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"content": "\n\u003ch2 class=\"wp-block-heading\">Transcript\u003c/h2>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>There are about 2,000 community clinics providing health care here in California.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>These clinics typically serve patients who don’t have any other options. Low-income people or those who are under-insured often go to these clinics for things like vaccines, mental health, and social services.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>They’re also funded in part by our tax dollars. But one union says these clinics aren’t spending enough of their money on patients. And that’s where Proposition 44 comes in.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>Prop 44 would force community health clinics to spend 90% of their revenue on health care services or face penalties from the state.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Will Prop 44 help make healthcare dollars go where they belong? Or could it lead these clinics to cut services or even shut down entirely?\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>That’s for you to decide.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>I’m Ericka Cruz Guevarra, host of The Bay.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>And I’m Olivia Allen-Price, host of Bay Curious.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>And welcome back to Prop Fest, a collaboration between The Bay and Bay Curious. Today, we’re walking you through Proposition 44. Here’s how it reads on your ballot.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Speaker: \u003c/strong>Prop 44 requires community health clinics spend 90% of revenue on program services.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Here to help us break this all down is KQED health correspondent, Lesley McClurg. Hey there, Lesley!\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>Hello.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>What exactly would Prop 44 change for these clinics?\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>The clinics would have to prove that they are spending 90% of their revenue, so they are tax-funded clinics, so they would have to prove they’re spending 90 percent of that money on health care services, so basically medical offerings for their patients. At the end of the day, the attorney general would decide on exactly what qualifies within that 90%. If the clinics don’t comply, they would face fines. Although the penalties that they would have to pay could be returned to them if they were able to hit that 90% quota spending target basically within five years.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Lesley, who put Proposition 44 on the ballot, and what is the problem that they say they’re trying to solve with Prop 44?\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>The proponents of Prop 44 are SEIU, United Health Care Workers West, which is the union that represents health care workers.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Renee Saldana: \u003c/strong>I’d like to remind folks that community clinics were started with the mission of serving some of the folks in California that need these services the most.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>I spoke with Renee Saldana, the press secretary for the union, and she said the union is really trying to ensure that clinics are investing their money correctly.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Renee Saldana: \u003c/strong>It’s essentially anything that would help patients receive care or the direct care itself. So this includes medical visits, lab tests and x-rays, preventative care, of course, like vaccines and screenings, mammograms, things like outreach, transportation, language interpretation…\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>They have found that some clinics are using their revenue poorly, maybe even wasting it on anything that the union says could be, say, unnecessary administrative costs. So they’re spending too much on running the clinic rather than putting that money towards patients. Maybe spending too much on fundraising. But the main thing that they’re pointing out is potentially executive compensation, so over bloated salaries for the top, for the people who are running these clinics.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Renee Saldana: \u003c/strong>So I think a lot of Californians really understand how important these clinics are to our healthcare system and they wanna make sure that they are prioritizing patients by spending our public dollars where the dollars are needed most, which is directly on patient care and other mission-related services.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>The California Legislative Analyst’s Office, which is a nonpartisan fiscal advisor, notes that these clinics currently spend, on average, about 80% of their revenue on healthcare services, although it does vary and depend on each individual clinic. But the yes on 44 or the union believes that that really should be 90% across the board.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>And do they also mention, I mean, these cuts that we’ve seen to health care at the federal level as a reason also to pass this?\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>Absolutely. So you’ve got this H.R.1, which is the federal bill, it’s also been called, you know, the big, beautiful bill. But basically, the Trump administration is heavily cutting federal funding for medical care. And so these clinics are going to be hurting and working on a much tighter budget. And so the union is arguing that they need to ensure that these clinics are using their budgets as well as possible so that best care can reach patients. Since it’s a really hard time to ensure that everybody has the medical care that they need under these federal cuts.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Renee Saldana: \u003c/strong>Again, all we want is that these clinics are able to stay open when these health care cuts from H.R.1 really hit California next year.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>So you have SEIU, the union that represents many healthcare workers in favor of Prop 44. Any other groups in favor of this measure?\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>The only group that I’m aware of is the California Labor Federation is also in favor.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>We’ll have more on Prop 44 right after this. By the way, did you know that KQED is funded almost entirely by listeners just like you? Join the thousands of everyday listeners who help make this work happen. Just go to donate.kqed.org/podcasts. We’ll be right back. And we’re back talking about Prop 44 with KQED health correspondent, Lesley McClurg. Lesley, this measure has a long list of opponents actually, tell me a little bit more about who’s against Prop 44 and what their argument is?\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>So it’s made up mostly of medical groups, although there are other groups in addition to the medical groups. But you’ve got the California Primary Care Association, the California Medical Association. You’ve got Planned Parenthood Affiliates of California. You’ve got the the California Hospital Association. And they are all worried that at the end of the day the clinics would fail to meet the spending threshold and that the non-compliance fees that these clinics would ultimately be forced to pay would end up leading to either significantly reduced services at these clinics or even force some of these clinics to close.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Mark Shotwell: \u003c/strong>Health centers do a great job of managing those funds, getting high quality healthcare outcomes and this ballot measure would really erode our ability to do that.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>I spoke specifically with Mark Shotwell. He’s the CEO of Ritter Center. This is a nonprofit who serves a largely unhoused population in San Rafael. And he says about 30% of their costs under his… and this is his opinion, would not qualify as quote health care services.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Mark Shotwell: \u003c/strong>Things like telehealth services, patient navigation, transportation to ensure that people get to their necessary medical appointments or translation services.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>He said these are wraparound services like education, housing, home health care. These are all services that he worries would not qualify as direct medical care, you know, offerings and that they would end up, the clinic, Ritter Clinic would end paying kind of precious dollars on penalties when they’re already operating on a really tight budget.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Mark Shotwell: \u003c/strong>They’ve decided to focus on CEO or executive salaries and that somehow that’s a problem that we’re not having money go to the patients. It also doesn’t include things like human resources or accounting or IT. So these are all necessary services to run a health clinic. And we have the oversight of family members, boards, the state of California, the federal government. These are highly regulated environments to ensure that patients are getting the very best services, so it’s also unnecessary.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>So then, Lesley, if Prop 44 actually passes, then 90% of the revenue at these clinics must be spent on healthcare services, as you said. But it seems like the yes and the no sides aren’t really on the same page about what exactly falls under the umbrella of healthcare services. You have Renee on the yes side who’s saying it covers anything related to patient care, but then you have Mark on the no side who says, that this would threaten really essential services at his clinic, so what exactly am I supposed to make of this as a voter?\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>Yeah, it’s not clear. The yes and no sides are telling me very different things about how this 90% would be defined. The LAO says that the state attorney general would be able to define in more detail which kinds of expenses would qualify. The proposition is not quite as simple as it looks on the ballot. You also have a background that I think is important to know about, which is that there has been pressure to unionize these clinics and some of these clinics have said no to that pressure. There’s an argument from the opponents that this bill is a push or kind of like a political pressure to be like, okay, we’re going to put this thing on the ballot, that’s not going to, that’s going to be really hard for you to meet, if you don’t unionize. Now the union denies that that is part of their agenda, but the opponents arguing that that could potentially be at play here and there has been a past, there’s a history here of SEIU, has filed ballot measures in the past for organizations that have resisted unionization. This includes a series of recent measures that would have placed new regulations on dialysis clinics. So that there is a history there of SEIU doing this. And again, they’re denying it in this moment, but potentially that’s also at play.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>What’s going on with campaign spending on Prop 44 on both the yes and the no sides?\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>According to CalMatters, who has been reporting on this, they note that SEIU has raised $16.9 million, and the opponents, all those different medical groups, et cetera, have raised about $37.5 million. So more than twice as much has been raised by the opponents.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Well Lesley, I appreciate you for breaking this one down for us. Thank you so much.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>Thank you.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>In a nutshell, a yes vote on this measure means certain private non-profit health care clinics would have to spend at least 90% of their revenue each year on providing health care services or face a fine. A no vote on the measure means this new requirement on health care clinic spending would not go into effect.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>That’s it for our latest episode of PropFest, a collaboration between The Bay and Bay Curious. You’re almost to the finish line.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>KQED.org/propfest is the place to return for all these PropFest breakdowns, and if this series is helping you, do us a favor and tell one friend about it.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>Word of mouth really helps our shows grow. PropFest is made possible thanks to Katrina Schwartz, Pauline Bartolone, Anna Casalme, Olivia Allen-Price:, Gabriela Glueck. Christopher Beale, Alan Montecillo.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>And me, Ericka Cruz Guevarra. We get extra support from Maha Sanad, Katie Springer, Jen Chien, Ethan Toven-Lindsey and everyone on Team KQED.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Our show is made in San Francisco at member-supported KQED. Support for The Bay is provided in part by the Osher Production Fund. Some members of the KQED podcast team are represented by the Screen Actors Guild, American Federation of Television and Radio Artists, San Francisco, Northern California Local.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>I’m Ericka Cruz Guevarra.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>And I’m Olivia Allen-Price:. Thanks for listening.\u003c/p>\n\n\n\n\u003cp>\u003cem>Some members of the KQED podcast team are represented by The Screen Actors Guild, American Federation of Television and Radio Artists, San Francisco-Northern California Local.\u003c/em>\u003c/p>\n",
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>There are about 2,000 community clinics providing health care here in California.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>There are about 2,000 community clinics providing health care here in California.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>These clinics typically serve patients who don’t have any other options. Low-income people or those who are under-insured often go to these clinics for things like vaccines, mental health, and social services.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>These clinics typically serve patients who don’t have any other options. Low-income people or those who are under-insured often go to these clinics for things like vaccines, mental health, and social services.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>They’re also funded in part by our tax dollars. But one union says these clinics aren’t spending enough of their money on patients. And that’s where Proposition 44 comes in.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>They’re also funded in part by our tax dollars. But one union says these clinics aren’t spending enough of their money on patients. And that’s where Proposition 44 comes in.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>Prop 44 would force community health clinics to spend 90% of their revenue on health care services or face penalties from the state.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>Prop 44 would force community health clinics to spend 90% of their revenue on health care services or face penalties from the state.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Will Prop 44 help make healthcare dollars go where they belong? Or could it lead these clinics to cut services or even shut down entirely?\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Will Prop 44 help make healthcare dollars go where they belong? Or could it lead these clinics to cut services or even shut down entirely?\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>That’s for you to decide.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>That’s for you to decide.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>I’m Ericka Cruz Guevarra, host of The Bay.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>I’m Ericka Cruz Guevarra, host of The Bay.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>And I’m Olivia Allen-Price, host of Bay Curious.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>And I’m Olivia Allen-Price, host of Bay Curious.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>And welcome back to Prop Fest, a collaboration between The Bay and Bay Curious. Today, we’re walking you through Proposition 44. Here’s how it reads on your ballot.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>And welcome back to Prop Fest, a collaboration between The Bay and Bay Curious. Today, we’re walking you through Proposition 44. Here’s how it reads on your ballot.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Speaker: \u003c/strong>Prop 44 requires community health clinics spend 90% of revenue on program services.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Speaker: \u003c/strong>Prop 44 requires community health clinics spend 90% of revenue on program services.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Here to help us break this all down is KQED health correspondent, Lesley McClurg. Hey there, Lesley!\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Here to help us break this all down is KQED health correspondent, Lesley McClurg. Hey there, Lesley!\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>Hello.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>Hello.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>What exactly would Prop 44 change for these clinics?\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>What exactly would Prop 44 change for these clinics?\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>The clinics would have to prove that they are spending 90% of their revenue, so they are tax-funded clinics, so they would have to prove they’re spending 90 percent of that money on health care services, so basically medical offerings for their patients. At the end of the day, the attorney general would decide on exactly what qualifies within that 90%. If the clinics don’t comply, they would face fines. Although the penalties that they would have to pay could be returned to them if they were able to hit that 90% quota spending target basically within five years.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>The clinics would have to prove that they are spending 90% of their revenue, so they are tax-funded clinics, so they would have to prove they’re spending 90 percent of that money on health care services, so basically medical offerings for their patients. At the end of the day, the attorney general would decide on exactly what qualifies within that 90%. If the clinics don’t comply, they would face fines. Although the penalties that they would have to pay could be returned to them if they were able to hit that 90% quota spending target basically within five years.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Lesley, who put Proposition 44 on the ballot, and what is the problem that they say they’re trying to solve with Prop 44?\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Lesley, who put Proposition 44 on the ballot, and what is the problem that they say they’re trying to solve with Prop 44?\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>The proponents of Prop 44 are SEIU, United Health Care Workers West, which is the union that represents health care workers.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>The proponents of Prop 44 are SEIU, United Health Care Workers West, which is the union that represents health care workers.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Renee Saldana: \u003c/strong>I’d like to remind folks that community clinics were started with the mission of serving some of the folks in California that need these services the most.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Renee Saldana: \u003c/strong>I’d like to remind folks that community clinics were started with the mission of serving some of the folks in California that need these services the most.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>I spoke with Renee Saldana, the press secretary for the union, and she said the union is really trying to ensure that clinics are investing their money correctly.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>I spoke with Renee Saldana, the press secretary for the union, and she said the union is really trying to ensure that clinics are investing their money correctly.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Renee Saldana: \u003c/strong>It’s essentially anything that would help patients receive care or the direct care itself. So this includes medical visits, lab tests and x-rays, preventative care, of course, like vaccines and screenings, mammograms, things like outreach, transportation, language interpretation…\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Renee Saldana: \u003c/strong>It’s essentially anything that would help patients receive care or the direct care itself. So this includes medical visits, lab tests and x-rays, preventative care, of course, like vaccines and screenings, mammograms, things like outreach, transportation, language interpretation…\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>They have found that some clinics are using their revenue poorly, maybe even wasting it on anything that the union says could be, say, unnecessary administrative costs. So they’re spending too much on running the clinic rather than putting that money towards patients. Maybe spending too much on fundraising. But the main thing that they’re pointing out is potentially executive compensation, so over bloated salaries for the top, for the people who are running these clinics.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>They have found that some clinics are using their revenue poorly, maybe even wasting it on anything that the union says could be, say, unnecessary administrative costs. So they’re spending too much on running the clinic rather than putting that money towards patients. Maybe spending too much on fundraising. But the main thing that they’re pointing out is potentially executive compensation, so over bloated salaries for the top, for the people who are running these clinics.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Renee Saldana: \u003c/strong>So I think a lot of Californians really understand how important these clinics are to our healthcare system and they wanna make sure that they are prioritizing patients by spending our public dollars where the dollars are needed most, which is directly on patient care and other mission-related services.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Renee Saldana: \u003c/strong>So I think a lot of Californians really understand how important these clinics are to our healthcare system and they wanna make sure that they are prioritizing patients by spending our public dollars where the dollars are needed most, which is directly on patient care and other mission-related services.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>The California Legislative Analyst’s Office, which is a nonpartisan fiscal advisor, notes that these clinics currently spend, on average, about 80% of their revenue on healthcare services, although it does vary and depend on each individual clinic. But the yes on 44 or the union believes that that really should be 90% across the board.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>The California Legislative Analyst’s Office, which is a nonpartisan fiscal advisor, notes that these clinics currently spend, on average, about 80% of their revenue on healthcare services, although it does vary and depend on each individual clinic. But the yes on 44 or the union believes that that really should be 90% across the board.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>And do they also mention, I mean, these cuts that we’ve seen to health care at the federal level as a reason also to pass this?\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>And do they also mention, I mean, these cuts that we’ve seen to health care at the federal level as a reason also to pass this?\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>Absolutely. So you’ve got this H.R.1, which is the federal bill, it’s also been called, you know, the big, beautiful bill. But basically, the Trump administration is heavily cutting federal funding for medical care. And so these clinics are going to be hurting and working on a much tighter budget. And so the union is arguing that they need to ensure that these clinics are using their budgets as well as possible so that best care can reach patients. Since it’s a really hard time to ensure that everybody has the medical care that they need under these federal cuts.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>Absolutely. So you’ve got this H.R.1, which is the federal bill, it’s also been called, you know, the big, beautiful bill. But basically, the Trump administration is heavily cutting federal funding for medical care. And so these clinics are going to be hurting and working on a much tighter budget. And so the union is arguing that they need to ensure that these clinics are using their budgets as well as possible so that best care can reach patients. Since it’s a really hard time to ensure that everybody has the medical care that they need under these federal cuts.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Renee Saldana: \u003c/strong>Again, all we want is that these clinics are able to stay open when these health care cuts from H.R.1 really hit California next year.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Renee Saldana: \u003c/strong>Again, all we want is that these clinics are able to stay open when these health care cuts from H.R.1 really hit California next year.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>So you have SEIU, the union that represents many healthcare workers in favor of Prop 44. Any other groups in favor of this measure?\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>So you have SEIU, the union that represents many healthcare workers in favor of Prop 44. Any other groups in favor of this measure?\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>The only group that I’m aware of is the California Labor Federation is also in favor.\u003c/p>\n",
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>We’ll have more on Prop 44 right after this. By the way, did you know that KQED is funded almost entirely by listeners just like you? Join the thousands of everyday listeners who help make this work happen. Just go to donate.kqed.org/podcasts. We’ll be right back. And we’re back talking about Prop 44 with KQED health correspondent, Lesley McClurg. Lesley, this measure has a long list of opponents actually, tell me a little bit more about who’s against Prop 44 and what their argument is?\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>We’ll have more on Prop 44 right after this. By the way, did you know that KQED is funded almost entirely by listeners just like you? Join the thousands of everyday listeners who help make this work happen. Just go to donate.kqed.org/podcasts. We’ll be right back. And we’re back talking about Prop 44 with KQED health correspondent, Lesley McClurg. Lesley, this measure has a long list of opponents actually, tell me a little bit more about who’s against Prop 44 and what their argument is?\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>So it’s made up mostly of medical groups, although there are other groups in addition to the medical groups. But you’ve got the California Primary Care Association, the California Medical Association. You’ve got Planned Parenthood Affiliates of California. You’ve got the the California Hospital Association. And they are all worried that at the end of the day the clinics would fail to meet the spending threshold and that the non-compliance fees that these clinics would ultimately be forced to pay would end up leading to either significantly reduced services at these clinics or even force some of these clinics to close.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>So it’s made up mostly of medical groups, although there are other groups in addition to the medical groups. But you’ve got the California Primary Care Association, the California Medical Association. You’ve got Planned Parenthood Affiliates of California. You’ve got the the California Hospital Association. And they are all worried that at the end of the day the clinics would fail to meet the spending threshold and that the non-compliance fees that these clinics would ultimately be forced to pay would end up leading to either significantly reduced services at these clinics or even force some of these clinics to close.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Mark Shotwell: \u003c/strong>Health centers do a great job of managing those funds, getting high quality healthcare outcomes and this ballot measure would really erode our ability to do that.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Mark Shotwell: \u003c/strong>Health centers do a great job of managing those funds, getting high quality healthcare outcomes and this ballot measure would really erode our ability to do that.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>I spoke specifically with Mark Shotwell. He’s the CEO of Ritter Center. This is a nonprofit who serves a largely unhoused population in San Rafael. And he says about 30% of their costs under his… and this is his opinion, would not qualify as quote health care services.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>I spoke specifically with Mark Shotwell. He’s the CEO of Ritter Center. This is a nonprofit who serves a largely unhoused population in San Rafael. And he says about 30% of their costs under his… and this is his opinion, would not qualify as quote health care services.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Mark Shotwell: \u003c/strong>Things like telehealth services, patient navigation, transportation to ensure that people get to their necessary medical appointments or translation services.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Mark Shotwell: \u003c/strong>Things like telehealth services, patient navigation, transportation to ensure that people get to their necessary medical appointments or translation services.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>He said these are wraparound services like education, housing, home health care. These are all services that he worries would not qualify as direct medical care, you know, offerings and that they would end up, the clinic, Ritter Clinic would end paying kind of precious dollars on penalties when they’re already operating on a really tight budget.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>He said these are wraparound services like education, housing, home health care. These are all services that he worries would not qualify as direct medical care, you know, offerings and that they would end up, the clinic, Ritter Clinic would end paying kind of precious dollars on penalties when they’re already operating on a really tight budget.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Mark Shotwell: \u003c/strong>They’ve decided to focus on CEO or executive salaries and that somehow that’s a problem that we’re not having money go to the patients. It also doesn’t include things like human resources or accounting or IT. So these are all necessary services to run a health clinic. And we have the oversight of family members, boards, the state of California, the federal government. These are highly regulated environments to ensure that patients are getting the very best services, so it’s also unnecessary.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Mark Shotwell: \u003c/strong>They’ve decided to focus on CEO or executive salaries and that somehow that’s a problem that we’re not having money go to the patients. It also doesn’t include things like human resources or accounting or IT. So these are all necessary services to run a health clinic. And we have the oversight of family members, boards, the state of California, the federal government. These are highly regulated environments to ensure that patients are getting the very best services, so it’s also unnecessary.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>So then, Lesley, if Prop 44 actually passes, then 90% of the revenue at these clinics must be spent on healthcare services, as you said. But it seems like the yes and the no sides aren’t really on the same page about what exactly falls under the umbrella of healthcare services. You have Renee on the yes side who’s saying it covers anything related to patient care, but then you have Mark on the no side who says, that this would threaten really essential services at his clinic, so what exactly am I supposed to make of this as a voter?\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>So then, Lesley, if Prop 44 actually passes, then 90% of the revenue at these clinics must be spent on healthcare services, as you said. But it seems like the yes and the no sides aren’t really on the same page about what exactly falls under the umbrella of healthcare services. You have Renee on the yes side who’s saying it covers anything related to patient care, but then you have Mark on the no side who says, that this would threaten really essential services at his clinic, so what exactly am I supposed to make of this as a voter?\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>Yeah, it’s not clear. The yes and no sides are telling me very different things about how this 90% would be defined. The LAO says that the state attorney general would be able to define in more detail which kinds of expenses would qualify. The proposition is not quite as simple as it looks on the ballot. You also have a background that I think is important to know about, which is that there has been pressure to unionize these clinics and some of these clinics have said no to that pressure. There’s an argument from the opponents that this bill is a push or kind of like a political pressure to be like, okay, we’re going to put this thing on the ballot, that’s not going to, that’s going to be really hard for you to meet, if you don’t unionize. Now the union denies that that is part of their agenda, but the opponents arguing that that could potentially be at play here and there has been a past, there’s a history here of SEIU, has filed ballot measures in the past for organizations that have resisted unionization. This includes a series of recent measures that would have placed new regulations on dialysis clinics. So that there is a history there of SEIU doing this. And again, they’re denying it in this moment, but potentially that’s also at play.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>Yeah, it’s not clear. The yes and no sides are telling me very different things about how this 90% would be defined. The LAO says that the state attorney general would be able to define in more detail which kinds of expenses would qualify. The proposition is not quite as simple as it looks on the ballot. You also have a background that I think is important to know about, which is that there has been pressure to unionize these clinics and some of these clinics have said no to that pressure. There’s an argument from the opponents that this bill is a push or kind of like a political pressure to be like, okay, we’re going to put this thing on the ballot, that’s not going to, that’s going to be really hard for you to meet, if you don’t unionize. Now the union denies that that is part of their agenda, but the opponents arguing that that could potentially be at play here and there has been a past, there’s a history here of SEIU, has filed ballot measures in the past for organizations that have resisted unionization. This includes a series of recent measures that would have placed new regulations on dialysis clinics. So that there is a history there of SEIU doing this. And again, they’re denying it in this moment, but potentially that’s also at play.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>What’s going on with campaign spending on Prop 44 on both the yes and the no sides?\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>What’s going on with campaign spending on Prop 44 on both the yes and the no sides?\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>According to CalMatters, who has been reporting on this, they note that SEIU has raised $16.9 million, and the opponents, all those different medical groups, et cetera, have raised about $37.5 million. So more than twice as much has been raised by the opponents.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>According to CalMatters, who has been reporting on this, they note that SEIU has raised $16.9 million, and the opponents, all those different medical groups, et cetera, have raised about $37.5 million. So more than twice as much has been raised by the opponents.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Well Lesley, I appreciate you for breaking this one down for us. Thank you so much.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Well Lesley, I appreciate you for breaking this one down for us. Thank you so much.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>Thank you.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>Thank you.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>In a nutshell, a yes vote on this measure means certain private non-profit health care clinics would have to spend at least 90% of their revenue each year on providing health care services or face a fine. A no vote on the measure means this new requirement on health care clinic spending would not go into effect.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>In a nutshell, a yes vote on this measure means certain private non-profit health care clinics would have to spend at least 90% of their revenue each year on providing health care services or face a fine. A no vote on the measure means this new requirement on health care clinic spending would not go into effect.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>That’s it for our latest episode of PropFest, a collaboration between The Bay and Bay Curious. You’re almost to the finish line.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>That’s it for our latest episode of PropFest, a collaboration between The Bay and Bay Curious. You’re almost to the finish line.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>KQED.org/propfest is the place to return for all these PropFest breakdowns, and if this series is helping you, do us a favor and tell one friend about it.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>KQED.org/propfest is the place to return for all these PropFest breakdowns, and if this series is helping you, do us a favor and tell one friend about it.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>Word of mouth really helps our shows grow. PropFest is made possible thanks to Katrina Schwartz, Pauline Bartolone, Anna Casalme, Olivia Allen-Price:, Gabriela Glueck. Christopher Beale, Alan Montecillo.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>Word of mouth really helps our shows grow. PropFest is made possible thanks to Katrina Schwartz, Pauline Bartolone, Anna Casalme, Olivia Allen-Price:, Gabriela Glueck. Christopher Beale, Alan Montecillo.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>And me, Ericka Cruz Guevarra. We get extra support from Maha Sanad, Katie Springer, Jen Chien, Ethan Toven-Lindsey and everyone on Team KQED.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>And me, Ericka Cruz Guevarra. We get extra support from Maha Sanad, Katie Springer, Jen Chien, Ethan Toven-Lindsey and everyone on Team KQED.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Our show is made in San Francisco at member-supported KQED. Support for The Bay is provided in part by the Osher Production Fund. Some members of the KQED podcast team are represented by the Screen Actors Guild, American Federation of Television and Radio Artists, San Francisco, Northern California Local.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Our show is made in San Francisco at member-supported KQED. Support for The Bay is provided in part by the Osher Production Fund. Some members of the KQED podcast team are represented by the Screen Actors Guild, American Federation of Television and Radio Artists, San Francisco, Northern California Local.\u003c/p>\n"
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003ch2 class=\"wp-block-heading\">Transcript\u003c/h2>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>There are about 2,000 community clinics providing health care here in California.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>These clinics typically serve patients who don’t have any other options. Low-income people or those who are under-insured often go to these clinics for things like vaccines, mental health, and social services.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>They’re also funded in part by our tax dollars. But one union says these clinics aren’t spending enough of their money on patients. And that’s where Proposition 44 comes in.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>Prop 44 would force community health clinics to spend 90% of their revenue on health care services or face penalties from the state.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Will Prop 44 help make healthcare dollars go where they belong? Or could it lead these clinics to cut services or even shut down entirely?\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>That’s for you to decide.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>I’m Ericka Cruz Guevarra, host of The Bay.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>And I’m Olivia Allen-Price, host of Bay Curious.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>And welcome back to Prop Fest, a collaboration between The Bay and Bay Curious. Today, we’re walking you through Proposition 44. Here’s how it reads on your ballot.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Speaker: \u003c/strong>Prop 44 requires community health clinics spend 90% of revenue on program services.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Here to help us break this all down is KQED health correspondent, Lesley McClurg. Hey there, Lesley!\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>Hello.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>What exactly would Prop 44 change for these clinics?\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>The clinics would have to prove that they are spending 90% of their revenue, so they are tax-funded clinics, so they would have to prove they’re spending 90 percent of that money on health care services, so basically medical offerings for their patients. At the end of the day, the attorney general would decide on exactly what qualifies within that 90%. If the clinics don’t comply, they would face fines. Although the penalties that they would have to pay could be returned to them if they were able to hit that 90% quota spending target basically within five years.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Lesley, who put Proposition 44 on the ballot, and what is the problem that they say they’re trying to solve with Prop 44?\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>The proponents of Prop 44 are SEIU, United Health Care Workers West, which is the union that represents health care workers.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Renee Saldana: \u003c/strong>I’d like to remind folks that community clinics were started with the mission of serving some of the folks in California that need these services the most.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>I spoke with Renee Saldana, the press secretary for the union, and she said the union is really trying to ensure that clinics are investing their money correctly.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Renee Saldana: \u003c/strong>It’s essentially anything that would help patients receive care or the direct care itself. So this includes medical visits, lab tests and x-rays, preventative care, of course, like vaccines and screenings, mammograms, things like outreach, transportation, language interpretation…\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>They have found that some clinics are using their revenue poorly, maybe even wasting it on anything that the union says could be, say, unnecessary administrative costs. So they’re spending too much on running the clinic rather than putting that money towards patients. Maybe spending too much on fundraising. But the main thing that they’re pointing out is potentially executive compensation, so over bloated salaries for the top, for the people who are running these clinics.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Renee Saldana: \u003c/strong>So I think a lot of Californians really understand how important these clinics are to our healthcare system and they wanna make sure that they are prioritizing patients by spending our public dollars where the dollars are needed most, which is directly on patient care and other mission-related services.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>The California Legislative Analyst’s Office, which is a nonpartisan fiscal advisor, notes that these clinics currently spend, on average, about 80% of their revenue on healthcare services, although it does vary and depend on each individual clinic. But the yes on 44 or the union believes that that really should be 90% across the board.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>And do they also mention, I mean, these cuts that we’ve seen to health care at the federal level as a reason also to pass this?\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>Absolutely. So you’ve got this H.R.1, which is the federal bill, it’s also been called, you know, the big, beautiful bill. But basically, the Trump administration is heavily cutting federal funding for medical care. And so these clinics are going to be hurting and working on a much tighter budget. And so the union is arguing that they need to ensure that these clinics are using their budgets as well as possible so that best care can reach patients. Since it’s a really hard time to ensure that everybody has the medical care that they need under these federal cuts.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Renee Saldana: \u003c/strong>Again, all we want is that these clinics are able to stay open when these health care cuts from H.R.1 really hit California next year.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>So you have SEIU, the union that represents many healthcare workers in favor of Prop 44. Any other groups in favor of this measure?\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>The only group that I’m aware of is the California Labor Federation is also in favor.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>We’ll have more on Prop 44 right after this. By the way, did you know that KQED is funded almost entirely by listeners just like you? Join the thousands of everyday listeners who help make this work happen. Just go to donate.kqed.org/podcasts. We’ll be right back. And we’re back talking about Prop 44 with KQED health correspondent, Lesley McClurg. Lesley, this measure has a long list of opponents actually, tell me a little bit more about who’s against Prop 44 and what their argument is?\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>So it’s made up mostly of medical groups, although there are other groups in addition to the medical groups. But you’ve got the California Primary Care Association, the California Medical Association. You’ve got Planned Parenthood Affiliates of California. You’ve got the the California Hospital Association. And they are all worried that at the end of the day the clinics would fail to meet the spending threshold and that the non-compliance fees that these clinics would ultimately be forced to pay would end up leading to either significantly reduced services at these clinics or even force some of these clinics to close.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Mark Shotwell: \u003c/strong>Health centers do a great job of managing those funds, getting high quality healthcare outcomes and this ballot measure would really erode our ability to do that.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>I spoke specifically with Mark Shotwell. He’s the CEO of Ritter Center. This is a nonprofit who serves a largely unhoused population in San Rafael. And he says about 30% of their costs under his… and this is his opinion, would not qualify as quote health care services.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Mark Shotwell: \u003c/strong>Things like telehealth services, patient navigation, transportation to ensure that people get to their necessary medical appointments or translation services.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>He said these are wraparound services like education, housing, home health care. These are all services that he worries would not qualify as direct medical care, you know, offerings and that they would end up, the clinic, Ritter Clinic would end paying kind of precious dollars on penalties when they’re already operating on a really tight budget.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Mark Shotwell: \u003c/strong>They’ve decided to focus on CEO or executive salaries and that somehow that’s a problem that we’re not having money go to the patients. It also doesn’t include things like human resources or accounting or IT. So these are all necessary services to run a health clinic. And we have the oversight of family members, boards, the state of California, the federal government. These are highly regulated environments to ensure that patients are getting the very best services, so it’s also unnecessary.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>So then, Lesley, if Prop 44 actually passes, then 90% of the revenue at these clinics must be spent on healthcare services, as you said. But it seems like the yes and the no sides aren’t really on the same page about what exactly falls under the umbrella of healthcare services. You have Renee on the yes side who’s saying it covers anything related to patient care, but then you have Mark on the no side who says, that this would threaten really essential services at his clinic, so what exactly am I supposed to make of this as a voter?\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>Yeah, it’s not clear. The yes and no sides are telling me very different things about how this 90% would be defined. The LAO says that the state attorney general would be able to define in more detail which kinds of expenses would qualify. The proposition is not quite as simple as it looks on the ballot. You also have a background that I think is important to know about, which is that there has been pressure to unionize these clinics and some of these clinics have said no to that pressure. There’s an argument from the opponents that this bill is a push or kind of like a political pressure to be like, okay, we’re going to put this thing on the ballot, that’s not going to, that’s going to be really hard for you to meet, if you don’t unionize. Now the union denies that that is part of their agenda, but the opponents arguing that that could potentially be at play here and there has been a past, there’s a history here of SEIU, has filed ballot measures in the past for organizations that have resisted unionization. This includes a series of recent measures that would have placed new regulations on dialysis clinics. So that there is a history there of SEIU doing this. And again, they’re denying it in this moment, but potentially that’s also at play.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>What’s going on with campaign spending on Prop 44 on both the yes and the no sides?\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>According to CalMatters, who has been reporting on this, they note that SEIU has raised $16.9 million, and the opponents, all those different medical groups, et cetera, have raised about $37.5 million. So more than twice as much has been raised by the opponents.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Well Lesley, I appreciate you for breaking this one down for us. Thank you so much.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Lesley McClurg: \u003c/strong>Thank you.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>In a nutshell, a yes vote on this measure means certain private non-profit health care clinics would have to spend at least 90% of their revenue each year on providing health care services or face a fine. A no vote on the measure means this new requirement on health care clinic spending would not go into effect.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>That’s it for our latest episode of PropFest, a collaboration between The Bay and Bay Curious. You’re almost to the finish line.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>KQED.org/propfest is the place to return for all these PropFest breakdowns, and if this series is helping you, do us a favor and tell one friend about it.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>Word of mouth really helps our shows grow. PropFest is made possible thanks to Katrina Schwartz, Pauline Bartolone, Anna Casalme, Olivia Allen-Price:, Gabriela Glueck. Christopher Beale, Alan Montecillo.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>And me, Ericka Cruz Guevarra. We get extra support from Maha Sanad, Katie Springer, Jen Chien, Ethan Toven-Lindsey and everyone on Team KQED.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Our show is made in San Francisco at member-supported KQED. Support for The Bay is provided in part by the Osher Production Fund. Some members of the KQED podcast team are represented by the Screen Actors Guild, American Federation of Television and Radio Artists, San Francisco, Northern California Local.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>I’m Ericka Cruz Guevarra.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>And I’m Olivia Allen-Price:. Thanks for listening.\u003c/p>\n\n\n\n\u003cp>\u003cem>Some members of the KQED podcast team are represented by The Screen Actors Guild, American Federation of Television and Radio Artists, San Francisco-Northern California Local.\u003c/em>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "prop-38-borrows-8-4-billion-to-fund-immunology-research",
"title": "Prop 38: Borrows $8.4 Billion to Fund Immunology Research",
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"content": "\n\u003ch2 class=\"wp-block-heading\">Transcript\u003c/h2>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:00:00] \u003c/em>Immunotherapy has been around for a really long time. Things like vaccines are considered part of immunology, but it also includes more recent innovations like newer treatments for blood and skin cancers. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>\u003cem>[00:00:15] \u003c/em>In simple terms, immunotherapy is individualized treatment designed to harness a patient’s immune system to fight disease. For some, immunotherapy has been life-changing. And voters are being asked this November whether to fund immunology and immunotherapy research with one very specific beneficiary in mind. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:00:38] \u003c/em>I’m Ericka Cruz Guevarra, host of The Bay. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>\u003cem>[00:00:41] \u003c/em>And I’m Olivia Allen-Price, host of Bay Curious. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:00:44] \u003c/em>And welcome to Prop Fest. A collaboration between the Bay and Bay Curious, where we break down all 14 statewide propositions on your ballot this year November. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>\u003cem>[00:00:54] \u003c/em>And we’re back at it again with Proposition 38. Here’s how it reads on your ballot. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Reporter: \u003c/strong>\u003cem>[00:01:01] \u003c/em>Prop 38 authorizes bonds for immunology medical research. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:01:08] \u003c/em>Here to walk us through all of this is KQED Health Correspondent April Dembosky. April, first of all, what is Prop 38 all about? \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:01:16] \u003c/em>Prop 38 is a bond measure that would fund immunology and immunotherapy research. It would allow the state to borrow $8.4 billion and distribute it to nonprofit research centers that are studying immunotherapy treatments for cancer, heart disease, and Alzheimer’s. The measure is expected to cost the state about $500 million a year for 20 years in bond repayments. And about $4 billion of that would be interest payments on top of the original 8.4 billion for a total cost of about $12 billion. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:01:58] \u003c/em>There is sort of an interesting story about how this came on the ballot in the first place, right? Can you actually talk about why voters are even being asked to fund immunotherapy in this year’s election?\u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:02:11] \u003c/em>Prop 38 was the brainchild of a philanthropist named Gary Michelson. He raised the money to collect the signatures and put Prop 38 on the ballot. Something that’s really interesting about the initiative is how it’s worded. The language is very careful. It lists very strict criteria for the type of academic institution that should receive half of the money. This criteria is so specific. That only one university in the state meets the criteria, and that is UCLA. Half the funds would go toward launching a new immunology institute at UCLA, and the other half would be awarded through competitive grants to other institutes also in California. And so, as it turns out, Michelson has already donated $120 million of his own money to establish a new institute for immunotherapy at UCLA. It’s called the California Institute for Immunology and Immunotherapy. That same institution would also be the touch point for all the research. So the other half of the funding that would get distributed in competitive grants would all be sort of centered at UCLA. So it’s safe to say that this is on the ballot because a very wealthy philanthropist put it there as a way to finance a research institution focused on his interest, which is immunology and immunotherapy.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:03:50] \u003c/em>Okay, April, so Prop 38 was put on the ballot by this wealthy philanthropist, Gary Michelson, and it’s written in this way that would, it sounds like directly benefit a research institute at UCLA that he’s helping to fund. So clearly he has some skin in the game here. Is Prop 38 getting much support from elsewhere? Like how else is the pro-Prop 38 side kind of shaping up?\u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:04:18] \u003c/em>There’s a long list of foundations and advocacy groups that have signed on in support of Prop 38, places like Blood Cancer United, the Melanoma Research Alliance, the Alzheimer’s Association, the ALS Association, the National Multiple Sclerosis Society, the Michael J. Fox Foundation for Parkinson’s Research. So these are groups that hope and believe that new immunotherapies could be developed to treat these specific diseases. Proponents also say this initiative is necessary because federal funding for this kind of research has become unreliable under the current administration. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Jillian McCool: \u003c/strong>\u003cem>[00:04:58] \u003c/em>The big thing right now is that current CAR T therapy is really expensive. It’s not as efficient as we want it to be. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:05:05] \u003c/em>So I spoke to one researcher who was working on a project funded by the NIH, the National Institutes of Health. Her name is Jillian McCool, and she was working at Lawrence Livermore National Laboratory studying vaccines and a kind of therapy for cancer. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Jillian McCool: \u003c/strong>\u003cem>[00:05:20] \u003c/em>We basically can take your immune cells and we can take them out of your body and we an alter them so they’re better fit and better suited to fight cancer cells specifically. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:05:29] \u003c/em>And then some of their grants ran out after they reached the end of the term, but then some of the funding was paused because of the most recent government shutdown. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Jillian McCool: \u003c/strong>\u003cem>[00:05:38] \u003c/em>All of the sudden we have this weird rhetoric around vaccines and all of the sudden there’s this new administration coming in that’s kind of pushing that rhetoric. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:05:47] \u003c/em>McCool says about 100 scientists were laid off, including her. She was out of work for a year and a half. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Jillian McCool: \u003c/strong>\u003cem>[00:05:54] \u003c/em>And then the public is no longer trusting scientists and what they have to say in the data we’ve collected, it kind of makes you question your whole career in general. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:06:05] \u003c/em>So it’s personal for McCool, but she says Prop 38 is a way to correct what’s happening at the federal level and protect the jobs of lots of other scientists. She also says, you know, California is a center of excellence in this kind of research, and so it makes sense to root it here. She also points out that the measure is designed to be cost neutral, with 10% of revenues generated from successful discoveries being funneled back to the state. Californians would also be entitled to a 20% discount on any new therapies that are generated from the bond money.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:06:41] \u003c/em>And a big part of immunotherapy research is directed towards cancer research and you actually met a cancer patient who’s pretty gung-ho about Prop 38, right? Tell me about her. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Laurie Adami: \u003c/strong>\u003cem>[00:06:52] \u003c/em>My name is Laurie Adami and I live in Los Angeles, California. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:06:57] \u003c/em>Laurie was diagnosed with non-Hodgkin’s lymphoma. It’s a kind of blood cancer, and this was 20 years ago. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Laurie Adami: \u003c/strong>\u003cem>[00:07:04] \u003c/em>And when I got sick and I ended up losing my career as a result of my very long battle with cancer. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:07:13] \u003c/em>Several years ago, she enrolled in a clinical trial for an immunotherapy called CAR-T. So, Laurie had one infusion of this immunotherapy about eight years ago and her cancer has not come back since. Now, she’s only one person. You know, it’s important to point out there’s still a large proportion of patients who participated in these trials who did not respond in the same way. But as you can imagine, Laurie is pretty gung-ho for Prop 38. Because of the prospect that it could fund more research and develop more treatments like this to fight other kinds of cancers and other diseases and help more people. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Laurie Adami: \u003c/strong>\u003cem>[00:07:54] \u003c/em>You know, not every family is gonna be affected by cancer, but every family is gonna affected by these other diseases. And so I am a huge proponent and supporter because immunotherapy saved my life. So why wouldn’t I believe? And why wouldn’t I want more patients to be able to access the type of treatment that finally saved my live? \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:08:23] \u003c/em>We’ll have more on Proposition 38 right after this. By the way, if you appreciate the work we’re doing here on PropFest, consider becoming a sustaining member of KQED. We can’t do this work without you. Just go to donate.kqed.org slash podcasts. We’ll be right back. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:08:47] \u003c/em>And we’re back breaking down Proposition 38 with KQED’s April Dembosky. April, you talked about the various different groups supporting Prop 38, including a patient who really believes in the power of immunotherapy research to potentially save lives. So who’s coming out against Prop 38 and what is their argument? \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:09:10] \u003c/em>Yeah, so there’s a very small group of opponents. They’re pretty much all volunteers. It’s very grassroots. And they have organized to point out what they see as the weaknesses and even what they might call the dangers of Prop 38\u003cem>.\u003c/em>\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Robert Kaplan: \u003c/strong>\u003cem>[00:09:26] \u003c/em>I just think that there are inherent conflicts of interest. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:09:29] \u003c/em>The main one is Robert Kaplan. He’s a biomedical researcher and administrator at Stanford University School of Medicine. And he also worked at the NIH, the National Institutes of Health. So he has a lot of experience coordinating the kind of research that we’re talking about and at a really grand scale. So he says he supports biomedical research. He’s in favor of science, including immunotherapy. But he says this proposition is not the way to fund it. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Robert Kaplan: \u003c/strong>\u003cem>[00:09:58] \u003c/em>If you look at NIH support for biomedical research in general or immunology research, there are several institutions in California that are the national leaders, but because of the sort of arbitrary criteria in Proposition 38, they’re not eligible to compete. And we think that’s not right.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:10:17] \u003c/em>So science grants are usually awarded based on an open, competitive process. People have to have a proven track record. He says it’s a good idea to spread that kind of research across different institutions, so you have different people with different ideas and different methodology. But half of the money for Prop 38 goes directly to one brand new institute that is barely off the ground yet, and it has zero track record. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Robert Kaplan: \u003c/strong>\u003cem>[00:10:47] \u003c/em>I think [if] taxpayers are going to have to repay these bonds. We think that should be a fair competition that allows all of these excellent institutions in California to have an opportunity to be in that competition. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:10:59] \u003c/em>The opponents would really point out it’s only for immunotherapy and immunology research. So if you think that there are other kinds of health priorities, like mental illness or kidney disease or other kinds treatments, those are not included here. The other people speaking out against Prop 38, they’re a very interesting group. They are financial analysts who used to work at the LAO. That’s the Legislative Analyst’s Office. And this is a nonpartisan state agency. It’s tasked with evaluating proposed legislation and ballot measures like this one. And they are trained to never take a stand on political issues. And in this case, three retired analysts from the LAOs are breaking that wall, because of their concerns on Prop 38.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Dan Carson: \u003c/strong>\u003cem>[00:11:56] \u003c/em>Hi. I’m Dan Carson. I’m here today as a cancer survivor myself, who is obviously not against good medical research.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:12:05] \u003c/em>So one of them is Dan Carson. He ran the health section of the LAO back in 2004 when another bond measure was on the ballot to fund stem cell research. So proponents said the $3 billion for that initiative would be paid back by all the new stem cell discoveries that researchers made with the money.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Dan Carson: \u003c/strong>\u003cem>[00:12:26] \u003c/em>In fact, as our analysis at the time made really clear, the state eventually received only a tiny fraction of the billions of dollars we were promised. So here we go again with Prop 38. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:12:41] \u003c/em>The opponents of Prop 38 take issue with one of the main claims that the supporters of Prop 38 have, which is they say that the proposition will be cost neutral, that the money that California borrows and spends on the research will be made back by revenues from all of the scientific discoveries that they made. The LAO analysts say the math just doesn’t add up. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Dan Carson: \u003c/strong>\u003cem>[00:13:08] \u003c/em>Oh, once again, we’re being promised in this initiative and by its advocates that will quote, pay for itself with no net cost to the state or taxpayers, closed quote. I’m here to tell you that after reviewing the fine print of this ballot measure, that won’t happen. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:13:32] \u003c/em>April, what’s spending on Prop 38 looking like on either side, the yes and the no side? \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:13:38] \u003c/em>So the Yes on Prop 38 campaign has raised about $27 million so far, and that comes mainly from Gary Michaelson and another billionaire who have donated to the same institute that would be the main beneficiary of the Prop 38 funds. The no side has not raised any money so far.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:13:59] \u003c/em>It seems like we as voters are sort of being asked to decide how scientific research should happen almost and the best way to go about that. How do you think voters should sort of navigate the question being asked before them? \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:14:15] \u003c/em>It’s such a tricky one to put voters in a position of having to become experts on a field of science that maybe they haven’t even heard about. Totally, that’s how I feel. Right. You know, I think on its face, Prop 38 is very appealing and we’ve seen various ballot measures over the years that are healthcare oriented and we find that they often play well. For people who feel really strongly about this area of research, they may feel happy to have the opportunity to vote on something like this and set aside a pot of money that is just for this kind of research. On the other hand, the way that this proposition is worded and the way the money would be distributed looks very, very different from the kind of process that’s used at the federal level. So you’re not just creating a new fund for stability, you’re actually creating a new way of how that science gets funded and how the money gets distributed. Propositions like this, you could say are direct democracy, but in another way, they also circumvent that other democratic process.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:15:35] \u003c/em>Well, April Dombosky, thank you so much for breaking this down. Appreciate it.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:15:40] \u003c/em>Thanks, Ericka.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:15:42] \u003c/em>In a nutshell, a yes vote on this measure means the state could borrow $8.4 billion to support medical research in immunology and immunotherapy. A no vote means the state cannot borrow 8.4 billion for immunology, and immunotherapy research. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>\u003cem>[00:16:02] \u003c/em>And that’s it for our latest episode of PropFest, a collaboration between The Bay and Bay Curious. If this series is helping you get educated on all the statewide props, we sure hope that you’re going to share them with your friends and family. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:16:16] \u003c/em>The link is kqed.org slash propfest and we’ll be dropping new breakdowns until October 9th. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>\u003cem>[00:16:24] \u003c/em>PropFest is made possible thanks to Katrina Schwartz, Pauline Bartolone, Anna Casalme, Ericka Cruz Guevara, Gabriela Glueck. Christopher Beale, Alan Montecillo. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>\u003cem>[00:16:35] \u003c/em>And me, Olivia Allen Price. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:16:37] \u003c/em>We get extra support from Maha Sanad, Katie Springer, Jen Chien. Ethan Tovan Lindsey and everyone on Team KQED. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>\u003cem>[00:16:46] \u003c/em>Our show is made in San Francisco at member-supported KQED.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:16:51] \u003c/em>Support for The Bay is provided in part by the Osher Production Fund. Some members of the KQED podcast team are represented by the Screen Actors Guild, American Federation of Television and Radio Artists, San Francisco, Northern California Local. I’m Ericka Cruz Guevarra. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>\u003cem>[00:17:08] \u003c/em>And I’m Olivia Allen-Price. Have a good one. \u003c/p>\n\n\n\n\u003cp>\u003cem>Some members of the KQED podcast team are represented by The Screen Actors Guild, American Federation of Television and Radio Artists, San Francisco-Northern California Local.\u003c/em>\u003c/p>\n\n\n\n\u003cp>\u003c/p>\n",
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:00:00] \u003c/em>Immunotherapy has been around for a really long time. Things like vaccines are considered part of immunology, but it also includes more recent innovations like newer treatments for blood and skin cancers. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:00:00] \u003c/em>Immunotherapy has been around for a really long time. Things like vaccines are considered part of immunology, but it also includes more recent innovations like newer treatments for blood and skin cancers. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>\u003cem>[00:00:15] \u003c/em>In simple terms, immunotherapy is individualized treatment designed to harness a patient’s immune system to fight disease. For some, immunotherapy has been life-changing. And voters are being asked this November whether to fund immunology and immunotherapy research with one very specific beneficiary in mind. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>\u003cem>[00:00:15] \u003c/em>In simple terms, immunotherapy is individualized treatment designed to harness a patient’s immune system to fight disease. For some, immunotherapy has been life-changing. And voters are being asked this November whether to fund immunology and immunotherapy research with one very specific beneficiary in mind. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:00:38] \u003c/em>I’m Ericka Cruz Guevarra, host of The Bay. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:00:38] \u003c/em>I’m Ericka Cruz Guevarra, host of The Bay. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>\u003cem>[00:00:41] \u003c/em>And I’m Olivia Allen-Price, host of Bay Curious. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>\u003cem>[00:00:41] \u003c/em>And I’m Olivia Allen-Price, host of Bay Curious. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:00:44] \u003c/em>And welcome to Prop Fest. A collaboration between the Bay and Bay Curious, where we break down all 14 statewide propositions on your ballot this year November. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:00:44] \u003c/em>And welcome to Prop Fest. A collaboration between the Bay and Bay Curious, where we break down all 14 statewide propositions on your ballot this year November. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>\u003cem>[00:00:54] \u003c/em>And we’re back at it again with Proposition 38. Here’s how it reads on your ballot. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>\u003cem>[00:00:54] \u003c/em>And we’re back at it again with Proposition 38. Here’s how it reads on your ballot. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Reporter: \u003c/strong>\u003cem>[00:01:01] \u003c/em>Prop 38 authorizes bonds for immunology medical research. \u003c/p>\n",
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:01:08] \u003c/em>Here to walk us through all of this is KQED Health Correspondent April Dembosky. April, first of all, what is Prop 38 all about? \u003c/p>\n",
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"innerHTML": "\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:01:16] \u003c/em>Prop 38 is a bond measure that would fund immunology and immunotherapy research. It would allow the state to borrow $8.4 billion and distribute it to nonprofit research centers that are studying immunotherapy treatments for cancer, heart disease, and Alzheimer’s. The measure is expected to cost the state about $500 million a year for 20 years in bond repayments. And about $4 billion of that would be interest payments on top of the original 8.4 billion for a total cost of about $12 billion. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:01:16] \u003c/em>Prop 38 is a bond measure that would fund immunology and immunotherapy research. It would allow the state to borrow $8.4 billion and distribute it to nonprofit research centers that are studying immunotherapy treatments for cancer, heart disease, and Alzheimer’s. The measure is expected to cost the state about $500 million a year for 20 years in bond repayments. And about $4 billion of that would be interest payments on top of the original 8.4 billion for a total cost of about $12 billion. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:01:58] \u003c/em>There is sort of an interesting story about how this came on the ballot in the first place, right? Can you actually talk about why voters are even being asked to fund immunotherapy in this year’s election?\u003c/p>\n",
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"innerHTML": "\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:02:11] \u003c/em>Prop 38 was the brainchild of a philanthropist named Gary Michelson. He raised the money to collect the signatures and put Prop 38 on the ballot. Something that’s really interesting about the initiative is how it’s worded. The language is very careful. It lists very strict criteria for the type of academic institution that should receive half of the money. This criteria is so specific. That only one university in the state meets the criteria, and that is UCLA. Half the funds would go toward launching a new immunology institute at UCLA, and the other half would be awarded through competitive grants to other institutes also in California. And so, as it turns out, Michelson has already donated $120 million of his own money to establish a new institute for immunotherapy at UCLA. It’s called the California Institute for Immunology and Immunotherapy. That same institution would also be the touch point for all the research. So the other half of the funding that would get distributed in competitive grants would all be sort of centered at UCLA. So it’s safe to say that this is on the ballot because a very wealthy philanthropist put it there as a way to finance a research institution focused on his interest, which is immunology and immunotherapy.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:02:11] \u003c/em>Prop 38 was the brainchild of a philanthropist named Gary Michelson. He raised the money to collect the signatures and put Prop 38 on the ballot. Something that’s really interesting about the initiative is how it’s worded. The language is very careful. It lists very strict criteria for the type of academic institution that should receive half of the money. This criteria is so specific. That only one university in the state meets the criteria, and that is UCLA. Half the funds would go toward launching a new immunology institute at UCLA, and the other half would be awarded through competitive grants to other institutes also in California. And so, as it turns out, Michelson has already donated $120 million of his own money to establish a new institute for immunotherapy at UCLA. It’s called the California Institute for Immunology and Immunotherapy. That same institution would also be the touch point for all the research. So the other half of the funding that would get distributed in competitive grants would all be sort of centered at UCLA. So it’s safe to say that this is on the ballot because a very wealthy philanthropist put it there as a way to finance a research institution focused on his interest, which is immunology and immunotherapy.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:03:50] \u003c/em>Okay, April, so Prop 38 was put on the ballot by this wealthy philanthropist, Gary Michelson, and it’s written in this way that would, it sounds like directly benefit a research institute at UCLA that he’s helping to fund. So clearly he has some skin in the game here. Is Prop 38 getting much support from elsewhere? Like how else is the pro-Prop 38 side kind of shaping up?\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:03:50] \u003c/em>Okay, April, so Prop 38 was put on the ballot by this wealthy philanthropist, Gary Michelson, and it’s written in this way that would, it sounds like directly benefit a research institute at UCLA that he’s helping to fund. So clearly he has some skin in the game here. Is Prop 38 getting much support from elsewhere? Like how else is the pro-Prop 38 side kind of shaping up?\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:04:18] \u003c/em>There’s a long list of foundations and advocacy groups that have signed on in support of Prop 38, places like Blood Cancer United, the Melanoma Research Alliance, the Alzheimer’s Association, the ALS Association, the National Multiple Sclerosis Society, the Michael J. Fox Foundation for Parkinson’s Research. So these are groups that hope and believe that new immunotherapies could be developed to treat these specific diseases. Proponents also say this initiative is necessary because federal funding for this kind of research has become unreliable under the current administration. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:04:18] \u003c/em>There’s a long list of foundations and advocacy groups that have signed on in support of Prop 38, places like Blood Cancer United, the Melanoma Research Alliance, the Alzheimer’s Association, the ALS Association, the National Multiple Sclerosis Society, the Michael J. Fox Foundation for Parkinson’s Research. So these are groups that hope and believe that new immunotherapies could be developed to treat these specific diseases. Proponents also say this initiative is necessary because federal funding for this kind of research has become unreliable under the current administration. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Jillian McCool: \u003c/strong>\u003cem>[00:04:58] \u003c/em>The big thing right now is that current CAR T therapy is really expensive. It’s not as efficient as we want it to be. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>Jillian McCool: \u003c/strong>\u003cem>[00:04:58] \u003c/em>The big thing right now is that current CAR T therapy is really expensive. It’s not as efficient as we want it to be. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:05:05] \u003c/em>So I spoke to one researcher who was working on a project funded by the NIH, the National Institutes of Health. Her name is Jillian McCool, and she was working at Lawrence Livermore National Laboratory studying vaccines and a kind of therapy for cancer. \u003c/p>\n",
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"innerHTML": "\n\u003cp>\u003cstrong>Jillian McCool: \u003c/strong>\u003cem>[00:05:20] \u003c/em>We basically can take your immune cells and we can take them out of your body and we an alter them so they’re better fit and better suited to fight cancer cells specifically. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>Jillian McCool: \u003c/strong>\u003cem>[00:05:20] \u003c/em>We basically can take your immune cells and we can take them out of your body and we an alter them so they’re better fit and better suited to fight cancer cells specifically. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:05:29] \u003c/em>And then some of their grants ran out after they reached the end of the term, but then some of the funding was paused because of the most recent government shutdown. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:05:29] \u003c/em>And then some of their grants ran out after they reached the end of the term, but then some of the funding was paused because of the most recent government shutdown. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Jillian McCool: \u003c/strong>\u003cem>[00:05:38] \u003c/em>All of the sudden we have this weird rhetoric around vaccines and all of the sudden there’s this new administration coming in that’s kind of pushing that rhetoric. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>Jillian McCool: \u003c/strong>\u003cem>[00:05:38] \u003c/em>All of the sudden we have this weird rhetoric around vaccines and all of the sudden there’s this new administration coming in that’s kind of pushing that rhetoric. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:05:47] \u003c/em>McCool says about 100 scientists were laid off, including her. She was out of work for a year and a half. \u003c/p>\n",
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"innerHTML": "\n\u003cp>\u003cstrong>Jillian McCool: \u003c/strong>\u003cem>[00:05:54] \u003c/em>And then the public is no longer trusting scientists and what they have to say in the data we’ve collected, it kind of makes you question your whole career in general. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>Jillian McCool: \u003c/strong>\u003cem>[00:05:54] \u003c/em>And then the public is no longer trusting scientists and what they have to say in the data we’ve collected, it kind of makes you question your whole career in general. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:06:05] \u003c/em>So it’s personal for McCool, but she says Prop 38 is a way to correct what’s happening at the federal level and protect the jobs of lots of other scientists. She also says, you know, California is a center of excellence in this kind of research, and so it makes sense to root it here. She also points out that the measure is designed to be cost neutral, with 10% of revenues generated from successful discoveries being funneled back to the state. Californians would also be entitled to a 20% discount on any new therapies that are generated from the bond money.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:06:05] \u003c/em>So it’s personal for McCool, but she says Prop 38 is a way to correct what’s happening at the federal level and protect the jobs of lots of other scientists. She also says, you know, California is a center of excellence in this kind of research, and so it makes sense to root it here. She also points out that the measure is designed to be cost neutral, with 10% of revenues generated from successful discoveries being funneled back to the state. Californians would also be entitled to a 20% discount on any new therapies that are generated from the bond money.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:06:41] \u003c/em>And a big part of immunotherapy research is directed towards cancer research and you actually met a cancer patient who’s pretty gung-ho about Prop 38, right? Tell me about her. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:06:41] \u003c/em>And a big part of immunotherapy research is directed towards cancer research and you actually met a cancer patient who’s pretty gung-ho about Prop 38, right? Tell me about her. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Laurie Adami: \u003c/strong>\u003cem>[00:06:52] \u003c/em>My name is Laurie Adami and I live in Los Angeles, California. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>Laurie Adami: \u003c/strong>\u003cem>[00:06:52] \u003c/em>My name is Laurie Adami and I live in Los Angeles, California. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:06:57] \u003c/em>Laurie was diagnosed with non-Hodgkin’s lymphoma. It’s a kind of blood cancer, and this was 20 years ago. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:06:57] \u003c/em>Laurie was diagnosed with non-Hodgkin’s lymphoma. It’s a kind of blood cancer, and this was 20 years ago. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Laurie Adami: \u003c/strong>\u003cem>[00:07:04] \u003c/em>And when I got sick and I ended up losing my career as a result of my very long battle with cancer. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>Laurie Adami: \u003c/strong>\u003cem>[00:07:04] \u003c/em>And when I got sick and I ended up losing my career as a result of my very long battle with cancer. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:07:13] \u003c/em>Several years ago, she enrolled in a clinical trial for an immunotherapy called CAR-T. So, Laurie had one infusion of this immunotherapy about eight years ago and her cancer has not come back since. Now, she’s only one person. You know, it’s important to point out there’s still a large proportion of patients who participated in these trials who did not respond in the same way. But as you can imagine, Laurie is pretty gung-ho for Prop 38. Because of the prospect that it could fund more research and develop more treatments like this to fight other kinds of cancers and other diseases and help more people. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:07:13] \u003c/em>Several years ago, she enrolled in a clinical trial for an immunotherapy called CAR-T. So, Laurie had one infusion of this immunotherapy about eight years ago and her cancer has not come back since. Now, she’s only one person. You know, it’s important to point out there’s still a large proportion of patients who participated in these trials who did not respond in the same way. But as you can imagine, Laurie is pretty gung-ho for Prop 38. Because of the prospect that it could fund more research and develop more treatments like this to fight other kinds of cancers and other diseases and help more people. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Laurie Adami: \u003c/strong>\u003cem>[00:07:54] \u003c/em>You know, not every family is gonna be affected by cancer, but every family is gonna affected by these other diseases. And so I am a huge proponent and supporter because immunotherapy saved my life. So why wouldn’t I believe? And why wouldn’t I want more patients to be able to access the type of treatment that finally saved my live? \u003c/p>\n",
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"\n\u003cp>\u003cstrong>Laurie Adami: \u003c/strong>\u003cem>[00:07:54] \u003c/em>You know, not every family is gonna be affected by cancer, but every family is gonna affected by these other diseases. And so I am a huge proponent and supporter because immunotherapy saved my life. So why wouldn’t I believe? And why wouldn’t I want more patients to be able to access the type of treatment that finally saved my live? \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:08:23] \u003c/em>We’ll have more on Proposition 38 right after this. By the way, if you appreciate the work we’re doing here on PropFest, consider becoming a sustaining member of KQED. We can’t do this work without you. Just go to donate.kqed.org slash podcasts. We’ll be right back. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:08:23] \u003c/em>We’ll have more on Proposition 38 right after this. By the way, if you appreciate the work we’re doing here on PropFest, consider becoming a sustaining member of KQED. We can’t do this work without you. Just go to donate.kqed.org slash podcasts. We’ll be right back. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:08:47] \u003c/em>And we’re back breaking down Proposition 38 with KQED’s April Dembosky. April, you talked about the various different groups supporting Prop 38, including a patient who really believes in the power of immunotherapy research to potentially save lives. So who’s coming out against Prop 38 and what is their argument? \u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:08:47] \u003c/em>And we’re back breaking down Proposition 38 with KQED’s April Dembosky. April, you talked about the various different groups supporting Prop 38, including a patient who really believes in the power of immunotherapy research to potentially save lives. So who’s coming out against Prop 38 and what is their argument? \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:09:10] \u003c/em>Yeah, so there’s a very small group of opponents. They’re pretty much all volunteers. It’s very grassroots. And they have organized to point out what they see as the weaknesses and even what they might call the dangers of Prop 38\u003cem>.\u003c/em>\u003c/p>\n",
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"\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:09:10] \u003c/em>Yeah, so there’s a very small group of opponents. They’re pretty much all volunteers. It’s very grassroots. And they have organized to point out what they see as the weaknesses and even what they might call the dangers of Prop 38\u003cem>.\u003c/em>\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Robert Kaplan: \u003c/strong>\u003cem>[00:09:26] \u003c/em>I just think that there are inherent conflicts of interest. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>Robert Kaplan: \u003c/strong>\u003cem>[00:09:26] \u003c/em>I just think that there are inherent conflicts of interest. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:09:29] \u003c/em>The main one is Robert Kaplan. He’s a biomedical researcher and administrator at Stanford University School of Medicine. And he also worked at the NIH, the National Institutes of Health. So he has a lot of experience coordinating the kind of research that we’re talking about and at a really grand scale. So he says he supports biomedical research. He’s in favor of science, including immunotherapy. But he says this proposition is not the way to fund it. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:09:29] \u003c/em>The main one is Robert Kaplan. He’s a biomedical researcher and administrator at Stanford University School of Medicine. And he also worked at the NIH, the National Institutes of Health. So he has a lot of experience coordinating the kind of research that we’re talking about and at a really grand scale. So he says he supports biomedical research. He’s in favor of science, including immunotherapy. But he says this proposition is not the way to fund it. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Robert Kaplan: \u003c/strong>\u003cem>[00:09:58] \u003c/em>If you look at NIH support for biomedical research in general or immunology research, there are several institutions in California that are the national leaders, but because of the sort of arbitrary criteria in Proposition 38, they’re not eligible to compete. And we think that’s not right.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Robert Kaplan: \u003c/strong>\u003cem>[00:09:58] \u003c/em>If you look at NIH support for biomedical research in general or immunology research, there are several institutions in California that are the national leaders, but because of the sort of arbitrary criteria in Proposition 38, they’re not eligible to compete. And we think that’s not right.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:10:17] \u003c/em>So science grants are usually awarded based on an open, competitive process. People have to have a proven track record. He says it’s a good idea to spread that kind of research across different institutions, so you have different people with different ideas and different methodology. But half of the money for Prop 38 goes directly to one brand new institute that is barely off the ground yet, and it has zero track record. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:10:17] \u003c/em>So science grants are usually awarded based on an open, competitive process. People have to have a proven track record. He says it’s a good idea to spread that kind of research across different institutions, so you have different people with different ideas and different methodology. But half of the money for Prop 38 goes directly to one brand new institute that is barely off the ground yet, and it has zero track record. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Robert Kaplan: \u003c/strong>\u003cem>[00:10:47] \u003c/em>I think [if] taxpayers are going to have to repay these bonds. We think that should be a fair competition that allows all of these excellent institutions in California to have an opportunity to be in that competition. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>Robert Kaplan: \u003c/strong>\u003cem>[00:10:47] \u003c/em>I think [if] taxpayers are going to have to repay these bonds. We think that should be a fair competition that allows all of these excellent institutions in California to have an opportunity to be in that competition. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:10:59] \u003c/em>The opponents would really point out it’s only for immunotherapy and immunology research. So if you think that there are other kinds of health priorities, like mental illness or kidney disease or other kinds treatments, those are not included here. The other people speaking out against Prop 38, they’re a very interesting group. They are financial analysts who used to work at the LAO. That’s the Legislative Analyst’s Office. And this is a nonpartisan state agency. It’s tasked with evaluating proposed legislation and ballot measures like this one. And they are trained to never take a stand on political issues. And in this case, three retired analysts from the LAOs are breaking that wall, because of their concerns on Prop 38.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:10:59] \u003c/em>The opponents would really point out it’s only for immunotherapy and immunology research. So if you think that there are other kinds of health priorities, like mental illness or kidney disease or other kinds treatments, those are not included here. The other people speaking out against Prop 38, they’re a very interesting group. They are financial analysts who used to work at the LAO. That’s the Legislative Analyst’s Office. And this is a nonpartisan state agency. It’s tasked with evaluating proposed legislation and ballot measures like this one. And they are trained to never take a stand on political issues. And in this case, three retired analysts from the LAOs are breaking that wall, because of their concerns on Prop 38.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Dan Carson: \u003c/strong>\u003cem>[00:11:56] \u003c/em>Hi. I’m Dan Carson. I’m here today as a cancer survivor myself, who is obviously not against good medical research.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Dan Carson: \u003c/strong>\u003cem>[00:11:56] \u003c/em>Hi. I’m Dan Carson. I’m here today as a cancer survivor myself, who is obviously not against good medical research.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:12:05] \u003c/em>So one of them is Dan Carson. He ran the health section of the LAO back in 2004 when another bond measure was on the ballot to fund stem cell research. So proponents said the $3 billion for that initiative would be paid back by all the new stem cell discoveries that researchers made with the money.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:12:05] \u003c/em>So one of them is Dan Carson. He ran the health section of the LAO back in 2004 when another bond measure was on the ballot to fund stem cell research. So proponents said the $3 billion for that initiative would be paid back by all the new stem cell discoveries that researchers made with the money.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Dan Carson: \u003c/strong>\u003cem>[00:12:26] \u003c/em>In fact, as our analysis at the time made really clear, the state eventually received only a tiny fraction of the billions of dollars we were promised. So here we go again with Prop 38. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>Dan Carson: \u003c/strong>\u003cem>[00:12:26] \u003c/em>In fact, as our analysis at the time made really clear, the state eventually received only a tiny fraction of the billions of dollars we were promised. So here we go again with Prop 38. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:12:41] \u003c/em>The opponents of Prop 38 take issue with one of the main claims that the supporters of Prop 38 have, which is they say that the proposition will be cost neutral, that the money that California borrows and spends on the research will be made back by revenues from all of the scientific discoveries that they made. The LAO analysts say the math just doesn’t add up. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:12:41] \u003c/em>The opponents of Prop 38 take issue with one of the main claims that the supporters of Prop 38 have, which is they say that the proposition will be cost neutral, that the money that California borrows and spends on the research will be made back by revenues from all of the scientific discoveries that they made. The LAO analysts say the math just doesn’t add up. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Dan Carson: \u003c/strong>\u003cem>[00:13:08] \u003c/em>Oh, once again, we’re being promised in this initiative and by its advocates that will quote, pay for itself with no net cost to the state or taxpayers, closed quote. I’m here to tell you that after reviewing the fine print of this ballot measure, that won’t happen. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>Dan Carson: \u003c/strong>\u003cem>[00:13:08] \u003c/em>Oh, once again, we’re being promised in this initiative and by its advocates that will quote, pay for itself with no net cost to the state or taxpayers, closed quote. I’m here to tell you that after reviewing the fine print of this ballot measure, that won’t happen. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:13:32] \u003c/em>April, what’s spending on Prop 38 looking like on either side, the yes and the no side? \u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:13:32] \u003c/em>April, what’s spending on Prop 38 looking like on either side, the yes and the no side? \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:13:38] \u003c/em>So the Yes on Prop 38 campaign has raised about $27 million so far, and that comes mainly from Gary Michaelson and another billionaire who have donated to the same institute that would be the main beneficiary of the Prop 38 funds. The no side has not raised any money so far.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:13:38] \u003c/em>So the Yes on Prop 38 campaign has raised about $27 million so far, and that comes mainly from Gary Michaelson and another billionaire who have donated to the same institute that would be the main beneficiary of the Prop 38 funds. The no side has not raised any money so far.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:13:59] \u003c/em>It seems like we as voters are sort of being asked to decide how scientific research should happen almost and the best way to go about that. How do you think voters should sort of navigate the question being asked before them? \u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:13:59] \u003c/em>It seems like we as voters are sort of being asked to decide how scientific research should happen almost and the best way to go about that. How do you think voters should sort of navigate the question being asked before them? \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:14:15] \u003c/em>It’s such a tricky one to put voters in a position of having to become experts on a field of science that maybe they haven’t even heard about. Totally, that’s how I feel. Right. You know, I think on its face, Prop 38 is very appealing and we’ve seen various ballot measures over the years that are healthcare oriented and we find that they often play well. For people who feel really strongly about this area of research, they may feel happy to have the opportunity to vote on something like this and set aside a pot of money that is just for this kind of research. On the other hand, the way that this proposition is worded and the way the money would be distributed looks very, very different from the kind of process that’s used at the federal level. So you’re not just creating a new fund for stability, you’re actually creating a new way of how that science gets funded and how the money gets distributed. Propositions like this, you could say are direct democracy, but in another way, they also circumvent that other democratic process.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:14:15] \u003c/em>It’s such a tricky one to put voters in a position of having to become experts on a field of science that maybe they haven’t even heard about. Totally, that’s how I feel. Right. You know, I think on its face, Prop 38 is very appealing and we’ve seen various ballot measures over the years that are healthcare oriented and we find that they often play well. For people who feel really strongly about this area of research, they may feel happy to have the opportunity to vote on something like this and set aside a pot of money that is just for this kind of research. On the other hand, the way that this proposition is worded and the way the money would be distributed looks very, very different from the kind of process that’s used at the federal level. So you’re not just creating a new fund for stability, you’re actually creating a new way of how that science gets funded and how the money gets distributed. Propositions like this, you could say are direct democracy, but in another way, they also circumvent that other democratic process.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:15:35] \u003c/em>Well, April Dombosky, thank you so much for breaking this down. Appreciate it.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:15:35] \u003c/em>Well, April Dombosky, thank you so much for breaking this down. Appreciate it.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:15:40] \u003c/em>Thanks, Ericka.\u003c/p>\n",
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"\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:15:40] \u003c/em>Thanks, Ericka.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:15:42] \u003c/em>In a nutshell, a yes vote on this measure means the state could borrow $8.4 billion to support medical research in immunology and immunotherapy. A no vote means the state cannot borrow 8.4 billion for immunology, and immunotherapy research. \u003c/p>\n",
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"\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:15:42] \u003c/em>In a nutshell, a yes vote on this measure means the state could borrow $8.4 billion to support medical research in immunology and immunotherapy. A no vote means the state cannot borrow 8.4 billion for immunology, and immunotherapy research. \u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>\u003cem>[00:16:02] \u003c/em>And that’s it for our latest episode of PropFest, a collaboration between The Bay and Bay Curious. If this series is helping you get educated on all the statewide props, we sure hope that you’re going to share them with your friends and family. \u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003ch2 class=\"wp-block-heading\">Transcript\u003c/h2>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:00:00] \u003c/em>Immunotherapy has been around for a really long time. Things like vaccines are considered part of immunology, but it also includes more recent innovations like newer treatments for blood and skin cancers. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>\u003cem>[00:00:15] \u003c/em>In simple terms, immunotherapy is individualized treatment designed to harness a patient’s immune system to fight disease. For some, immunotherapy has been life-changing. And voters are being asked this November whether to fund immunology and immunotherapy research with one very specific beneficiary in mind. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:00:38] \u003c/em>I’m Ericka Cruz Guevarra, host of The Bay. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>\u003cem>[00:00:41] \u003c/em>And I’m Olivia Allen-Price, host of Bay Curious. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:00:44] \u003c/em>And welcome to Prop Fest. A collaboration between the Bay and Bay Curious, where we break down all 14 statewide propositions on your ballot this year November. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>\u003cem>[00:00:54] \u003c/em>And we’re back at it again with Proposition 38. Here’s how it reads on your ballot. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Reporter: \u003c/strong>\u003cem>[00:01:01] \u003c/em>Prop 38 authorizes bonds for immunology medical research. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:01:08] \u003c/em>Here to walk us through all of this is KQED Health Correspondent April Dembosky. April, first of all, what is Prop 38 all about? \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:01:16] \u003c/em>Prop 38 is a bond measure that would fund immunology and immunotherapy research. It would allow the state to borrow $8.4 billion and distribute it to nonprofit research centers that are studying immunotherapy treatments for cancer, heart disease, and Alzheimer’s. The measure is expected to cost the state about $500 million a year for 20 years in bond repayments. And about $4 billion of that would be interest payments on top of the original 8.4 billion for a total cost of about $12 billion. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:01:58] \u003c/em>There is sort of an interesting story about how this came on the ballot in the first place, right? Can you actually talk about why voters are even being asked to fund immunotherapy in this year’s election?\u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:02:11] \u003c/em>Prop 38 was the brainchild of a philanthropist named Gary Michelson. He raised the money to collect the signatures and put Prop 38 on the ballot. Something that’s really interesting about the initiative is how it’s worded. The language is very careful. It lists very strict criteria for the type of academic institution that should receive half of the money. This criteria is so specific. That only one university in the state meets the criteria, and that is UCLA. Half the funds would go toward launching a new immunology institute at UCLA, and the other half would be awarded through competitive grants to other institutes also in California. And so, as it turns out, Michelson has already donated $120 million of his own money to establish a new institute for immunotherapy at UCLA. It’s called the California Institute for Immunology and Immunotherapy. That same institution would also be the touch point for all the research. So the other half of the funding that would get distributed in competitive grants would all be sort of centered at UCLA. So it’s safe to say that this is on the ballot because a very wealthy philanthropist put it there as a way to finance a research institution focused on his interest, which is immunology and immunotherapy.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:03:50] \u003c/em>Okay, April, so Prop 38 was put on the ballot by this wealthy philanthropist, Gary Michelson, and it’s written in this way that would, it sounds like directly benefit a research institute at UCLA that he’s helping to fund. So clearly he has some skin in the game here. Is Prop 38 getting much support from elsewhere? Like how else is the pro-Prop 38 side kind of shaping up?\u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:04:18] \u003c/em>There’s a long list of foundations and advocacy groups that have signed on in support of Prop 38, places like Blood Cancer United, the Melanoma Research Alliance, the Alzheimer’s Association, the ALS Association, the National Multiple Sclerosis Society, the Michael J. Fox Foundation for Parkinson’s Research. So these are groups that hope and believe that new immunotherapies could be developed to treat these specific diseases. Proponents also say this initiative is necessary because federal funding for this kind of research has become unreliable under the current administration. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Jillian McCool: \u003c/strong>\u003cem>[00:04:58] \u003c/em>The big thing right now is that current CAR T therapy is really expensive. It’s not as efficient as we want it to be. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:05:05] \u003c/em>So I spoke to one researcher who was working on a project funded by the NIH, the National Institutes of Health. Her name is Jillian McCool, and she was working at Lawrence Livermore National Laboratory studying vaccines and a kind of therapy for cancer. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Jillian McCool: \u003c/strong>\u003cem>[00:05:20] \u003c/em>We basically can take your immune cells and we can take them out of your body and we an alter them so they’re better fit and better suited to fight cancer cells specifically. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:05:29] \u003c/em>And then some of their grants ran out after they reached the end of the term, but then some of the funding was paused because of the most recent government shutdown. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Jillian McCool: \u003c/strong>\u003cem>[00:05:38] \u003c/em>All of the sudden we have this weird rhetoric around vaccines and all of the sudden there’s this new administration coming in that’s kind of pushing that rhetoric. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:05:47] \u003c/em>McCool says about 100 scientists were laid off, including her. She was out of work for a year and a half. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Jillian McCool: \u003c/strong>\u003cem>[00:05:54] \u003c/em>And then the public is no longer trusting scientists and what they have to say in the data we’ve collected, it kind of makes you question your whole career in general. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:06:05] \u003c/em>So it’s personal for McCool, but she says Prop 38 is a way to correct what’s happening at the federal level and protect the jobs of lots of other scientists. She also says, you know, California is a center of excellence in this kind of research, and so it makes sense to root it here. She also points out that the measure is designed to be cost neutral, with 10% of revenues generated from successful discoveries being funneled back to the state. Californians would also be entitled to a 20% discount on any new therapies that are generated from the bond money.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:06:41] \u003c/em>And a big part of immunotherapy research is directed towards cancer research and you actually met a cancer patient who’s pretty gung-ho about Prop 38, right? Tell me about her. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Laurie Adami: \u003c/strong>\u003cem>[00:06:52] \u003c/em>My name is Laurie Adami and I live in Los Angeles, California. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:06:57] \u003c/em>Laurie was diagnosed with non-Hodgkin’s lymphoma. It’s a kind of blood cancer, and this was 20 years ago. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Laurie Adami: \u003c/strong>\u003cem>[00:07:04] \u003c/em>And when I got sick and I ended up losing my career as a result of my very long battle with cancer. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:07:13] \u003c/em>Several years ago, she enrolled in a clinical trial for an immunotherapy called CAR-T. So, Laurie had one infusion of this immunotherapy about eight years ago and her cancer has not come back since. Now, she’s only one person. You know, it’s important to point out there’s still a large proportion of patients who participated in these trials who did not respond in the same way. But as you can imagine, Laurie is pretty gung-ho for Prop 38. Because of the prospect that it could fund more research and develop more treatments like this to fight other kinds of cancers and other diseases and help more people. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Laurie Adami: \u003c/strong>\u003cem>[00:07:54] \u003c/em>You know, not every family is gonna be affected by cancer, but every family is gonna affected by these other diseases. And so I am a huge proponent and supporter because immunotherapy saved my life. So why wouldn’t I believe? And why wouldn’t I want more patients to be able to access the type of treatment that finally saved my live? \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:08:23] \u003c/em>We’ll have more on Proposition 38 right after this. By the way, if you appreciate the work we’re doing here on PropFest, consider becoming a sustaining member of KQED. We can’t do this work without you. Just go to donate.kqed.org slash podcasts. We’ll be right back. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:08:47] \u003c/em>And we’re back breaking down Proposition 38 with KQED’s April Dembosky. April, you talked about the various different groups supporting Prop 38, including a patient who really believes in the power of immunotherapy research to potentially save lives. So who’s coming out against Prop 38 and what is their argument? \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:09:10] \u003c/em>Yeah, so there’s a very small group of opponents. They’re pretty much all volunteers. It’s very grassroots. And they have organized to point out what they see as the weaknesses and even what they might call the dangers of Prop 38\u003cem>.\u003c/em>\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Robert Kaplan: \u003c/strong>\u003cem>[00:09:26] \u003c/em>I just think that there are inherent conflicts of interest. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:09:29] \u003c/em>The main one is Robert Kaplan. He’s a biomedical researcher and administrator at Stanford University School of Medicine. And he also worked at the NIH, the National Institutes of Health. So he has a lot of experience coordinating the kind of research that we’re talking about and at a really grand scale. So he says he supports biomedical research. He’s in favor of science, including immunotherapy. But he says this proposition is not the way to fund it. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Robert Kaplan: \u003c/strong>\u003cem>[00:09:58] \u003c/em>If you look at NIH support for biomedical research in general or immunology research, there are several institutions in California that are the national leaders, but because of the sort of arbitrary criteria in Proposition 38, they’re not eligible to compete. And we think that’s not right.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:10:17] \u003c/em>So science grants are usually awarded based on an open, competitive process. People have to have a proven track record. He says it’s a good idea to spread that kind of research across different institutions, so you have different people with different ideas and different methodology. But half of the money for Prop 38 goes directly to one brand new institute that is barely off the ground yet, and it has zero track record. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Robert Kaplan: \u003c/strong>\u003cem>[00:10:47] \u003c/em>I think [if] taxpayers are going to have to repay these bonds. We think that should be a fair competition that allows all of these excellent institutions in California to have an opportunity to be in that competition. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:10:59] \u003c/em>The opponents would really point out it’s only for immunotherapy and immunology research. So if you think that there are other kinds of health priorities, like mental illness or kidney disease or other kinds treatments, those are not included here. The other people speaking out against Prop 38, they’re a very interesting group. They are financial analysts who used to work at the LAO. That’s the Legislative Analyst’s Office. And this is a nonpartisan state agency. It’s tasked with evaluating proposed legislation and ballot measures like this one. And they are trained to never take a stand on political issues. And in this case, three retired analysts from the LAOs are breaking that wall, because of their concerns on Prop 38.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Dan Carson: \u003c/strong>\u003cem>[00:11:56] \u003c/em>Hi. I’m Dan Carson. I’m here today as a cancer survivor myself, who is obviously not against good medical research.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:12:05] \u003c/em>So one of them is Dan Carson. He ran the health section of the LAO back in 2004 when another bond measure was on the ballot to fund stem cell research. So proponents said the $3 billion for that initiative would be paid back by all the new stem cell discoveries that researchers made with the money.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Dan Carson: \u003c/strong>\u003cem>[00:12:26] \u003c/em>In fact, as our analysis at the time made really clear, the state eventually received only a tiny fraction of the billions of dollars we were promised. So here we go again with Prop 38. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:12:41] \u003c/em>The opponents of Prop 38 take issue with one of the main claims that the supporters of Prop 38 have, which is they say that the proposition will be cost neutral, that the money that California borrows and spends on the research will be made back by revenues from all of the scientific discoveries that they made. The LAO analysts say the math just doesn’t add up. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Dan Carson: \u003c/strong>\u003cem>[00:13:08] \u003c/em>Oh, once again, we’re being promised in this initiative and by its advocates that will quote, pay for itself with no net cost to the state or taxpayers, closed quote. I’m here to tell you that after reviewing the fine print of this ballot measure, that won’t happen. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:13:32] \u003c/em>April, what’s spending on Prop 38 looking like on either side, the yes and the no side? \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:13:38] \u003c/em>So the Yes on Prop 38 campaign has raised about $27 million so far, and that comes mainly from Gary Michaelson and another billionaire who have donated to the same institute that would be the main beneficiary of the Prop 38 funds. The no side has not raised any money so far.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:13:59] \u003c/em>It seems like we as voters are sort of being asked to decide how scientific research should happen almost and the best way to go about that. How do you think voters should sort of navigate the question being asked before them? \u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:14:15] \u003c/em>It’s such a tricky one to put voters in a position of having to become experts on a field of science that maybe they haven’t even heard about. Totally, that’s how I feel. Right. You know, I think on its face, Prop 38 is very appealing and we’ve seen various ballot measures over the years that are healthcare oriented and we find that they often play well. For people who feel really strongly about this area of research, they may feel happy to have the opportunity to vote on something like this and set aside a pot of money that is just for this kind of research. On the other hand, the way that this proposition is worded and the way the money would be distributed looks very, very different from the kind of process that’s used at the federal level. So you’re not just creating a new fund for stability, you’re actually creating a new way of how that science gets funded and how the money gets distributed. Propositions like this, you could say are direct democracy, but in another way, they also circumvent that other democratic process.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:15:35] \u003c/em>Well, April Dombosky, thank you so much for breaking this down. Appreciate it.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>April Dembosky: \u003c/strong>\u003cem>[00:15:40] \u003c/em>Thanks, Ericka.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:15:42] \u003c/em>In a nutshell, a yes vote on this measure means the state could borrow $8.4 billion to support medical research in immunology and immunotherapy. A no vote means the state cannot borrow 8.4 billion for immunology, and immunotherapy research. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>\u003cem>[00:16:02] \u003c/em>And that’s it for our latest episode of PropFest, a collaboration between The Bay and Bay Curious. If this series is helping you get educated on all the statewide props, we sure hope that you’re going to share them with your friends and family. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:16:16] \u003c/em>The link is kqed.org slash propfest and we’ll be dropping new breakdowns until October 9th. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>\u003cem>[00:16:24] \u003c/em>PropFest is made possible thanks to Katrina Schwartz, Pauline Bartolone, Anna Casalme, Ericka Cruz Guevara, Gabriela Glueck. Christopher Beale, Alan Montecillo. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>\u003cem>[00:16:35] \u003c/em>And me, Olivia Allen Price. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:16:37] \u003c/em>We get extra support from Maha Sanad, Katie Springer, Jen Chien. Ethan Tovan Lindsey and everyone on Team KQED. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>\u003cem>[00:16:46] \u003c/em>Our show is made in San Francisco at member-supported KQED.\u003c/p>\n\n\n\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>\u003cem>[00:16:51] \u003c/em>Support for The Bay is provided in part by the Osher Production Fund. Some members of the KQED podcast team are represented by the Screen Actors Guild, American Federation of Television and Radio Artists, San Francisco, Northern California Local. I’m Ericka Cruz Guevarra. \u003c/p>\n\n\n\n\u003cp>\u003cstrong>Olivia Allen-Price: \u003c/strong>\u003cem>[00:17:08] \u003c/em>And I’m Olivia Allen-Price. Have a good one. \u003c/p>\n\n\n\n\u003cp>\u003cem>Some members of the KQED podcast team are represented by The Screen Actors Guild, American Federation of Television and Radio Artists, San Francisco-Northern California Local.\u003c/em>\u003c/p>\n\n\n\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\n\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/oakland\">Oakland\u003c/a> mom Anna Karrer Manley remembers one of the hardest conversations she had two years ago.\u003c/p>\n\n\n\n\u003cp>She was 45 and had recently learned about her breast cancer diagnosis. She needed to share the news with her two kids, then ages 6 and 11, to prepare them for her battle with the disease — six rounds of chemotherapy and their most recognizable side effect, hair loss. \u003c/p>\n\n\n\n\u003cp>“My son had just started a new school in sixth grade, and he sheepishly asked me, ‘So, Mom, are you still gonna come to pick up?’” Karrer Manley said. “[My daughter] just cried because she didn’t want Mommy to change\u003cem>.\u003c/em>”\u003c/p>\n\n\n\n\u003cp>Soon after her diagnosis, Karrer Manley joined a breast cancer patient support group, \u003ca href=\"https://bayareayoungsurvivors.org/\">Bay Area Young Survivors\u003c/a>, where she learned about scalp cooling, an FDA-cleared treatment that helps patients keep their hair through cooling caps, which can be worn before, during and after chemotherapy infusions. The technology helps restrict blood flow and reduce the amount of medication that reaches the hair follicles. The vast majority of people who use scalp cooling, like Karrer Manley, are battling breast cancer, according to \u003ca href=\"https://ascopubs.org/doi/10.1200/JCO.2021.39.15_suppl.e18739\">research\u003c/a> presented at the American Society of Clinical Oncology in 2021. \u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-46-KQED.jpg\" alt=\"\" class=\"wp-image-12099645\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-46-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-46-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-46-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Ines (from left), Stacey Manley, Etienne, Anna Karrer Manley, and their chemo puppy, Asa, at their home in Oakland on Sept. 13, 2026. (Nina Glick/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cfigure class=\"wp-block-gallery has-nested-images columns-default is-cropped wp-block-gallery-5 is-layout-flex wp-block-gallery-is-layout-flex\">\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12099642\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-27-KQED.jpg\" alt=\"\" class=\"wp-image-12099642\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-27-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-27-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-27-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Anna Karrer Manley shows strands of her hair that grew back darker and curlier after falling out during chemotherapy. (Nina Glick/KQED)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12099641\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-26-KQED.jpg\" alt=\"\" class=\"wp-image-12099641\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-26-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-26-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-26-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Anna Karrer Manley holds a photo of herself wearing a cold cap at her home in Oakland on Sept. 13, 2026. (Nina Glick/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/figure>\n\n\n\n\u003cp>The technology wasn’t covered through insurance, but Karrer Manley said she and her husband scraped around $5,000 to pay for the treatment. (She returned to work part time during treatment.) The cooling caps allowed her to keep 70% of her hair, she said.\u003c/p>\n\n\n\n\u003cp>Her vibrant complexion and beyond-shoulder-length hair belie the difficult journey of survival — and advocacy — she’s undertaken. Karrer Manley has since joined survivors, medical professionals and public health advocates calling for the passage of \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202520260AB1682\">AB 1682\u003c/a>, which is currently on Gov. Gavin Newsom’s desk, that aims to make automated mechanical scalp-cooling devices more accessible, beginning in 2027.\u003c/p>\n\n\n\n\u003cp>“To move about the world during chemo treatment with your hair and not everybody realizing what’s going on with you or staring at you, I think that’s really meaningful and important, and it has such an impact on your mental health,” said Karrer Manley, sitting at her dining room table alongside Asa, the “chemo puppy” she adopted for treatment support. “You know, cancer takes so much from you, it really robs so much of you, but at least I had a little bit of hair.”\u003c/p>\n\n\n\n\n\n\u003cp>At a June \u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260ab1682\">hearing\u003c/a> in Sacramento, the bill’s co-author Assemblymember Gregg Hart of Santa Barbara said the measure – which resembles \u003ca href=\"https://rapunzelproject.org/\">similar\u003c/a> laws in five states (Connecticut, Louisiana, Maryland, New York and West Virginia) — would preserve “dignity, confidence and quality of life” for Californians fighting cancer, regardless of their ability to pay.\u003c/p>\n\n\n\n\u003cp>The amended proposal — which state legislators passed unanimously — applies to large group insurers and Medi-Cal plans.\u003c/p>\n\n\n\n\u003cp>In April, the California Health Benefits Review Program, a nonpartisan \u003ca href=\"https://www.chbrp.org/about\">group\u003c/a> tasked with responding to the state Legislature’s request for independent review of all proposed bills related to health benefits, reviewed an earlier, broader draft of AB 1682. The original legislation would have applied to \u003cem>all\u003c/em> state-regulated health insurance, but would have resulted in 680 additional enrollees receiving scalp cooling, for an additional $4 million in annual premiums paid by employers and enrollees.\u003c/p>\n\n\n\n\u003cp>Janet Coffman, a member of the benefits review program and a health policy expert with UCSF, said the technology has a relatively small fiscal impact (unlike, for example, proposed insurance \u003ca href=\"https://abcnews.com/GMA/Wellness/halle-berry-criticizes-gov-gavin-newsom-devaluing-women/story?id=128104843\">mandates\u003c/a> for pre- and postmenopausal hormone replacement therapy that Newsom vetoed in 2025, calling it “too far-reaching”).\u003c/p>\n\n\n\n\u003cp>“It’s only for people who are actively undergoing cancer treatment. And they’re really only used with a subset of cancers,” Coffman said. “The marginal cost is pretty small.”\u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-57-KQED.jpg\" alt=\"\" class=\"wp-image-12099646\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-57-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-57-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-57-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Anna Karrer Manley (center) with her children Etienne (left) and Ines (right) at their home in Oakland on Sept. 13, 2026. (Nina Glick/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cfigure class=\"wp-block-gallery has-nested-images columns-default is-cropped wp-block-gallery-6 is-layout-flex wp-block-gallery-is-layout-flex\">\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12099647\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-69-KQED.jpg\" alt=\"\" class=\"wp-image-12099647\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-69-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-69-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-69-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Anna Karrer Manley walks her dog, Asa, whom she got while she was undergoing chemotherapy, near her home in Oakland on Sept. 13, 2026. (Nina Glick/KQED)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12099639\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-19-KQED.jpg\" alt=\"\" class=\"wp-image-12099639\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-19-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-19-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-19-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Cookbooks, including The Cancer-Fighting Kitchen: Nourishing, Big-Flavor Recipes for Cancer Treatment and Recovery, in Anna Karrer Manley’s home in Oakland on Sept. 13, 2026. (Nina Glick/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/figure>\n\n\n\n\u003cp>The insurance lobby group California Association of Health Plans has opposed the measure, arguing that Californians are facing a health care affordability crisis, citing a \u003ca href=\"https://calmatters.org/health/2026/06/california-health-tax-medi-cal-premiums/\">health tax redesign\u003c/a> recently approved by the governor that the California Medical Association, a physician advocacy group, has \u003ca href=\"https://www.cmadocs.org/newsroom/news/view/cma-warns-2026-27-state-budget-will-increase-health-insurance-costs\">warned\u003c/a> could pass through to consumers in the form of higher premiums.\u003c/p>\n\n\n\n\u003cp>“At the same time, six additional health care mandates, including AB 1682, have been sent to the governor for his signature that will altogether increase premiums by more than $170 million, piling on even more health care costs for working families across the state,” the CAHP said in a statement.\u003c/p>\n\n\n\n\u003cp>The governor’s office declined to comment on bills pending action from Newsom by a Sept. 30 deadline. He is no stranger to the disease, as he has previously \u003ca href=\"https://www.washingtonpost.com/politics/2026/02/04/gavin-newsom-assisted-suicide\">spoken\u003c/a> about being with his mother during her assisted suicide in 2002 after her yearslong battle with breast cancer.\u003c/p>\n\n\n\n\u003cp>Karrer Manley hopes that he will advocate for supportive cancer care for people who otherwise cannot afford it. \u003c/p>\n\n\n\n\u003cp>“There are just too many people impacted by cancer, and yet the fiscal impact is so small,” she said.\u003c/p>\n",
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"innerHTML": "\n\u003cp>The technology wasn’t covered through insurance, but Karrer Manley said she and her husband scraped around $5,000 to pay for the treatment. (She returned to work part time during treatment.) The cooling caps allowed her to keep 70% of her hair, she said.\u003c/p>\n",
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"innerHTML": "\n\u003cp>Her vibrant complexion and beyond-shoulder-length hair belie the difficult journey of survival — and advocacy — she’s undertaken. Karrer Manley has since joined survivors, medical professionals and public health advocates calling for the passage of \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202520260AB1682\">AB 1682\u003c/a>, which is currently on Gov. Gavin Newsom’s desk, that aims to make automated mechanical scalp-cooling devices more accessible, beginning in 2027.\u003c/p>\n",
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"innerHTML": "\n\u003cp>“To move about the world during chemo treatment with your hair and not everybody realizing what’s going on with you or staring at you, I think that’s really meaningful and important, and it has such an impact on your mental health,” said Karrer Manley, sitting at her dining room table alongside Asa, the “chemo puppy” she adopted for treatment support. “You know, cancer takes so much from you, it really robs so much of you, but at least I had a little bit of hair.”\u003c/p>\n",
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"innerHTML": "\n\u003cp>At a June \u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260ab1682\">hearing\u003c/a> in Sacramento, the bill’s co-author Assemblymember Gregg Hart of Santa Barbara said the measure – which resembles \u003ca href=\"https://rapunzelproject.org/\">similar\u003c/a> laws in five states (Connecticut, Louisiana, Maryland, New York and West Virginia) — would preserve “dignity, confidence and quality of life” for Californians fighting cancer, regardless of their ability to pay.\u003c/p>\n",
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"innerHTML": "\n\u003cp>In April, the California Health Benefits Review Program, a nonpartisan \u003ca href=\"https://www.chbrp.org/about\">group\u003c/a> tasked with responding to the state Legislature’s request for independent review of all proposed bills related to health benefits, reviewed an earlier, broader draft of AB 1682. The original legislation would have applied to \u003cem>all\u003c/em> state-regulated health insurance, but would have resulted in 680 additional enrollees receiving scalp cooling, for an additional $4 million in annual premiums paid by employers and enrollees.\u003c/p>\n",
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"\n\u003cp>In April, the California Health Benefits Review Program, a nonpartisan \u003ca href=\"https://www.chbrp.org/about\">group\u003c/a> tasked with responding to the state Legislature’s request for independent review of all proposed bills related to health benefits, reviewed an earlier, broader draft of AB 1682. The original legislation would have applied to \u003cem>all\u003c/em> state-regulated health insurance, but would have resulted in 680 additional enrollees receiving scalp cooling, for an additional $4 million in annual premiums paid by employers and enrollees.\u003c/p>\n"
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"innerHTML": "\n\u003cp>Janet Coffman, a member of the benefits review program and a health policy expert with UCSF, said the technology has a relatively small fiscal impact (unlike, for example, proposed insurance \u003ca href=\"https://abcnews.com/GMA/Wellness/halle-berry-criticizes-gov-gavin-newsom-devaluing-women/story?id=128104843\">mandates\u003c/a> for pre- and postmenopausal hormone replacement therapy that Newsom vetoed in 2025, calling it “too far-reaching”).\u003c/p>\n",
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"\n\u003cp>Janet Coffman, a member of the benefits review program and a health policy expert with UCSF, said the technology has a relatively small fiscal impact (unlike, for example, proposed insurance \u003ca href=\"https://abcnews.com/GMA/Wellness/halle-berry-criticizes-gov-gavin-newsom-devaluing-women/story?id=128104843\">mandates\u003c/a> for pre- and postmenopausal hormone replacement therapy that Newsom vetoed in 2025, calling it “too far-reaching”).\u003c/p>\n"
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"innerHTML": "\n\u003cp>“It’s only for people who are actively undergoing cancer treatment. And they’re really only used with a subset of cancers,” Coffman said. “The marginal cost is pretty small.”\u003c/p>\n",
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"innerHTML": "\n\u003cp>The insurance lobby group California Association of Health Plans has opposed the measure, arguing that Californians are facing a health care affordability crisis, citing a \u003ca href=\"https://calmatters.org/health/2026/06/california-health-tax-medi-cal-premiums/\">health tax redesign\u003c/a> recently approved by the governor that the California Medical Association, a physician advocacy group, has \u003ca href=\"https://www.cmadocs.org/newsroom/news/view/cma-warns-2026-27-state-budget-will-increase-health-insurance-costs\">warned\u003c/a> could pass through to consumers in the form of higher premiums.\u003c/p>\n",
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"innerHTML": "\n\u003cp>“At the same time, six additional health care mandates, including AB 1682, have been sent to the governor for his signature that will altogether increase premiums by more than $170 million, piling on even more health care costs for working families across the state,” the CAHP said in a statement.\u003c/p>\n",
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"innerHTML": "\n\u003cp>The governor’s office declined to comment on bills pending action from Newsom by a Sept. 30 deadline. He is no stranger to the disease, as he has previously \u003ca href=\"https://www.washingtonpost.com/politics/2026/02/04/gavin-newsom-assisted-suicide\">spoken\u003c/a> about being with his mother during her assisted suicide in 2002 after her yearslong battle with breast cancer.\u003c/p>\n",
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"innerHTML": "\n\u003cp>Karrer Manley hopes that he will advocate for supportive cancer care for people who otherwise cannot afford it. \u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/oakland\">Oakland\u003c/a> mom Anna Karrer Manley remembers one of the hardest conversations she had two years ago.\u003c/p>\n\n\n\n\u003cp>She was 45 and had recently learned about her breast cancer diagnosis. She needed to share the news with her two kids, then ages 6 and 11, to prepare them for her battle with the disease — six rounds of chemotherapy and their most recognizable side effect, hair loss. \u003c/p>\n\n\n\n\u003cp>“My son had just started a new school in sixth grade, and he sheepishly asked me, ‘So, Mom, are you still gonna come to pick up?’” Karrer Manley said. “[My daughter] just cried because she didn’t want Mommy to change\u003cem>.\u003c/em>”\u003c/p>\n\n\n\n\u003cp>Soon after her diagnosis, Karrer Manley joined a breast cancer patient support group, \u003ca href=\"https://bayareayoungsurvivors.org/\">Bay Area Young Survivors\u003c/a>, where she learned about scalp cooling, an FDA-cleared treatment that helps patients keep their hair through cooling caps, which can be worn before, during and after chemotherapy infusions. The technology helps restrict blood flow and reduce the amount of medication that reaches the hair follicles. The vast majority of people who use scalp cooling, like Karrer Manley, are battling breast cancer, according to \u003ca href=\"https://ascopubs.org/doi/10.1200/JCO.2021.39.15_suppl.e18739\">research\u003c/a> presented at the American Society of Clinical Oncology in 2021. \u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-46-KQED.jpg\" alt=\"\" class=\"wp-image-12099645\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-46-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-46-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-46-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Ines (from left), Stacey Manley, Etienne, Anna Karrer Manley, and their chemo puppy, Asa, at their home in Oakland on Sept. 13, 2026. (Nina Glick/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cfigure class=\"wp-block-gallery has-nested-images columns-default is-cropped wp-block-gallery-5 is-layout-flex wp-block-gallery-is-layout-flex\">\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12099642\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-27-KQED.jpg\" alt=\"\" class=\"wp-image-12099642\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-27-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-27-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-27-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Anna Karrer Manley shows strands of her hair that grew back darker and curlier after falling out during chemotherapy. (Nina Glick/KQED)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12099641\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-26-KQED.jpg\" alt=\"\" class=\"wp-image-12099641\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-26-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-26-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-26-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Anna Karrer Manley holds a photo of herself wearing a cold cap at her home in Oakland on Sept. 13, 2026. (Nina Glick/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/figure>\n\n\n\n\u003cp>The technology wasn’t covered through insurance, but Karrer Manley said she and her husband scraped around $5,000 to pay for the treatment. (She returned to work part time during treatment.) The cooling caps allowed her to keep 70% of her hair, she said.\u003c/p>\n\n\n\n\u003cp>Her vibrant complexion and beyond-shoulder-length hair belie the difficult journey of survival — and advocacy — she’s undertaken. Karrer Manley has since joined survivors, medical professionals and public health advocates calling for the passage of \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202520260AB1682\">AB 1682\u003c/a>, which is currently on Gov. Gavin Newsom’s desk, that aims to make automated mechanical scalp-cooling devices more accessible, beginning in 2027.\u003c/p>\n\n\n\n\u003cp>“To move about the world during chemo treatment with your hair and not everybody realizing what’s going on with you or staring at you, I think that’s really meaningful and important, and it has such an impact on your mental health,” said Karrer Manley, sitting at her dining room table alongside Asa, the “chemo puppy” she adopted for treatment support. “You know, cancer takes so much from you, it really robs so much of you, but at least I had a little bit of hair.”\u003c/p>\n\n\n\n\n\n\u003cp>At a June \u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260ab1682\">hearing\u003c/a> in Sacramento, the bill’s co-author Assemblymember Gregg Hart of Santa Barbara said the measure – which resembles \u003ca href=\"https://rapunzelproject.org/\">similar\u003c/a> laws in five states (Connecticut, Louisiana, Maryland, New York and West Virginia) — would preserve “dignity, confidence and quality of life” for Californians fighting cancer, regardless of their ability to pay.\u003c/p>\n\n\n\n\u003cp>The amended proposal — which state legislators passed unanimously — applies to large group insurers and Medi-Cal plans.\u003c/p>\n\n\n\n\u003cp>In April, the California Health Benefits Review Program, a nonpartisan \u003ca href=\"https://www.chbrp.org/about\">group\u003c/a> tasked with responding to the state Legislature’s request for independent review of all proposed bills related to health benefits, reviewed an earlier, broader draft of AB 1682. The original legislation would have applied to \u003cem>all\u003c/em> state-regulated health insurance, but would have resulted in 680 additional enrollees receiving scalp cooling, for an additional $4 million in annual premiums paid by employers and enrollees.\u003c/p>\n\n\n\n\u003cp>Janet Coffman, a member of the benefits review program and a health policy expert with UCSF, said the technology has a relatively small fiscal impact (unlike, for example, proposed insurance \u003ca href=\"https://abcnews.com/GMA/Wellness/halle-berry-criticizes-gov-gavin-newsom-devaluing-women/story?id=128104843\">mandates\u003c/a> for pre- and postmenopausal hormone replacement therapy that Newsom vetoed in 2025, calling it “too far-reaching”).\u003c/p>\n\n\n\n\u003cp>“It’s only for people who are actively undergoing cancer treatment. And they’re really only used with a subset of cancers,” Coffman said. “The marginal cost is pretty small.”\u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-57-KQED.jpg\" alt=\"\" class=\"wp-image-12099646\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-57-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-57-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-57-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Anna Karrer Manley (center) with her children Etienne (left) and Ines (right) at their home in Oakland on Sept. 13, 2026. (Nina Glick/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cfigure class=\"wp-block-gallery has-nested-images columns-default is-cropped wp-block-gallery-6 is-layout-flex wp-block-gallery-is-layout-flex\">\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12099647\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-69-KQED.jpg\" alt=\"\" class=\"wp-image-12099647\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-69-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-69-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-69-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Anna Karrer Manley walks her dog, Asa, whom she got while she was undergoing chemotherapy, near her home in Oakland on Sept. 13, 2026. (Nina Glick/KQED)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12099639\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-19-KQED.jpg\" alt=\"\" class=\"wp-image-12099639\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-19-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-19-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260913-CancerScalpTreatment-NG-19-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Cookbooks, including The Cancer-Fighting Kitchen: Nourishing, Big-Flavor Recipes for Cancer Treatment and Recovery, in Anna Karrer Manley’s home in Oakland on Sept. 13, 2026. (Nina Glick/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/figure>\n\n\n\n\u003cp>The insurance lobby group California Association of Health Plans has opposed the measure, arguing that Californians are facing a health care affordability crisis, citing a \u003ca href=\"https://calmatters.org/health/2026/06/california-health-tax-medi-cal-premiums/\">health tax redesign\u003c/a> recently approved by the governor that the California Medical Association, a physician advocacy group, has \u003ca href=\"https://www.cmadocs.org/newsroom/news/view/cma-warns-2026-27-state-budget-will-increase-health-insurance-costs\">warned\u003c/a> could pass through to consumers in the form of higher premiums.\u003c/p>\n\n\n\n\u003cp>“At the same time, six additional health care mandates, including AB 1682, have been sent to the governor for his signature that will altogether increase premiums by more than $170 million, piling on even more health care costs for working families across the state,” the CAHP said in a statement.\u003c/p>\n\n\n\n\u003cp>The governor’s office declined to comment on bills pending action from Newsom by a Sept. 30 deadline. He is no stranger to the disease, as he has previously \u003ca href=\"https://www.washingtonpost.com/politics/2026/02/04/gavin-newsom-assisted-suicide\">spoken\u003c/a> about being with his mother during her assisted suicide in 2002 after her yearslong battle with breast cancer.\u003c/p>\n\n\n\n\u003cp>Karrer Manley hopes that he will advocate for supportive cancer care for people who otherwise cannot afford it. \u003c/p>\n\n\n\n\u003cp>“There are just too many people impacted by cancer, and yet the fiscal impact is so small,” she said.\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "this-bay-area-immigrant-rights-organization-is-helping-filipino-caregivers-care-for-themselves",
"title": "This Bay Area Immigrant Rights Organization Is Helping Filipino Caregivers Care for Themselves",
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"headTitle": "This Bay Area Immigrant Rights Organization Is Helping Filipino Caregivers Care for Themselves | KQED",
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"content": "\n\u003cp>\u003cem>This project was produced jointly by KQED and CatchLight as part of the \u003c/em>\u003ca href=\"http://catchlight.io/mental-health\">\u003cem>mental health visual desk initiative.\u003c/em>\u003c/a>\u003c/p>\n\n\n\n\u003cp>Pakbet’s only obligation was to focus on himself. At least for one day. In the bright orange office of Filipino Advocates for Justice (FAJ), where he was attending a special wellness meeting for caregiver worker leaders like himself, he closed his eyes, relaxed his shoulders and breathed. \u003c/p>\n\n\n\n\u003cp>“You are seen. Inhale,” a staff member told the group. “You are valued. Exhale.”\u003c/p>\n\n\n\n\u003cp>Sometimes, Pakbet said he feels valued, like when he was a private aide for Teddy, a 98-year-old woman at the retirement home. They developed a relationship like a mother and son, and he would treat her so — cooking her homemade chicken feet adobo, or watching makeup tutorials with her online. He’d apply her lipstick, dress her in a gown and accompany her into the dining room, declaring, “The queen has arrived!” Besides bathing her and monitoring vitals, he saw it as his job to make her laugh.\u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2500\" height=\"833\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-1.jpg\" alt=\"\" class=\"wp-image-12099853\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-1.jpg 2500w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-1-2000x666.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-1-160x53.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-1-1536x512.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-1-2048x682.jpg 2048w\" sizes=\"auto, (max-width: 2500px) 100vw, 2500px\" />\u003cfigcaption class=\"wp-element-caption\">Left: Karen Villanueva, executive director of Kilusan Wellness, leads a mental wellness breathing and massage exercise to open FAJ’s Kapwa Circle, a monthly community-building event, at the organization’s Union City location on March 6, 2026. Right: Pakbet (center) sings “Precious and Few” as the FAJ community honors FAJ worker organizer, Santi Tagle Buensuceso, during a surprise farewell party about one week before Buensuceso relocates back to the Philippines. Although Pakbet had a caregiving shift that evening, he joined the first half of the Kapwa Circle to attend the surprise going-away party for Buensuceso, who he considers an older sister. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1332\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-07.jpg\" alt=\"\" class=\"wp-image-12096175\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-07.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-07-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-07-1536x1023.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Members of the Filipino Advocates for Justice community practice a breathing and movement exercise during the organization’s March Kapwa Circle. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>Other times, his body remembers: panic attacks from the chronic stress of unstable paychecks and exploitative employers, grief for his mother with cancer back home in the Philippines, whom he hasn’t hugged in a decade. The depression has led to insomnia and isolation.\u003c/p>\n\n\n\n\u003cp>“My world is work, home. I don’t have any trusted friends,” he said. “This is my life.”\u003c/p>\n\n\n\n\u003cp>Pakbet, 54, said caregivers like him can feel overworked and undervalued. A Bay Area immigrant rights organization, FAJ creates an affirming space for them to rest and celebrate, so they can show up whole — not only for themselves but for others.\u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"994\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-18.jpg\" alt=\"\" class=\"wp-image-12096186\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-18.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-18-160x80.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-18-1536x763.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Center: Pakbet poses for a portrait in his Bay Area home on May 4, 2026, where he has lived with his family for six years. Previously, they lived in abusive situations, sharing cramped spaces and experiencing mistreatment. In 2020, with guidance from a friend at FAJ, they secured their own apartment. “We rent, and we’re very happy because my son has a room. I can cook now,” said Pakbet. “That’s our paradise.” Left and Right: A Bible and cross adorn the walls of Pakbet’s apartment. The demands of caregiving often weigh heavily on his mind, but he finds solace in his faith. “It’s hard, it’s very tiring,” he said. “Without my son, without my faith, I almost give up.” (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>Leaning on Filipino cultural practices and intergenerational connection, mental health is woven into everything they do, from monthly gatherings and wellness clinics to everyday grounding techniques and artistic expression. Yet the Trump administration’s immigration crackdown and statewide funding cuts to mental health services have threatened their prevention work, even as a shortage in \u003ca href=\"https://mpa.aging.ca.gov/Goals/4\">care workers \u003c/a>looms. \u003c/p>\n\n\n\n\u003cp>Filipinos are heavily represented in the healthcare workforce, according to \u003ca href=\"https://pmc.ncbi.nlm.nih.gov/articles/PMC7969854/\">research\u003c/a>, and many are paid to care for older adults. Respect for elders is a deeply embedded cultural value. As California’s population continues to age — \u003ca href=\"https://mpa.aging.ca.gov/\">about 25% will be an older adult by 2030\u003c/a> — caregivers will become even more essential. But isolation, burnout, racial discrimination, wage theft, and more can all contribute to mental health challenges.\u003c/p>\n\n\n\n\u003cp>“They are the first to take care of everybody else. And that’s done at the expense of their own bodies, their own emotional health,” said Geraldine Alcid, executive director of FAJ. “They deserve to take care of themselves, and they deserve rest.”\u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1272\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-17.jpg\" alt=\"\" class=\"wp-image-12096185\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-17.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-17-160x102.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-17-1536x977.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">An old photograph of Pakbet and Teddy decorated with makeup and his written reflections. To help Teddy prepare for outings, Pakbet watched YouTube tutorials to learn makeup and helped her choose dresses and jewelry. At the care home, Pakbet recalls people asking him, “Where is your master?” but Teddy always defended him, responding that he was her family. (Florence Middleton for Catchlight/KQED; instant photo made with and handwriting and decorations by Pakbet)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"1620\" height=\"1080\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/FAJ_Video_05_Caregiver1_CookingAdobo_TEST.gif\" alt=\"\" class=\"wp-image-12096600\" />\u003cfigcaption class=\"wp-element-caption\">Pakbet cooks chicken adobo at home. He de-stresses through cooking and finds joy in sharing his food. When caring for Teddy, a former client who was bedridden, he learned she had grown tired of retirement home meals and missed eating dim sum and chicken feet. He made her chicken feet adobo and began cooking for her. Over time, Pakbet says, she regained energy and began walking again. (Florence Middleton for Catchlight/KQED; handwriting by Pakbet)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>When Pakbet first arrived in the States alone over a decade ago, he lived and worked at a residential care home for older adults. He said his boss forced him to sleep on cardboard in the garage, and his paychecks didn’t reflect the long, exhausting hours. He also knew caregivers who died by suicide. Pakbet, at times, didn’t know if he’d make it. The reason he immigrated was to provide for his son’s education.\u003cbr>\u003cbr>Pakbet said his Bible and a photo of his son got him through.\u003c/p>\n\n\n\n\u003cp>Pakbet’s experience is common. Yet cultural \u003ca href=\"https://filipinos4justice.org/wp-content/uploads/2022/06/3-30-22-Filipino-Advocates-for-Justice-FAJ_-A-Mental-Health-Report-_-Kumusta-Tayo-2021.pdf?utm_source=chatgpt.com\">stigma\u003c/a> and shame can prevent Filipino immigrants from seeking support. “I’ve witnessed many times caregivers who need help. They get scared and hide in the dark,” Pakbet said.\u003c/p>\n\n\n\n\u003cp>Over a decade ago, Oakland-based community health center Asian Health Services referred an exploited caregiver who was anxious and stressed to FAJ. The organization realized others had similar stories, and it was the catalyst for it to focus efforts on prevention. In 2015, they launched a mental health support group for caregivers, many of them older, funded through a two-year Alameda County innovations grant. \u003c/p>\n\n\n\n\u003cp>FAJ expanded its program with the help of an eight-year county contract. They hired a licensed mental health professional on staff, as well as three part-time community outreach specialists to facilitate mental health offerings rooted in culture. FAJ also created a Healing Advisory Committee that organizes free annual wellness clinics, featuring Filipino traditions such as hilot, a massage focused on releasing trauma. \u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1332\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-11.jpg\" alt=\"\" class=\"wp-image-12096179\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-11.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-11-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-11-1536x1023.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Pakbet hangs a wet sheet to dry near the window in his Bay Area home. After years of living in the United States without access to an in-home washing machine, he set up a small washer in his apartment kitchen — a change he says has saved him time and eased the routines of daily life. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"920\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-10.jpg\" alt=\"\" class=\"wp-image-12096178\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-10.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-10-160x74.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-10-1536x707.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Left: Pakbet holds calamansi — a sweet and sour Filipino citrus with fragrant flowers — that he harvested from the office garden at Filipino Advocates for Justice for cooking. Right: Pakbet’s caregiving scrubs drape the living room couch where he sleeps so that his son can have the only bedroom in their apartment. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>In 2023, a one-time state grant from the Department of Aging enabled FAJ to shift attention again to caregivers. They provided training on topics such as nutrition and managing grief, weaving in hands-on clinics for everyday self-care. \u003c/p>\n\n\n\n\u003cp>At first, caregivers expressed apprehensive curiosity. Then eventually, they requested chia seed pudding recipes and acupuncture, even the caregivers who feared needles. The organization also provided acupressure rings people could roll on their fingers whenever they needed to calm themselves.\u003c/p>\n\n\n\n\u003cp>Nervous system regulation is essential for moving from merely surviving to thriving, said Dr. Karen Villanueva, training lead and executive director of Kilusan Wellness. And for the majority of caregivers with little time or money, accessibility is key. “So much the better if you can tuck it in your pocket and take it out when you need it.”\u003c/p>\n\n\n\n\u003cp>This July, the policy changes California made to its landmark Behavioral Services Act took effect. When voters passed Proposition 1 in 2024, they approved Gov. Gavin Newsom’s plans to shift funds away from prevention and early intervention toward treatment beds. FAJ’s prevention funding, which supports half of their direct services, was reduced from $360,000 to zero dollars — the organization lost its licensed mental health professional and folded its community outreach advisers into other roles.\u003c/p>\n\n\n\n\u003cp>At the special meeting for wellness worker leaders, where Pakbet could slow down and breathe, the thinning manifested in another way. Usually, nearly a dozen caregivers would be gearing up to knock on the doors of care homes in the East Bay, handing “know your rights” information to employees. The organization pays these workers a learning stipend to perform this outreach work. \u003c/p>\n\n\n\n\u003cp>But when Pakbet looked around the office, he was one of the few caregivers who had stayed. Half of the group had chosen to spend their remaining years in the Philippines as the Trump administration pushes to aggressively crack down on immigration. Many said they were tired of feeling criminalized and undervalued, or, as one staff member of the organization said, an “America-doesn’t-deserve-me” mentality. Others said they missed moments with loved ones.\u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1332\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-09.jpg\" alt=\"\" class=\"wp-image-12096177\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-09.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-09-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-09-1536x1023.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Pakbet listens to a talk on safety in sanctuary cities during an FAJ informational session for caregivers and their community. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>Along with other caregivers in this story, KQED is referring to Pakbet only by a nickname to allow them to speak openly about their mental health struggles and working conditions without jeopardizing their employment.\u003c/p>\n\n\n\n\u003cp>Pakbet understands the impulse to return home. Still, he said he was feeling especially tender.\u003c/p>\n\n\n\n\u003cp>His “lifeline,” FAJ’s worker organizer and seasoned activist Santi Tagle Buensuceso, had announced that she was also returning to her homeland.\u003c/p>\n\n\n\n\u003cp>Whenever Pakbet struggled, instead of crying alone, he’d call Tagle Buensuceso. Sometimes, he’d voice his doubts about his ability to be a provider: “Am I a good father? Am I doing OK? Do I need to go back to the Philippines?” \u003c/p>\n\n\n\n\u003cp>She would assure him that trying his best was good enough, that he was a great father and husband. She also realized caregivers like Pakbet needed more outlets and two years ago suggested FAJ host monthly Kapwa Circles for the wider community. A third space to unwind, to reflect, to create joy. \u003ca href=\"https://sswr.confex.com/sswr/2026/webprogram/Paper61579.html\">Kapwa\u003c/a>, a Filipino value meaning interconnectedness, the recognition of yourself in each other.\u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1332\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-08.jpg\" alt=\"\" class=\"wp-image-12096176\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-08.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-08-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-08-1536x1023.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Community members practice a breathing and movement exercise as Santi Tagle Buensuceso reads a farewell card signed by the Filipino Advocates for Justice community during a surprise party held a week before her return to the Philippines. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1332\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-03.jpg\" alt=\"\" class=\"wp-image-12096171\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-03.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-03-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-03-1536x1023.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Pakbet, right, says goodbye to Tagle Buensuceso during her surprise farewell party. To Pakbet, Buensuceso was like an older sister, someone who always looked out for and advocated for him. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>On a Friday evening in March, the young and old came together at FAJ’s Union City office to recreate a slice of the Philippines.\u003c/p>\n\n\n\n\u003cp>Fried chicken from Jollibee piled high on paper plates, the sounds of people speaking Tagalog could be heard. Outside, a community garden where calamansi, a citrus fruit native to the Philippines, had been harvested for a jar of juice. \u003c/p>\n\n\n\n\u003cp>The event is what FAJ leadership describes as a “Filipino family party” or a Kapwa Circle. It has a different flavor each month and begins with a discussion of a social justice topic — sanctuary cities, for one, or voter registration — to invite people into FAJ’s organizing work. After the community conversation, they host an activity like bingo or mahjong. Always karaoke, whether planned or not. There is a rule of no chisme, but many will say gossip is their favorite part. \u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1332\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-06.jpg\" alt=\"\" class=\"wp-image-12096174\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-06.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-06-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-06-1536x1023.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">People dance the Pinoy Cha-Cha during the March Kapwa Circle at the offices of Filipino Advocates for Justice in Union City, California. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2500\" height=\"833\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-3-1.jpg\" alt=\"\" class=\"wp-image-12099855\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-3-1.jpg 2500w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-3-1-2000x666.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-3-1-160x53.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-3-1-1536x512.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-3-1-2048x682.jpg 2048w\" sizes=\"auto, (max-width: 2500px) 100vw, 2500px\" />\u003cfigcaption class=\"wp-element-caption\">Left: Cristy Ferrer, a Filipino Advocates for Justice organizer, left, and Ine, a caregiver and FAJ worker leader, lead a Pinoy Cha-Cha dance lesson. Right: Ine dances with another community member during the Kapwa Circle. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>The evening was Tagle Buensuceso’s last circle. Pakbet was there, drawn to a space where he could laugh and smile naturally. “I don’t need to fake it,” he said. He must leave early, however, to care for a client. Pakbet is now a certified nurse assistant and works hourly one-on-one with clients, but stability has been elusive lately. Clients have entered hospital care or passed away. With fewer hours, he has no choice.\u003c/p>\n\n\n\n\u003cp>For now, he joined in celebrating Tagle Buensuceso. As a surprise, staff handed out printed lyrics of her favorite song, “Precious and Few” by the band Climax. Ine, a fellow caregiver worker leader, grabbed her guitar. She led the group for a sing-along to the ’70s soft-rock song about cherishing moments, and the metaphor was not lost.\u003c/p>\n\n\n\n\u003cp>A mother of three, Ine came solo to the U.S. 15 years ago to provide her children a good college education, and has lived and worked at a care home ever since. As the home’s cook, Ine, 63, plates green pesto pasta and other colorful food with the intention to appeal to her dementia patients. She also administers medicine, having gone back to school to become a pharmacy technician, graduating with honors. \u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-embed aligncenter is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\">\u003cdiv class=\"wp-block-embed__wrapper\">\nhttps://www.youtube.com/watch?v=U9ectSMWvm4\n\u003c/div>\u003c/figure>\n\n\n\n\u003cp>She said she talks with her husband and children via video every night, but misses them the most on holidays and birthdays. \u003c/p>\n\n\n\n\u003cp>Back in her room at the care home, she filled a balikbayan box for her son’s 41st birthday. \u003c/p>\n\n\n\n\u003cp>She lovingly selected Lacoste polo shirts, Ferrero Rocher chocolate and other items for the care package by hand, a proxy for her presence. \u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"1513\" height=\"1500\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/FAJ_Video_06_VideoPortraits_TEST.gif\" alt=\"\" class=\"wp-image-12096610\" />\u003cfigcaption class=\"wp-element-caption\">Caregivers, community members and staff of Filipino Advocates for Justice pose for portraits in the garden near a calamansi tree cared for by staff and harvested by caregivers for their food. Some chose gestures of wellness to express in their portraits. “There’s such a deep, immense healing power that caregivers have,” said Daisy Maxion, FAJ organizing director. “They remind us of what it means to be human.” (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>Every month, she makes sure she has time off for the Kapwa Circle. When she is tired, when the monotony of caregiving is grueling, she said being with other caregivers at FAJ and, better, using her musical talent to entertain, gives her the “strength to work for another day.”\u003c/p>\n\n\n\n\u003cp>This evening, Ine passed the mic to Tagle Buensuceso, who said that before FAJ, she believed cigarettes were the only form of wellness. She left the group with one last piece of wisdom. “If you don’t take care of yourself, you can’t take care of your community.” Pakbet clapped. The music began. \u003c/p>\n\n\n\n\u003cp>Hands linked and people moved to the Cupid Shuffle, the Macarena, the Pinoy Cha-Cha. Ine was in her element, her first love, dance. The food whittled down. When a delivery worker stopped by to drop off more Spam musubi, she was met with a chorus of: “Stay. Take a plate.”\u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"920\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-13.jpg\" alt=\"\" class=\"wp-image-12096181\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-13.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-13-160x74.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-13-1536x707.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Left: A community member of Filipino Advocates for Justice holds a flower in her hand as she poses in front of a backdrop. “If you’re able to breathe deeply and freely, if you’re able to sit with difficult emotions, if you’re able to get regular sleep and eat food that has some nutrition in it … you’re leaving room for creativity and imagination and the courage to reach out,” said Karen Villanueva, executive director of Kilusan Wellness. “Nervous system regulation allows us to really know who we are.” Right: Two attendees wear Filipiniana dresses as they fill ttheir plates during a Kapwa Circle potluck. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>There is power in knowing others share similar experiences, said Dr. Annalisa Enrile, a Filipina community organizer and professor at the USC School of Social Work.\u003cbr>\u003cbr>Enrile has researched how \u003ca href=\"https://psycnet.apa.org/fulltext/2026-27795-003.html\">communal care in Filipino immigrant communities\u003c/a> that draws on cultural practices can ease stress and improve mental well-being. “If you feel like you belong in a way that gives you agency, and reduces stigma,” she said, “then you’re more apt to ask for help.” \u003c/p>\n\n\n\n\u003cp>FAJ’s leaders, too, realized belonging was a way to build trust and encourage caregivers to open up, and it’s why they have prioritized connection as the heart of their programming. Recently, they were relieved to hear they received one year of bridge funding to bring back their mental health specialist as they figure out how to sustain their wellness and mental health services. A temporary bandage, executive director Geraldine Alcid said, but enough to keep going. \u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1332\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-16.jpg\" alt=\"\" class=\"wp-image-12096184\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-16.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-16-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-16-1536x1023.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Ine near the San Francisco Bay, where she likes to go and recharge when she has time. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>Despite the funding uncertainty, the group is sustained by a deep hope: Show up, and something might shift. \u003c/p>\n\n\n\n\u003cp>Pakbet wasn’t sure if he’d come back to FAJ when Tagle Buensuceso left. He decided to keep showing up anyway, without a community elsewhere. Later that spring, he attended a picnic for caregivers at Contra Loma Regional Park in Contra Costa County. The stillness of the oak-tree-dotted hills contrasted with the chaos of the last few months. \u003c/p>\n\n\n\n\u003cp>One of his male clients was in the hospital, which meant Pakbet was not being paid to take care of him and was spending too much time alone at home in his apartment. He nearly missed a rent payment until he reached out to FAJ to help. \u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"1998\" height=\"1332\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-12.jpg\" alt=\"\" class=\"wp-image-12096180\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-12.jpg 1998w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-12-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-12-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1998px) 100vw, 1998px\" />\u003cfigcaption class=\"wp-element-caption\">Pakbet, center, joins other caregivers and staff of Filipino Advocates for Justice under the shade of a tree at Contra Loma Regional Park in Antioch for an annual picnic–an opportunity to connect with caregivers from across the Bay Area and enjoy nature. Caregivers practiced wellness stretching, shared food and reenacted moments from caregiving through a “Theater of the Oppressed” activity. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>Grateful for people, for peaceful nature, he set up his phone on a tripod to document the picnic. The wind was gentle. The wetlands glassy. A duck swam by and Pakbet paused to look at it, reminding him of balut, a delicacy with roots in his mother’s province. \u003c/p>\n\n\n\n\u003cp>The caregivers took turns sharing their favorite stretch before acting out a scripted scene from \u003cem>Theater of the Oppressed\u003c/em>, an approach that uses roleplay to explore solutions to social problems. Pakbet assumed the role of a care home owner. Drawing from his own experience, he joked about doling out “expensive” perfume from the Dollar Tree instead of actual dollars for overtime. People burst out laughing.\u003c/p>\n\n\n\n\u003cp>Pakbet reflected afterward and said he has never felt more anchored in his purpose to empower caregivers like himself. Next outreach, when he knocks on doors, before asking about rights, before handing them a booklet, he will first ask, “How are you doing?”\u003c/p>\n\n\n\n\u003cp>\u003cem>This story was made possible in part by the Aging Beat workshop, convened by the Craig Newmark Graduate School of Journalism at CUNY.\u003c/em>\u003c/p>\n",
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"innerHTML": "\n\u003cp>Sometimes, Pakbet said he feels valued, like when he was a private aide for Teddy, a 98-year-old woman at the retirement home. They developed a relationship like a mother and son, and he would treat her so — cooking her homemade chicken feet adobo, or watching makeup tutorials with her online. He’d apply her lipstick, dress her in a gown and accompany her into the dining room, declaring, “The queen has arrived!” Besides bathing her and monitoring vitals, he saw it as his job to make her laugh.\u003c/p>\n",
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"\n\u003cp>Sometimes, Pakbet said he feels valued, like when he was a private aide for Teddy, a 98-year-old woman at the retirement home. They developed a relationship like a mother and son, and he would treat her so — cooking her homemade chicken feet adobo, or watching makeup tutorials with her online. He’d apply her lipstick, dress her in a gown and accompany her into the dining room, declaring, “The queen has arrived!” Besides bathing her and monitoring vitals, he saw it as his job to make her laugh.\u003c/p>\n"
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"innerHTML": "\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-1.jpg\" alt=\"\" class=\"wp-image-12099853\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-1.jpg 2500w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-1-2000x666.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-1-160x53.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-1-1536x512.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-1-2048x682.jpg 2048w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\" />\u003cfigcaption class=\"wp-element-caption\">Left: Karen Villanueva, executive director of Kilusan Wellness, leads a mental wellness breathing and massage exercise to open FAJ’s Kapwa Circle, a monthly community-building event, at the organization’s Union City location on March 6, 2026. Right: Pakbet (center) sings “Precious and Few” as the FAJ community honors FAJ worker organizer, Santi Tagle Buensuceso, during a surprise farewell party about one week before Buensuceso relocates back to the Philippines. Although Pakbet had a caregiving shift that evening, he joined the first half of the Kapwa Circle to attend the surprise going-away party for Buensuceso, who he considers an older sister.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
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"\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-1.jpg\" alt=\"\" class=\"wp-image-12099853\" />\u003cfigcaption class=\"wp-element-caption\">Left: Karen Villanueva, executive director of Kilusan Wellness, leads a mental wellness breathing and massage exercise to open FAJ’s Kapwa Circle, a monthly community-building event, at the organization’s Union City location on March 6, 2026. Right: Pakbet (center) sings “Precious and Few” as the FAJ community honors FAJ worker organizer, Santi Tagle Buensuceso, during a surprise farewell party about one week before Buensuceso relocates back to the Philippines. Although Pakbet had a caregiving shift that evening, he joined the first half of the Kapwa Circle to attend the surprise going-away party for Buensuceso, who he considers an older sister.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-07.jpg\" alt=\"\" class=\"wp-image-12096175\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-07.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-07-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-07-1536x1023.jpg 1536w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\" />\u003cfigcaption class=\"wp-element-caption\">Members of the Filipino Advocates for Justice community practice a breathing and movement exercise during the organization’s March Kapwa Circle.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
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"\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-07.jpg\" alt=\"\" class=\"wp-image-12096175\" />\u003cfigcaption class=\"wp-element-caption\">Members of the Filipino Advocates for Justice community practice a breathing and movement exercise during the organization’s March Kapwa Circle.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cp>Other times, his body remembers: panic attacks from the chronic stress of unstable paychecks and exploitative employers, grief for his mother with cancer back home in the Philippines, whom he hasn’t hugged in a decade. The depression has led to insomnia and isolation.\u003c/p>\n",
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"\n\u003cp>Other times, his body remembers: panic attacks from the chronic stress of unstable paychecks and exploitative employers, grief for his mother with cancer back home in the Philippines, whom he hasn’t hugged in a decade. The depression has led to insomnia and isolation.\u003c/p>\n"
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"innerHTML": "\n\u003cp>“My world is work, home. I don’t have any trusted friends,” he said. “This is my life.”\u003c/p>\n",
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"\n\u003cp>“My world is work, home. I don’t have any trusted friends,” he said. “This is my life.”\u003c/p>\n"
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"innerHTML": "\n\u003cp>Pakbet, 54, said caregivers like him can feel overworked and undervalued. A Bay Area immigrant rights organization, FAJ creates an affirming space for them to rest and celebrate, so they can show up whole — not only for themselves but for others.\u003c/p>\n",
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"\n\u003cp>Pakbet, 54, said caregivers like him can feel overworked and undervalued. A Bay Area immigrant rights organization, FAJ creates an affirming space for them to rest and celebrate, so they can show up whole — not only for themselves but for others.\u003c/p>\n"
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"innerHTML": "\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-18.jpg\" alt=\"\" class=\"wp-image-12096186\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-18.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-18-160x80.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-18-1536x763.jpg 1536w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\" />\u003cfigcaption class=\"wp-element-caption\">Center: Pakbet poses for a portrait in his Bay Area home on May 4, 2026, where he has lived with his family for six years. Previously, they lived in abusive situations, sharing cramped spaces and experiencing mistreatment. In 2020, with guidance from a friend at FAJ, they secured their own apartment. “We rent, and we’re very happy because my son has a room. I can cook now,” said Pakbet. “That’s our paradise.” Left and Right: A Bible and cross adorn the walls of Pakbet’s apartment. The demands of caregiving often weigh heavily on his mind, but he finds solace in his faith. “It’s hard, it’s very tiring,” he said. “Without my son, without my faith, I almost give up.”\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
"innerContent": [
"\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-18.jpg\" alt=\"\" class=\"wp-image-12096186\" />\u003cfigcaption class=\"wp-element-caption\">Center: Pakbet poses for a portrait in his Bay Area home on May 4, 2026, where he has lived with his family for six years. Previously, they lived in abusive situations, sharing cramped spaces and experiencing mistreatment. In 2020, with guidance from a friend at FAJ, they secured their own apartment. “We rent, and we’re very happy because my son has a room. I can cook now,” said Pakbet. “That’s our paradise.” Left and Right: A Bible and cross adorn the walls of Pakbet’s apartment. The demands of caregiving often weigh heavily on his mind, but he finds solace in his faith. “It’s hard, it’s very tiring,” he said. “Without my son, without my faith, I almost give up.”\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cp>Leaning on Filipino cultural practices and intergenerational connection, mental health is woven into everything they do, from monthly gatherings and wellness clinics to everyday grounding techniques and artistic expression. Yet the Trump administration’s immigration crackdown and statewide funding cuts to mental health services have threatened their prevention work, even as a shortage in \u003ca href=\"https://mpa.aging.ca.gov/Goals/4\">care workers \u003c/a>looms. \u003c/p>\n",
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"\n\u003cp>Leaning on Filipino cultural practices and intergenerational connection, mental health is woven into everything they do, from monthly gatherings and wellness clinics to everyday grounding techniques and artistic expression. Yet the Trump administration’s immigration crackdown and statewide funding cuts to mental health services have threatened their prevention work, even as a shortage in \u003ca href=\"https://mpa.aging.ca.gov/Goals/4\">care workers \u003c/a>looms. \u003c/p>\n"
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"innerHTML": "\n\u003cp>Filipinos are heavily represented in the healthcare workforce, according to \u003ca href=\"https://pmc.ncbi.nlm.nih.gov/articles/PMC7969854/\">research\u003c/a>, and many are paid to care for older adults. Respect for elders is a deeply embedded cultural value. As California’s population continues to age — \u003ca href=\"https://mpa.aging.ca.gov/\">about 25% will be an older adult by 2030\u003c/a> — caregivers will become even more essential. But isolation, burnout, racial discrimination, wage theft, and more can all contribute to mental health challenges.\u003c/p>\n",
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"\n\u003cp>Filipinos are heavily represented in the healthcare workforce, according to \u003ca href=\"https://pmc.ncbi.nlm.nih.gov/articles/PMC7969854/\">research\u003c/a>, and many are paid to care for older adults. Respect for elders is a deeply embedded cultural value. As California’s population continues to age — \u003ca href=\"https://mpa.aging.ca.gov/\">about 25% will be an older adult by 2030\u003c/a> — caregivers will become even more essential. But isolation, burnout, racial discrimination, wage theft, and more can all contribute to mental health challenges.\u003c/p>\n"
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"innerHTML": "\n\u003cp>“They are the first to take care of everybody else. And that’s done at the expense of their own bodies, their own emotional health,” said Geraldine Alcid, executive director of FAJ. “They deserve to take care of themselves, and they deserve rest.”\u003c/p>\n",
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"\n\u003cp>“They are the first to take care of everybody else. And that’s done at the expense of their own bodies, their own emotional health,” said Geraldine Alcid, executive director of FAJ. “They deserve to take care of themselves, and they deserve rest.”\u003c/p>\n"
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"innerHTML": "\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-17.jpg\" alt=\"\" class=\"wp-image-12096185\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-17.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-17-160x102.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-17-1536x977.jpg 1536w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\" />\u003cfigcaption class=\"wp-element-caption\">An old photograph of Pakbet and Teddy decorated with makeup and his written reflections. To help Teddy prepare for outings, Pakbet watched YouTube tutorials to learn makeup and helped her choose dresses and jewelry. At the care home, Pakbet recalls people asking him, “Where is your master?” but Teddy always defended him, responding that he was her family.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED; instant photo made with and handwriting and decorations by Pakbet)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
"innerContent": [
"\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-17.jpg\" alt=\"\" class=\"wp-image-12096185\" />\u003cfigcaption class=\"wp-element-caption\">An old photograph of Pakbet and Teddy decorated with makeup and his written reflections. To help Teddy prepare for outings, Pakbet watched YouTube tutorials to learn makeup and helped her choose dresses and jewelry. At the care home, Pakbet recalls people asking him, “Where is your master?” but Teddy always defended him, responding that he was her family.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED; instant photo made with and handwriting and decorations by Pakbet)\u003c/cite>\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/FAJ_Video_05_Caregiver1_CookingAdobo_TEST.gif\" alt=\"\" class=\"wp-image-12096600\" />\u003cfigcaption class=\"wp-element-caption\">Pakbet cooks chicken adobo at home. He de-stresses through cooking and finds joy in sharing his food. When caring for Teddy, a former client who was bedridden, he learned she had grown tired of retirement home meals and missed eating dim sum and chicken feet. He made her chicken feet adobo and began cooking for her. Over time, Pakbet says, she regained energy and began walking again.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED; handwriting by Pakbet)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
"innerContent": [
"\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/FAJ_Video_05_Caregiver1_CookingAdobo_TEST.gif\" alt=\"\" class=\"wp-image-12096600\" />\u003cfigcaption class=\"wp-element-caption\">Pakbet cooks chicken adobo at home. He de-stresses through cooking and finds joy in sharing his food. When caring for Teddy, a former client who was bedridden, he learned she had grown tired of retirement home meals and missed eating dim sum and chicken feet. He made her chicken feet adobo and began cooking for her. Over time, Pakbet says, she regained energy and began walking again.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED; handwriting by Pakbet)\u003c/cite>\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cp>When Pakbet first arrived in the States alone over a decade ago, he lived and worked at a residential care home for older adults. He said his boss forced him to sleep on cardboard in the garage, and his paychecks didn’t reflect the long, exhausting hours. He also knew caregivers who died by suicide. Pakbet, at times, didn’t know if he’d make it. The reason he immigrated was to provide for his son’s education.\u003cbr>\u003cbr>Pakbet said his Bible and a photo of his son got him through.\u003c/p>\n",
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"\n\u003cp>When Pakbet first arrived in the States alone over a decade ago, he lived and worked at a residential care home for older adults. He said his boss forced him to sleep on cardboard in the garage, and his paychecks didn’t reflect the long, exhausting hours. He also knew caregivers who died by suicide. Pakbet, at times, didn’t know if he’d make it. The reason he immigrated was to provide for his son’s education.\u003cbr>\u003cbr>Pakbet said his Bible and a photo of his son got him through.\u003c/p>\n"
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"innerHTML": "\n\u003cp>Pakbet’s experience is common. Yet cultural \u003ca href=\"https://filipinos4justice.org/wp-content/uploads/2022/06/3-30-22-Filipino-Advocates-for-Justice-FAJ_-A-Mental-Health-Report-_-Kumusta-Tayo-2021.pdf?utm_source=chatgpt.com\">stigma\u003c/a> and shame can prevent Filipino immigrants from seeking support. “I’ve witnessed many times caregivers who need help. They get scared and hide in the dark,” Pakbet said.\u003c/p>\n",
"innerContent": [
"\n\u003cp>Pakbet’s experience is common. Yet cultural \u003ca href=\"https://filipinos4justice.org/wp-content/uploads/2022/06/3-30-22-Filipino-Advocates-for-Justice-FAJ_-A-Mental-Health-Report-_-Kumusta-Tayo-2021.pdf?utm_source=chatgpt.com\">stigma\u003c/a> and shame can prevent Filipino immigrants from seeking support. “I’ve witnessed many times caregivers who need help. They get scared and hide in the dark,” Pakbet said.\u003c/p>\n"
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"innerHTML": "\n\u003cp>Over a decade ago, Oakland-based community health center Asian Health Services referred an exploited caregiver who was anxious and stressed to FAJ. The organization realized others had similar stories, and it was the catalyst for it to focus efforts on prevention. In 2015, they launched a mental health support group for caregivers, many of them older, funded through a two-year Alameda County innovations grant. \u003c/p>\n",
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"\n\u003cp>Over a decade ago, Oakland-based community health center Asian Health Services referred an exploited caregiver who was anxious and stressed to FAJ. The organization realized others had similar stories, and it was the catalyst for it to focus efforts on prevention. In 2015, they launched a mental health support group for caregivers, many of them older, funded through a two-year Alameda County innovations grant. \u003c/p>\n"
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"innerHTML": "\n\u003cp>FAJ expanded its program with the help of an eight-year county contract. They hired a licensed mental health professional on staff, as well as three part-time community outreach specialists to facilitate mental health offerings rooted in culture. FAJ also created a Healing Advisory Committee that organizes free annual wellness clinics, featuring Filipino traditions such as hilot, a massage focused on releasing trauma. \u003c/p>\n",
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"\n\u003cp>FAJ expanded its program with the help of an eight-year county contract. They hired a licensed mental health professional on staff, as well as three part-time community outreach specialists to facilitate mental health offerings rooted in culture. FAJ also created a Healing Advisory Committee that organizes free annual wellness clinics, featuring Filipino traditions such as hilot, a massage focused on releasing trauma. \u003c/p>\n"
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"innerHTML": "\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-11.jpg\" alt=\"\" class=\"wp-image-12096179\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-11.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-11-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-11-1536x1023.jpg 1536w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\" />\u003cfigcaption class=\"wp-element-caption\">Pakbet hangs a wet sheet to dry near the window in his Bay Area home. After years of living in the United States without access to an in-home washing machine, he set up a small washer in his apartment kitchen — a change he says has saved him time and eased the routines of daily life.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
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"\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-11.jpg\" alt=\"\" class=\"wp-image-12096179\" />\u003cfigcaption class=\"wp-element-caption\">Pakbet hangs a wet sheet to dry near the window in his Bay Area home. After years of living in the United States without access to an in-home washing machine, he set up a small washer in his apartment kitchen — a change he says has saved him time and eased the routines of daily life.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-10.jpg\" alt=\"\" class=\"wp-image-12096178\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-10.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-10-160x74.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-10-1536x707.jpg 1536w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\" />\u003cfigcaption class=\"wp-element-caption\">Left: Pakbet holds calamansi — a sweet and sour Filipino citrus with fragrant flowers — that he harvested from the office garden at Filipino Advocates for Justice for cooking. Right: Pakbet’s caregiving scrubs drape the living room couch where he sleeps so that his son can have the only bedroom in their apartment.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
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"\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-10.jpg\" alt=\"\" class=\"wp-image-12096178\" />\u003cfigcaption class=\"wp-element-caption\">Left: Pakbet holds calamansi — a sweet and sour Filipino citrus with fragrant flowers — that he harvested from the office garden at Filipino Advocates for Justice for cooking. Right: Pakbet’s caregiving scrubs drape the living room couch where he sleeps so that his son can have the only bedroom in their apartment.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cp>In 2023, a one-time state grant from the Department of Aging enabled FAJ to shift attention again to caregivers. They provided training on topics such as nutrition and managing grief, weaving in hands-on clinics for everyday self-care. \u003c/p>\n",
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"\n\u003cp>In 2023, a one-time state grant from the Department of Aging enabled FAJ to shift attention again to caregivers. They provided training on topics such as nutrition and managing grief, weaving in hands-on clinics for everyday self-care. \u003c/p>\n"
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"innerHTML": "\n\u003cp>At first, caregivers expressed apprehensive curiosity. Then eventually, they requested chia seed pudding recipes and acupuncture, even the caregivers who feared needles. The organization also provided acupressure rings people could roll on their fingers whenever they needed to calm themselves.\u003c/p>\n",
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"\n\u003cp>At first, caregivers expressed apprehensive curiosity. Then eventually, they requested chia seed pudding recipes and acupuncture, even the caregivers who feared needles. The organization also provided acupressure rings people could roll on their fingers whenever they needed to calm themselves.\u003c/p>\n"
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"innerHTML": "\n\u003cp>Nervous system regulation is essential for moving from merely surviving to thriving, said Dr. Karen Villanueva, training lead and executive director of Kilusan Wellness. And for the majority of caregivers with little time or money, accessibility is key. “So much the better if you can tuck it in your pocket and take it out when you need it.”\u003c/p>\n",
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"\n\u003cp>Nervous system regulation is essential for moving from merely surviving to thriving, said Dr. Karen Villanueva, training lead and executive director of Kilusan Wellness. And for the majority of caregivers with little time or money, accessibility is key. “So much the better if you can tuck it in your pocket and take it out when you need it.”\u003c/p>\n"
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"innerHTML": "\n\u003cp>This July, the policy changes California made to its landmark Behavioral Services Act took effect. When voters passed Proposition 1 in 2024, they approved Gov. Gavin Newsom’s plans to shift funds away from prevention and early intervention toward treatment beds. FAJ’s prevention funding, which supports half of their direct services, was reduced from $360,000 to zero dollars — the organization lost its licensed mental health professional and folded its community outreach advisers into other roles.\u003c/p>\n",
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"\n\u003cp>This July, the policy changes California made to its landmark Behavioral Services Act took effect. When voters passed Proposition 1 in 2024, they approved Gov. Gavin Newsom’s plans to shift funds away from prevention and early intervention toward treatment beds. FAJ’s prevention funding, which supports half of their direct services, was reduced from $360,000 to zero dollars — the organization lost its licensed mental health professional and folded its community outreach advisers into other roles.\u003c/p>\n"
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"innerHTML": "\n\u003cp>At the special meeting for wellness worker leaders, where Pakbet could slow down and breathe, the thinning manifested in another way. Usually, nearly a dozen caregivers would be gearing up to knock on the doors of care homes in the East Bay, handing “know your rights” information to employees. The organization pays these workers a learning stipend to perform this outreach work. \u003c/p>\n",
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"\n\u003cp>At the special meeting for wellness worker leaders, where Pakbet could slow down and breathe, the thinning manifested in another way. Usually, nearly a dozen caregivers would be gearing up to knock on the doors of care homes in the East Bay, handing “know your rights” information to employees. The organization pays these workers a learning stipend to perform this outreach work. \u003c/p>\n"
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"innerHTML": "\n\u003cp>But when Pakbet looked around the office, he was one of the few caregivers who had stayed. Half of the group had chosen to spend their remaining years in the Philippines as the Trump administration pushes to aggressively crack down on immigration. Many said they were tired of feeling criminalized and undervalued, or, as one staff member of the organization said, an “America-doesn’t-deserve-me” mentality. Others said they missed moments with loved ones.\u003c/p>\n",
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"\n\u003cp>But when Pakbet looked around the office, he was one of the few caregivers who had stayed. Half of the group had chosen to spend their remaining years in the Philippines as the Trump administration pushes to aggressively crack down on immigration. Many said they were tired of feeling criminalized and undervalued, or, as one staff member of the organization said, an “America-doesn’t-deserve-me” mentality. Others said they missed moments with loved ones.\u003c/p>\n"
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"innerHTML": "\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-09.jpg\" alt=\"\" class=\"wp-image-12096177\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-09.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-09-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-09-1536x1023.jpg 1536w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\" />\u003cfigcaption class=\"wp-element-caption\">Pakbet listens to a talk on safety in sanctuary cities during an FAJ informational session for caregivers and their community. \u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
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"\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-09.jpg\" alt=\"\" class=\"wp-image-12096177\" />\u003cfigcaption class=\"wp-element-caption\">Pakbet listens to a talk on safety in sanctuary cities during an FAJ informational session for caregivers and their community. \u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cp>Along with other caregivers in this story, KQED is referring to Pakbet only by a nickname to allow them to speak openly about their mental health struggles and working conditions without jeopardizing their employment.\u003c/p>\n",
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"\n\u003cp>Along with other caregivers in this story, KQED is referring to Pakbet only by a nickname to allow them to speak openly about their mental health struggles and working conditions without jeopardizing their employment.\u003c/p>\n"
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"innerHTML": "\n\u003cp>Pakbet understands the impulse to return home. Still, he said he was feeling especially tender.\u003c/p>\n",
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"\n\u003cp>Pakbet understands the impulse to return home. Still, he said he was feeling especially tender.\u003c/p>\n"
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"innerHTML": "\n\u003cp>His “lifeline,” FAJ’s worker organizer and seasoned activist Santi Tagle Buensuceso, had announced that she was also returning to her homeland.\u003c/p>\n",
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"\n\u003cp>His “lifeline,” FAJ’s worker organizer and seasoned activist Santi Tagle Buensuceso, had announced that she was also returning to her homeland.\u003c/p>\n"
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"innerHTML": "\n\u003cp>Whenever Pakbet struggled, instead of crying alone, he’d call Tagle Buensuceso. Sometimes, he’d voice his doubts about his ability to be a provider: “Am I a good father? Am I doing OK? Do I need to go back to the Philippines?” \u003c/p>\n",
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"\n\u003cp>Whenever Pakbet struggled, instead of crying alone, he’d call Tagle Buensuceso. Sometimes, he’d voice his doubts about his ability to be a provider: “Am I a good father? Am I doing OK? Do I need to go back to the Philippines?” \u003c/p>\n"
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"innerHTML": "\n\u003cp>She would assure him that trying his best was good enough, that he was a great father and husband. She also realized caregivers like Pakbet needed more outlets and two years ago suggested FAJ host monthly Kapwa Circles for the wider community. A third space to unwind, to reflect, to create joy. \u003ca href=\"https://sswr.confex.com/sswr/2026/webprogram/Paper61579.html\">Kapwa\u003c/a>, a Filipino value meaning interconnectedness, the recognition of yourself in each other.\u003c/p>\n",
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"\n\u003cp>She would assure him that trying his best was good enough, that he was a great father and husband. She also realized caregivers like Pakbet needed more outlets and two years ago suggested FAJ host monthly Kapwa Circles for the wider community. A third space to unwind, to reflect, to create joy. \u003ca href=\"https://sswr.confex.com/sswr/2026/webprogram/Paper61579.html\">Kapwa\u003c/a>, a Filipino value meaning interconnectedness, the recognition of yourself in each other.\u003c/p>\n"
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"innerHTML": "\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-08.jpg\" alt=\"\" class=\"wp-image-12096176\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-08.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-08-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-08-1536x1023.jpg 1536w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\" />\u003cfigcaption class=\"wp-element-caption\">Community members practice a breathing and movement exercise as Santi Tagle Buensuceso reads a farewell card signed by the Filipino Advocates for Justice community during a surprise party held a week before her return to the Philippines.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
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"\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-08.jpg\" alt=\"\" class=\"wp-image-12096176\" />\u003cfigcaption class=\"wp-element-caption\">Community members practice a breathing and movement exercise as Santi Tagle Buensuceso reads a farewell card signed by the Filipino Advocates for Justice community during a surprise party held a week before her return to the Philippines.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-03.jpg\" alt=\"\" class=\"wp-image-12096171\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-03.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-03-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-03-1536x1023.jpg 1536w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\" />\u003cfigcaption class=\"wp-element-caption\">Pakbet, right, says goodbye to Tagle Buensuceso during her surprise farewell party. To Pakbet, Buensuceso was like an older sister, someone who always looked out for and advocated for him.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
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"\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-03.jpg\" alt=\"\" class=\"wp-image-12096171\" />\u003cfigcaption class=\"wp-element-caption\">Pakbet, right, says goodbye to Tagle Buensuceso during her surprise farewell party. To Pakbet, Buensuceso was like an older sister, someone who always looked out for and advocated for him.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cp>On a Friday evening in March, the young and old came together at FAJ’s Union City office to recreate a slice of the Philippines.\u003c/p>\n",
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"\n\u003cp>On a Friday evening in March, the young and old came together at FAJ’s Union City office to recreate a slice of the Philippines.\u003c/p>\n"
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"innerHTML": "\n\u003cp>Fried chicken from Jollibee piled high on paper plates, the sounds of people speaking Tagalog could be heard. Outside, a community garden where calamansi, a citrus fruit native to the Philippines, had been harvested for a jar of juice. \u003c/p>\n",
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"\n\u003cp>Fried chicken from Jollibee piled high on paper plates, the sounds of people speaking Tagalog could be heard. Outside, a community garden where calamansi, a citrus fruit native to the Philippines, had been harvested for a jar of juice. \u003c/p>\n"
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"innerHTML": "\n\u003cp>The event is what FAJ leadership describes as a “Filipino family party” or a Kapwa Circle. It has a different flavor each month and begins with a discussion of a social justice topic — sanctuary cities, for one, or voter registration — to invite people into FAJ’s organizing work. After the community conversation, they host an activity like bingo or mahjong. Always karaoke, whether planned or not. There is a rule of no chisme, but many will say gossip is their favorite part. \u003c/p>\n",
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"\n\u003cp>The event is what FAJ leadership describes as a “Filipino family party” or a Kapwa Circle. It has a different flavor each month and begins with a discussion of a social justice topic — sanctuary cities, for one, or voter registration — to invite people into FAJ’s organizing work. After the community conversation, they host an activity like bingo or mahjong. Always karaoke, whether planned or not. There is a rule of no chisme, but many will say gossip is their favorite part. \u003c/p>\n"
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"innerHTML": "\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-06.jpg\" alt=\"\" class=\"wp-image-12096174\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-06.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-06-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-06-1536x1023.jpg 1536w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\" />\u003cfigcaption class=\"wp-element-caption\">People dance the Pinoy Cha-Cha during the March Kapwa Circle at the offices of Filipino Advocates for Justice in Union City, California.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
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"\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-06.jpg\" alt=\"\" class=\"wp-image-12096174\" />\u003cfigcaption class=\"wp-element-caption\">People dance the Pinoy Cha-Cha during the March Kapwa Circle at the offices of Filipino Advocates for Justice in Union City, California.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-3-1.jpg\" alt=\"\" class=\"wp-image-12099855\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-3-1.jpg 2500w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-3-1-2000x666.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-3-1-160x53.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-3-1-1536x512.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-3-1-2048x682.jpg 2048w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\" />\u003cfigcaption class=\"wp-element-caption\">Left: Cristy Ferrer, a Filipino Advocates for Justice organizer, left, and Ine, a caregiver and FAJ worker leader, lead a Pinoy Cha-Cha dance lesson. Right: Ine dances with another community member during the Kapwa Circle.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
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"\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-3-1.jpg\" alt=\"\" class=\"wp-image-12099855\" />\u003cfigcaption class=\"wp-element-caption\">Left: Cristy Ferrer, a Filipino Advocates for Justice organizer, left, and Ine, a caregiver and FAJ worker leader, lead a Pinoy Cha-Cha dance lesson. Right: Ine dances with another community member during the Kapwa Circle.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cp>The evening was Tagle Buensuceso’s last circle. Pakbet was there, drawn to a space where he could laugh and smile naturally. “I don’t need to fake it,” he said. He must leave early, however, to care for a client. Pakbet is now a certified nurse assistant and works hourly one-on-one with clients, but stability has been elusive lately. Clients have entered hospital care or passed away. With fewer hours, he has no choice.\u003c/p>\n",
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"\n\u003cp>The evening was Tagle Buensuceso’s last circle. Pakbet was there, drawn to a space where he could laugh and smile naturally. “I don’t need to fake it,” he said. He must leave early, however, to care for a client. Pakbet is now a certified nurse assistant and works hourly one-on-one with clients, but stability has been elusive lately. Clients have entered hospital care or passed away. With fewer hours, he has no choice.\u003c/p>\n"
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"innerHTML": "\n\u003cp>For now, he joined in celebrating Tagle Buensuceso. As a surprise, staff handed out printed lyrics of her favorite song, “Precious and Few” by the band Climax. Ine, a fellow caregiver worker leader, grabbed her guitar. She led the group for a sing-along to the ’70s soft-rock song about cherishing moments, and the metaphor was not lost.\u003c/p>\n",
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"\n\u003cp>For now, he joined in celebrating Tagle Buensuceso. As a surprise, staff handed out printed lyrics of her favorite song, “Precious and Few” by the band Climax. Ine, a fellow caregiver worker leader, grabbed her guitar. She led the group for a sing-along to the ’70s soft-rock song about cherishing moments, and the metaphor was not lost.\u003c/p>\n"
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"innerHTML": "\n\u003cp>A mother of three, Ine came solo to the U.S. 15 years ago to provide her children a good college education, and has lived and worked at a care home ever since. As the home’s cook, Ine, 63, plates green pesto pasta and other colorful food with the intention to appeal to her dementia patients. She also administers medicine, having gone back to school to become a pharmacy technician, graduating with honors. \u003c/p>\n",
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"\n\u003cp>A mother of three, Ine came solo to the U.S. 15 years ago to provide her children a good college education, and has lived and worked at a care home ever since. As the home’s cook, Ine, 63, plates green pesto pasta and other colorful food with the intention to appeal to her dementia patients. She also administers medicine, having gone back to school to become a pharmacy technician, graduating with honors. \u003c/p>\n"
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"innerHTML": "\n\u003cfigure class=\"wp-block-embed aligncenter is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\">\u003cdiv class=\"wp-block-embed__wrapper\">\nhttps://www.youtube.com/watch?v=U9ectSMWvm4\n\u003c/div>\u003c/figure>\n",
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"innerHTML": "\n\u003cp>She said she talks with her husband and children via video every night, but misses them the most on holidays and birthdays. \u003c/p>\n",
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"innerHTML": "\n\u003cp>Back in her room at the care home, she filled a balikbayan box for her son’s 41st birthday. \u003c/p>\n",
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"innerHTML": "\n\u003cp>She lovingly selected Lacoste polo shirts, Ferrero Rocher chocolate and other items for the care package by hand, a proxy for her presence. \u003c/p>\n",
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"innerHTML": "\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/FAJ_Video_06_VideoPortraits_TEST.gif\" alt=\"\" class=\"wp-image-12096610\" />\u003cfigcaption class=\"wp-element-caption\">Caregivers, community members and staff of Filipino Advocates for Justice pose for portraits in the garden near a calamansi tree cared for by staff and harvested by caregivers for their food. Some chose gestures of wellness to express in their portraits. “There’s such a deep, immense healing power that caregivers have,” said Daisy Maxion, FAJ organizing director. “They remind us of what it means to be human.”\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
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"\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/FAJ_Video_06_VideoPortraits_TEST.gif\" alt=\"\" class=\"wp-image-12096610\" />\u003cfigcaption class=\"wp-element-caption\">Caregivers, community members and staff of Filipino Advocates for Justice pose for portraits in the garden near a calamansi tree cared for by staff and harvested by caregivers for their food. Some chose gestures of wellness to express in their portraits. “There’s such a deep, immense healing power that caregivers have,” said Daisy Maxion, FAJ organizing director. “They remind us of what it means to be human.”\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cp>Every month, she makes sure she has time off for the Kapwa Circle. When she is tired, when the monotony of caregiving is grueling, she said being with other caregivers at FAJ and, better, using her musical talent to entertain, gives her the “strength to work for another day.”\u003c/p>\n",
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"\n\u003cp>Every month, she makes sure she has time off for the Kapwa Circle. When she is tired, when the monotony of caregiving is grueling, she said being with other caregivers at FAJ and, better, using her musical talent to entertain, gives her the “strength to work for another day.”\u003c/p>\n"
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"innerHTML": "\n\u003cp>This evening, Ine passed the mic to Tagle Buensuceso, who said that before FAJ, she believed cigarettes were the only form of wellness. She left the group with one last piece of wisdom. “If you don’t take care of yourself, you can’t take care of your community.” Pakbet clapped. The music began. \u003c/p>\n",
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"\n\u003cp>This evening, Ine passed the mic to Tagle Buensuceso, who said that before FAJ, she believed cigarettes were the only form of wellness. She left the group with one last piece of wisdom. “If you don’t take care of yourself, you can’t take care of your community.” Pakbet clapped. The music began. \u003c/p>\n"
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"innerHTML": "\n\u003cp>Hands linked and people moved to the Cupid Shuffle, the Macarena, the Pinoy Cha-Cha. Ine was in her element, her first love, dance. The food whittled down. When a delivery worker stopped by to drop off more Spam musubi, she was met with a chorus of: “Stay. Take a plate.”\u003c/p>\n",
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"\n\u003cp>Hands linked and people moved to the Cupid Shuffle, the Macarena, the Pinoy Cha-Cha. Ine was in her element, her first love, dance. The food whittled down. When a delivery worker stopped by to drop off more Spam musubi, she was met with a chorus of: “Stay. Take a plate.”\u003c/p>\n"
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"innerHTML": "\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-13.jpg\" alt=\"\" class=\"wp-image-12096181\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-13.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-13-160x74.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-13-1536x707.jpg 1536w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\" />\u003cfigcaption class=\"wp-element-caption\">Left: A community member of Filipino Advocates for Justice holds a flower in her hand as she poses in front of a backdrop. “If you’re able to breathe deeply and freely, if you’re able to sit with difficult emotions, if you’re able to get regular sleep and eat food that has some nutrition in it … you’re leaving room for creativity and imagination and the courage to reach out,” said Karen Villanueva, executive director of Kilusan Wellness. “Nervous system regulation allows us to really know who we are.” Right: Two attendees wear Filipiniana dresses as they fill ttheir plates during a Kapwa Circle potluck.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
"innerContent": [
"\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-13.jpg\" alt=\"\" class=\"wp-image-12096181\" />\u003cfigcaption class=\"wp-element-caption\">Left: A community member of Filipino Advocates for Justice holds a flower in her hand as she poses in front of a backdrop. “If you’re able to breathe deeply and freely, if you’re able to sit with difficult emotions, if you’re able to get regular sleep and eat food that has some nutrition in it … you’re leaving room for creativity and imagination and the courage to reach out,” said Karen Villanueva, executive director of Kilusan Wellness. “Nervous system regulation allows us to really know who we are.” Right: Two attendees wear Filipiniana dresses as they fill ttheir plates during a Kapwa Circle potluck.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cp>There is power in knowing others share similar experiences, said Dr. Annalisa Enrile, a Filipina community organizer and professor at the USC School of Social Work.\u003cbr>\u003cbr>Enrile has researched how \u003ca href=\"https://psycnet.apa.org/fulltext/2026-27795-003.html\">communal care in Filipino immigrant communities\u003c/a> that draws on cultural practices can ease stress and improve mental well-being. “If you feel like you belong in a way that gives you agency, and reduces stigma,” she said, “then you’re more apt to ask for help.” \u003c/p>\n",
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"\n\u003cp>There is power in knowing others share similar experiences, said Dr. Annalisa Enrile, a Filipina community organizer and professor at the USC School of Social Work.\u003cbr>\u003cbr>Enrile has researched how \u003ca href=\"https://psycnet.apa.org/fulltext/2026-27795-003.html\">communal care in Filipino immigrant communities\u003c/a> that draws on cultural practices can ease stress and improve mental well-being. “If you feel like you belong in a way that gives you agency, and reduces stigma,” she said, “then you’re more apt to ask for help.” \u003c/p>\n"
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"innerHTML": "\n\u003cp>FAJ’s leaders, too, realized belonging was a way to build trust and encourage caregivers to open up, and it’s why they have prioritized connection as the heart of their programming. Recently, they were relieved to hear they received one year of bridge funding to bring back their mental health specialist as they figure out how to sustain their wellness and mental health services. A temporary bandage, executive director Geraldine Alcid said, but enough to keep going. \u003c/p>\n",
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"\n\u003cp>FAJ’s leaders, too, realized belonging was a way to build trust and encourage caregivers to open up, and it’s why they have prioritized connection as the heart of their programming. Recently, they were relieved to hear they received one year of bridge funding to bring back their mental health specialist as they figure out how to sustain their wellness and mental health services. A temporary bandage, executive director Geraldine Alcid said, but enough to keep going. \u003c/p>\n"
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"innerHTML": "\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-16.jpg\" alt=\"\" class=\"wp-image-12096184\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-16.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-16-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-16-1536x1023.jpg 1536w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\" />\u003cfigcaption class=\"wp-element-caption\">Ine near the San Francisco Bay, where she likes to go and recharge when she has time.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
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"\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-16.jpg\" alt=\"\" class=\"wp-image-12096184\" />\u003cfigcaption class=\"wp-element-caption\">Ine near the San Francisco Bay, where she likes to go and recharge when she has time.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cp>Despite the funding uncertainty, the group is sustained by a deep hope: Show up, and something might shift. \u003c/p>\n",
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"\n\u003cp>Despite the funding uncertainty, the group is sustained by a deep hope: Show up, and something might shift. \u003c/p>\n"
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"innerHTML": "\n\u003cp>Pakbet wasn’t sure if he’d come back to FAJ when Tagle Buensuceso left. He decided to keep showing up anyway, without a community elsewhere. Later that spring, he attended a picnic for caregivers at Contra Loma Regional Park in Contra Costa County. The stillness of the oak-tree-dotted hills contrasted with the chaos of the last few months. \u003c/p>\n",
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"\n\u003cp>Pakbet wasn’t sure if he’d come back to FAJ when Tagle Buensuceso left. He decided to keep showing up anyway, without a community elsewhere. Later that spring, he attended a picnic for caregivers at Contra Loma Regional Park in Contra Costa County. The stillness of the oak-tree-dotted hills contrasted with the chaos of the last few months. \u003c/p>\n"
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"innerHTML": "\n\u003cp>One of his male clients was in the hospital, which meant Pakbet was not being paid to take care of him and was spending too much time alone at home in his apartment. He nearly missed a rent payment until he reached out to FAJ to help. \u003c/p>\n",
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"\n\u003cp>One of his male clients was in the hospital, which meant Pakbet was not being paid to take care of him and was spending too much time alone at home in his apartment. He nearly missed a rent payment until he reached out to FAJ to help. \u003c/p>\n"
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"sizes": "(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)"
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"innerHTML": "\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-12.jpg\" alt=\"\" class=\"wp-image-12096180\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-12.jpg 1998w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-12-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-12-1536x1024.jpg 1536w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\" />\u003cfigcaption class=\"wp-element-caption\">Pakbet, center, joins other caregivers and staff of Filipino Advocates for Justice under the shade of a tree at Contra Loma Regional Park in Antioch for an annual picnic–an opportunity to connect with caregivers from across the Bay Area and enjoy nature. Caregivers practiced wellness stretching, shared food and reenacted moments from caregiving through a “Theater of the Oppressed” activity.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
"innerContent": [
"\n\u003cfigure class=\"wp-block-image aligncenter size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-12.jpg\" alt=\"\" class=\"wp-image-12096180\" />\u003cfigcaption class=\"wp-element-caption\">Pakbet, center, joins other caregivers and staff of Filipino Advocates for Justice under the shade of a tree at Contra Loma Regional Park in Antioch for an annual picnic–an opportunity to connect with caregivers from across the Bay Area and enjoy nature. Caregivers practiced wellness stretching, shared food and reenacted moments from caregiving through a “Theater of the Oppressed” activity.\u003ccite class=\"wp-inline-image-credit\"> (Florence Middleton for Catchlight/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cp>Grateful for people, for peaceful nature, he set up his phone on a tripod to document the picnic. The wind was gentle. The wetlands glassy. A duck swam by and Pakbet paused to look at it, reminding him of balut, a delicacy with roots in his mother’s province. \u003c/p>\n",
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"\n\u003cp>Grateful for people, for peaceful nature, he set up his phone on a tripod to document the picnic. The wind was gentle. The wetlands glassy. A duck swam by and Pakbet paused to look at it, reminding him of balut, a delicacy with roots in his mother’s province. \u003c/p>\n"
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"innerHTML": "\n\u003cp>The caregivers took turns sharing their favorite stretch before acting out a scripted scene from \u003cem>Theater of the Oppressed\u003c/em>, an approach that uses roleplay to explore solutions to social problems. Pakbet assumed the role of a care home owner. Drawing from his own experience, he joked about doling out “expensive” perfume from the Dollar Tree instead of actual dollars for overtime. People burst out laughing.\u003c/p>\n",
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"\n\u003cp>The caregivers took turns sharing their favorite stretch before acting out a scripted scene from \u003cem>Theater of the Oppressed\u003c/em>, an approach that uses roleplay to explore solutions to social problems. Pakbet assumed the role of a care home owner. Drawing from his own experience, he joked about doling out “expensive” perfume from the Dollar Tree instead of actual dollars for overtime. People burst out laughing.\u003c/p>\n"
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"innerHTML": "\n\u003cp>Pakbet reflected afterward and said he has never felt more anchored in his purpose to empower caregivers like himself. Next outreach, when he knocks on doors, before asking about rights, before handing them a booklet, he will first ask, “How are you doing?”\u003c/p>\n",
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"\n\u003cp>Pakbet reflected afterward and said he has never felt more anchored in his purpose to empower caregivers like himself. Next outreach, when he knocks on doors, before asking about rights, before handing them a booklet, he will first ask, “How are you doing?”\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cem>This story was made possible in part by the Aging Beat workshop, convened by the Craig Newmark Graduate School of Journalism at CUNY.\u003c/em>\u003c/p>\n",
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"\n\u003cp>\u003cem>This story was made possible in part by the Aging Beat workshop, convened by the Craig Newmark Graduate School of Journalism at CUNY.\u003c/em>\u003c/p>\n"
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"excerpt": "Filipino Advocates for Justice creates an affirming space for them to rest and celebrate, so they can show up whole — not only for themselves but for others.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>\u003cem>This project was produced jointly by KQED and CatchLight as part of the \u003c/em>\u003ca href=\"http://catchlight.io/mental-health\">\u003cem>mental health visual desk initiative.\u003c/em>\u003c/a>\u003c/p>\n\n\n\n\u003cp>Pakbet’s only obligation was to focus on himself. At least for one day. In the bright orange office of Filipino Advocates for Justice (FAJ), where he was attending a special wellness meeting for caregiver worker leaders like himself, he closed his eyes, relaxed his shoulders and breathed. \u003c/p>\n\n\n\n\u003cp>“You are seen. Inhale,” a staff member told the group. “You are valued. Exhale.”\u003c/p>\n\n\n\n\u003cp>Sometimes, Pakbet said he feels valued, like when he was a private aide for Teddy, a 98-year-old woman at the retirement home. They developed a relationship like a mother and son, and he would treat her so — cooking her homemade chicken feet adobo, or watching makeup tutorials with her online. He’d apply her lipstick, dress her in a gown and accompany her into the dining room, declaring, “The queen has arrived!” Besides bathing her and monitoring vitals, he saw it as his job to make her laugh.\u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2500\" height=\"833\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-1.jpg\" alt=\"\" class=\"wp-image-12099853\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-1.jpg 2500w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-1-2000x666.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-1-160x53.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-1-1536x512.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-1-2048x682.jpg 2048w\" sizes=\"auto, (max-width: 2500px) 100vw, 2500px\" />\u003cfigcaption class=\"wp-element-caption\">Left: Karen Villanueva, executive director of Kilusan Wellness, leads a mental wellness breathing and massage exercise to open FAJ’s Kapwa Circle, a monthly community-building event, at the organization’s Union City location on March 6, 2026. Right: Pakbet (center) sings “Precious and Few” as the FAJ community honors FAJ worker organizer, Santi Tagle Buensuceso, during a surprise farewell party about one week before Buensuceso relocates back to the Philippines. Although Pakbet had a caregiving shift that evening, he joined the first half of the Kapwa Circle to attend the surprise going-away party for Buensuceso, who he considers an older sister. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1332\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-07.jpg\" alt=\"\" class=\"wp-image-12096175\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-07.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-07-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-07-1536x1023.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Members of the Filipino Advocates for Justice community practice a breathing and movement exercise during the organization’s March Kapwa Circle. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>Other times, his body remembers: panic attacks from the chronic stress of unstable paychecks and exploitative employers, grief for his mother with cancer back home in the Philippines, whom he hasn’t hugged in a decade. The depression has led to insomnia and isolation.\u003c/p>\n\n\n\n\u003cp>“My world is work, home. I don’t have any trusted friends,” he said. “This is my life.”\u003c/p>\n\n\n\n\u003cp>Pakbet, 54, said caregivers like him can feel overworked and undervalued. A Bay Area immigrant rights organization, FAJ creates an affirming space for them to rest and celebrate, so they can show up whole — not only for themselves but for others.\u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"994\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-18.jpg\" alt=\"\" class=\"wp-image-12096186\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-18.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-18-160x80.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-18-1536x763.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Center: Pakbet poses for a portrait in his Bay Area home on May 4, 2026, where he has lived with his family for six years. Previously, they lived in abusive situations, sharing cramped spaces and experiencing mistreatment. In 2020, with guidance from a friend at FAJ, they secured their own apartment. “We rent, and we’re very happy because my son has a room. I can cook now,” said Pakbet. “That’s our paradise.” Left and Right: A Bible and cross adorn the walls of Pakbet’s apartment. The demands of caregiving often weigh heavily on his mind, but he finds solace in his faith. “It’s hard, it’s very tiring,” he said. “Without my son, without my faith, I almost give up.” (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>Leaning on Filipino cultural practices and intergenerational connection, mental health is woven into everything they do, from monthly gatherings and wellness clinics to everyday grounding techniques and artistic expression. Yet the Trump administration’s immigration crackdown and statewide funding cuts to mental health services have threatened their prevention work, even as a shortage in \u003ca href=\"https://mpa.aging.ca.gov/Goals/4\">care workers \u003c/a>looms. \u003c/p>\n\n\n\n\u003cp>Filipinos are heavily represented in the healthcare workforce, according to \u003ca href=\"https://pmc.ncbi.nlm.nih.gov/articles/PMC7969854/\">research\u003c/a>, and many are paid to care for older adults. Respect for elders is a deeply embedded cultural value. As California’s population continues to age — \u003ca href=\"https://mpa.aging.ca.gov/\">about 25% will be an older adult by 2030\u003c/a> — caregivers will become even more essential. But isolation, burnout, racial discrimination, wage theft, and more can all contribute to mental health challenges.\u003c/p>\n\n\n\n\u003cp>“They are the first to take care of everybody else. And that’s done at the expense of their own bodies, their own emotional health,” said Geraldine Alcid, executive director of FAJ. “They deserve to take care of themselves, and they deserve rest.”\u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1272\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-17.jpg\" alt=\"\" class=\"wp-image-12096185\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-17.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-17-160x102.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-17-1536x977.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">An old photograph of Pakbet and Teddy decorated with makeup and his written reflections. To help Teddy prepare for outings, Pakbet watched YouTube tutorials to learn makeup and helped her choose dresses and jewelry. At the care home, Pakbet recalls people asking him, “Where is your master?” but Teddy always defended him, responding that he was her family. (Florence Middleton for Catchlight/KQED; instant photo made with and handwriting and decorations by Pakbet)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"1620\" height=\"1080\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/FAJ_Video_05_Caregiver1_CookingAdobo_TEST.gif\" alt=\"\" class=\"wp-image-12096600\" />\u003cfigcaption class=\"wp-element-caption\">Pakbet cooks chicken adobo at home. He de-stresses through cooking and finds joy in sharing his food. When caring for Teddy, a former client who was bedridden, he learned she had grown tired of retirement home meals and missed eating dim sum and chicken feet. He made her chicken feet adobo and began cooking for her. Over time, Pakbet says, she regained energy and began walking again. (Florence Middleton for Catchlight/KQED; handwriting by Pakbet)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>When Pakbet first arrived in the States alone over a decade ago, he lived and worked at a residential care home for older adults. He said his boss forced him to sleep on cardboard in the garage, and his paychecks didn’t reflect the long, exhausting hours. He also knew caregivers who died by suicide. Pakbet, at times, didn’t know if he’d make it. The reason he immigrated was to provide for his son’s education.\u003cbr>\u003cbr>Pakbet said his Bible and a photo of his son got him through.\u003c/p>\n\n\n\n\u003cp>Pakbet’s experience is common. Yet cultural \u003ca href=\"https://filipinos4justice.org/wp-content/uploads/2022/06/3-30-22-Filipino-Advocates-for-Justice-FAJ_-A-Mental-Health-Report-_-Kumusta-Tayo-2021.pdf?utm_source=chatgpt.com\">stigma\u003c/a> and shame can prevent Filipino immigrants from seeking support. “I’ve witnessed many times caregivers who need help. They get scared and hide in the dark,” Pakbet said.\u003c/p>\n\n\n\n\u003cp>Over a decade ago, Oakland-based community health center Asian Health Services referred an exploited caregiver who was anxious and stressed to FAJ. The organization realized others had similar stories, and it was the catalyst for it to focus efforts on prevention. In 2015, they launched a mental health support group for caregivers, many of them older, funded through a two-year Alameda County innovations grant. \u003c/p>\n\n\n\n\u003cp>FAJ expanded its program with the help of an eight-year county contract. They hired a licensed mental health professional on staff, as well as three part-time community outreach specialists to facilitate mental health offerings rooted in culture. FAJ also created a Healing Advisory Committee that organizes free annual wellness clinics, featuring Filipino traditions such as hilot, a massage focused on releasing trauma. \u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1332\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-11.jpg\" alt=\"\" class=\"wp-image-12096179\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-11.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-11-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-11-1536x1023.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Pakbet hangs a wet sheet to dry near the window in his Bay Area home. After years of living in the United States without access to an in-home washing machine, he set up a small washer in his apartment kitchen — a change he says has saved him time and eased the routines of daily life. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"920\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-10.jpg\" alt=\"\" class=\"wp-image-12096178\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-10.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-10-160x74.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-10-1536x707.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Left: Pakbet holds calamansi — a sweet and sour Filipino citrus with fragrant flowers — that he harvested from the office garden at Filipino Advocates for Justice for cooking. Right: Pakbet’s caregiving scrubs drape the living room couch where he sleeps so that his son can have the only bedroom in their apartment. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>In 2023, a one-time state grant from the Department of Aging enabled FAJ to shift attention again to caregivers. They provided training on topics such as nutrition and managing grief, weaving in hands-on clinics for everyday self-care. \u003c/p>\n\n\n\n\u003cp>At first, caregivers expressed apprehensive curiosity. Then eventually, they requested chia seed pudding recipes and acupuncture, even the caregivers who feared needles. The organization also provided acupressure rings people could roll on their fingers whenever they needed to calm themselves.\u003c/p>\n\n\n\n\u003cp>Nervous system regulation is essential for moving from merely surviving to thriving, said Dr. Karen Villanueva, training lead and executive director of Kilusan Wellness. And for the majority of caregivers with little time or money, accessibility is key. “So much the better if you can tuck it in your pocket and take it out when you need it.”\u003c/p>\n\n\n\n\u003cp>This July, the policy changes California made to its landmark Behavioral Services Act took effect. When voters passed Proposition 1 in 2024, they approved Gov. Gavin Newsom’s plans to shift funds away from prevention and early intervention toward treatment beds. FAJ’s prevention funding, which supports half of their direct services, was reduced from $360,000 to zero dollars — the organization lost its licensed mental health professional and folded its community outreach advisers into other roles.\u003c/p>\n\n\n\n\u003cp>At the special meeting for wellness worker leaders, where Pakbet could slow down and breathe, the thinning manifested in another way. Usually, nearly a dozen caregivers would be gearing up to knock on the doors of care homes in the East Bay, handing “know your rights” information to employees. The organization pays these workers a learning stipend to perform this outreach work. \u003c/p>\n\n\n\n\u003cp>But when Pakbet looked around the office, he was one of the few caregivers who had stayed. Half of the group had chosen to spend their remaining years in the Philippines as the Trump administration pushes to aggressively crack down on immigration. Many said they were tired of feeling criminalized and undervalued, or, as one staff member of the organization said, an “America-doesn’t-deserve-me” mentality. Others said they missed moments with loved ones.\u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1332\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-09.jpg\" alt=\"\" class=\"wp-image-12096177\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-09.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-09-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-09-1536x1023.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Pakbet listens to a talk on safety in sanctuary cities during an FAJ informational session for caregivers and their community. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>Along with other caregivers in this story, KQED is referring to Pakbet only by a nickname to allow them to speak openly about their mental health struggles and working conditions without jeopardizing their employment.\u003c/p>\n\n\n\n\u003cp>Pakbet understands the impulse to return home. Still, he said he was feeling especially tender.\u003c/p>\n\n\n\n\u003cp>His “lifeline,” FAJ’s worker organizer and seasoned activist Santi Tagle Buensuceso, had announced that she was also returning to her homeland.\u003c/p>\n\n\n\n\u003cp>Whenever Pakbet struggled, instead of crying alone, he’d call Tagle Buensuceso. Sometimes, he’d voice his doubts about his ability to be a provider: “Am I a good father? Am I doing OK? Do I need to go back to the Philippines?” \u003c/p>\n\n\n\n\u003cp>She would assure him that trying his best was good enough, that he was a great father and husband. She also realized caregivers like Pakbet needed more outlets and two years ago suggested FAJ host monthly Kapwa Circles for the wider community. A third space to unwind, to reflect, to create joy. \u003ca href=\"https://sswr.confex.com/sswr/2026/webprogram/Paper61579.html\">Kapwa\u003c/a>, a Filipino value meaning interconnectedness, the recognition of yourself in each other.\u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1332\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-08.jpg\" alt=\"\" class=\"wp-image-12096176\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-08.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-08-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-08-1536x1023.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Community members practice a breathing and movement exercise as Santi Tagle Buensuceso reads a farewell card signed by the Filipino Advocates for Justice community during a surprise party held a week before her return to the Philippines. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1332\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-03.jpg\" alt=\"\" class=\"wp-image-12096171\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-03.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-03-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-03-1536x1023.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Pakbet, right, says goodbye to Tagle Buensuceso during her surprise farewell party. To Pakbet, Buensuceso was like an older sister, someone who always looked out for and advocated for him. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>On a Friday evening in March, the young and old came together at FAJ’s Union City office to recreate a slice of the Philippines.\u003c/p>\n\n\n\n\u003cp>Fried chicken from Jollibee piled high on paper plates, the sounds of people speaking Tagalog could be heard. Outside, a community garden where calamansi, a citrus fruit native to the Philippines, had been harvested for a jar of juice. \u003c/p>\n\n\n\n\u003cp>The event is what FAJ leadership describes as a “Filipino family party” or a Kapwa Circle. It has a different flavor each month and begins with a discussion of a social justice topic — sanctuary cities, for one, or voter registration — to invite people into FAJ’s organizing work. After the community conversation, they host an activity like bingo or mahjong. Always karaoke, whether planned or not. There is a rule of no chisme, but many will say gossip is their favorite part. \u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1332\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-06.jpg\" alt=\"\" class=\"wp-image-12096174\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-06.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-06-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-06-1536x1023.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">People dance the Pinoy Cha-Cha during the March Kapwa Circle at the offices of Filipino Advocates for Justice in Union City, California. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2500\" height=\"833\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-3-1.jpg\" alt=\"\" class=\"wp-image-12099855\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-3-1.jpg 2500w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-3-1-2000x666.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-3-1-160x53.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-3-1-1536x512.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260820-FAJCatchlight-FM-DIP-3-1-2048x682.jpg 2048w\" sizes=\"auto, (max-width: 2500px) 100vw, 2500px\" />\u003cfigcaption class=\"wp-element-caption\">Left: Cristy Ferrer, a Filipino Advocates for Justice organizer, left, and Ine, a caregiver and FAJ worker leader, lead a Pinoy Cha-Cha dance lesson. Right: Ine dances with another community member during the Kapwa Circle. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>The evening was Tagle Buensuceso’s last circle. Pakbet was there, drawn to a space where he could laugh and smile naturally. “I don’t need to fake it,” he said. He must leave early, however, to care for a client. Pakbet is now a certified nurse assistant and works hourly one-on-one with clients, but stability has been elusive lately. Clients have entered hospital care or passed away. With fewer hours, he has no choice.\u003c/p>\n\n\n\n\u003cp>For now, he joined in celebrating Tagle Buensuceso. As a surprise, staff handed out printed lyrics of her favorite song, “Precious and Few” by the band Climax. Ine, a fellow caregiver worker leader, grabbed her guitar. She led the group for a sing-along to the ’70s soft-rock song about cherishing moments, and the metaphor was not lost.\u003c/p>\n\n\n\n\u003cp>A mother of three, Ine came solo to the U.S. 15 years ago to provide her children a good college education, and has lived and worked at a care home ever since. As the home’s cook, Ine, 63, plates green pesto pasta and other colorful food with the intention to appeal to her dementia patients. She also administers medicine, having gone back to school to become a pharmacy technician, graduating with honors. \u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-embed aligncenter is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\">\u003cdiv class=\"wp-block-embed__wrapper\">\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/U9ectSMWvm4'\n title='//www.youtube.com/embed/U9ectSMWvm4'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003c/div>\u003c/figure>\n\n\n\n\u003cp>She said she talks with her husband and children via video every night, but misses them the most on holidays and birthdays. \u003c/p>\n\n\n\n\u003cp>Back in her room at the care home, she filled a balikbayan box for her son’s 41st birthday. \u003c/p>\n\n\n\n\u003cp>She lovingly selected Lacoste polo shirts, Ferrero Rocher chocolate and other items for the care package by hand, a proxy for her presence. \u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"1513\" height=\"1500\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/FAJ_Video_06_VideoPortraits_TEST.gif\" alt=\"\" class=\"wp-image-12096610\" />\u003cfigcaption class=\"wp-element-caption\">Caregivers, community members and staff of Filipino Advocates for Justice pose for portraits in the garden near a calamansi tree cared for by staff and harvested by caregivers for their food. Some chose gestures of wellness to express in their portraits. “There’s such a deep, immense healing power that caregivers have,” said Daisy Maxion, FAJ organizing director. “They remind us of what it means to be human.” (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>Every month, she makes sure she has time off for the Kapwa Circle. When she is tired, when the monotony of caregiving is grueling, she said being with other caregivers at FAJ and, better, using her musical talent to entertain, gives her the “strength to work for another day.”\u003c/p>\n\n\n\n\u003cp>This evening, Ine passed the mic to Tagle Buensuceso, who said that before FAJ, she believed cigarettes were the only form of wellness. She left the group with one last piece of wisdom. “If you don’t take care of yourself, you can’t take care of your community.” Pakbet clapped. The music began. \u003c/p>\n\n\n\n\u003cp>Hands linked and people moved to the Cupid Shuffle, the Macarena, the Pinoy Cha-Cha. Ine was in her element, her first love, dance. The food whittled down. When a delivery worker stopped by to drop off more Spam musubi, she was met with a chorus of: “Stay. Take a plate.”\u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"920\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-13.jpg\" alt=\"\" class=\"wp-image-12096181\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-13.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-13-160x74.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-13-1536x707.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Left: A community member of Filipino Advocates for Justice holds a flower in her hand as she poses in front of a backdrop. “If you’re able to breathe deeply and freely, if you’re able to sit with difficult emotions, if you’re able to get regular sleep and eat food that has some nutrition in it … you’re leaving room for creativity and imagination and the courage to reach out,” said Karen Villanueva, executive director of Kilusan Wellness. “Nervous system regulation allows us to really know who we are.” Right: Two attendees wear Filipiniana dresses as they fill ttheir plates during a Kapwa Circle potluck. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>There is power in knowing others share similar experiences, said Dr. Annalisa Enrile, a Filipina community organizer and professor at the USC School of Social Work.\u003cbr>\u003cbr>Enrile has researched how \u003ca href=\"https://psycnet.apa.org/fulltext/2026-27795-003.html\">communal care in Filipino immigrant communities\u003c/a> that draws on cultural practices can ease stress and improve mental well-being. “If you feel like you belong in a way that gives you agency, and reduces stigma,” she said, “then you’re more apt to ask for help.” \u003c/p>\n\n\n\n\u003cp>FAJ’s leaders, too, realized belonging was a way to build trust and encourage caregivers to open up, and it’s why they have prioritized connection as the heart of their programming. Recently, they were relieved to hear they received one year of bridge funding to bring back their mental health specialist as they figure out how to sustain their wellness and mental health services. A temporary bandage, executive director Geraldine Alcid said, but enough to keep going. \u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1332\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-16.jpg\" alt=\"\" class=\"wp-image-12096184\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-16.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-16-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-16-1536x1023.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Ine near the San Francisco Bay, where she likes to go and recharge when she has time. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>Despite the funding uncertainty, the group is sustained by a deep hope: Show up, and something might shift. \u003c/p>\n\n\n\n\u003cp>Pakbet wasn’t sure if he’d come back to FAJ when Tagle Buensuceso left. He decided to keep showing up anyway, without a community elsewhere. Later that spring, he attended a picnic for caregivers at Contra Loma Regional Park in Contra Costa County. The stillness of the oak-tree-dotted hills contrasted with the chaos of the last few months. \u003c/p>\n\n\n\n\u003cp>One of his male clients was in the hospital, which meant Pakbet was not being paid to take care of him and was spending too much time alone at home in his apartment. He nearly missed a rent payment until he reached out to FAJ to help. \u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"1998\" height=\"1332\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-12.jpg\" alt=\"\" class=\"wp-image-12096180\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-12.jpg 1998w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-12-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260820-FAJCatchlight-FM-12-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1998px) 100vw, 1998px\" />\u003cfigcaption class=\"wp-element-caption\">Pakbet, center, joins other caregivers and staff of Filipino Advocates for Justice under the shade of a tree at Contra Loma Regional Park in Antioch for an annual picnic–an opportunity to connect with caregivers from across the Bay Area and enjoy nature. Caregivers practiced wellness stretching, shared food and reenacted moments from caregiving through a “Theater of the Oppressed” activity. (Florence Middleton for Catchlight/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>Grateful for people, for peaceful nature, he set up his phone on a tripod to document the picnic. The wind was gentle. The wetlands glassy. A duck swam by and Pakbet paused to look at it, reminding him of balut, a delicacy with roots in his mother’s province. \u003c/p>\n\n\n\n\u003cp>The caregivers took turns sharing their favorite stretch before acting out a scripted scene from \u003cem>Theater of the Oppressed\u003c/em>, an approach that uses roleplay to explore solutions to social problems. Pakbet assumed the role of a care home owner. Drawing from his own experience, he joked about doling out “expensive” perfume from the Dollar Tree instead of actual dollars for overtime. People burst out laughing.\u003c/p>\n\n\n\n\u003cp>Pakbet reflected afterward and said he has never felt more anchored in his purpose to empower caregivers like himself. Next outreach, when he knocks on doors, before asking about rights, before handing them a booklet, he will first ask, “How are you doing?”\u003c/p>\n\n\n\n\u003cp>\u003cem>This story was made possible in part by the Aging Beat workshop, convened by the Craig Newmark Graduate School of Journalism at CUNY.\u003c/em>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "cancer-research-saved-this-berkley-resident-its-future-may-depend-on-trump",
"title": "Cancer Research Saved This Berkeley Resident. Its Future May Depend on Trump",
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"headTitle": "Cancer Research Saved This Berkeley Resident. Its Future May Depend on Trump | KQED",
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"content": "\n\u003cp>In 2017, \u003ca href=\"https://www.kqed.org/news/tag/berkeley\">Berkeley\u003c/a> resident Ben Stein-Lobovits was celebrating his friend’s marriage when he noticed a headache and numbness in his tongue. His friends chalked the neurological symptoms up to a hangover. \u003c/p>\n\n\n\n\u003cp>On the eve of his 32nd birthday, he was diagnosed with a brainstem glioma, an inoperable brain tumor.\u003c/p>\n\n\n\n\u003cp>“I like to say, ‘I-turned-30 tumor,’” Stein-Lobovits said, laughing. \u003c/p>\n\n\n\n\u003cp>What followed is a period of his life that is hard to recall, he said, a “tornado” of appointments. The standard care of treatment was chemo and radiation — with a prognosis of six t0 10 months. \u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-gallery has-nested-images columns-default is-cropped wp-block-gallery-3 is-layout-flex wp-block-gallery-is-layout-flex\">\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12099890\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260915-CANCERSURVIVOR-02-BL-KQED.jpg\" alt=\"\" class=\"wp-image-12099890\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260915-CANCERSURVIVOR-02-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260915-CANCERSURVIVOR-02-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260915-CANCERSURVIVOR-02-BL-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Ben Stein-Lobovits holds a childhood photo of himself with his father at his home in Berkeley on Sept. 15, 2026. (Beth LaBerge/KQED)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12099891\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260915-CANCERSURVIVOR-03-BL-KQED.jpg\" alt=\"\" class=\"wp-image-12099891\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260915-CANCERSURVIVOR-03-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260915-CANCERSURVIVOR-03-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260915-CANCERSURVIVOR-03-BL-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Ben Stein-Lobovits sits outside his home in Berkeley on Sept. 15, 2026. He was diagnosed with brain cancer in 2018. (Beth LaBerge/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/figure>\n\n\n\n\u003cp>“There has to be another solution,” Stein-Lobovits remembered saying at the time.\u003c/p>\n\n\n\n\u003cp>He began reading papers and getting in touch with researchers, eventually leading him to a trial of an experimental treatment — dordaviprone, a drug that blocks survival signals in tumor cells. Nine years later, his tumor has shrunk by about 70%, he said.\u003c/p>\n\n\n\n\u003cp>Thanks to breakthroughs in cancer treatment, reduced smoking and improved detection, cancer rates declined by 35% between 1991 and 2024, according to a new report from the American Association for Cancer Research, the first and largest professional organization dedicated to preventing and curing all cancers. And over the last year alone, new scientific breakthroughs have reached patients in the form of new treatments for their specific disease. \u003c/p>\n\n\n\n\u003cp>Between July 1, 2025, and June 30, 2026, the FDA approved one new treatment device, expanded five previously approved therapies to include new cancer types and green-lit 11 new cancer therapeutics — including dordaviprone. \u003c/p>\n\n\n\n\u003cp>The report, which highlights Stein-Lobovits’ experience with the drug, also notes several advances in cancer prevention and detection — vaccines that prevent cancers in high-risk individuals and train immune systems to eliminate existing tumors; at-home test kits for HPV, a disease linked to cervical cancer; and AI-based tools to help doctors interpret routine medical imaging and carry out complex research tasks. \u003c/p>\n\n\n\n\n\n\u003cp>Despite the progress, cancer continues to be one of the leading causes of death in the U.S., killing about \u003ca href=\"https://www.cdc.gov/nchs/products/databriefs/db548.htm\">610,000\u003c/a> people annually. An estimated 2.1 million new cancer cases will be diagnosed in 2026, and this number is projected to rise to 2.5 million by 2050, according to AACR findings. \u003c/p>\n\n\n\n\u003cp>Cancer’s risks are not distributed equally — racial and ethnic minority groups and other medically underserved populations in the U.S. continue to shoulder a disproportionate burden of the disease. \u003c/p>\n\n\n\n\u003cp>“Even the strongest research system falls short if patients cannot benefit from its advances,” the report states. \u003c/p>\n\n\n\n\u003cp>Despite significant strides, researchers warned of a major threat to cancer research: another wave of funding cuts following policy changes from the Trump administration. \u003c/p>\n\n\n\n\u003cp>A report from the \u003ca href=\"https://www.brennancenter.org/our-work/research-reports/cost-trump-administrations-attacks-research-funding\">Brennan Center for Justice\u003c/a> says the administration’s actions — including the decision to remove all members of the board of advisers to the National Science Foundation — have caused grantmaking to “slow to a crawl” since the start of this fiscal year. \u003c/p>\n\n\n\n\u003cp>In early 2025, the administration cut or froze more than 2,200 active National Institutes of Health research grants and withdrew billions of dollars in previously awarded research funding, according to the AACR report. Then, the president’s budget request for fiscal year 2027, released in April 2026, proposed a $5 billion reduction in overall NIH funding, compared with the previous year’s levels.\u003c/p>\n\n\n\n\u003cp>A new \u003ca href=\"https://www.federalregister.gov/documents/2026/05/29/2026-10817/regulation-for-federal-financial-assistance?utm_campaign=subscription+mailing+list&utm_medium=email&utm_source=federalregister.gov#addresses\">rule\u003c/a> proposed by the Office of Management and Budget to overhaul federal grantmaking could “inject political considerations into funding decisions and broaden federal agencies’ authority to terminate grants for reasons unrelated to scientific merit or recipient performance,” the report says. This could further reduce funding if the Senate’s decision to block the rule is allowed to expire in December. \u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/20250424_UCSFFile_GC-16_qed.jpg\" alt=\"\" class=\"wp-image-12040284\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/20250424_UCSFFile_GC-16_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/20250424_UCSFFile_GC-16_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/20250424_UCSFFile_GC-16_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/20250424_UCSFFile_GC-16_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/20250424_UCSFFile_GC-16_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/20250424_UCSFFile_GC-16_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">UCSF Medical Center at Mission Bay in San Francisco on April 24, 2025. (Gina Castro/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>Without strong federal support for medical research, the U.S. risks losing its position as a global leader in scientific discovery, innovation and the development of lifesaving cancer treatments, the report warns.\u003c/p>\n\n\n\n\u003cp>Dr. Iona Cheng, a cancer epidemiologist at UCSF and a co-investigator of the Greater Bay Area Cancer Registry, said that the federal action “significantly impacts our ability to continue and sustain important cancer research.” \u003c/p>\n\n\n\n\u003cp>Stein-Lobovits, now 40, credits cutting-edge research with allowing him to live. \u003c/p>\n\n\n\n\u003cp>“It’s allowed me to watch my girls grow up,” he said. “It has given me so much hope.”\u003c/p>\n\n\n\n\u003cp>He advised other survivors going through their own cancer journeys to “not take no for an answer.” \u003c/p>\n\n\n\n\u003cp>“Advocate for yourself, question everything, and don’t be hard on yourself,” Stein-Lobovits said.\u003c/p>\n",
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"innerHTML": "\n\u003cp>“There has to be another solution,” Stein-Lobovits remembered saying at the time.\u003c/p>\n",
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"innerHTML": "\n\u003cp>He began reading papers and getting in touch with researchers, eventually leading him to a trial of an experimental treatment — dordaviprone, a drug that blocks survival signals in tumor cells. Nine years later, his tumor has shrunk by about 70%, he said.\u003c/p>\n",
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"innerHTML": "\n\u003cp>Thanks to breakthroughs in cancer treatment, reduced smoking and improved detection, cancer rates declined by 35% between 1991 and 2024, according to a new report from the American Association for Cancer Research, the first and largest professional organization dedicated to preventing and curing all cancers. And over the last year alone, new scientific breakthroughs have reached patients in the form of new treatments for their specific disease. \u003c/p>\n",
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"\n\u003cp>Thanks to breakthroughs in cancer treatment, reduced smoking and improved detection, cancer rates declined by 35% between 1991 and 2024, according to a new report from the American Association for Cancer Research, the first and largest professional organization dedicated to preventing and curing all cancers. And over the last year alone, new scientific breakthroughs have reached patients in the form of new treatments for their specific disease. \u003c/p>\n"
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"innerHTML": "\n\u003cp>Between July 1, 2025, and June 30, 2026, the FDA approved one new treatment device, expanded five previously approved therapies to include new cancer types and green-lit 11 new cancer therapeutics — including dordaviprone. \u003c/p>\n",
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"innerHTML": "\n\u003cp>The report, which highlights Stein-Lobovits’ experience with the drug, also notes several advances in cancer prevention and detection — vaccines that prevent cancers in high-risk individuals and train immune systems to eliminate existing tumors; at-home test kits for HPV, a disease linked to cervical cancer; and AI-based tools to help doctors interpret routine medical imaging and carry out complex research tasks. \u003c/p>\n",
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"innerHTML": "\n\u003cp>Despite the progress, cancer continues to be one of the leading causes of death in the U.S., killing about \u003ca href=\"https://www.cdc.gov/nchs/products/databriefs/db548.htm\">610,000\u003c/a> people annually. An estimated 2.1 million new cancer cases will be diagnosed in 2026, and this number is projected to rise to 2.5 million by 2050, according to AACR findings. \u003c/p>\n",
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"innerHTML": "\n\u003cp>Cancer’s risks are not distributed equally — racial and ethnic minority groups and other medically underserved populations in the U.S. continue to shoulder a disproportionate burden of the disease. \u003c/p>\n",
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"innerHTML": "\n\u003cp>“Even the strongest research system falls short if patients cannot benefit from its advances,” the report states. \u003c/p>\n",
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"innerHTML": "\n\u003cp>Despite significant strides, researchers warned of a major threat to cancer research: another wave of funding cuts following policy changes from the Trump administration. \u003c/p>\n",
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"innerHTML": "\n\u003cp>A report from the \u003ca href=\"https://www.brennancenter.org/our-work/research-reports/cost-trump-administrations-attacks-research-funding\">Brennan Center for Justice\u003c/a> says the administration’s actions — including the decision to remove all members of the board of advisers to the National Science Foundation — have caused grantmaking to “slow to a crawl” since the start of this fiscal year. \u003c/p>\n",
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"innerHTML": "\n\u003cp>He advised other survivors going through their own cancer journeys to “not take no for an answer.” \u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>In 2017, \u003ca href=\"https://www.kqed.org/news/tag/berkeley\">Berkeley\u003c/a> resident Ben Stein-Lobovits was celebrating his friend’s marriage when he noticed a headache and numbness in his tongue. His friends chalked the neurological symptoms up to a hangover. \u003c/p>\n\n\n\n\u003cp>On the eve of his 32nd birthday, he was diagnosed with a brainstem glioma, an inoperable brain tumor.\u003c/p>\n\n\n\n\u003cp>“I like to say, ‘I-turned-30 tumor,’” Stein-Lobovits said, laughing. \u003c/p>\n\n\n\n\u003cp>What followed is a period of his life that is hard to recall, he said, a “tornado” of appointments. The standard care of treatment was chemo and radiation — with a prognosis of six t0 10 months. \u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-gallery has-nested-images columns-default is-cropped wp-block-gallery-3 is-layout-flex wp-block-gallery-is-layout-flex\">\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12099890\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260915-CANCERSURVIVOR-02-BL-KQED.jpg\" alt=\"\" class=\"wp-image-12099890\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260915-CANCERSURVIVOR-02-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260915-CANCERSURVIVOR-02-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260915-CANCERSURVIVOR-02-BL-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Ben Stein-Lobovits holds a childhood photo of himself with his father at his home in Berkeley on Sept. 15, 2026. (Beth LaBerge/KQED)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12099891\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260915-CANCERSURVIVOR-03-BL-KQED.jpg\" alt=\"\" class=\"wp-image-12099891\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260915-CANCERSURVIVOR-03-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260915-CANCERSURVIVOR-03-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/260915-CANCERSURVIVOR-03-BL-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Ben Stein-Lobovits sits outside his home in Berkeley on Sept. 15, 2026. He was diagnosed with brain cancer in 2018. (Beth LaBerge/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/figure>\n\n\n\n\u003cp>“There has to be another solution,” Stein-Lobovits remembered saying at the time.\u003c/p>\n\n\n\n\u003cp>He began reading papers and getting in touch with researchers, eventually leading him to a trial of an experimental treatment — dordaviprone, a drug that blocks survival signals in tumor cells. Nine years later, his tumor has shrunk by about 70%, he said.\u003c/p>\n\n\n\n\u003cp>Thanks to breakthroughs in cancer treatment, reduced smoking and improved detection, cancer rates declined by 35% between 1991 and 2024, according to a new report from the American Association for Cancer Research, the first and largest professional organization dedicated to preventing and curing all cancers. And over the last year alone, new scientific breakthroughs have reached patients in the form of new treatments for their specific disease. \u003c/p>\n\n\n\n\u003cp>Between July 1, 2025, and June 30, 2026, the FDA approved one new treatment device, expanded five previously approved therapies to include new cancer types and green-lit 11 new cancer therapeutics — including dordaviprone. \u003c/p>\n\n\n\n\u003cp>The report, which highlights Stein-Lobovits’ experience with the drug, also notes several advances in cancer prevention and detection — vaccines that prevent cancers in high-risk individuals and train immune systems to eliminate existing tumors; at-home test kits for HPV, a disease linked to cervical cancer; and AI-based tools to help doctors interpret routine medical imaging and carry out complex research tasks. \u003c/p>\n\n\n\n\n\n\u003cp>Despite the progress, cancer continues to be one of the leading causes of death in the U.S., killing about \u003ca href=\"https://www.cdc.gov/nchs/products/databriefs/db548.htm\">610,000\u003c/a> people annually. An estimated 2.1 million new cancer cases will be diagnosed in 2026, and this number is projected to rise to 2.5 million by 2050, according to AACR findings. \u003c/p>\n\n\n\n\u003cp>Cancer’s risks are not distributed equally — racial and ethnic minority groups and other medically underserved populations in the U.S. continue to shoulder a disproportionate burden of the disease. \u003c/p>\n\n\n\n\u003cp>“Even the strongest research system falls short if patients cannot benefit from its advances,” the report states. \u003c/p>\n\n\n\n\u003cp>Despite significant strides, researchers warned of a major threat to cancer research: another wave of funding cuts following policy changes from the Trump administration. \u003c/p>\n\n\n\n\u003cp>A report from the \u003ca href=\"https://www.brennancenter.org/our-work/research-reports/cost-trump-administrations-attacks-research-funding\">Brennan Center for Justice\u003c/a> says the administration’s actions — including the decision to remove all members of the board of advisers to the National Science Foundation — have caused grantmaking to “slow to a crawl” since the start of this fiscal year. \u003c/p>\n\n\n\n\u003cp>In early 2025, the administration cut or froze more than 2,200 active National Institutes of Health research grants and withdrew billions of dollars in previously awarded research funding, according to the AACR report. Then, the president’s budget request for fiscal year 2027, released in April 2026, proposed a $5 billion reduction in overall NIH funding, compared with the previous year’s levels.\u003c/p>\n\n\n\n\u003cp>A new \u003ca href=\"https://www.federalregister.gov/documents/2026/05/29/2026-10817/regulation-for-federal-financial-assistance?utm_campaign=subscription+mailing+list&utm_medium=email&utm_source=federalregister.gov#addresses\">rule\u003c/a> proposed by the Office of Management and Budget to overhaul federal grantmaking could “inject political considerations into funding decisions and broaden federal agencies’ authority to terminate grants for reasons unrelated to scientific merit or recipient performance,” the report says. This could further reduce funding if the Senate’s decision to block the rule is allowed to expire in December. \u003c/p>\n\n\n\u003cdiv class=\"wp-block-image\">\n\u003cfigure class=\"aligncenter size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/20250424_UCSFFile_GC-16_qed.jpg\" alt=\"\" class=\"wp-image-12040284\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/20250424_UCSFFile_GC-16_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/20250424_UCSFFile_GC-16_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/20250424_UCSFFile_GC-16_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/20250424_UCSFFile_GC-16_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/20250424_UCSFFile_GC-16_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/20250424_UCSFFile_GC-16_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">UCSF Medical Center at Mission Bay in San Francisco on April 24, 2025. (Gina Castro/KQED)\u003c/figcaption>\u003c/figure>\n\u003c/div>\n\n\n\u003cp>Without strong federal support for medical research, the U.S. risks losing its position as a global leader in scientific discovery, innovation and the development of lifesaving cancer treatments, the report warns.\u003c/p>\n\n\n\n\u003cp>Dr. Iona Cheng, a cancer epidemiologist at UCSF and a co-investigator of the Greater Bay Area Cancer Registry, said that the federal action “significantly impacts our ability to continue and sustain important cancer research.” \u003c/p>\n\n\n\n\u003cp>Stein-Lobovits, now 40, credits cutting-edge research with allowing him to live. \u003c/p>\n\n\n\n\u003cp>“It’s allowed me to watch my girls grow up,” he said. “It has given me so much hope.”\u003c/p>\n\n\n\n\u003cp>He advised other survivors going through their own cancer journeys to “not take no for an answer.” \u003c/p>\n\n\n\n\u003cp>“Advocate for yourself, question everything, and don’t be hard on yourself,” Stein-Lobovits said.\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "how-trumps-immigration-policies-can-leave-doctors-feeling-powerless",
"title": "How Trump’s Immigration Policies Can Leave Doctors Feeling Powerless",
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"headTitle": "How Trump’s Immigration Policies Can Leave Doctors Feeling Powerless | KQED",
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"content": "\n\u003cp>When a patient comes into Dr. Miguel San Miguel Benavides’ exam room at \u003ca href=\"https://www.kqed.org/news/tag/san-francisco-general-hospital\">San Francisco General Hospital\u003c/a> with a cough, a rash, diabetes or high blood pressure, he knows where to start. \u003c/p>\n\n\n\n\u003cp>But over the past year, people have been bringing him a problem he feels less equipped to tackle as a primary care physician: their fear over immigration enforcement. \u003c/p>\n\n\n\n\u003cp>Among other actions, the Trump administration has rolled back protections keeping immigration agents away from healthcare facilities and sought to \u003ca href=\"https://www.kff.org/immigrant-health/potential-implications-of-the-new-medicaid-data-sharing-agreement-between-cms-and-ice/\">give ICE access to Medicaid data\u003c/a>. Since then, San Miguel and colleagues at SF General who work with immigrant patients say they’ve watched with a sense of powerlessness as people avoid or delay treatment, and as mounting stress exacerbates their underlying conditions.\u003c/p>\n\n\n\n\u003cp>A \u003ca href=\"https://phr.org/news/ice-tactics-and-deportation-fears-limit-access-to-health-care-for-children-of-immigrants-survey/\">2025 survey\u003c/a> of healthcare workers who serve immigrants echoes that experience: Among hundreds of respondents across 30 states, 84% said patient visits were down substantially; many said their ability to provide preventive care and manage chronic conditions suffered.\u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-5-KQED.jpg\" alt=\"\" class=\"wp-image-12097362\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-5-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-5-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-5-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Miguel San Miguel Benavides, a resident physician at the Zuckerberg San Francisco General Hospital, poses for a portrait at the hospital on Aug. 26, 2026. (Gina Castro for KQED)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cp>Now, a small study from UCSF suggests that immigration policies can force some doctors to practice in a way that’s at odds with their sense of moral or professional duty, taking a toll on them. \u003c/p>\n\n\n\n\u003cp>The experience has become routine for San Miguel as he finishes his residency.\u003c/p>\n\n\n\n\u003cp>“This is the type of care that I always wanted to give,” he said of working with patients who, like him, immigrated to this country. “But I think part of that has become realizing that the amount of support we can give isn’t necessarily enough.”\u003c/p>\n\n\n\n\u003cp>Researchers call that kind of ethical conflict “\u003ca href=\"https://www.npr.org/2012/11/21/165663154/moral-injury-the-psychological-wounds-of-war\">moral injury\u003c/a>,” a term coined by a Department of Veterans Affairs psychiatrist working with Vietnam War veterans.\u003c/p>\n\n\n\n\n\n\u003cp>Dr. Marlene Martín, a UCSF clinical medicine professor, was inspired to do the study last summer, around the time ICE was \u003ca href=\"https://www.kqed.org/news/12049326/as-ice-operations-expand-how-are-immigrant-allies-responding\">conducting widespread raids\u003c/a> in Los Angeles. A colleague who works with immigrant patients told her no one had shown up to their appointment that day at SF General. If that was happening in San Francisco, where there was relatively little high-profile ICE activity at the time, Martín wondered what doctors elsewhere were seeing. \u003c/p>\n\n\n\n\u003cp>So she and her colleagues interviewed 38 primary care doctors in 13 states about their experiences caring for immigrant patients in this climate. They recently published their findings \u003ca href=\"https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2851433\">in JAMA Internal Medicine\u003c/a>.\u003c/p>\n\n\n\n\u003cp>The interviews confirmed that doctors across the country were seeing patients miss appointments, with some suffering more from chronic diseases as their treatment lapsed. For instance, Martín said, one interviewee described a patient whose diabetes had spiraled out of control because his son, who’d been driving him to his appointments, had been arrested by ICE. \u003c/p>\n\n\n\n\u003cp>“You can’t fix that,” she said. “You can’t address that in a clinical visit.”\u003c/p>\n\n\n\n\u003cp>Some doctors told the researchers they were afraid to even ask their patients how they were doing, “because it would open this whole topic that they didn’t know how to answer. They didn’t know how to make it better,” Martín said. “In medicine we’re used to being able to address things that patients are talking about and to help them get better.” \u003c/p>\n\n\n\n\u003cp>One doctor described to researchers the kind of dilemmas they face, given fears about encountering immigration agents in hospitals: “Would I rather have [my patient] be at home while they’re having substernal, crushing chest pain vs. what are the costs and benefits of going [to the hospital]?” \u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1350\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-10-KQED.jpg\" alt=\"\" class=\"wp-image-12097364\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-10-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-10-KQED-160x108.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-10-KQED-1536x1037.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">The Zuckerberg San Francisco General Hospital and Trauma Center on Aug. 26, 2026. (Gina Castro for KQED)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cp>In some cases, the interviewees reported their clinics had stopped accepting undocumented patients altogether, for fear of losing federal funding. \u003c/p>\n\n\n\n\u003cp>Those experiences, day after day, are what can lead to moral injury.\u003c/p>\n\n\n\n\u003cp>What surprised study co-author Dr. Alicia Fernandez was how much doctors changed the way they practiced in response to immigration policy changes. “What we saw was many physicians and practices, entire practices, altering their patterns of care,” the UCSF professor and SF General primary care doctor said. \u003c/p>\n\n\n\n\u003cp>Some transitioned to telehealth appointments. Others switched medications so patients didn’t have to go into the clinic or pharmacy as often. \u003c/p>\n\n\n\n\u003cp>But Fernandez said the changes can come at a cost — both for the patients and the doctors who care for them. \u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1421\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-8-KQED.jpg\" alt=\"\" class=\"wp-image-12097363\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-8-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-8-KQED-160x114.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-8-KQED-1536x1091.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Miguel San Miguel Benavides, a resident physician at the Zuckerberg San Francisco General Hospital, and Alicia Fernandez, a UCSF professor and general internist at SF General, talk at the hospital on Aug. 26, 2026. (Gina Castro for KQED)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cp>“We definitely feel that our patients are getting worse, and we feel that the care that we are giving is an inferior form of care, and that’s why it’s associated with moral distress,” Fernandez said. \u003c/p>\n\n\n\n\u003cp>She points to a recent experience with an undocumented patient who’d avoided being seen out of fear. “He came in already having damage from his diabetes,” she said. “That’s a terrible feeling.” \u003c/p>\n\n\n\n\u003cp>This kind of distress isn’t just bad for individual doctors. \u003c/p>\n\n\n\n\u003cp>“Moral injury can contribute to burnout,” said Dr. Robert Pearl, a physician and Stanford professor who served as CEO of the Permanente Medical Group for nearly two decades. And data show burnout affects doctors’ quality of care.\u003c/p>\n\n\n\n\u003cp>“If the patient before you required all this extra work, has had this added fear, had all these challenges,” he said, referencing the study, “when the clinician sees you, he or she may not be as good and sharp as you would like them to be.”\u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/20260826_UCSFStudy_GC-11_qed.jpg\" alt=\"\" class=\"wp-image-12099231\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/20260826_UCSFStudy_GC-11_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/20260826_UCSFStudy_GC-11_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/20260826_UCSFStudy_GC-11_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Individuals walk towards the Zuckerberg San Francisco General Hospital and Trauma Center on Aug. 26, 2026. (Gina Castro for KQED)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cp>Burnout and moral injury can also lead doctors and other healthcare workers to leave their professions, he said, with particularly dire effects in primary care. \u003c/p>\n\n\n\n\u003cp>“We already have a shortage,” he said, so “when you need a primary care doctor, that individual might not be there. And we’re certainly seeing that in many communities across the United States, where it’s almost impossible to find a primary care physician with an open panel.”\u003c/p>\n\n\n\n\u003cp>For doctors in the study who were themselves immigrants, the distress was compounded. That has broad implications given that almost half of the country’s internal medicine doctors are foreign-born, according to \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/2852745?guestAccessKey=da3ba888-5ff2-456f-9d94-b301cf5d2884&utm_source=for_the_media&utm_medium=referral&utm_campaign=ftm_links&utm_term=081226\">a study\u003c/a> released last month. \u003c/p>\n\n\n\n\u003cp>While the UCSF study on moral injury is small and qualitative, it points to ways healthcare institutions can support staff in an increasingly difficult environment. Doctors whose clinics protected patients’ immigration-related information and expanded telehealth, for example, described ways those changes helped them care for patients.\u003c/p>\n\n\n\n\n\n\u003cp>A sense of powerlessness contributed to the moral distress doctors in the study felt. Carolyn Dewa, a psychiatry and behavioral medicine professor at the UC Davis School of Medicine, said social support can protect against that. \u003c/p>\n\n\n\n\u003cp>“If you feel supported by colleagues and peers, or you feel supported by supervisors,” she said, “if people are not isolated from one another but feel that they’re part of a group, it also is protective.” \u003c/p>\n\n\n\n\u003cp>The doctors interviewed for the study also described the importance of having a sense of agency. “This paper pointed out that feeling like you could take an active role does help mitigate some of the distress,” said Dr. Anne Rosenthal, who runs the adult primary care clinic at SF General, where Fernandez and San Miguel work. \u003c/p>\n\n\n\n\u003cp>Her clinic has tried to do that in part by training staff on what to do if immigration enforcement shows up and proactively educating patients about what they need to do to keep Medi-Cal coverage as state enrollment rules change.\u003c/p>\n\n\n\n\u003cp>The \u003ca href=\"https://laborcenter.berkeley.edu/over-two-million-more-californians-projected-to-lack-health-insurance-by-2030/\">UC Berkeley Labor Center projects\u003c/a> half of undocumented residents in California under age 65 could be uninsured by 2030, double the rate now.\u003c/p>\n\n\n\n\u003cp>“We live in fear of losing our patients, because we know that their physical health will suffer, the health of their kids will suffer, and the health of the community will suffer,” she said.\u003c/p>\n",
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"innerHTML": "\n\u003cp>A \u003ca href=\"https://phr.org/news/ice-tactics-and-deportation-fears-limit-access-to-health-care-for-children-of-immigrants-survey/\">2025 survey\u003c/a> of healthcare workers who serve immigrants echoes that experience: Among hundreds of respondents across 30 states, 84% said patient visits were down substantially; many said their ability to provide preventive care and manage chronic conditions suffered.\u003c/p>\n",
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"innerHTML": "\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-5-KQED.jpg\" alt=\"\" class=\"wp-image-12097362\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-5-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-5-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-5-KQED-1536x1024.jpg 1536w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\" />\u003cfigcaption class=\"wp-element-caption\">Miguel San Miguel Benavides, a resident physician at the Zuckerberg San Francisco General Hospital, poses for a portrait at the hospital on Aug. 26, 2026.\u003ccite class=\"wp-inline-image-credit\"> (Gina Castro for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
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"innerHTML": "\n\u003cp>Now, a small study from UCSF suggests that immigration policies can force some doctors to practice in a way that’s at odds with their sense of moral or professional duty, taking a toll on them. \u003c/p>\n",
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"innerHTML": "\n\u003cp>The experience has become routine for San Miguel as he finishes his residency.\u003c/p>\n",
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"innerHTML": "\n\u003cp>“This is the type of care that I always wanted to give,” he said of working with patients who, like him, immigrated to this country. “But I think part of that has become realizing that the amount of support we can give isn’t necessarily enough.”\u003c/p>\n",
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"innerHTML": "\n\u003cp>Researchers call that kind of ethical conflict “\u003ca href=\"https://www.npr.org/2012/11/21/165663154/moral-injury-the-psychological-wounds-of-war\">moral injury\u003c/a>,” a term coined by a Department of Veterans Affairs psychiatrist working with Vietnam War veterans.\u003c/p>\n",
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"innerHTML": "\n\u003cp>Dr. Marlene Martín, a UCSF clinical medicine professor, was inspired to do the study last summer, around the time ICE was \u003ca href=\"https://www.kqed.org/news/12049326/as-ice-operations-expand-how-are-immigrant-allies-responding\">conducting widespread raids\u003c/a> in Los Angeles. A colleague who works with immigrant patients told her no one had shown up to their appointment that day at SF General. If that was happening in San Francisco, where there was relatively little high-profile ICE activity at the time, Martín wondered what doctors elsewhere were seeing. \u003c/p>\n",
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"\n\u003cp>Dr. Marlene Martín, a UCSF clinical medicine professor, was inspired to do the study last summer, around the time ICE was \u003ca href=\"https://www.kqed.org/news/12049326/as-ice-operations-expand-how-are-immigrant-allies-responding\">conducting widespread raids\u003c/a> in Los Angeles. A colleague who works with immigrant patients told her no one had shown up to their appointment that day at SF General. If that was happening in San Francisco, where there was relatively little high-profile ICE activity at the time, Martín wondered what doctors elsewhere were seeing. \u003c/p>\n"
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"innerHTML": "\n\u003cp>So she and her colleagues interviewed 38 primary care doctors in 13 states about their experiences caring for immigrant patients in this climate. They recently published their findings \u003ca href=\"https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2851433\">in JAMA Internal Medicine\u003c/a>.\u003c/p>\n",
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"\n\u003cp>So she and her colleagues interviewed 38 primary care doctors in 13 states about their experiences caring for immigrant patients in this climate. They recently published their findings \u003ca href=\"https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2851433\">in JAMA Internal Medicine\u003c/a>.\u003c/p>\n"
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"innerHTML": "\n\u003cp>The interviews confirmed that doctors across the country were seeing patients miss appointments, with some suffering more from chronic diseases as their treatment lapsed. For instance, Martín said, one interviewee described a patient whose diabetes had spiraled out of control because his son, who’d been driving him to his appointments, had been arrested by ICE. \u003c/p>\n",
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"\n\u003cp>The interviews confirmed that doctors across the country were seeing patients miss appointments, with some suffering more from chronic diseases as their treatment lapsed. For instance, Martín said, one interviewee described a patient whose diabetes had spiraled out of control because his son, who’d been driving him to his appointments, had been arrested by ICE. \u003c/p>\n"
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"innerHTML": "\n\u003cp>“You can’t fix that,” she said. “You can’t address that in a clinical visit.”\u003c/p>\n",
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"\n\u003cp>“You can’t fix that,” she said. “You can’t address that in a clinical visit.”\u003c/p>\n"
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"innerHTML": "\n\u003cp>Some doctors told the researchers they were afraid to even ask their patients how they were doing, “because it would open this whole topic that they didn’t know how to answer. They didn’t know how to make it better,” Martín said. “In medicine we’re used to being able to address things that patients are talking about and to help them get better.” \u003c/p>\n",
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"\n\u003cp>Some doctors told the researchers they were afraid to even ask their patients how they were doing, “because it would open this whole topic that they didn’t know how to answer. They didn’t know how to make it better,” Martín said. “In medicine we’re used to being able to address things that patients are talking about and to help them get better.” \u003c/p>\n"
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"innerHTML": "\n\u003cp>One doctor described to researchers the kind of dilemmas they face, given fears about encountering immigration agents in hospitals: “Would I rather have [my patient] be at home while they’re having substernal, crushing chest pain vs. what are the costs and benefits of going [to the hospital]?” \u003c/p>\n",
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"\n\u003cp>One doctor described to researchers the kind of dilemmas they face, given fears about encountering immigration agents in hospitals: “Would I rather have [my patient] be at home while they’re having substernal, crushing chest pain vs. what are the costs and benefits of going [to the hospital]?” \u003c/p>\n"
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"innerHTML": "\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-10-KQED.jpg\" alt=\"\" class=\"wp-image-12097364\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-10-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-10-KQED-160x108.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-10-KQED-1536x1037.jpg 1536w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\" />\u003cfigcaption class=\"wp-element-caption\">The Zuckerberg San Francisco General Hospital and Trauma Center on Aug. 26, 2026.\u003ccite class=\"wp-inline-image-credit\"> (Gina Castro for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
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"\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-10-KQED.jpg\" alt=\"\" class=\"wp-image-12097364\" />\u003cfigcaption class=\"wp-element-caption\">The Zuckerberg San Francisco General Hospital and Trauma Center on Aug. 26, 2026.\u003ccite class=\"wp-inline-image-credit\"> (Gina Castro for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cp>In some cases, the interviewees reported their clinics had stopped accepting undocumented patients altogether, for fear of losing federal funding. \u003c/p>\n",
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"innerHTML": "\n\u003cp>Those experiences, day after day, are what can lead to moral injury.\u003c/p>\n",
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"innerHTML": "\n\u003cp>What surprised study co-author Dr. Alicia Fernandez was how much doctors changed the way they practiced in response to immigration policy changes. “What we saw was many physicians and practices, entire practices, altering their patterns of care,” the UCSF professor and SF General primary care doctor said. \u003c/p>\n",
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"innerHTML": "\n\u003cp>Some transitioned to telehealth appointments. Others switched medications so patients didn’t have to go into the clinic or pharmacy as often. \u003c/p>\n",
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"innerHTML": "\n\u003cp>But Fernandez said the changes can come at a cost — both for the patients and the doctors who care for them. \u003c/p>\n",
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"innerHTML": "\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-8-KQED.jpg\" alt=\"\" class=\"wp-image-12097363\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-8-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-8-KQED-160x114.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-8-KQED-1536x1091.jpg 1536w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\" />\u003cfigcaption class=\"wp-element-caption\">Miguel San Miguel Benavides, a resident physician at the Zuckerberg San Francisco General Hospital, and Alicia Fernandez, a UCSF professor and general internist at SF General, talk at the hospital on Aug. 26, 2026.\u003ccite class=\"wp-inline-image-credit\"> (Gina Castro for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
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"innerHTML": "\n\u003cp>“We definitely feel that our patients are getting worse, and we feel that the care that we are giving is an inferior form of care, and that’s why it’s associated with moral distress,” Fernandez said. \u003c/p>\n",
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"innerHTML": "\n\u003cp>She points to a recent experience with an undocumented patient who’d avoided being seen out of fear. “He came in already having damage from his diabetes,” she said. “That’s a terrible feeling.” \u003c/p>\n",
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"innerHTML": "\n\u003cp>This kind of distress isn’t just bad for individual doctors. \u003c/p>\n",
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"innerHTML": "\n\u003cp>“Moral injury can contribute to burnout,” said Dr. Robert Pearl, a physician and Stanford professor who served as CEO of the Permanente Medical Group for nearly two decades. And data show burnout affects doctors’ quality of care.\u003c/p>\n",
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"\n\u003cp>“Moral injury can contribute to burnout,” said Dr. Robert Pearl, a physician and Stanford professor who served as CEO of the Permanente Medical Group for nearly two decades. And data show burnout affects doctors’ quality of care.\u003c/p>\n"
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"innerHTML": "\n\u003cp>“If the patient before you required all this extra work, has had this added fear, had all these challenges,” he said, referencing the study, “when the clinician sees you, he or she may not be as good and sharp as you would like them to be.”\u003c/p>\n",
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"\n\u003cp>“If the patient before you required all this extra work, has had this added fear, had all these challenges,” he said, referencing the study, “when the clinician sees you, he or she may not be as good and sharp as you would like them to be.”\u003c/p>\n"
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"innerHTML": "\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/20260826_UCSFStudy_GC-11_qed.jpg\" alt=\"\" class=\"wp-image-12099231\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/20260826_UCSFStudy_GC-11_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/20260826_UCSFStudy_GC-11_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/20260826_UCSFStudy_GC-11_qed-1536x1024.jpg 1536w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\" />\u003cfigcaption class=\"wp-element-caption\">Individuals walk towards the Zuckerberg San Francisco General Hospital and Trauma Center on Aug. 26, 2026.\u003ccite class=\"wp-inline-image-credit\"> (Gina Castro for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
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"\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/20260826_UCSFStudy_GC-11_qed.jpg\" alt=\"\" class=\"wp-image-12099231\" />\u003cfigcaption class=\"wp-element-caption\">Individuals walk towards the Zuckerberg San Francisco General Hospital and Trauma Center on Aug. 26, 2026.\u003ccite class=\"wp-inline-image-credit\"> (Gina Castro for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cp>Burnout and moral injury can also lead doctors and other healthcare workers to leave their professions, he said, with particularly dire effects in primary care. \u003c/p>\n",
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"innerHTML": "\n\u003cp>“We already have a shortage,” he said, so “when you need a primary care doctor, that individual might not be there. And we’re certainly seeing that in many communities across the United States, where it’s almost impossible to find a primary care physician with an open panel.”\u003c/p>\n",
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"\n\u003cp>“We already have a shortage,” he said, so “when you need a primary care doctor, that individual might not be there. And we’re certainly seeing that in many communities across the United States, where it’s almost impossible to find a primary care physician with an open panel.”\u003c/p>\n"
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"innerHTML": "\n\u003cp>For doctors in the study who were themselves immigrants, the distress was compounded. That has broad implications given that almost half of the country’s internal medicine doctors are foreign-born, according to \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/2852745?guestAccessKey=da3ba888-5ff2-456f-9d94-b301cf5d2884&utm_source=for_the_media&utm_medium=referral&utm_campaign=ftm_links&utm_term=081226\">a study\u003c/a> released last month. \u003c/p>\n",
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"innerHTML": "\n\u003cp>While the UCSF study on moral injury is small and qualitative, it points to ways healthcare institutions can support staff in an increasingly difficult environment. Doctors whose clinics protected patients’ immigration-related information and expanded telehealth, for example, described ways those changes helped them care for patients.\u003c/p>\n",
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"innerHTML": "\n\u003cp>A sense of powerlessness contributed to the moral distress doctors in the study felt. Carolyn Dewa, a psychiatry and behavioral medicine professor at the UC Davis School of Medicine, said social support can protect against that. \u003c/p>\n",
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"\n\u003cp>A sense of powerlessness contributed to the moral distress doctors in the study felt. Carolyn Dewa, a psychiatry and behavioral medicine professor at the UC Davis School of Medicine, said social support can protect against that. \u003c/p>\n"
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"innerHTML": "\n\u003cp>“If you feel supported by colleagues and peers, or you feel supported by supervisors,” she said, “if people are not isolated from one another but feel that they’re part of a group, it also is protective.” \u003c/p>\n",
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"innerHTML": "\n\u003cp>The doctors interviewed for the study also described the importance of having a sense of agency. “This paper pointed out that feeling like you could take an active role does help mitigate some of the distress,” said Dr. Anne Rosenthal, who runs the adult primary care clinic at SF General, where Fernandez and San Miguel work. \u003c/p>\n",
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"innerHTML": "\n\u003cp>Her clinic has tried to do that in part by training staff on what to do if immigration enforcement shows up and proactively educating patients about what they need to do to keep Medi-Cal coverage as state enrollment rules change.\u003c/p>\n",
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"\n\u003cp>Her clinic has tried to do that in part by training staff on what to do if immigration enforcement shows up and proactively educating patients about what they need to do to keep Medi-Cal coverage as state enrollment rules change.\u003c/p>\n"
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"innerHTML": "\n\u003cp>The \u003ca href=\"https://laborcenter.berkeley.edu/over-two-million-more-californians-projected-to-lack-health-insurance-by-2030/\">UC Berkeley Labor Center projects\u003c/a> half of undocumented residents in California under age 65 could be uninsured by 2030, double the rate now.\u003c/p>\n",
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"innerHTML": "\n\u003cp>“We live in fear of losing our patients, because we know that their physical health will suffer, the health of their kids will suffer, and the health of the community will suffer,” she said.\u003c/p>\n",
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"excerpt": "The Trump administration’s immigration crackdown is making it harder for primary care doctors who work with immigrant patients to do their jobs, a UCSF study finds.",
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"title": "How Trump’s Immigration Policies Can Leave Doctors Feeling Powerless | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>When a patient comes into Dr. Miguel San Miguel Benavides’ exam room at \u003ca href=\"https://www.kqed.org/news/tag/san-francisco-general-hospital\">San Francisco General Hospital\u003c/a> with a cough, a rash, diabetes or high blood pressure, he knows where to start. \u003c/p>\n\n\n\n\u003cp>But over the past year, people have been bringing him a problem he feels less equipped to tackle as a primary care physician: their fear over immigration enforcement. \u003c/p>\n\n\n\n\u003cp>Among other actions, the Trump administration has rolled back protections keeping immigration agents away from healthcare facilities and sought to \u003ca href=\"https://www.kff.org/immigrant-health/potential-implications-of-the-new-medicaid-data-sharing-agreement-between-cms-and-ice/\">give ICE access to Medicaid data\u003c/a>. Since then, San Miguel and colleagues at SF General who work with immigrant patients say they’ve watched with a sense of powerlessness as people avoid or delay treatment, and as mounting stress exacerbates their underlying conditions.\u003c/p>\n\n\n\n\u003cp>A \u003ca href=\"https://phr.org/news/ice-tactics-and-deportation-fears-limit-access-to-health-care-for-children-of-immigrants-survey/\">2025 survey\u003c/a> of healthcare workers who serve immigrants echoes that experience: Among hundreds of respondents across 30 states, 84% said patient visits were down substantially; many said their ability to provide preventive care and manage chronic conditions suffered.\u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-5-KQED.jpg\" alt=\"\" class=\"wp-image-12097362\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-5-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-5-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-5-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Miguel San Miguel Benavides, a resident physician at the Zuckerberg San Francisco General Hospital, poses for a portrait at the hospital on Aug. 26, 2026. (Gina Castro for KQED)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cp>Now, a small study from UCSF suggests that immigration policies can force some doctors to practice in a way that’s at odds with their sense of moral or professional duty, taking a toll on them. \u003c/p>\n\n\n\n\u003cp>The experience has become routine for San Miguel as he finishes his residency.\u003c/p>\n\n\n\n\u003cp>“This is the type of care that I always wanted to give,” he said of working with patients who, like him, immigrated to this country. “But I think part of that has become realizing that the amount of support we can give isn’t necessarily enough.”\u003c/p>\n\n\n\n\u003cp>Researchers call that kind of ethical conflict “\u003ca href=\"https://www.npr.org/2012/11/21/165663154/moral-injury-the-psychological-wounds-of-war\">moral injury\u003c/a>,” a term coined by a Department of Veterans Affairs psychiatrist working with Vietnam War veterans.\u003c/p>\n\n\n\n\n\n\u003cp>Dr. Marlene Martín, a UCSF clinical medicine professor, was inspired to do the study last summer, around the time ICE was \u003ca href=\"https://www.kqed.org/news/12049326/as-ice-operations-expand-how-are-immigrant-allies-responding\">conducting widespread raids\u003c/a> in Los Angeles. A colleague who works with immigrant patients told her no one had shown up to their appointment that day at SF General. If that was happening in San Francisco, where there was relatively little high-profile ICE activity at the time, Martín wondered what doctors elsewhere were seeing. \u003c/p>\n\n\n\n\u003cp>So she and her colleagues interviewed 38 primary care doctors in 13 states about their experiences caring for immigrant patients in this climate. They recently published their findings \u003ca href=\"https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2851433\">in JAMA Internal Medicine\u003c/a>.\u003c/p>\n\n\n\n\u003cp>The interviews confirmed that doctors across the country were seeing patients miss appointments, with some suffering more from chronic diseases as their treatment lapsed. For instance, Martín said, one interviewee described a patient whose diabetes had spiraled out of control because his son, who’d been driving him to his appointments, had been arrested by ICE. \u003c/p>\n\n\n\n\u003cp>“You can’t fix that,” she said. “You can’t address that in a clinical visit.”\u003c/p>\n\n\n\n\u003cp>Some doctors told the researchers they were afraid to even ask their patients how they were doing, “because it would open this whole topic that they didn’t know how to answer. They didn’t know how to make it better,” Martín said. “In medicine we’re used to being able to address things that patients are talking about and to help them get better.” \u003c/p>\n\n\n\n\u003cp>One doctor described to researchers the kind of dilemmas they face, given fears about encountering immigration agents in hospitals: “Would I rather have [my patient] be at home while they’re having substernal, crushing chest pain vs. what are the costs and benefits of going [to the hospital]?” \u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1350\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-10-KQED.jpg\" alt=\"\" class=\"wp-image-12097364\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-10-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-10-KQED-160x108.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-10-KQED-1536x1037.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">The Zuckerberg San Francisco General Hospital and Trauma Center on Aug. 26, 2026. (Gina Castro for KQED)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cp>In some cases, the interviewees reported their clinics had stopped accepting undocumented patients altogether, for fear of losing federal funding. \u003c/p>\n\n\n\n\u003cp>Those experiences, day after day, are what can lead to moral injury.\u003c/p>\n\n\n\n\u003cp>What surprised study co-author Dr. Alicia Fernandez was how much doctors changed the way they practiced in response to immigration policy changes. “What we saw was many physicians and practices, entire practices, altering their patterns of care,” the UCSF professor and SF General primary care doctor said. \u003c/p>\n\n\n\n\u003cp>Some transitioned to telehealth appointments. Others switched medications so patients didn’t have to go into the clinic or pharmacy as often. \u003c/p>\n\n\n\n\u003cp>But Fernandez said the changes can come at a cost — both for the patients and the doctors who care for them. \u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1421\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-8-KQED.jpg\" alt=\"\" class=\"wp-image-12097363\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-8-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-8-KQED-160x114.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/20260826_UCSFStudy_GC-8-KQED-1536x1091.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Miguel San Miguel Benavides, a resident physician at the Zuckerberg San Francisco General Hospital, and Alicia Fernandez, a UCSF professor and general internist at SF General, talk at the hospital on Aug. 26, 2026. (Gina Castro for KQED)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cp>“We definitely feel that our patients are getting worse, and we feel that the care that we are giving is an inferior form of care, and that’s why it’s associated with moral distress,” Fernandez said. \u003c/p>\n\n\n\n\u003cp>She points to a recent experience with an undocumented patient who’d avoided being seen out of fear. “He came in already having damage from his diabetes,” she said. “That’s a terrible feeling.” \u003c/p>\n\n\n\n\u003cp>This kind of distress isn’t just bad for individual doctors. \u003c/p>\n\n\n\n\u003cp>“Moral injury can contribute to burnout,” said Dr. Robert Pearl, a physician and Stanford professor who served as CEO of the Permanente Medical Group for nearly two decades. And data show burnout affects doctors’ quality of care.\u003c/p>\n\n\n\n\u003cp>“If the patient before you required all this extra work, has had this added fear, had all these challenges,” he said, referencing the study, “when the clinician sees you, he or she may not be as good and sharp as you would like them to be.”\u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/20260826_UCSFStudy_GC-11_qed.jpg\" alt=\"\" class=\"wp-image-12099231\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/20260826_UCSFStudy_GC-11_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/20260826_UCSFStudy_GC-11_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/20260826_UCSFStudy_GC-11_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Individuals walk towards the Zuckerberg San Francisco General Hospital and Trauma Center on Aug. 26, 2026. (Gina Castro for KQED)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cp>Burnout and moral injury can also lead doctors and other healthcare workers to leave their professions, he said, with particularly dire effects in primary care. \u003c/p>\n\n\n\n\u003cp>“We already have a shortage,” he said, so “when you need a primary care doctor, that individual might not be there. And we’re certainly seeing that in many communities across the United States, where it’s almost impossible to find a primary care physician with an open panel.”\u003c/p>\n\n\n\n\u003cp>For doctors in the study who were themselves immigrants, the distress was compounded. That has broad implications given that almost half of the country’s internal medicine doctors are foreign-born, according to \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/2852745?guestAccessKey=da3ba888-5ff2-456f-9d94-b301cf5d2884&utm_source=for_the_media&utm_medium=referral&utm_campaign=ftm_links&utm_term=081226\">a study\u003c/a> released last month. \u003c/p>\n\n\n\n\u003cp>While the UCSF study on moral injury is small and qualitative, it points to ways healthcare institutions can support staff in an increasingly difficult environment. Doctors whose clinics protected patients’ immigration-related information and expanded telehealth, for example, described ways those changes helped them care for patients.\u003c/p>\n\n\n\n\n\n\u003cp>A sense of powerlessness contributed to the moral distress doctors in the study felt. Carolyn Dewa, a psychiatry and behavioral medicine professor at the UC Davis School of Medicine, said social support can protect against that. \u003c/p>\n\n\n\n\u003cp>“If you feel supported by colleagues and peers, or you feel supported by supervisors,” she said, “if people are not isolated from one another but feel that they’re part of a group, it also is protective.” \u003c/p>\n\n\n\n\u003cp>The doctors interviewed for the study also described the importance of having a sense of agency. “This paper pointed out that feeling like you could take an active role does help mitigate some of the distress,” said Dr. Anne Rosenthal, who runs the adult primary care clinic at SF General, where Fernandez and San Miguel work. \u003c/p>\n\n\n\n\u003cp>Her clinic has tried to do that in part by training staff on what to do if immigration enforcement shows up and proactively educating patients about what they need to do to keep Medi-Cal coverage as state enrollment rules change.\u003c/p>\n\n\n\n\u003cp>The \u003ca href=\"https://laborcenter.berkeley.edu/over-two-million-more-californians-projected-to-lack-health-insurance-by-2030/\">UC Berkeley Labor Center projects\u003c/a> half of undocumented residents in California under age 65 could be uninsured by 2030, double the rate now.\u003c/p>\n\n\n\n\u003cp>“We live in fear of losing our patients, because we know that their physical health will suffer, the health of their kids will suffer, and the health of the community will suffer,” she said.\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "medi-cal-wont-pay-for-assisted-living-in-most-of-california-one-brother-fought-back",
"title": "Medi-Cal Won’t Pay for Assisted Living in Most of California. One Brother Fought Back",
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"headTitle": "Medi-Cal Won’t Pay for Assisted Living in Most of California. One Brother Fought Back | KQED",
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"content": "\n\u003cp>\u003cem>Welcome to CalMatters, the only nonprofit newsroom devoted solely to covering issues that affect all Californians. Sign up for \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/whatmatters\">WhatMatters\u003c/a> to receive the latest news and commentary on the most important issues in the Golden State.\u003c/em>\u003c/p>\n\n\n\n\u003cp>Last summer, siblings Roselie and John Aiello decided it was time for Roselie to leave her home of 73 years. \u003c/p>\n\n\n\n\u003cp>Raised on a cattle ranch in the small town of Mount Shasta, Roselie spent her life working as a butcher and handling animals, assisting her father until his death. When her three brothers moved away, she stayed at home on the ranch, with its winding dirt roads and green pastures. But over the years, the hard manual labor left her bones weak and her back curved, slowing her pace. \u003c/p>\n\n\n\n\u003cp>John moved back to the ranch in far \u003ca href=\"https://www.kqed.org/news/tag/northern-california\">Northern California\u003c/a> to take care of Roselie, who needed some assistance with showering and getting dressed. But these tasks began to weigh on John as he balanced his career as a writer with tending to the land, which was getting more difficult for Roselie to navigate. \u003c/p>\n\n\n\n\u003cp>The two siblings made a decision: Roselie, who qualified for Medicaid, would move into assisted living. John would find an appropriate place for her to live and receive care.\u003c/p>\n\n\n\n\u003cp>But when John tried to apply for assisted living benefits on his sister’s behalf, he found that Medi-Cal — California’s version of Medicaid — does not offer a waiver to pay for assisted living care in Siskiyou County, nor does it in 42 others across the state. Only \u003ca href=\"https://www.dhcs.ca.gov/services/long-term-care-alternatives-home-and-community-based-service-options/assisted-living-waiver/\">15 California counties\u003c/a>, most of them urban, offer this option.\u003c/p>\n\n\n\n\u003cp>This has created geographic disparity that gives aging adults in urban areas more options for care than those in rural areas, pushing Northern California seniors like Roselie Aiello into nursing homes or out of their communities, not because they need that level of care, but because they can’t afford to pay out of pocket for assisted living. \u003c/p>\n\n\n\n\u003cp>“You’re wasting money by dumping somebody like my sister in a skilled nursing facility and lessening her quality of life and her chance at doing better,” John said. “By doing this, it makes no fundamental sense.”\u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-gallery has-nested-images columns-default is-cropped wp-block-gallery-1 is-layout-flex wp-block-gallery-is-layout-flex\">\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12098658\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare2.jpg\" alt=\"\" class=\"wp-image-12098658\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare2.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare2-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare2-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Roselie Aiello at Sundial Assisted Living in Shasta County on March 25, 2026. \u003cbr> (Jessica Blough for CalMatters)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12098659\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare3.jpg\" alt=\"\" class=\"wp-image-12098659\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare3.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare3-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare3-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Roselie Aiello at Sundial Assisted Living in Shasta County on March 25, 2026. (Jessica Blough for CalMatters)\u003c/figcaption>\u003c/figure>\n\u003c/figure>\n\n\n\n\u003cp>In the coming decade, many more Californians may face the same predicament, given that one in four will be older than 60. As the state prepares for this explosion in the older adult population, it is prioritizing the ability to age in community-based settings like homes or assisted living facilities. \u003c/p>\n\n\n\n\u003cp>But availability of assisted living options varies county to county and is based on decisions by the various managed care providers contracted to deliver healthcare to the state’s lowest-income residents.\u003c/p>\n\n\n\n\u003cp>“There’s not a lot of options to begin with in rural counties. You take (the assisted living waiver) off a table, which already has a history of a long waiting list, and the options are pretty bleak,” said Maura Gibney, executive director of California Advocates for Nursing Home Reform.\u003c/p>\n\n\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr />\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/PCZuA/\" width=\"800\" height=\"800\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\n\n\n\u003cp>Partnership HealthPlan, which Roselie Aiello is enrolled in, contracts with the state to provide coverage to almost a million Californians on Medi-Cal, making it the largest Medi-Cal managed care plan in Northern California. It is the only Medi-Cal managed care plan available in a separate set of 15 California counties. \u003c/p>\n\n\n\n\u003cp>Managed care providers are encouraged, but not required, to offer as many “\u003ca href=\"https://calaim.dhcs.ca.gov/pages/community-supports\">community supports\u003c/a>” as they can, Tessa Outhyse, a spokesperson for the California Department of Health Care Services, said in an email. CalAIM, the state’s multiyear initiative to overhaul Medi-Cal, includes community supports such as assistance transitioning to an assisted living facility as well as transitional rent, caregiver respite and personal care services. \u003c/p>\n\n\n\n\u003cp>These services are intended to offer healthcare options to Medi-Cal members before their conditions escalate to needing more serious care, therefore saving money. Even when CalAIM’s current waivers expire at the end of the year, the community supports benefits will continue through the managed care plans. \u003c/p>\n\n\n\n\u003cp>When determining which supports to offer, managed care plans take into consideration provider availability and local capacity to offer care, Outhyse said. Partnership chose not to offer assisted living support based on financial factors and a lack of appropriate facilities in the rural areas where it provides care, said Dustin Lyda, spokesperson for the organization. \u003c/p>\n\n\n\n\u003cp>Lyda said any change in what the organization offers would require proof that assisted living facilities would be safer and healthier for members than nursing homes. But he acknowledged that options are more limited for rural members. \u003c/p>\n\n\n\n\u003cp>“There’s definitely a lot more work that we need to do on our end to navigate the more rural areas,” Lyda said. \u003c/p>\n\n\n\n\u003ch2 class=\"wp-block-heading\" id=\"hitting-roadblocks\">Hitting roadblocks\u003c/h2>\n\n\n\n\u003cp>When John Aiello heard about assisted living benefits through Medi-Cal, he saw it as the perfect match for his sister’s needs. He knew that he likely would have to move her out of Siskiyou County, where there was only one facility for Medi-Cal recipients, a nursing home.\u003c/p>\n\n\n\n\u003cp>Roselie had spent some time at an assisted living facility in neighboring Shasta County, which they saw as a better fit. But Partnership didn’t offer assisted living as a community support in that county. \u003c/p>\n\n\n\n\n\n\u003cp>Instead, the provider offered Roselie a waiver to go into assisted living in Sonoma County, which is about five hours from her home. The Aiellos turned that down, thinking it would not be good for Roselie. \u003c/p>\n\n\n\n\u003cp>“If you remove her totally from a family contact, she would not be thriving right now. She needs to see family,” John Aiello said. “When there were resources available that fit her needs in Redding — that’s the closest point to her home county — why do I need to move her to Oakland, to Los Angeles, to San Diego?”\u003c/p>\n\n\n\n\u003cp>Over the course of nine months, John sent dozens of emails and spent hours on phone calls to get Partnership HealthPlan to cover Roselie’s placement in assisted living. He had the support of her doctor and a spot for Roselie at the residence in Shasta County. \u003c/p>\n\n\n\n\u003cp>The process was so intense and frustrating that it drove a wedge between him and his sister in their final months of living together. \u003c/p>\n\n\n\n\u003cp>“He was doing all of this to help me,” Roselie said. “Where was it going to end?”\u003c/p>\n\n\n\n\u003ch2 class=\"wp-block-heading\" id=\"encouraged-or-required\">Encouraged or required? \u003c/h2>\n\n\n\n\u003cp>Most people prefer community-based services over skilled nursing care, which is \u003ca href=\"https://heller.brandeis.edu/community-living-policy/research-policy/publications/pdfs/briefs/hcbs-improve-outcomes-and-reduce-costs.pdf\">generally more expensive\u003c/a>. But nursing home beds are in short supply and should be reserved for those who truly need them, Gibney said.\u003c/p>\n\n\n\n\u003cp>“We really try to help people look at the other options that exist for remaining in the community,” Gibney said. “You’re going to have better health outcomes, better quality of care, if you can stay in the community and out of an institutional setting.”\u003c/p>\n\n\n\n\u003cp>Research indicates that while assisted living may provide better outcomes for some, people in assisted living are more likely than nursing home residents to be hospitalized, which can drive up costs, said Dr. Kenneth Lam, a geriatrician and assistant professor at the University of Colorado Anschutz Medical Campus. \u003c/p>\n\n\n\n\u003cp>“The evidence suggests that it’s a trade-off,” he said. \u003c/p>\n\n\n\n\n\n\u003cp>Contracts for managed care plans are not competitively bid, Outhyse said. And potential contractors aren’t asked to include specific community supports, such as assisted living, in their managed care plans.\u003c/p>\n\n\n\n\u003cp>“Whether a plan chooses to provide specific community supports is not a factor in contract renewal, which focuses instead on overall compliance with state and federal performance standards,” Outhyse wrote in the email.\u003c/p>\n\n\n\n\u003cp>Partnership’s contract with the state was set to expire in December, but will be extended until 2029 because the state \u003ca href=\"https://www.dhcs.ca.gov/services/Pages/ManagedCarePlanProcurementUpdate.aspx\">delayed\u003c/a> the process of soliciting managed care contracts. Lyda said Partnership is facing increasing demand for its community supports — which mainly address social needs, such as housing and food security — and for assisted living benefits. But even people in counties where the managed care provider offers an assisted living benefit can have a long wait for placement. \u003c/p>\n\n\n\n\u003cp>After years of constant increases, the number of Californians receiving an assisted living waiver for the first time dropped at the beginning of 2025, though the waitlist continued to climb. \u003c/p>\n\n\n\n\u003cp>By September, the number of Californians waiting for a waiver had surpassed the number of people who were being supported by it.\u003c/p>\n\n\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr />\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/kH9D7\" width=\"800\" height=\"800\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\n\n\n\u003cp>Gibney said that Medi-Cal members are often encouraged to get on the waitlist before applying for assisted living funding, which could contribute to the long wait. \u003c/p>\n\n\n\n\u003cp>Older adults might spend months on a waitlist, only to be told that they are ineligible for assisted living coverage. \u003c/p>\n\n\n\n\u003cp>“It’s a lot of shifting sand, that’s what people are finding themselves in the middle of,” Lam said. “They’re being told that they get to choose, but it’s a complex choice.”\u003c/p>\n\n\n\n\u003ch2 class=\"wp-block-heading\" id=\"a-new-home\">A new home\u003c/h2>\n\n\n\n\u003cp>In March, Roselie moved into her new home, Sundial Assisted Living, the Shasta County facility where she had previously spent some time. Two months earlier, Partnership had informed the Aiellos that it would cover Roselie’s assisted living care. \u003c/p>\n\n\n\n\u003cp>Partnership offered Roselie early access to a pilot program that launched on July 1, which extends the assisted living options to select members of the network. There will be no open application process, but members can ask to be considered or referred through a healthcare provider. \u003c/p>\n\n\n\n\u003cp>The goal is to discover if offering the assisted living option will provide better health outcomes at a lower price.\u003c/p>\n\n\n\n\u003cp>“Success would also be having these individuals being able to continue to receive care within their community setting, being in their home,” Lyda said. “We know that that is more impactful to health than being completely taken out of a familiar area.” \u003c/p>\n\n\n\n\u003cp>The adjustment has not been easy for Roselie. She has been hospitalized twice since she moved to Sundial and briefly entered a nursing home. \u003cs> \u003c/s>\u003c/p>\n\n\n\n\u003cp>Socially, things have gone better. Roselie has made friends and is often called on to teach card games to her fellow Sundial residents. While she was hospitalized, her neighbors and caretakers at Sundial visited her. She’s grateful to John for navigating through red tape to get her here. \u003c/p>\n\n\n\n\u003cp>“I’m looking at it like this: It’s a new adventure,” she said. \u003c/p>\n\n\n\n\u003cp>John worries about his sister’s health issues and whether Sundial will be a long-term solution for her. He’s gratified that his fight ended with his sister’s placement in their chosen facility. But he resents having to wage the battle.\u003c/p>\n\n\n\n\u003cp>“I don’t understand why I was the guy fighting for everybody,” John said. “I’m just one person trying to support myself, trying to take care of a family member.”\u003c/p>\n\n\n\n\u003cp>\u003cem>Jessica Blough reported on this story while with the\u003c/em> \u003ca href=\"https://journalism.berkeley.edu/programs/mj/investigative-reporting/\">\u003cem>Investigative Reporting Program\u003c/em>\u003c/a> \u003cem>at UC Berkeley Journalism School, with a grant from\u003c/em> \u003ca href=\"https://www.thescanfoundation.org/\">\u003cem>The SCAN Foundation\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n",
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"innerHTML": "\n\u003cp>\u003cem>Welcome to CalMatters, the only nonprofit newsroom devoted solely to covering issues that affect all Californians. Sign up for \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/whatmatters\">WhatMatters\u003c/a> to receive the latest news and commentary on the most important issues in the Golden State.\u003c/em>\u003c/p>\n",
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"innerHTML": "\n\u003cp>Raised on a cattle ranch in the small town of Mount Shasta, Roselie spent her life working as a butcher and handling animals, assisting her father until his death. When her three brothers moved away, she stayed at home on the ranch, with its winding dirt roads and green pastures. But over the years, the hard manual labor left her bones weak and her back curved, slowing her pace. \u003c/p>\n",
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"innerHTML": "\n\u003cp>John moved back to the ranch in far \u003ca href=\"https://www.kqed.org/news/tag/northern-california\">Northern California\u003c/a> to take care of Roselie, who needed some assistance with showering and getting dressed. But these tasks began to weigh on John as he balanced his career as a writer with tending to the land, which was getting more difficult for Roselie to navigate. \u003c/p>\n",
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"\n\u003cp>John moved back to the ranch in far \u003ca href=\"https://www.kqed.org/news/tag/northern-california\">Northern California\u003c/a> to take care of Roselie, who needed some assistance with showering and getting dressed. But these tasks began to weigh on John as he balanced his career as a writer with tending to the land, which was getting more difficult for Roselie to navigate. \u003c/p>\n"
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"innerHTML": "\n\u003cp>The two siblings made a decision: Roselie, who qualified for Medicaid, would move into assisted living. John would find an appropriate place for her to live and receive care.\u003c/p>\n",
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"innerHTML": "\n\u003cp>But when John tried to apply for assisted living benefits on his sister’s behalf, he found that Medi-Cal — California’s version of Medicaid — does not offer a waiver to pay for assisted living care in Siskiyou County, nor does it in 42 others across the state. Only \u003ca href=\"https://www.dhcs.ca.gov/services/long-term-care-alternatives-home-and-community-based-service-options/assisted-living-waiver/\">15 California counties\u003c/a>, most of them urban, offer this option.\u003c/p>\n",
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"innerHTML": "\n\u003cp>This has created geographic disparity that gives aging adults in urban areas more options for care than those in rural areas, pushing Northern California seniors like Roselie Aiello into nursing homes or out of their communities, not because they need that level of care, but because they can’t afford to pay out of pocket for assisted living. \u003c/p>\n",
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"innerHTML": "\n\u003cp>“You’re wasting money by dumping somebody like my sister in a skilled nursing facility and lessening her quality of life and her chance at doing better,” John said. “By doing this, it makes no fundamental sense.”\u003c/p>\n",
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"innerHTML": "\n\u003cp>In the coming decade, many more Californians may face the same predicament, given that one in four will be older than 60. As the state prepares for this explosion in the older adult population, it is prioritizing the ability to age in community-based settings like homes or assisted living facilities. \u003c/p>\n",
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"innerHTML": "\n\u003cp>Partnership HealthPlan, which Roselie Aiello is enrolled in, contracts with the state to provide coverage to almost a million Californians on Medi-Cal, making it the largest Medi-Cal managed care plan in Northern California. It is the only Medi-Cal managed care plan available in a separate set of 15 California counties. \u003c/p>\n",
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"innerHTML": "\n\u003cp>Managed care providers are encouraged, but not required, to offer as many “\u003ca href=\"https://calaim.dhcs.ca.gov/pages/community-supports\">community supports\u003c/a>” as they can, Tessa Outhyse, a spokesperson for the California Department of Health Care Services, said in an email. CalAIM, the state’s multiyear initiative to overhaul Medi-Cal, includes community supports such as assistance transitioning to an assisted living facility as well as transitional rent, caregiver respite and personal care services. \u003c/p>\n",
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"innerHTML": "\n\u003cp>These services are intended to offer healthcare options to Medi-Cal members before their conditions escalate to needing more serious care, therefore saving money. Even when CalAIM’s current waivers expire at the end of the year, the community supports benefits will continue through the managed care plans. \u003c/p>\n",
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"innerHTML": "\n\u003cp>When determining which supports to offer, managed care plans take into consideration provider availability and local capacity to offer care, Outhyse said. Partnership chose not to offer assisted living support based on financial factors and a lack of appropriate facilities in the rural areas where it provides care, said Dustin Lyda, spokesperson for the organization. \u003c/p>\n",
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"innerHTML": "\n\u003cp>Lyda said any change in what the organization offers would require proof that assisted living facilities would be safer and healthier for members than nursing homes. But he acknowledged that options are more limited for rural members. \u003c/p>\n",
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"innerHTML": "\n\u003cp>“There’s definitely a lot more work that we need to do on our end to navigate the more rural areas,” Lyda said. \u003c/p>\n",
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"innerHTML": "\n\u003cp>When John Aiello heard about assisted living benefits through Medi-Cal, he saw it as the perfect match for his sister’s needs. He knew that he likely would have to move her out of Siskiyou County, where there was only one facility for Medi-Cal recipients, a nursing home.\u003c/p>\n",
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"innerHTML": "\n\u003cp>Roselie had spent some time at an assisted living facility in neighboring Shasta County, which they saw as a better fit. But Partnership didn’t offer assisted living as a community support in that county. \u003c/p>\n",
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"innerHTML": "\n\u003cp>Instead, the provider offered Roselie a waiver to go into assisted living in Sonoma County, which is about five hours from her home. The Aiellos turned that down, thinking it would not be good for Roselie. \u003c/p>\n",
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"innerHTML": "\n\u003cp>“If you remove her totally from a family contact, she would not be thriving right now. She needs to see family,” John Aiello said. “When there were resources available that fit her needs in Redding — that’s the closest point to her home county — why do I need to move her to Oakland, to Los Angeles, to San Diego?”\u003c/p>\n",
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"innerHTML": "\n\u003cp>Over the course of nine months, John sent dozens of emails and spent hours on phone calls to get Partnership HealthPlan to cover Roselie’s placement in assisted living. He had the support of her doctor and a spot for Roselie at the residence in Shasta County. \u003c/p>\n",
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"\n\u003cp>Over the course of nine months, John sent dozens of emails and spent hours on phone calls to get Partnership HealthPlan to cover Roselie’s placement in assisted living. He had the support of her doctor and a spot for Roselie at the residence in Shasta County. \u003c/p>\n"
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"innerHTML": "\n\u003cp>“He was doing all of this to help me,” Roselie said. “Where was it going to end?”\u003c/p>\n",
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"innerHTML": "\n\u003cp>Most people prefer community-based services over skilled nursing care, which is \u003ca href=\"https://heller.brandeis.edu/community-living-policy/research-policy/publications/pdfs/briefs/hcbs-improve-outcomes-and-reduce-costs.pdf\">generally more expensive\u003c/a>. But nursing home beds are in short supply and should be reserved for those who truly need them, Gibney said.\u003c/p>\n",
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"\n\u003cp>Most people prefer community-based services over skilled nursing care, which is \u003ca href=\"https://heller.brandeis.edu/community-living-policy/research-policy/publications/pdfs/briefs/hcbs-improve-outcomes-and-reduce-costs.pdf\">generally more expensive\u003c/a>. But nursing home beds are in short supply and should be reserved for those who truly need them, Gibney said.\u003c/p>\n"
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"innerHTML": "\n\u003cp>“We really try to help people look at the other options that exist for remaining in the community,” Gibney said. “You’re going to have better health outcomes, better quality of care, if you can stay in the community and out of an institutional setting.”\u003c/p>\n",
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"\n\u003cp>“We really try to help people look at the other options that exist for remaining in the community,” Gibney said. “You’re going to have better health outcomes, better quality of care, if you can stay in the community and out of an institutional setting.”\u003c/p>\n"
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"innerHTML": "\n\u003cp>Research indicates that while assisted living may provide better outcomes for some, people in assisted living are more likely than nursing home residents to be hospitalized, which can drive up costs, said Dr. Kenneth Lam, a geriatrician and assistant professor at the University of Colorado Anschutz Medical Campus. \u003c/p>\n",
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"innerHTML": "\n\u003cp>Contracts for managed care plans are not competitively bid, Outhyse said. And potential contractors aren’t asked to include specific community supports, such as assisted living, in their managed care plans.\u003c/p>\n",
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"innerHTML": "\n\u003cp>“Whether a plan chooses to provide specific community supports is not a factor in contract renewal, which focuses instead on overall compliance with state and federal performance standards,” Outhyse wrote in the email.\u003c/p>\n",
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"innerHTML": "\n\u003cp>Partnership’s contract with the state was set to expire in December, but will be extended until 2029 because the state \u003ca href=\"https://www.dhcs.ca.gov/services/Pages/ManagedCarePlanProcurementUpdate.aspx\">delayed\u003c/a> the process of soliciting managed care contracts. Lyda said Partnership is facing increasing demand for its community supports — which mainly address social needs, such as housing and food security — and for assisted living benefits. But even people in counties where the managed care provider offers an assisted living benefit can have a long wait for placement. \u003c/p>\n",
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"\n\u003cp>Partnership’s contract with the state was set to expire in December, but will be extended until 2029 because the state \u003ca href=\"https://www.dhcs.ca.gov/services/Pages/ManagedCarePlanProcurementUpdate.aspx\">delayed\u003c/a> the process of soliciting managed care contracts. Lyda said Partnership is facing increasing demand for its community supports — which mainly address social needs, such as housing and food security — and for assisted living benefits. But even people in counties where the managed care provider offers an assisted living benefit can have a long wait for placement. \u003c/p>\n"
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"innerHTML": "\n\u003cp>After years of constant increases, the number of Californians receiving an assisted living waiver for the first time dropped at the beginning of 2025, though the waitlist continued to climb. \u003c/p>\n",
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"\n\u003cp>After years of constant increases, the number of Californians receiving an assisted living waiver for the first time dropped at the beginning of 2025, though the waitlist continued to climb. \u003c/p>\n"
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"innerHTML": "\n\u003cp>By September, the number of Californians waiting for a waiver had surpassed the number of people who were being supported by it.\u003c/p>\n",
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"\n\u003cp>By September, the number of Californians waiting for a waiver had surpassed the number of people who were being supported by it.\u003c/p>\n"
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"innerHTML": "\n\u003cp>Gibney said that Medi-Cal members are often encouraged to get on the waitlist before applying for assisted living funding, which could contribute to the long wait. \u003c/p>\n",
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"innerHTML": "\n\u003cp>Older adults might spend months on a waitlist, only to be told that they are ineligible for assisted living coverage. \u003c/p>\n",
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"innerHTML": "\n\u003cp>“It’s a lot of shifting sand, that’s what people are finding themselves in the middle of,” Lam said. “They’re being told that they get to choose, but it’s a complex choice.”\u003c/p>\n",
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"\n\u003cp>“It’s a lot of shifting sand, that’s what people are finding themselves in the middle of,” Lam said. “They’re being told that they get to choose, but it’s a complex choice.”\u003c/p>\n"
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"innerHTML": "\n\u003cp>In March, Roselie moved into her new home, Sundial Assisted Living, the Shasta County facility where she had previously spent some time. Two months earlier, Partnership had informed the Aiellos that it would cover Roselie’s assisted living care. \u003c/p>\n",
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"\n\u003cp>In March, Roselie moved into her new home, Sundial Assisted Living, the Shasta County facility where she had previously spent some time. Two months earlier, Partnership had informed the Aiellos that it would cover Roselie’s assisted living care. \u003c/p>\n"
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"innerHTML": "\n\u003cp>Partnership offered Roselie early access to a pilot program that launched on July 1, which extends the assisted living options to select members of the network. There will be no open application process, but members can ask to be considered or referred through a healthcare provider. \u003c/p>\n",
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"\n\u003cp>Partnership offered Roselie early access to a pilot program that launched on July 1, which extends the assisted living options to select members of the network. There will be no open application process, but members can ask to be considered or referred through a healthcare provider. \u003c/p>\n"
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"innerHTML": "\n\u003cp>The goal is to discover if offering the assisted living option will provide better health outcomes at a lower price.\u003c/p>\n",
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"innerHTML": "\n\u003cp>“Success would also be having these individuals being able to continue to receive care within their community setting, being in their home,” Lyda said. “We know that that is more impactful to health than being completely taken out of a familiar area.” \u003c/p>\n",
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"innerHTML": "\n\u003cp>The adjustment has not been easy for Roselie. She has been hospitalized twice since she moved to Sundial and briefly entered a nursing home. \u003cs> \u003c/s>\u003c/p>\n",
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"\n\u003cp>The adjustment has not been easy for Roselie. She has been hospitalized twice since she moved to Sundial and briefly entered a nursing home. \u003cs> \u003c/s>\u003c/p>\n"
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"innerHTML": "\n\u003cp>Socially, things have gone better. Roselie has made friends and is often called on to teach card games to her fellow Sundial residents. While she was hospitalized, her neighbors and caretakers at Sundial visited her. She’s grateful to John for navigating through red tape to get her here. \u003c/p>\n",
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"\n\u003cp>Socially, things have gone better. Roselie has made friends and is often called on to teach card games to her fellow Sundial residents. While she was hospitalized, her neighbors and caretakers at Sundial visited her. She’s grateful to John for navigating through red tape to get her here. \u003c/p>\n"
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"innerHTML": "\n\u003cp>John worries about his sister’s health issues and whether Sundial will be a long-term solution for her. He’s gratified that his fight ended with his sister’s placement in their chosen facility. But he resents having to wage the battle.\u003c/p>\n",
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"\n\u003cp>John worries about his sister’s health issues and whether Sundial will be a long-term solution for her. He’s gratified that his fight ended with his sister’s placement in their chosen facility. But he resents having to wage the battle.\u003c/p>\n"
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"innerHTML": "\n\u003cp>“I don’t understand why I was the guy fighting for everybody,” John said. “I’m just one person trying to support myself, trying to take care of a family member.”\u003c/p>\n",
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"innerHTML": "\n\u003cp>\u003cem>Jessica Blough reported on this story while with the\u003c/em> \u003ca href=\"https://journalism.berkeley.edu/programs/mj/investigative-reporting/\">\u003cem>Investigative Reporting Program\u003c/em>\u003c/a> \u003cem>at UC Berkeley Journalism School, with a grant from\u003c/em> \u003ca href=\"https://www.thescanfoundation.org/\">\u003cem>The SCAN Foundation\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n",
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"excerpt": "A pilot program providing more assisted living coverage in rural California has emerged from one man’s fight to change his sister’s options.",
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"title": "Medi-Cal Won’t Pay for Assisted Living in Most of California. One Brother Fought Back | KQED",
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"headline": "Medi-Cal Won’t Pay for Assisted Living in Most of California. One Brother Fought Back",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>\u003cem>Welcome to CalMatters, the only nonprofit newsroom devoted solely to covering issues that affect all Californians. Sign up for \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/whatmatters\">WhatMatters\u003c/a> to receive the latest news and commentary on the most important issues in the Golden State.\u003c/em>\u003c/p>\n\n\n\n\u003cp>Last summer, siblings Roselie and John Aiello decided it was time for Roselie to leave her home of 73 years. \u003c/p>\n\n\n\n\u003cp>Raised on a cattle ranch in the small town of Mount Shasta, Roselie spent her life working as a butcher and handling animals, assisting her father until his death. When her three brothers moved away, she stayed at home on the ranch, with its winding dirt roads and green pastures. But over the years, the hard manual labor left her bones weak and her back curved, slowing her pace. \u003c/p>\n\n\n\n\u003cp>John moved back to the ranch in far \u003ca href=\"https://www.kqed.org/news/tag/northern-california\">Northern California\u003c/a> to take care of Roselie, who needed some assistance with showering and getting dressed. But these tasks began to weigh on John as he balanced his career as a writer with tending to the land, which was getting more difficult for Roselie to navigate. \u003c/p>\n\n\n\n\u003cp>The two siblings made a decision: Roselie, who qualified for Medicaid, would move into assisted living. John would find an appropriate place for her to live and receive care.\u003c/p>\n\n\n\n\u003cp>But when John tried to apply for assisted living benefits on his sister’s behalf, he found that Medi-Cal — California’s version of Medicaid — does not offer a waiver to pay for assisted living care in Siskiyou County, nor does it in 42 others across the state. Only \u003ca href=\"https://www.dhcs.ca.gov/services/long-term-care-alternatives-home-and-community-based-service-options/assisted-living-waiver/\">15 California counties\u003c/a>, most of them urban, offer this option.\u003c/p>\n\n\n\n\u003cp>This has created geographic disparity that gives aging adults in urban areas more options for care than those in rural areas, pushing Northern California seniors like Roselie Aiello into nursing homes or out of their communities, not because they need that level of care, but because they can’t afford to pay out of pocket for assisted living. \u003c/p>\n\n\n\n\u003cp>“You’re wasting money by dumping somebody like my sister in a skilled nursing facility and lessening her quality of life and her chance at doing better,” John said. “By doing this, it makes no fundamental sense.”\u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-gallery has-nested-images columns-default is-cropped wp-block-gallery-1 is-layout-flex wp-block-gallery-is-layout-flex\">\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12098658\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare2.jpg\" alt=\"\" class=\"wp-image-12098658\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare2.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare2-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare2-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Roselie Aiello at Sundial Assisted Living in Shasta County on March 25, 2026. \u003cbr> (Jessica Blough for CalMatters)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12098659\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare3.jpg\" alt=\"\" class=\"wp-image-12098659\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare3.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare3-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare3-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Roselie Aiello at Sundial Assisted Living in Shasta County on March 25, 2026. (Jessica Blough for CalMatters)\u003c/figcaption>\u003c/figure>\n\u003c/figure>\n\n\n\n\u003cp>In the coming decade, many more Californians may face the same predicament, given that one in four will be older than 60. As the state prepares for this explosion in the older adult population, it is prioritizing the ability to age in community-based settings like homes or assisted living facilities. \u003c/p>\n\n\n\n\u003cp>But availability of assisted living options varies county to county and is based on decisions by the various managed care providers contracted to deliver healthcare to the state’s lowest-income residents.\u003c/p>\n\n\n\n\u003cp>“There’s not a lot of options to begin with in rural counties. You take (the assisted living waiver) off a table, which already has a history of a long waiting list, and the options are pretty bleak,” said Maura Gibney, executive director of California Advocates for Nursing Home Reform.\u003c/p>\n\n\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr />\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/PCZuA/\" width=\"800\" height=\"800\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\n\n\n\u003cp>Partnership HealthPlan, which Roselie Aiello is enrolled in, contracts with the state to provide coverage to almost a million Californians on Medi-Cal, making it the largest Medi-Cal managed care plan in Northern California. It is the only Medi-Cal managed care plan available in a separate set of 15 California counties. \u003c/p>\n\n\n\n\u003cp>Managed care providers are encouraged, but not required, to offer as many “\u003ca href=\"https://calaim.dhcs.ca.gov/pages/community-supports\">community supports\u003c/a>” as they can, Tessa Outhyse, a spokesperson for the California Department of Health Care Services, said in an email. CalAIM, the state’s multiyear initiative to overhaul Medi-Cal, includes community supports such as assistance transitioning to an assisted living facility as well as transitional rent, caregiver respite and personal care services. \u003c/p>\n\n\n\n\u003cp>These services are intended to offer healthcare options to Medi-Cal members before their conditions escalate to needing more serious care, therefore saving money. Even when CalAIM’s current waivers expire at the end of the year, the community supports benefits will continue through the managed care plans. \u003c/p>\n\n\n\n\u003cp>When determining which supports to offer, managed care plans take into consideration provider availability and local capacity to offer care, Outhyse said. Partnership chose not to offer assisted living support based on financial factors and a lack of appropriate facilities in the rural areas where it provides care, said Dustin Lyda, spokesperson for the organization. \u003c/p>\n\n\n\n\u003cp>Lyda said any change in what the organization offers would require proof that assisted living facilities would be safer and healthier for members than nursing homes. But he acknowledged that options are more limited for rural members. \u003c/p>\n\n\n\n\u003cp>“There’s definitely a lot more work that we need to do on our end to navigate the more rural areas,” Lyda said. \u003c/p>\n\n\n\n\u003ch2 class=\"wp-block-heading\" id=\"hitting-roadblocks\">Hitting roadblocks\u003c/h2>\n\n\n\n\u003cp>When John Aiello heard about assisted living benefits through Medi-Cal, he saw it as the perfect match for his sister’s needs. He knew that he likely would have to move her out of Siskiyou County, where there was only one facility for Medi-Cal recipients, a nursing home.\u003c/p>\n\n\n\n\u003cp>Roselie had spent some time at an assisted living facility in neighboring Shasta County, which they saw as a better fit. But Partnership didn’t offer assisted living as a community support in that county. \u003c/p>\n\n\n\n\n\n\u003cp>Instead, the provider offered Roselie a waiver to go into assisted living in Sonoma County, which is about five hours from her home. The Aiellos turned that down, thinking it would not be good for Roselie. \u003c/p>\n\n\n\n\u003cp>“If you remove her totally from a family contact, she would not be thriving right now. She needs to see family,” John Aiello said. “When there were resources available that fit her needs in Redding — that’s the closest point to her home county — why do I need to move her to Oakland, to Los Angeles, to San Diego?”\u003c/p>\n\n\n\n\u003cp>Over the course of nine months, John sent dozens of emails and spent hours on phone calls to get Partnership HealthPlan to cover Roselie’s placement in assisted living. He had the support of her doctor and a spot for Roselie at the residence in Shasta County. \u003c/p>\n\n\n\n\u003cp>The process was so intense and frustrating that it drove a wedge between him and his sister in their final months of living together. \u003c/p>\n\n\n\n\u003cp>“He was doing all of this to help me,” Roselie said. “Where was it going to end?”\u003c/p>\n\n\n\n\u003ch2 class=\"wp-block-heading\" id=\"encouraged-or-required\">Encouraged or required? \u003c/h2>\n\n\n\n\u003cp>Most people prefer community-based services over skilled nursing care, which is \u003ca href=\"https://heller.brandeis.edu/community-living-policy/research-policy/publications/pdfs/briefs/hcbs-improve-outcomes-and-reduce-costs.pdf\">generally more expensive\u003c/a>. But nursing home beds are in short supply and should be reserved for those who truly need them, Gibney said.\u003c/p>\n\n\n\n\u003cp>“We really try to help people look at the other options that exist for remaining in the community,” Gibney said. “You’re going to have better health outcomes, better quality of care, if you can stay in the community and out of an institutional setting.”\u003c/p>\n\n\n\n\u003cp>Research indicates that while assisted living may provide better outcomes for some, people in assisted living are more likely than nursing home residents to be hospitalized, which can drive up costs, said Dr. Kenneth Lam, a geriatrician and assistant professor at the University of Colorado Anschutz Medical Campus. \u003c/p>\n\n\n\n\u003cp>“The evidence suggests that it’s a trade-off,” he said. \u003c/p>\n\n\n\n\n\n\u003cp>Contracts for managed care plans are not competitively bid, Outhyse said. And potential contractors aren’t asked to include specific community supports, such as assisted living, in their managed care plans.\u003c/p>\n\n\n\n\u003cp>“Whether a plan chooses to provide specific community supports is not a factor in contract renewal, which focuses instead on overall compliance with state and federal performance standards,” Outhyse wrote in the email.\u003c/p>\n\n\n\n\u003cp>Partnership’s contract with the state was set to expire in December, but will be extended until 2029 because the state \u003ca href=\"https://www.dhcs.ca.gov/services/Pages/ManagedCarePlanProcurementUpdate.aspx\">delayed\u003c/a> the process of soliciting managed care contracts. Lyda said Partnership is facing increasing demand for its community supports — which mainly address social needs, such as housing and food security — and for assisted living benefits. But even people in counties where the managed care provider offers an assisted living benefit can have a long wait for placement. \u003c/p>\n\n\n\n\u003cp>After years of constant increases, the number of Californians receiving an assisted living waiver for the first time dropped at the beginning of 2025, though the waitlist continued to climb. \u003c/p>\n\n\n\n\u003cp>By September, the number of Californians waiting for a waiver had surpassed the number of people who were being supported by it.\u003c/p>\n\n\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr />\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/kH9D7\" width=\"800\" height=\"800\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\n\n\n\u003cp>Gibney said that Medi-Cal members are often encouraged to get on the waitlist before applying for assisted living funding, which could contribute to the long wait. \u003c/p>\n\n\n\n\u003cp>Older adults might spend months on a waitlist, only to be told that they are ineligible for assisted living coverage. \u003c/p>\n\n\n\n\u003cp>“It’s a lot of shifting sand, that’s what people are finding themselves in the middle of,” Lam said. “They’re being told that they get to choose, but it’s a complex choice.”\u003c/p>\n\n\n\n\u003ch2 class=\"wp-block-heading\" id=\"a-new-home\">A new home\u003c/h2>\n\n\n\n\u003cp>In March, Roselie moved into her new home, Sundial Assisted Living, the Shasta County facility where she had previously spent some time. Two months earlier, Partnership had informed the Aiellos that it would cover Roselie’s assisted living care. \u003c/p>\n\n\n\n\u003cp>Partnership offered Roselie early access to a pilot program that launched on July 1, which extends the assisted living options to select members of the network. There will be no open application process, but members can ask to be considered or referred through a healthcare provider. \u003c/p>\n\n\n\n\u003cp>The goal is to discover if offering the assisted living option will provide better health outcomes at a lower price.\u003c/p>\n\n\n\n\u003cp>“Success would also be having these individuals being able to continue to receive care within their community setting, being in their home,” Lyda said. “We know that that is more impactful to health than being completely taken out of a familiar area.” \u003c/p>\n\n\n\n\u003cp>The adjustment has not been easy for Roselie. She has been hospitalized twice since she moved to Sundial and briefly entered a nursing home. \u003cs> \u003c/s>\u003c/p>\n\n\n\n\u003cp>Socially, things have gone better. Roselie has made friends and is often called on to teach card games to her fellow Sundial residents. While she was hospitalized, her neighbors and caretakers at Sundial visited her. She’s grateful to John for navigating through red tape to get her here. \u003c/p>\n\n\n\n\u003cp>“I’m looking at it like this: It’s a new adventure,” she said. \u003c/p>\n\n\n\n\u003cp>John worries about his sister’s health issues and whether Sundial will be a long-term solution for her. He’s gratified that his fight ended with his sister’s placement in their chosen facility. But he resents having to wage the battle.\u003c/p>\n\n\n\n\u003cp>“I don’t understand why I was the guy fighting for everybody,” John said. “I’m just one person trying to support myself, trying to take care of a family member.”\u003c/p>\n\n\n\n\u003cp>\u003cem>Jessica Blough reported on this story while with the\u003c/em> \u003ca href=\"https://journalism.berkeley.edu/programs/mj/investigative-reporting/\">\u003cem>Investigative Reporting Program\u003c/em>\u003c/a> \u003cem>at UC Berkeley Journalism School, with a grant from\u003c/em> \u003ca href=\"https://www.thescanfoundation.org/\">\u003cem>The SCAN Foundation\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "bay-area-nurses-protest-use-of-palantirs-ai-tech-at-hospitals",
"title": "Bay Area Nurses Protest Use of Palantir’s AI Tech at Hospitals",
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"content": "\n\u003cp>More than a hundred registered nurses in red union T-shirts blocked traffic and chanted outside \u003ca href=\"https://www.kqed.org/forum/2010101864924/a-deeper-look-into-palantir-technologies\">Palantir’s\u003c/a> former headquarters in Palo Alto on Thursday, calling on hospital executives and elected officials to cut ties with the artificial intelligence software and data analytics giant. \u003c/p>\n\n\n\n\u003cp>National Nurses United, which held similar protests in Los Angeles, Chicago, Washington, D.C. and four other cities, said the demonstrations were the union’s largest to date against Palantir, now based in the Miami area. \u003c/p>\n\n\n\n\u003cp>Nurses are worried that the company, which has won lucrative but controversial contracts with federal defense and immigration enforcement agencies, is expanding into healthcare.\u003c/p>\n\n\n\n\u003cp>Hospital executives at HCA Healthcare, one of the largest for-profit hospital operators in the U.S., have introduced Palantir’s AI-powered tools for nurse staffing and scheduling. New York’s Mount Sinai Health System uses the company’s products to evaluate patient records and determine which ones are eligible for at-home care, according to Palantir’s \u003ca href=\"https://www.palantir.com/offerings/palantir-for-hospitals/\">website\u003c/a>.\u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1500\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-03-KQED.jpg\" alt=\"\" class=\"wp-image-12097137\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-03-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-03-KQED-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-03-KQED-1536x1152.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Nurses place Band-Aids over photos of notes written by children detained by U.S. immigration agents at a protest against intelligence giant Palantir in Palo Alto on Aug. 27, 2026. (Courtesy of National Nurses United)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cp>Craig Cedotal, a pediatric nurse at Kaiser Oakland who previously worked at an HCA hospital in New Orleans, said nurses want more transparency and a greater say in the use of AI in hospitals, including Palantir’s platforms.\u003c/p>\n\n\n\n\u003cp>“It’s affecting staffing decisions and care decisions in ways that are not in line with what healthcare should be,” said Cedotal, one of the protesters in Palo Alto. “A machine should not make decisions about how we take care of each other. That is not good healthcare.”\u003c/p>\n\n\n\n\u003cp>Palantir did not respond to a request for comment. \u003c/p>\n\n\n\n\u003cp>In a \u003ca href=\"https://www.palantir.com/q2-2026-letter/en/\">letter to\u003c/a> shareholders this month, CEO Alex Karp said the company’s business has nearly doubled in a span of 12 months. Palantir earned nearly \u003ca href=\"https://investors.palantir.com/news-details/2026/Palantir-Reports-Q2-2026-U-S--Comm-Revenue-Growth-of-149-YY-and-Revenue-Growth-of-93-YY-Raises-FY-2026-Revenue-Guidance-to-82-YY-Growth-and-U-S--Comm-Revenue-Guidance-to-134-YY-Crushing-Consensus-Expectations/\">$2 billion\u003c/a> in net income, after expenses, during the first half of this year. \u003c/p>\n\n\n\n\n\n\u003cp>“The core of our business, in the United States, continues to expand at an unrelenting and breakneck pace,” Karp said. \u003c/p>\n\n\n\n\u003cp>On Thursday, California lawmakers approved a bill sponsored by the California Nurses Association that would establish some guardrails in the deployment of AI in patient care. \u003c/p>\n\n\n\n\u003cp>The \u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260ab1979\">bill\u003c/a>, by Assemblymember Mia Bonta, D-Oakland, would prohibit a health facility or doctor’s office from using an AI tool to perform any function that requires a professional license. Gov. Gavin Newsom is considering the proposed legislation.\u003c/p>\n\n\n\n\u003cp>Cedotal said that nurses at HCA hospitals have found the new automated staffing platform disruptive, with scheduling not always matching the needs of the day. The union contends the technology is exacerbating an understaffing crisis in the healthcare industry.\u003c/p>\n\n\n\n\u003cp>“The major concern is that humans are not involved in the equation,” said Cedotal, who has worked as a nurse for 32 years. The software “recommendations usually end up being something unfavorable for staffing or the nurses or patient care in general, or all three together.”\u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1500\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-04-KQED.jpg\" alt=\"\" class=\"wp-image-12097138\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-04-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-04-KQED-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-04-KQED-1536x1152.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Nurses block the street in Palo Alto outside the headquarters of artificial intelligence giant Palantir on Aug. 27, 2026. The actions cited the “deadly costs” of Palantir’s products, including its development and operation of ELITE, an application used by federal agents that identifies people for arrest using, in part, Medicaid data. (Courtesy of National Nurses United)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cp>\u003ca href=\"https://www.hcahealthcare.com/about\">HCA Healthcare\u003c/a>, which operates about 190 hospitals in the U.S. and the United Kingdom, did not respond to a request for comment. Good Samaritan Hospital in San José is affiliated with the company.\u003c/p>\n\n\n\n\u003cp>National Nurses United, which represents more than 225,000 members nationwide with affiliates like the California Nurses Association, is getting ready to begin contract negotiations with HCA, Kaiser Permanente and other major employers. \u003c/p>\n\n\n\n\u003cp>At the protest Thursday, the union joined community groups in criticizing Palantir for profiting from the Trump administration’s push to arrest and deport thousands of immigrants, and working with Israel’s Ministry of Defense to support its war in Gaza.\u003c/p>\n\n\n\n\u003cp>“Their technology has enabled the systematic destruction of hospitals, the killing of hundreds of healthcare workers, and the collapse of Gaza’s most vital infrastructure, how can we in good conscience place that same technology at the heart of U.S. healthcare facilities?” said Aisha Nizar with the Palestinian Youth Movement, in a statement. “Our message for the Bay Area is clear: Protect patients, stop fueling genocide, and cut ties with Palantir immediately.”\u003c/p>\n",
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"innerHTML": "\n\u003cp>National Nurses United, which held similar protests in Los Angeles, Chicago, Washington, D.C. and four other cities, said the demonstrations were the union’s largest to date against Palantir, now based in the Miami area. \u003c/p>\n",
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"innerHTML": "\n\u003cp>Nurses are worried that the company, which has won lucrative but controversial contracts with federal defense and immigration enforcement agencies, is expanding into healthcare.\u003c/p>\n",
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"innerHTML": "\n\u003cp>Hospital executives at HCA Healthcare, one of the largest for-profit hospital operators in the U.S., have introduced Palantir’s AI-powered tools for nurse staffing and scheduling. New York’s Mount Sinai Health System uses the company’s products to evaluate patient records and determine which ones are eligible for at-home care, according to Palantir’s \u003ca href=\"https://www.palantir.com/offerings/palantir-for-hospitals/\">website\u003c/a>.\u003c/p>\n",
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"\n\u003cp>Hospital executives at HCA Healthcare, one of the largest for-profit hospital operators in the U.S., have introduced Palantir’s AI-powered tools for nurse staffing and scheduling. New York’s Mount Sinai Health System uses the company’s products to evaluate patient records and determine which ones are eligible for at-home care, according to Palantir’s \u003ca href=\"https://www.palantir.com/offerings/palantir-for-hospitals/\">website\u003c/a>.\u003c/p>\n"
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"innerHTML": "\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-03-KQED.jpg\" alt=\"\" class=\"wp-image-12097137\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-03-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-03-KQED-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-03-KQED-1536x1152.jpg 1536w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\" />\u003cfigcaption class=\"wp-element-caption\">Nurses place Band-Aids over photos of notes written by children detained by U.S. immigration agents at a protest against intelligence giant Palantir in Palo Alto on Aug. 27, 2026.\u003ccite class=\"wp-inline-image-credit\"> (Courtesy of National Nurses United)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
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"\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-03-KQED.jpg\" alt=\"\" class=\"wp-image-12097137\" />\u003cfigcaption class=\"wp-element-caption\">Nurses place Band-Aids over photos of notes written by children detained by U.S. immigration agents at a protest against intelligence giant Palantir in Palo Alto on Aug. 27, 2026.\u003ccite class=\"wp-inline-image-credit\"> (Courtesy of National Nurses United)\u003c/cite>\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cp>Craig Cedotal, a pediatric nurse at Kaiser Oakland who previously worked at an HCA hospital in New Orleans, said nurses want more transparency and a greater say in the use of AI in hospitals, including Palantir’s platforms.\u003c/p>\n",
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"innerHTML": "\n\u003cp>“It’s affecting staffing decisions and care decisions in ways that are not in line with what healthcare should be,” said Cedotal, one of the protesters in Palo Alto. “A machine should not make decisions about how we take care of each other. That is not good healthcare.”\u003c/p>\n",
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"\n\u003cp>“It’s affecting staffing decisions and care decisions in ways that are not in line with what healthcare should be,” said Cedotal, one of the protesters in Palo Alto. “A machine should not make decisions about how we take care of each other. That is not good healthcare.”\u003c/p>\n"
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"innerHTML": "\n\u003cp>Palantir did not respond to a request for comment. \u003c/p>\n",
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"innerHTML": "\n\u003cp>In a \u003ca href=\"https://www.palantir.com/q2-2026-letter/en/\">letter to\u003c/a> shareholders this month, CEO Alex Karp said the company’s business has nearly doubled in a span of 12 months. Palantir earned nearly \u003ca href=\"https://investors.palantir.com/news-details/2026/Palantir-Reports-Q2-2026-U-S--Comm-Revenue-Growth-of-149-YY-and-Revenue-Growth-of-93-YY-Raises-FY-2026-Revenue-Guidance-to-82-YY-Growth-and-U-S--Comm-Revenue-Guidance-to-134-YY-Crushing-Consensus-Expectations/\">$2 billion\u003c/a> in net income, after expenses, during the first half of this year. \u003c/p>\n",
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"\n\u003cp>In a \u003ca href=\"https://www.palantir.com/q2-2026-letter/en/\">letter to\u003c/a> shareholders this month, CEO Alex Karp said the company’s business has nearly doubled in a span of 12 months. Palantir earned nearly \u003ca href=\"https://investors.palantir.com/news-details/2026/Palantir-Reports-Q2-2026-U-S--Comm-Revenue-Growth-of-149-YY-and-Revenue-Growth-of-93-YY-Raises-FY-2026-Revenue-Guidance-to-82-YY-Growth-and-U-S--Comm-Revenue-Guidance-to-134-YY-Crushing-Consensus-Expectations/\">$2 billion\u003c/a> in net income, after expenses, during the first half of this year. \u003c/p>\n"
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"innerHTML": "\n\u003cp>“The core of our business, in the United States, continues to expand at an unrelenting and breakneck pace,” Karp said. \u003c/p>\n",
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"innerHTML": "\n\u003cp>On Thursday, California lawmakers approved a bill sponsored by the California Nurses Association that would establish some guardrails in the deployment of AI in patient care. \u003c/p>\n",
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"innerHTML": "\n\u003cp>The \u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260ab1979\">bill\u003c/a>, by Assemblymember Mia Bonta, D-Oakland, would prohibit a health facility or doctor’s office from using an AI tool to perform any function that requires a professional license. Gov. Gavin Newsom is considering the proposed legislation.\u003c/p>\n",
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"\n\u003cp>The \u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260ab1979\">bill\u003c/a>, by Assemblymember Mia Bonta, D-Oakland, would prohibit a health facility or doctor’s office from using an AI tool to perform any function that requires a professional license. Gov. Gavin Newsom is considering the proposed legislation.\u003c/p>\n"
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"innerHTML": "\n\u003cp>Cedotal said that nurses at HCA hospitals have found the new automated staffing platform disruptive, with scheduling not always matching the needs of the day. The union contends the technology is exacerbating an understaffing crisis in the healthcare industry.\u003c/p>\n",
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"\n\u003cp>Cedotal said that nurses at HCA hospitals have found the new automated staffing platform disruptive, with scheduling not always matching the needs of the day. The union contends the technology is exacerbating an understaffing crisis in the healthcare industry.\u003c/p>\n"
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"innerHTML": "\n\u003cp>“The major concern is that humans are not involved in the equation,” said Cedotal, who has worked as a nurse for 32 years. The software “recommendations usually end up being something unfavorable for staffing or the nurses or patient care in general, or all three together.”\u003c/p>\n",
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"\n\u003cp>“The major concern is that humans are not involved in the equation,” said Cedotal, who has worked as a nurse for 32 years. The software “recommendations usually end up being something unfavorable for staffing or the nurses or patient care in general, or all three together.”\u003c/p>\n"
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"innerHTML": "\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-04-KQED.jpg\" alt=\"\" class=\"wp-image-12097138\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-04-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-04-KQED-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-04-KQED-1536x1152.jpg 1536w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\" />\u003cfigcaption class=\"wp-element-caption\">Nurses block the street in Palo Alto outside the headquarters of artificial intelligence giant Palantir on Aug. 27, 2026. The actions cited the “deadly costs” of Palantir’s products, including its development and operation of ELITE, an application used by federal agents that identifies people for arrest using, in part, Medicaid data.\u003ccite class=\"wp-inline-image-credit\"> (Courtesy of National Nurses United)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
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"\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-04-KQED.jpg\" alt=\"\" class=\"wp-image-12097138\" />\u003cfigcaption class=\"wp-element-caption\">Nurses block the street in Palo Alto outside the headquarters of artificial intelligence giant Palantir on Aug. 27, 2026. The actions cited the “deadly costs” of Palantir’s products, including its development and operation of ELITE, an application used by federal agents that identifies people for arrest using, in part, Medicaid data.\u003ccite class=\"wp-inline-image-credit\"> (Courtesy of National Nurses United)\u003c/cite>\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cp>\u003ca href=\"https://www.hcahealthcare.com/about\">HCA Healthcare\u003c/a>, which operates about 190 hospitals in the U.S. and the United Kingdom, did not respond to a request for comment. Good Samaritan Hospital in San José is affiliated with the company.\u003c/p>\n",
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"\n\u003cp>\u003ca href=\"https://www.hcahealthcare.com/about\">HCA Healthcare\u003c/a>, which operates about 190 hospitals in the U.S. and the United Kingdom, did not respond to a request for comment. Good Samaritan Hospital in San José is affiliated with the company.\u003c/p>\n"
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"innerHTML": "\n\u003cp>National Nurses United, which represents more than 225,000 members nationwide with affiliates like the California Nurses Association, is getting ready to begin contract negotiations with HCA, Kaiser Permanente and other major employers. \u003c/p>\n",
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"innerHTML": "\n\u003cp>At the protest Thursday, the union joined community groups in criticizing Palantir for profiting from the Trump administration’s push to arrest and deport thousands of immigrants, and working with Israel’s Ministry of Defense to support its war in Gaza.\u003c/p>\n",
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"innerHTML": "\n\u003cp>“Their technology has enabled the systematic destruction of hospitals, the killing of hundreds of healthcare workers, and the collapse of Gaza’s most vital infrastructure, how can we in good conscience place that same technology at the heart of U.S. healthcare facilities?” said Aisha Nizar with the Palestinian Youth Movement, in a statement. “Our message for the Bay Area is clear: Protect patients, stop fueling genocide, and cut ties with Palantir immediately.”\u003c/p>\n",
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"\n\u003cp>“Their technology has enabled the systematic destruction of hospitals, the killing of hundreds of healthcare workers, and the collapse of Gaza’s most vital infrastructure, how can we in good conscience place that same technology at the heart of U.S. healthcare facilities?” said Aisha Nizar with the Palestinian Youth Movement, in a statement. “Our message for the Bay Area is clear: Protect patients, stop fueling genocide, and cut ties with Palantir immediately.”\u003c/p>\n"
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"excerpt": "Nurses held protests in Palo Alto, Los Angeles and six other cities, calling on hospitals and elected officials to cut ties with the AI software and data analytics company.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>More than a hundred registered nurses in red union T-shirts blocked traffic and chanted outside \u003ca href=\"https://www.kqed.org/forum/2010101864924/a-deeper-look-into-palantir-technologies\">Palantir’s\u003c/a> former headquarters in Palo Alto on Thursday, calling on hospital executives and elected officials to cut ties with the artificial intelligence software and data analytics giant. \u003c/p>\n\n\n\n\u003cp>National Nurses United, which held similar protests in Los Angeles, Chicago, Washington, D.C. and four other cities, said the demonstrations were the union’s largest to date against Palantir, now based in the Miami area. \u003c/p>\n\n\n\n\u003cp>Nurses are worried that the company, which has won lucrative but controversial contracts with federal defense and immigration enforcement agencies, is expanding into healthcare.\u003c/p>\n\n\n\n\u003cp>Hospital executives at HCA Healthcare, one of the largest for-profit hospital operators in the U.S., have introduced Palantir’s AI-powered tools for nurse staffing and scheduling. New York’s Mount Sinai Health System uses the company’s products to evaluate patient records and determine which ones are eligible for at-home care, according to Palantir’s \u003ca href=\"https://www.palantir.com/offerings/palantir-for-hospitals/\">website\u003c/a>.\u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1500\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-03-KQED.jpg\" alt=\"\" class=\"wp-image-12097137\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-03-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-03-KQED-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-03-KQED-1536x1152.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Nurses place Band-Aids over photos of notes written by children detained by U.S. immigration agents at a protest against intelligence giant Palantir in Palo Alto on Aug. 27, 2026. (Courtesy of National Nurses United)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cp>Craig Cedotal, a pediatric nurse at Kaiser Oakland who previously worked at an HCA hospital in New Orleans, said nurses want more transparency and a greater say in the use of AI in hospitals, including Palantir’s platforms.\u003c/p>\n\n\n\n\u003cp>“It’s affecting staffing decisions and care decisions in ways that are not in line with what healthcare should be,” said Cedotal, one of the protesters in Palo Alto. “A machine should not make decisions about how we take care of each other. That is not good healthcare.”\u003c/p>\n\n\n\n\u003cp>Palantir did not respond to a request for comment. \u003c/p>\n\n\n\n\u003cp>In a \u003ca href=\"https://www.palantir.com/q2-2026-letter/en/\">letter to\u003c/a> shareholders this month, CEO Alex Karp said the company’s business has nearly doubled in a span of 12 months. Palantir earned nearly \u003ca href=\"https://investors.palantir.com/news-details/2026/Palantir-Reports-Q2-2026-U-S--Comm-Revenue-Growth-of-149-YY-and-Revenue-Growth-of-93-YY-Raises-FY-2026-Revenue-Guidance-to-82-YY-Growth-and-U-S--Comm-Revenue-Guidance-to-134-YY-Crushing-Consensus-Expectations/\">$2 billion\u003c/a> in net income, after expenses, during the first half of this year. \u003c/p>\n\n\n\n\n\n\u003cp>“The core of our business, in the United States, continues to expand at an unrelenting and breakneck pace,” Karp said. \u003c/p>\n\n\n\n\u003cp>On Thursday, California lawmakers approved a bill sponsored by the California Nurses Association that would establish some guardrails in the deployment of AI in patient care. \u003c/p>\n\n\n\n\u003cp>The \u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260ab1979\">bill\u003c/a>, by Assemblymember Mia Bonta, D-Oakland, would prohibit a health facility or doctor’s office from using an AI tool to perform any function that requires a professional license. Gov. Gavin Newsom is considering the proposed legislation.\u003c/p>\n\n\n\n\u003cp>Cedotal said that nurses at HCA hospitals have found the new automated staffing platform disruptive, with scheduling not always matching the needs of the day. The union contends the technology is exacerbating an understaffing crisis in the healthcare industry.\u003c/p>\n\n\n\n\u003cp>“The major concern is that humans are not involved in the equation,” said Cedotal, who has worked as a nurse for 32 years. The software “recommendations usually end up being something unfavorable for staffing or the nurses or patient care in general, or all three together.”\u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1500\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-04-KQED.jpg\" alt=\"\" class=\"wp-image-12097138\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-04-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-04-KQED-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/260827-Palantir-Nurses-04-KQED-1536x1152.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Nurses block the street in Palo Alto outside the headquarters of artificial intelligence giant Palantir on Aug. 27, 2026. The actions cited the “deadly costs” of Palantir’s products, including its development and operation of ELITE, an application used by federal agents that identifies people for arrest using, in part, Medicaid data. (Courtesy of National Nurses United)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cp>\u003ca href=\"https://www.hcahealthcare.com/about\">HCA Healthcare\u003c/a>, which operates about 190 hospitals in the U.S. and the United Kingdom, did not respond to a request for comment. Good Samaritan Hospital in San José is affiliated with the company.\u003c/p>\n\n\n\n\u003cp>National Nurses United, which represents more than 225,000 members nationwide with affiliates like the California Nurses Association, is getting ready to begin contract negotiations with HCA, Kaiser Permanente and other major employers. \u003c/p>\n\n\n\n\u003cp>At the protest Thursday, the union joined community groups in criticizing Palantir for profiting from the Trump administration’s push to arrest and deport thousands of immigrants, and working with Israel’s Ministry of Defense to support its war in Gaza.\u003c/p>\n\n\n\n\u003cp>“Their technology has enabled the systematic destruction of hospitals, the killing of hundreds of healthcare workers, and the collapse of Gaza’s most vital infrastructure, how can we in good conscience place that same technology at the heart of U.S. healthcare facilities?” said Aisha Nizar with the Palestinian Youth Movement, in a statement. “Our message for the Bay Area is clear: Protect patients, stop fueling genocide, and cut ties with Palantir immediately.”\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "theres-a-political-power-struggle-in-the-city-of-avenal",
"title": "There's a Political Power Struggle in the City of Avenal",
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"content": "\u003cp>\u003cstrong>Here are the morning’s top stories for Monday, July 27, 2026: \u003c/strong>\u003c/p>\n\n\n\n\u003cul class=\"wp-block-list\">\n\u003cli>The city of Avenal in Kings County \u003ca href=\"https://www.kvpr.org/government-politics/2026-07-24/lawsuits-recalled-council-members-a-self-appointed-mayor-who-is-in-charge-in-avenal\">is facing a political power struggle\u003c/a>. Voters recently recalled four council members, but the city is disputing the election results, and the only member who wasn’t recalled now claims he is the mayor. \u003c/li>\n\n\n\n\u003cli>Health care advocates are \u003ca href=\"https://www.kcbx.org/health-science-and-technology/2026-07-22/health-advocates-urge-stronger-oversight-of-hospital-costs-in-santa-barbara-county\">calling for stronger state oversight\u003c/a> over rising hospital costs in Santa Barbara County.\u003c/li>\n\n\n\n\u003cli>A team leading the closure of L.A. County’s aging Men’s Central Jail \u003ca href=\"https://laist.com/news/criminal-justice/mens-central-jail-closure-beyond-2031\">says people will have to be held there for at least five more years\u003c/a> even though the facility was supposed to close in 2021.\u003c/li>\n\n\n\n\u003cli>A judge has convicted a man of igniting the Park Fire in 2024, the largest wildfire that year and the fourth largest in the state’s history. He’s facing up to 25 years to life in prison for what prosecutors said was him pushing a burning car into an embankment, where the fire started. \u003c/li>\n\u003c/ul>\n\n\n\n\u003ch2 class=\"wp-block-heading\">\u003ca href=\"https://www.kvpr.org/government-politics/2026-07-24/lawsuits-recalled-council-members-a-self-appointed-mayor-who-is-in-charge-in-avenal\">A small Kings County community has big struggles\u003c/a>\u003c/h2>\n\n\n\n\u003cp>Arriving in Avenal, known as the “Pistachio Capital of the World,” nothing seems out of the ordinary at first. The streets are quiet. Residents are going about their daily routines, stopping at local businesses or chatting with neighbors.\u003c/p>\n\n\n\n\u003cp>The loudest sounds come from birds perched in the trees, and large pickup trucks that roll through.\u003c/p>\n\n\n\n\u003cp>But behind its small-town charm, Avenal has become the center of one of the most unusual political disputes unfolding anywhere in California. It’s a battle over city leadership that has divided residents, drawn legal scrutiny and raised questions about how local government should function.\u003c/p>\n\n\n\n\u003cp>It all started last year when elected officials in Avenal wanted to establish their \u003ca href=\"https://www.kvpr.org/government-politics/2026-03-29/lives-at-stake-a-fire-department-divides-a-california-town\" target=\"_blank\" rel=\"noreferrer noopener\">\u003cu>own fire department\u003c/u>\u003c/a>. At one point, the city was paying Kings County $425,000 each year for fire services, but last year, the county informed the city that the annual fee would increase to nearly $1.1 million.\u003c/p>\n\n\n\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Avenal officials, feeling the pinch of rising costs for fire services, ultimately pushed the city to consider creating its own fire department.\u003c/p>\n\n\n\n\u003cp>Kings County sued the City of Avenal for alleged \u003ca href=\"https://www.kvpr.org/government-politics/2026-03-29/lives-at-stake-a-fire-department-divides-a-california-town\" target=\"_blank\" rel=\"noreferrer noopener\">Brown Act violations\u003c/a> involving decisions made over the department. \u003c/p>\n\n\n\n\u003cp>The Registrar of Voters also certified the election results in May. Not all residents cast a vote, but of those who did, more than \u003ca href=\"https://www.kvpr.org/2026-05-29/in-avenal-four-of-five-city-councilmembers-ousted-in-citizen-led-recall-effort\" target=\"_blank\" rel=\"noreferrer noopener\">\u003cu>75% voted to oust\u003c/u>\u003c/a> Mayor Alvaro Preciado and Councilmembers Leticia Gamez, David Reynosa and Pablo Hernandez.\u003c/p>\n\n\n\n\u003cp>The officials who were recalled have contested the election results, saying the election wasn’t valid because it wasn’t ordered by the city.\u003c/p>\n\n\n\n\u003ch2 class=\"wp-block-heading\">\u003ca href=\"https://www.kcbx.org/health-science-and-technology/2026-07-22/health-advocates-urge-stronger-oversight-of-hospital-costs-in-santa-barbara-county\">Stronger health care oversight in Santa Barbara County\u003c/a>\u003c/h2>\n\n\n\n\u003cp>Health care advocates are calling for stronger state oversight of hospital costs in Santa Barbara County. During a virtual town hall last week hosted by Health Access California, advocates said rising hospital prices are driving up insurance premiums, deductibles and other out-of-pocket costs for patients.\u003c/p>\n\n\n\n\u003cp>The group released a report highlighting Santa Barbara Cottage Hospital as one of seven hospitals statewide — identified by California’s Office of Health Care Affordability — as unusually expensive.\u003c/p>\n\n\n\n\u003cp>According to the report, nearly 48,000 Santa Barbara County residents report having difficulty paying medical bills. Health Access California argues that high hospital prices contribute to rising health care costs across the region.\u003c/p>\n\n\n\n\u003cp>“When hospital prices go up, that directly impacts how much people are paying for their premiums, as well as their deductibles and other cost sharing,” said Katie Van Deynze, policy and legislative advocate for Health Access California.\u003c/p>\n\n\n\n\u003cp>The report says Santa Barbara Cottage Hospital receives payments from commercial insurers that are significantly higher than Medicare reimbursement rates for the same care.\u003c/p>\n\n\n\n\u003ch2 class=\"wp-block-heading\">\u003ca href=\"https://laist.com/news/criminal-justice/mens-central-jail-closure-beyond-2031\">Los Angeles jail operates longer\u003c/a>\u003c/h2>\n\n\n\n\u003cp>The team leading L.A. County’s push to close Men’s Central Jail says a full closure is not feasible in the next five years.\u003c/p>\n\n\n\n\u003cp>This is yet another delay since the county Board of Supervisors voted in July 2020 to close the jail within one year. A \u003ca href=\"https://file.lacounty.gov/SDSInter/bos/bc/1104568_DEVELO_1.PDF\" target=\"_blank\" rel=\"noreferrer noopener\">two-year \u003cu>plan\u003c/u>\u003c/a> was announced in 2021, then a \u003ca href=\"https://laist.com/news/criminal-justice/activists-frustrated-with-countys-5-year-plan-to-close-uninhabitable-mens-central-jail\">five-year plan\u003c/a> in 2024.\u003c/p>\n\n\n\n\u003cp>The Jail Closure Implementation Team, also known as JCIT, told the Board of Supervisors this week that they’ve outlined a framework that will improve conditions for thousands of people in L.A. County’s justice system, but the steps they’ve identified are still not enough to safely close the jail within the five-year timeline.\u003c/p>\n\n\n\n\u003ch2 class=\"wp-block-heading\">Park Fire conviction two years after the blaze started\u003c/h2>\n\n\n\n\u003cp>A judge convicted a Northern California man last week \u003ca href=\"https://www.kqed.org/news/11998589/park-fire-is-now-4th-largest-in-california-history-and-growing-amid-dangerous-weather\">of starting the fire that destroyed hundreds of homes and burned for hundreds of miles\u003c/a>. \u003c/p>\n\n\n\n\u003cp>Known as the \u003ca href=\"https://www.kqed.org/news/tag/park-fire\">Park Fire\u003c/a>, the 2024 blaze was started by what prosecutors say was Ronnie Stout II pushing his mom’s burning car into an embankment. The fire started there, authorities said. \u003c/p>\n\n\n\n\u003cp>Stout faces 25 years to life for the crimes, with enhancements from the state’s so-called “Three Strikes Law” and for arson with special circumstances. \u003c/p>\n\n\n\n\u003cp>A witness for the state said that Stout had physically pushed the burning car he had previously been driving, though Stout’s lawyer argued that the vehicle could have been in the embankment because of its own movement. \u003c/p>\n\n\n\n\u003cp>\u003c/p>\n\u003cp>Stout is scheduled to be sentenced on Oct. 9. \u003c/p>\n\n",
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"A team leading the closure of L.A. County’s aging Men’s Central Jail says people will have to be held there for at least five more years even though the facility was supposed to close in 2021.",
"A judge has convicted a man of igniting the Park Fire in 2024, the largest wildfire that year and the fourth largest in the state’s history. He’s facing up to 25 years to life in prison for what prosecutors said was him pushing a burning car into an embankment, where the fire started."
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"innerHTML": "\n\u003cli>The city of Avenal in Kings County \u003ca href=\"https://www.kvpr.org/government-politics/2026-07-24/lawsuits-recalled-council-members-a-self-appointed-mayor-who-is-in-charge-in-avenal\">is facing a political power struggle\u003c/a>. Voters recently recalled four council members, but the city is disputing the election results, and the only member who wasn’t recalled now claims he is the mayor. \u003c/li>\n",
"innerContent": [
"\n\u003cli>The city of Avenal in Kings County \u003ca href=\"https://www.kvpr.org/government-politics/2026-07-24/lawsuits-recalled-council-members-a-self-appointed-mayor-who-is-in-charge-in-avenal\">is facing a political power struggle\u003c/a>. Voters recently recalled four council members, but the city is disputing the election results, and the only member who wasn’t recalled now claims he is the mayor. \u003c/li>\n"
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"innerHTML": "\n\u003cli>Health care advocates are \u003ca href=\"https://www.kcbx.org/health-science-and-technology/2026-07-22/health-advocates-urge-stronger-oversight-of-hospital-costs-in-santa-barbara-county\">calling for stronger state oversight\u003c/a> over rising hospital costs in Santa Barbara County.\u003c/li>\n",
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"\n\u003cli>Health care advocates are \u003ca href=\"https://www.kcbx.org/health-science-and-technology/2026-07-22/health-advocates-urge-stronger-oversight-of-hospital-costs-in-santa-barbara-county\">calling for stronger state oversight\u003c/a> over rising hospital costs in Santa Barbara County.\u003c/li>\n"
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"innerHTML": "\n\u003cli>A team leading the closure of L.A. County’s aging Men’s Central Jail \u003ca href=\"https://laist.com/news/criminal-justice/mens-central-jail-closure-beyond-2031\">says people will have to be held there for at least five more years\u003c/a> even though the facility was supposed to close in 2021.\u003c/li>\n",
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"\n\u003cli>A team leading the closure of L.A. County’s aging Men’s Central Jail \u003ca href=\"https://laist.com/news/criminal-justice/mens-central-jail-closure-beyond-2031\">says people will have to be held there for at least five more years\u003c/a> even though the facility was supposed to close in 2021.\u003c/li>\n"
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"innerHTML": "\n\u003cli>A judge has convicted a man of igniting the Park Fire in 2024, the largest wildfire that year and the fourth largest in the state’s history. He’s facing up to 25 years to life in prison for what prosecutors said was him pushing a burning car into an embankment, where the fire started. \u003c/li>\n",
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"\n\u003cli>A judge has convicted a man of igniting the Park Fire in 2024, the largest wildfire that year and the fourth largest in the state’s history. He’s facing up to 25 years to life in prison for what prosecutors said was him pushing a burning car into an embankment, where the fire started. \u003c/li>\n"
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"text": "A small Kings County community has big struggles",
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"innerHTML": "\n\u003ch2 class=\"wp-block-heading\">\u003ca href=\"https://www.kvpr.org/government-politics/2026-07-24/lawsuits-recalled-council-members-a-self-appointed-mayor-who-is-in-charge-in-avenal\">A small Kings County community has big struggles\u003c/a>\u003c/h2>\n",
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"\n\u003ch2 class=\"wp-block-heading\">\u003ca href=\"https://www.kvpr.org/government-politics/2026-07-24/lawsuits-recalled-council-members-a-self-appointed-mayor-who-is-in-charge-in-avenal\">A small Kings County community has big struggles\u003c/a>\u003c/h2>\n"
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"innerHTML": "\n\u003cp>Arriving in Avenal, known as the “Pistachio Capital of the World,” nothing seems out of the ordinary at first. The streets are quiet. Residents are going about their daily routines, stopping at local businesses or chatting with neighbors.\u003c/p>\n",
"innerContent": [
"\n\u003cp>Arriving in Avenal, known as the “Pistachio Capital of the World,” nothing seems out of the ordinary at first. The streets are quiet. Residents are going about their daily routines, stopping at local businesses or chatting with neighbors.\u003c/p>\n"
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"innerHTML": "\n\u003cp>The loudest sounds come from birds perched in the trees, and large pickup trucks that roll through.\u003c/p>\n",
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"\n\u003cp>The loudest sounds come from birds perched in the trees, and large pickup trucks that roll through.\u003c/p>\n"
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"innerHTML": "\n\u003cp>But behind its small-town charm, Avenal has become the center of one of the most unusual political disputes unfolding anywhere in California. It’s a battle over city leadership that has divided residents, drawn legal scrutiny and raised questions about how local government should function.\u003c/p>\n",
"innerContent": [
"\n\u003cp>But behind its small-town charm, Avenal has become the center of one of the most unusual political disputes unfolding anywhere in California. It’s a battle over city leadership that has divided residents, drawn legal scrutiny and raised questions about how local government should function.\u003c/p>\n"
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"blockName": "core/paragraph",
"attrs": [],
"innerHTML": "\n\u003cp>It all started last year when elected officials in Avenal wanted to establish their \u003ca href=\"https://www.kvpr.org/government-politics/2026-03-29/lives-at-stake-a-fire-department-divides-a-california-town\" target=\"_blank\" rel=\"noreferrer noopener\">\u003cu>own fire department\u003c/u>\u003c/a>. At one point, the city was paying Kings County $425,000 each year for fire services, but last year, the county informed the city that the annual fee would increase to nearly $1.1 million.\u003c/p>\n",
"innerContent": [
"\n\u003cp>It all started last year when elected officials in Avenal wanted to establish their \u003ca href=\"https://www.kvpr.org/government-politics/2026-03-29/lives-at-stake-a-fire-department-divides-a-california-town\" target=\"_blank\" rel=\"noreferrer noopener\">\u003cu>own fire department\u003c/u>\u003c/a>. At one point, the city was paying Kings County $425,000 each year for fire services, but last year, the county informed the city that the annual fee would increase to nearly $1.1 million.\u003c/p>\n"
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"innerHTML": "\n\u003cp>Avenal officials, feeling the pinch of rising costs for fire services, ultimately pushed the city to consider creating its own fire department.\u003c/p>\n",
"innerContent": [
"\n\u003cp>Avenal officials, feeling the pinch of rising costs for fire services, ultimately pushed the city to consider creating its own fire department.\u003c/p>\n"
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"blockName": "core/paragraph",
"attrs": [],
"innerHTML": "\n\u003cp>Kings County sued the City of Avenal for alleged \u003ca href=\"https://www.kvpr.org/government-politics/2026-03-29/lives-at-stake-a-fire-department-divides-a-california-town\" target=\"_blank\" rel=\"noreferrer noopener\">Brown Act violations\u003c/a> involving decisions made over the department. \u003c/p>\n",
"innerContent": [
"\n\u003cp>Kings County sued the City of Avenal for alleged \u003ca href=\"https://www.kvpr.org/government-politics/2026-03-29/lives-at-stake-a-fire-department-divides-a-california-town\" target=\"_blank\" rel=\"noreferrer noopener\">Brown Act violations\u003c/a> involving decisions made over the department. \u003c/p>\n"
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"innerHTML": "\n\u003cp>The Registrar of Voters also certified the election results in May. Not all residents cast a vote, but of those who did, more than \u003ca href=\"https://www.kvpr.org/2026-05-29/in-avenal-four-of-five-city-councilmembers-ousted-in-citizen-led-recall-effort\" target=\"_blank\" rel=\"noreferrer noopener\">\u003cu>75% voted to oust\u003c/u>\u003c/a> Mayor Alvaro Preciado and Councilmembers Leticia Gamez, David Reynosa and Pablo Hernandez.\u003c/p>\n",
"innerContent": [
"\n\u003cp>The Registrar of Voters also certified the election results in May. Not all residents cast a vote, but of those who did, more than \u003ca href=\"https://www.kvpr.org/2026-05-29/in-avenal-four-of-five-city-councilmembers-ousted-in-citizen-led-recall-effort\" target=\"_blank\" rel=\"noreferrer noopener\">\u003cu>75% voted to oust\u003c/u>\u003c/a> Mayor Alvaro Preciado and Councilmembers Leticia Gamez, David Reynosa and Pablo Hernandez.\u003c/p>\n"
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"blockName": "core/paragraph",
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"innerHTML": "\n\u003cp>The officials who were recalled have contested the election results, saying the election wasn’t valid because it wasn’t ordered by the city.\u003c/p>\n",
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"\n\u003cp>The officials who were recalled have contested the election results, saying the election wasn’t valid because it wasn’t ordered by the city.\u003c/p>\n"
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"blockName": "core/heading",
"attrs": {
"text": "Stronger health care oversight in Santa Barbara County",
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"innerHTML": "\n\u003ch2 class=\"wp-block-heading\">\u003ca href=\"https://www.kcbx.org/health-science-and-technology/2026-07-22/health-advocates-urge-stronger-oversight-of-hospital-costs-in-santa-barbara-county\">Stronger health care oversight in Santa Barbara County\u003c/a>\u003c/h2>\n",
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"\n\u003ch2 class=\"wp-block-heading\">\u003ca href=\"https://www.kcbx.org/health-science-and-technology/2026-07-22/health-advocates-urge-stronger-oversight-of-hospital-costs-in-santa-barbara-county\">Stronger health care oversight in Santa Barbara County\u003c/a>\u003c/h2>\n"
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"innerHTML": "\n\u003cp>Health care advocates are calling for stronger state oversight of hospital costs in Santa Barbara County. During a virtual town hall last week hosted by Health Access California, advocates said rising hospital prices are driving up insurance premiums, deductibles and other out-of-pocket costs for patients.\u003c/p>\n",
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"\n\u003cp>Health care advocates are calling for stronger state oversight of hospital costs in Santa Barbara County. During a virtual town hall last week hosted by Health Access California, advocates said rising hospital prices are driving up insurance premiums, deductibles and other out-of-pocket costs for patients.\u003c/p>\n"
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"innerHTML": "\n\u003cp>The group released a report highlighting Santa Barbara Cottage Hospital as one of seven hospitals statewide — identified by California’s Office of Health Care Affordability — as unusually expensive.\u003c/p>\n",
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"innerHTML": "\n\u003cp>According to the report, nearly 48,000 Santa Barbara County residents report having difficulty paying medical bills. Health Access California argues that high hospital prices contribute to rising health care costs across the region.\u003c/p>\n",
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"innerHTML": "\n\u003cp>“When hospital prices go up, that directly impacts how much people are paying for their premiums, as well as their deductibles and other cost sharing,” said Katie Van Deynze, policy and legislative advocate for Health Access California.\u003c/p>\n",
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"innerHTML": "\n\u003cp>The report says Santa Barbara Cottage Hospital receives payments from commercial insurers that are significantly higher than Medicare reimbursement rates for the same care.\u003c/p>\n",
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"text": "Los Angeles jail operates longer",
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"innerHTML": "\n\u003cp>The team leading L.A. County’s push to close Men’s Central Jail says a full closure is not feasible in the next five years.\u003c/p>\n",
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"innerHTML": "\n\u003cp>This is yet another delay since the county Board of Supervisors voted in July 2020 to close the jail within one year. A \u003ca href=\"https://file.lacounty.gov/SDSInter/bos/bc/1104568_DEVELO_1.PDF\" target=\"_blank\" rel=\"noreferrer noopener\">two-year \u003cu>plan\u003c/u>\u003c/a> was announced in 2021, then a \u003ca href=\"https://laist.com/news/criminal-justice/activists-frustrated-with-countys-5-year-plan-to-close-uninhabitable-mens-central-jail\">five-year plan\u003c/a> in 2024.\u003c/p>\n",
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"innerHTML": "\n\u003cp>The Jail Closure Implementation Team, also known as JCIT, told the Board of Supervisors this week that they’ve outlined a framework that will improve conditions for thousands of people in L.A. County’s justice system, but the steps they’ve identified are still not enough to safely close the jail within the five-year timeline.\u003c/p>\n",
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"innerHTML": "\n\u003cp>A judge convicted a Northern California man last week \u003ca href=\"https://www.kqed.org/news/11998589/park-fire-is-now-4th-largest-in-california-history-and-growing-amid-dangerous-weather\">of starting the fire that destroyed hundreds of homes and burned for hundreds of miles\u003c/a>. \u003c/p>\n",
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"innerHTML": "\n\u003cp>Known as the \u003ca href=\"https://www.kqed.org/news/tag/park-fire\">Park Fire\u003c/a>, the 2024 blaze was started by what prosecutors say was Ronnie Stout II pushing his mom’s burning car into an embankment. The fire started there, authorities said. \u003c/p>\n",
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"innerHTML": "\n\u003cp>Stout faces 25 years to life for the crimes, with enhancements from the state’s so-called “Three Strikes Law” and for arson with special circumstances. \u003c/p>\n",
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"innerHTML": "\n\u003cp>A witness for the state said that Stout had physically pushed the burning car he had previously been driving, though Stout’s lawyer argued that the vehicle could have been in the embankment because of its own movement. \u003c/p>\n",
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"innerHTML": "\n\u003cp>Stout is scheduled to be sentenced on Oct. 9. \u003c/p>\n",
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"excerpt": "Voters in the small Kings County city of Avenal recently recalled four council members, but the city is disputing the election results, and the only member who wasn’t recalled now claims he is the mayor.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Here are the morning’s top stories for Monday, July 27, 2026: \u003c/strong>\u003c/p>\n\n\n\n\u003cul class=\"wp-block-list\">\n\u003cli>The city of Avenal in Kings County \u003ca href=\"https://www.kvpr.org/government-politics/2026-07-24/lawsuits-recalled-council-members-a-self-appointed-mayor-who-is-in-charge-in-avenal\">is facing a political power struggle\u003c/a>. Voters recently recalled four council members, but the city is disputing the election results, and the only member who wasn’t recalled now claims he is the mayor. \u003c/li>\n\n\n\n\u003cli>Health care advocates are \u003ca href=\"https://www.kcbx.org/health-science-and-technology/2026-07-22/health-advocates-urge-stronger-oversight-of-hospital-costs-in-santa-barbara-county\">calling for stronger state oversight\u003c/a> over rising hospital costs in Santa Barbara County.\u003c/li>\n\n\n\n\u003cli>A team leading the closure of L.A. County’s aging Men’s Central Jail \u003ca href=\"https://laist.com/news/criminal-justice/mens-central-jail-closure-beyond-2031\">says people will have to be held there for at least five more years\u003c/a> even though the facility was supposed to close in 2021.\u003c/li>\n\n\n\n\u003cli>A judge has convicted a man of igniting the Park Fire in 2024, the largest wildfire that year and the fourth largest in the state’s history. He’s facing up to 25 years to life in prison for what prosecutors said was him pushing a burning car into an embankment, where the fire started. \u003c/li>\n\u003c/ul>\n\n\n\n\u003ch2 class=\"wp-block-heading\">\u003ca href=\"https://www.kvpr.org/government-politics/2026-07-24/lawsuits-recalled-council-members-a-self-appointed-mayor-who-is-in-charge-in-avenal\">A small Kings County community has big struggles\u003c/a>\u003c/h2>\n\n\n\n\u003cp>Arriving in Avenal, known as the “Pistachio Capital of the World,” nothing seems out of the ordinary at first. The streets are quiet. Residents are going about their daily routines, stopping at local businesses or chatting with neighbors.\u003c/p>\n\n\n\n\u003cp>The loudest sounds come from birds perched in the trees, and large pickup trucks that roll through.\u003c/p>\n\n\n\n\u003cp>But behind its small-town charm, Avenal has become the center of one of the most unusual political disputes unfolding anywhere in California. It’s a battle over city leadership that has divided residents, drawn legal scrutiny and raised questions about how local government should function.\u003c/p>\n\n\n\n\u003cp>It all started last year when elected officials in Avenal wanted to establish their \u003ca href=\"https://www.kvpr.org/government-politics/2026-03-29/lives-at-stake-a-fire-department-divides-a-california-town\" target=\"_blank\" rel=\"noreferrer noopener\">\u003cu>own fire department\u003c/u>\u003c/a>. At one point, the city was paying Kings County $425,000 each year for fire services, but last year, the county informed the city that the annual fee would increase to nearly $1.1 million.\u003c/p>\n\n\n\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Avenal officials, feeling the pinch of rising costs for fire services, ultimately pushed the city to consider creating its own fire department.\u003c/p>\n\n\n\n\u003cp>Kings County sued the City of Avenal for alleged \u003ca href=\"https://www.kvpr.org/government-politics/2026-03-29/lives-at-stake-a-fire-department-divides-a-california-town\" target=\"_blank\" rel=\"noreferrer noopener\">Brown Act violations\u003c/a> involving decisions made over the department. \u003c/p>\n\n\n\n\u003cp>The Registrar of Voters also certified the election results in May. Not all residents cast a vote, but of those who did, more than \u003ca href=\"https://www.kvpr.org/2026-05-29/in-avenal-four-of-five-city-councilmembers-ousted-in-citizen-led-recall-effort\" target=\"_blank\" rel=\"noreferrer noopener\">\u003cu>75% voted to oust\u003c/u>\u003c/a> Mayor Alvaro Preciado and Councilmembers Leticia Gamez, David Reynosa and Pablo Hernandez.\u003c/p>\n\n\n\n\u003cp>The officials who were recalled have contested the election results, saying the election wasn’t valid because it wasn’t ordered by the city.\u003c/p>\n\n\n\n\u003ch2 class=\"wp-block-heading\">\u003ca href=\"https://www.kcbx.org/health-science-and-technology/2026-07-22/health-advocates-urge-stronger-oversight-of-hospital-costs-in-santa-barbara-county\">Stronger health care oversight in Santa Barbara County\u003c/a>\u003c/h2>\n\n\n\n\u003cp>Health care advocates are calling for stronger state oversight of hospital costs in Santa Barbara County. During a virtual town hall last week hosted by Health Access California, advocates said rising hospital prices are driving up insurance premiums, deductibles and other out-of-pocket costs for patients.\u003c/p>\n\n\n\n\u003cp>The group released a report highlighting Santa Barbara Cottage Hospital as one of seven hospitals statewide — identified by California’s Office of Health Care Affordability — as unusually expensive.\u003c/p>\n\n\n\n\u003cp>According to the report, nearly 48,000 Santa Barbara County residents report having difficulty paying medical bills. Health Access California argues that high hospital prices contribute to rising health care costs across the region.\u003c/p>\n\n\n\n\u003cp>“When hospital prices go up, that directly impacts how much people are paying for their premiums, as well as their deductibles and other cost sharing,” said Katie Van Deynze, policy and legislative advocate for Health Access California.\u003c/p>\n\n\n\n\u003cp>The report says Santa Barbara Cottage Hospital receives payments from commercial insurers that are significantly higher than Medicare reimbursement rates for the same care.\u003c/p>\n\n\n\n\u003ch2 class=\"wp-block-heading\">\u003ca href=\"https://laist.com/news/criminal-justice/mens-central-jail-closure-beyond-2031\">Los Angeles jail operates longer\u003c/a>\u003c/h2>\n\n\n\n\u003cp>The team leading L.A. County’s push to close Men’s Central Jail says a full closure is not feasible in the next five years.\u003c/p>\n\n\n\n\u003cp>This is yet another delay since the county Board of Supervisors voted in July 2020 to close the jail within one year. A \u003ca href=\"https://file.lacounty.gov/SDSInter/bos/bc/1104568_DEVELO_1.PDF\" target=\"_blank\" rel=\"noreferrer noopener\">two-year \u003cu>plan\u003c/u>\u003c/a> was announced in 2021, then a \u003ca href=\"https://laist.com/news/criminal-justice/activists-frustrated-with-countys-5-year-plan-to-close-uninhabitable-mens-central-jail\">five-year plan\u003c/a> in 2024.\u003c/p>\n\n\n\n\u003cp>The Jail Closure Implementation Team, also known as JCIT, told the Board of Supervisors this week that they’ve outlined a framework that will improve conditions for thousands of people in L.A. County’s justice system, but the steps they’ve identified are still not enough to safely close the jail within the five-year timeline.\u003c/p>\n\n\n\n\u003ch2 class=\"wp-block-heading\">Park Fire conviction two years after the blaze started\u003c/h2>\n\n\n\n\u003cp>A judge convicted a Northern California man last week \u003ca href=\"https://www.kqed.org/news/11998589/park-fire-is-now-4th-largest-in-california-history-and-growing-amid-dangerous-weather\">of starting the fire that destroyed hundreds of homes and burned for hundreds of miles\u003c/a>. \u003c/p>\n\n\n\n\u003cp>Known as the \u003ca href=\"https://www.kqed.org/news/tag/park-fire\">Park Fire\u003c/a>, the 2024 blaze was started by what prosecutors say was Ronnie Stout II pushing his mom’s burning car into an embankment. The fire started there, authorities said. \u003c/p>\n\n\n\n\u003cp>Stout faces 25 years to life for the crimes, with enhancements from the state’s so-called “Three Strikes Law” and for arson with special circumstances. \u003c/p>\n\n\n\n\u003cp>A witness for the state said that Stout had physically pushed the burning car he had previously been driving, though Stout’s lawyer argued that the vehicle could have been in the embankment because of its own movement. \u003c/p>\n\n\n\n\u003cp>\u003c/p>\n\u003cp>Stout is scheduled to be sentenced on Oct. 9. \u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>President Trump’s H.R. 1 policy bill made deep cuts to Medi-Cal, the state’s version of Medicaid. After weeks of debate in Sacramento over how to fund the program, Gov. Gavin Newsom signed a budget with a tax plan that could raise premiums by $100 a year for privately insured Californians. KQED’s Lesley McClurg and Guy Marzorati discuss why this has become such a political battleground.\u003c/p>\n\u003cp>Then, Lesley talks with KFF’s chief Washington correspondent Julie Rovner about the state of scientific research. The Trump administration is moving to give political appointees more power over who receives federal science and health grants, blocking funding for research that doesn’t align with the president’s policy priorities. Plus, Health and Human Services Secretary Robert F. Kennedy Jr. has escalated his fight with medical journals, calling them “corrupt” and threatening to prosecute them.\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=z71_cpIlPQc\u003c/p>\n\u003cp>Check out \u003ca href=\"https://www.kqed.org/newsletters/political-breakdown\">Political Breakdown’s weekly newsletter\u003c/a>, delivered straight to your inbox.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>President Trump’s H.R. 1 policy bill made deep cuts to Medi-Cal, the state’s version of Medicaid. After weeks of debate in Sacramento over how to fund the program, Gov. Gavin Newsom signed a budget with a tax plan that could raise premiums by $100 a year for privately insured Californians. KQED’s Lesley McClurg and Guy Marzorati discuss why this has become such a political battleground.\u003c/p>\n\u003cp>Then, Lesley talks with KFF’s chief Washington correspondent Julie Rovner about the state of scientific research. The Trump administration is moving to give political appointees more power over who receives federal science and health grants, blocking funding for research that doesn’t align with the president’s policy priorities. Plus, Health and Human Services Secretary Robert F. Kennedy Jr. has escalated his fight with medical journals, calling them “corrupt” and threatening to prosecute them.\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/z71_cpIlPQc'\n title='//www.youtube.com/embed/z71_cpIlPQc'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>Check out \u003ca href=\"https://www.kqed.org/newsletters/political-breakdown\">Political Breakdown’s weekly newsletter\u003c/a>, delivered straight to your inbox.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "San Francisco CEO Gets 6 Years for Scheme to Sell Adderall Online",
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"content": "\u003cp>A \u003ca href=\"https://www.kqed.org/news/tag/san-francisco\">San Francisco-based\u003c/a> telehealth company’s top executives were sentenced to years in prison on Tuesday over a $100 million scheme to fraudulently distribute Adderall and other stimulants.\u003c/p>\n\u003cp>Ruthia He, the founder and CEO of Done Global, and David Brody, its clinical president, were convicted of conspiring to commit healthcare fraud and distributing controlled substances to people without a medical need and conspiring to defraud pharmacies, along with Medicaid, Medicare and commercial insurers, to dispense stimulants in violation of their corresponding responsibilities.\u003c/p>\n\u003cp>He was handed down the six-year sentence, followed by three years of supervised release, though Judge Charles Breyer said she was likely to be deported after her release.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>He, who came to the U.S. from China 14 years ago, told the court tearfully that she had wanted to contribute and make a positive impact.\u003c/p>\n\u003cp>Brody, 70, was given a shorter two-year sentence, followed by three years of supervised release. His lawyer, Roberto Escobar, said he planned to appeal.\u003c/p>\n\u003cp>Prior to his sentencing, he said he was remorseful for his actions and asked to be sentenced to home confinement. His defense counsel said he had spent three decades providing mental-health care to underserved communities in San Francisco.\u003c/p>\n\u003cp>“I was faced with a challenging situational operation, and I chose poorly,” he told Breyer. “I relied too heavily on my own judgment. At the very moment when outside input would have made a crucial difference, I failed to engage others. I also owe an apology to the patients and staff of Done.”\u003c/p>\n\u003cfigure id=\"attachment_12003275\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12003275\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/USDeptofJusticeGetty.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/USDeptofJusticeGetty.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/USDeptofJusticeGetty-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/USDeptofJusticeGetty-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/USDeptofJusticeGetty-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/USDeptofJusticeGetty-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/USDeptofJusticeGetty-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The U.S. Department of Justice headquarters, pictured on Sept. 5, 2024. \u003ccite>(J. David Ake/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Both will be fined $1 million, in addition to restitution to the families of victims.\u003c/p>\n\u003cp>The pair spearheaded the online mental health treatment venture to provide easy access to Adderall, Vyvanse and other stimulants. The Department of Justice alleged that they took advantage of eased restrictions on prescribing controlled substances without in-person consultations amid the COVID-19 pandemic.\u003c/p>\n\u003cp>“The defendants allegedly preyed on Americans and put profits over patients by exploiting telemedicine rules that facilitated access to medications during the unprecedented COVID-19 public health emergency,” Anne Milgram, then-administrator of the Drug Enforcement Administration, said in a statement after their arrests.\u003c/p>\n\u003cp>Since the beginning of the pandemic, the company arranged for the prescription of more than 40 million pills, according to court documents.[aside postID=news_12089481 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/260420-SCCDAANNOUNCEMENT-17-BL-KQED-1536x1024.jpg']“Instead of properly addressing medical needs, the defendants allegedly made millions of dollars by pushing addictive medications,” Milgram said.\u003c/p>\n\u003cp>According to the company’s now-defunct website, Brody \u003ca href=\"https://pitchbook.com/profiles/company/442850-23\">co-founded\u003c/a> Done Global in 2019, calling it a “passion project” to help friends and coworkers in need of mental-health care navigate a complex system.\u003c/p>\n\u003cp>The startup promoted a quick and easy process to become a monthly subscriber: members completed a one-minute assessment, followed by a telehealth appointment with a licensed clinician before paying the $79 monthly fee for “worry-free refills” and ongoing care.\u003c/p>\n\u003cp>In 2022, major pharmacies stopped filling prescriptions from prescribers at Done, and another online mental health company, Cerebral — which also came under federal investigation — after reports that some healthcare professionals felt pressured into diagnoses. In 2024, Cerebral agreed to pay more than $3.6 million “for engaging in practices that encouraged the unauthorized distribution of controlled substances” as part of a \u003ca href=\"https://www.justice.gov/usao-edny/pr/telehealth-company-cerebral-agrees-pay-over-36-million-connection-business-practices\">non-prosecution agreement\u003c/a> with the U.S. Attorney’s Office in the Eastern District of New York.\u003c/p>\n\u003cp>Done faced similar scrutiny, and according to court documents, paid medical professionals to diagnose members with attention-deficit hyperactivity disorder and write them prescriptions for Adderall and other stimulants, even when people did not qualify for the medications.\u003c/p>\n\u003cp>He and Brody, among others at the company, created policies including limiting the information available to prescribers, instructing them to issue Adderall and other stimulants even if the Done member did not qualify, and limiting appointments to under 30 minutes.\u003c/p>\n\u003cp>The Department of Justice alleged that they falsely represented their prescription policies, claiming that they were able to keep appointments short with a screening process designed to weed out people who were unlikely to qualify for a diagnosis — a factor that could have diverted Adderall from people who needed it amid a nationwide shortage that began in 2022.\u003c/p>\n\u003cp>The DOJ also claimed that the company continued to operate even after He and Brody became aware that information had been posted on social media instructing people to use Done to gain easy access to stimulants — and that some members had overdosed and died.\u003c/p>\n\u003cp>On Tuesday, Kimberly Atwood told Breyer and the court that her brother Michael had died after he was misdiagnosed by a Done provider and relapsed.\u003c/p>\n\u003cp>“I have a mistrust of doctors now,” she said.\u003c/p>\n\u003cp>\u003cem>KQED’s \u003c/em>\u003ca href=\"https://www.kqed.org/author/adahlstromeckman\">\u003cem>Azul Dahlstrom-Eckman\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>\u003c/p>\n\u003cp>He, who came to the U.S. from China 14 years ago, told the court tearfully that she had wanted to contribute and make a positive impact.\u003c/p>\n\u003cp>Brody, 70, was given a shorter two-year sentence, followed by three years of supervised release. His lawyer, Roberto Escobar, said he planned to appeal.\u003c/p>\n\u003cp>Prior to his sentencing, he said he was remorseful for his actions and asked to be sentenced to home confinement. His defense counsel said he had spent three decades providing mental-health care to underserved communities in San Francisco.\u003c/p>\n\u003cp>“I was faced with a challenging situational operation, and I chose poorly,” he told Breyer. “I relied too heavily on my own judgment. At the very moment when outside input would have made a crucial difference, I failed to engage others. I also owe an apology to the patients and staff of Done.”\u003c/p>\n\u003cfigure id=\"attachment_12003275\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12003275\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/USDeptofJusticeGetty.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/USDeptofJusticeGetty.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/USDeptofJusticeGetty-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/USDeptofJusticeGetty-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/USDeptofJusticeGetty-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/USDeptofJusticeGetty-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/USDeptofJusticeGetty-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The U.S. Department of Justice headquarters, pictured on Sept. 5, 2024. \u003ccite>(J. David Ake/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Both will be fined $1 million, in addition to restitution to the families of victims.\u003c/p>\n\u003cp>The pair spearheaded the online mental health treatment venture to provide easy access to Adderall, Vyvanse and other stimulants. The Department of Justice alleged that they took advantage of eased restrictions on prescribing controlled substances without in-person consultations amid the COVID-19 pandemic.\u003c/p>\n\u003cp>“The defendants allegedly preyed on Americans and put profits over patients by exploiting telemedicine rules that facilitated access to medications during the unprecedented COVID-19 public health emergency,” Anne Milgram, then-administrator of the Drug Enforcement Administration, said in a statement after their arrests.\u003c/p>\n\u003cp>Since the beginning of the pandemic, the company arranged for the prescription of more than 40 million pills, according to court documents.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“Instead of properly addressing medical needs, the defendants allegedly made millions of dollars by pushing addictive medications,” Milgram said.\u003c/p>\n\u003cp>According to the company’s now-defunct website, Brody \u003ca href=\"https://pitchbook.com/profiles/company/442850-23\">co-founded\u003c/a> Done Global in 2019, calling it a “passion project” to help friends and coworkers in need of mental-health care navigate a complex system.\u003c/p>\n\u003cp>The startup promoted a quick and easy process to become a monthly subscriber: members completed a one-minute assessment, followed by a telehealth appointment with a licensed clinician before paying the $79 monthly fee for “worry-free refills” and ongoing care.\u003c/p>\n\u003cp>In 2022, major pharmacies stopped filling prescriptions from prescribers at Done, and another online mental health company, Cerebral — which also came under federal investigation — after reports that some healthcare professionals felt pressured into diagnoses. In 2024, Cerebral agreed to pay more than $3.6 million “for engaging in practices that encouraged the unauthorized distribution of controlled substances” as part of a \u003ca href=\"https://www.justice.gov/usao-edny/pr/telehealth-company-cerebral-agrees-pay-over-36-million-connection-business-practices\">non-prosecution agreement\u003c/a> with the U.S. Attorney’s Office in the Eastern District of New York.\u003c/p>\n\u003cp>Done faced similar scrutiny, and according to court documents, paid medical professionals to diagnose members with attention-deficit hyperactivity disorder and write them prescriptions for Adderall and other stimulants, even when people did not qualify for the medications.\u003c/p>\n\u003cp>He and Brody, among others at the company, created policies including limiting the information available to prescribers, instructing them to issue Adderall and other stimulants even if the Done member did not qualify, and limiting appointments to under 30 minutes.\u003c/p>\n\u003cp>The Department of Justice alleged that they falsely represented their prescription policies, claiming that they were able to keep appointments short with a screening process designed to weed out people who were unlikely to qualify for a diagnosis — a factor that could have diverted Adderall from people who needed it amid a nationwide shortage that began in 2022.\u003c/p>\n\u003cp>The DOJ also claimed that the company continued to operate even after He and Brody became aware that information had been posted on social media instructing people to use Done to gain easy access to stimulants — and that some members had overdosed and died.\u003c/p>\n\u003cp>On Tuesday, Kimberly Atwood told Breyer and the court that her brother Michael had died after he was misdiagnosed by a Done provider and relapsed.\u003c/p>\n\u003cp>“I have a mistrust of doctors now,” she said.\u003c/p>\n\u003cp>\u003cem>KQED’s \u003c/em>\u003ca href=\"https://www.kqed.org/author/adahlstromeckman\">\u003cem>Azul Dahlstrom-Eckman\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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"content": "\u003cp>When Congress allowed COVID-era subsidies for health insurance to expire, \u003ca href=\"https://www.kqed.org/news/tag/california\">California\u003c/a> used its own funds to offset the hike in Obamacare premium costs for residents with low incomes.\u003c/p>\n\u003cp>But the reach has been limited.\u003c/p>\n\u003cp>As Gov. Gavin Newsom negotiates his last budget with the legislature, the Democrat wants to offer financial help to more than 1 in 4 enrollees in Covered California, the nation’s largest state-run health insurance marketplace. Democratic lawmakers, who hold a supermajority, are still debating the plan.\u003c/p>\n\u003cp>“My budget proposal would KEEP $0 monthly plans for low-income Californians to help clean up the financial disaster Trump created,” Newsom \u003ca href=\"https://www.facebook.com/CAgovernor/posts/pfbid0D7ZbfX4NexjyjBrNuyXribDdCep4aDahzNSHaZX9g8Cnyu9MA7AaUAg99dxp7K7Sl\">posted on Facebook\u003c/a>, where he often chides the president and GOP Congress.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"https://stateline.org/2026/02/18/some-states-are-helping-to-make-obamacare-plans-more-affordable/\">Ten blue states\u003c/a> have put up their own funds to keep Affordable Care Act plans affordable and residents insured, as the rising cost of healthcare has emerged as a \u003ca href=\"https://www.kff.org/public-opinion/poll-the-cost-of-health-care-remains-at-the-top-of-the-publics-list-of-economic-concerns-even-as-concerns-about-gas-prices-climb/\">top concern\u003c/a> among voters. Newsom’s $300 million proposal would make California’s program among the most generous, but even the nation’s richest state can’t patch a \u003ca href=\"https://hbex.coveredca.com/data-research/library/Brief%201%20IRA%20ACA%20Premium%20Impacts%202026.pdf\">$2.5 billion hole\u003c/a> left by the expiration of enhanced subsidies at the end of last year.\u003c/p>\n\u003cp>“The gap between what people can pay in their monthly budget and what health insurance costs is so big that it’s a lot for states to take on,” said \u003ca href=\"https://www.commonwealthfund.org/person/stacey-pogue\">Stacey Pogue\u003c/a>, a senior research fellow at the Center on Health Insurance Reforms at Georgetown University. “They’re going to have to figure out how they can finance that.”\u003c/p>\n\u003cp>New Mexico lawmakers have \u003ca href=\"https://stateline.org/2026/02/18/some-states-are-helping-to-make-obamacare-plans-more-affordable/\">backfilled 100%\u003c/a> of the lost federal subsidies with state money. It seems to have worked; New Mexico saw \u003ca href=\"https://www.hca.nm.gov/2026/02/10/health-insurance-enrollment-up-in-new-mexico-amid-national-decline/\">double-digit increases\u003c/a> in marketplace enrollment this year, but state analysts \u003ca href=\"https://www.nmlegis.gov/Sessions/26%20Regular/firs/HB0004.PDF\">have warned\u003c/a> that the subsidy program isn’t sustainable.\u003c/p>\n\u003cfigure id=\"attachment_12040844\" class=\"wp-caption aligncenter\" style=\"max-width: 1760px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12040844\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/npr.brightspotcdn.jpg\" alt=\"\" width=\"1760\" height=\"1174\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/npr.brightspotcdn.jpg 1760w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/npr.brightspotcdn-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/npr.brightspotcdn-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/npr.brightspotcdn-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/npr.brightspotcdn-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 1760px) 100vw, 1760px\">\u003cfigcaption class=\"wp-caption-text\">Protesters gather outside Kern Medical Hospital in Bakersfield. They’re opposing proposed GOP cuts to Medicaid, which provides health insurance to lower-income Americans. \u003ccite>(Joshua Yeager/KVPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ca href=\"https://www.wgbh.org/news/politics/2026-01-08/massachusetts-spending-250-million-to-blunt-cost-increases-from-expired-health-care-subsidies\">Massachusetts\u003c/a> and \u003ca href=\"https://newjerseymonitor.com/2026/05/20/new-jersey-healthcare-fiscal-abyss/\">New Jersey\u003c/a>, which, like California, tax residents \u003ca href=\"https://www.kff.org/faqs/faqs-health-insurance-marketplace-and-the-aca/marketplace-basics/im-uninsured-am-i-required-to-get-health-insurance/\">for not having health insurance\u003c/a>, are also spending hundreds of millions of dollars to try to keep premium payments low. Their hope, healthcare experts say, is to avoid the exodus seen in states such as Georgia that didn’t offer enrollees help.\u003c/p>\n\u003cp>Since the enhanced subsidies expired, \u003ca href=\"https://www.kff.org/affordable-care-act/what-we-know-so-far-about-2026-aca-marketplace-enrollment-premiums-and-deductibles/\">enrollees nationwide\u003c/a> have seen their premium payments increase by $65 a month on average.\u003c/p>\n\u003cp>Conservatives, including \u003ca href=\"https://www.ocregister.com/2026/01/13/insurance-company-subsidies-are-no-prescription-for-lowering-healthcare-costs/\">congressional Republicans\u003c/a>, have long argued that the subsidy expansion was too generous to high-income enrollees and \u003ca href=\"https://www.facebook.com/reel/25473637075567865\">inflated healthcare costs\u003c/a>.\u003c/p>\n\u003cp>“There are never enough subsidies to make health insurance affordable because subsidies are the problem,” said Michael Cannon, director of health policy studies at the libertarian Cato Institute. “They are causing people to turn a blind eye to fraud and waste and excessive prices because it’s someone else’s money that they’re spending, not their own.”\u003c/p>\n\u003ch2>Helping the poorest?\u003c/h2>\n\u003cp>People who earn too much to qualify for Medicaid got relief starting in January after Newsom and legislators softened the blow for about 300,000 of the lowest-income enrollees. They offset lost federal premium tax credits for individuals who \u003ca href=\"https://board.coveredca.com/meetings/2026/May%2021,%202026/Presentation_2027_State_Premium_Subsidy_Program_Design.pdf\">earned up to $23,475\u003c/a> last year and partially filled the gap for those who earned up to $25,823.\u003c/p>\n\u003cp>The governor now wants to expand subsidies to those who earn up to $31,920 this year for an individual and $66,000 for a family of four — an estimated 218,000 additional people.\u003c/p>\n\u003cp>Veronica and William Walter, who live in the San Francisco Bay Area, earn less than $40,000 a year in one of the nation’s most expensive regions. They’re counting on a more generous state healthcare tax credit if they have to pay for health insurance next year.\u003c/p>\n\u003cfigure id=\"attachment_12086988\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12086988\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/06/PricedOutCA2.jpg\" alt=\"\" width=\"2000\" height=\"1500\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/06/PricedOutCA2.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/06/PricedOutCA2-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/06/PricedOutCA2-1536x1152.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Veronica Walter talks through her financial challenges while sitting at the dining table in her two-bedroom condo in Newark, California. Walter says she wouldn’t be able to afford the nearly $200 monthly premium for health insurance that she and her husband would likely pay on Covered California, even after a proposed expansion of state subsidies. \u003ccite>(Christine Mai-Duc/KFF Health News)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A car accident two years ago left William temporarily disabled, qualifying the couple for Medi-Cal, the state’s Medicaid program.\u003c/p>\n\u003cp>Now he’s back at work as a security guard, and Veronica said she’s worried they’ll be kicked off Medi-Cal. She’s even more worried about how they’ll get by with federal premium tax credits not nearly as generous as before.\u003c/p>\n\u003cp>“Without it, we’re going to be facing worse problems than we have now,” she said. Under Newsom’s proposal, Veronica and others in the highest eligible income bracket could receive an average monthly subsidy of $36 a person.[aside postID=news_12084761 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2026/05/IMG_1522.jpg']“For them, $36 a month is the sort of thing that can make a difference between keeping coverage and losing coverage,” said Peter Lee, former executive director of Covered California. “We can’t fix everything with that gap, but we can focus the dollars on those who need it most.”\u003c/p>\n\u003cp>The Walter family, though, may still face a nearly $200 monthly premium payment to cover both of them, $130 more than they previously paid for healthcare and prescriptions through Covered California.\u003c/p>\n\u003cp>“I can’t afford that, not really,” said Veronica, a pet sitter who works part-time at a school. “A giant state like this with this many people, and this many resources? You can’t just leave the people with nothing for healthcare or healthcare they can’t afford.”\u003c/p>\n\u003cp>California policy researchers and health advocates acknowledge the limits of a partial subsidy but say that concentrating funds on those who earn less is the most efficient way to maximize impact. People who drop coverage are \u003ca href=\"https://www.kff.org/affordable-care-act/what-we-know-so-far-about-2026-aca-marketplace-enrollment-premiums-and-deductibles/#:~:text=Declines%20in%20plan%20sign%2Dups%20for%20young%20adults%20ages%2018%20to%2034%20account%20for%20more%20of%20the%20decrease%20in%20ACA%20Marketplace%20plan%20selections%20than%20any%20other%20age%20group.\">often younger\u003c/a>, healthier, and less likely to have high healthcare costs — all factors that help stabilize the insurance risk pool. Without coverage, Lee said, they’re also more likely to experience debt from medical emergencies or leave unpaid hospital bills that strain the \u003ca href=\"https://lao.ca.gov/Publications/Report/5180\">taxpayer-funded safety net\u003c/a>.\u003c/p>\n\u003cp>Cary Sanders, senior policy director at the California Pan-Ethnic Health Network, a health advocacy group, said the state’s move last year kept low-income enrollment in Covered California steady and reduced racial disparities in coverage.\u003c/p>\n\u003cp>“It’s working; it’s just that it’s not enough,” Sanders said. “We need the federal subsidies back.”\u003c/p>\n\u003ch2>Still no help for many\u003c/h2>\n\u003cp>When Congress passed enhanced subsidies in 2021, it capped monthly premium payments for \u003ca href=\"https://kffhealthnews.org/health-industry/obamacare-premiums-subsidies-trump-republicans-policy-fallout-kff-analysis/\">even the highest earners\u003c/a> at 8.5% of income. Those temporary enhancements allowed about 8 million Americans to choose robust plans with no monthly premium payment last year and helped double Obamacare enrollment to \u003ca href=\"https://www.kff.org/affordable-care-act/enrollment-growth-in-the-aca-marketplaces/\">an all-time high\u003c/a> of 24 million.\u003c/p>\n\u003cp>At the end of last year, 22 million of them lost that help when the GOP Congress blocked the extension.\u003c/p>\n\u003cp>The pressures on Obamacare enrollees don’t stop at premiums. Federal legislation Republicans passed last summer, known as the \u003ca href=\"https://dmhc.ca.gov/Portals/0/Docs/OFR/FSSB/Feb2026/CoveredCaliforniaUpdate.pdf#page=11\">One Big Beautiful Bill Act\u003c/a>, also shortens enrollment windows, tightens income verification requirements for subsidies, and requires enrollees who earn more than they projected to pay back the full amount.\u003c/p>\n\u003cfigure id=\"attachment_12052592\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12052592\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/Covered-CA-lawn-sign.jpg\" alt=\"Una persona camina sobre la acera, a lado del patio de una casa donde está el letrero de Covered California.\" width=\"2000\" height=\"1232\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/Covered-CA-lawn-sign.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/Covered-CA-lawn-sign-160x99.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/Covered-CA-lawn-sign-1536x946.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Carteles de Covered California en Berkeley el 13 de enero de 2017. A partir del 31 de agosto, los beneficiarios de DACA ya no podrán encontrar planes de salud a través de Covered California. Hay algunas opciones limitadas disponibles. \u003ccite>(Lea Suzuki/The San Francisco Chronicle vía Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Even if Newsom’s proposal passes, most Covered California customers won’t get state help. Nearly 1 million enrollees — 52% — earn above the $31,300-a-year individual earning cutoff.\u003c/p>\n\u003cp>Victoria Garzouzi was one of many \u003ca href=\"https://kffhealthnews.org/health-care-costs/insurance-premium-payments-terminal-diagnosis-aca-subsidies-covered-california/\">middle-income retirees\u003c/a> hit with one of the most extreme premium increases: The monthly payment for her low-level bronze plan jumped eightfold to $1,600.\u003c/p>\n\u003cp>To make ends meet, she came out of retirement and dipped into her savings. “I’m working to pay for my insurance,” she said. “I am an army of one.”\u003c/p>\n\u003cp>Despite a $6,000 deductible, her health insurance premium payment is more than the mortgage on her two-bedroom house. She’s putting off a needed cataract surgery until October, when she turns 65 and qualifies for Medicare.\u003c/p>\n\u003cp>While GOP leaders have not publicly weighed in on the state subsidies, some Democratic lawmakers have questioned why more help hasn’t been proposed.[aside postID=news_12086370 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2026/06/MBC-profile-view-with-driver.jpg']Assembly member Dawn Addis, who chairs the chamber’s budget subcommittee on health, suggested Newsom could tap an additional $230 million from a fund for healthcare cost relief — money raised from a state penalty levied on those who can afford to enroll in health insurance but choose not to.\u003c/p>\n\u003cp>Lawmakers have \u003ca href=\"https://kffhealthnews.org/health-care-costs/california-stockpiles-penalties-from-uninsured-residents-instead-of-lowering-care-costs/\">previously criticized state officials\u003c/a> for socking away much of the penalty revenue, which was supposed to go toward healthcare affordability. After California discontinued its premium subsidies thanks to increased federal assistance, the Newsom administration said the state was saving to help consumers once those temporary subsidies expired. Instead, California borrowed from the subsidy fund to cover state budget shortfalls, to the tune of $771 million. Starting this year, the subsidy fund should see an influx of cash as the state pays back the loan.\u003c/p>\n\u003cp>At a May legislative hearing, Joseph Donaldson, then a Department of Finance analyst, said maintaining the reserve was a prudent and financially sustainable approach.\u003c/p>\n\u003cp>Dylan Roby, a public health professor at the University of California-Irvine who consults for Covered California, said the focus on lower-income enrollees is deliberate. They qualify for federal subsidies that higher earners don’t, maximizing federal investment and strengthening the broader system.\u003c/p>\n\u003cp>“You end up with more advanced premium tax credits flowing into the state that you would have been leaving on the table,” he said.\u003c/p>\n\u003cp>State lawmakers have until June 15 to pass a state budget. Then, Covered California’s board would decide eligibility and benefit amounts, a decision that could come this summer, with new subsidies starting Jan. 1.\u003c/p>\n\u003cp>Even with the extra help, Walter and her husband worry they won’t be able to afford a potential $200 monthly premium payment. Walter said she’d likely have to rely on free clinics or ration medications.\u003c/p>\n\u003cp>“I take so many pills, I rattle,” she said. “That, on top of the $200? For us, it really adds up.”\u003c/p>\n\u003cp>\u003cem>Are you struggling to afford your health insurance? Have you decided to forgo coverage? \u003c/em>\u003ca href=\"https://kffhealthnews.org/help-us-report-on-rising-insurance-costs/\">\u003cem>Click here\u003c/em>\u003c/a>\u003cem> to contact KFF Health News and share your story.\u003c/em>\u003c/p>\n\u003cp>\u003ca href=\"https://kffhealthnews.org/about-us/\">\u003cem>KFF Health News\u003c/em>\u003c/a>\u003cem> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at\u003c/em> \u003ca href=\"https://www.kff.org/about-us/\">\u003cem>KFF\u003c/em>\u003c/a>\u003cem> — the independent source for health policy research, polling, and journalism.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "California is considering expanding financial help for low-income residents struggling to pay high health insurance premiums after losing federal subsidies. But relief for state marketplace customers will be limited. Here’s who may get help and what it could mean for premiums.",
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"title": "1 in 4 Covered California Enrollees Could Get State Aid Under Newsom Proposal | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When Congress allowed COVID-era subsidies for health insurance to expire, \u003ca href=\"https://www.kqed.org/news/tag/california\">California\u003c/a> used its own funds to offset the hike in Obamacare premium costs for residents with low incomes.\u003c/p>\n\u003cp>But the reach has been limited.\u003c/p>\n\u003cp>As Gov. Gavin Newsom negotiates his last budget with the legislature, the Democrat wants to offer financial help to more than 1 in 4 enrollees in Covered California, the nation’s largest state-run health insurance marketplace. Democratic lawmakers, who hold a supermajority, are still debating the plan.\u003c/p>\n\u003cp>“My budget proposal would KEEP $0 monthly plans for low-income Californians to help clean up the financial disaster Trump created,” Newsom \u003ca href=\"https://www.facebook.com/CAgovernor/posts/pfbid0D7ZbfX4NexjyjBrNuyXribDdCep4aDahzNSHaZX9g8Cnyu9MA7AaUAg99dxp7K7Sl\">posted on Facebook\u003c/a>, where he often chides the president and GOP Congress.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://stateline.org/2026/02/18/some-states-are-helping-to-make-obamacare-plans-more-affordable/\">Ten blue states\u003c/a> have put up their own funds to keep Affordable Care Act plans affordable and residents insured, as the rising cost of healthcare has emerged as a \u003ca href=\"https://www.kff.org/public-opinion/poll-the-cost-of-health-care-remains-at-the-top-of-the-publics-list-of-economic-concerns-even-as-concerns-about-gas-prices-climb/\">top concern\u003c/a> among voters. Newsom’s $300 million proposal would make California’s program among the most generous, but even the nation’s richest state can’t patch a \u003ca href=\"https://hbex.coveredca.com/data-research/library/Brief%201%20IRA%20ACA%20Premium%20Impacts%202026.pdf\">$2.5 billion hole\u003c/a> left by the expiration of enhanced subsidies at the end of last year.\u003c/p>\n\u003cp>“The gap between what people can pay in their monthly budget and what health insurance costs is so big that it’s a lot for states to take on,” said \u003ca href=\"https://www.commonwealthfund.org/person/stacey-pogue\">Stacey Pogue\u003c/a>, a senior research fellow at the Center on Health Insurance Reforms at Georgetown University. “They’re going to have to figure out how they can finance that.”\u003c/p>\n\u003cp>New Mexico lawmakers have \u003ca href=\"https://stateline.org/2026/02/18/some-states-are-helping-to-make-obamacare-plans-more-affordable/\">backfilled 100%\u003c/a> of the lost federal subsidies with state money. It seems to have worked; New Mexico saw \u003ca href=\"https://www.hca.nm.gov/2026/02/10/health-insurance-enrollment-up-in-new-mexico-amid-national-decline/\">double-digit increases\u003c/a> in marketplace enrollment this year, but state analysts \u003ca href=\"https://www.nmlegis.gov/Sessions/26%20Regular/firs/HB0004.PDF\">have warned\u003c/a> that the subsidy program isn’t sustainable.\u003c/p>\n\u003cfigure id=\"attachment_12040844\" class=\"wp-caption aligncenter\" style=\"max-width: 1760px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12040844\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/npr.brightspotcdn.jpg\" alt=\"\" width=\"1760\" height=\"1174\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/npr.brightspotcdn.jpg 1760w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/npr.brightspotcdn-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/npr.brightspotcdn-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/npr.brightspotcdn-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/npr.brightspotcdn-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 1760px) 100vw, 1760px\">\u003cfigcaption class=\"wp-caption-text\">Protesters gather outside Kern Medical Hospital in Bakersfield. They’re opposing proposed GOP cuts to Medicaid, which provides health insurance to lower-income Americans. \u003ccite>(Joshua Yeager/KVPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ca href=\"https://www.wgbh.org/news/politics/2026-01-08/massachusetts-spending-250-million-to-blunt-cost-increases-from-expired-health-care-subsidies\">Massachusetts\u003c/a> and \u003ca href=\"https://newjerseymonitor.com/2026/05/20/new-jersey-healthcare-fiscal-abyss/\">New Jersey\u003c/a>, which, like California, tax residents \u003ca href=\"https://www.kff.org/faqs/faqs-health-insurance-marketplace-and-the-aca/marketplace-basics/im-uninsured-am-i-required-to-get-health-insurance/\">for not having health insurance\u003c/a>, are also spending hundreds of millions of dollars to try to keep premium payments low. Their hope, healthcare experts say, is to avoid the exodus seen in states such as Georgia that didn’t offer enrollees help.\u003c/p>\n\u003cp>Since the enhanced subsidies expired, \u003ca href=\"https://www.kff.org/affordable-care-act/what-we-know-so-far-about-2026-aca-marketplace-enrollment-premiums-and-deductibles/\">enrollees nationwide\u003c/a> have seen their premium payments increase by $65 a month on average.\u003c/p>\n\u003cp>Conservatives, including \u003ca href=\"https://www.ocregister.com/2026/01/13/insurance-company-subsidies-are-no-prescription-for-lowering-healthcare-costs/\">congressional Republicans\u003c/a>, have long argued that the subsidy expansion was too generous to high-income enrollees and \u003ca href=\"https://www.facebook.com/reel/25473637075567865\">inflated healthcare costs\u003c/a>.\u003c/p>\n\u003cp>“There are never enough subsidies to make health insurance affordable because subsidies are the problem,” said Michael Cannon, director of health policy studies at the libertarian Cato Institute. “They are causing people to turn a blind eye to fraud and waste and excessive prices because it’s someone else’s money that they’re spending, not their own.”\u003c/p>\n\u003ch2>Helping the poorest?\u003c/h2>\n\u003cp>People who earn too much to qualify for Medicaid got relief starting in January after Newsom and legislators softened the blow for about 300,000 of the lowest-income enrollees. They offset lost federal premium tax credits for individuals who \u003ca href=\"https://board.coveredca.com/meetings/2026/May%2021,%202026/Presentation_2027_State_Premium_Subsidy_Program_Design.pdf\">earned up to $23,475\u003c/a> last year and partially filled the gap for those who earned up to $25,823.\u003c/p>\n\u003cp>The governor now wants to expand subsidies to those who earn up to $31,920 this year for an individual and $66,000 for a family of four — an estimated 218,000 additional people.\u003c/p>\n\u003cp>Veronica and William Walter, who live in the San Francisco Bay Area, earn less than $40,000 a year in one of the nation’s most expensive regions. They’re counting on a more generous state healthcare tax credit if they have to pay for health insurance next year.\u003c/p>\n\u003cfigure id=\"attachment_12086988\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12086988\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/06/PricedOutCA2.jpg\" alt=\"\" width=\"2000\" height=\"1500\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/06/PricedOutCA2.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/06/PricedOutCA2-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/06/PricedOutCA2-1536x1152.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Veronica Walter talks through her financial challenges while sitting at the dining table in her two-bedroom condo in Newark, California. Walter says she wouldn’t be able to afford the nearly $200 monthly premium for health insurance that she and her husband would likely pay on Covered California, even after a proposed expansion of state subsidies. \u003ccite>(Christine Mai-Duc/KFF Health News)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A car accident two years ago left William temporarily disabled, qualifying the couple for Medi-Cal, the state’s Medicaid program.\u003c/p>\n\u003cp>Now he’s back at work as a security guard, and Veronica said she’s worried they’ll be kicked off Medi-Cal. She’s even more worried about how they’ll get by with federal premium tax credits not nearly as generous as before.\u003c/p>\n\u003cp>“Without it, we’re going to be facing worse problems than we have now,” she said. Under Newsom’s proposal, Veronica and others in the highest eligible income bracket could receive an average monthly subsidy of $36 a person.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“For them, $36 a month is the sort of thing that can make a difference between keeping coverage and losing coverage,” said Peter Lee, former executive director of Covered California. “We can’t fix everything with that gap, but we can focus the dollars on those who need it most.”\u003c/p>\n\u003cp>The Walter family, though, may still face a nearly $200 monthly premium payment to cover both of them, $130 more than they previously paid for healthcare and prescriptions through Covered California.\u003c/p>\n\u003cp>“I can’t afford that, not really,” said Veronica, a pet sitter who works part-time at a school. “A giant state like this with this many people, and this many resources? You can’t just leave the people with nothing for healthcare or healthcare they can’t afford.”\u003c/p>\n\u003cp>California policy researchers and health advocates acknowledge the limits of a partial subsidy but say that concentrating funds on those who earn less is the most efficient way to maximize impact. People who drop coverage are \u003ca href=\"https://www.kff.org/affordable-care-act/what-we-know-so-far-about-2026-aca-marketplace-enrollment-premiums-and-deductibles/#:~:text=Declines%20in%20plan%20sign%2Dups%20for%20young%20adults%20ages%2018%20to%2034%20account%20for%20more%20of%20the%20decrease%20in%20ACA%20Marketplace%20plan%20selections%20than%20any%20other%20age%20group.\">often younger\u003c/a>, healthier, and less likely to have high healthcare costs — all factors that help stabilize the insurance risk pool. Without coverage, Lee said, they’re also more likely to experience debt from medical emergencies or leave unpaid hospital bills that strain the \u003ca href=\"https://lao.ca.gov/Publications/Report/5180\">taxpayer-funded safety net\u003c/a>.\u003c/p>\n\u003cp>Cary Sanders, senior policy director at the California Pan-Ethnic Health Network, a health advocacy group, said the state’s move last year kept low-income enrollment in Covered California steady and reduced racial disparities in coverage.\u003c/p>\n\u003cp>“It’s working; it’s just that it’s not enough,” Sanders said. “We need the federal subsidies back.”\u003c/p>\n\u003ch2>Still no help for many\u003c/h2>\n\u003cp>When Congress passed enhanced subsidies in 2021, it capped monthly premium payments for \u003ca href=\"https://kffhealthnews.org/health-industry/obamacare-premiums-subsidies-trump-republicans-policy-fallout-kff-analysis/\">even the highest earners\u003c/a> at 8.5% of income. Those temporary enhancements allowed about 8 million Americans to choose robust plans with no monthly premium payment last year and helped double Obamacare enrollment to \u003ca href=\"https://www.kff.org/affordable-care-act/enrollment-growth-in-the-aca-marketplaces/\">an all-time high\u003c/a> of 24 million.\u003c/p>\n\u003cp>At the end of last year, 22 million of them lost that help when the GOP Congress blocked the extension.\u003c/p>\n\u003cp>The pressures on Obamacare enrollees don’t stop at premiums. Federal legislation Republicans passed last summer, known as the \u003ca href=\"https://dmhc.ca.gov/Portals/0/Docs/OFR/FSSB/Feb2026/CoveredCaliforniaUpdate.pdf#page=11\">One Big Beautiful Bill Act\u003c/a>, also shortens enrollment windows, tightens income verification requirements for subsidies, and requires enrollees who earn more than they projected to pay back the full amount.\u003c/p>\n\u003cfigure id=\"attachment_12052592\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12052592\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/Covered-CA-lawn-sign.jpg\" alt=\"Una persona camina sobre la acera, a lado del patio de una casa donde está el letrero de Covered California.\" width=\"2000\" height=\"1232\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/Covered-CA-lawn-sign.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/Covered-CA-lawn-sign-160x99.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/Covered-CA-lawn-sign-1536x946.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Carteles de Covered California en Berkeley el 13 de enero de 2017. A partir del 31 de agosto, los beneficiarios de DACA ya no podrán encontrar planes de salud a través de Covered California. Hay algunas opciones limitadas disponibles. \u003ccite>(Lea Suzuki/The San Francisco Chronicle vía Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Even if Newsom’s proposal passes, most Covered California customers won’t get state help. Nearly 1 million enrollees — 52% — earn above the $31,300-a-year individual earning cutoff.\u003c/p>\n\u003cp>Victoria Garzouzi was one of many \u003ca href=\"https://kffhealthnews.org/health-care-costs/insurance-premium-payments-terminal-diagnosis-aca-subsidies-covered-california/\">middle-income retirees\u003c/a> hit with one of the most extreme premium increases: The monthly payment for her low-level bronze plan jumped eightfold to $1,600.\u003c/p>\n\u003cp>To make ends meet, she came out of retirement and dipped into her savings. “I’m working to pay for my insurance,” she said. “I am an army of one.”\u003c/p>\n\u003cp>Despite a $6,000 deductible, her health insurance premium payment is more than the mortgage on her two-bedroom house. She’s putting off a needed cataract surgery until October, when she turns 65 and qualifies for Medicare.\u003c/p>\n\u003cp>While GOP leaders have not publicly weighed in on the state subsidies, some Democratic lawmakers have questioned why more help hasn’t been proposed.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Assembly member Dawn Addis, who chairs the chamber’s budget subcommittee on health, suggested Newsom could tap an additional $230 million from a fund for healthcare cost relief — money raised from a state penalty levied on those who can afford to enroll in health insurance but choose not to.\u003c/p>\n\u003cp>Lawmakers have \u003ca href=\"https://kffhealthnews.org/health-care-costs/california-stockpiles-penalties-from-uninsured-residents-instead-of-lowering-care-costs/\">previously criticized state officials\u003c/a> for socking away much of the penalty revenue, which was supposed to go toward healthcare affordability. After California discontinued its premium subsidies thanks to increased federal assistance, the Newsom administration said the state was saving to help consumers once those temporary subsidies expired. Instead, California borrowed from the subsidy fund to cover state budget shortfalls, to the tune of $771 million. Starting this year, the subsidy fund should see an influx of cash as the state pays back the loan.\u003c/p>\n\u003cp>At a May legislative hearing, Joseph Donaldson, then a Department of Finance analyst, said maintaining the reserve was a prudent and financially sustainable approach.\u003c/p>\n\u003cp>Dylan Roby, a public health professor at the University of California-Irvine who consults for Covered California, said the focus on lower-income enrollees is deliberate. They qualify for federal subsidies that higher earners don’t, maximizing federal investment and strengthening the broader system.\u003c/p>\n\u003cp>“You end up with more advanced premium tax credits flowing into the state that you would have been leaving on the table,” he said.\u003c/p>\n\u003cp>State lawmakers have until June 15 to pass a state budget. Then, Covered California’s board would decide eligibility and benefit amounts, a decision that could come this summer, with new subsidies starting Jan. 1.\u003c/p>\n\u003cp>Even with the extra help, Walter and her husband worry they won’t be able to afford a potential $200 monthly premium payment. Walter said she’d likely have to rely on free clinics or ration medications.\u003c/p>\n\u003cp>“I take so many pills, I rattle,” she said. “That, on top of the $200? For us, it really adds up.”\u003c/p>\n\u003cp>\u003cem>Are you struggling to afford your health insurance? Have you decided to forgo coverage? \u003c/em>\u003ca href=\"https://kffhealthnews.org/help-us-report-on-rising-insurance-costs/\">\u003cem>Click here\u003c/em>\u003c/a>\u003cem> to contact KFF Health News and share your story.\u003c/em>\u003c/p>\n\u003cp>\u003ca href=\"https://kffhealthnews.org/about-us/\">\u003cem>KFF Health News\u003c/em>\u003c/a>\u003cem> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at\u003c/em> \u003ca href=\"https://www.kff.org/about-us/\">\u003cem>KFF\u003c/em>\u003c/a>\u003cem> — the independent source for health policy research, polling, and journalism.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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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": {
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"source": "Commonwealth Club of California"
},
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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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.",
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"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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"order": 9
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"id": "freakonomics-radio",
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"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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},
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"id": "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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},
"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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},
"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
},
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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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"order": 18
},
"link": "/podcasts/jerrybrown",
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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/",
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"link": "/radio/program/latino-usa",
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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": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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},
"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": {
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"source": "WaitWhat"
},
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"rss": "https://rss.art19.com/masters-of-scale"
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},
"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",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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}
},
"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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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
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"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
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"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
}
},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
"airtime": "MON-FRI 3pm-4pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.pbs.org/newshour/",
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"source": "pbs"
},
"link": "/radio/program/pbs-newshour",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
}
},
"perspectives": {
"id": "perspectives",
"title": "Perspectives",
"tagline": "KQED's series of daily listener commentaries since 1991",
"info": "KQED's series of daily listener commentaries since 1991.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/01/Perspectives_Tile_Final.jpg",
"imageAlt": "KQED Perspectives",
"officialWebsiteLink": "/perspectives/",
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"source": "kqed",
"order": 14
},
"link": "/perspectives",
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"npr": "https://www.npr.org/podcasts/432309616/perspectives",
"rss": "https://ww2.kqed.org/perspectives/category/perspectives/feed/",
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},
"planet-money": {
"id": "planet-money",
"title": "Planet Money",
"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
"officialWebsiteLink": "https://www.npr.org/sections/money/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/planet-money",
"subscribe": {
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"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
"tuneIn": "https://tunein.com/podcasts/Business--Economics-Podcasts/Planet-Money-p164680/",
"rss": "https://feeds.npr.org/510289/podcast.xml"
}
},
"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Political Breakdown",
"officialWebsiteLink": "/podcasts/politicalbreakdown",
"meta": {
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"source": "kqed",
"order": 5
},
"link": "/podcasts/politicalbreakdown",
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"amazon": "https://music.amazon.com/podcasts/e0c2d153-ad36-4c8d-901d-f1da6a724824/political-breakdown",
"npr": "https://www.npr.org/podcasts/572155894/political-breakdown",
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