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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. 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The state has already lifted most of its restrictions — including the indoor mask mandate, which expired earlier this week. 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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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"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": "\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": "\u003cp>California is in limbo with the death penalty. We have an execution moratorium, and no one has been put to death in the state since 2006. But it’s still legal to sentence someone to die, which means there are hundreds of people sitting on death row, often in solitary confinement.\u003c/p>\n\u003cp>But a move by Gov. Gavin Newsom begins to chip away at this system. The nation’s largest death row at San Quentin State Prison will close, and the men inside will be sent to other maximum security prisons where they can have access to jobs. Meanwhile, the state plans to transform the former site of San Quentin’s death row into a “positive, healing environment.”\u003c/p>\n\u003cp>\u003cstrong>Guests: \u003c/strong>\u003ca href=\"https://twitter.com/EmEffHarvin\" target=\"_blank\" rel=\"noopener noreferrer\">Mary Franklin Harvin\u003c/a>, KQED producer and reporter, and \u003ca href=\"https://twitter.com/katewolffe\" target=\"_blank\" rel=\"noopener noreferrer\">Kate Wolffe\u003c/a>, KQED producer, reporter and weekend anchor\u003c/p>\n\u003cp id=\"embed-code\" class=\"inconsolata\">\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" frameborder=\"0\" height=\"200\" scrolling=\"no\" src=\"https://playlist.megaphone.fm?e=KQINC9478053214&light=true\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\n\u003c/p>\n\u003cp>\u003ci>Follow \u003c/i>\u003ca href=\"https://www.kqed.org/news/tag/the-bay\">\u003ci>The Bay\u003c/i>\u003c/a>\u003ci> to hear more local Bay Area stories like this one. New episodes are released Monday, Wednesday and Friday at 3 a.m. Find The Bay on \u003c/i>\u003ca href=\"https://podcasts.apple.com/us/podcast/the-bay/id1350043452?mt=2\">\u003ci>Apple Podcasts\u003c/i>\u003c/a>\u003ci>, \u003c/i>\u003ca href=\"https://open.spotify.com/show/4BIKBKIujizLHlIlBNaAqQ\">\u003ci>Spotify\u003c/i>\u003c/a>\u003ci>, \u003c/i>\u003ca href=\"https://www.stitcher.com/podcast/kqed/the-bay\">\u003ci>Stitcher\u003c/i>\u003c/a>\u003ci>, NPR One or via \u003c/i>\u003ca href=\"https://www.amazon.com/KQED-The-Bay-Flash-Briefing/dp/B07H6YYV23\">\u003ci>Alexa\u003c/i>\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California is in limbo with the death penalty. We have an execution moratorium, and no one has been put to death in the state since 2006. But it’s still legal to sentence someone to die, which means there are hundreds of people sitting on death row, often in solitary confinement.\u003c/p>\n\u003cp>But a move by Gov. Gavin Newsom begins to chip away at this system. The nation’s largest death row at San Quentin State Prison will close, and the men inside will be sent to other maximum security prisons where they can have access to jobs. Meanwhile, the state plans to transform the former site of San Quentin’s death row into a “positive, healing environment.”\u003c/p>\n\u003cp>\u003cstrong>Guests: \u003c/strong>\u003ca href=\"https://twitter.com/EmEffHarvin\" target=\"_blank\" rel=\"noopener noreferrer\">Mary Franklin Harvin\u003c/a>, KQED producer and reporter, and \u003ca href=\"https://twitter.com/katewolffe\" target=\"_blank\" rel=\"noopener noreferrer\">Kate Wolffe\u003c/a>, KQED producer, reporter and weekend anchor\u003c/p>\n\u003cp id=\"embed-code\" class=\"inconsolata\">\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" frameborder=\"0\" height=\"200\" scrolling=\"no\" src=\"https://playlist.megaphone.fm?e=KQINC9478053214&light=true\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\n\u003c/p>\n\u003cp>\u003ci>Follow \u003c/i>\u003ca href=\"https://www.kqed.org/news/tag/the-bay\">\u003ci>The Bay\u003c/i>\u003c/a>\u003ci> to hear more local Bay Area stories like this one. New episodes are released Monday, Wednesday and Friday at 3 a.m. Find The Bay on \u003c/i>\u003ca href=\"https://podcasts.apple.com/us/podcast/the-bay/id1350043452?mt=2\">\u003ci>Apple Podcasts\u003c/i>\u003c/a>\u003ci>, \u003c/i>\u003ca href=\"https://open.spotify.com/show/4BIKBKIujizLHlIlBNaAqQ\">\u003ci>Spotify\u003c/i>\u003c/a>\u003ci>, \u003c/i>\u003ca href=\"https://www.stitcher.com/podcast/kqed/the-bay\">\u003ci>Stitcher\u003c/i>\u003c/a>\u003ci>, NPR One or via \u003c/i>\u003ca href=\"https://www.amazon.com/KQED-The-Bay-Flash-Briefing/dp/B07H6YYV23\">\u003ci>Alexa\u003c/i>\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cb>San Francisco and Statewide African American Reparations\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400;\">California is the first state in the nation to create a task force to investigate the possibility of some form of compensation for Black residents, in recognition of historical and ongoing discrimination. In the Bay Area, the city of San Francisco has also taken up the matter with its own commission. Both groups have been meeting since last year and are beginning the process of researching how African Americans have been harmed by racist policies and what could be done to make amends.\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;\">Eric McDonnell, SF African American Reparations Advisory Committee chair\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400;\">\u003cspan style=\"font-weight: 400;\">Otis R. Taylor Jr., KQED \u003c/span>\u003cspan style=\"font-weight: 400;\">supervising senior editor of race and equity\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400;\">\u003cspan style=\"font-weight: 400;\">Lakshmi Sarah, KQED digital producer/reporter\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 signed pandemic relief legislation to assist small businesses and also extended COVID-19 paid sick leave. Meanwhile, the state announced that it is lifting indoor mask mandates on Feb. 16 as test-positivity rates continue to fall. We also chew on other news of the week, including a lawsuit filed against Tesla for an alleged hostile and racist workplace and the latest fundraising numbers in a local school board election that’s drawn national attention.\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;\">Guy Marzorati, KQED politics and government reporter\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400;\">\u003cspan style=\"font-weight: 400;\">Rachael Myrow, KQED Silicon Valley News Desk senior editor\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Something Beautiful: Iacopi Farms Super Bloom\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400;\">It’s super bloom season — when fields of flowers explode into color at roughly the same time after winter rains. For this week’s Something Beautiful, we go to Iacopi Farms in Half Moon Bay.\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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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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"excerpt": "The deal, hammered out behind closed doors between Kaiser Permanente and senior officials in Gov. Newsom's office, could complicate a long-planned transformation of Medi-Cal, which covers roughly 14 million lower-income Californians.",
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"title": "California Inks Sweetheart Deal With Kaiser Permanente, Jeopardizing Medicaid Reforms | KQED",
"description": "The deal, hammered out behind closed doors between Kaiser Permanente and senior officials in Gov. Newsom's office, could complicate a long-planned transformation of Medi-Cal, which covers roughly 14 million lower-income Californians.",
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"nprByline": "\u003ca href=\"https://khn.org/news/author/bernard-j-wolfson/\">Bernard J. Wolfson\u003c/a>, \u003ca href=\"https://khn.org/news/author/angela-hart/\">Angela Hart\u003c/a> and \u003ca href=\"https://khn.org/news/author/samantha-young/\">Samantha Young\u003c/a>",
"subhead": "The backroom deal with politically connected Kaiser Permanente, which infuriated executives of other Medi-Cal health plans, allows the health care giant to continue selecting the enrollees it wants.",
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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": "‘[This deal] has caused a massive amount of frenzy.’",
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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>\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": "\u003cp>\u003cb>COVID-19 Update\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">It’s been a week of pandemic record highs across the nation and in California. State health officials say 23% of professionally administered COVID-19 tests are positive, while the daily count of new cases has been topping 100,000 for the past several days. Some school districts have closed their doors and returned temporarily to online learning, while Sonoma County has taken the step of banning large indoor and outdoor gatherings for the next month.\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. Sundari R. Mase, Sonoma County Health Officer\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>SF Mayor London Breed\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Last month, Mayor London Breed declared a state of emergency in the Tenderloin neighborhood, vowing a police crackdown on the regular — and open — crime there. Criticism of her call for increased police intervention came swiftly from the city’s district attorney, Chesa Boudin, and other city leaders. The situation in the Tenderloin, and the debate over how to handle it, reveal tensions in a city known for its progressive politics.\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\">San Francisco Mayor London Breed\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>This Week in California Politics\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">This week, Gov. Gavin Newsom unveiled a $286 billion budget that includes a surplus of $45 billion. Newsom’s proposal aims to address five key areas: COVID-19, climate change, homelessness, the cost of living, and public safety. Our panel of reporters looks at what these spending priorities mean for where California is heading.\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\">Scott Shafer, KQED senior politics and government editor\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Tal Kopan, San Francisco Chronicle Washington, D.C., correspondent\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\n\u003cp>\u003cb>Something Beautiful: Baughman’s Western Outfitters\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">We don’t usually feature a store in this segment, but Baughman’s Western Outfitters has a strong local history: It’s been family-owned for 140 years. If you want to visit a piece of California’s Wild West past, check out their selection of jeans, cowboy hats and boots. \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\">It’s been a week of pandemic record highs across the nation and in California. State health officials say 23% of professionally administered COVID-19 tests are positive, while the daily count of new cases has been topping 100,000 for the past several days. Some school districts have closed their doors and returned temporarily to online learning, while Sonoma County has taken the step of banning large indoor and outdoor gatherings for the next month.\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. Sundari R. Mase, Sonoma County Health Officer\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>SF Mayor London Breed\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Last month, Mayor London Breed declared a state of emergency in the Tenderloin neighborhood, vowing a police crackdown on the regular — and open — crime there. Criticism of her call for increased police intervention came swiftly from the city’s district attorney, Chesa Boudin, and other city leaders. The situation in the Tenderloin, and the debate over how to handle it, reveal tensions in a city known for its progressive politics.\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\">San Francisco Mayor London Breed\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>This Week in California Politics\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">This week, Gov. Gavin Newsom unveiled a $286 billion budget that includes a surplus of $45 billion. Newsom’s proposal aims to address five key areas: COVID-19, climate change, homelessness, the cost of living, and public safety. Our panel of reporters looks at what these spending priorities mean for where California is heading.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "'Nothing Compassionate About Someone Dying in the Streets': Newsom Proposes $2 Billion to Address Homelessness",
"title": "'Nothing Compassionate About Someone Dying in the Streets': Newsom Proposes $2 Billion to Address Homelessness",
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"content": "\u003cp>\u003cem>Lea este artículo en \u003c/em>\u003ca href=\"https://calmatters.org/calmatters-en-espanol/2022/01/newsom-sobre-la-falta-de-vivienda-tenemos-que-limpiar-esos-campamentos/\">\u003cem>español\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>In his January budget proposal to the state Legislature, Gov. Gavin Newsom delivered a clear message: California needs to move people off the streets.\u003c/p>\n\u003cp>“I don’t want to see any more people die in the streets and call that compassion,” Newsom said Monday, detailing \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2022/01/Governors-California-Blueprint-Fact-Sheet.pdf\">his $286.4 billion blueprint\u003c/a>. “There is nothing compassionate about someone dying in the streets or stepping over someone on the streets or sidewalks.”\u003c/p>\n\u003cp>Newsom \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2022/01/Confronting-Homelessness-Fact-Sheet.pdf\">proposed $2 billion to address California's homelessness crisis\u003c/a> — including $1.5 billion to buy and set up “tiny homes” and other temporary shelter options, which \u003ca href=\"https://calmatters.org/housing/homeless/2021/11/california-homeless-camps-clearing-plan/\">often fall far short of need\u003c/a> and which he conceded would only be a “bridge” to permanent housing with services.\u003c/p>\n\u003cp>While substantial, the governor’s request pales in comparison to the funding he and the Legislature approved last year — \u003ca href=\"https://calmatters.org/explainers/californias-homelessness-crisis-explained/\">$12 billion\u003c/a> to create supportive housing facilities and help fund green-lit affordable housing projects.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“What we’re offering this year is additional money to find a bridge to the permanent supportive housing, and that’s tiny homes, that’s procuring treatment, that’s house slots and shelter slots in the interim,” Newsom said.\u003c/p>\n\u003cp>The governor projected that the funding would yield another 11,000 beds for \u003ca href=\"https://calmatters.org/explainers/californias-homelessness-crisis-explained/\">unhoused people\u003c/a>, in addition to the estimated 44,000 that will be created with money earmarked from last year’s budget.\u003c/p>\n\u003cp>The remaining $500 million would go toward grants, to be distributed next summer, to local governments to help relocate \u003ca href=\"https://calmatters.org/housing/homeless/2021/11/california-homeless-camps-clearing-plan/\">people living in encampments\u003c/a> — a 10-fold increase from the grant funding available in 2021.\u003c/p>\n\u003cp>Demand for such grants has, to date, far outpaced supply, according to the agency in charge of reviewing grant applications: The state’s Business, Consumer Services and Housing Agency (BCSH) reported it had \u003ca href=\"https://twitter.com/CAbcsh/status/1479149572798574593\">received an \"overwhelming\" number of grant applications on Dec. 31 \u003c/a>— from 26 cities and 10 counties — requesting a total of $120 million, which was $72 million more than it had to give.[aside label=\"related coverage\" tag=\"housing\"]But despite the proposed increase in grant funding, Christopher Martin, policy director for \u003ca href=\"https://www.housingca.org/\">Housing California\u003c/a>, lamented the lack of funds to quickly move unhoused people into existing housing.\u003c/p>\n\u003cp>“There’s not a dime in here that is going towards rental assistance or permanent housing,” he said. “Building shelter and treatment beds, that takes time. That’s going to take years. These people are dealing with the elements today.”\u003c/p>\n\u003cp>Rental assistance for people with housing but who are at risk of being evicted also is running out. The state has so far \u003ca href=\"https://housing.ca.gov/covid_rr/dashboard.html\">received relief application requests totaling more than $6.8 billion, according to BCSH's dashboard\u003c/a>. That's well over the $5.2 billion it has gotten from the federal government, about half of which is administered by local jurisdictions.\u003c/p>\n\u003cp>The agency previously expressed confidence that the need would be filled by another round of federal funding, but in response to California’s recent $1.9 billion request to the U.S. Treasury Department, the state only received $62 million on Friday, Newsom said.\u003c/p>\n\u003cp>“And so for the purposes of this budget, we are looking to continue to engage directly with Treasury, the Biden administration, as we have been, and directly with legislative leaders,” he added.\u003c/p>\n\u003cp>Newsom’s blueprint to tackle \u003ca href=\"https://calmatters.org/explainers/housing-costs-high-california/\">California’s housing crisis\u003c/a> totals another $2 billion and prioritizes the state’s climate goals.\u003c/p>\n\u003cp>“I just want to reinforce, to some extent … moving away from investments in housing that don’t focus on climate, health, integrating downtown schools, jobs, parks and restaurants,” Newsom said.\u003c/p>\n\u003cp>That includes about $800 million in grants to develop housing units and the infrastructure around them in mostly downtown areas, “in that space away from the sprawl,” he said. The idea is to avoid building in areas prone to wildfires, and to prevent the greenhouse gas emissions that result from long commutes.\u003c/p>\n\u003cp>Of that money, Newsom wants to set aside $100 million to help offset the high costs that can make it prohibitively expensive to \u003ca href=\"https://ternercenter.berkeley.edu/research-and-policy/commercial-residential-conversions/\">convert old offices and other buildings into apartments\u003c/a> — a practice that UC Berkeley’s Terner Center for Housing Innovation found is most common in Los Angeles.\u003c/p>\n\u003cp>Besides prioritizing housing in downtown areas, the grant also would help meet the state’s climate goals by \u003ca href=\"https://laist.com/news/housing-homelessness/los-angeles-conversions-housing-vacant-offices-remote-work-adaptive-reuse-element-omgivning-downtown?mc_cid=607e273f5a&mc_eid=cef0c46a71\">slashing the main culprit of construction waste: demolition\u003c/a>. The remaining $100 million would go toward affordable housing on vacant state-owned land.\u003c/p>\n\u003cp>The other $1 billion in Newsom’s housing budget is focused largely on creating more affordable housing for the state's lowest earners, with $500 million going toward the Low-Income Housing Tax Credit, the largest funding source for building subsidized housing. The other $500 million would be used to preserve deteriorating affordable housing in downtown areas and rehabilitate mobile home parks, among other initiatives.\u003c/p>\n\u003cp>Matt Schwartz, president and CEO of the nonprofit California Housing Partnership, said while he applauds the new “short-term investments,” the money won’t come close to building the 1.2 million homes his group estimates the state needs by 2030.\u003c/p>\n\u003cp>“It’s time for the governor and state leaders to go beyond proposing another year of short-term assistance and instead commit to a long-term plan with sustained investments at the scale needed to solve the homeless and housing affordability crises and address climate change,” he said.\u003c/p>\n\u003cp>The League of California Cities, however, responded more positively to Newsom’s blueprint.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“The proposal makes good on last year’s promises by the state to continue investing in housing production, as well as housing coupled with mental health services for those experiencing homelessness,” Carolyn Coleman, the league’s CEO, said in a statement. “These proposed investments are a critical down payment by the state on the long-term funding needed to solve a decades-in-the-making crisis.”\u003c/p>\n\n",
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"excerpt": "In his state budget proposal announced this week, Gov. Gavin Newsom said he supported local efforts to remove street encampments, while stressing the need for permanent housing.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Lea este artículo en \u003c/em>\u003ca href=\"https://calmatters.org/calmatters-en-espanol/2022/01/newsom-sobre-la-falta-de-vivienda-tenemos-que-limpiar-esos-campamentos/\">\u003cem>español\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>In his January budget proposal to the state Legislature, Gov. Gavin Newsom delivered a clear message: California needs to move people off the streets.\u003c/p>\n\u003cp>“I don’t want to see any more people die in the streets and call that compassion,” Newsom said Monday, detailing \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2022/01/Governors-California-Blueprint-Fact-Sheet.pdf\">his $286.4 billion blueprint\u003c/a>. “There is nothing compassionate about someone dying in the streets or stepping over someone on the streets or sidewalks.”\u003c/p>\n\u003cp>Newsom \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2022/01/Confronting-Homelessness-Fact-Sheet.pdf\">proposed $2 billion to address California's homelessness crisis\u003c/a> — including $1.5 billion to buy and set up “tiny homes” and other temporary shelter options, which \u003ca href=\"https://calmatters.org/housing/homeless/2021/11/california-homeless-camps-clearing-plan/\">often fall far short of need\u003c/a> and which he conceded would only be a “bridge” to permanent housing with services.\u003c/p>\n\u003cp>While substantial, the governor’s request pales in comparison to the funding he and the Legislature approved last year — \u003ca href=\"https://calmatters.org/explainers/californias-homelessness-crisis-explained/\">$12 billion\u003c/a> to create supportive housing facilities and help fund green-lit affordable housing projects.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“What we’re offering this year is additional money to find a bridge to the permanent supportive housing, and that’s tiny homes, that’s procuring treatment, that’s house slots and shelter slots in the interim,” Newsom said.\u003c/p>\n\u003cp>The governor projected that the funding would yield another 11,000 beds for \u003ca href=\"https://calmatters.org/explainers/californias-homelessness-crisis-explained/\">unhoused people\u003c/a>, in addition to the estimated 44,000 that will be created with money earmarked from last year’s budget.\u003c/p>\n\u003cp>The remaining $500 million would go toward grants, to be distributed next summer, to local governments to help relocate \u003ca href=\"https://calmatters.org/housing/homeless/2021/11/california-homeless-camps-clearing-plan/\">people living in encampments\u003c/a> — a 10-fold increase from the grant funding available in 2021.\u003c/p>\n\u003cp>Demand for such grants has, to date, far outpaced supply, according to the agency in charge of reviewing grant applications: The state’s Business, Consumer Services and Housing Agency (BCSH) reported it had \u003ca href=\"https://twitter.com/CAbcsh/status/1479149572798574593\">received an \"overwhelming\" number of grant applications on Dec. 31 \u003c/a>— from 26 cities and 10 counties — requesting a total of $120 million, which was $72 million more than it had to give.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>But despite the proposed increase in grant funding, Christopher Martin, policy director for \u003ca href=\"https://www.housingca.org/\">Housing California\u003c/a>, lamented the lack of funds to quickly move unhoused people into existing housing.\u003c/p>\n\u003cp>“There’s not a dime in here that is going towards rental assistance or permanent housing,” he said. “Building shelter and treatment beds, that takes time. That’s going to take years. These people are dealing with the elements today.”\u003c/p>\n\u003cp>Rental assistance for people with housing but who are at risk of being evicted also is running out. The state has so far \u003ca href=\"https://housing.ca.gov/covid_rr/dashboard.html\">received relief application requests totaling more than $6.8 billion, according to BCSH's dashboard\u003c/a>. That's well over the $5.2 billion it has gotten from the federal government, about half of which is administered by local jurisdictions.\u003c/p>\n\u003cp>The agency previously expressed confidence that the need would be filled by another round of federal funding, but in response to California’s recent $1.9 billion request to the U.S. Treasury Department, the state only received $62 million on Friday, Newsom said.\u003c/p>\n\u003cp>“And so for the purposes of this budget, we are looking to continue to engage directly with Treasury, the Biden administration, as we have been, and directly with legislative leaders,” he added.\u003c/p>\n\u003cp>Newsom’s blueprint to tackle \u003ca href=\"https://calmatters.org/explainers/housing-costs-high-california/\">California’s housing crisis\u003c/a> totals another $2 billion and prioritizes the state’s climate goals.\u003c/p>\n\u003cp>“I just want to reinforce, to some extent … moving away from investments in housing that don’t focus on climate, health, integrating downtown schools, jobs, parks and restaurants,” Newsom said.\u003c/p>\n\u003cp>That includes about $800 million in grants to develop housing units and the infrastructure around them in mostly downtown areas, “in that space away from the sprawl,” he said. The idea is to avoid building in areas prone to wildfires, and to prevent the greenhouse gas emissions that result from long commutes.\u003c/p>\n\u003cp>Of that money, Newsom wants to set aside $100 million to help offset the high costs that can make it prohibitively expensive to \u003ca href=\"https://ternercenter.berkeley.edu/research-and-policy/commercial-residential-conversions/\">convert old offices and other buildings into apartments\u003c/a> — a practice that UC Berkeley’s Terner Center for Housing Innovation found is most common in Los Angeles.\u003c/p>\n\u003cp>Besides prioritizing housing in downtown areas, the grant also would help meet the state’s climate goals by \u003ca href=\"https://laist.com/news/housing-homelessness/los-angeles-conversions-housing-vacant-offices-remote-work-adaptive-reuse-element-omgivning-downtown?mc_cid=607e273f5a&mc_eid=cef0c46a71\">slashing the main culprit of construction waste: demolition\u003c/a>. The remaining $100 million would go toward affordable housing on vacant state-owned land.\u003c/p>\n\u003cp>The other $1 billion in Newsom’s housing budget is focused largely on creating more affordable housing for the state's lowest earners, with $500 million going toward the Low-Income Housing Tax Credit, the largest funding source for building subsidized housing. The other $500 million would be used to preserve deteriorating affordable housing in downtown areas and rehabilitate mobile home parks, among other initiatives.\u003c/p>\n\u003cp>Matt Schwartz, president and CEO of the nonprofit California Housing Partnership, said while he applauds the new “short-term investments,” the money won’t come close to building the 1.2 million homes his group estimates the state needs by 2030.\u003c/p>\n\u003cp>“It’s time for the governor and state leaders to go beyond proposing another year of short-term assistance and instead commit to a long-term plan with sustained investments at the scale needed to solve the homeless and housing affordability crises and address climate change,” he said.\u003c/p>\n\u003cp>The League of California Cities, however, responded more positively to Newsom’s blueprint.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“The proposal makes good on last year’s promises by the state to continue investing in housing production, as well as housing coupled with mental health services for those experiencing homelessness,” Carolyn Coleman, the league’s CEO, said in a statement. “These proposed investments are a critical down payment by the state on the long-term funding needed to solve a decades-in-the-making crisis.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cem>Updated 2 p.m. Wednesday\u003c/em>\u003c/p>\n\u003cp>California Democrats on Tuesday took their first step toward abolishing the private health insurance market in the nation’s most populous state and replacing it with a government-run plan that they promised would never deny anyone the care they need.\u003c/p>\n\u003cp>But the proposal that cleared a legislative committee in the state Assembly is still a long way from becoming law. Assembly Bill 1400, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220AB1400\">which would create a universal health care system called CalCare\u003c/a>, faces strong opposition from powerful business interests who say it would cost too much. And even if it does become law, voters would have to approve a \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220ACA11\">major income tax increase\u003c/a> to pay for it — a vote that might not happen until 2024.\u003c/p>\n\u003cp>Still, Democrats hailed Tuesday’s vote for jump-starting one of their long-stalled policy goals and signaling they won’t back away from a fight even during an election year. In an hours-long hearing, some lawmakers and advocates assailed a health care industry they say has benefited corporate interests at the expense of consumers.\u003c/p>\n\u003cp>Ady Barkan, a 38-year-old father of two, was diagnosed with ALS six years ago and now is mostly paralyzed. He testified at Tuesday’s hearing with the help of a computerized voice that spoke as he typed using technology that followed the movement of his eyes. Barkan said he has battled his private insurance carrier to get treatment he needed, including suing them to get a ventilator that keeps him alive.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Even good health insurance, which I have, does not cover the cost of the care I need to survive,” he said.\u003c/p>\n\u003cp>The bill that advanced on Tuesday would create the universal health care system — CalCare — and set its rules. It cleared the Assembly Health Committee on an 11-3 vote. Republicans voted no, arguing the bill would cost too much and pay doctors and nurses less, potentially worsening a shortage of health care workers.\u003c/p>\n\u003cp>Assemblymember Ash Kalra, a Democrat from San Jos\u003cspan style=\"font-weight: 400\">é\u003c/span> and the author of the CalCare proposal, said Tuesday it could be 2024 before the tax increase proposal to pay for CalCare made it to the ballot.\u003c/p>\n\u003cp>An \u003ca href=\"https://calmatters.org/newsletters/whatmatters/2022/01/health-care-taxes-california/\">analysis from CalMatters\u003c/a> breaks down the proposed tax increase:\u003c/p>\n\u003cul>\n\u003cli>A 2.3% excise tax on businesses after their first $2 million in income\u003c/li>\n\u003cli>A 1.25% payroll tax on employers with 50-plus workers\u003c/li>\n\u003cli>An additional 1% payroll tax on wages for resident employees earning more than $49,900\u003c/li>\n\u003cli>A progressive income tax starting at 0.5% for Californians earning more than $149,500, up to 2.5% for people making about $2.5 million annually (with rates being adjusted for inflation)\u003c/li>\n\u003c/ul>\n\u003cp>The California Taxpayers Association, which opposes the plan, estimates it would raise taxes by about $163 billion per year.\u003c/p>\n\u003cp>“If government-run health care becomes law, millions of Californians will flee the state — either to avoid the $163 billion per year in new taxes or to escape the lengthy waits for care that will become the norm,” Assembly Republican Leader Marie Waldron said.\u003c/p>\n\u003cp>Even some Democrats who voted for the bill had sharp criticism for the proposal. Assemblymember Autumn Burke, a Democrat from Inglewood, said advancing the bill without a funding source made a mockery of the process.\u003c/p>\n\u003cp>“This bill has been sold to my community that it is going to change things now and that it is free. And neither one of those things are true,” she said.\u003c/p>\n\u003cp>Business groups, led by the California Chamber of Commerce, said the government-run health care system would be so expensive that the tax increase still wouldn’t be enough to pay for everything. In 2018, California’s total health care expenditures totaled $399.2 billion, accounting for 13.2% of the state’s gross domestic product, according to an analysis by the Healthy California for All Commission.\u003c/p>\n\u003cp>“Completely abolishing the current system in face of an unrelenting pandemic by annually taxing Californians hundreds of billions of dollars is not the solution,” said Preston Young, a policy advocate for the California Chamber of Commerce.\u003c/p>\n\u003cp>Kalra, the San Jos\u003cspan style=\"font-weight: 400\">é\u003c/span> Democrat and author of the proposal, said he knew opponents would focus on how much the plan would cost. But he said that argument distracts from the fact that Californians are already paying “the highest health tax in the world.”\u003c/p>\n\u003cp>“You may refer to it as premiums, deductibles, co-pays, denial of care,” Kalra said, saying none of those costs would exist under a universal health care system. “It’s clear as day they are being fleeced, and far too many understandably feel helpless about it.”\u003c/p>\n\u003cp>California’s health care system is paid for by multiple entities: patients, insurance companies, employers and government. But a universal health care system would be paid for by a single entity — the government, or the “single payer.”\u003c/p>\n\u003cp>A single-payer system has been a staple of California progressive political rhetoric for decades. But it’s not been easy to accomplish in a state where most people pay for private health insurance through their jobs. In 1994, voters overwhelmingly rejected a ballot initiative that would have created a universal health care system. Another attempt passed the state Senate in 2017, but it never got a vote in the state Assembly.\u003c/p>\n\u003cp>Questions about how to pay for a single-payer system have doomed previous plans. In 2011, Vermont enacted the nation’s first universal health care system in the country. But state officials abandoned it three years later because they said they couldn’t afford to pay for it.\u003c/p>\n\u003cp>[aside postID=news_11901253 hero='https://ww2.kqed.org/app/uploads/sites/10/2021/09/021_SanFrancisco_NewsomRecallEvent_09142021-1020x680.jpg']Gov. Gavin Newsom \u003ca href=\"https://calmatters.org/politics/2021/02/newsom-single-payer-health-care-dilemma/\">promised to do it when he ran for governor in 2018\u003c/a>, and voters elected him in a landslide. But in his first three years in office, Newsom has focused more on making sure everyone in California has health insurance. He has expanded Medi-Cal, the state’s health care program for lower-income Californians, to cover people 26 years old and younger and 50 years old and older, regardless of their immigration status. On Monday, \u003ca href=\"https://www.kqed.org/news/11901253/flush-with-cash-governor-newsom-wants-to-invest-in-pandemic-response-universal-health-access-fighting-inequality\">Newsom proposed extending Medi-Cal again, this time to all eligible Californians\u003c/a>, regardless of immigration status, older than 26 and younger than 50, at a potential cost of $2.7 billion per year.\u003c/p>\n\u003cp>Also on Monday, Newsom reiterated his support for a universal health care system, but declined to say whether he supported the plan in the Legislature \u003ca href=\"https://calmatters.org/newsletters/whatmatters/2022/01/california-health-insurance-newsom/\">because he said he had not read it\u003c/a>. Asked if he had “given up” on a universal health care system in California, Newsom pointed to a commission he founded that is examining such a system and how much it would cost.\u003c/p>\n\u003cp>He also said he’s working with President Joe Biden’s administration on the “flexibility” required for California to implement such a system.\u003c/p>\n\u003cp>“When you’re governor, you’ve got to be in the ‘how’ business,” Newsom said. “I believe in a single-payer financing model. The ‘how’ at the state level is the question that needs to be answered thoughtfully.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story includes reporting from Adam Beam of The Associated Press.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Updated 2 p.m. Wednesday\u003c/em>\u003c/p>\n\u003cp>California Democrats on Tuesday took their first step toward abolishing the private health insurance market in the nation’s most populous state and replacing it with a government-run plan that they promised would never deny anyone the care they need.\u003c/p>\n\u003cp>But the proposal that cleared a legislative committee in the state Assembly is still a long way from becoming law. Assembly Bill 1400, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220AB1400\">which would create a universal health care system called CalCare\u003c/a>, faces strong opposition from powerful business interests who say it would cost too much. And even if it does become law, voters would have to approve a \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220ACA11\">major income tax increase\u003c/a> to pay for it — a vote that might not happen until 2024.\u003c/p>\n\u003cp>Still, Democrats hailed Tuesday’s vote for jump-starting one of their long-stalled policy goals and signaling they won’t back away from a fight even during an election year. In an hours-long hearing, some lawmakers and advocates assailed a health care industry they say has benefited corporate interests at the expense of consumers.\u003c/p>\n\u003cp>Ady Barkan, a 38-year-old father of two, was diagnosed with ALS six years ago and now is mostly paralyzed. He testified at Tuesday’s hearing with the help of a computerized voice that spoke as he typed using technology that followed the movement of his eyes. Barkan said he has battled his private insurance carrier to get treatment he needed, including suing them to get a ventilator that keeps him alive.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Even good health insurance, which I have, does not cover the cost of the care I need to survive,” he said.\u003c/p>\n\u003cp>The bill that advanced on Tuesday would create the universal health care system — CalCare — and set its rules. It cleared the Assembly Health Committee on an 11-3 vote. Republicans voted no, arguing the bill would cost too much and pay doctors and nurses less, potentially worsening a shortage of health care workers.\u003c/p>\n\u003cp>Assemblymember Ash Kalra, a Democrat from San Jos\u003cspan style=\"font-weight: 400\">é\u003c/span> and the author of the CalCare proposal, said Tuesday it could be 2024 before the tax increase proposal to pay for CalCare made it to the ballot.\u003c/p>\n\u003cp>An \u003ca href=\"https://calmatters.org/newsletters/whatmatters/2022/01/health-care-taxes-california/\">analysis from CalMatters\u003c/a> breaks down the proposed tax increase:\u003c/p>\n\u003cul>\n\u003cli>A 2.3% excise tax on businesses after their first $2 million in income\u003c/li>\n\u003cli>A 1.25% payroll tax on employers with 50-plus workers\u003c/li>\n\u003cli>An additional 1% payroll tax on wages for resident employees earning more than $49,900\u003c/li>\n\u003cli>A progressive income tax starting at 0.5% for Californians earning more than $149,500, up to 2.5% for people making about $2.5 million annually (with rates being adjusted for inflation)\u003c/li>\n\u003c/ul>\n\u003cp>The California Taxpayers Association, which opposes the plan, estimates it would raise taxes by about $163 billion per year.\u003c/p>\n\u003cp>“If government-run health care becomes law, millions of Californians will flee the state — either to avoid the $163 billion per year in new taxes or to escape the lengthy waits for care that will become the norm,” Assembly Republican Leader Marie Waldron said.\u003c/p>\n\u003cp>Even some Democrats who voted for the bill had sharp criticism for the proposal. Assemblymember Autumn Burke, a Democrat from Inglewood, said advancing the bill without a funding source made a mockery of the process.\u003c/p>\n\u003cp>“This bill has been sold to my community that it is going to change things now and that it is free. And neither one of those things are true,” she said.\u003c/p>\n\u003cp>Business groups, led by the California Chamber of Commerce, said the government-run health care system would be so expensive that the tax increase still wouldn’t be enough to pay for everything. In 2018, California’s total health care expenditures totaled $399.2 billion, accounting for 13.2% of the state’s gross domestic product, according to an analysis by the Healthy California for All Commission.\u003c/p>\n\u003cp>“Completely abolishing the current system in face of an unrelenting pandemic by annually taxing Californians hundreds of billions of dollars is not the solution,” said Preston Young, a policy advocate for the California Chamber of Commerce.\u003c/p>\n\u003cp>Kalra, the San Jos\u003cspan style=\"font-weight: 400\">é\u003c/span> Democrat and author of the proposal, said he knew opponents would focus on how much the plan would cost. But he said that argument distracts from the fact that Californians are already paying “the highest health tax in the world.”\u003c/p>\n\u003cp>“You may refer to it as premiums, deductibles, co-pays, denial of care,” Kalra said, saying none of those costs would exist under a universal health care system. “It’s clear as day they are being fleeced, and far too many understandably feel helpless about it.”\u003c/p>\n\u003cp>California’s health care system is paid for by multiple entities: patients, insurance companies, employers and government. But a universal health care system would be paid for by a single entity — the government, or the “single payer.”\u003c/p>\n\u003cp>A single-payer system has been a staple of California progressive political rhetoric for decades. But it’s not been easy to accomplish in a state where most people pay for private health insurance through their jobs. In 1994, voters overwhelmingly rejected a ballot initiative that would have created a universal health care system. Another attempt passed the state Senate in 2017, but it never got a vote in the state Assembly.\u003c/p>\n\u003cp>Questions about how to pay for a single-payer system have doomed previous plans. In 2011, Vermont enacted the nation’s first universal health care system in the country. But state officials abandoned it three years later because they said they couldn’t afford to pay for it.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Gov. Gavin Newsom \u003ca href=\"https://calmatters.org/politics/2021/02/newsom-single-payer-health-care-dilemma/\">promised to do it when he ran for governor in 2018\u003c/a>, and voters elected him in a landslide. But in his first three years in office, Newsom has focused more on making sure everyone in California has health insurance. He has expanded Medi-Cal, the state’s health care program for lower-income Californians, to cover people 26 years old and younger and 50 years old and older, regardless of their immigration status. On Monday, \u003ca href=\"https://www.kqed.org/news/11901253/flush-with-cash-governor-newsom-wants-to-invest-in-pandemic-response-universal-health-access-fighting-inequality\">Newsom proposed extending Medi-Cal again, this time to all eligible Californians\u003c/a>, regardless of immigration status, older than 26 and younger than 50, at a potential cost of $2.7 billion per year.\u003c/p>\n\u003cp>Also on Monday, Newsom reiterated his support for a universal health care system, but declined to say whether he supported the plan in the Legislature \u003ca href=\"https://calmatters.org/newsletters/whatmatters/2022/01/california-health-insurance-newsom/\">because he said he had not read it\u003c/a>. Asked if he had “given up” on a universal health care system in California, Newsom pointed to a commission he founded that is examining such a system and how much it would cost.\u003c/p>\n\u003cp>He also said he’s working with President Joe Biden’s administration on the “flexibility” required for California to implement such a system.\u003c/p>\n\u003cp>“When you’re governor, you’ve got to be in the ‘how’ business,” Newsom said. “I believe in a single-payer financing model. The ‘how’ at the state level is the question that needs to be answered thoughtfully.”\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/leantesting_011022_final.png\">\u003cimg class=\"alignnone size-full wp-image-11901275\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/leantesting_011022_final.png\" alt='Cartoon: a three-legged stool with one leg, chopped shorter, that is labeled \"testi--.\" The other two legs read, \"masks\" and \"vaccines.\" Atop the stool is a small crowd of nervous people looking down as the stool leans toward covid virus.' width=\"1920\" height=\"1379\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/leantesting_011022_final.png 1920w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/leantesting_011022_final-800x575.png 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/leantesting_011022_final-1020x733.png 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/leantesting_011022_final-160x115.png 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/leantesting_011022_final-1536x1103.png 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003c/p>\n\u003cp>With COVID testing hard to come by, \u003ca href=\"https://bit.ly/fiorenewsombudgettesting\">the budget proposal Gov. Gavin Newsom released today includes $1.2 billion to expand capacity at testing sites\u003c/a> and distribute rapid tests across the state.\u003c/p>\n\u003cp>I still cannot believe that we are struggling to distribute rapid antigen tests and provide access to PCR testing this late in the game.\u003c/p>\n\u003cp>\u003ca href=\"https://www.sfchronicle.com/health/article/California-officials-warn-against-price-gouging-16761546.php\">From supply shortages to price gouging\u003c/a>, I'm beginning to suspect that capitalism may not be the best means for ending a deadly pandemic.\u003c/p>\n\u003cp>Let's hope Newsom's proposal makes it easier for people to get tested. In the meantime, \u003ca href=\"https://bit.ly/fiorecovidtesting\">here are some suggestions for finding a COVID test in the Bay Area\u003c/a>.\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/leantesting_011022_final.png\">\u003cimg class=\"alignnone size-full wp-image-11901275\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/leantesting_011022_final.png\" alt='Cartoon: a three-legged stool with one leg, chopped shorter, that is labeled \"testi--.\" The other two legs read, \"masks\" and \"vaccines.\" Atop the stool is a small crowd of nervous people looking down as the stool leans toward covid virus.' width=\"1920\" height=\"1379\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/01/leantesting_011022_final.png 1920w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/leantesting_011022_final-800x575.png 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/leantesting_011022_final-1020x733.png 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/leantesting_011022_final-160x115.png 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/01/leantesting_011022_final-1536x1103.png 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003c/p>\n\u003cp>With COVID testing hard to come by, \u003ca href=\"https://bit.ly/fiorenewsombudgettesting\">the budget proposal Gov. Gavin Newsom released today includes $1.2 billion to expand capacity at testing sites\u003c/a> and distribute rapid tests across the state.\u003c/p>\n\u003cp>I still cannot believe that we are struggling to distribute rapid antigen tests and provide access to PCR testing this late in the game.\u003c/p>\n\u003cp>\u003ca href=\"https://www.sfchronicle.com/health/article/California-officials-warn-against-price-gouging-16761546.php\">From supply shortages to price gouging\u003c/a>, I'm beginning to suspect that capitalism may not be the best means for ending a deadly pandemic.\u003c/p>\n\u003cp>Let's hope Newsom's proposal makes it easier for people to get tested. In the meantime, \u003ca href=\"https://bit.ly/fiorecovidtesting\">here are some suggestions for finding a COVID test in the Bay Area\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"radiolab": {
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"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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"reveal": {
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"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"order": 16
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},
"science-friday": {
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"info": "Science Friday is a weekly science talk show, broadcast live over public radio stations nationwide. Each week, the show focuses on science topics that are in the news and tries to bring an educated, balanced discussion to bear on the scientific issues at hand. Panels of expert guests join host Ira Flatow, a veteran science journalist, to discuss science and to take questions from listeners during the call-in portion of the program.",
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