure id=\"attachment_11906668\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11906668\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6082-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6082-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6082-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6082-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6082-1536x1152.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6082-2048x1536.jpg 2048w, https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6082-1920x1440.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">An encampment in Redwood City. \u003ccite>(Kate Wolffe, KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>One thing I can guarantee: Continue to do what you've done, you get what you've got. And there's a status quo anti-ism in all of this. If you don't create, as we say in psychology, a \"pattern interrupt\" — and this is a pattern interrupt for every single one of them — then you're not going to enliven someone to the opportunity to turn their lives around. They're just quite literally going to die.\u003c/p>\n\u003ch2>On his upcoming conservatorship proposal\u003c/h2>\n\u003cp>Laws on conservatorship are outdated and they're very controversial. It's very emotional and people have very strong opinions, and we've been fighting these fights for decades and nothing gets done. People say “too strong,” “too hard,” “too weak.”\u003c/p>\n\u003cp>So we are looking at a third way, a new conservatorship strategy, where we are going to provide a pathway for individuals to help with their own plan, but to have stepped-up strategies where we can get people the support they desperately need, even if they're absolutely convinced they don't need it, even though they may be out naked on the streets and sidewalks, talking to themselves and defecating and urinating.\u003c/p>\n\u003cp>And that's not humane, and we can't excuse that, and it should break all of our hearts. I feel for those folks. But I also feel for the mom in the stroller trying to go down the streets and the sidewalks being accosted and can’t get to the playground as well. And what's that balance? And so we're trying to strike that balance.\u003c/p>\n\u003cp>But, the status quo hasn't worked at all. And look at what's happened in my beloved city of San Francisco, in the last five or six years. It's just not acceptable.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>A lot of the conservatorship arguments have been done in the absence of resources. So we're saying, well, you need treatment and you're like, \"Where's the treatment? There's no treatment.\" You know, like \"get people off the streets!\" And like, where do they go? And that's the paradigm shift in the last few years: unprecedented money [and], building out an infrastructure with the support of the cities and counties over the last two years.\u003c/p>\n\n",
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"excerpt": "The Oakland Unified School District Board of Education recently voted to close, merge or shrink 11 schools over the next two years, which has met with condemnation from parents. Two Oakland educators went on hunger strikes to protest the decision, and asked for Gov. Gavin Newsom's intervention.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The governor visited Redwood City on Wednesday\u003ca href=\"https://www.grants.ca.gov/grants/encampment-resolution-funding-program/\"> to bring attention to his Encampment Resolution Funding Program\u003c/a>, which is doling out $50 million to counties that have plans to eliminate specific encampments.\u003c/p>\n\u003cp>While getting his hands dirty cleaning up a roadside encampment, Newsom previewed his upcoming conservatorship proposal, talked about his view on the Oakland school closures, and more, in this interview with KQED's Kate Wolffe.\u003c/p>\n\u003cp>\u003cem>This interview has been edited for length and clarity.\u003c/em>\u003c/p>\n\u003ch2>On the Oakland hunger strikers, who were protesting the closure and merging of 11 schools in the district\u003c/h2>\n\u003cp>I so appreciate their advocacy, and compassion for the community, and their advocacy on behalf of the school system and the communities the school system serves.\u003c/p>\n\u003cp>These local decisions are local decisions.\u003c/p>\n\u003cp>I remember in San Francisco when I was mayor, I think when I was supervisor, even prior, there were some schools that had to close. They’re deeply emotional, difficult decisions. I don't deny that.\u003c/p>\n\u003cp>But if the state is going to get involved in deciding that, then we should be running all the school systems, and that's not something you want, I don't think anyone wants. We've got to provide that local accountability, local framework. That's why school boards are essential and critical and public engagement, parental engagement, is critical and essential as well. But I deeply understand how emotional it is. I don't know the details of the decision. I just don't.\u003c/p>\n\u003cp>As a mayor in the past, I understand those local decisions need to be made and stay local. But at the state level, I know what we are doing, which is providing unprecedented support for our schools and record-breaking per-pupil investments that should provide more flexibility to Oakland [Unified] School District than they've ever had in their history to address some of their financial challenges.\u003c/p>\n\u003ch2>On efforts to resolve encampments in the state\u003c/h2>\n\u003cp>The last two years, we all know what happened. We didn't just have a pandemic, but we had stasis. And the CDC had specific, very explicit guidelines that said don't touch the encampments because of COVID.\u003c/p>\n\u003cfigure id=\"attachment_11906665\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-11906665 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6076-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6076-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6076-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6076-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6076-1536x1152.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6076-2048x1536.jpg 2048w, https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6076-1920x1440.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Gov. Newsom helps to clean up an encampment in Redwood City on Feb. 23, 2022. \u003ccite>(Kate Wolffe, KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>So the entire year 2020, I think there were two dozen encampments cleaned up the entire year by the state of California. We've done 431 just in the last few months. So we've got all this residual stress that has exacerbated conditions on the street more visible than it's ever been. And I recognize that. And now there's no excuse.\u003c/p>\n\u003ch2>On the importance of addressing homeless encampments locally\u003c/h2>\n\u003cp>If you're a local elected official, you step up. If this is the crisis that it is and you have identified as such, then get out here — act like it.\u003c/p>\n\u003cp>I'm serious. We're doing our part. Now you can come out and follow up, do your part. If you need help, identify specifically, what specific help do you need?\u003c/p>\n\u003cp>[When I was mayor,] the state of California was nowhere to be found on homelessness. Nowhere. When I was mayor, we didn't get a dollar. There was no strategy plan, no accountability. No one, ever. I mean, the last thing I ever thought about was calling Arnold Schwarzenegger or Gray Davis. It's completely, radically changed.\u003c/p>\n\u003cp>When I got here there was no plan. There was no accountability and there was no playbook. And there was half a billion dollars that the last administration threw out at the last minute. Now we have $14 billion. We have a plan, we have strategies, we actually have accountability plans, including this Encampment Resolution grant.\u003c/p>\n\u003ch2>On the challenges of resolving encampments\u003c/h2>\n\u003cp>(\u003cem>Note: At the particular encampment that Newsom was cleaning in Redwood City, Caltrans said no residents accepted a shelter bed.\u003c/em>)\u003c/p>\n\u003cp>We’re going to have to keep meeting people where they are. You don't give up. I mean, of course, that's the case. What I think, look, I mean, this is not my first encampment, this is not my first effort. I reject the fatalism that, well, because \"in this circumstance, that circumstance, we weren't successful in encouraging people to get the support and services they need\" that we give up. That just means keep working at it.\u003c/p>\n\u003cfigure id=\"attachment_11906668\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11906668\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6082-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6082-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6082-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6082-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6082-1536x1152.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6082-2048x1536.jpg 2048w, https://ww2.kqed.org/app/uploads/sites/10/2022/02/IMG_6082-1920x1440.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">An encampment in Redwood City. \u003ccite>(Kate Wolffe, KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>One thing I can guarantee: Continue to do what you've done, you get what you've got. And there's a status quo anti-ism in all of this. If you don't create, as we say in psychology, a \"pattern interrupt\" — and this is a pattern interrupt for every single one of them — then you're not going to enliven someone to the opportunity to turn their lives around. They're just quite literally going to die.\u003c/p>\n\u003ch2>On his upcoming conservatorship proposal\u003c/h2>\n\u003cp>Laws on conservatorship are outdated and they're very controversial. It's very emotional and people have very strong opinions, and we've been fighting these fights for decades and nothing gets done. People say “too strong,” “too hard,” “too weak.”\u003c/p>\n\u003cp>So we are looking at a third way, a new conservatorship strategy, where we are going to provide a pathway for individuals to help with their own plan, but to have stepped-up strategies where we can get people the support they desperately need, even if they're absolutely convinced they don't need it, even though they may be out naked on the streets and sidewalks, talking to themselves and defecating and urinating.\u003c/p>\n\u003cp>And that's not humane, and we can't excuse that, and it should break all of our hearts. I feel for those folks. But I also feel for the mom in the stroller trying to go down the streets and the sidewalks being accosted and can’t get to the playground as well. And what's that balance? And so we're trying to strike that balance.\u003c/p>\n\u003cp>But, the status quo hasn't worked at all. And look at what's happened in my beloved city of San Francisco, in the last five or six years. It's just not acceptable.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>A lot of the conservatorship arguments have been done in the absence of resources. So we're saying, well, you need treatment and you're like, \"Where's the treatment? There's no treatment.\" You know, like \"get people off the streets!\" And like, where do they go? And that's the paradigm shift in the last few years: unprecedented money [and], building out an infrastructure with the support of the cities and counties over the last two years.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cb>California and Oil From the Amazon\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">A quarter of the crude oil that California imports comes from the Amazon region. In fact, California imports more oil from Ecuador than from Saudi Arabia or Iraq, and the state is the world’s largest consumer of Ecuadorian oil, according to a \u003c/span>\u003ca href=\"https://www.stand.earth/LinkedFates\">\u003cspan style=\"font-weight: 400\">recent report\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">. The study, released by Amazon Watch and Stand.earth, also examines how fossil fuel extraction is affecting the communities and environment of the Ecuadorian rainforest.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Guests:\u003c/span>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Kevin Koenig, Amazon Watch climate and energy director\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Tyson Miller, Stand.earth Amazon program director\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>This Week in California News and Politics\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">This week, Gov. Gavin Newsom released his long-term plan for living with COVID-19 as the virus eventually becomes endemic. Meanwhile, a new \u003c/span>\u003ca href=\"https://escholarship.org/uc/item/6ft4h17c\">\u003cspan style=\"font-weight: 400\">poll\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> by the Institute of Governmental Studies finds that Californians are increasingly concerned about rising crime. We also chew on the latest political news, including legislation that aims to control the wild pig population, the run-off election for the state Assembly seat recently vacated by David Chiu, and what San Francisco District Attorney Chesa Boudin can do about the Asian American community’s concern about hate crimes.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Guests:\u003c/span>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Joe Fitzgerald Rodriguez, KQED reporter and digital producer\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Marisa Lagos, KQED politics and government correspondent\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Something Beautiful: Lands End Exhibit\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">This week’s Something Beautiful features a new art exhibit titled “Lands End,” which examines humanity’s relationship with the environment. The exhibit is organized by the FOR-SITE Foundation and runs through March 22. You can read our review of the show \u003c/span>\u003ca href=\"https://www.kqed.org/arts/13906957/lands-end-for-site-cliff-house-review\">\u003cspan style=\"font-weight: 400\">here\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">.\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cb>California and Oil From the Amazon\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">A quarter of the crude oil that California imports comes from the Amazon region. In fact, California imports more oil from Ecuador than from Saudi Arabia or Iraq, and the state is the world’s largest consumer of Ecuadorian oil, according to a \u003c/span>\u003ca href=\"https://www.stand.earth/LinkedFates\">\u003cspan style=\"font-weight: 400\">recent report\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">. The study, released by Amazon Watch and Stand.earth, also examines how fossil fuel extraction is affecting the communities and environment of the Ecuadorian rainforest.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Guests:\u003c/span>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Kevin Koenig, Amazon Watch climate and energy director\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Tyson Miller, Stand.earth Amazon program director\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>This Week in California News and Politics\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">This week, Gov. Gavin Newsom released his long-term plan for living with COVID-19 as the virus eventually becomes endemic. Meanwhile, a new \u003c/span>\u003ca href=\"https://escholarship.org/uc/item/6ft4h17c\">\u003cspan style=\"font-weight: 400\">poll\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> by the Institute of Governmental Studies finds that Californians are increasingly concerned about rising crime. We also chew on the latest political news, including legislation that aims to control the wild pig population, the run-off election for the state Assembly seat recently vacated by David Chiu, and what San Francisco District Attorney Chesa Boudin can do about the Asian American community’s concern about hate crimes.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Guests:\u003c/span>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Joe Fitzgerald Rodriguez, KQED reporter and digital producer\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Marisa Lagos, KQED politics and government correspondent\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Something Beautiful: Lands End Exhibit\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">This week’s Something Beautiful features a new art exhibit titled “Lands End,” which examines humanity’s relationship with the environment. The exhibit is organized by the FOR-SITE Foundation and runs through March 22. You can read our review of the show \u003c/span>\u003ca href=\"https://www.kqed.org/arts/13906957/lands-end-for-site-cliff-house-review\">\u003cspan style=\"font-weight: 400\">here\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>If the first two years of the pandemic were like driving in heavy rain with worn-out brakes and no windshield wipers, then the next phase will be like driving the same road in good weather with brand-new brakes and wipers.\u003c/p>\n\u003cp>That’s how California health officials are viewing the future of living with the coronavirus, and they unveiled a plan Thursday that provides a road map for doing just that.\u003c/p>\n\u003cp>“While we can’t predict the future, we can better prepare for it,” said Gov. Gavin Newsom, as he laid out what sorts of resources and capabilities the state will need both to turn a page on the pandemic, and to stay prepared for the next variant or surge. “We have your back — we have learned a lot. We are not approaching this the way we did last year, the way we did two years ago.”\u003c/p>\n\u003cp>That preparation will include maintaining testing capacity, even as cases fall, as well as continuing to monitor cases through \u003ca href=\"https://www.kqed.org/science/1978289/omicron-was-in-california-before-it-was-named-omicron-according-to-sewage-samples\">wastewater surveillance\u003c/a>.\u003c/p>\n\u003cp>But Newsom was clear: There’s no declaring victory against COVID-19.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Today is about turning a page, moving from this crisis mentality, moving from a reactive framework to a framework where we are more sentinel,” he said “[We are] moving away from a reactive mindset and a crisis mindset to living with this virus.”\u003c/p>\n\u003cp>The state issued a 30-page plan laying out what that means. Dubbed the\u003ca href=\"https://files.covid19.ca.gov/pdf/smarterplan.pdf\"> SMARTER Plan\u003c/a> — for Shots, Masking, Awareness, Readiness, Testing, Education and Rx (for therapeutic treatment) — officials say it will ensure that the state is ready to respond to changing scenarios.\u003c/p>\n\u003cp>It includes:\u003c/p>\n\u003cul>\n\u003cli>The capacity to administer at least 200,000 vaccines per day on top of existing pharmacy and provider infrastructure.\u003c/li>\n\u003cli>Maintaining a stockpile of 75 million high-quality masks.\u003c/li>\n\u003cli>Maintaining capability to promote vaccination, masking and other mitigation measures in all 58 counties, including by partnering with at least 150 community-based organizations.\u003c/li>\n\u003cli>Maintaining wastewater surveillance and enhancing respiratory surveillance in the health care system, while continuing to sequence at least 10% of positive COVID-19 test specimens.\u003c/li>\n\u003cli>Maintaining the ability to add 3,000 clinical staff within two to three weeks of need and across various health care facility types.\u003c/li>\n\u003cli>Maintaining commercial and local public health capacity statewide to perform at least 500,000 tests per day.\u003c/li>\n\u003cli>Expanding school-based vaccination sites by 25% to increase vaccination rates as eligibility expands and vaccination requirements are enacted.\u003c/li>\n\u003cli>Make clinically effective therapeutics available.\u003c/li>\n\u003c/ul>\n\u003cp>Most of what Newsom laid out won’t change the day-to-day reality for Californians, who still face varying local mandates depending on their city and county. The state has already lifted most of its restrictions — including the indoor mask mandate, which expired earlier this week. The school mask mandate will be revisited at the end of February, officials announced Monday.\u003c/p>\n\u003cp>Newsom said the state continues to let science and data lead its decision-making, and argued that his strategy has worked — he noted that California has experienced a far lower death rate than much of the nation throughout this pandemic.\u003c/p>\n\u003cp>[aside postID=news_11902122 hero='https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53138_GettyImages-1361961811-qut.jpg']\u003c/p>\n\u003cp>“I just want to underscore that California, as it relates to larger states, has among the lowest death rates in the United States of America — 50% lower death rates in California than in a state like Florida,” he said.\u003c/p>\n\u003cp>Dr. Mark Ghaly, the state’s secretary of health and human services, said California needs to remain ready for future variants and seasonal surges of the virus. But instead of approaching future waves with fear, he encouraged Californians to have “humble confidence” in the tools the state has relied on to stem infections and deaths — including vaccines, masks and testing.\u003c/p>\n\u003cp>“We aren’t out of the woods. We are just more familiar with the woods and don’t need to live fully afraid of what’s behind the next tree,” he said. “We’ve learned that we can’t predict the future of the virus. But perhaps we can have a more predictable response to whatever the future brings.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Ghaly warned that COVID likely will rear up again but says it’s “no longer a novel foe” and that Californians should be vigilant but not afraid.\u003c/p>\n\n",
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"headline": "California's New COVID-19 Plan Means Being Prepared to Live With It",
"datePublished": "2022-02-17T17:46:36-08:00",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>If the first two years of the pandemic were like driving in heavy rain with worn-out brakes and no windshield wipers, then the next phase will be like driving the same road in good weather with brand-new brakes and wipers.\u003c/p>\n\u003cp>That’s how California health officials are viewing the future of living with the coronavirus, and they unveiled a plan Thursday that provides a road map for doing just that.\u003c/p>\n\u003cp>“While we can’t predict the future, we can better prepare for it,” said Gov. Gavin Newsom, as he laid out what sorts of resources and capabilities the state will need both to turn a page on the pandemic, and to stay prepared for the next variant or surge. “We have your back — we have learned a lot. We are not approaching this the way we did last year, the way we did two years ago.”\u003c/p>\n\u003cp>That preparation will include maintaining testing capacity, even as cases fall, as well as continuing to monitor cases through \u003ca href=\"https://www.kqed.org/science/1978289/omicron-was-in-california-before-it-was-named-omicron-according-to-sewage-samples\">wastewater surveillance\u003c/a>.\u003c/p>\n\u003cp>But Newsom was clear: There’s no declaring victory against COVID-19.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Today is about turning a page, moving from this crisis mentality, moving from a reactive framework to a framework where we are more sentinel,” he said “[We are] moving away from a reactive mindset and a crisis mindset to living with this virus.”\u003c/p>\n\u003cp>The state issued a 30-page plan laying out what that means. Dubbed the\u003ca href=\"https://files.covid19.ca.gov/pdf/smarterplan.pdf\"> SMARTER Plan\u003c/a> — for Shots, Masking, Awareness, Readiness, Testing, Education and Rx (for therapeutic treatment) — officials say it will ensure that the state is ready to respond to changing scenarios.\u003c/p>\n\u003cp>It includes:\u003c/p>\n\u003cul>\n\u003cli>The capacity to administer at least 200,000 vaccines per day on top of existing pharmacy and provider infrastructure.\u003c/li>\n\u003cli>Maintaining a stockpile of 75 million high-quality masks.\u003c/li>\n\u003cli>Maintaining capability to promote vaccination, masking and other mitigation measures in all 58 counties, including by partnering with at least 150 community-based organizations.\u003c/li>\n\u003cli>Maintaining wastewater surveillance and enhancing respiratory surveillance in the health care system, while continuing to sequence at least 10% of positive COVID-19 test specimens.\u003c/li>\n\u003cli>Maintaining the ability to add 3,000 clinical staff within two to three weeks of need and across various health care facility types.\u003c/li>\n\u003cli>Maintaining commercial and local public health capacity statewide to perform at least 500,000 tests per day.\u003c/li>\n\u003cli>Expanding school-based vaccination sites by 25% to increase vaccination rates as eligibility expands and vaccination requirements are enacted.\u003c/li>\n\u003cli>Make clinically effective therapeutics available.\u003c/li>\n\u003c/ul>\n\u003cp>Most of what Newsom laid out won’t change the day-to-day reality for Californians, who still face varying local mandates depending on their city and county. The state has already lifted most of its restrictions — including the indoor mask mandate, which expired earlier this week. The school mask mandate will be revisited at the end of February, officials announced Monday.\u003c/p>\n\u003cp>Newsom said the state continues to let science and data lead its decision-making, and argued that his strategy has worked — he noted that California has experienced a far lower death rate than much of the nation throughout this pandemic.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I just want to underscore that California, as it relates to larger states, has among the lowest death rates in the United States of America — 50% lower death rates in California than in a state like Florida,” he said.\u003c/p>\n\u003cp>Dr. Mark Ghaly, the state’s secretary of health and human services, said California needs to remain ready for future variants and seasonal surges of the virus. But instead of approaching future waves with fear, he encouraged Californians to have “humble confidence” in the tools the state has relied on to stem infections and deaths — including vaccines, masks and testing.\u003c/p>\n\u003cp>“We aren’t out of the woods. We are just more familiar with the woods and don’t need to live fully afraid of what’s behind the next tree,” he said. “We’ve learned that we can’t predict the future of the virus. But perhaps we can have a more predictable response to whatever the future brings.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Ghaly warned that COVID likely will rear up again but says it’s “no longer a novel foe” and that Californians should be vigilant but not afraid.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "California Reformed Medi-Cal to Include 'Whole Person Care' — Is It Working?",
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"headTitle": "California Reformed Medi-Cal to Include ‘Whole Person Care’ — Is It Working? | KQED",
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"content": "\u003cp>At 66, Edward El has a new lease on life — literally. In two weeks, he’ll move into his own apartment in Berkeley after spending the better part of the past 16 years unhoused.\u003c/p>\n\u003cp>Years ago, a back injury and pinched nerves in his legs made standing and walking painful, and he was laid off from his construction job. He ended up in “shelter after shelter after shelter.”\u003c/p>\n\u003cp>But nine months ago, El moved into one of 12 Project Roomkey shelters in Alameda County designed to reduce COVID-19 among the unhoused population. He was connected with a housing navigator, a counselor and medical staff. They helped El apply for affordable housing and rental assistance vouchers, and coordinated with landlords who would give unhoused renters a chance.\u003c/p>\n\u003cfigure id=\"attachment_11905186\" class=\"wp-caption alignnone\" style=\"max-width: 1536px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11905186\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/02/020922-CALAIM-MHN-14-CM.jpg\" alt=\"A man, wearing a hoodie, beanie and a face mask, sits on a chair in an indoor space. He looks to the side, a bit away from the camera.\" width=\"1536\" height=\"1025\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/02/020922-CALAIM-MHN-14-CM.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/02/020922-CALAIM-MHN-14-CM-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/02/020922-CALAIM-MHN-14-CM-1020x681.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/02/020922-CALAIM-MHN-14-CM-160x107.jpg 160w\" sizes=\"auto, (max-width: 1536px) 100vw, 1536px\">\u003cfigcaption class=\"wp-caption-text\">As Edward El prepares to move to a permanent home, he has enrolled in Medi-Cal. He said he couldn’t have navigated the array of complex systems if it weren’t for his new case management team. ‘I’m happy. They knew about programs that I didn’t know about that allowed me to get a place,’ he said. \u003ccite>(Martin do Nascimento/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Now El will pay a fraction of the cost to live in an area where one-bedroom apartments often exceed $3,000 per month.\u003c/p>\n\u003cp>The team also made sure that El was enrolled in Medi-Cal and had transportation to his doctor’s appointments. He said he couldn’t have navigated the array of complex systems if it weren’t for his new case management team. “I’m happy. They knew about programs that I didn’t know about that allowed me to get a place,” he said.\u003c/p>\n\u003cp>Intensive case management like this is an example of the ambitious, sweeping changes California made to Medi-Cal beginning in January under an initiative it’s calling CalAIM, or California Advancing and Innovating Medi-Cal.\u003c/p>\n\u003cp>Medi-Cal \u003ca href=\"https://www.chcf.org/publication/2021-edition-medi-cal-facts-figures/\">offers medical insurance to lower-income Californians\u003c/a>, serving as a lifeline for nearly half the state’s children, 1 in 5 adults and 2 million seniors and people with disabilities. But the program is inefficient: More than half of Medi-Cal’s \u003ca href=\"https://calmatters.org/health/coronavirus/2021/07/medi-cal-covid-vaccinations/\">roughly $133 billion annual budget is spent on just 5% of the program’s highest-needs individuals\u003c/a> — people with multiple complex health problems compounded by homelessness, poverty, substance abuse, mental illness or incarceration, \u003ca href=\"https://www.dhcs.ca.gov/CalAIM/Documents/CalAIM-ECM-a11y.pdf\">according the Department of Health Care Services\u003c/a>.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Edward El, CalAIM beneficiary\"]‘I’m happy. They knew about programs that I didn’t know about that allowed me to get a place.’[/pullquote]Over the next five years, CalAIM will seek to address the upstream drivers of deteriorating health — things like food insecurity and housing instability — in an effort to reduce costly emergency department visits, hospitalizations and nursing home stays. The program redesign is based on “whole person care” principles, which help people avoid situations that worsen their physical and mental health.\u003c/p>\n\u003cp>“This was designed at the county level to identify very high-risk populations — oftentimes people who were coming to the emergency room five to 10 times a month.” said Erica Murray, president and CEO of the California Association of Public Hospitals and Health Systems.\u003c/p>\n\u003cp>In his January budget, \u003ca href=\"https://www.ebudget.ca.gov/2022-23/pdf/GovernorsBudget/4000.pdf\">Gov. Gavin Newsom proposed $8 billion over five years to implement the program\u003c/a>, about 6% of Medi-Cal’s total budget. Included are temporary payments to managed care plans to offer enhanced case management and other services.\u003c/p>\n\u003cp>These so-called social determinants of health have not been historically covered by health insurance like Medi-Cal. Yet they have an outsized impact on people who often struggle with economic instability, poor nutrition, discrimination, violence and disproportionate exposure to polluted air and water.\u003c/p>\n\u003cp>“One of my patients calls it social deterrents to health,” said Alameda County Medical Director Dr. Kathleen Clanon.\u003c/p>\n\u003cp>No other state has mounted such a comprehensive program that wraps in so many elements. The scale is unprecedented, too: Medi-Cal provides health insurance for more than 13 million people.\u003c/p>\n\u003cp>[aside postID=\"news_11887815\" hero=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/GettyImages-1233456190-1020x680.jpg\"]“This is a big deal. Not only is California taking the lead but also setting a precedent for potentially other states to follow it,” said Anthony Wright, executive director of Health Access California, a consumer advocate group.\u003c/p>\n\u003cp>Pilot programs in 25 counties helped get CalAIM off the ground. Roughly \u003ca href=\"https://healthpolicy.ucla.edu/publications/Documents/PDF/2020/wholepersoncare-report-jan2020.pdf\">108,000 Medi-Cal patients were enrolled in county pilots\u003c/a> and \u003ca href=\"https://healthpolicy.ucla.edu/publications/Documents/PDF/2020/First-Interim-Evaluation-CA-HHP-Report-sep2020.pdf\">15,000 in managed care pilots during a two-year period\u003c/a>, according to an early analysis by UCLA researchers. As a result of the success, federal officials granted a waiver allowing CalAIM to move forward for the next five years.\u003c/p>\n\u003cp>In Placer County, David Norris, 67, was one of the patients who benefited from the experimental programs.\u003c/p>\n\u003cp>Norris ended up in a homeless shelter after his mother, for whom he was a long-term caregiver, died. He earns $900 a month in Social Security and retirement, but it’s not enough for rent and living expenses. In April, an infected foot wound spread to the bone and cost Norris his left leg. Another infection resulted in more trips to the ER and subsequent surgeries. Several months later, a fight at the shelter ended in a shove, a fall and a broken right leg.\u003c/p>\n\u003cp>His caseworker, Todd Perbetsky, helped him enroll in Medi-Cal, find a nursing home where he could recuperate and apply for a housing voucher. He’s now helping Norris find permanent housing after leaving the nursing home.\u003c/p>\n\u003cp>“These are definitely people that are falling through the cracks,” Perbetsky said. “They may not meet the criteria of some programs. They may need linkage to services. They can have tons of barriers to even getting their CalFresh turned on or other benefits they qualify for.”\u003c/p>\n\u003cp>Norris called Perbetsky a “hell of a godsend. If you don’t know the ins and outs, you just get spit out. You get absolutely no help at all. That’s where Todd … helps me and people like me navigate the waters and get all squared away.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003ch2>\u003cstrong>Creating a one-stop shop\u003c/strong>\u003c/h2>\n\u003cp>Wraparound services aren’t new, but they haven’t always been easy to access, nor have they been directly connected to medical care. Walk through the wrong door and you might not get any help at all.\u003c/p>\n\u003cp>An unhoused patient who suffers from addiction and mental health issues and has diabetes would have to approach three different county departments and a doctor to get all their needs addressed, and even then they’re likely to get lost in the system.\u003c/p>\n\u003cp>“It’s a little bit like if you needed to get ingredients for a meal and instead of just going to the supermarket, you had to go to different stores to get your proteins and your fruits and your grains and your vegetables. And at those stores, you had to pay with different cards and navigate different rules about what you could buy,” said Melora Simon, a senior strategist at the California Health Care Foundation.\u003c/p>\n\u003cp>[aside postID=\"news_11894981\" hero=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/NPR-fentanyl-1-1020x766.jpg\"]This fragmentation frequently causes barriers to health care and is one of the primary reasons the Department of Health Care Services is focused on reforming Medi-Cal under CalAIM.\u003c/p>\n\u003cp>One such barrier is making sure patients don’t get lost between systems that don’t traditionally talk to one another.\u003c/p>\n\u003cp>Clanon, who also works as a physician in Alameda County, said a few years ago a pregnant, HIV-positive patient needed to begin HIV treatment but had left the usual encampment she stayed in and couldn’t be found. A nurse spent more than an hour calling local emergency departments, homeless shelters and case managers to see whether anyone had seen the patient, with no luck.\u003c/p>\n\u003cp>Had the system been integrated, Clanon’s patient would have been flagged as needing critical medical care any time she entered a homeless shelter, emergency department, substance abuse center or mental health facility.\u003c/p>\n\u003cp>“CalAIM is trying to fix the problem of disparate systems of care both among and between different counties and among and between different parts of the health care system,” said Diana Douglas, a health policy expert with Health Access California.\u003c/p>\n\u003ch2>\u003cstrong>Accountability and missing pieces\u003c/strong>\u003c/h2>\n\u003cp>Since 2016, California has dedicated more than $3 billion in state and federal funds to experiment with doing just that.\u003c/p>\n\u003cp>Four years after launch, the pilots demonstrated “substantial evidence” of improved follow-up after hospitalization for mental illness, increased participation in substance abuse treatment and decreased use of emergency services, among other metrics, \u003ca href=\"https://healthpolicy.ucla.edu/publications/Documents/PDF/2020/First-Interim-Evaluation-CA-HHP-Report-sep2020.pdf\">according to the UCLA analysis\u003c/a>.\u003c/p>\n\u003cp>In Contra Costa County, more than 12,000 patients were enrolled in the pilot annually, and the county health department hired more than 100 public health nurses, mental health specialists, community health workers, homeless service specialists, substance abuse specialists and social workers to provide coordinated case management.\u003c/p>\n\u003cp>“Most of them were types of positions that existed in the county before, but they were very siloed,” said Emily Parmenter, the pilot’s program manager at Contra Costa County Health Services. “So we brought them all together in these multidisciplinary teams where they had a wealth of experience … and were able to provide case consultations across divisions.”\u003c/p>\n\u003cp>Medi-Cal patients who enrolled in the Contra Costa pilot experienced medical emergencies less frequently than nonenrolled patients.\u003c/p>\n\u003cp>“We found that after being involved in the program for a year, our hospital admission rates decreased by 25% … and our [emergency department] rates were 14% lower compared to the control group,” Parmenter said.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Emily Parmenter, Contra Costa Health Services\"]‘We found that after being involved in the program for a year, our hospital admission rates decreased by 25%.’[/pullquote]UCLA researcher Nadereh Pourat, who conducted the pilot evaluation, said her team has just begun to analyze the impact on specific health conditions, such as blood pressure and congestive heart failure, as well as cost-effectiveness.\u003c/p>\n\u003cp>Despite their promise — or perhaps because of it — advocates say the transition from pilot programs to CalAIM will need to be watched carefully.\u003c/p>\n\u003cp>Responsibility has now shifted from county health departments to health care plans, which don’t always meet quality benchmarks. And health care plans in the 33 counties that did not have pilots are starting from scratch.\u003c/p>\n\u003cp>“There are serious concerns about Medi-Cal [health care] plans on the ground being able to implement some of the work necessary for CalAIM to really be effective and live up to its potential,” health policy expert Douglas said.\u003c/p>\n\u003cp>“In some cases, plans struggle to deliver quality care across what we think of as very basic measures: childhood immunizations, are people getting mammograms on time, just very basic preventive care and chronic disease management,” she said.\u003c/p>\n\u003cfigure id=\"attachment_11905185\" class=\"wp-caption alignnone\" style=\"max-width: 1024px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11905185\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/02/020922-CALAIM-MHN-10-CM_11.jpg\" alt=\"Two people sit at a table, handling paperwork. One person has their backed to the camera, the other one sits across from them.\" width=\"1024\" height=\"682\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/02/020922-CALAIM-MHN-10-CM_11.jpg 1024w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/02/020922-CALAIM-MHN-10-CM_11-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/02/020922-CALAIM-MHN-10-CM_11-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/02/020922-CALAIM-MHN-10-CM_11-160x107.jpg 160w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\">\u003cfigcaption class=\"wp-caption-text\">Alameda County intake specialist Annie Wyley meets with a Medi-Cal patient in the repurposed dining room at the Radisson Hotel in Oakland. \u003ccite>(Martin do Nascimento/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Accountability is especially important for improving equity among communities of color, advocates say.\u003c/p>\n\u003cp>“Communities of color are disproportionately impacted by these same factors: lack of housing, lack of income, lack of food security,” said Cary Sanders, senior policy director for the California Pan-Ethnic Health Network.\u003c/p>\n\u003cp>Health plans need to provide services that are “linguistically and culturally appropriate,” Sanders said.\u003c/p>\n\u003cp>One critical piece of the pilot programs that was left out of CalAIM is legal aid. In counties that funded legal aid during the pilot programs, lawyers and paralegals were stationed in medical clinics to assist patients who needed help with benefit denials, eviction notices, immigration issues or domestic abuse cases.\u003c/p>\n\u003cp>Frequently patients and even their doctors don’t realize that their issue could use the help of a lawyer, said Daniel Nesbit, managing attorney for medical legal partnerships with California Rural Legal Assistance. Nesbit said that during the pilot program in Monterey County his team helped 700 clients with more than 1,000 cases.\u003c/p>\n\u003cp>“A really good example is someone struggling with some sort of medical condition, and it’s making it hard for them to go to work every day and do their job to the full extent,” Nesbit said. “They might not know, for example, that they have a possible right to a reasonable accommodation under the Americans with Disabilities Act.”\u003c/p>\n\u003cp>Alameda and Contra Costa counties, which contracted with Bay Area Legal Aid to participate in the pilot, hired five additional attorneys dedicated to assisting Medi-Cal patients. The partnership helped reach people who ordinarily wouldn’t be able to access legal aid because their disability prevented them from attending an appointment or they didn’t have a phone number or an address. Case managers were able to link people to the attorneys, accounting for 300 referrals a year.\u003c/p>\n\u003cp>But when the pilot ended in December and state funding dried up, attorneys were reassigned and are no longer able to focus on Medi-Cal patients.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Diana Douglas, Health Access California\"]‘There are serious concerns about Medi-Cal [health care] … being able to implement some of the work necessary for CalAIM to really be effective.’[/pullquote]“I’m still getting emails and phone calls from the case managers I worked with who I think are now kind of scrambling to figure out how to help,” said Abby Khodayari, an attorney who worked in Contra Costa County’s program. “Case managers are hoping to get help analyzing eviction notices and figuring out the validity of them. It’s hard not having dedicated time to be able to spend working on those issues.”\u003c/p>\n\u003cp>While legal services aren’t explicitly named as one of 14 preapproved services under CalAIM, the Department of Health Care Services said health care plans could integrate them as part of supportive housing services, which are covered.\u003c/p>\n\u003cp>But attorneys say it’s unlikely to happen unless plans get specific guarantees that CalAIM will cover the cost. They hope that subsequent phases of CalAIM will include legal aid.\u003c/p>\n\u003cp>“There hasn’t been a health plan here in LA who’s come forward and said we want to offer these legal services,” said Gerson Sorto, a managing attorney with Neighborhood Legal Services of Los Angeles County.\u003c/p>\n\u003cp>Los Angeles County has continued funding their partnership through the summer, but there’s no permanent money in sight. “As of today, there is no funding secured or confirmed beyond June 30,” Sorto said.\u003c/p>\n\u003ch2>\u003cstrong>Life under ‘whole person care’\u003c/strong>\u003c/h2>\n\u003cp>Back at the Radisson Hotel in Oakland, the shelter where El is waiting patiently to move into his new apartment, he watches a home renovation show on the television. He likes to see how the hosts redesign the interior and gets ideas for his own future home.\u003c/p>\n\u003cp>Before losing his job, El lived in an apartment near Lake Merritt but hasn’t had a place to call his own in years. After he enrolled in Alameda County’s pilot program, things started turning around for him.\u003c/p>\n\u003cp>“These people really respect you and help if you ask for it,” El said.\u003c/p>\n\u003cp>Part of the program is connecting Medi-Cal patients to peers with similar backgrounds.\u003c/p>\n\u003cp>[aside label='More Housing Coverage' tag='housing']“You can’t tell them ‘do this and do that.’ You walk alongside someone and support whatever they’ve got going on,” said Michael Webb, a CalAIM peer support navigator who experienced addiction and homelessness. “Most importantly,” he said, “[is] someone to listen. I might not have any answer at all but there’s power in listening.”\u003c/p>\n\u003cp>Down the hall from El’s room, shelter monitors are delivering lunch to residents who can’t make it to the dining room. Lunch is a chicken sandwich, banana, salad and a soda, but those with dietary restrictions or certain medical conditions like diabetes get tailored meals.\u003c/p>\n\u003cp>As part of the CalAIM program, caretakers perform wellness checks on shelter residents with disabilities, helping them clean, bathe and use the restroom.\u003c/p>\n\u003cp>In the lobby, an intake worker asks a new guest about his seizure disorder and works to link him to his CalAIM team of health care providers, case workers and housing navigators. As the program grows, millions more Californians may benefit. On this day alone, the Oakland team expects to sign up eight new people.\u003cbr>\n[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "California's first-of-its-kind Medi-Cal reform aims to help lower-income patients navigate problems like homelessness, poverty and substance abuse that can harm health.",
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"title": "California Reformed Medi-Cal to Include 'Whole Person Care' — Is It Working? | KQED",
"description": "California's first-of-its-kind Medi-Cal reform aims to help lower-income patients navigate problems like homelessness, poverty and substance abuse that can harm health.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>At 66, Edward El has a new lease on life — literally. In two weeks, he’ll move into his own apartment in Berkeley after spending the better part of the past 16 years unhoused.\u003c/p>\n\u003cp>Years ago, a back injury and pinched nerves in his legs made standing and walking painful, and he was laid off from his construction job. He ended up in “shelter after shelter after shelter.”\u003c/p>\n\u003cp>But nine months ago, El moved into one of 12 Project Roomkey shelters in Alameda County designed to reduce COVID-19 among the unhoused population. He was connected with a housing navigator, a counselor and medical staff. They helped El apply for affordable housing and rental assistance vouchers, and coordinated with landlords who would give unhoused renters a chance.\u003c/p>\n\u003cfigure id=\"attachment_11905186\" class=\"wp-caption alignnone\" style=\"max-width: 1536px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11905186\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/02/020922-CALAIM-MHN-14-CM.jpg\" alt=\"A man, wearing a hoodie, beanie and a face mask, sits on a chair in an indoor space. He looks to the side, a bit away from the camera.\" width=\"1536\" height=\"1025\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/02/020922-CALAIM-MHN-14-CM.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/02/020922-CALAIM-MHN-14-CM-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/02/020922-CALAIM-MHN-14-CM-1020x681.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/02/020922-CALAIM-MHN-14-CM-160x107.jpg 160w\" sizes=\"auto, (max-width: 1536px) 100vw, 1536px\">\u003cfigcaption class=\"wp-caption-text\">As Edward El prepares to move to a permanent home, he has enrolled in Medi-Cal. He said he couldn’t have navigated the array of complex systems if it weren’t for his new case management team. ‘I’m happy. They knew about programs that I didn’t know about that allowed me to get a place,’ he said. \u003ccite>(Martin do Nascimento/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Now El will pay a fraction of the cost to live in an area where one-bedroom apartments often exceed $3,000 per month.\u003c/p>\n\u003cp>The team also made sure that El was enrolled in Medi-Cal and had transportation to his doctor’s appointments. He said he couldn’t have navigated the array of complex systems if it weren’t for his new case management team. “I’m happy. They knew about programs that I didn’t know about that allowed me to get a place,” he said.\u003c/p>\n\u003cp>Intensive case management like this is an example of the ambitious, sweeping changes California made to Medi-Cal beginning in January under an initiative it’s calling CalAIM, or California Advancing and Innovating Medi-Cal.\u003c/p>\n\u003cp>Medi-Cal \u003ca href=\"https://www.chcf.org/publication/2021-edition-medi-cal-facts-figures/\">offers medical insurance to lower-income Californians\u003c/a>, serving as a lifeline for nearly half the state’s children, 1 in 5 adults and 2 million seniors and people with disabilities. But the program is inefficient: More than half of Medi-Cal’s \u003ca href=\"https://calmatters.org/health/coronavirus/2021/07/medi-cal-covid-vaccinations/\">roughly $133 billion annual budget is spent on just 5% of the program’s highest-needs individuals\u003c/a> — people with multiple complex health problems compounded by homelessness, poverty, substance abuse, mental illness or incarceration, \u003ca href=\"https://www.dhcs.ca.gov/CalAIM/Documents/CalAIM-ECM-a11y.pdf\">according the Department of Health Care Services\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Over the next five years, CalAIM will seek to address the upstream drivers of deteriorating health — things like food insecurity and housing instability — in an effort to reduce costly emergency department visits, hospitalizations and nursing home stays. The program redesign is based on “whole person care” principles, which help people avoid situations that worsen their physical and mental health.\u003c/p>\n\u003cp>“This was designed at the county level to identify very high-risk populations — oftentimes people who were coming to the emergency room five to 10 times a month.” said Erica Murray, president and CEO of the California Association of Public Hospitals and Health Systems.\u003c/p>\n\u003cp>In his January budget, \u003ca href=\"https://www.ebudget.ca.gov/2022-23/pdf/GovernorsBudget/4000.pdf\">Gov. Gavin Newsom proposed $8 billion over five years to implement the program\u003c/a>, about 6% of Medi-Cal’s total budget. Included are temporary payments to managed care plans to offer enhanced case management and other services.\u003c/p>\n\u003cp>These so-called social determinants of health have not been historically covered by health insurance like Medi-Cal. Yet they have an outsized impact on people who often struggle with economic instability, poor nutrition, discrimination, violence and disproportionate exposure to polluted air and water.\u003c/p>\n\u003cp>“One of my patients calls it social deterrents to health,” said Alameda County Medical Director Dr. Kathleen Clanon.\u003c/p>\n\u003cp>No other state has mounted such a comprehensive program that wraps in so many elements. The scale is unprecedented, too: Medi-Cal provides health insurance for more than 13 million people.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“This is a big deal. Not only is California taking the lead but also setting a precedent for potentially other states to follow it,” said Anthony Wright, executive director of Health Access California, a consumer advocate group.\u003c/p>\n\u003cp>Pilot programs in 25 counties helped get CalAIM off the ground. Roughly \u003ca href=\"https://healthpolicy.ucla.edu/publications/Documents/PDF/2020/wholepersoncare-report-jan2020.pdf\">108,000 Medi-Cal patients were enrolled in county pilots\u003c/a> and \u003ca href=\"https://healthpolicy.ucla.edu/publications/Documents/PDF/2020/First-Interim-Evaluation-CA-HHP-Report-sep2020.pdf\">15,000 in managed care pilots during a two-year period\u003c/a>, according to an early analysis by UCLA researchers. As a result of the success, federal officials granted a waiver allowing CalAIM to move forward for the next five years.\u003c/p>\n\u003cp>In Placer County, David Norris, 67, was one of the patients who benefited from the experimental programs.\u003c/p>\n\u003cp>Norris ended up in a homeless shelter after his mother, for whom he was a long-term caregiver, died. He earns $900 a month in Social Security and retirement, but it’s not enough for rent and living expenses. In April, an infected foot wound spread to the bone and cost Norris his left leg. Another infection resulted in more trips to the ER and subsequent surgeries. Several months later, a fight at the shelter ended in a shove, a fall and a broken right leg.\u003c/p>\n\u003cp>His caseworker, Todd Perbetsky, helped him enroll in Medi-Cal, find a nursing home where he could recuperate and apply for a housing voucher. He’s now helping Norris find permanent housing after leaving the nursing home.\u003c/p>\n\u003cp>“These are definitely people that are falling through the cracks,” Perbetsky said. “They may not meet the criteria of some programs. They may need linkage to services. They can have tons of barriers to even getting their CalFresh turned on or other benefits they qualify for.”\u003c/p>\n\u003cp>Norris called Perbetsky a “hell of a godsend. If you don’t know the ins and outs, you just get spit out. You get absolutely no help at all. That’s where Todd … helps me and people like me navigate the waters and get all squared away.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch2>\u003cstrong>Creating a one-stop shop\u003c/strong>\u003c/h2>\n\u003cp>Wraparound services aren’t new, but they haven’t always been easy to access, nor have they been directly connected to medical care. Walk through the wrong door and you might not get any help at all.\u003c/p>\n\u003cp>An unhoused patient who suffers from addiction and mental health issues and has diabetes would have to approach three different county departments and a doctor to get all their needs addressed, and even then they’re likely to get lost in the system.\u003c/p>\n\u003cp>“It’s a little bit like if you needed to get ingredients for a meal and instead of just going to the supermarket, you had to go to different stores to get your proteins and your fruits and your grains and your vegetables. And at those stores, you had to pay with different cards and navigate different rules about what you could buy,” said Melora Simon, a senior strategist at the California Health Care Foundation.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>This fragmentation frequently causes barriers to health care and is one of the primary reasons the Department of Health Care Services is focused on reforming Medi-Cal under CalAIM.\u003c/p>\n\u003cp>One such barrier is making sure patients don’t get lost between systems that don’t traditionally talk to one another.\u003c/p>\n\u003cp>Clanon, who also works as a physician in Alameda County, said a few years ago a pregnant, HIV-positive patient needed to begin HIV treatment but had left the usual encampment she stayed in and couldn’t be found. A nurse spent more than an hour calling local emergency departments, homeless shelters and case managers to see whether anyone had seen the patient, with no luck.\u003c/p>\n\u003cp>Had the system been integrated, Clanon’s patient would have been flagged as needing critical medical care any time she entered a homeless shelter, emergency department, substance abuse center or mental health facility.\u003c/p>\n\u003cp>“CalAIM is trying to fix the problem of disparate systems of care both among and between different counties and among and between different parts of the health care system,” said Diana Douglas, a health policy expert with Health Access California.\u003c/p>\n\u003ch2>\u003cstrong>Accountability and missing pieces\u003c/strong>\u003c/h2>\n\u003cp>Since 2016, California has dedicated more than $3 billion in state and federal funds to experiment with doing just that.\u003c/p>\n\u003cp>Four years after launch, the pilots demonstrated “substantial evidence” of improved follow-up after hospitalization for mental illness, increased participation in substance abuse treatment and decreased use of emergency services, among other metrics, \u003ca href=\"https://healthpolicy.ucla.edu/publications/Documents/PDF/2020/First-Interim-Evaluation-CA-HHP-Report-sep2020.pdf\">according to the UCLA analysis\u003c/a>.\u003c/p>\n\u003cp>In Contra Costa County, more than 12,000 patients were enrolled in the pilot annually, and the county health department hired more than 100 public health nurses, mental health specialists, community health workers, homeless service specialists, substance abuse specialists and social workers to provide coordinated case management.\u003c/p>\n\u003cp>“Most of them were types of positions that existed in the county before, but they were very siloed,” said Emily Parmenter, the pilot’s program manager at Contra Costa County Health Services. “So we brought them all together in these multidisciplinary teams where they had a wealth of experience … and were able to provide case consultations across divisions.”\u003c/p>\n\u003cp>Medi-Cal patients who enrolled in the Contra Costa pilot experienced medical emergencies less frequently than nonenrolled patients.\u003c/p>\n\u003cp>“We found that after being involved in the program for a year, our hospital admission rates decreased by 25% … and our [emergency department] rates were 14% lower compared to the control group,” Parmenter said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘We found that after being involved in the program for a year, our hospital admission rates decreased by 25%.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>UCLA researcher Nadereh Pourat, who conducted the pilot evaluation, said her team has just begun to analyze the impact on specific health conditions, such as blood pressure and congestive heart failure, as well as cost-effectiveness.\u003c/p>\n\u003cp>Despite their promise — or perhaps because of it — advocates say the transition from pilot programs to CalAIM will need to be watched carefully.\u003c/p>\n\u003cp>Responsibility has now shifted from county health departments to health care plans, which don’t always meet quality benchmarks. And health care plans in the 33 counties that did not have pilots are starting from scratch.\u003c/p>\n\u003cp>“There are serious concerns about Medi-Cal [health care] plans on the ground being able to implement some of the work necessary for CalAIM to really be effective and live up to its potential,” health policy expert Douglas said.\u003c/p>\n\u003cp>“In some cases, plans struggle to deliver quality care across what we think of as very basic measures: childhood immunizations, are people getting mammograms on time, just very basic preventive care and chronic disease management,” she said.\u003c/p>\n\u003cfigure id=\"attachment_11905185\" class=\"wp-caption alignnone\" style=\"max-width: 1024px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11905185\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/02/020922-CALAIM-MHN-10-CM_11.jpg\" alt=\"Two people sit at a table, handling paperwork. One person has their backed to the camera, the other one sits across from them.\" width=\"1024\" height=\"682\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/02/020922-CALAIM-MHN-10-CM_11.jpg 1024w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/02/020922-CALAIM-MHN-10-CM_11-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/02/020922-CALAIM-MHN-10-CM_11-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/02/020922-CALAIM-MHN-10-CM_11-160x107.jpg 160w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\">\u003cfigcaption class=\"wp-caption-text\">Alameda County intake specialist Annie Wyley meets with a Medi-Cal patient in the repurposed dining room at the Radisson Hotel in Oakland. \u003ccite>(Martin do Nascimento/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Accountability is especially important for improving equity among communities of color, advocates say.\u003c/p>\n\u003cp>“Communities of color are disproportionately impacted by these same factors: lack of housing, lack of income, lack of food security,” said Cary Sanders, senior policy director for the California Pan-Ethnic Health Network.\u003c/p>\n\u003cp>Health plans need to provide services that are “linguistically and culturally appropriate,” Sanders said.\u003c/p>\n\u003cp>One critical piece of the pilot programs that was left out of CalAIM is legal aid. In counties that funded legal aid during the pilot programs, lawyers and paralegals were stationed in medical clinics to assist patients who needed help with benefit denials, eviction notices, immigration issues or domestic abuse cases.\u003c/p>\n\u003cp>Frequently patients and even their doctors don’t realize that their issue could use the help of a lawyer, said Daniel Nesbit, managing attorney for medical legal partnerships with California Rural Legal Assistance. Nesbit said that during the pilot program in Monterey County his team helped 700 clients with more than 1,000 cases.\u003c/p>\n\u003cp>“A really good example is someone struggling with some sort of medical condition, and it’s making it hard for them to go to work every day and do their job to the full extent,” Nesbit said. “They might not know, for example, that they have a possible right to a reasonable accommodation under the Americans with Disabilities Act.”\u003c/p>\n\u003cp>Alameda and Contra Costa counties, which contracted with Bay Area Legal Aid to participate in the pilot, hired five additional attorneys dedicated to assisting Medi-Cal patients. The partnership helped reach people who ordinarily wouldn’t be able to access legal aid because their disability prevented them from attending an appointment or they didn’t have a phone number or an address. Case managers were able to link people to the attorneys, accounting for 300 referrals a year.\u003c/p>\n\u003cp>But when the pilot ended in December and state funding dried up, attorneys were reassigned and are no longer able to focus on Medi-Cal patients.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“I’m still getting emails and phone calls from the case managers I worked with who I think are now kind of scrambling to figure out how to help,” said Abby Khodayari, an attorney who worked in Contra Costa County’s program. “Case managers are hoping to get help analyzing eviction notices and figuring out the validity of them. It’s hard not having dedicated time to be able to spend working on those issues.”\u003c/p>\n\u003cp>While legal services aren’t explicitly named as one of 14 preapproved services under CalAIM, the Department of Health Care Services said health care plans could integrate them as part of supportive housing services, which are covered.\u003c/p>\n\u003cp>But attorneys say it’s unlikely to happen unless plans get specific guarantees that CalAIM will cover the cost. They hope that subsequent phases of CalAIM will include legal aid.\u003c/p>\n\u003cp>“There hasn’t been a health plan here in LA who’s come forward and said we want to offer these legal services,” said Gerson Sorto, a managing attorney with Neighborhood Legal Services of Los Angeles County.\u003c/p>\n\u003cp>Los Angeles County has continued funding their partnership through the summer, but there’s no permanent money in sight. “As of today, there is no funding secured or confirmed beyond June 30,” Sorto said.\u003c/p>\n\u003ch2>\u003cstrong>Life under ‘whole person care’\u003c/strong>\u003c/h2>\n\u003cp>Back at the Radisson Hotel in Oakland, the shelter where El is waiting patiently to move into his new apartment, he watches a home renovation show on the television. He likes to see how the hosts redesign the interior and gets ideas for his own future home.\u003c/p>\n\u003cp>Before losing his job, El lived in an apartment near Lake Merritt but hasn’t had a place to call his own in years. After he enrolled in Alameda County’s pilot program, things started turning around for him.\u003c/p>\n\u003cp>“These people really respect you and help if you ask for it,” El said.\u003c/p>\n\u003cp>Part of the program is connecting Medi-Cal patients to peers with similar backgrounds.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“You can’t tell them ‘do this and do that.’ You walk alongside someone and support whatever they’ve got going on,” said Michael Webb, a CalAIM peer support navigator who experienced addiction and homelessness. “Most importantly,” he said, “[is] someone to listen. I might not have any answer at all but there’s power in listening.”\u003c/p>\n\u003cp>Down the hall from El’s room, shelter monitors are delivering lunch to residents who can’t make it to the dining room. Lunch is a chicken sandwich, banana, salad and a soda, but those with dietary restrictions or certain medical conditions like diabetes get tailored meals.\u003c/p>\n\u003cp>As part of the CalAIM program, caretakers perform wellness checks on shelter residents with disabilities, helping them clean, bathe and use the restroom.\u003c/p>\n\u003cp>In the lobby, an intake worker asks a new guest about his seizure disorder and works to link him to his CalAIM team of health care providers, case workers and housing navigators. As the program grows, millions more Californians may benefit. On this day alone, the Oakland team expects to sign up eight new people.\u003cbr>\n\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cb>Oakland Mayor Libby Schaaf\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">We talk with Oakland Mayor Libby Schaaf about the latest news, including plans to end the city’s Safe Oakland Streets, recent developments on the Oakland A’s proposed new stadium at Howard Terminal, her support of the Oakland Unified School District board’s plan to close or merge 15 schools, and whether the culture of Oakland’s police department has improved enough.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Guest:\u003c/span>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Mayor Libby Schaaf, D-Oakland\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>This Week in California News and Politics\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Gov. Gavin Newsom is facing criticism after photos surfaced of him and other politicians, including San Francisco Mayor London Breed, without masks at the NFC Championship game in Los Angeles last Sunday, in violation of SoFi Stadium rules. We also talk about the end of death row at San Quentin State Prison, a new study that finds that alleviating poverty can help a baby’s brain development, and a contentious recall in Shasta County that is pitting Republicans against Republicans.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Guests:\u003c/span>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Scott Shafer, KQED politics and government senior editor\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Alexis Madrigal, KQED Forum co-host\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Something Beautiful: Oakland Zoo’s Glowfari\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">This week’s Something Beautiful is the Oakland Zoo’s annual Glowfari, where larger-than-life animal lanterns prowl the grounds alongside the zoo’s usual critters.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cem>Editor’s note: KHN is not affiliated with Kaiser Permanente.\u003c/em>\u003c/p>\n\u003cp>Gov. Gavin Newsom’s administration has negotiated a secret deal to give Kaiser Permanente a special Medicaid contract that would allow the health care behemoth to expand its reach in California and largely continue selecting the enrollees it wants, which other health care plans say leaves them with a disproportionate share of the program’s sickest and costliest patients.\u003c/p>\n\u003cp>The deal, hammered out behind closed doors between Kaiser Permanente and senior officials in Newsom’s office, could complicate a long-planned and expensive transformation of Medi-Cal, the state’s Medicaid program, which covers roughly 14 million lower-income Californians.\u003c/p>\n\u003cp>It has infuriated executives of other managed-care insurance plans in Medi-Cal, who say they stand to lose hundreds of thousands of patients and millions of dollars a year. The deal allows KP to limit enrollment primarily to its previous enrollees, except in the case of kids in foster care and people who are eligible for both Medicare and Medi-Cal.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Jarrod McNaughton, CEO, Inland Empire Health Plan\"]‘[This deal] has caused a massive amount of frenzy.’[/pullquote]\u003c/p>\n\u003cp>“It has caused a massive amount of frenzy,” said Jarrod McNaughton, CEO of the Inland Empire Health Plan, which covers about 1.5 million Medi-Cal enrollees in Riverside and San Bernardino counties. “All of us are doing our best to implement the most transformational Medi-Cal initiative in state history, and to put all this together without a public process is very disconcerting.”\u003c/p>\n\u003cp>Linnea Koopmans, CEO of the Local Health Plans of California, echoed McNaughton’s concerns.\u003c/p>\n\u003cp>Insurance plans got wind of the backroom talks when broad outlines of the deal were leaked days before the state briefed their executives Thursday.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Dr. Bechara Choucair, Kaiser Permanente’s chief health officer, argued \u003ca href=\"https://khn.org/wp-content/uploads/sites/2/2022/02/Kaiser-Permanente-response-to-KHN-inquiry.pdf\">in a prepared written response\u003c/a> on behalf of KP that because it operates both as a health insurer and a health care provider, KP should be treated differently from other commercial health care plans that participate in Medi-Cal. Doing business directly with the state will eliminate complexity and improve the quality of care for the Medi-Cal patients it serves, he said.\u003c/p>\n\u003cp>“We are not seeking to turn a profit off Medi-Cal enrollment,” Choucair said. “Kaiser Permanente participates in Medi-Cal because it is part of our mission to improve the health of the communities we serve. We participate in Medi-Cal despite incurring losses every year.”\u003c/p>\n\u003cp>His statement cited nearly $1.8 billion in losses in the program in 2020 and said KP had donated $402 million to help care for uninsured people that year.\u003c/p>\n\u003cp>Kaiser Permanente, the state’s largest managed-care organization, is one of Newsom’s most generous supporters and close political allies.\u003c/p>\n\u003cp>The new, five-year contract, confirmed to KHN by administration officials and expected to be announced publicly Friday, will take effect in 2024 pending approval from the Legislature — and will make KP the only insurer with a statewide Medi-Cal contract. It allows KP to solidify its position before California’s other commercial Medi-Cal plans participate in a \u003ca href=\"https://californiahealthline.org/news/article/californias-reboot-of-troubled-medi-cal-puts-pressure-on-health-plans/\">statewide bidding process\u003c/a> — and after those plans have spent many months and considerable resources developing their bidding strategies.\u003c/p>\n\u003cp>[aside postID=news_11902149 hero='https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS53217_034_Richmond_LifelongCOVIDClinic_01192022-qut-1020x680.jpg']Other health care plans fear the contract could also muddle a massive and expensive initiative called \u003ca href=\"https://californiahealthline.org/news/article/california-medicaid-makeover-calaim-homeless-whole-body-care/\">CalAIM\u003c/a> that seeks to provide social services to the state’s most vulnerable patients, including home-delivered meals, housing aid for unhoused people, and \u003ca href=\"https://californiahealthline.org/news/article/mattresses-and-mold-removal-medi-cal-to-offer-unconventional-treatments-to-asthma-patients/\">mold removal\u003c/a> from homes. Under its new contract, KP must provide some of those services. But some executives at other health care plans say KP will not have to enroll a large number of sick patients who need such services because of how it limits enrollment.\u003c/p>\n\u003cp>Critics of the deal noted Newsom’s close relationship with KP, which has given nearly $100 million in charitable funding and grant money to boost Newsom’s efforts against homelessness, COVID response and wildfire relief since 2019, according to state records and KP news releases. The health care giant was also one of two hospital systems awarded a no-bid contract from the state to run a \u003ca href=\"https://about.kaiserpermanente.org/our-story/news/announcements/innovative-partnership-creates-los-angeles-surge-hospital\">field hospital in Los Angeles\u003c/a> during the early days of the COVID pandemic, and it got \u003ca href=\"https://khn.org/news/article/blue-shield-spent-years-cultivating-a-relationship-with-newsom-it-got-the-state-vaccine-contract/\">a special agreement\u003c/a> from the Newsom administration to help vaccinate Californians last year.\u003c/p>\n\u003cp>Jim DeBoo, Newsom’s executive secretary, \u003ca href=\"https://cal-access.sos.ca.gov/Lobbying/Firms/Detail.aspx?id=1364764&session=2019\">used to lobby for KP\u003c/a> before joining the administration. Toby Douglas, a former director of the state Department of Health Care Services, which runs Medi-Cal, is now Kaiser Permanente’s vice president for national Medicaid.\u003c/p>\n\u003cp>https://twitter.com/Paul_Erskine/status/1218294697593933825?s=20&t=VHrby3saI4V4EOHIQJNoWg\u003c/p>\n\u003cp>Still, many critics agree that Kaiser Permanente is a linchpin of the state’s health care system, with its strong focus on preventive care and high marks for quality of care. Many of the public insurance plans upset by the deal subcontract with KP for patient care and acknowledge that their overall quality scores will likely decline when KP goes its own way.\u003c/p>\n\u003cp>Michelle Baass, director of the state Department of Health Care Services, said Medi-Cal had risked losing KP’s “high quality” and “clinical expertise” altogether had it been required to accept all enrollees, as the other health plans must. But she said KP will have to comply with all other conditions that other plans must meet, including tightened requirements on access, quality, consumer satisfaction and health equity.\u003c/p>\n\u003cp>The state will also have greater oversight over patient care, she said.\u003c/p>\n\u003cp>“This proposal is a way to help ensure Kaiser treats more low-income patients, and that more low-income patients have access to Kaiser’s high-quality services,” Baass said.\u003c/p>\n\u003cp>Though Kaiser Permanente has 9 million enrollees, close to a quarter of all Californians, only about 900,000 of them are Medi-Cal members.\u003c/p>\n\u003cp>Under the current system, 12 of the 24 other managed care insurance plans that participate in Medi-Cal subcontract with KP to care for a subset of their patients, keeping a small slice of the Medi-Cal dollars earmarked for those patients. Under the new contract, KP can take those patients away and keep all the money.\u003c/p>\n\u003cp>In its subcontracts, and in counties where it enrolls patients directly, KP accepts only people who are recent Kaiser Permanente members and, in some cases, their family members. It is the only health plan that can limit its Medi-Cal enrollment in this way.\u003c/p>\n\u003cp>The new contract allows KP to continue this practice, but it also requires Kaiser Permanente to take on more children in foster care and complex, expensive patients who are eligible for both Medi-Cal and Medicare. It allows KP to expand its geographic reach in Medi-Cal to do so.\u003c/p>\n\u003cp>Baass said the state expects KP’s Medi-Cal enrollment to increase 25% over the life of the contract.\u003c/p>\n\u003cp>KP defended the practice of limiting enrollment primarily to its previous members, arguing that it provides “continuity of care when members transition into and out of Medi-Cal.”\u003c/p>\n\u003cp>[aside label='More Health Coverage' tag='health']The state has long pushed for a larger KP footprint in Medi-Cal, citing its high quality ratings, its strong integrated network, and its huge role on the broader health care landscape.\u003c/p>\n\u003cp>“Kaiser Permanente historically has not played a very big role in Medi-Cal, and the state has long recognized that we would benefit from having them more engaged because they get better health outcomes and focus on prevention,” said Daniel Zingale, a former Newsom administration official and health insurance regulator who now advises a lobbying firm that has Kaiser Permanente as a client.\u003c/p>\n\u003cp>But by accepting primarily people who have been KP members in the recent past, the health care system has been able to limit its share of high-need, expensive patients, say rival health plan executives and former state health officials.\u003c/p>\n\u003cp>The executives fear the deal could saddle them with even more of these patients in the future, including unhoused people and those with mental illnesses — and make it harder to provide adequate care for them. Many of those patients will join Medi-Cal for the first time under the CalAIM initiative, and KP will not be required to accept many of them.\u003c/p>\n\u003cp>“Awarding a no-bid Medi-Cal contract to a statewide commercial plan with a track record of ‘cherry picking’ members and offering only limited behavioral health and community support benefits not only conflicts with the intent and goals of CalAIM but undermines publicly organized health care,” according to an internal document prepared by the Inland Empire Health Plan.\u003c/p>\n\u003cp>The plan said it stands to lose the roughly 144,000 Medi-Cal members it delegates to KP and about $10 million in annual revenue. LA Care, the nation’s largest Medicaid health plan, with 2.4 million enrollees in Los Angeles County, will lose its 244,000 KP members, based on data shared by the plan.\u003c/p>\n\u003cp>The state had been scheduled on Wednesday to release final details and instructions for the commercial plans that are submitting bids for new contracts starting in 2024. But it delayed the release a week to make the KP deal public beforehand.\u003c/p>\n\u003cp>Baass said the state agreed to exempt KP from the bidding process because the standardized contract expected to result from it would have required the insurer to accept all enrollees, which Kaiser Permanente does not have the capacity to do.\u003c/p>\n\u003cp>“It’s not surprising to me that the state will go to extraordinary means to make sure that Kaiser is in the mix, given it has been in the vanguard of our health care delivery system,” Zingale said.\u003c/p>\n\u003cp>Having a direct statewide Medi-Cal contract will greatly reduce the administrative workload for KP, which will now deal with only one agency on reporting and oversight, rather than the 12 public plans it currently subcontracts with.\u003c/p>\n\u003cp>And the new contract will give it an even closer relationship with Newsom and state health officials.\u003c/p>\n\u003cp>In 2020, \u003ca href=\"https://about.kaiserpermanente.org/community-health/news/25m-pledge-to-california-governors-housing-fund\">KP gave $25 million to one of Newsom’s key initiatives\u003c/a>, a state homelessness fund to move people off the streets and into hotel rooms, according to a KHN analysis of charitable payments filed with the California \u003ca href=\"https://www.fppc.ca.gov/transparency/behested-payments.html\">Fair Political Practices Commission\u003c/a>. The same year, it donated $9.75 million to a state COVID relief fund.\u003c/p>\n\u003cp>In summer 2020, when local and state public health departments struggled to contain COVID spread, the health care giant pledged \u003ca href=\"https://about.kaiserpermanente.org/community-health/news/kaiser-permanente-commits-63m-to-support-contact-tracing-in-california\">$63 million in grant funding to help contract-tracing efforts\u003c/a>.\u003c/p>\n\u003cp>KP’s influence extends beyond its massive charitable giving. Its CEO, Greg Adams, landed an appointment on the governor’s economic recovery task force early in the pandemic, and Newsom has showcased KP hospitals at vaccine media events throughout the state.\u003c/p>\n\u003cp>https://twitter.com/KPSCALnews/status/1338603794062438400?s=20&t=4dpVkiilzowe4ESRlCyPOg\u003c/p>\n\u003cp>“In California and across the U.S., the campaign contributions and the organizing, the lobbying, all of that stuff is important,” said Andrew Kelly, an assistant professor of health policy at California State University, East Bay. “But there’s a different type of power that comes from your ability to have this privileged position within public programs.”\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"https://khn.org/\">KHN\u003c/a>, which publishes \u003ca href=\"http://www.californiahealthline.org/\">California Healthline\u003c/a>, an editorially independent service of the \u003ca href=\"http://www.chcf.org/\">California Health Care Foundation\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003cem>KHN is not affiliated with Kaiser Permanente.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Editor’s note: KHN is not affiliated with Kaiser Permanente.\u003c/em>\u003c/p>\n\u003cp>Gov. Gavin Newsom’s administration has negotiated a secret deal to give Kaiser Permanente a special Medicaid contract that would allow the health care behemoth to expand its reach in California and largely continue selecting the enrollees it wants, which other health care plans say leaves them with a disproportionate share of the program’s sickest and costliest patients.\u003c/p>\n\u003cp>The deal, hammered out behind closed doors between Kaiser Permanente and senior officials in Newsom’s office, could complicate a long-planned and expensive transformation of Medi-Cal, the state’s Medicaid program, which covers roughly 14 million lower-income Californians.\u003c/p>\n\u003cp>It has infuriated executives of other managed-care insurance plans in Medi-Cal, who say they stand to lose hundreds of thousands of patients and millions of dollars a year. The deal allows KP to limit enrollment primarily to its previous enrollees, except in the case of kids in foster care and people who are eligible for both Medicare and Medi-Cal.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It has caused a massive amount of frenzy,” said Jarrod McNaughton, CEO of the Inland Empire Health Plan, which covers about 1.5 million Medi-Cal enrollees in Riverside and San Bernardino counties. “All of us are doing our best to implement the most transformational Medi-Cal initiative in state history, and to put all this together without a public process is very disconcerting.”\u003c/p>\n\u003cp>Linnea Koopmans, CEO of the Local Health Plans of California, echoed McNaughton’s concerns.\u003c/p>\n\u003cp>Insurance plans got wind of the backroom talks when broad outlines of the deal were leaked days before the state briefed their executives Thursday.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Dr. Bechara Choucair, Kaiser Permanente’s chief health officer, argued \u003ca href=\"https://khn.org/wp-content/uploads/sites/2/2022/02/Kaiser-Permanente-response-to-KHN-inquiry.pdf\">in a prepared written response\u003c/a> on behalf of KP that because it operates both as a health insurer and a health care provider, KP should be treated differently from other commercial health care plans that participate in Medi-Cal. Doing business directly with the state will eliminate complexity and improve the quality of care for the Medi-Cal patients it serves, he said.\u003c/p>\n\u003cp>“We are not seeking to turn a profit off Medi-Cal enrollment,” Choucair said. “Kaiser Permanente participates in Medi-Cal because it is part of our mission to improve the health of the communities we serve. We participate in Medi-Cal despite incurring losses every year.”\u003c/p>\n\u003cp>His statement cited nearly $1.8 billion in losses in the program in 2020 and said KP had donated $402 million to help care for uninsured people that year.\u003c/p>\n\u003cp>Kaiser Permanente, the state’s largest managed-care organization, is one of Newsom’s most generous supporters and close political allies.\u003c/p>\n\u003cp>The new, five-year contract, confirmed to KHN by administration officials and expected to be announced publicly Friday, will take effect in 2024 pending approval from the Legislature — and will make KP the only insurer with a statewide Medi-Cal contract. It allows KP to solidify its position before California’s other commercial Medi-Cal plans participate in a \u003ca href=\"https://californiahealthline.org/news/article/californias-reboot-of-troubled-medi-cal-puts-pressure-on-health-plans/\">statewide bidding process\u003c/a> — and after those plans have spent many months and considerable resources developing their bidding strategies.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Other health care plans fear the contract could also muddle a massive and expensive initiative called \u003ca href=\"https://californiahealthline.org/news/article/california-medicaid-makeover-calaim-homeless-whole-body-care/\">CalAIM\u003c/a> that seeks to provide social services to the state’s most vulnerable patients, including home-delivered meals, housing aid for unhoused people, and \u003ca href=\"https://californiahealthline.org/news/article/mattresses-and-mold-removal-medi-cal-to-offer-unconventional-treatments-to-asthma-patients/\">mold removal\u003c/a> from homes. Under its new contract, KP must provide some of those services. But some executives at other health care plans say KP will not have to enroll a large number of sick patients who need such services because of how it limits enrollment.\u003c/p>\n\u003cp>Critics of the deal noted Newsom’s close relationship with KP, which has given nearly $100 million in charitable funding and grant money to boost Newsom’s efforts against homelessness, COVID response and wildfire relief since 2019, according to state records and KP news releases. The health care giant was also one of two hospital systems awarded a no-bid contract from the state to run a \u003ca href=\"https://about.kaiserpermanente.org/our-story/news/announcements/innovative-partnership-creates-los-angeles-surge-hospital\">field hospital in Los Angeles\u003c/a> during the early days of the COVID pandemic, and it got \u003ca href=\"https://khn.org/news/article/blue-shield-spent-years-cultivating-a-relationship-with-newsom-it-got-the-state-vaccine-contract/\">a special agreement\u003c/a> from the Newsom administration to help vaccinate Californians last year.\u003c/p>\n\u003cp>Jim DeBoo, Newsom’s executive secretary, \u003ca href=\"https://cal-access.sos.ca.gov/Lobbying/Firms/Detail.aspx?id=1364764&session=2019\">used to lobby for KP\u003c/a> before joining the administration. Toby Douglas, a former director of the state Department of Health Care Services, which runs Medi-Cal, is now Kaiser Permanente’s vice president for national Medicaid.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>Still, many critics agree that Kaiser Permanente is a linchpin of the state’s health care system, with its strong focus on preventive care and high marks for quality of care. Many of the public insurance plans upset by the deal subcontract with KP for patient care and acknowledge that their overall quality scores will likely decline when KP goes its own way.\u003c/p>\n\u003cp>Michelle Baass, director of the state Department of Health Care Services, said Medi-Cal had risked losing KP’s “high quality” and “clinical expertise” altogether had it been required to accept all enrollees, as the other health plans must. But she said KP will have to comply with all other conditions that other plans must meet, including tightened requirements on access, quality, consumer satisfaction and health equity.\u003c/p>\n\u003cp>The state will also have greater oversight over patient care, she said.\u003c/p>\n\u003cp>“This proposal is a way to help ensure Kaiser treats more low-income patients, and that more low-income patients have access to Kaiser’s high-quality services,” Baass said.\u003c/p>\n\u003cp>Though Kaiser Permanente has 9 million enrollees, close to a quarter of all Californians, only about 900,000 of them are Medi-Cal members.\u003c/p>\n\u003cp>Under the current system, 12 of the 24 other managed care insurance plans that participate in Medi-Cal subcontract with KP to care for a subset of their patients, keeping a small slice of the Medi-Cal dollars earmarked for those patients. Under the new contract, KP can take those patients away and keep all the money.\u003c/p>\n\u003cp>In its subcontracts, and in counties where it enrolls patients directly, KP accepts only people who are recent Kaiser Permanente members and, in some cases, their family members. It is the only health plan that can limit its Medi-Cal enrollment in this way.\u003c/p>\n\u003cp>The new contract allows KP to continue this practice, but it also requires Kaiser Permanente to take on more children in foster care and complex, expensive patients who are eligible for both Medi-Cal and Medicare. It allows KP to expand its geographic reach in Medi-Cal to do so.\u003c/p>\n\u003cp>Baass said the state expects KP’s Medi-Cal enrollment to increase 25% over the life of the contract.\u003c/p>\n\u003cp>KP defended the practice of limiting enrollment primarily to its previous members, arguing that it provides “continuity of care when members transition into and out of Medi-Cal.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The state has long pushed for a larger KP footprint in Medi-Cal, citing its high quality ratings, its strong integrated network, and its huge role on the broader health care landscape.\u003c/p>\n\u003cp>“Kaiser Permanente historically has not played a very big role in Medi-Cal, and the state has long recognized that we would benefit from having them more engaged because they get better health outcomes and focus on prevention,” said Daniel Zingale, a former Newsom administration official and health insurance regulator who now advises a lobbying firm that has Kaiser Permanente as a client.\u003c/p>\n\u003cp>But by accepting primarily people who have been KP members in the recent past, the health care system has been able to limit its share of high-need, expensive patients, say rival health plan executives and former state health officials.\u003c/p>\n\u003cp>The executives fear the deal could saddle them with even more of these patients in the future, including unhoused people and those with mental illnesses — and make it harder to provide adequate care for them. Many of those patients will join Medi-Cal for the first time under the CalAIM initiative, and KP will not be required to accept many of them.\u003c/p>\n\u003cp>“Awarding a no-bid Medi-Cal contract to a statewide commercial plan with a track record of ‘cherry picking’ members and offering only limited behavioral health and community support benefits not only conflicts with the intent and goals of CalAIM but undermines publicly organized health care,” according to an internal document prepared by the Inland Empire Health Plan.\u003c/p>\n\u003cp>The plan said it stands to lose the roughly 144,000 Medi-Cal members it delegates to KP and about $10 million in annual revenue. LA Care, the nation’s largest Medicaid health plan, with 2.4 million enrollees in Los Angeles County, will lose its 244,000 KP members, based on data shared by the plan.\u003c/p>\n\u003cp>The state had been scheduled on Wednesday to release final details and instructions for the commercial plans that are submitting bids for new contracts starting in 2024. But it delayed the release a week to make the KP deal public beforehand.\u003c/p>\n\u003cp>Baass said the state agreed to exempt KP from the bidding process because the standardized contract expected to result from it would have required the insurer to accept all enrollees, which Kaiser Permanente does not have the capacity to do.\u003c/p>\n\u003cp>“It’s not surprising to me that the state will go to extraordinary means to make sure that Kaiser is in the mix, given it has been in the vanguard of our health care delivery system,” Zingale said.\u003c/p>\n\u003cp>Having a direct statewide Medi-Cal contract will greatly reduce the administrative workload for KP, which will now deal with only one agency on reporting and oversight, rather than the 12 public plans it currently subcontracts with.\u003c/p>\n\u003cp>And the new contract will give it an even closer relationship with Newsom and state health officials.\u003c/p>\n\u003cp>In 2020, \u003ca href=\"https://about.kaiserpermanente.org/community-health/news/25m-pledge-to-california-governors-housing-fund\">KP gave $25 million to one of Newsom’s key initiatives\u003c/a>, a state homelessness fund to move people off the streets and into hotel rooms, according to a KHN analysis of charitable payments filed with the California \u003ca href=\"https://www.fppc.ca.gov/transparency/behested-payments.html\">Fair Political Practices Commission\u003c/a>. The same year, it donated $9.75 million to a state COVID relief fund.\u003c/p>\n\u003cp>In summer 2020, when local and state public health departments struggled to contain COVID spread, the health care giant pledged \u003ca href=\"https://about.kaiserpermanente.org/community-health/news/kaiser-permanente-commits-63m-to-support-contact-tracing-in-california\">$63 million in grant funding to help contract-tracing efforts\u003c/a>.\u003c/p>\n\u003cp>KP’s influence extends beyond its massive charitable giving. Its CEO, Greg Adams, landed an appointment on the governor’s economic recovery task force early in the pandemic, and Newsom has showcased KP hospitals at vaccine media events throughout the state.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>“In California and across the U.S., the campaign contributions and the organizing, the lobbying, all of that stuff is important,” said Andrew Kelly, an assistant professor of health policy at California State University, East Bay. “But there’s a different type of power that comes from your ability to have this privileged position within public programs.”\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"https://khn.org/\">KHN\u003c/a>, which publishes \u003ca href=\"http://www.californiahealthline.org/\">California Healthline\u003c/a>, an editorially independent service of the \u003ca href=\"http://www.chcf.org/\">California Health Care Foundation\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003cem>KHN is not affiliated with Kaiser Permanente.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/personal_012522_final.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-11902667\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/personal_012522_final.png\" alt='Cartoon: an anti-vaccine parent with anti-vax signs and phony covid cures stands next to his child. An arrow pointing at the child reads, \"personal belief exemption.\" The arrow pointing at the shrunken brain of the parent reads, \"parenting skills exemption.\"' width=\"1920\" height=\"1287\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/personal_012522_final.png 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/personal_012522_final-800x536.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/personal_012522_final-1020x684.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/personal_012522_final-160x107.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/personal_012522_final-1536x1030.png 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003c/p>\n\u003cp>The \u003ca href=\"https://calmatters.org/newsletters/whatmatters/2022/01/california-vaccine-mandate-children/\">bill Democratic state Sen. Richard Pan introduced on Monday\u003c/a> would require all California students in grades K-12 to be vaccinated against COVID-19 by Jan. 1, 2023, eliminating the personal belief exemption.\u003c/p>\n\u003cp>Pan’s bill goes a step further than \u003ca href=\"https://www.kqed.org/news/11890715/newsom-enacts-first-in-nation-statewide-student-vaccine-mandate\">Gov. Gavin Newsom’s mandate announced in the fall\u003c/a>, which allows for personal belief exemptions.\u003c/p>\n\u003cp>In this era of rampant anti-science misinformation, a personal belief exemption is far too easy of an out, and it only serves to sabotage herd immunity and prolong the pandemic.\u003c/p>\n\u003cp>Sorry, if you really want to put yourself, your kids and others at risk, you’re going to need a much better reason than “personal belief.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/personal_012522_final.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-11902667\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/personal_012522_final.png\" alt='Cartoon: an anti-vaccine parent with anti-vax signs and phony covid cures stands next to his child. An arrow pointing at the child reads, \"personal belief exemption.\" The arrow pointing at the shrunken brain of the parent reads, \"parenting skills exemption.\"' width=\"1920\" height=\"1287\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/personal_012522_final.png 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/personal_012522_final-800x536.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/personal_012522_final-1020x684.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/personal_012522_final-160x107.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/personal_012522_final-1536x1030.png 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003c/p>\n\u003cp>The \u003ca href=\"https://calmatters.org/newsletters/whatmatters/2022/01/california-vaccine-mandate-children/\">bill Democratic state Sen. Richard Pan introduced on Monday\u003c/a> would require all California students in grades K-12 to be vaccinated against COVID-19 by Jan. 1, 2023, eliminating the personal belief exemption.\u003c/p>\n\u003cp>Pan’s bill goes a step further than \u003ca href=\"https://www.kqed.org/news/11890715/newsom-enacts-first-in-nation-statewide-student-vaccine-mandate\">Gov. Gavin Newsom’s mandate announced in the fall\u003c/a>, which allows for personal belief exemptions.\u003c/p>\n\u003cp>In this era of rampant anti-science misinformation, a personal belief exemption is far too easy of an out, and it only serves to sabotage herd immunity and prolong the pandemic.\u003c/p>\n\u003cp>Sorry, if you really want to put yourself, your kids and others at risk, you’re going to need a much better reason than “personal belief.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cb>COVID-19 Update\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">This week, California logged 7 million cases of the coronavirus since the beginning of the pandemic – adding 1 million cases in just one week. Still, there are signs that the omicron surge is starting to climb down from its peak, as test positivity rates dropped from a high of 23% to 20%. But hospitals are still scrambling and death rates are still nearly double what they were a month ago.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Guest:\u003c/span>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Dr. Matt Willis, Marin County public health officer\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Judge LaDoris Cordell’s “Her Honor”\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Judge LaDoris Hazzard Cordell shattered glass ceilings when she became the first African American female judge in Northern California. Cordell, now retired, is calling out America’s criminal justice system for racial and ethnic bias, which study after study has also highlighted. She says the courts regularly and unfairly punish people of color more severely than white people and she has plenty of ideas for how to fix the system. Cordell shares her insights in her recent book, “\u003c/span>\u003cspan style=\"font-weight: 400\">Her Honor: My Life on the Bench… What Works, What’s Broken, and How to Change It.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Guest:\u003c/span>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Judge LaDoris Cordell, author, “Her Honor” \u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>This Week in California News & Politics\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Despite the good news that COVID cases may be declining, the impact of the pandemic continues to be felt everywhere. Gov. Gavin Newsom and some lawmakers are looking to ramp up work-place COVID vaccine mandates and even remove the personal belief exemption. The issue of whether or not to require vaccination is also playing a role in the state Assembly race for David Chiu’s seat, which he vacated to take the job of San Francisco’s City Attorney.\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Guests:\u003c/span>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Guy Marzorati, KQED politics and government reporter\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Brian Watt, KQED morning edition host\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\n\u003cp>\u003cb>Something Beautiful: Art of the Brick\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">This week’s look at Something Beautiful is the “Art of the Brick,” an exhibition featuring more than 70 sculptures made from more than 1 million LEGO bricks by artist Nathan\u003c/span> \u003cspan style=\"font-weight: 400\">Sawaya.\u003c/span>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cb>COVID-19 Update\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">This week, California logged 7 million cases of the coronavirus since the beginning of the pandemic – adding 1 million cases in just one week. Still, there are signs that the omicron surge is starting to climb down from its peak, as test positivity rates dropped from a high of 23% to 20%. But hospitals are still scrambling and death rates are still nearly double what they were a month ago.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Guest:\u003c/span>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Dr. Matt Willis, Marin County public health officer\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Judge LaDoris Cordell’s “Her Honor”\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Judge LaDoris Hazzard Cordell shattered glass ceilings when she became the first African American female judge in Northern California. Cordell, now retired, is calling out America’s criminal justice system for racial and ethnic bias, which study after study has also highlighted. She says the courts regularly and unfairly punish people of color more severely than white people and she has plenty of ideas for how to fix the system. Cordell shares her insights in her recent book, “\u003c/span>\u003cspan style=\"font-weight: 400\">Her Honor: My Life on the Bench… What Works, What’s Broken, and How to Change It.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Guest:\u003c/span>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Judge LaDoris Cordell, author, “Her Honor” \u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>This Week in California News & Politics\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Despite the good news that COVID cases may be declining, the impact of the pandemic continues to be felt everywhere. Gov. Gavin Newsom and some lawmakers are looking to ramp up work-place COVID vaccine mandates and even remove the personal belief exemption. The issue of whether or not to require vaccination is also playing a role in the state Assembly race for David Chiu’s seat, which he vacated to take the job of San Francisco’s City Attorney.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"soldout": {
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