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"content": "\u003cp>Emma Denice Milligan can be a prankster. Her warm eyes, big smile and wheelchair can be misleading, said her caregiver, Wanda Kincy. But Emma once crashed a wedding and helped herself to the food. Another time, she put herself on a plane from \u003ca href=\"https://www.kqed.org/news/tag/oakland\">Oakland\u003c/a> to Chicago to meet her high school sweetheart without telling her caregivers.\u003c/p>\n\u003cp>Kincy points two fingers at her own eyes and then at Milligan’s. “I know you,” she said with a grin.\u003c/p>\n\u003cp>Kincy arrives at the Oakland home Milligan shares with her aunt and uncle at 8 a.m., five days a week, staying until at least 10 p.m. and overnight on Thursdays and Fridays. She helps Milligan, 57, get dressed, bathed and ready for her adult day program. Kincy books Milligan’s paratransit rides, times medication reminders and keeps track of the small details that make her independence possible.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The care Kincy provides is covered through California’s Medicaid program, also known as Medi-Cal. Federal cuts have many advocates worried about the future of such care.\u003c/p>\n\u003cp>Under federal law, most home- and community-based services are optional benefits, meaning states can choose whether to include services like personal care in their Medicaid plans and how broadly to offer them.\u003c/p>\n\u003cp>In California, Medicaid covers in-home supportive services to Californians who are elderly, blind or disabled and would otherwise be at risk of nursing home placement. The federal government reimburses California for about half of the cost of IHSS.\u003c/p>\n\u003cfigure id=\"attachment_12070295\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12070295\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare2.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare2.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare2-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare2-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">In her Oakland home on Dec. 12, 2025, Emma Denice Milligan smiles at her caregiver, Wanda Kincy, as Kincy recounts how Milligan has coped with the death of her mother, Carolyn Milligan, a human rights activist who worked on housing rights in Chicago and served Black communities in Oakland, in 2023. \u003ccite>(Courtesy of Hyeyoon Cho)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In-home services enable Milligan’s family to hire Kincy to assist with daily personal care and household tasks so Milligan can remain safely in her family home.\u003c/p>\n\u003cp>“If I lose Wanda, then I would probably have to go to a facility,” she said. “People at the facility don’t care. I would be calling them for help, and they wouldn’t come. I’d be left alone and be wet all night, because I can’t go to the bathroom.”\u003c/p>\n\u003cp>Milligan has received IHSS on and off while living in both California and Chicago. In 2011, she moved to Oakland and has relied on the program continuously since. But there is a growing concern about how long the services can last.[aside postID=news_12068383 hero='https://ww2.kqed.org/app/uploads/sites/10/2020/04/001_KQED_Oakland_HighlandHospital_041152020-1020x680.jpg']In July, Congress approved roughly $1 trillion in Medicaid cuts over the next decade, beginning in 2026. Because the federal government pays roughly 54% of California’s total home- and community-based services costs, the impending cuts immediately raised alarm.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.whitehouse.gov/articles/2025/06/myth-vs-fact-the-one-big-beautiful-bill/\">White House\u003c/a> has said the budget package would not affect Medicaid coverage for people with disabilities. Advocates warn the changes will nonetheless fall heavily on home- and community-based services, which aren’t protected like nursing home services. They say optional services are often the first to be reduced.\u003c/p>\n\u003cp>Hagar Dickman, a senior attorney at Justice in Aging, said the risk to in-home services is not theoretical. During last year’s state budget negotiations, she said, Gov. Gavin Newsom’s administration initially looked to IHSS as one of the first areas to cut when facing a projected shortfall.\u003c/p>\n\u003cp>“In the May budget revision, home- and community-based services were immediately on the table,” Dickman said.\u003c/p>\n\u003cp>The budget proposed \u003ca href=\"https://calbudgetcenter.org/resources/first-look-understanding-the-governors-2025-26-may-revision/#h-revised-budget-fails-to-invest-in-older-adults-and-californians-with-disabilities\">over $1 billion\u003c/a> in mostly ongoing cuts to in-home supportive services, including limits on provider pay and hours and the elimination of benefits for certain groups. Although this was not adopted in the final budget, the plan for freezing Medi-Cal enrollment and ending IHSS eligibility for undocumented adults was adopted and is set to begin in 2026.\u003c/p>\n\u003cfigure id=\"attachment_12070297\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12070297\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare3.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare3.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare3-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare3-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Emma Denice Milligan jokes with Wanda Kincy in Ability Now, an Oakland-based adult day center for people with disabilities, on Nov. 20, 2025. \u003ccite>(Courtesy of Hyeyoon Cho)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Dickman said this episode underscored how quickly optional services can be targeted.\u003c/p>\n\u003cp>“When states are under pressure, they go after HCBS [home- and community-based services] first because they’re optional under federal law,” she said.\u003c/p>\n\u003cp>Congress has agreed to restructure \u003ca href=\"https://calbudgetcenter.org/resources/how-federal-funding-cuts-threaten-the-health-of-californians/\">Medicaid\u003c/a> by reducing the federal government’s share of reimbursements, restricting how states raise Medicaid revenue and imposing new eligibility checks, work requirements and exclusions for certain immigrant groups.\u003c/p>\n\u003cp>A recent analysis by the \u003ca href=\"https://www.chcf.org/wp-content/uploads/2025/10/HowCutsMediCalHomeCommunityBasedServicesImpactCA.pdf\">California Health Care Foundation \u003c/a>suggests the consequences could be costly. If the state reduces HCBS by 10% in response to federal cuts, California could face roughly $1 billion in added Medicaid expenses as more residents are moved into institutional settings.[aside postID=news_12068555 hero='https://ww2.kqed.org/app/uploads/sites/10/2022/07/GettyImages-1197447255-1020x680.jpg']“The federal Medicaid cuts are an absolute disaster for HCBS,” said Sabrina Epstein, a policy analyst at Disability Rights California. She said the cuts will push many people off Medicaid, leaving them without access to the only program that funds round-the-clock in-home support.\u003c/p>\n\u003cp>“People will be forced into nursing homes or left to rely on unpaid family care,” Epstein said.\u003c/p>\n\u003cp>During the Great Recession, the federal government gave states more money for Medicaid. Researchers at UCSF and the Disability Rights Education and Defense Fund \u003ca href=\"https://geigergibson.publichealth.gwu.edu/sites/g/files/zaxdzs4421/files/2025-04/Kaye%20HCBS%20Cuts%202010-2012%20%282%29%20%281%29.pdf\">examined what happened\u003c/a> when Congress ended enhanced federal Medicaid funding to states between 2010 and 2012.\u003c/p>\n\u003cp>Every state responded by cutting home- and community-based services in some way — reducing benefits, the number of people covered, or both. Waiting lists for home care grew across the country.\u003c/p>\n\u003cp>California will not be able to absorb the loss if federal Medicaid cuts take effect in 2026, said Mike Pereira, executive director of Ala Costa Centers in Berkeley, which offers adult day services to people with developmental disabilities.\u003c/p>\n\u003cp>“We’re all bracing,” he said. “We’re watching the sand run out of the hourglass.”\u003c/p>\n\u003ch2>Round-the-clock care\u003c/h2>\n\u003cp>Milligan’s bedroom is crowded but intentional. A metal lift helps get her out of bed. A tray table holds adaptive cups and utensils. Framed photographs line the walls: Emma smiling at family gatherings, dressed up for celebrations, captured at different points in her life. One large portrait shows her late mother smiling for the camera.\u003c/p>\n\u003cp>Milligan’s uncle, Austin Long-Scott, is in his 80s and has Parkinson’s disease, which has increasingly limited what he can physically do. His wife, Ethel, is also in her 80s and not able to do as much as she used to do for Milligan.\u003c/p>\n\u003cp>“We used to stay with her 24/7,” Austin Long-Scott said. “We can’t do that anymore.”\u003c/p>\n\u003cfigure id=\"attachment_12070294\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12070294\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare1.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare1.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare1-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Photos of Emma Denice Milligan with friends and pastors sit in the corner of her room in Oakland on Dec. 12, 2025. \u003ccite>(Courtesy of Hyeyoon Cho)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In October, Milligan had a setback, spending weeks in the hospital as doctors struggled to manage severe chest and stomach pain. Kincy often stayed with her, helping communicate with nurses and doctors, monitoring pain levels and watching for changes.\u003c/p>\n\u003cp>Without IHSS, Long-Scott said, their options would be grim. Paying out of pocket to retain Kincy would be financially overwhelming.\u003c/p>\n\u003cp>Without a caregiver, Milligan would not be able to speak at churches and community organizations about disability justice or connect domestic violence survivors with resources, advocacy that she’s been committed to for more than a decade.[aside postID=news_12069772 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/011426_SF-VA-CUTS-_GH_013-KQED.jpg']Kincy reads the statements Milligan writes and facilitates questions from the audience. Their coordination allows Milligan to remain active in her community.\u003c/p>\n\u003cp>“The two of them just bonded,” Long-Scott said. “It was almost instant.”\u003c/p>\n\u003cp>In the afternoons, Milligan attends Ability Now Bay Area, a center for people with disabilities. There, she is developing a business idea on adaptive clothing, which grew out of her daily care needs. She wants to design garments secured with snaps, magnets or velcro — clothing that can be put on and taken off with minimal movement.\u003c/p>\n\u003cp>Fridays leave small joys for Milligan: browsing with Kincy at Macy’s Backstage in Pleasanton or getting dumplings in Alameda. Recently, at an outlet store in Berkeley, Kincy used her charms to talk a cashier into reducing the price of a new jacket for Milligan by 15%. They were thrilled about the bargain.\u003c/p>\n\u003cp>Milligan appreciates Kincy and the programs that enable her to remain vibrant in her community. “People I meet at Ability Now and the community around me understand me. They can relate,” she said. “Wanda and I always crack up when we’re there. They bring a lot of joy.”\u003c/p>\n\u003cp>\u003cem>This story is part of \u003c/em>\u003ca href=\"https://archive.is/o/DQQxE/https:/hub.journalism.berkeley.edu/thestakes/\">\u003cem>“The Stakes,”\u003c/em>\u003c/a>\u003cem> a UC Berkeley Journalism project on executive orders and actions affecting Californians and their communities.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "After Congress approved roughly $1 trillion in Medicaid cuts over the next decade, California advocates are worried about the future of home-based care covered by Medi-Cal.\r\n",
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"title": "‘I’d Be Left Alone’: Medicaid Cuts Put Disabled Patients’ In-Home Care at Risk | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Emma Denice Milligan can be a prankster. Her warm eyes, big smile and wheelchair can be misleading, said her caregiver, Wanda Kincy. But Emma once crashed a wedding and helped herself to the food. Another time, she put herself on a plane from \u003ca href=\"https://www.kqed.org/news/tag/oakland\">Oakland\u003c/a> to Chicago to meet her high school sweetheart without telling her caregivers.\u003c/p>\n\u003cp>Kincy points two fingers at her own eyes and then at Milligan’s. “I know you,” she said with a grin.\u003c/p>\n\u003cp>Kincy arrives at the Oakland home Milligan shares with her aunt and uncle at 8 a.m., five days a week, staying until at least 10 p.m. and overnight on Thursdays and Fridays. She helps Milligan, 57, get dressed, bathed and ready for her adult day program. Kincy books Milligan’s paratransit rides, times medication reminders and keeps track of the small details that make her independence possible.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The care Kincy provides is covered through California’s Medicaid program, also known as Medi-Cal. Federal cuts have many advocates worried about the future of such care.\u003c/p>\n\u003cp>Under federal law, most home- and community-based services are optional benefits, meaning states can choose whether to include services like personal care in their Medicaid plans and how broadly to offer them.\u003c/p>\n\u003cp>In California, Medicaid covers in-home supportive services to Californians who are elderly, blind or disabled and would otherwise be at risk of nursing home placement. The federal government reimburses California for about half of the cost of IHSS.\u003c/p>\n\u003cfigure id=\"attachment_12070295\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12070295\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare2.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare2.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare2-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare2-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">In her Oakland home on Dec. 12, 2025, Emma Denice Milligan smiles at her caregiver, Wanda Kincy, as Kincy recounts how Milligan has coped with the death of her mother, Carolyn Milligan, a human rights activist who worked on housing rights in Chicago and served Black communities in Oakland, in 2023. \u003ccite>(Courtesy of Hyeyoon Cho)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In-home services enable Milligan’s family to hire Kincy to assist with daily personal care and household tasks so Milligan can remain safely in her family home.\u003c/p>\n\u003cp>“If I lose Wanda, then I would probably have to go to a facility,” she said. “People at the facility don’t care. I would be calling them for help, and they wouldn’t come. I’d be left alone and be wet all night, because I can’t go to the bathroom.”\u003c/p>\n\u003cp>Milligan has received IHSS on and off while living in both California and Chicago. In 2011, she moved to Oakland and has relied on the program continuously since. But there is a growing concern about how long the services can last.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>In July, Congress approved roughly $1 trillion in Medicaid cuts over the next decade, beginning in 2026. Because the federal government pays roughly 54% of California’s total home- and community-based services costs, the impending cuts immediately raised alarm.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.whitehouse.gov/articles/2025/06/myth-vs-fact-the-one-big-beautiful-bill/\">White House\u003c/a> has said the budget package would not affect Medicaid coverage for people with disabilities. Advocates warn the changes will nonetheless fall heavily on home- and community-based services, which aren’t protected like nursing home services. They say optional services are often the first to be reduced.\u003c/p>\n\u003cp>Hagar Dickman, a senior attorney at Justice in Aging, said the risk to in-home services is not theoretical. During last year’s state budget negotiations, she said, Gov. Gavin Newsom’s administration initially looked to IHSS as one of the first areas to cut when facing a projected shortfall.\u003c/p>\n\u003cp>“In the May budget revision, home- and community-based services were immediately on the table,” Dickman said.\u003c/p>\n\u003cp>The budget proposed \u003ca href=\"https://calbudgetcenter.org/resources/first-look-understanding-the-governors-2025-26-may-revision/#h-revised-budget-fails-to-invest-in-older-adults-and-californians-with-disabilities\">over $1 billion\u003c/a> in mostly ongoing cuts to in-home supportive services, including limits on provider pay and hours and the elimination of benefits for certain groups. Although this was not adopted in the final budget, the plan for freezing Medi-Cal enrollment and ending IHSS eligibility for undocumented adults was adopted and is set to begin in 2026.\u003c/p>\n\u003cfigure id=\"attachment_12070297\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12070297\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare3.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare3.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare3-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare3-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Emma Denice Milligan jokes with Wanda Kincy in Ability Now, an Oakland-based adult day center for people with disabilities, on Nov. 20, 2025. \u003ccite>(Courtesy of Hyeyoon Cho)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Dickman said this episode underscored how quickly optional services can be targeted.\u003c/p>\n\u003cp>“When states are under pressure, they go after HCBS [home- and community-based services] first because they’re optional under federal law,” she said.\u003c/p>\n\u003cp>Congress has agreed to restructure \u003ca href=\"https://calbudgetcenter.org/resources/how-federal-funding-cuts-threaten-the-health-of-californians/\">Medicaid\u003c/a> by reducing the federal government’s share of reimbursements, restricting how states raise Medicaid revenue and imposing new eligibility checks, work requirements and exclusions for certain immigrant groups.\u003c/p>\n\u003cp>A recent analysis by the \u003ca href=\"https://www.chcf.org/wp-content/uploads/2025/10/HowCutsMediCalHomeCommunityBasedServicesImpactCA.pdf\">California Health Care Foundation \u003c/a>suggests the consequences could be costly. If the state reduces HCBS by 10% in response to federal cuts, California could face roughly $1 billion in added Medicaid expenses as more residents are moved into institutional settings.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“The federal Medicaid cuts are an absolute disaster for HCBS,” said Sabrina Epstein, a policy analyst at Disability Rights California. She said the cuts will push many people off Medicaid, leaving them without access to the only program that funds round-the-clock in-home support.\u003c/p>\n\u003cp>“People will be forced into nursing homes or left to rely on unpaid family care,” Epstein said.\u003c/p>\n\u003cp>During the Great Recession, the federal government gave states more money for Medicaid. Researchers at UCSF and the Disability Rights Education and Defense Fund \u003ca href=\"https://geigergibson.publichealth.gwu.edu/sites/g/files/zaxdzs4421/files/2025-04/Kaye%20HCBS%20Cuts%202010-2012%20%282%29%20%281%29.pdf\">examined what happened\u003c/a> when Congress ended enhanced federal Medicaid funding to states between 2010 and 2012.\u003c/p>\n\u003cp>Every state responded by cutting home- and community-based services in some way — reducing benefits, the number of people covered, or both. Waiting lists for home care grew across the country.\u003c/p>\n\u003cp>California will not be able to absorb the loss if federal Medicaid cuts take effect in 2026, said Mike Pereira, executive director of Ala Costa Centers in Berkeley, which offers adult day services to people with developmental disabilities.\u003c/p>\n\u003cp>“We’re all bracing,” he said. “We’re watching the sand run out of the hourglass.”\u003c/p>\n\u003ch2>Round-the-clock care\u003c/h2>\n\u003cp>Milligan’s bedroom is crowded but intentional. A metal lift helps get her out of bed. A tray table holds adaptive cups and utensils. Framed photographs line the walls: Emma smiling at family gatherings, dressed up for celebrations, captured at different points in her life. One large portrait shows her late mother smiling for the camera.\u003c/p>\n\u003cp>Milligan’s uncle, Austin Long-Scott, is in his 80s and has Parkinson’s disease, which has increasingly limited what he can physically do. His wife, Ethel, is also in her 80s and not able to do as much as she used to do for Milligan.\u003c/p>\n\u003cp>“We used to stay with her 24/7,” Austin Long-Scott said. “We can’t do that anymore.”\u003c/p>\n\u003cfigure id=\"attachment_12070294\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12070294\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare1.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare1.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/InHomeCare1-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Photos of Emma Denice Milligan with friends and pastors sit in the corner of her room in Oakland on Dec. 12, 2025. \u003ccite>(Courtesy of Hyeyoon Cho)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In October, Milligan had a setback, spending weeks in the hospital as doctors struggled to manage severe chest and stomach pain. Kincy often stayed with her, helping communicate with nurses and doctors, monitoring pain levels and watching for changes.\u003c/p>\n\u003cp>Without IHSS, Long-Scott said, their options would be grim. Paying out of pocket to retain Kincy would be financially overwhelming.\u003c/p>\n\u003cp>Without a caregiver, Milligan would not be able to speak at churches and community organizations about disability justice or connect domestic violence survivors with resources, advocacy that she’s been committed to for more than a decade.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Kincy reads the statements Milligan writes and facilitates questions from the audience. Their coordination allows Milligan to remain active in her community.\u003c/p>\n\u003cp>“The two of them just bonded,” Long-Scott said. “It was almost instant.”\u003c/p>\n\u003cp>In the afternoons, Milligan attends Ability Now Bay Area, a center for people with disabilities. There, she is developing a business idea on adaptive clothing, which grew out of her daily care needs. She wants to design garments secured with snaps, magnets or velcro — clothing that can be put on and taken off with minimal movement.\u003c/p>\n\u003cp>Fridays leave small joys for Milligan: browsing with Kincy at Macy’s Backstage in Pleasanton or getting dumplings in Alameda. Recently, at an outlet store in Berkeley, Kincy used her charms to talk a cashier into reducing the price of a new jacket for Milligan by 15%. They were thrilled about the bargain.\u003c/p>\n\u003cp>Milligan appreciates Kincy and the programs that enable her to remain vibrant in her community. “People I meet at Ability Now and the community around me understand me. They can relate,” she said. “Wanda and I always crack up when we’re there. They bring a lot of joy.”\u003c/p>\n\u003cp>\u003cem>This story is part of \u003c/em>\u003ca href=\"https://archive.is/o/DQQxE/https:/hub.journalism.berkeley.edu/thestakes/\">\u003cem>“The Stakes,”\u003c/em>\u003c/a>\u003cem> a UC Berkeley Journalism project on executive orders and actions affecting Californians and their communities.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/california\">California\u003c/a> political leaders are rallying behind a Sonoma County doctor at the center of an interstate abortion dispute.\u003c/p>\n\u003cp>Louisiana officials have charged physician Dr. Rémy Coeytaux, a physician in Healdsburg, with providing abortion medication to a woman in the Gulf Coast state, where the procedure is banned. Leaders there asked California to send him back to face charges — a request Gov. Gavin Newsom refused, citing California laws designed to shield abortion providers from out-of-state prosecution.\u003c/p>\n\u003cp>The case tests how far abortion bans can reach beyond state borders — and the strength of California’s telemedicine abortion shield law, passed in September 2023. It’s part of a broader clash that’s deepened since the Supreme Court overturned Roe v. Wade in 2022, leaving states to chart opposing paths on abortion.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Louisiana should be ashamed for attempting to drag this country backward by criminalizing health care and threatening doctors for doing their jobs,” East Bay Assemblymember Mia Bonta said in a statement.\u003c/p>\n\u003cp>Coeytaux has not been charged in California in connection with the Louisiana allegations. He declined an interview request. In a statement provided by his attorney, Nancy Northup — president and CEO of abortion rights group Center for Reproductive Rights — wrote: “These allegations are just that: allegations. As such, they are unproven and should not be reported as fact.”\u003c/p>\n\u003cfigure id=\"attachment_11983101\" class=\"wp-caption aligncenter\" style=\"max-width: 1760px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11983101 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/abortion-pill-661e839c21f49.jpg\" alt=\"abortion pill\" width=\"1760\" height=\"1220\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/abortion-pill-661e839c21f49.jpg 1760w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/abortion-pill-661e839c21f49-800x555.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/abortion-pill-661e839c21f49-1020x707.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/abortion-pill-661e839c21f49-160x111.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/abortion-pill-661e839c21f49-1536x1065.jpg 1536w\" sizes=\"auto, (max-width: 1760px) 100vw, 1760px\">\u003cfigcaption class=\"wp-caption-text\">A combination pack of mifepristone (L) and misoprostol tablets, two medicines used together for abortions. \u003ccite>(Elisa Wells Plan C/AFP via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Northup argued the case reflects a broader conflict between states that protect abortion access and those that ban it. Louisiana is “going after doctors for allegedly harming women” while enforcing an abortion ban that “puts women’s lives at risk every day,” she said.\u003c/p>\n\u003cp>Doctors stress that abortion pills are widely used and safe, including when provided via telehealth. Many patients seek medication by mail because abortion is banned where they live.[aside postID=news_12069825 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/GettyImages-2244069197_qed.jpg']Legal experts say the case could have sweeping implications. Since the U.S. Supreme Court overturned Roe v. Wade in 2022, states have taken sharply divergent approaches to abortion.\u003c/p>\n\u003cp>California has passed a series of laws aimed at protecting providers and patients from out-of-state civil and criminal actions tied to abortion care. Louisiana, meanwhile, has one of the nation’s strictest abortion bans.\u003c/p>\n\u003cp>“Louisiana is a state that denies women the right to control their own bodies,” said Assemblymember Chris Rogers, who represents Sonoma County. “We will not accept their attempt to control when and how our medical professionals choose to render care as well.”\u003c/p>\n\u003cp>Rogers said the state went further by publicly posting the doctor’s personal information, a move he described as punitive and potentially dangerous.\u003c/p>\n\u003cp>Whether states can enforce their abortion laws beyond their borders is likely to face further court challenges. For now, California officials say they will not assist other states in prosecuting doctors for care that is legal here.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/california\">California\u003c/a> political leaders are rallying behind a Sonoma County doctor at the center of an interstate abortion dispute.\u003c/p>\n\u003cp>Louisiana officials have charged physician Dr. Rémy Coeytaux, a physician in Healdsburg, with providing abortion medication to a woman in the Gulf Coast state, where the procedure is banned. Leaders there asked California to send him back to face charges — a request Gov. Gavin Newsom refused, citing California laws designed to shield abortion providers from out-of-state prosecution.\u003c/p>\n\u003cp>The case tests how far abortion bans can reach beyond state borders — and the strength of California’s telemedicine abortion shield law, passed in September 2023. It’s part of a broader clash that’s deepened since the Supreme Court overturned Roe v. Wade in 2022, leaving states to chart opposing paths on abortion.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Louisiana should be ashamed for attempting to drag this country backward by criminalizing health care and threatening doctors for doing their jobs,” East Bay Assemblymember Mia Bonta said in a statement.\u003c/p>\n\u003cp>Coeytaux has not been charged in California in connection with the Louisiana allegations. He declined an interview request. In a statement provided by his attorney, Nancy Northup — president and CEO of abortion rights group Center for Reproductive Rights — wrote: “These allegations are just that: allegations. As such, they are unproven and should not be reported as fact.”\u003c/p>\n\u003cfigure id=\"attachment_11983101\" class=\"wp-caption aligncenter\" style=\"max-width: 1760px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11983101 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/abortion-pill-661e839c21f49.jpg\" alt=\"abortion pill\" width=\"1760\" height=\"1220\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/abortion-pill-661e839c21f49.jpg 1760w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/abortion-pill-661e839c21f49-800x555.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/abortion-pill-661e839c21f49-1020x707.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/abortion-pill-661e839c21f49-160x111.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/abortion-pill-661e839c21f49-1536x1065.jpg 1536w\" sizes=\"auto, (max-width: 1760px) 100vw, 1760px\">\u003cfigcaption class=\"wp-caption-text\">A combination pack of mifepristone (L) and misoprostol tablets, two medicines used together for abortions. \u003ccite>(Elisa Wells Plan C/AFP via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Northup argued the case reflects a broader conflict between states that protect abortion access and those that ban it. Louisiana is “going after doctors for allegedly harming women” while enforcing an abortion ban that “puts women’s lives at risk every day,” she said.\u003c/p>\n\u003cp>Doctors stress that abortion pills are widely used and safe, including when provided via telehealth. Many patients seek medication by mail because abortion is banned where they live.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Legal experts say the case could have sweeping implications. Since the U.S. Supreme Court overturned Roe v. Wade in 2022, states have taken sharply divergent approaches to abortion.\u003c/p>\n\u003cp>California has passed a series of laws aimed at protecting providers and patients from out-of-state civil and criminal actions tied to abortion care. Louisiana, meanwhile, has one of the nation’s strictest abortion bans.\u003c/p>\n\u003cp>“Louisiana is a state that denies women the right to control their own bodies,” said Assemblymember Chris Rogers, who represents Sonoma County. “We will not accept their attempt to control when and how our medical professionals choose to render care as well.”\u003c/p>\n\u003cp>Rogers said the state went further by publicly posting the doctor’s personal information, a move he described as punitive and potentially dangerous.\u003c/p>\n\u003cp>Whether states can enforce their abortion laws beyond their borders is likely to face further court challenges. For now, California officials say they will not assist other states in prosecuting doctors for care that is legal here.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "trump-eliminates-157-jobs-at-the-san-francisco-veterans-affairs-medical-center",
"title": "Trump Eliminates 157 Jobs at the San Francisco Veterans Affairs Medical Center",
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"content": "\u003cp>The \u003ca href=\"https://www.kqed.org/news/tag/donald-trump\">Trump\u003c/a> administration has cut over 157 open roles at the \u003ca href=\"https://www.kqed.org/news/tag/san-francisco\">San Francisco\u003c/a> Veterans Affairs Medical Center and outpatient clinics across the Bay Area.\u003c/p>\n\u003cp>That’s according to the Federal Unionists Network, an association of federal workers, who say these jobs are critical. The SFVAMC employs physicians, nurses, social workers, psychologists and other healthcare professionals.\u003c/p>\n\u003cp>Frontline VA workers, veterans and union representatives from the National Federation of Federal Employees held a rally outside the Medical Center at 4150 Clement St. in San Francisco on Wednesday afternoon to protest the cuts.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>They warned that cuts will weaken the VA health care system by translating into higher strain on the medical center in the form of “longer wait times, heavier patient loads, reduced services and increased safety risks for the veterans who rely on the VA for care”.\u003c/p>\n\u003cp>Mark Smith, an occupational therapist and the NFFE Local 1 Union president, said the positions lost include peer support specialists — veterans hired to support fellow veterans’ access to mental health treatment — as well as psychologists, therapists and nurses.\u003c/p>\n\u003cfigure id=\"attachment_12069822\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12069822\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/011426_SF-VA-CUTS-_GH_003-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/011426_SF-VA-CUTS-_GH_003-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/011426_SF-VA-CUTS-_GH_003-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/011426_SF-VA-CUTS-_GH_003-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Suzanne Gordon, an award-winning journalist and co-founder of the Veterans Healthcare Policy Institute, speaks during a rally opposing proposed staffing cuts at the San Francisco VA Medical Center on Jan. 14, 2026, in San Francisco. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>That includes the SFVAMC’s singular emergency room social worker position.\u003c/p>\n\u003cp>“I think that one is just ludicrous frankly … They help ensure veterans get the resources that they need when they’re in a crisis. This is absolutely going to have an impact on Bay Area veterans.”\u003c/p>\n\u003cp>This month, the U.S. Department of Veterans Affairs has begun the process of cutting up to 37,000 vacant positions nationwide in what government officials have called a \u003ca href=\"https://news.va.gov/press-room/va-launches-veterans-health-administration-reorganization/\">“reorganization”\u003c/a> of the VA health care system.\u003c/p>\n\u003cp>“Since March, we’ve been conducting a holistic review of the department centered on reducing bureaucracy and improving services to Veterans,” VA Secretary Doug Collins said in a \u003ca href=\"https://news.va.gov/press-room/va-to-reduce-staff-by-nearly-30k-by-end-of-fy2025/\">statement\u003c/a> in July. “As a result of our efforts, VA is headed in the right direction — both in terms of staff levels and customer service. A department-wide [Reduction in Force] is off the table, but that doesn’t mean we’re done improving VA. Our review has resulted in a host of new ideas for better serving Veterans that we will continue to pursue.”[aside postID=news_12068953 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/230913-ChildCareCenterEviction-007-BL_qed.jpg']Collins is expected to \u003ca href=\"https://www.veterans.senate.gov/2026/1/chairman-moran-announces-committee-hearing-with-secretary-collins-on-reorganization-of-va-healthcare-system\">testify\u003c/a> before the Senate Committee on Veterans Affairs on the details surrounding proposed changes on Jan. 28.\u003c/p>\n\u003cp>The nationwide cuts were announced in December, targeting positions that have been vacant for at least a year. The VA has argued that the dissolution of these positions will not negatively affect care.\u003c/p>\n\u003cp>“No VA employees are being removed, and this will have zero impact on veteran care,” VA Press Secretary Pete Kasperowicz said. He called the positions “mostly COVID-era roles that are no longer necessary.”\u003c/p>\n\u003cp>“That’s sort of like saying that, you know, you could throw out your fire extinguisher because your house hasn’t caught fire lately, and you have a sink and a bucket,” Smith said.\u003c/p>\n\u003cp>The sunny afternoon rally in San Francisco’s Land End drew honks and cheers from passing cars. Suzanne Gordon, co-founder of the Veterans Healthcare Policy Institute, told the crowd that the administration’s decision will strangle the system and kill patients.\u003c/p>\n\u003cp>“It’ll end up depriving them of healthcare because of staff cuts and capping cuts … Every healthcare system has vacant positions, but a healthy healthcare system fills them quickly.”\u003c/p>\n\u003cp>The San Francisco rally followed one in New York City \u003ca href=\"https://www.nationalnursesunited.org/press/nurses-and-veterans-to-rally-against-trump-plan-to-eliminate-hundreds-of-va-jobs-in-nyc\">last week\u003c/a>. Nurses and Veterans rallied in the Bronx against the Trump administration’s cuts, after the VA eliminated at least 383 veterans-related health care positions across the five boroughs.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The \u003ca href=\"https://www.kqed.org/news/tag/donald-trump\">Trump\u003c/a> administration has cut over 157 open roles at the \u003ca href=\"https://www.kqed.org/news/tag/san-francisco\">San Francisco\u003c/a> Veterans Affairs Medical Center and outpatient clinics across the Bay Area.\u003c/p>\n\u003cp>That’s according to the Federal Unionists Network, an association of federal workers, who say these jobs are critical. The SFVAMC employs physicians, nurses, social workers, psychologists and other healthcare professionals.\u003c/p>\n\u003cp>Frontline VA workers, veterans and union representatives from the National Federation of Federal Employees held a rally outside the Medical Center at 4150 Clement St. in San Francisco on Wednesday afternoon to protest the cuts.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>They warned that cuts will weaken the VA health care system by translating into higher strain on the medical center in the form of “longer wait times, heavier patient loads, reduced services and increased safety risks for the veterans who rely on the VA for care”.\u003c/p>\n\u003cp>Mark Smith, an occupational therapist and the NFFE Local 1 Union president, said the positions lost include peer support specialists — veterans hired to support fellow veterans’ access to mental health treatment — as well as psychologists, therapists and nurses.\u003c/p>\n\u003cfigure id=\"attachment_12069822\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12069822\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/011426_SF-VA-CUTS-_GH_003-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/011426_SF-VA-CUTS-_GH_003-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/011426_SF-VA-CUTS-_GH_003-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/011426_SF-VA-CUTS-_GH_003-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Suzanne Gordon, an award-winning journalist and co-founder of the Veterans Healthcare Policy Institute, speaks during a rally opposing proposed staffing cuts at the San Francisco VA Medical Center on Jan. 14, 2026, in San Francisco. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>That includes the SFVAMC’s singular emergency room social worker position.\u003c/p>\n\u003cp>“I think that one is just ludicrous frankly … They help ensure veterans get the resources that they need when they’re in a crisis. This is absolutely going to have an impact on Bay Area veterans.”\u003c/p>\n\u003cp>This month, the U.S. Department of Veterans Affairs has begun the process of cutting up to 37,000 vacant positions nationwide in what government officials have called a \u003ca href=\"https://news.va.gov/press-room/va-launches-veterans-health-administration-reorganization/\">“reorganization”\u003c/a> of the VA health care system.\u003c/p>\n\u003cp>“Since March, we’ve been conducting a holistic review of the department centered on reducing bureaucracy and improving services to Veterans,” VA Secretary Doug Collins said in a \u003ca href=\"https://news.va.gov/press-room/va-to-reduce-staff-by-nearly-30k-by-end-of-fy2025/\">statement\u003c/a> in July. “As a result of our efforts, VA is headed in the right direction — both in terms of staff levels and customer service. A department-wide [Reduction in Force] is off the table, but that doesn’t mean we’re done improving VA. Our review has resulted in a host of new ideas for better serving Veterans that we will continue to pursue.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Collins is expected to \u003ca href=\"https://www.veterans.senate.gov/2026/1/chairman-moran-announces-committee-hearing-with-secretary-collins-on-reorganization-of-va-healthcare-system\">testify\u003c/a> before the Senate Committee on Veterans Affairs on the details surrounding proposed changes on Jan. 28.\u003c/p>\n\u003cp>The nationwide cuts were announced in December, targeting positions that have been vacant for at least a year. The VA has argued that the dissolution of these positions will not negatively affect care.\u003c/p>\n\u003cp>“No VA employees are being removed, and this will have zero impact on veteran care,” VA Press Secretary Pete Kasperowicz said. He called the positions “mostly COVID-era roles that are no longer necessary.”\u003c/p>\n\u003cp>“That’s sort of like saying that, you know, you could throw out your fire extinguisher because your house hasn’t caught fire lately, and you have a sink and a bucket,” Smith said.\u003c/p>\n\u003cp>The sunny afternoon rally in San Francisco’s Land End drew honks and cheers from passing cars. Suzanne Gordon, co-founder of the Veterans Healthcare Policy Institute, told the crowd that the administration’s decision will strangle the system and kill patients.\u003c/p>\n\u003cp>“It’ll end up depriving them of healthcare because of staff cuts and capping cuts … Every healthcare system has vacant positions, but a healthy healthcare system fills them quickly.”\u003c/p>\n\u003cp>The San Francisco rally followed one in New York City \u003ca href=\"https://www.nationalnursesunited.org/press/nurses-and-veterans-to-rally-against-trump-plan-to-eliminate-hundreds-of-va-jobs-in-nyc\">last week\u003c/a>. Nurses and Veterans rallied in the Bronx against the Trump administration’s cuts, after the VA eliminated at least 383 veterans-related health care positions across the five boroughs.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>San Francisco Mayor \u003ca href=\"https://www.kqed.org/news/tag/daniel-lurie\">Daniel Lurie\u003c/a> is backing a proposed state law that would allow courts to authorize involuntary medication for people struggling with behavioral health issues.\u003c/p>\n\u003cp>Under current law, judges can order people to participate in assisted outpatient treatment, but they cannot require medication that officials said is “often essential” to stabilizing severe mental illness. This bill would allow courts to implement involuntary medication into an individual’s treatment plan “when clinically necessary,” and assign a psychiatrist to oversee case specifics like dosages and effectiveness over time.\u003c/p>\n\u003cp>Lurie, San Francisco Assemblymember Catherine Stefani — the bill’s author — and Supervisor Rafael Mandelman gathered with other local and state officials on the steps of City Hall on Monday to emphasize the need for additional care options for the city’s most vulnerable residents.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We have a situation where courts can mandate so-called treatment, but can’t actually mandate treatment like necessary medication that provides the relief that is desperately needed,” Stefani said. “The result is predictable: people fall off their care plans, they deteriorate, they cycle again through our emergency rooms, psychiatric holds, jails and back out onto the street. This is not compassion, it’s failure.”\u003c/p>\n\u003cp>The program marks the latest in the city’s recent efforts to curb a visible behavioral health crisis. Lurie last week announced the launch of the Rapid Enforcement, Support, Evaluation, and Triage Center — which offers an alternative to jail or hospitalization for individuals arrested for public intoxication. Last year, the mayor’s office consolidated the city’s 10 street outreach teams and opened a drop-in \u003ca href=\"https://www.kqed.org/news/12038376/tenderloin-welcomes-mental-health-clinic-demands-broader-city-action-on-homelessness\">mental health stabilization center\u003c/a> at 822 Geary Street in the Tenderloin as part of the city’s 2025 \u003ca href=\"https://www.kqed.org/news/12031581/first-look-sf-mayor-luries-yearlong-plan-homelessness-response\">Breaking the Cycle plan.\u003c/a>[aside postID=news_12068599 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-19-BL.jpg']“Too many people in San Francisco are falling into crisis when intervention could — and should — come sooner. At the center of this effort is a simple reality: Stability is the gateway to recovery,” Lurie said. “For many people with severe mental illness, medication is what allows treatment to work at all. Without it, housing placements fail, care plans break down, and crises repeat themselves — often with greater harm each time.”\u003c/p>\n\u003cp>Involuntary commitments and forced treatment of mental health in California \u003ca href=\"https://www.kqed.org/news/11944448/a-war-of-compassion-debate-over-forced-treatment-of-mental-illness-splits-california-liberals\">have long been controversial.\u003c/a> And past attempts by the city to place those struggling with mental health issues into involuntary medical treatment have been called “\u003ca href=\"https://www.sfchronicle.com/sf/article/modest-gains-effort-force-mentally-ill-treatment-20394450.php\">disappointing\u003c/a>” by city leaders — in part due to a shortage of facilities that can specifically address the combination of mental illness and addiction.\u003c/p>\n\u003cp>Officials are hopeful that this addition of medication authorization will provide care to individuals who may not need a full conservatorship.\u003c/p>\n\u003cp>“We certainly do not have the beds or the staffing capacity to provide full-blown conservatorships for all of those people,” Mandelman said. “So, this is a less-intrusive intervention to get medical care through assisted outpatient treatment to people who could benefit [from] it.”\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>San Francisco Mayor \u003ca href=\"https://www.kqed.org/news/tag/daniel-lurie\">Daniel Lurie\u003c/a> is backing a proposed state law that would allow courts to authorize involuntary medication for people struggling with behavioral health issues.\u003c/p>\n\u003cp>Under current law, judges can order people to participate in assisted outpatient treatment, but they cannot require medication that officials said is “often essential” to stabilizing severe mental illness. This bill would allow courts to implement involuntary medication into an individual’s treatment plan “when clinically necessary,” and assign a psychiatrist to oversee case specifics like dosages and effectiveness over time.\u003c/p>\n\u003cp>Lurie, San Francisco Assemblymember Catherine Stefani — the bill’s author — and Supervisor Rafael Mandelman gathered with other local and state officials on the steps of City Hall on Monday to emphasize the need for additional care options for the city’s most vulnerable residents.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We have a situation where courts can mandate so-called treatment, but can’t actually mandate treatment like necessary medication that provides the relief that is desperately needed,” Stefani said. “The result is predictable: people fall off their care plans, they deteriorate, they cycle again through our emergency rooms, psychiatric holds, jails and back out onto the street. This is not compassion, it’s failure.”\u003c/p>\n\u003cp>The program marks the latest in the city’s recent efforts to curb a visible behavioral health crisis. Lurie last week announced the launch of the Rapid Enforcement, Support, Evaluation, and Triage Center — which offers an alternative to jail or hospitalization for individuals arrested for public intoxication. Last year, the mayor’s office consolidated the city’s 10 street outreach teams and opened a drop-in \u003ca href=\"https://www.kqed.org/news/12038376/tenderloin-welcomes-mental-health-clinic-demands-broader-city-action-on-homelessness\">mental health stabilization center\u003c/a> at 822 Geary Street in the Tenderloin as part of the city’s 2025 \u003ca href=\"https://www.kqed.org/news/12031581/first-look-sf-mayor-luries-yearlong-plan-homelessness-response\">Breaking the Cycle plan.\u003c/a>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“Too many people in San Francisco are falling into crisis when intervention could — and should — come sooner. At the center of this effort is a simple reality: Stability is the gateway to recovery,” Lurie said. “For many people with severe mental illness, medication is what allows treatment to work at all. Without it, housing placements fail, care plans break down, and crises repeat themselves — often with greater harm each time.”\u003c/p>\n\u003cp>Involuntary commitments and forced treatment of mental health in California \u003ca href=\"https://www.kqed.org/news/11944448/a-war-of-compassion-debate-over-forced-treatment-of-mental-illness-splits-california-liberals\">have long been controversial.\u003c/a> And past attempts by the city to place those struggling with mental health issues into involuntary medical treatment have been called “\u003ca href=\"https://www.sfchronicle.com/sf/article/modest-gains-effort-force-mentally-ill-treatment-20394450.php\">disappointing\u003c/a>” by city leaders — in part due to a shortage of facilities that can specifically address the combination of mental illness and addiction.\u003c/p>\n\u003cp>Officials are hopeful that this addition of medication authorization will provide care to individuals who may not need a full conservatorship.\u003c/p>\n\u003cp>“We certainly do not have the beds or the staffing capacity to provide full-blown conservatorships for all of those people,” Mandelman said. “So, this is a less-intrusive intervention to get medical care through assisted outpatient treatment to people who could benefit [from] it.”\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Alex Alvarez said the whole event felt like a blur. On Dec. 4, the social worker was doing his typical rounds at Zuckerberg \u003ca href=\"https://www.kqed.org/news/tag/san-francisco\">San Francisco\u003c/a> General Hospital when he heard a commotion and saw the back of a man who appeared to be \u003ca href=\"https://www.kqed.org/news/12066248/stabbing-at-san-francisco-general-hospital-leaves-social-worker-in-critical-condition\">attacking his friend\u003c/a>.\u003c/p>\n\u003cp>Alvarez, who also goes by Alejandro, didn’t yet know the hooded attacker was a patient, the same one his colleagues had voiced safety concerns about multiple times after facing threats of violence. He didn’t yet know that the patient, who suffered from severe mental illness, was armed with a knife. He just knew he had to act quickly.\u003c/p>\n\u003cp>“I just bolt out, and I pull the guy off of him because I noticed no one is doing anything. But that’s likely because everyone saw what was already unfolding, and I didn’t from my vantage point, holding him from the back of his shirt,” Alvarez recalled recently. “And there I am in the hallway, he’s holding him and then he drops him. Nothing was catching up to me when I saw what was actually happening. I just kind of was in shock. And it was at that moment that I realized, oh shoot, he wasn’t punching him, he was actually stabbing him.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Alvarez had pulled 34-year-old Wilfredo Tortolero-Arriechi off Alberto Rangel, a 51-year-old beloved social worker at Ward 86, the historic HIV/AIDS clinic located in San Francisco General. In the moments that followed, medical staff hurried to provide life-saving care. But Rangel died of his injuries within two days, setting off a fierce debate over the hospital’s safety protocols.\u003c/p>\n\u003cp>The aftermath of the tragedy has been a whirlwind for the close-knit staff of Ward 86. The fatal stabbing has reignited frustration and fears among workers who told KQED that reports were made to the Department of Public Health, which oversees the hospital, about Tortolero-Arriechi’s concerning behavior and threats of violence leading up to the event.\u003c/p>\n\u003cfigure id=\"attachment_12066546\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12066546\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251209-SFGENERALMEMORIAL-06-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251209-SFGENERALMEMORIAL-06-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251209-SFGENERALMEMORIAL-06-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251209-SFGENERALMEMORIAL-06-BL-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A memorial for social worker Alberto Rangel, who was fatally stabbed on Dec. 4 at Zuckerberg San Francisco General Hospital, outside the hospital on Dec. 9, 2025. Rangel, 51, died two days after the attack, sparking renewed calls for improved safety at the facility. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Now, workers say they’ve been doubly traumatized by public reports they say unfairly portray what happened that afternoon in Ward 86, alongside demands from hospital leadership for them to stay silent and return to work as usual amid an ongoing investigation about the incident and events that led up to it.\u003c/p>\n\u003cp>“Hospital leadership and security were notified at least two weeks in advance that the patient had exhibited escalating instability, threats to stab healthcare workers, and increasingly violent threats documented by multiple providers. Providers expressed explicit fears for their safety,” reads \u003ca href=\"https://upte.org/statement\" target=\"_blank\" rel=\"noopener\">a new collective statement\u003c/a> aimed at hospital leadership and law enforcement from a group of several dozen Ward 86 staff members that was shared with KQED. “Despite these warnings, no clinic-wide safety plan was communicated to Ward 86.”\u003c/p>\n\u003cp>Officials at UC San Francisco, which runs the hospital with the Department of Public Health, did not respond to multiple requests for a response to the allegations.[aside postID=news_12066248 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/RS46625_009_SanFrancisco_Hospital_01142021-qut-1020x680.jpg']In a statement after the stabbing, the Sheriff’s Office said an on-site deputy “intervened immediately, restraining the suspect and securing the scene.”\u003c/p>\n\u003cp>The union representing sheriff’s deputies went a step further, placing a sponsored post in all-capital letters on Instagram saying that a “deputy sheriff saved Ward 86 from a rapid mass casualty stabbing.”\u003c/p>\n\u003cp>“This is exactly what deputy sheriffs are supposed to do on high-risk units: be close enough to stop an attack in progress and protect frontline healthcare workers,” Ken Lomba, president of the San Francisco Sheriff’s Association, said in a press release.\u003c/p>\n\u003cp>The Sheriff’s Office declined to comment for this story.\u003c/p>\n\u003cp>Alvarez, 32, said he sees the department’s sponsored post regularly, making it hard even to take a break from reality with a social media scroll. Both the post and the city’s official description feel like a blow on top of the trauma he’s still processing from that moment he jumped in to try to save Rangel, whom he looked up to as a fellow queer Latino on the ward.\u003c/p>\n\u003cp>Multiple Ward 86 social workers told KQED, some on the condition of anonymity, that Alvarez was the first person to intervene in the attack, and eyewitnesses said the suspect dropped the 5-inch knife after being pulled off Rangel, with a deputy intervening shortly afterward.\u003c/p>\n\u003cfigure id=\"attachment_12068514\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12068514\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-22-BL_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-22-BL_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-22-BL_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-22-BL_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Alex Alvarez, a clinical social worker, stands on a parking garage at UCSF Parnassus campus in San Francisco on Dec. 30, 2025. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Officials at UCSF directed Ward 86 staff not to discuss any aspects of the incident unless university legal counsel is present, according to an email reviewed by KQED.\u003c/p>\n\u003cp>“The sheriff’s deputy did not intervene immediately during the attack. Ward 86 staff — not law enforcement — physically intervened to stop the assault,” reads the collective statement from staff. “The attacker remained unrestrained for several minutes after the assault ended.\u003c/p>\n\u003cp>Staff had to repeatedly direct the deputy to remove the attacker from the scene.”\u003c/p>\n\u003cp>Tortolero-Arriechi allegedly stabbed Rangel in the shoulder and neck. He has been charged with murder in connection with the fatal stabbing, according to the District Attorney’s office, and he is scheduled to enter a plea on Wednesday. After his arrest, he was hospitalized at San Francisco General and was recently discharged from the psychiatric ward and transferred to county jail.\u003c/p>\n\u003cp>“A life was lost, and that is never something we take lightly. I give my condolences to Mr. Rangel’s family, friends, and colleagues,” his attorney, Deputy Public Defender Sylvia Nguyen, said in an email. “Being a social worker — working behind the scenes in all aspects of medical care, serving residents who are most in need of resources and support — is often a thankless job that people do out of the goodness of their hearts. It’s clear he made an impact on so many lives.”\u003c/p>\n\u003cfigure id=\"attachment_12066544\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12066544 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251209-SFGENERALMEMORIAL-01-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251209-SFGENERALMEMORIAL-01-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251209-SFGENERALMEMORIAL-01-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251209-SFGENERALMEMORIAL-01-BL-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A memorial for social worker Alberto Rangel, who was fatally stabbed on Dec. 4 at Zuckerberg San Francisco General Hospital, outside the hospital on Dec. 9, 2025. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The hospital has increased security and law enforcement presence in the ward, which did not have metal detectors prior to the incident, by tightening control over access points and adding weapon-detection technology.\u003c/p>\n\u003cp>“We are implementing immediate security enhancements to protect staff and patients, while also advancing long-term structural changes to prevent future incidents,” a spokesperson for the Department of Public Health said in an email. “In addition, the city is engaging an independent security firm to objectively review the Ward 86 incident and our safety practices systemwide. These assessments will inform both immediate corrective actions and long-term investments.”\u003c/p>\n\u003cp>The city reported the incident to the California Department of Public Health, Cal/OSHA and the Joint Commission, which evaluates and accredits healthcare organizations.\u003c/p>\n\u003cp>One social worker said the hospital made some crisis counselors available and told workers they can visit San Francisco General’s trauma and recovery center for group processing sessions, but accessing those services has not been straightforward.\u003c/p>\n\u003cp>In the meantime, staff have been told to report back to work, with a welcome breakfast scheduled for this morning. Several said they still don’t feel safe enough to return yet.\u003c/p>\n\u003cfigure id=\"attachment_12068508\" class=\"wp-caption aligncenter\" style=\"max-width: 1999px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12068508\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-07-BL_qed.jpg\" alt=\"\" width=\"1999\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-07-BL_qed.jpg 1999w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-07-BL_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-07-BL_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1999px) 100vw, 1999px\">\u003cfigcaption class=\"wp-caption-text\">Lindsay Felten sits in her apartment on Dec. 20, 2025. Her colleague Alberto Rangel was fatally stabbed at Zuckerberg San Francisco General Hospital on Dec. 4, 2025. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“My colleagues and myself experienced a really traumatic incident that should have been prevented,” said Lindsay Felten, a clinical social worker at Ward 86. She said that the lack of support from management has felt like “adding salt to a wound.”\u003c/p>\n\u003cp>Felten and other Ward 86 staff are calling for protected time off, as many are now navigating both the trauma of the event and paperwork for additional therapy needs and workers’ compensation. Others are dipping into their sick leave and vacation bank to give themselves more time to heal.\u003c/p>\n\u003cp>“We’re being told they did everything they could, that the sheriff saved the day, when the way we see it is like we showed up for ourselves,” Felten said. “We kept our other patients and colleagues safe.”\u003c/p>\n\u003cp>Alvarez is seeking workers’ compensation and has yet to return to the ward. “I’ve been too nervous to go back,” he said. “I will avoid the area. I don’t even drive by it.”\u003c/p>\n\u003cp>Threats and risky situations were not uncommon at San Francisco General before the incident last month. The hospital is known as a “safety net” for many of the city’s most vulnerable, and that often means taking in patients who are turned away from other places due to behavior, needs or because they are on Medi-Cal.\u003c/p>\n\u003cfigure id=\"attachment_12068507\" class=\"wp-caption aligncenter\" style=\"max-width: 1999px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12068507\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-02-BL_qed.jpg\" alt=\"\" width=\"1999\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-02-BL_qed.jpg 1999w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-02-BL_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-02-BL_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1999px) 100vw, 1999px\">\u003cfigcaption class=\"wp-caption-text\">An altar honoring Alberto Rangel sits in Lindsay Felten’s apartment on Dec. 20, 2025. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Ward 86 started as the first-ever dedicated HIV/AIDS outpatient clinic in 1983, at a time when the government and many medical institutions turned a blind eye to the epidemic.\u003c/p>\n\u003cp>The clinic still performs essential HIV care, and over the years, the population it serves has grown increasingly complex. Many patients are extremely low-income and come in with dual diagnoses, including substance use disorder and other mental health challenges.\u003c/p>\n\u003cp>The fatal stabbing has intensified debate over hospital security for both workers and patients.\u003c/p>\n\u003cp>Alvarez, who was in the midst of finals for pre-med classes he’s taking at City College at the time of the attack, wishes there was more he could do in Rangel’s final moments. He’s hoping to one day become a physician’s assistant or doctor.\u003c/p>\n\u003cp>“It cemented,” he said, “why I want to do this.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"title": "‘Salt to a Wound’: Social Workers Still Reeling in Aftermath of Ward 86 Stabbing | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Alex Alvarez said the whole event felt like a blur. On Dec. 4, the social worker was doing his typical rounds at Zuckerberg \u003ca href=\"https://www.kqed.org/news/tag/san-francisco\">San Francisco\u003c/a> General Hospital when he heard a commotion and saw the back of a man who appeared to be \u003ca href=\"https://www.kqed.org/news/12066248/stabbing-at-san-francisco-general-hospital-leaves-social-worker-in-critical-condition\">attacking his friend\u003c/a>.\u003c/p>\n\u003cp>Alvarez, who also goes by Alejandro, didn’t yet know the hooded attacker was a patient, the same one his colleagues had voiced safety concerns about multiple times after facing threats of violence. He didn’t yet know that the patient, who suffered from severe mental illness, was armed with a knife. He just knew he had to act quickly.\u003c/p>\n\u003cp>“I just bolt out, and I pull the guy off of him because I noticed no one is doing anything. But that’s likely because everyone saw what was already unfolding, and I didn’t from my vantage point, holding him from the back of his shirt,” Alvarez recalled recently. “And there I am in the hallway, he’s holding him and then he drops him. Nothing was catching up to me when I saw what was actually happening. I just kind of was in shock. And it was at that moment that I realized, oh shoot, he wasn’t punching him, he was actually stabbing him.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Alvarez had pulled 34-year-old Wilfredo Tortolero-Arriechi off Alberto Rangel, a 51-year-old beloved social worker at Ward 86, the historic HIV/AIDS clinic located in San Francisco General. In the moments that followed, medical staff hurried to provide life-saving care. But Rangel died of his injuries within two days, setting off a fierce debate over the hospital’s safety protocols.\u003c/p>\n\u003cp>The aftermath of the tragedy has been a whirlwind for the close-knit staff of Ward 86. The fatal stabbing has reignited frustration and fears among workers who told KQED that reports were made to the Department of Public Health, which oversees the hospital, about Tortolero-Arriechi’s concerning behavior and threats of violence leading up to the event.\u003c/p>\n\u003cfigure id=\"attachment_12066546\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12066546\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251209-SFGENERALMEMORIAL-06-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251209-SFGENERALMEMORIAL-06-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251209-SFGENERALMEMORIAL-06-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251209-SFGENERALMEMORIAL-06-BL-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A memorial for social worker Alberto Rangel, who was fatally stabbed on Dec. 4 at Zuckerberg San Francisco General Hospital, outside the hospital on Dec. 9, 2025. Rangel, 51, died two days after the attack, sparking renewed calls for improved safety at the facility. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Now, workers say they’ve been doubly traumatized by public reports they say unfairly portray what happened that afternoon in Ward 86, alongside demands from hospital leadership for them to stay silent and return to work as usual amid an ongoing investigation about the incident and events that led up to it.\u003c/p>\n\u003cp>“Hospital leadership and security were notified at least two weeks in advance that the patient had exhibited escalating instability, threats to stab healthcare workers, and increasingly violent threats documented by multiple providers. Providers expressed explicit fears for their safety,” reads \u003ca href=\"https://upte.org/statement\" target=\"_blank\" rel=\"noopener\">a new collective statement\u003c/a> aimed at hospital leadership and law enforcement from a group of several dozen Ward 86 staff members that was shared with KQED. “Despite these warnings, no clinic-wide safety plan was communicated to Ward 86.”\u003c/p>\n\u003cp>Officials at UC San Francisco, which runs the hospital with the Department of Public Health, did not respond to multiple requests for a response to the allegations.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>In a statement after the stabbing, the Sheriff’s Office said an on-site deputy “intervened immediately, restraining the suspect and securing the scene.”\u003c/p>\n\u003cp>The union representing sheriff’s deputies went a step further, placing a sponsored post in all-capital letters on Instagram saying that a “deputy sheriff saved Ward 86 from a rapid mass casualty stabbing.”\u003c/p>\n\u003cp>“This is exactly what deputy sheriffs are supposed to do on high-risk units: be close enough to stop an attack in progress and protect frontline healthcare workers,” Ken Lomba, president of the San Francisco Sheriff’s Association, said in a press release.\u003c/p>\n\u003cp>The Sheriff’s Office declined to comment for this story.\u003c/p>\n\u003cp>Alvarez, 32, said he sees the department’s sponsored post regularly, making it hard even to take a break from reality with a social media scroll. Both the post and the city’s official description feel like a blow on top of the trauma he’s still processing from that moment he jumped in to try to save Rangel, whom he looked up to as a fellow queer Latino on the ward.\u003c/p>\n\u003cp>Multiple Ward 86 social workers told KQED, some on the condition of anonymity, that Alvarez was the first person to intervene in the attack, and eyewitnesses said the suspect dropped the 5-inch knife after being pulled off Rangel, with a deputy intervening shortly afterward.\u003c/p>\n\u003cfigure id=\"attachment_12068514\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12068514\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-22-BL_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-22-BL_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-22-BL_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-22-BL_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Alex Alvarez, a clinical social worker, stands on a parking garage at UCSF Parnassus campus in San Francisco on Dec. 30, 2025. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Officials at UCSF directed Ward 86 staff not to discuss any aspects of the incident unless university legal counsel is present, according to an email reviewed by KQED.\u003c/p>\n\u003cp>“The sheriff’s deputy did not intervene immediately during the attack. Ward 86 staff — not law enforcement — physically intervened to stop the assault,” reads the collective statement from staff. “The attacker remained unrestrained for several minutes after the assault ended.\u003c/p>\n\u003cp>Staff had to repeatedly direct the deputy to remove the attacker from the scene.”\u003c/p>\n\u003cp>Tortolero-Arriechi allegedly stabbed Rangel in the shoulder and neck. He has been charged with murder in connection with the fatal stabbing, according to the District Attorney’s office, and he is scheduled to enter a plea on Wednesday. After his arrest, he was hospitalized at San Francisco General and was recently discharged from the psychiatric ward and transferred to county jail.\u003c/p>\n\u003cp>“A life was lost, and that is never something we take lightly. I give my condolences to Mr. Rangel’s family, friends, and colleagues,” his attorney, Deputy Public Defender Sylvia Nguyen, said in an email. “Being a social worker — working behind the scenes in all aspects of medical care, serving residents who are most in need of resources and support — is often a thankless job that people do out of the goodness of their hearts. It’s clear he made an impact on so many lives.”\u003c/p>\n\u003cfigure id=\"attachment_12066544\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12066544 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251209-SFGENERALMEMORIAL-01-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251209-SFGENERALMEMORIAL-01-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251209-SFGENERALMEMORIAL-01-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251209-SFGENERALMEMORIAL-01-BL-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A memorial for social worker Alberto Rangel, who was fatally stabbed on Dec. 4 at Zuckerberg San Francisco General Hospital, outside the hospital on Dec. 9, 2025. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The hospital has increased security and law enforcement presence in the ward, which did not have metal detectors prior to the incident, by tightening control over access points and adding weapon-detection technology.\u003c/p>\n\u003cp>“We are implementing immediate security enhancements to protect staff and patients, while also advancing long-term structural changes to prevent future incidents,” a spokesperson for the Department of Public Health said in an email. “In addition, the city is engaging an independent security firm to objectively review the Ward 86 incident and our safety practices systemwide. These assessments will inform both immediate corrective actions and long-term investments.”\u003c/p>\n\u003cp>The city reported the incident to the California Department of Public Health, Cal/OSHA and the Joint Commission, which evaluates and accredits healthcare organizations.\u003c/p>\n\u003cp>One social worker said the hospital made some crisis counselors available and told workers they can visit San Francisco General’s trauma and recovery center for group processing sessions, but accessing those services has not been straightforward.\u003c/p>\n\u003cp>In the meantime, staff have been told to report back to work, with a welcome breakfast scheduled for this morning. Several said they still don’t feel safe enough to return yet.\u003c/p>\n\u003cfigure id=\"attachment_12068508\" class=\"wp-caption aligncenter\" style=\"max-width: 1999px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12068508\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-07-BL_qed.jpg\" alt=\"\" width=\"1999\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-07-BL_qed.jpg 1999w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-07-BL_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-07-BL_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1999px) 100vw, 1999px\">\u003cfigcaption class=\"wp-caption-text\">Lindsay Felten sits in her apartment on Dec. 20, 2025. Her colleague Alberto Rangel was fatally stabbed at Zuckerberg San Francisco General Hospital on Dec. 4, 2025. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“My colleagues and myself experienced a really traumatic incident that should have been prevented,” said Lindsay Felten, a clinical social worker at Ward 86. She said that the lack of support from management has felt like “adding salt to a wound.”\u003c/p>\n\u003cp>Felten and other Ward 86 staff are calling for protected time off, as many are now navigating both the trauma of the event and paperwork for additional therapy needs and workers’ compensation. Others are dipping into their sick leave and vacation bank to give themselves more time to heal.\u003c/p>\n\u003cp>“We’re being told they did everything they could, that the sheriff saved the day, when the way we see it is like we showed up for ourselves,” Felten said. “We kept our other patients and colleagues safe.”\u003c/p>\n\u003cp>Alvarez is seeking workers’ compensation and has yet to return to the ward. “I’ve been too nervous to go back,” he said. “I will avoid the area. I don’t even drive by it.”\u003c/p>\n\u003cp>Threats and risky situations were not uncommon at San Francisco General before the incident last month. The hospital is known as a “safety net” for many of the city’s most vulnerable, and that often means taking in patients who are turned away from other places due to behavior, needs or because they are on Medi-Cal.\u003c/p>\n\u003cfigure id=\"attachment_12068507\" class=\"wp-caption aligncenter\" style=\"max-width: 1999px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12068507\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-02-BL_qed.jpg\" alt=\"\" width=\"1999\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-02-BL_qed.jpg 1999w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-02-BL_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/251230-SFSocialWorker-02-BL_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1999px) 100vw, 1999px\">\u003cfigcaption class=\"wp-caption-text\">An altar honoring Alberto Rangel sits in Lindsay Felten’s apartment on Dec. 20, 2025. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Ward 86 started as the first-ever dedicated HIV/AIDS outpatient clinic in 1983, at a time when the government and many medical institutions turned a blind eye to the epidemic.\u003c/p>\n\u003cp>The clinic still performs essential HIV care, and over the years, the population it serves has grown increasingly complex. Many patients are extremely low-income and come in with dual diagnoses, including substance use disorder and other mental health challenges.\u003c/p>\n\u003cp>The fatal stabbing has intensified debate over hospital security for both workers and patients.\u003c/p>\n\u003cp>Alvarez, who was in the midst of finals for pre-med classes he’s taking at City College at the time of the attack, wishes there was more he could do in Rangel’s final moments. He’s hoping to one day become a physician’s assistant or doctor.\u003c/p>\n\u003cp>“It cemented,” he said, “why I want to do this.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "South Bay Lawmaker Slams Trump Admin’s $1.6 Million Hepatitis B Study in West Africa",
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"content": "\u003cp>A \u003ca href=\"https://www.kqed.org/news/tag/zoe-lofgren\">Bay Area lawmaker\u003c/a> slammed a Trump administration plan to conduct research on the Hepatitis B vaccine on infants in Guinea-Bissau, where nearly one in five adults lives with the virus.\u003c/p>\n\u003cp> The grant, awarded to a group of Danish scientists with ties to the anti-vaccine movement, will fund a five-year randomized control trial in the West African nation. According to the House Science, Space, and Technology Committee, 14,000 newborns will either receive the vaccine at birth or after a six-week delay to compare health outcomes.\u003c/p>\n\u003cp>South Bay Rep. Zoe Lofgren (D-San José) called the decision to approve the $1.6 million dollar study — which followed the Centers for Disease Control and Prevention rollback of newborn Hepatitis B vaccine recommendations last week — “deplorable” and a “new low.” \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In a statement released Friday, Lofgren alleged the study is being used to promote U.S. Health Secretary Robert F. Kennedy Jr.’s “anti-vaccine agenda.”\u003c/p>\n\u003cp>“To withhold a lifesaving vaccine from babies across the globe to promote your anti-vaccine agenda at home is deplorable,” Lofgren said. “How has it come to this? RFK Jr. must be stopped.”\u003c/p>\n\u003cp>Since 1991, the CDC recommended newborns receive the Hepatitis B vaccine within 24 hours of birth. \u003c/p>\n\u003cfigure id=\"attachment_11901022\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981.jpg\" alt=\"\" width=\"1024\" height=\"683\" class=\"size-full wp-image-11901022\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981.jpg 1024w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981-160x107.jpg 160w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rep. Zoe Lofgren (D-CA) speaks at a news conference at the U.S. Capitol on Sept. 21, 2021 in Washington, DC. \u003ccite>(Kevin Dietsch/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In an email, U.S. Department of Health and Human Services spokesperson Emily G. Hilliard defended the award as an independent study designed to fill “evidence gaps” regarding the “broader health effects” of the vaccine. Hilliard noted that because Guinea-Bissau does not plan to officially introduce the birth dose until 2027, the infants not receiving the shot are still receiving the “current standard of care.”\u003c/p>\n\u003cp>Local medical experts, however, say the science behind the birth dose is already settled. Dr. Jake Scott, an infectious disease specialist at Stanford University, said waiting six weeks to vaccinate newborns in a region where Hepatitis B is common will lead to “preventable infections.”\u003c/p>\n\u003cp>According to Scott, infants infected at birth have about a 90% chance of developing chronic hepatitis, which can lead to liver failure and cancer. He said the administration is attempting to “manufacture doubt” to justify the recent rollbacks.[aside postID=news_12068383 hero='https://ww2.kqed.org/app/uploads/sites/10/2020/04/001_KQED_Oakland_HighlandHospital_041152020-1020x680.jpg']“They’re doing that to generate evidence for a policy they have already implemented,” Scott said. “It’s clearly going to cause far more harm than any benefits.”\u003c/p>\n\u003cp>Scott estimated that if the birth dose is successfully rolled back on a larger scale, it could lead to 1,400 additional chronic pediatric infections and nearly 500 preventable deaths annually.\u003c/p>\n\u003cp>According to background information from the House Science Committee staff, the research group did not apply for an award through a standard competitive process; instead, staff said Kennedy specifically sought out the researchers.\u003c/p>\n\u003cp>“The typical way of going about it is to put out a request for proposal … and fund the most rigorous study,” Arthur Reingold, a former professor of epidemiology at UC Berkeley and a former Chief of the Respiratory Diseases Branch at the CDC, said. “Obviously, that was not done in this case.”\u003c/p>\n\u003cp>Reingold added that without a detailed study protocol, it is impossible to know if the trial can actually measure the “broader health effects” HHS claims to be looking for. He warned that if a study lacks the statistical power to answer important questions, it is a “waste of money.”\u003c/p>\n\u003cp>The House Science Committee stated it is considering all oversight options, though staff noted their authority is currently limited by their status in the Minority.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A \u003ca href=\"https://www.kqed.org/news/tag/zoe-lofgren\">Bay Area lawmaker\u003c/a> slammed a Trump administration plan to conduct research on the Hepatitis B vaccine on infants in Guinea-Bissau, where nearly one in five adults lives with the virus.\u003c/p>\n\u003cp> The grant, awarded to a group of Danish scientists with ties to the anti-vaccine movement, will fund a five-year randomized control trial in the West African nation. According to the House Science, Space, and Technology Committee, 14,000 newborns will either receive the vaccine at birth or after a six-week delay to compare health outcomes.\u003c/p>\n\u003cp>South Bay Rep. Zoe Lofgren (D-San José) called the decision to approve the $1.6 million dollar study — which followed the Centers for Disease Control and Prevention rollback of newborn Hepatitis B vaccine recommendations last week — “deplorable” and a “new low.” \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In a statement released Friday, Lofgren alleged the study is being used to promote U.S. Health Secretary Robert F. Kennedy Jr.’s “anti-vaccine agenda.”\u003c/p>\n\u003cp>“To withhold a lifesaving vaccine from babies across the globe to promote your anti-vaccine agenda at home is deplorable,” Lofgren said. “How has it come to this? RFK Jr. must be stopped.”\u003c/p>\n\u003cp>Since 1991, the CDC recommended newborns receive the Hepatitis B vaccine within 24 hours of birth. \u003c/p>\n\u003cfigure id=\"attachment_11901022\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981.jpg\" alt=\"\" width=\"1024\" height=\"683\" class=\"size-full wp-image-11901022\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981.jpg 1024w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981-160x107.jpg 160w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rep. Zoe Lofgren (D-CA) speaks at a news conference at the U.S. Capitol on Sept. 21, 2021 in Washington, DC. \u003ccite>(Kevin Dietsch/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In an email, U.S. Department of Health and Human Services spokesperson Emily G. Hilliard defended the award as an independent study designed to fill “evidence gaps” regarding the “broader health effects” of the vaccine. Hilliard noted that because Guinea-Bissau does not plan to officially introduce the birth dose until 2027, the infants not receiving the shot are still receiving the “current standard of care.”\u003c/p>\n\u003cp>Local medical experts, however, say the science behind the birth dose is already settled. Dr. Jake Scott, an infectious disease specialist at Stanford University, said waiting six weeks to vaccinate newborns in a region where Hepatitis B is common will lead to “preventable infections.”\u003c/p>\n\u003cp>According to Scott, infants infected at birth have about a 90% chance of developing chronic hepatitis, which can lead to liver failure and cancer. He said the administration is attempting to “manufacture doubt” to justify the recent rollbacks.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“They’re doing that to generate evidence for a policy they have already implemented,” Scott said. “It’s clearly going to cause far more harm than any benefits.”\u003c/p>\n\u003cp>Scott estimated that if the birth dose is successfully rolled back on a larger scale, it could lead to 1,400 additional chronic pediatric infections and nearly 500 preventable deaths annually.\u003c/p>\n\u003cp>According to background information from the House Science Committee staff, the research group did not apply for an award through a standard competitive process; instead, staff said Kennedy specifically sought out the researchers.\u003c/p>\n\u003cp>“The typical way of going about it is to put out a request for proposal … and fund the most rigorous study,” Arthur Reingold, a former professor of epidemiology at UC Berkeley and a former Chief of the Respiratory Diseases Branch at the CDC, said. “Obviously, that was not done in this case.”\u003c/p>\n\u003cp>Reingold added that without a detailed study protocol, it is impossible to know if the trial can actually measure the “broader health effects” HHS claims to be looking for. He warned that if a study lacks the statistical power to answer important questions, it is a “waste of money.”\u003c/p>\n\u003cp>The House Science Committee stated it is considering all oversight options, though staff noted their authority is currently limited by their status in the Minority.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>In anticipation of the Trump administration’s \u003ca href=\"https://www.kqed.org/news/12047647/trumps-health-law-spurs-big-medi-cal-changes-what-californians-need-to-know\">major cuts to Medicaid\u003c/a>, \u003ca href=\"https://www.kqed.org/healthnews\">the Alameda Health System\u003c/a>, which runs public hospitals and clinics throughout the East Bay, is planning to lay off nearly 300 people in January.\u003c/p>\n\u003cp>It’s one of many healthcare systems around the state and nation threatened as a result of significant expected losses in revenue from Medicaid, the nation’s insurance system for lower-income people, known as Medi-Cal in California. \u003c/p>\n\u003cp>However, some union employees of the health system have said layoff notices, which are expected on Jan. 6, are premature, as the financial impacts of the cuts have yet to be felt. \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I think they’re bowing to pressures before those pressures have actually come into play,” Reilly Gardine, a clinical dietitian at Wilma Chan Highland Hospital Campus in Oakland, told KQED on Monday. “And I think they’re not being creative enough in figuring out alternative ways for funding.”\u003c/p>\n\u003cp>The health system, in an emailed statement to KQED, said it expects to lose “more than $100 million annually by 2030,” due to H.R. 1, the tax and spending bill President Donald Trump refers to as “Big” and “Beautiful.”\u003c/p>\n\u003cfigure id=\"attachment_11891411\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1.jpg\" alt=\"\" width=\"1920\" height=\"1280\" class=\"size-full wp-image-11891411\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Monish Ullal speaks with patient Jay Flohr at Highland Hospital in Oakland on Oct. 6, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The total annual budget for AHS is roughly $1.4 billion, according to its budget documents. The system could face an additional potential $60 million in cuts annually in the coming years due to cuts to federal funding that allows states to pay hospitals who treat a large share of Medi-Cal patients, officials said. \u003c/p>\n\u003cp>“AHS projects that cash will run out by approximately August of 2026 without immediate action,” the statement said. “In order to be proactive and ensure that AHS can continue to provide a range of emergency and comprehensive care, AHS has made the painful decision to reduce some services, reduce its workforce, and eliminate certain programs.”\u003c/p>\n\u003cp>Veronica Palacios, an eligibility specialist, and a chapter leader with labor union SEIU 1021, said workers have not been given a clear reason why the cuts need to be made now. \u003c/p>\n\u003cp>“Because if it’s being done right now and it’s not necessarily needed at this point, it sounds like you’re purposely cutting services to the community. Why do that?” Palacios said.[aside postID=news_12067733 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-1262848052-1020x680.jpg']The cuts were initially planned to go out on Dec. 24, which Gardine called “insulting,” and which Palacios said sows chaos among workers when they should be spending time with family during the holidays. \u003c/p>\n\u003cp>In what appeared to be a response to pressure from union members, the health system said late Monday it would delay the notices until Jan. 6. \u003c/p>\n\u003cp>Palacios said the layoff notices will send workers into “damage-control” mode. \u003c/p>\n\u003cp>“How am I going to support my family, how am I going to survive? Can I get another job if this is happening with our health care system? Is this happening throughout the state of California?” she said, reflecting her colleagues’ concerns. “They’re stressed out, they’re worried, they’re afraid of what the what ifs.” \u003c/p>\n\u003cp>The health system said the 296 people it needs to lay off will be from “departments and disciplines across the system including management, support and administrative services, and clinical care,” and that those that are affected will have access to job search assistance and resume writing guidance. Some will receive severance packages. \u003c/p>\n\u003cp>“AHS leadership continues to pursue multiple strategies to restore funding and strengthen sustainability,” the agency’s statement said. “We are working in partnership with federal, state and county leaders to hopefully mitigate these adverse conditions.”\u003c/p>\n\u003cp>Gardine said before resorting to layoffs, executives at AHS should take pay cuts, and explore other options, such as ending leases at pricey office buildings in downtown and the Jack London areas of Oakland. The system should also consider hiring more permanent staff instead of relying on traveling contractors. \u003c/p>\n\u003cp>“The resources are there, the state of California is an incredibly wealthy state. So, the fact that we are cutting essential services for our most vulnerable communities is completely outrageous,” Gardine said. “I think we have a huge fight ahead and that I think there’s a lot of us who are ready to start fighting.” \u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I think they’re bowing to pressures before those pressures have actually come into play,” Reilly Gardine, a clinical dietitian at Wilma Chan Highland Hospital Campus in Oakland, told KQED on Monday. “And I think they’re not being creative enough in figuring out alternative ways for funding.”\u003c/p>\n\u003cp>The health system, in an emailed statement to KQED, said it expects to lose “more than $100 million annually by 2030,” due to H.R. 1, the tax and spending bill President Donald Trump refers to as “Big” and “Beautiful.”\u003c/p>\n\u003cfigure id=\"attachment_11891411\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1.jpg\" alt=\"\" width=\"1920\" height=\"1280\" class=\"size-full wp-image-11891411\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Monish Ullal speaks with patient Jay Flohr at Highland Hospital in Oakland on Oct. 6, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The total annual budget for AHS is roughly $1.4 billion, according to its budget documents. The system could face an additional potential $60 million in cuts annually in the coming years due to cuts to federal funding that allows states to pay hospitals who treat a large share of Medi-Cal patients, officials said. \u003c/p>\n\u003cp>“AHS projects that cash will run out by approximately August of 2026 without immediate action,” the statement said. “In order to be proactive and ensure that AHS can continue to provide a range of emergency and comprehensive care, AHS has made the painful decision to reduce some services, reduce its workforce, and eliminate certain programs.”\u003c/p>\n\u003cp>Veronica Palacios, an eligibility specialist, and a chapter leader with labor union SEIU 1021, said workers have not been given a clear reason why the cuts need to be made now. \u003c/p>\n\u003cp>“Because if it’s being done right now and it’s not necessarily needed at this point, it sounds like you’re purposely cutting services to the community. Why do that?” Palacios said.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The cuts were initially planned to go out on Dec. 24, which Gardine called “insulting,” and which Palacios said sows chaos among workers when they should be spending time with family during the holidays. \u003c/p>\n\u003cp>In what appeared to be a response to pressure from union members, the health system said late Monday it would delay the notices until Jan. 6. \u003c/p>\n\u003cp>Palacios said the layoff notices will send workers into “damage-control” mode. \u003c/p>\n\u003cp>“How am I going to support my family, how am I going to survive? Can I get another job if this is happening with our health care system? Is this happening throughout the state of California?” she said, reflecting her colleagues’ concerns. “They’re stressed out, they’re worried, they’re afraid of what the what ifs.” \u003c/p>\n\u003cp>The health system said the 296 people it needs to lay off will be from “departments and disciplines across the system including management, support and administrative services, and clinical care,” and that those that are affected will have access to job search assistance and resume writing guidance. Some will receive severance packages. \u003c/p>\n\u003cp>“AHS leadership continues to pursue multiple strategies to restore funding and strengthen sustainability,” the agency’s statement said. “We are working in partnership with federal, state and county leaders to hopefully mitigate these adverse conditions.”\u003c/p>\n\u003cp>Gardine said before resorting to layoffs, executives at AHS should take pay cuts, and explore other options, such as ending leases at pricey office buildings in downtown and the Jack London areas of Oakland. The system should also consider hiring more permanent staff instead of relying on traveling contractors. \u003c/p>\n\u003cp>“The resources are there, the state of California is an incredibly wealthy state. So, the fact that we are cutting essential services for our most vulnerable communities is completely outrageous,” Gardine said. “I think we have a huge fight ahead and that I think there’s a lot of us who are ready to start fighting.” \u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/flu\">Flu\u003c/a> season is back in \u003ca href=\"https://www.kqed.org/news/tag/san-francisco\">San Francisco\u003c/a>.\u003c/p>\n\u003cp>According to data released Wednesday by the city’s Department of Public Health, the rate of tests positive for influenza reached 5% as of Dec. 6.\u003c/p>\n\u003cp>Though cases are still low overall, they are on the rise — and the state’s respiratory virus dashboard indicates hospitalizations are “expected to increase.” Dr. Farrell Tobolowsky, an infectious disease physician for the city’s Public Health Department, said the holidays are prime time for gathering with loved ones and sharing germs.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We suspect that this is definitely a time where there will be risk of transmission. We also know that people gather with people from other parts of the country where flu activity may actually be higher than it is in California at this time,” Tobolowsky said.\u003c/p>\n\u003cp>Earlier this year, the state \u003ca href=\"https://www.kqed.org/news/12028312/californias-worst-flu-season-years-may-finally-easing\">recorded one of its worst flu seasons\u003c/a> on record. Early mild symptoms can include a fever, runny nose, cough, body aches, sore throat or fatigue. More severe symptoms include vomiting and diarrhea.\u003c/p>\n\u003cp>Historically, these seasonal upticks of the flu can last for weeks to months. According to Dr. Tobolowsky, cases are lower than they’ve been at this time of year in the past, meaning the winter flu season could simply be beginning later than expected.[aside postID=news_12027283 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/02/GettyImages-1720991107-1020x680.jpg']Older adults, infants and toddlers, and people with chronic medical conditions are most at-risk for complications associated with the illness.\u003c/p>\n\u003cp>SFDPH recommended the 2025-2026 shot for anyone over six months old who has not already received it. Experts usually suggest that \u003ca href=\"https://www.kqed.org/news/12027283/forgot-your-flu-vaccine-with-historic-infections-its-not-too-late-for-a-shot\">people get their shot in the fall,\u003c/a> ahead of the coming season’s peak. You can find \u003ca href=\"https://www.sf.gov/get-vaccinated-against-covid-19-flu-and-rsv\">access \u003c/a>to a vaccine here, and many local pharmacies accommodate walk-ins.\u003c/p>\n\u003cp>SFDPH also suggests the use of high-quality masks — especially if you’re sick — but also beneficial even when you’re not. KN95 masks have been proven to lower the risk of spreading respiratory illnesses, and all mask types are especially recommended in crowded indoor spaces.\u003c/p>\n\u003cp>And as usual, the SFDPH urges good hygiene practices such as washing your hands frequently with soap and water, and using alcohol-based hand sanitizers.\u003c/p>\n\u003cp>While sick, it’s important to stay home from school or work until symptoms resolve. Being fever-free for 24 hours without fever-reducing medication is a good indicator of when to return to ease back into your typical routine.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/flu\">Flu\u003c/a> season is back in \u003ca href=\"https://www.kqed.org/news/tag/san-francisco\">San Francisco\u003c/a>.\u003c/p>\n\u003cp>According to data released Wednesday by the city’s Department of Public Health, the rate of tests positive for influenza reached 5% as of Dec. 6.\u003c/p>\n\u003cp>Though cases are still low overall, they are on the rise — and the state’s respiratory virus dashboard indicates hospitalizations are “expected to increase.” Dr. Farrell Tobolowsky, an infectious disease physician for the city’s Public Health Department, said the holidays are prime time for gathering with loved ones and sharing germs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Older adults, infants and toddlers, and people with chronic medical conditions are most at-risk for complications associated with the illness.\u003c/p>\n\u003cp>SFDPH recommended the 2025-2026 shot for anyone over six months old who has not already received it. Experts usually suggest that \u003ca href=\"https://www.kqed.org/news/12027283/forgot-your-flu-vaccine-with-historic-infections-its-not-too-late-for-a-shot\">people get their shot in the fall,\u003c/a> ahead of the coming season’s peak. You can find \u003ca href=\"https://www.sf.gov/get-vaccinated-against-covid-19-flu-and-rsv\">access \u003c/a>to a vaccine here, and many local pharmacies accommodate walk-ins.\u003c/p>\n\u003cp>SFDPH also suggests the use of high-quality masks — especially if you’re sick — but also beneficial even when you’re not. KN95 masks have been proven to lower the risk of spreading respiratory illnesses, and all mask types are especially recommended in crowded indoor spaces.\u003c/p>\n\u003cp>And as usual, the SFDPH urges good hygiene practices such as washing your hands frequently with soap and water, and using alcohol-based hand sanitizers.\u003c/p>\n\u003cp>While sick, it’s important to stay home from school or work until symptoms resolve. Being fever-free for 24 hours without fever-reducing medication is a good indicator of when to return to ease back into your typical routine.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"title": "Sutter Health’s Trans Youth Care Hasn’t Stopped, Parents Say, but Trump Wants a Ban",
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"content": "\u003cp>After families were informed last month that Sutter Health planned to join a growing list of health care providers \u003ca href=\"https://www.kqed.org/news/12065480/its-just-cruel-bay-area-parents-say-sutter-health-is-set-to-halt-trans-youth-care\">limiting gender-affirming care for minors\u003c/a>, some say the Northern California-based network is reversing course, despite mounting pressure from the federal government.\u003c/p>\n\u003cp>But the temporary reprieve is shaky, according to East Bay mother Nikki, whose 14-year-old son relies on a Sutter doctor for frequent, steady care. The Trump administration on Thursday announced funding restrictions that could effectively \u003ca href=\"https://www.npr.org/sections/shots-health-news/2025/12/18/nx-s1-5647789/transgender-gender-affirming-care-rfk-jr-dr-oz-trump\">halt all pediatric gender-affirming care\u003c/a>, and Nikki worries the move could push Sutter to backtrack — and make it nearly impossible to find a provider.\u003c/p>\n\u003cp>“I’m trying really hard to hold on to the victory of this last week and a half or so that this care has not stopped,” she told KQED. “But that unforeseeable future weighs heavily on my husband and I. We do our best to shelter our children, but this is the world intruding upon our lives and the government trying to make decisions for us.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In November, Nikki, who asked to be identified by only her first name for fear of retribution against her and her son’s caregiver, was informed that his care would be discontinued just weeks later, on Dec. 10. Several other families with transgender children said their doctors had relayed similar messages.\u003c/p>\n\u003cp>But last week, according to Nikki, her son’s doctor said the hospital network appeared to reverse course and would no longer stop offering treatments on that date.\u003c/p>\n\u003cp>In a statement, Sutter said it was working to ensure compliance with recent federal actions affecting gender-affirming care for patients under 19.\u003c/p>\n\u003cfigure id=\"attachment_11980957\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11980957\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">The Sutter Health CPMC Davies Campus in San Francisco on Feb. 8, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Sutter-aligned physicians are engaging directly with their patients to have open and thoughtful conversations and to determine individual care plans that will meet anticipated requirements,” the nonprofit hospital network said, adding that gender-affirming surgeries for young patients had previously ceased. “We continue to support careful, patient-centered discussions with appropriate resources and guidance.”\u003c/p>\n\u003cp>Nikki said she’s still waiting for her son’s future appointments to be rescheduled after they were canceled last month, but she’s heard from other families that they’ve been able to get back on their caregivers’ calendars.\u003c/p>\n\u003cp>Still, she said, the last few weeks have been extremely nerve-wracking as she and other families awaited pending federal policy moves that would essentially ban gender-affirming care for youth, even in states where it’s legal.\u003c/p>\n\u003cp>That came Thursday morning, when Health Secretary Robert F. Kennedy Jr. and Medicaid Administrator Dr. Mehmet Oz announced two new rules.[aside postID=news_12065480 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/20250725_KaiserTransProtest_GC-1_qed.jpg']The first would prevent hospitals and doctors from receiving Medicaid reimbursements for gender-affirming care for children. Medicaid offers health coverage to millions of low-income Americans. The second would go further, blocking all funding from Medicaid and Medicare, which covers older people and those with disabilities, for medical centers that provide gender-affirming care to youth.\u003c/p>\n\u003cp>Hospitals rely heavily on Medicaid and Medicare funding to operate — combined, the two federal programs covered about 45% of spending on hospital care in 2023, \u003ca href=\"https://www.kff.org/health-costs/key-facts-about-hospitals/?entry=national-hospital-spending-spending-by-payer\">according to the health policy research organization KFF\u003c/a>.\u003c/p>\n\u003cp>The proposed rules have to go through a 60-day period during which the public can weigh in, and they are likely to face legal challenges; the American Civil Liberties Union has already said it plans to sue.\u003c/p>\n\u003cp>If they’re finalized, though, Nikki worries that it will become nearly impossible to find a doctor who offers the care her son needs.\u003c/p>\n\u003cp>“Then what am I going to do to find a physician? Who are those physicians?” Nikki asked.\u003c/p>\n\u003cp>That’s because other major networks have already moved to limit gender-affirming care in light of the Trump administration’s crackdown. In June, Stanford Medicine paused gender-affirming surgeries and stopped providing prescriptions for puberty blockers to young people, and Kaiser Permanente halted surgical care in July.\u003c/p>\n\u003cfigure id=\"attachment_12049926\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12049926\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/20250725_KaiserTransProtest_GC-31_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/20250725_KaiserTransProtest_GC-31_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/20250725_KaiserTransProtest_GC-31_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/20250725_KaiserTransProtest_GC-31_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Calder Storm waves a transgender flag at a rally and vigil, honoring transgender patients affected by Kaiser’s decision to halt gender-affirming care to minors, outside of Kaiser Permanente on July 25, 2025. \u003ccite>(Gina Castro/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nikki called the president’s efforts to withhold funding from caregivers who provide gender affirming care “financial sabotage.”\u003c/p>\n\u003cp>“It’s terrifying,” she said. “It feels completely helpless and hopeless.”\u003c/p>\n\u003cp>She’s been searching for a new provider who doesn’t rely on federal funding since the initial word last month from her Sutter doctor, but she hasn’t found one yet. The threat that her son’s care could be stopped with just days or weeks of notice is especially worrisome, she said, because of how time sensitive it is.\u003c/p>\n\u003cp>He takes a weekly testosterone shot, which has to be picked up one dose at a time, and re-prescribed every six months, due to their insurance coverage.\u003c/p>\n\u003cp>Right now, he’s out of refills. He’s still within his normal dose cycle, Nikki said, but if he’s unable to get a new prescription within days and falls behind, the effects will be pretty immediately noticeable.\u003c/p>\n\u003cp>While she thinks he’ll be able to see his Sutter caregiver for a prescription this time, if that option goes away in the future, “I’m, for lack of a word, shit out of luck,” Nikki said.\u003c/p>\n\u003cp>\u003cem>KQED’s \u003c/em>\u003ca href=\"https://www.kqed.org/author/nnavarro\">\u003cem>Natalia Navarro\u003c/em>\u003c/a>\u003cem> contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>After families were informed last month that Sutter Health planned to join a growing list of health care providers \u003ca href=\"https://www.kqed.org/news/12065480/its-just-cruel-bay-area-parents-say-sutter-health-is-set-to-halt-trans-youth-care\">limiting gender-affirming care for minors\u003c/a>, some say the Northern California-based network is reversing course, despite mounting pressure from the federal government.\u003c/p>\n\u003cp>But the temporary reprieve is shaky, according to East Bay mother Nikki, whose 14-year-old son relies on a Sutter doctor for frequent, steady care. The Trump administration on Thursday announced funding restrictions that could effectively \u003ca href=\"https://www.npr.org/sections/shots-health-news/2025/12/18/nx-s1-5647789/transgender-gender-affirming-care-rfk-jr-dr-oz-trump\">halt all pediatric gender-affirming care\u003c/a>, and Nikki worries the move could push Sutter to backtrack — and make it nearly impossible to find a provider.\u003c/p>\n\u003cp>“I’m trying really hard to hold on to the victory of this last week and a half or so that this care has not stopped,” she told KQED. “But that unforeseeable future weighs heavily on my husband and I. We do our best to shelter our children, but this is the world intruding upon our lives and the government trying to make decisions for us.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In November, Nikki, who asked to be identified by only her first name for fear of retribution against her and her son’s caregiver, was informed that his care would be discontinued just weeks later, on Dec. 10. Several other families with transgender children said their doctors had relayed similar messages.\u003c/p>\n\u003cp>But last week, according to Nikki, her son’s doctor said the hospital network appeared to reverse course and would no longer stop offering treatments on that date.\u003c/p>\n\u003cp>In a statement, Sutter said it was working to ensure compliance with recent federal actions affecting gender-affirming care for patients under 19.\u003c/p>\n\u003cfigure id=\"attachment_11980957\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11980957\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">The Sutter Health CPMC Davies Campus in San Francisco on Feb. 8, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Sutter-aligned physicians are engaging directly with their patients to have open and thoughtful conversations and to determine individual care plans that will meet anticipated requirements,” the nonprofit hospital network said, adding that gender-affirming surgeries for young patients had previously ceased. “We continue to support careful, patient-centered discussions with appropriate resources and guidance.”\u003c/p>\n\u003cp>Nikki said she’s still waiting for her son’s future appointments to be rescheduled after they were canceled last month, but she’s heard from other families that they’ve been able to get back on their caregivers’ calendars.\u003c/p>\n\u003cp>Still, she said, the last few weeks have been extremely nerve-wracking as she and other families awaited pending federal policy moves that would essentially ban gender-affirming care for youth, even in states where it’s legal.\u003c/p>\n\u003cp>That came Thursday morning, when Health Secretary Robert F. Kennedy Jr. and Medicaid Administrator Dr. Mehmet Oz announced two new rules.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The first would prevent hospitals and doctors from receiving Medicaid reimbursements for gender-affirming care for children. Medicaid offers health coverage to millions of low-income Americans. The second would go further, blocking all funding from Medicaid and Medicare, which covers older people and those with disabilities, for medical centers that provide gender-affirming care to youth.\u003c/p>\n\u003cp>Hospitals rely heavily on Medicaid and Medicare funding to operate — combined, the two federal programs covered about 45% of spending on hospital care in 2023, \u003ca href=\"https://www.kff.org/health-costs/key-facts-about-hospitals/?entry=national-hospital-spending-spending-by-payer\">according to the health policy research organization KFF\u003c/a>.\u003c/p>\n\u003cp>The proposed rules have to go through a 60-day period during which the public can weigh in, and they are likely to face legal challenges; the American Civil Liberties Union has already said it plans to sue.\u003c/p>\n\u003cp>If they’re finalized, though, Nikki worries that it will become nearly impossible to find a doctor who offers the care her son needs.\u003c/p>\n\u003cp>“Then what am I going to do to find a physician? Who are those physicians?” Nikki asked.\u003c/p>\n\u003cp>That’s because other major networks have already moved to limit gender-affirming care in light of the Trump administration’s crackdown. In June, Stanford Medicine paused gender-affirming surgeries and stopped providing prescriptions for puberty blockers to young people, and Kaiser Permanente halted surgical care in July.\u003c/p>\n\u003cfigure id=\"attachment_12049926\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12049926\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/20250725_KaiserTransProtest_GC-31_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/20250725_KaiserTransProtest_GC-31_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/20250725_KaiserTransProtest_GC-31_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/20250725_KaiserTransProtest_GC-31_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Calder Storm waves a transgender flag at a rally and vigil, honoring transgender patients affected by Kaiser’s decision to halt gender-affirming care to minors, outside of Kaiser Permanente on July 25, 2025. \u003ccite>(Gina Castro/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nikki called the president’s efforts to withhold funding from caregivers who provide gender affirming care “financial sabotage.”\u003c/p>\n\u003cp>“It’s terrifying,” she said. “It feels completely helpless and hopeless.”\u003c/p>\n\u003cp>She’s been searching for a new provider who doesn’t rely on federal funding since the initial word last month from her Sutter doctor, but she hasn’t found one yet. The threat that her son’s care could be stopped with just days or weeks of notice is especially worrisome, she said, because of how time sensitive it is.\u003c/p>\n\u003cp>He takes a weekly testosterone shot, which has to be picked up one dose at a time, and re-prescribed every six months, due to their insurance coverage.\u003c/p>\n\u003cp>Right now, he’s out of refills. He’s still within his normal dose cycle, Nikki said, but if he’s unable to get a new prescription within days and falls behind, the effects will be pretty immediately noticeable.\u003c/p>\n\u003cp>While she thinks he’ll be able to see his Sutter caregiver for a prescription this time, if that option goes away in the future, “I’m, for lack of a word, shit out of luck,” Nikki said.\u003c/p>\n\u003cp>\u003cem>KQED’s \u003c/em>\u003ca href=\"https://www.kqed.org/author/nnavarro\">\u003cem>Natalia Navarro\u003c/em>\u003c/a>\u003cem> contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"info": "KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.",
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"order": 3
},
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},
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"info": "The day's top stories from BBC News compiled twice daily in the week, once at weekends.",
"airtime": "MON-FRI 9pm-10pm, TUE-FRI 1am-2am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg",
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"meta": {
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"source": "BBC World Service"
},
"link": "/radio/program/bbc-world-service",
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"tuneIn": "https://tunein.com/radio/BBC-World-Service-p455581/",
"rss": "https://podcasts.files.bbci.co.uk/p02nq0gn.rss"
}
},
"californiareport": {
"id": "californiareport",
"title": "The California Report",
"tagline": "California, day by day",
"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-California-Report-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/californiareport",
"meta": {
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"source": "kqed",
"order": 8
},
"link": "/californiareport",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1MDAyODE4NTgz",
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}
},
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"title": "The California Report Magazine",
"tagline": "Your state, your stories",
"info": "Every week, The California Report Magazine takes you on a road trip for the ears: to visit the places and meet the people who make California unique. The in-depth storytelling podcast from the California Report.",
"airtime": "FRI 4:30pm-5pm, 6:30pm-7pm, 11pm-11:30pm",
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"officialWebsiteLink": "/californiareportmagazine",
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"order": 10
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM3NjkwNjk1OTAz",
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},
"city-arts": {
"id": "city-arts",
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"info": "A one-hour radio program to hear celebrated writers, artists and thinkers address contemporary ideas and values, often discussing the creative process. Please note: tapes or transcripts are not available",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/cityartsandlecture-300x300.jpg",
"officialWebsiteLink": "https://www.cityarts.net/",
"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
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"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
"subscribe": {
"tuneIn": "https://tunein.com/radio/City-Arts-and-Lectures-p692/",
"rss": "https://www.cityarts.net/feed/"
}
},
"closealltabs": {
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"info": "Close All Tabs breaks down how digital culture shapes our world through thoughtful insights and irreverent humor.",
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"officialWebsiteLink": "/podcasts/closealltabs",
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"source": "kqed",
"order": 1
},
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"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"meta": {
"site": "radio",
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},
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},
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
"site": "news",
"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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}
},
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"meta": {
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"source": "kqed",
"order": 9
},
"link": "/forum",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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}
},
"freakonomics-radio": {
"id": "freakonomics-radio",
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"info": "Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. It is produced in partnership with WNYC.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
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},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"rss": "https://feeds.npr.org/510051/podcast.xml"
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"hidden-brain": {
"id": "hidden-brain",
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"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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},
"how-i-built-this": {
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"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
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"source": "npr"
},
"link": "/radio/program/how-i-built-this",
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"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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},
"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"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. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"officialWebsiteLink": "/podcasts/hyphenacion",
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"order": 15
},
"link": "/podcasts/hyphenacion",
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"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
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}
},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"source": "kqed",
"order": 18
},
"link": "/podcasts/jerrybrown",
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"apple": "https://itunes.apple.com/us/podcast/id1492194549",
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}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/latino-usa",
"subscribe": {
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"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.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
}
},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
"site": "radio",
"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
"subscribe": {
"apple": "http://mastersofscale.app.link/",
"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"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>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
"npr": "https://www.npr.org/podcasts/464615685/mind-shift-podcast",
"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
"spotify": "https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"
}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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