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"content": "\u003cp>Unlike many things from the Summer of Love, the Haight Ashbury Free Clinic survived. The clinic still operates out of a second-floor office overlooking Haight Street. You enter by way of a steep wooden staircase, which leads to a warren of small rooms. One exam room still has a wall covered by a faded psychedelic mural, featuring a collage of famous rock stars, naked bodies and peace signs.\u003c/p>\n\u003cp>The decor used to be even more colorful, according to lab manager Pam Olton. She has worked at the Free Clinic for more than 40 years.\u003c/p>\n\u003cp>“Pink, aqua, Day-Glo orange … all of these exam rooms were painted in those Day-Glo colors,” she said.\u003c/p>\n\u003cp>Olton explained the colors helped the hippies feel welcome, easing their drug-induced paranoia or reassuring them that the clinic was a safe space. In the summer of ’67, and for years after, the Free Clinic treated the countercultural denizens of the Haight-Ashbury neighborhood. They were often the patients that nobody else wanted.\u003c/p>\n\u003cp>[audio src=\"http://www.kqed.org/.stream/anon/radio/tcrmag/2017/08/TCRMag20170811a.mp3\" Image=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/08/RS26136_HAFMC-2-qut-800x494.jpg\" Title=\"How a 'Hippie Clinic' in the Haight-Ashbury Started a Medical Revolution\" program=\"The California Report\"]\u003c/p>\n\u003cp>“You had a big flash mob of kids coming to this neighborhood, from all over, from everywhere in America,” Olton said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Most were uninsured, and some were living in parks, on the street, or sharing crowded apartments.\u003c/p>\n\u003cp>“They’re kids, they’re dirty, they’re a mess and they’re addicted, but we have to take care of their medical needs first,” Olton said. “And we have to be nonjudgmental. They’re human beings, they’re somebody’s kid and we need to take care of them.”\u003c/p>\n\u003cfigure id=\"attachment_11615332\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/08/Free-Clinic-Pam-and-Mural-e1504305340780-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\" class=\"size-medium wp-image-11615332\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Pam-and-Mural-e1504305340780-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Pam-and-Mural-e1504305340780-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Pam-and-Mural-e1504305340780-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Pam-and-Mural-e1504305340780-1920x1440.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Pam-and-Mural-e1504305340780-1180x885.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Pam-and-Mural-e1504305340780-960x720.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Pam-and-Mural-e1504305340780-240x180.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Pam-and-Mural-e1504305340780-375x281.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Pam-and-Mural-e1504305340780-520x390.jpg 520w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Pam Olton, a lab manager and accupuncturist, has worked at the Haight Ashbury Free Clinics for more than 40 years. An exam room at the original location in the Haight still has a mural created by a grateful patient. \u003ccite>(Carrie Feibel/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Dr. David Smith was a young faculty member at UCSF when he started the free clinic 50 years ago. He’s now 78, but still works in addiction medicine.\u003c/p>\n\u003cfigure id=\"attachment_11611306\" class=\"wp-caption aligncenter\" style=\"max-width: 600px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11611306 size-full\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/08/RS26134_HAFMC-4-qut.jpg\" alt=\"\" width=\"600\" height=\"900\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26134_HAFMC-4-qut.jpg 600w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26134_HAFMC-4-qut-160x240.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26134_HAFMC-4-qut-240x360.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26134_HAFMC-4-qut-375x563.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26134_HAFMC-4-qut-520x780.jpg 520w\" sizes=\"auto, (max-width: 600px) 100vw, 600px\">\u003cfigcaption class=\"wp-caption-text\">Dr. David Smith stands outside the Haight Ashbury Free Medical Clinic circa 1975. The clinic still provides treatment today, and the iconic sign remains. \u003ccite>(Courtesy of David Smith Archives)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We were kind of the caregivers to the love generation,” he said. At the beginning of 1967, Smith had one foot in the world of academic medicine and one foot in the burgeoning counterculture. He lived in the Haight and had experimented with drugs.\u003c/p>\n\u003cp>“I had an LSD spiritual experience, and a vision that denial of health care to one segment of the population is a denial to all,” Smith recalled.\u003c/p>\n\u003cp>“So there was a transformation of me in that period, in ’67, like what happened to so many young people. I just happened to have a medical skill when that transformation occurred.”\u003c/p>\n\u003ch3>‘Health Care Is a Right, Not a Privilege’\u003c/h3>\n\u003cp>Smith knew that thousands of young adults would flood into San Francisco that summer, and he was worried not only about who would treat them, but how these young people would be treated by people in mainstream medicine.\u003c/p>\n\u003cp>“Some of us went to the city and said there’s going to be a huge problem this summer, and we need what we called then ‘a hippie clinic,’ ” Smith said. “And it was soundly rejected by the health department. They had no interest in this. They said, ‘We don’t want to take care of them. We want them to go away.’ ”\u003c/p>\n\u003cp>Smith and his colleagues, along with residents of the Haight, started getting ready anyway.\u003c/p>\n\u003cp>It was during one of their planning meetings when Smith stood up and declared: “Health care is a right, not a privilege.”\u003c/p>\n\u003cp>As far as he knows, Smith coined the phrase right then and there. “It became the founding slogan of our Haight Ashbury Free Clinic,” he said.\u003c/p>\n\u003cfigure id=\"attachment_11611312\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11611312 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/08/RS26140_HA2-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26140_HA2-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26140_HA2-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26140_HA2-qut-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26140_HA2-qut-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26140_HA2-qut-520x347.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26140_HA2-qut.jpg 900w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. David Smith (C), Dr. George ‘Skip’ Gay (R) and an unidentified man look over papers in an office at the Haight Ashbury Free Clinic. \u003ccite>(Courtesy of David Smith Archives)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The clinic opened on June 7, 1967, to a line of people stretching down the block. As Smith recalls, the team treated 250 people and worked through the night. The next day, the staff treated 350 people.\u003c/p>\n\u003cp>At that time, the staff was entirely volunteer — a mix of sympathetic doctors, progressive nurses and politically driven students from the medical and pharmacy schools.\u003c/p>\n\u003cp>Keeping the clinic going was a struggle. Public health officials opposed it. Money, for rent and supplies, was in short supply. Police officers would frequently show up and search the rooms, looking for illicit drugs and underage runaways.\u003c/p>\n\u003cp>But Smith was determined to keep the clinic open. The established medical institutions had made their disdain for the counterculture quite clear.\u003c/p>\n\u003ch3>Free of Charge, Free From Judgment\u003c/h3>\n\u003cp>If hippies hurt themselves, for example, lots of doctors thought they got what they deserved. Sometimes hospitals turned them away. And when they got sick from taking illegal drugs, or overdosed, or became psychotic, they were often shamed, restrained or thrown in jail.\u003c/p>\n\u003cp>But the Free Clinic offered a safe space.\u003c/p>\n\u003cp>“If you were taken to the Haight Ashbury Free Clinic, you would be put into a room with a tie-dye, and a talk-down guide, and a lava lamp,” he said. “You’d be examined by a physician to see if you needed medication to help you come down.”\u003c/p>\n\u003cp>And it was free. Not only free of charge, but also free from hierarchy, moral judgment and condescension.\u003c/p>\n\u003cfigure id=\"attachment_11611309\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11611309 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/08/RS26137_HAFMC-1-qut-e1502472021980-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26137_HAFMC-1-qut-e1502472021980-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26137_HAFMC-1-qut-e1502472021980-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26137_HAFMC-1-qut-e1502472021980-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26137_HAFMC-1-qut-e1502472021980-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26137_HAFMC-1-qut-e1502472021980-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26137_HAFMC-1-qut-e1502472021980-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26137_HAFMC-1-qut-e1502472021980-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26137_HAFMC-1-qut-e1502472021980-520x347.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26137_HAFMC-1-qut-e1502472021980.jpg 1756w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. David Smith (second from left) helps a young woman by bandaging her feet as part of the clinic’s street medicine in 1968. \u003ccite>(Courtesy of David Smith Archives)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>After the Summer of Love, the clinic continued to function as a medical refuge, offering help to alienated and traumatized Vietnam veterans, hard-core addicts, AIDS patients and the homeless.\u003c/p>\n\u003cp>Eric Smith remembers visiting the Free Clinic about 15 years ago. He was living on the streets of San Francisco and using heroin. He can’t remember why he went there for care, but he does remember what it felt like to be there.\u003c/p>\n\u003cp>“I went in there, there was a whole bunch of people hanging out. It was cool,” he said. They asked him, “How can we help you out?”\u003c/p>\n\u003cp>“People were eating,” he said. “Some girl asked if I was hungry. She brought me a vegetarian burrito.\u003c/p>\n\u003cp>“It was very welcoming and I didn’t feel nervous or ashamed being in there. You know? I felt like these are my people, they’ll help me out. I can be honest with them. I think that carries on right now.”\u003c/p>\n\u003ch3>Meeting Modern Challenges\u003c/h3>\n\u003cp>Eric Smith eventually got sober, and for the last two years has worked for the clinic as a patient coordinator. He is usually based at the clinic’s second location, a larger building in the Mission District of San Francisco.\u003c/p>\n\u003cp>When patients come to the clinic, Eric makes sure they are connected to the services they need — whether that’s medical or dental care, therapy, detox or a drug recovery program.\u003c/p>\n\u003cp>But he also walks the neighborhood, doing outreach.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘You want the best for everybody, but you can’t really push yourself too hard on them. You’ve got to meet them where they’re at.’\u003ccite>Eric Smith, Haight Ashbury Free Clinic\u003c/cite>\u003c/aside>\n\u003cp>He brings Narcan for opioid overdoses and a CPR mask. He has a big backpack full of snacks to hand out, along with gloves, socks, condoms and toothbrushes.\u003c/p>\n\u003cfigure id=\"attachment_11615319\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11615319\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/08/Free-Clinic-Eric-Smith-at-work-e1504304263652-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Eric-Smith-at-work-e1504304263652-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Eric-Smith-at-work-e1504304263652-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Eric-Smith-at-work-e1504304263652-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Eric-Smith-at-work-e1504304263652-1920x1440.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Eric-Smith-at-work-e1504304263652-1180x885.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Eric-Smith-at-work-e1504304263652-960x720.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Eric-Smith-at-work-e1504304263652-240x180.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Eric-Smith-at-work-e1504304263652-375x281.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Eric-Smith-at-work-e1504304263652-520x390.jpg 520w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Eric Smith shares socks, snacks and advice with Kat and Sean, who recently moved to San Francisco from Ukiah, in Mendocino County. “There’s businesses that will absolutely refuse to serve you if you’re homeless,” Sean said, explaining why they left Ukiah. “It’s actually nicer down here than it is up there. The homeless community is actually somewhat being taken care of.” \u003ccite>(Carrie Feibel/KQED )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>On the day I joined him for his rounds, Eric stopped by a row of tents on Folsom Street. Men gathered around as he passed out supplies.\u003c/p>\n\u003cp>“You guys know who I work with, right?” he asked as he handed out socks and granola bars. “So you guys need any services at all? Is there anything you need?”\u003c/p>\n\u003cp>None of the men were interested in visiting the clinic that day.\u003c/p>\n\u003cp>Eric just smiled and moved on. He told me no encounter is ever wasted.\u003c/p>\n\u003cp>“I have to build a trust and rapport with the individual, so they know no matter what they tell me, that it’s safe,” he said.\u003c/p>\n\u003cp>“You want the best for everybody, but you can’t really push yourself too hard on them,” he added. “You’ve got to meet them where they’re at, and in their time they’ll come around eventually, you hope.”\u003c/p>\n\u003cfigure id=\"attachment_11611310\" class=\"wp-caption alignright\" style=\"max-width: 355px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11611310\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut.jpg\" alt=\"\" width=\"355\" height=\"800\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut.jpg 355w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut-160x361.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut-240x541.jpg 240w\" sizes=\"auto, (max-width: 355px) 100vw, 355px\">\u003cfigcaption class=\"wp-caption-text\">This painted door marked the entrance to the detox clinic across the street from the Haight Ashbury Free Medical Clinic. \u003ccite>(Courtesy of David Smith archives)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Erie Street is just one block from the Haight Ashbury Free Clinic’s location in the Mission. District. It’s a long alleyway of sharp shadows and slants of sunlight. There was a tent at the far end, and a guy on a stepladder, spray-painting a mural on a large blank wall.\u003c/p>\n\u003cp>“It’s heartbreaking,” Eric said. “I used to get high in this alley, too.”\u003c/p>\n\u003cp>He nodded to a spot on the curb. “Right here.” He pointed to another: “Right here. So for someone who’s come from the pit, I actually really care. I feel for these individuals.”\u003c/p>\n\u003cp>But there was no time to dwell on that past, because Eric had spotted some new faces.\u003c/p>\n\u003cp>“Hey, guys,” he boomed, smiling and striding over. “You need any socks?”\u003c/p>\n\u003cp>A man and a woman were cuddling together sleepily with just thin sleeping bags against the hard sidewalk.\u003c/p>\n\u003cp>Nearby was a shopping cart stuffed with belongings and a cooler. A pit bull puppy flopped across their legs. They sat up and happily accepted everything Eric offered.\u003c/p>\n\u003cp>“Hey, so you guys, you guys need any medical attention at all?” Eric asked. “Do you got Medi-Cal?”\u003c/p>\n\u003cp>Sean and Kat are from Ukiah, in Mendocino County, and had been in San Francisco for only a month. They needed advice, and Eric had plenty: They talked about places to get day-old pastries, charities that offered free breakfast or lunch, or even showers. Eric pointed out the clinic. They discussed getting the puppy fixed at the SPCA.\u003c/p>\n\u003cp>“You guys use?” Eric asked. “I mean I’m an old junkie, all right?”\u003c/p>\n\u003cp>“We’re working on quitting,” Kat said.\u003c/p>\n\u003cp>“Oh what, heroin?”\u003c/p>\n\u003cp>“No,” said Sean.\u003c/p>\n\u003cp>“Meth?”\u003c/p>\n\u003cp>“Yeah.”\u003c/p>\n\u003cp>“Slamming it?”\u003c/p>\n\u003cp>“No.”\u003c/p>\n\u003cp>“Smoking?”\u003c/p>\n\u003cp>“Yeah, we smoke.”\u003c/p>\n\u003cp>Kat told Eric she used to slam, meaning she used to inject it. But after meeting Sean, she was able to stop that. He helped her “get off the needle.”\u003c/p>\n\u003cp>Eric jumped on this: “Really? So you guys are together. And you’re supporting one another, all right?”\u003c/p>\n\u003cp>Giving up the needle is a small step, but a positive one. It’s a little less harmful. Eric wanted them to know he gets it: They’re \u003ci>trying\u003c/i>.\u003c/p>\n\u003cp>“So you guys, come and talk to me, OK?” he told them. “Seriously, if you want help at all. I don’t care if you don’t want recovery or not, but just to know that there’s someone out there. I used to get high right here in this alley, dude, back in the day.”\u003c/p>\n\u003cp>The kind of care Eric is offering — nonjudgmental, patient, compassionate — goes straight back to the earliest days of the Haight Ashbury Free Clinic.\u003c/p>\n\u003cp>It’s an unremarkable approach these days, common in social services. But 50 years ago, before the Summer of Love, it was radical and new.\u003c/p>\n\u003ch3>Survival in Consolidation\u003c/h3>\n\u003cp>Today, the Haight Ashbury Free Clinics are part of an umbrella organization called \u003ca href=\"https://www.healthright360.org/\">HealthRIGHT 360\u003c/a>. It’s a large network of social service agencies, tackling a variety of problems besides health care: domestic abuse, rehabilitation for ex-inmates, gay, lesbian and transgender health, and addiction.\u003c/p>\n\u003cp>Consolidating with other agencies helped the Haight Ashbury Free Clinic survive.\u003c/p>\n\u003cp>Seven years ago, in 2010, it was struggling financially. Some staffers had been caught embezzling, and the clinic couldn’t afford the transition to electronic medical records, a new requirement of the Affordable Care Act.\u003c/p>\n\u003cp>In 2011, the Free Clinic joined forces with \u003ca href=\"https://www.healthright360.org/agency/walden-house\">\u003cspan style=\"font-weight: 400\">Walden House\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, a nearby addiction recovery center. Other nonprofits soon joined as well, and HealthRIGHT 360 became the umbrella brand, allowing the smaller agencies to pool resources for administration, electronic records and fundraising.\u003c/span>\u003c/p>\n\u003cp>[contextly_sidebar id=”NckxdwUTJRX5RxeRAHpp4vO0ZfgWRb0b”]\u003c/p>\n\u003cp>Dr. David Smith, who started it all, applauds the decision to consolidate with other nonprofits. But he does miss the intimacy of those early days, when volunteers from the neighborhood worked at the clinic.\u003c/p>\n\u003cp>When money got tight, there were benefit concerts featuring local bands like Big Brother and the Holding Company, during the time Janis Joplin was the lead singer.\u003c/p>\n\u003cp>Dr. Smith lived in the Haight, and so did Janis Joplin. He remembered the night he saved her life.\u003c/p>\n\u003cp>“There was somebody at our clinic that was close with her — her name was Sunshine,” he recalled. “It was near the Grateful Dead house, and we got a call that she’d overdosed. So we zipped up there with the Narcan and reversed her overdose.”\u003c/p>\n\u003cp>“She was a wonderful woman, a great singer, very involved in the community,” Smith said. “But she had a very serious addiction problem, bounced back and forth between heroin and alcohol.”\u003c/p>\n\u003cp>After the Summer of Love, free clinics opened in Seattle, L.A. and Berkeley. By the end of the ’60s, the U.S. had dozens of free clinics, a third of them in California.\u003c/p>\n\u003cp>All were founded on that simple principle Dr. Smith first articulated 50 years ago: Health care is a right, not a privilege. No matter how you look, dress or act.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“In other words, when you get treated in a humane way in the medical system, the spirit of the Summer of Love lives on,” Smith said.\u003c/p>\n\n",
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"title": "How a 'Hippie Clinic' in the Haight-Ashbury Started a Medical Revolution | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Unlike many things from the Summer of Love, the Haight Ashbury Free Clinic survived. The clinic still operates out of a second-floor office overlooking Haight Street. You enter by way of a steep wooden staircase, which leads to a warren of small rooms. One exam room still has a wall covered by a faded psychedelic mural, featuring a collage of famous rock stars, naked bodies and peace signs.\u003c/p>\n\u003cp>The decor used to be even more colorful, according to lab manager Pam Olton. She has worked at the Free Clinic for more than 40 years.\u003c/p>\n\u003cp>“Pink, aqua, Day-Glo orange … all of these exam rooms were painted in those Day-Glo colors,” she said.\u003c/p>\n\u003cp>Olton explained the colors helped the hippies feel welcome, easing their drug-induced paranoia or reassuring them that the clinic was a safe space. In the summer of ’67, and for years after, the Free Clinic treated the countercultural denizens of the Haight-Ashbury neighborhood. They were often the patients that nobody else wanted.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“You had a big flash mob of kids coming to this neighborhood, from all over, from everywhere in America,” Olton said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Most were uninsured, and some were living in parks, on the street, or sharing crowded apartments.\u003c/p>\n\u003cp>“They’re kids, they’re dirty, they’re a mess and they’re addicted, but we have to take care of their medical needs first,” Olton said. “And we have to be nonjudgmental. They’re human beings, they’re somebody’s kid and we need to take care of them.”\u003c/p>\n\u003cfigure id=\"attachment_11615332\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/08/Free-Clinic-Pam-and-Mural-e1504305340780-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\" class=\"size-medium wp-image-11615332\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Pam-and-Mural-e1504305340780-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Pam-and-Mural-e1504305340780-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Pam-and-Mural-e1504305340780-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Pam-and-Mural-e1504305340780-1920x1440.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Pam-and-Mural-e1504305340780-1180x885.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Pam-and-Mural-e1504305340780-960x720.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Pam-and-Mural-e1504305340780-240x180.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Pam-and-Mural-e1504305340780-375x281.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Pam-and-Mural-e1504305340780-520x390.jpg 520w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Pam Olton, a lab manager and accupuncturist, has worked at the Haight Ashbury Free Clinics for more than 40 years. An exam room at the original location in the Haight still has a mural created by a grateful patient. \u003ccite>(Carrie Feibel/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Dr. David Smith was a young faculty member at UCSF when he started the free clinic 50 years ago. He’s now 78, but still works in addiction medicine.\u003c/p>\n\u003cfigure id=\"attachment_11611306\" class=\"wp-caption aligncenter\" style=\"max-width: 600px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11611306 size-full\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/08/RS26134_HAFMC-4-qut.jpg\" alt=\"\" width=\"600\" height=\"900\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26134_HAFMC-4-qut.jpg 600w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26134_HAFMC-4-qut-160x240.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26134_HAFMC-4-qut-240x360.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26134_HAFMC-4-qut-375x563.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26134_HAFMC-4-qut-520x780.jpg 520w\" sizes=\"auto, (max-width: 600px) 100vw, 600px\">\u003cfigcaption class=\"wp-caption-text\">Dr. David Smith stands outside the Haight Ashbury Free Medical Clinic circa 1975. The clinic still provides treatment today, and the iconic sign remains. \u003ccite>(Courtesy of David Smith Archives)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We were kind of the caregivers to the love generation,” he said. At the beginning of 1967, Smith had one foot in the world of academic medicine and one foot in the burgeoning counterculture. He lived in the Haight and had experimented with drugs.\u003c/p>\n\u003cp>“I had an LSD spiritual experience, and a vision that denial of health care to one segment of the population is a denial to all,” Smith recalled.\u003c/p>\n\u003cp>“So there was a transformation of me in that period, in ’67, like what happened to so many young people. I just happened to have a medical skill when that transformation occurred.”\u003c/p>\n\u003ch3>‘Health Care Is a Right, Not a Privilege’\u003c/h3>\n\u003cp>Smith knew that thousands of young adults would flood into San Francisco that summer, and he was worried not only about who would treat them, but how these young people would be treated by people in mainstream medicine.\u003c/p>\n\u003cp>“Some of us went to the city and said there’s going to be a huge problem this summer, and we need what we called then ‘a hippie clinic,’ ” Smith said. “And it was soundly rejected by the health department. They had no interest in this. They said, ‘We don’t want to take care of them. We want them to go away.’ ”\u003c/p>\n\u003cp>Smith and his colleagues, along with residents of the Haight, started getting ready anyway.\u003c/p>\n\u003cp>It was during one of their planning meetings when Smith stood up and declared: “Health care is a right, not a privilege.”\u003c/p>\n\u003cp>As far as he knows, Smith coined the phrase right then and there. “It became the founding slogan of our Haight Ashbury Free Clinic,” he said.\u003c/p>\n\u003cfigure id=\"attachment_11611312\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11611312 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/08/RS26140_HA2-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26140_HA2-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26140_HA2-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26140_HA2-qut-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26140_HA2-qut-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26140_HA2-qut-520x347.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26140_HA2-qut.jpg 900w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. David Smith (C), Dr. George ‘Skip’ Gay (R) and an unidentified man look over papers in an office at the Haight Ashbury Free Clinic. \u003ccite>(Courtesy of David Smith Archives)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The clinic opened on June 7, 1967, to a line of people stretching down the block. As Smith recalls, the team treated 250 people and worked through the night. The next day, the staff treated 350 people.\u003c/p>\n\u003cp>At that time, the staff was entirely volunteer — a mix of sympathetic doctors, progressive nurses and politically driven students from the medical and pharmacy schools.\u003c/p>\n\u003cp>Keeping the clinic going was a struggle. Public health officials opposed it. Money, for rent and supplies, was in short supply. Police officers would frequently show up and search the rooms, looking for illicit drugs and underage runaways.\u003c/p>\n\u003cp>But Smith was determined to keep the clinic open. The established medical institutions had made their disdain for the counterculture quite clear.\u003c/p>\n\u003ch3>Free of Charge, Free From Judgment\u003c/h3>\n\u003cp>If hippies hurt themselves, for example, lots of doctors thought they got what they deserved. Sometimes hospitals turned them away. And when they got sick from taking illegal drugs, or overdosed, or became psychotic, they were often shamed, restrained or thrown in jail.\u003c/p>\n\u003cp>But the Free Clinic offered a safe space.\u003c/p>\n\u003cp>“If you were taken to the Haight Ashbury Free Clinic, you would be put into a room with a tie-dye, and a talk-down guide, and a lava lamp,” he said. “You’d be examined by a physician to see if you needed medication to help you come down.”\u003c/p>\n\u003cp>And it was free. Not only free of charge, but also free from hierarchy, moral judgment and condescension.\u003c/p>\n\u003cfigure id=\"attachment_11611309\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11611309 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/08/RS26137_HAFMC-1-qut-e1502472021980-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26137_HAFMC-1-qut-e1502472021980-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26137_HAFMC-1-qut-e1502472021980-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26137_HAFMC-1-qut-e1502472021980-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26137_HAFMC-1-qut-e1502472021980-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26137_HAFMC-1-qut-e1502472021980-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26137_HAFMC-1-qut-e1502472021980-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26137_HAFMC-1-qut-e1502472021980-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26137_HAFMC-1-qut-e1502472021980-520x347.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26137_HAFMC-1-qut-e1502472021980.jpg 1756w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. David Smith (second from left) helps a young woman by bandaging her feet as part of the clinic’s street medicine in 1968. \u003ccite>(Courtesy of David Smith Archives)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>After the Summer of Love, the clinic continued to function as a medical refuge, offering help to alienated and traumatized Vietnam veterans, hard-core addicts, AIDS patients and the homeless.\u003c/p>\n\u003cp>Eric Smith remembers visiting the Free Clinic about 15 years ago. He was living on the streets of San Francisco and using heroin. He can’t remember why he went there for care, but he does remember what it felt like to be there.\u003c/p>\n\u003cp>“I went in there, there was a whole bunch of people hanging out. It was cool,” he said. They asked him, “How can we help you out?”\u003c/p>\n\u003cp>“People were eating,” he said. “Some girl asked if I was hungry. She brought me a vegetarian burrito.\u003c/p>\n\u003cp>“It was very welcoming and I didn’t feel nervous or ashamed being in there. You know? I felt like these are my people, they’ll help me out. I can be honest with them. I think that carries on right now.”\u003c/p>\n\u003ch3>Meeting Modern Challenges\u003c/h3>\n\u003cp>Eric Smith eventually got sober, and for the last two years has worked for the clinic as a patient coordinator. He is usually based at the clinic’s second location, a larger building in the Mission District of San Francisco.\u003c/p>\n\u003cp>When patients come to the clinic, Eric makes sure they are connected to the services they need — whether that’s medical or dental care, therapy, detox or a drug recovery program.\u003c/p>\n\u003cp>But he also walks the neighborhood, doing outreach.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘You want the best for everybody, but you can’t really push yourself too hard on them. You’ve got to meet them where they’re at.’\u003ccite>Eric Smith, Haight Ashbury Free Clinic\u003c/cite>\u003c/aside>\n\u003cp>He brings Narcan for opioid overdoses and a CPR mask. He has a big backpack full of snacks to hand out, along with gloves, socks, condoms and toothbrushes.\u003c/p>\n\u003cfigure id=\"attachment_11615319\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11615319\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/08/Free-Clinic-Eric-Smith-at-work-e1504304263652-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Eric-Smith-at-work-e1504304263652-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Eric-Smith-at-work-e1504304263652-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Eric-Smith-at-work-e1504304263652-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Eric-Smith-at-work-e1504304263652-1920x1440.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Eric-Smith-at-work-e1504304263652-1180x885.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Eric-Smith-at-work-e1504304263652-960x720.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Eric-Smith-at-work-e1504304263652-240x180.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Eric-Smith-at-work-e1504304263652-375x281.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/Free-Clinic-Eric-Smith-at-work-e1504304263652-520x390.jpg 520w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Eric Smith shares socks, snacks and advice with Kat and Sean, who recently moved to San Francisco from Ukiah, in Mendocino County. “There’s businesses that will absolutely refuse to serve you if you’re homeless,” Sean said, explaining why they left Ukiah. “It’s actually nicer down here than it is up there. The homeless community is actually somewhat being taken care of.” \u003ccite>(Carrie Feibel/KQED )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>On the day I joined him for his rounds, Eric stopped by a row of tents on Folsom Street. Men gathered around as he passed out supplies.\u003c/p>\n\u003cp>“You guys know who I work with, right?” he asked as he handed out socks and granola bars. “So you guys need any services at all? Is there anything you need?”\u003c/p>\n\u003cp>None of the men were interested in visiting the clinic that day.\u003c/p>\n\u003cp>Eric just smiled and moved on. He told me no encounter is ever wasted.\u003c/p>\n\u003cp>“I have to build a trust and rapport with the individual, so they know no matter what they tell me, that it’s safe,” he said.\u003c/p>\n\u003cp>“You want the best for everybody, but you can’t really push yourself too hard on them,” he added. “You’ve got to meet them where they’re at, and in their time they’ll come around eventually, you hope.”\u003c/p>\n\u003cfigure id=\"attachment_11611310\" class=\"wp-caption alignright\" style=\"max-width: 355px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11611310\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut.jpg\" alt=\"\" width=\"355\" height=\"800\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut.jpg 355w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut-160x361.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut-240x541.jpg 240w\" sizes=\"auto, (max-width: 355px) 100vw, 355px\">\u003cfigcaption class=\"wp-caption-text\">This painted door marked the entrance to the detox clinic across the street from the Haight Ashbury Free Medical Clinic. \u003ccite>(Courtesy of David Smith archives)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Erie Street is just one block from the Haight Ashbury Free Clinic’s location in the Mission. District. It’s a long alleyway of sharp shadows and slants of sunlight. There was a tent at the far end, and a guy on a stepladder, spray-painting a mural on a large blank wall.\u003c/p>\n\u003cp>“It’s heartbreaking,” Eric said. “I used to get high in this alley, too.”\u003c/p>\n\u003cp>He nodded to a spot on the curb. “Right here.” He pointed to another: “Right here. So for someone who’s come from the pit, I actually really care. I feel for these individuals.”\u003c/p>\n\u003cp>But there was no time to dwell on that past, because Eric had spotted some new faces.\u003c/p>\n\u003cp>“Hey, guys,” he boomed, smiling and striding over. “You need any socks?”\u003c/p>\n\u003cp>A man and a woman were cuddling together sleepily with just thin sleeping bags against the hard sidewalk.\u003c/p>\n\u003cp>Nearby was a shopping cart stuffed with belongings and a cooler. A pit bull puppy flopped across their legs. They sat up and happily accepted everything Eric offered.\u003c/p>\n\u003cp>“Hey, so you guys, you guys need any medical attention at all?” Eric asked. “Do you got Medi-Cal?”\u003c/p>\n\u003cp>Sean and Kat are from Ukiah, in Mendocino County, and had been in San Francisco for only a month. They needed advice, and Eric had plenty: They talked about places to get day-old pastries, charities that offered free breakfast or lunch, or even showers. Eric pointed out the clinic. They discussed getting the puppy fixed at the SPCA.\u003c/p>\n\u003cp>“You guys use?” Eric asked. “I mean I’m an old junkie, all right?”\u003c/p>\n\u003cp>“We’re working on quitting,” Kat said.\u003c/p>\n\u003cp>“Oh what, heroin?”\u003c/p>\n\u003cp>“No,” said Sean.\u003c/p>\n\u003cp>“Meth?”\u003c/p>\n\u003cp>“Yeah.”\u003c/p>\n\u003cp>“Slamming it?”\u003c/p>\n\u003cp>“No.”\u003c/p>\n\u003cp>“Smoking?”\u003c/p>\n\u003cp>“Yeah, we smoke.”\u003c/p>\n\u003cp>Kat told Eric she used to slam, meaning she used to inject it. But after meeting Sean, she was able to stop that. He helped her “get off the needle.”\u003c/p>\n\u003cp>Eric jumped on this: “Really? So you guys are together. And you’re supporting one another, all right?”\u003c/p>\n\u003cp>Giving up the needle is a small step, but a positive one. It’s a little less harmful. Eric wanted them to know he gets it: They’re \u003ci>trying\u003c/i>.\u003c/p>\n\u003cp>“So you guys, come and talk to me, OK?” he told them. “Seriously, if you want help at all. I don’t care if you don’t want recovery or not, but just to know that there’s someone out there. I used to get high right here in this alley, dude, back in the day.”\u003c/p>\n\u003cp>The kind of care Eric is offering — nonjudgmental, patient, compassionate — goes straight back to the earliest days of the Haight Ashbury Free Clinic.\u003c/p>\n\u003cp>It’s an unremarkable approach these days, common in social services. But 50 years ago, before the Summer of Love, it was radical and new.\u003c/p>\n\u003ch3>Survival in Consolidation\u003c/h3>\n\u003cp>Today, the Haight Ashbury Free Clinics are part of an umbrella organization called \u003ca href=\"https://www.healthright360.org/\">HealthRIGHT 360\u003c/a>. It’s a large network of social service agencies, tackling a variety of problems besides health care: domestic abuse, rehabilitation for ex-inmates, gay, lesbian and transgender health, and addiction.\u003c/p>\n\u003cp>Consolidating with other agencies helped the Haight Ashbury Free Clinic survive.\u003c/p>\n\u003cp>Seven years ago, in 2010, it was struggling financially. Some staffers had been caught embezzling, and the clinic couldn’t afford the transition to electronic medical records, a new requirement of the Affordable Care Act.\u003c/p>\n\u003cp>In 2011, the Free Clinic joined forces with \u003ca href=\"https://www.healthright360.org/agency/walden-house\">\u003cspan style=\"font-weight: 400\">Walden House\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, a nearby addiction recovery center. Other nonprofits soon joined as well, and HealthRIGHT 360 became the umbrella brand, allowing the smaller agencies to pool resources for administration, electronic records and fundraising.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Dr. David Smith, who started it all, applauds the decision to consolidate with other nonprofits. But he does miss the intimacy of those early days, when volunteers from the neighborhood worked at the clinic.\u003c/p>\n\u003cp>When money got tight, there were benefit concerts featuring local bands like Big Brother and the Holding Company, during the time Janis Joplin was the lead singer.\u003c/p>\n\u003cp>Dr. Smith lived in the Haight, and so did Janis Joplin. He remembered the night he saved her life.\u003c/p>\n\u003cp>“There was somebody at our clinic that was close with her — her name was Sunshine,” he recalled. “It was near the Grateful Dead house, and we got a call that she’d overdosed. So we zipped up there with the Narcan and reversed her overdose.”\u003c/p>\n\u003cp>“She was a wonderful woman, a great singer, very involved in the community,” Smith said. “But she had a very serious addiction problem, bounced back and forth between heroin and alcohol.”\u003c/p>\n\u003cp>After the Summer of Love, free clinics opened in Seattle, L.A. and Berkeley. By the end of the ’60s, the U.S. had dozens of free clinics, a third of them in California.\u003c/p>\n\u003cp>All were founded on that simple principle Dr. Smith first articulated 50 years ago: Health care is a right, not a privilege. No matter how you look, dress or act.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>A federal jury in Brooklyn, N.Y., has convicted former pharmaceutical executive and “pharma bro” Martin Shkreli of securities fraud.\u003c/p>\n\u003cp>He was found guilty Friday on three counts — two counts of securities fraud and one count of conspiracy to commit securities fraud — out of a total of eight counts. Shkreli is best known for increasing the price of a life-saving drug for people with AIDS by 5,000 percent, from $13.50 to $750 per pill, when he was head of Turing Pharmaceuticals.\u003c/p>\n\u003cp>Shkreli has not been sentenced and faces up to 20 years in prison, as WSHU’s Charles Lane tells our Newscast unit. Still, he declared victory when he was acquitted of what he termed the most “important charges.”\u003c/p>\n\u003cp>“After the verdict was read, Shkreli and his lawyer said they were pleased and anticipated a light sentencing with minimal fines and no jail time,” Lane reported. “During the trial, Shkreli openly mocked prosecutors and ultimately never took the stand in his defense.”\u003c/p>\n\u003cp>\u003ca href=\"http://www.npr.org/sections/thetwo-way/2017/06/26/534411641/pharma-bro-martin-shkreli-goes-on-trial-on-securities-fraud-charges\">As NPR’s Laurel Wamsley\u003c/a> has written about the case:\u003c/p>\n\u003cblockquote>\n\u003cp>“Before he made headlines as the CEO of Turing Pharmaceuticals, Shkreli founded a pharmaceutical company, Retrophin, and a pair of hedge funds, MSMB Capital Management and MSMB Healthcare. Prosecutors say he committed a series of frauds while managing the funds between October 2009 and March 2014.\u003c/p>\n\u003cp>“The \u003ca href=\"https://www.sec.gov/litigation/complaints/2015/comp-pr2015-282.pdf\">SEC’s complaint\u003c/a> alleges ‘widespread fraudulent conduct’ by Shkreli — a series of misrepresentations and omissions, and of taking money from one fund to cover claims against the other. According to the complaint, he also issued stock and made cash payments from Retrophin (disguised as payments for consulting services) to disgruntled investors in the hedge funds who were threatening to sue.\u003c/p>\n\u003cp>“Prosecutors say Shkreli misled investors about the size and performance of MSMB Capital Management, claiming that its returns were ‘+35.77% since inception’ — when the fund had actually lost 18 percent. In another instance, he claimed the fund had $35 million in assets, when in fact it had less than $1,000 in assets.”\u003c/p>\n\u003c/blockquote>\n\u003cp>Shkreli attorney Ben Brafman told reporters after the verdict that he believed the conspiracy to commit wire fraud — which Shrekli was acquitted of — was the heart of the case. “It was the claim that Martin robbed money from his own company to pay back people, and that theory was soundly rejected.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>He added that Shkreli’s image issues have posed a challenge to the case:\u003c/p>\n\u003cblockquote>\n\u003cp>“Martin is a brilliant young man, but sometimes people skills don’t translate well. So we will have some good discussions, but at the end of the day, you know Martin, I think, has more than held his own in this case and despite the issues that travel with Martin, I think we’re standing here smiling even though it wasn’t a clean sweep that we would have preferred.”\u003c/p>\n\u003c/blockquote>\n\u003cp>As Brafman appeared to question Shkreli’s “people skills,” The Associated Press reported that the former executive “smiled and cocked his head quizzically in mock confusion.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>During his time in the limelight, Shkreli has appeared to embrace the role of villain. For example, \u003ca href=\"http://www.npr.org/sections/thetwo-way/2015/12/09/459059359/sole-copy-of-latest-wu-tang-album-was-sold-to-pharma-bro\">as NPR’s Camila Domonoske reported\u003c/a>, he purchased the sole copy of the Wu-Tang Clan’s double album — then said he would never listen to it. \u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=%27Pharma+Bro%27+Martin+Shkreli+Convicted+Of+Securities+Fraud&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A federal jury in Brooklyn, N.Y., has convicted former pharmaceutical executive and “pharma bro” Martin Shkreli of securities fraud.\u003c/p>\n\u003cp>He was found guilty Friday on three counts — two counts of securities fraud and one count of conspiracy to commit securities fraud — out of a total of eight counts. Shkreli is best known for increasing the price of a life-saving drug for people with AIDS by 5,000 percent, from $13.50 to $750 per pill, when he was head of Turing Pharmaceuticals.\u003c/p>\n\u003cp>Shkreli has not been sentenced and faces up to 20 years in prison, as WSHU’s Charles Lane tells our Newscast unit. Still, he declared victory when he was acquitted of what he termed the most “important charges.”\u003c/p>\n\u003cp>“After the verdict was read, Shkreli and his lawyer said they were pleased and anticipated a light sentencing with minimal fines and no jail time,” Lane reported. “During the trial, Shkreli openly mocked prosecutors and ultimately never took the stand in his defense.”\u003c/p>\n\u003cp>\u003ca href=\"http://www.npr.org/sections/thetwo-way/2017/06/26/534411641/pharma-bro-martin-shkreli-goes-on-trial-on-securities-fraud-charges\">As NPR’s Laurel Wamsley\u003c/a> has written about the case:\u003c/p>\n\u003cblockquote>\n\u003cp>“Before he made headlines as the CEO of Turing Pharmaceuticals, Shkreli founded a pharmaceutical company, Retrophin, and a pair of hedge funds, MSMB Capital Management and MSMB Healthcare. Prosecutors say he committed a series of frauds while managing the funds between October 2009 and March 2014.\u003c/p>\n\u003cp>“The \u003ca href=\"https://www.sec.gov/litigation/complaints/2015/comp-pr2015-282.pdf\">SEC’s complaint\u003c/a> alleges ‘widespread fraudulent conduct’ by Shkreli — a series of misrepresentations and omissions, and of taking money from one fund to cover claims against the other. According to the complaint, he also issued stock and made cash payments from Retrophin (disguised as payments for consulting services) to disgruntled investors in the hedge funds who were threatening to sue.\u003c/p>\n\u003cp>“Prosecutors say Shkreli misled investors about the size and performance of MSMB Capital Management, claiming that its returns were ‘+35.77% since inception’ — when the fund had actually lost 18 percent. In another instance, he claimed the fund had $35 million in assets, when in fact it had less than $1,000 in assets.”\u003c/p>\n\u003c/blockquote>\n\u003cp>Shkreli attorney Ben Brafman told reporters after the verdict that he believed the conspiracy to commit wire fraud — which Shrekli was acquitted of — was the heart of the case. “It was the claim that Martin robbed money from his own company to pay back people, and that theory was soundly rejected.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>He added that Shkreli’s image issues have posed a challenge to the case:\u003c/p>\n\u003cblockquote>\n\u003cp>“Martin is a brilliant young man, but sometimes people skills don’t translate well. So we will have some good discussions, but at the end of the day, you know Martin, I think, has more than held his own in this case and despite the issues that travel with Martin, I think we’re standing here smiling even though it wasn’t a clean sweep that we would have preferred.”\u003c/p>\n\u003c/blockquote>\n\u003cp>As Brafman appeared to question Shkreli’s “people skills,” The Associated Press reported that the former executive “smiled and cocked his head quizzically in mock confusion.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>During his time in the limelight, Shkreli has appeared to embrace the role of villain. For example, \u003ca href=\"http://www.npr.org/sections/thetwo-way/2015/12/09/459059359/sole-copy-of-latest-wu-tang-album-was-sold-to-pharma-bro\">as NPR’s Camila Domonoske reported\u003c/a>, he purchased the sole copy of the Wu-Tang Clan’s double album — then said he would never listen to it. \u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=%27Pharma+Bro%27+Martin+Shkreli+Convicted+Of+Securities+Fraud&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>It was 1 am at San Francisco General Hospital. Saturday. The ambulances were rolling in one after another. Resident doctor Josie Valenzuela was near the end of her shift, trying to stay awake.\u003c/p>\n\u003cp>“I was really tired. And my back hurt a lot,” she remembers. “My mind was wandering all over the place.”\u003c/p>\n\u003cp>She was caring for a heroin addict, cutting an abscess open on her leg to drain infection. Then her pager went off. Another ambulance was coming in and this would have to wait for later.\u003c/p>\n\u003cp>“So I went to put the scalpel in some sterile towels for when I could come back,” Valenzuela says, “and I cut my left index finger.”\u003c/p>\n\u003cp>The patient had HIV and hepatitis C.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I knew this was a bad exposure, and that all of the blood and pus that was on that scalpel was now touching my bloodstream,” she says.\u003c/p>\n\u003cp>[audio src=\"http:www.kqed.org/.stream/anon/radio//2017/08/28hourworkdayDembosky.mp3\" Image=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/08/Josie-Valenzuela-ultrasound-768x432.jpg\" Title=\"Is it OK for First-Year Doctors to Work 28 Hours in a Row? New Rule Says It's Fine\" program=\"The California Report\"]\u003c/p>\n\u003cp>Valenzuela would have to take anti-viral medications that would make her nauseated for weeks. And she’d have to explain to her husband that she may have contracted a life-long disease.\u003c/p>\n\u003cp>“We were going to start trying to have kids soon,” she says, choking up, “and so that would make it complicated for us.”\u003c/p>\n\u003cp>That’s what she was thinking about when she finally left the hospital at 4 in the morning.\u003c/p>\n\u003cp>“I found my car and I was backing out,” she says. “And I mixed up the gas and the brake. I've never done that before, but I backed right into a concrete pole.”\u003c/p>\n\u003cp>Mistakes like these led medical experts at the Institute of Medicine to issue a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23616719\" target=\"_blank\" rel=\"noopener noreferrer\">recommendation \u003c/a>in 2009 that residents' work shifts be capped at 16 hours. Until then, they were allowed to work up to 28 hours. After a year-long review of the scientific literature, the Institute concluded that human performance begins to decline after 16 hours, and the risk of medical errors and car accidents goes up.\u003c/p>\n\u003cp>So, in 2011, the \u003ca href=\"http://www.acgme.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Accreditation Council for Graduate Medical Education\u003c/a> made a rule, saying first-year doctors could only work a maximum of 16 hours per shift.\u003c/p>\n\u003cp>But this year, the council reversed itself, and starting this summer, new doctors can again work up to 28 hours in a row.\u003c/p>\n\u003cp>“I think the majority of patients in the United States expect that their physician will be available to them whether it's daytime, nighttime, Saturday or Sunday,” says Dr. Rowen Zetterman, co-chair of the task force that reviewed and changed the rule.\u003c/p>\n\u003cfigure id=\"attachment_360682\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-360682\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/08/Josie-Valenzuela-microscope-800x450.jpg\" alt=\"\" width=\"800\" height=\"450\">\u003cfigcaption class=\"wp-caption-text\">Josie Valenzuela looks through a slit lamp at work. The microscope is for examining the eye. \u003ccite>(Georgie Baumann/University of Arizona)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Patient and resident groups wanted to keep the 16-hour rule, Zetterman says. But senior doctors argued that long hours come with the profession. They complained that the shift limits cut into the time they had for teaching in the hospital, compromising the educational integrity of the residency.\u003c/p>\n\u003cp>“You ask residents a question and they'll say, ‘’I'm just covering, I don't know those things.’ That drives the more senior physicians batty,” says Adams Dudley, a pulmonologist and professor at UCSF School of Medicine. “The perception is they don't know what they're doing as well because they spend less time at the hospital.”\u003c/p>\n\u003cp>Physicians grouse that residents don’t seem as invested in the work when shift limits are in effect, he says, because they’re more focused on handing off their patients to others, rather then seeing them through the cycle of illness.\u003c/p>\n\u003cp>“Because they leave, they don't see the evolution of things, and they don't know the patients as well,” Dudley says. “If you're told you must pay attention to leaving, you have to detach yourself from the patient.”\u003c/p>\n\u003cp>Surgical residents complained about this, too.\u003c/p>\n\u003cp>“They would be in the middle of an operation that they felt like they were learning from, and they would hit the end of their 16 hours and be told that they had to leave the operation and go home,” Zetterman says.\u003c/p>\n\u003cp>This hurt morale on the health care team, he says, as other doctors watched first-year residents clock out when they had to stay, and raised patient-safety concerns.\u003c/p>\n\u003cp>“Let's say your copilot kept coming and going throughout the flight and, then was gone. Didn't come back for the remainder that flight,” Zetterman says. “It seems to me that would be disruptive.”\u003c/p>\n\u003cp>It’s unclear what’s riskier for patients: more frequent hand-offs between doctors, or doctors that are just exhausted. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/26054323\" target=\"_blank\" rel=\"noopener noreferrer\">Most studies \u003c/a>show little or no change in patient outcomes after shift limits were put in place, suggesting mistakes and miscommunications that resulted from transitions in care offset any gains made from reducing doctor fatigue.\u003c/p>\n\u003cp>If that's the case, Dr. Josie Valenzuela believes there should be more focus on residents’ well-being, in addition to patients. And while the shift limit was extended to 28 hours in the regulatory, other rules require residency programs to provide more support for residents who feel burned out, stressed, or depressed, including \u003ca href=\"https://ww2.kqed.org/news/2017/07/05/physicians-are-human-beings-new-rules-aim-to-battle-burnout-in-medical-residencies/\" target=\"_blank\" rel=\"noopener noreferrer\">24/7 access\u003c/a> to a mental health professional.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Valenzuela is in her last year of residency now. She says she was lucky after that accidental cut. After nearly a year of periodic checks, she's been officially declared negative for HIV and hepatitis C. Next year, she and her husband plan to have a baby.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Valenzuela would have to take anti-viral medications that would make her nauseated for weeks. And she’d have to explain to her husband that she may have contracted a life-long disease.\u003c/p>\n\u003cp>“We were going to start trying to have kids soon,” she says, choking up, “and so that would make it complicated for us.”\u003c/p>\n\u003cp>That’s what she was thinking about when she finally left the hospital at 4 in the morning.\u003c/p>\n\u003cp>“I found my car and I was backing out,” she says. “And I mixed up the gas and the brake. I've never done that before, but I backed right into a concrete pole.”\u003c/p>\n\u003cp>Mistakes like these led medical experts at the Institute of Medicine to issue a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23616719\" target=\"_blank\" rel=\"noopener noreferrer\">recommendation \u003c/a>in 2009 that residents' work shifts be capped at 16 hours. Until then, they were allowed to work up to 28 hours. After a year-long review of the scientific literature, the Institute concluded that human performance begins to decline after 16 hours, and the risk of medical errors and car accidents goes up.\u003c/p>\n\u003cp>So, in 2011, the \u003ca href=\"http://www.acgme.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Accreditation Council for Graduate Medical Education\u003c/a> made a rule, saying first-year doctors could only work a maximum of 16 hours per shift.\u003c/p>\n\u003cp>But this year, the council reversed itself, and starting this summer, new doctors can again work up to 28 hours in a row.\u003c/p>\n\u003cp>“I think the majority of patients in the United States expect that their physician will be available to them whether it's daytime, nighttime, Saturday or Sunday,” says Dr. Rowen Zetterman, co-chair of the task force that reviewed and changed the rule.\u003c/p>\n\u003cfigure id=\"attachment_360682\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-360682\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/08/Josie-Valenzuela-microscope-800x450.jpg\" alt=\"\" width=\"800\" height=\"450\">\u003cfigcaption class=\"wp-caption-text\">Josie Valenzuela looks through a slit lamp at work. The microscope is for examining the eye. \u003ccite>(Georgie Baumann/University of Arizona)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Patient and resident groups wanted to keep the 16-hour rule, Zetterman says. But senior doctors argued that long hours come with the profession. They complained that the shift limits cut into the time they had for teaching in the hospital, compromising the educational integrity of the residency.\u003c/p>\n\u003cp>“You ask residents a question and they'll say, ‘’I'm just covering, I don't know those things.’ That drives the more senior physicians batty,” says Adams Dudley, a pulmonologist and professor at UCSF School of Medicine. “The perception is they don't know what they're doing as well because they spend less time at the hospital.”\u003c/p>\n\u003cp>Physicians grouse that residents don’t seem as invested in the work when shift limits are in effect, he says, because they’re more focused on handing off their patients to others, rather then seeing them through the cycle of illness.\u003c/p>\n\u003cp>“Because they leave, they don't see the evolution of things, and they don't know the patients as well,” Dudley says. “If you're told you must pay attention to leaving, you have to detach yourself from the patient.”\u003c/p>\n\u003cp>Surgical residents complained about this, too.\u003c/p>\n\u003cp>“They would be in the middle of an operation that they felt like they were learning from, and they would hit the end of their 16 hours and be told that they had to leave the operation and go home,” Zetterman says.\u003c/p>\n\u003cp>This hurt morale on the health care team, he says, as other doctors watched first-year residents clock out when they had to stay, and raised patient-safety concerns.\u003c/p>\n\u003cp>“Let's say your copilot kept coming and going throughout the flight and, then was gone. Didn't come back for the remainder that flight,” Zetterman says. “It seems to me that would be disruptive.”\u003c/p>\n\u003cp>It’s unclear what’s riskier for patients: more frequent hand-offs between doctors, or doctors that are just exhausted. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/26054323\" target=\"_blank\" rel=\"noopener noreferrer\">Most studies \u003c/a>show little or no change in patient outcomes after shift limits were put in place, suggesting mistakes and miscommunications that resulted from transitions in care offset any gains made from reducing doctor fatigue.\u003c/p>\n\u003cp>If that's the case, Dr. Josie Valenzuela believes there should be more focus on residents’ well-being, in addition to patients. And while the shift limit was extended to 28 hours in the regulatory, other rules require residency programs to provide more support for residents who feel burned out, stressed, or depressed, including \u003ca href=\"https://ww2.kqed.org/news/2017/07/05/physicians-are-human-beings-new-rules-aim-to-battle-burnout-in-medical-residencies/\" target=\"_blank\" rel=\"noopener noreferrer\">24/7 access\u003c/a> to a mental health professional.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Valenzuela is in her last year of residency now. She says she was lucky after that accidental cut. After nearly a year of periodic checks, she's been officially declared negative for HIV and hepatitis C. Next year, she and her husband plan to have a baby.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Since July 1, 2016, Contra Costa County lost five psychiatrists who serve the county’s at-risk youth — minors in foster care and juvenile hall and victims of child sexual exploitation and domestic violence — and they have yet to replace them.\u003c/p>\n\u003cp>At a Family and Human Services Committee hearing on Monday, county officials responded to a civil grand jury report claiming that there is on average a 1-to-310 ratio of psychiatrists to cases of children with moderate to severe mental health issues. Sometimes it’s even worse.\u003c/p>\n\u003cp>That was an alarming ratio for most in the room, but committee members said they couldn’t be sure the statistic was accurate because they don’t know where the grand jury got its data. So Cynthia Belon, director of Contra Costa’s Behavioral Health Services, was asked to dig deeper.\u003c/p>\n\u003cp>“We will then be able to see that all these tables are accurate or not, which we believe they’re not, but we need to actually do further analysis,” Belon said.\u003c/p>\n\u003cp>The committee requested that Belon put together a report for its Aug. 15 meeting. It is expected to include the number of currently open cases and the number of psychiatrists on staff and how they are distributed. The committee also requested demographic breakdowns to see if the deficit is disproportionately affecting black and Latino children.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>According to Belon, only two full-time and seven part-time psychiatrists are currently working in the county’s three mental health clinics for children in Richmond, Antioch and Concord.\u003c/p>\n\u003cp>Belon says the county is always recruiting for mental health professionals, but that the budget poses limits.\u003c/p>\n\u003cp>Psychiatrists are expensive, and Contra Costa is competing with other counties and the private sector, which can pay 25 percent to 50 percent more, according to Dr. Frank Barham, a retired county psychiatrist.\u003c/p>\n\u003cp>He says it wasn’t uncommon for grandparents to bring children in to see him because their parents were either in rehab or jail. He treated these kids for issues like depression and dyslexia, among others.\u003c/p>\n\u003cp>“The problems are generally quite severe, and they’re not going to be able to function in society [without help],” he said.\u003c/p>\n\u003cp>Behavioral Health Services is expected to suggest a pay increase to the committee, based on salaries of other Bay Area county psychiatrists.\u003c/p>\n\u003cp>Still, Barham, says there’s a snowball effect happening at the children’s mental health clinics because of high turnover rates and low pay.\u003c/p>\n\u003cp>“[It’s] going to get worse because, when you get fewer staff, that means there’s an overload on those there. Case in point, which is the worst, is East County, where they had hundreds of kids on the waitlist,” he said.\u003c/p>\n\u003cp>Belon said she couldn’t be sure how many kids are on the waitlist, but that at-risk youth receive a referral to see a mental health clinician within eight to 13 days of reaching out.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Barham stressed the importance of these children seeing psychiatrists, and not just mental health clinicians, who he said don’t have the training or knowledge of how to correctly diagnosis mental health issues in children or track their development.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Since July 1, 2016, Contra Costa County lost five psychiatrists who serve the county’s at-risk youth — minors in foster care and juvenile hall and victims of child sexual exploitation and domestic violence — and they have yet to replace them.\u003c/p>\n\u003cp>At a Family and Human Services Committee hearing on Monday, county officials responded to a civil grand jury report claiming that there is on average a 1-to-310 ratio of psychiatrists to cases of children with moderate to severe mental health issues. Sometimes it’s even worse.\u003c/p>\n\u003cp>That was an alarming ratio for most in the room, but committee members said they couldn’t be sure the statistic was accurate because they don’t know where the grand jury got its data. So Cynthia Belon, director of Contra Costa’s Behavioral Health Services, was asked to dig deeper.\u003c/p>\n\u003cp>“We will then be able to see that all these tables are accurate or not, which we believe they’re not, but we need to actually do further analysis,” Belon said.\u003c/p>\n\u003cp>The committee requested that Belon put together a report for its Aug. 15 meeting. It is expected to include the number of currently open cases and the number of psychiatrists on staff and how they are distributed. The committee also requested demographic breakdowns to see if the deficit is disproportionately affecting black and Latino children.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>According to Belon, only two full-time and seven part-time psychiatrists are currently working in the county’s three mental health clinics for children in Richmond, Antioch and Concord.\u003c/p>\n\u003cp>Belon says the county is always recruiting for mental health professionals, but that the budget poses limits.\u003c/p>\n\u003cp>Psychiatrists are expensive, and Contra Costa is competing with other counties and the private sector, which can pay 25 percent to 50 percent more, according to Dr. Frank Barham, a retired county psychiatrist.\u003c/p>\n\u003cp>He says it wasn’t uncommon for grandparents to bring children in to see him because their parents were either in rehab or jail. He treated these kids for issues like depression and dyslexia, among others.\u003c/p>\n\u003cp>“The problems are generally quite severe, and they’re not going to be able to function in society [without help],” he said.\u003c/p>\n\u003cp>Behavioral Health Services is expected to suggest a pay increase to the committee, based on salaries of other Bay Area county psychiatrists.\u003c/p>\n\u003cp>Still, Barham, says there’s a snowball effect happening at the children’s mental health clinics because of high turnover rates and low pay.\u003c/p>\n\u003cp>“[It’s] going to get worse because, when you get fewer staff, that means there’s an overload on those there. Case in point, which is the worst, is East County, where they had hundreds of kids on the waitlist,” he said.\u003c/p>\n\u003cp>Belon said she couldn’t be sure how many kids are on the waitlist, but that at-risk youth receive a referral to see a mental health clinician within eight to 13 days of reaching out.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Barham stressed the importance of these children seeing psychiatrists, and not just mental health clinicians, who he said don’t have the training or knowledge of how to correctly diagnosis mental health issues in children or track their development.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "What Does It Say When Jail Is a Safety Net for Pregnant Women?",
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"content": "\u003cp>Dr. Carolyn Sufrin is sitting before a classroom reading a passage from her book, “Jailcare.”\u003c/p>\n\u003cp>Based on her experience as an obstetrician inside San Francisco’s jail, Sufrin is relating a passage about an inmate who recently gave birth in jail.\u003c/p>\n\u003cp>“She said to me, ‘I mean, my worst day in jail is way better than my best day on the streets.’ I had heard Kima say this before, but each time the comparison emerged, I had to pause to digest it: My worst day in jail is better than my best day on the streets. It was a profound statement,” Sufrin read.\u003c/p>\n\u003cp>As Sufrin was reading, Jamesa had to rush out of the classroom, into an adjacent bathroom, to throw up. She’s 11 weeks pregnant. She’s also, like all the students in this classroom, an inmate at San Francisco’s women’s jail — because of that, we’re using only her first name.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘The idea jail can be a site of caregiving, or of safety and a place that some women might sometimes desire. … That’s really troubling and problematic.’\u003ccite>Carolyn Sufrin\u003c/cite>\u003c/aside>\n\u003cp>Jamesa is 25 and has a 4-year-old son at home, but said she’s never been pregnant in jail before. And, she said, it’s scary.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I don’t want to have my baby in jail, ’cause I would like to go home with my baby — I got to go home with my first son, when I had him, I never was in jail or nothing, so I got to go home with my baby. I don’t want to feel that detachment, only get three days and then from the hospital I have to go to jail and my baby gotta go somewhere else,” she said.\u003c/p>\n\u003cp>Sufrin is here to hear these stories. She’s made this her life’s work, after she delivered a baby from a shackled inmate in Pennsylvania during her medical training. Sufrin says she was shocked — and decided she wanted to work with incarcerated women.\u003c/p>\n\u003cp>From 2007 to 2013, she worked inside the San Francisco County Jail — as an ob/gyn and then doing research for a Ph.D. in medical anthropology. Her book is based on that research, and the paradoxical nature of finding support while being incarcerated.\u003c/p>\n\u003cp>“The idea jail can be a site of caregiving, or of safety or of home and a place that some women might sometimes desire, like I said, that’s really troubling and problematic,” she said.\u003c/p>\n\u003cfigure id=\"attachment_11591987\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11591987\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/07/SufrinReads-800x1038.jpg\" alt=\"Dr. Carolyn Sufrin reads to female inmates at San Francisco Jail from her book.\" width=\"800\" height=\"1038\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/07/SufrinReads-800x1038.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/07/SufrinReads-160x208.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/07/SufrinReads-1020x1323.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/07/SufrinReads.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/07/SufrinReads-1180x1530.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/07/SufrinReads-960x1245.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/07/SufrinReads-240x311.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/07/SufrinReads-375x486.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/07/SufrinReads-520x674.jpg 520w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Carolyn Sufrin reads to female inmates at San Francisco County Jail from her book. \u003ccite>(Marisa Lagos/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sufrin tells the women that to some people this may indicate the system’s working — because women are getting some medical care.\u003c/p>\n\u003cp>“But to read this depiction of the safety net of jail in such a practical and also fatalistic way, it ignores the punishment, and the putative structures from which this caregiving arises. It claims to see glimmer of home in fundamentally flawed system,” she said.\u003c/p>\n\u003cp>Her message is that something is deeply wrong with our society if jail is where women — particularly poor women of color — get the most consistent medical care. The students seem to agree, but they say this is about more than just pregnancy.\u003c/p>\n\u003cp>Jamesa said the baby growing in her belly isn’t the only child she’s thinking about: Since her first son was born, they’ve been inseparable — and that being there for him is the most important thing to her.\u003c/p>\n\u003cp>“My son is all I got. I don’t got my mama — I was in foster care. She’s around, I know her, but that ain’t my mama, she just had me,” she said. “It hurt hecka bad to know I can’t be with my baby every day.”\u003c/p>\n\u003cp>Tonnette, another inmate, says she’s never been pregnant in jail. But she is missing her 5-year-old son, who she talks to on the phone as much as she can.\u003c/p>\n\u003cp>“He has been going through this for years to the point that he’s like, all right, and that makes me feel bad — not him crying but him understanding about what I’m going through. At 5 years old, that’s kinda heavy on me,” she said.\u003c/p>\n\u003cp>The women say there’s another excruciating thing about being separated from your kids — the chance you might lose custody of them while you’re locked up.\u003c/p>\n\u003cp>Shanti, 29, said she was in jail a year ago when she got papers informing her that her son’s grandmother was trying to take full custody of him.\u003c/p>\n\u003cp>“She just took him. I asked her to hold my son until I get my life together, and have a place to live,” she said. “So I was crying, because she took my son, and they took me out our of class, to a holding cell, then I am talking about committing suicide.”\u003c/p>\n\u003cp>Shanti said a female deputy eventually came and talked to her, calming her down. But she said the default in these situations, when you’re behind bars, is to be put in a cell alone, not supported.\u003c/p>\n\u003cp>The issue of pregnant women and mothers in prisons and jails was recently tackled by California Sen. Kamala Harris in a speech before a bipartisan criminal justice reform group in Washington, D.C.\u003c/p>\n\u003cp>“Right now, there are women who are shackled while they are pregnant and in some states, while they give birth. That’s wrong,” Harris said. “What impacts a mother impacts a child. Because the fact is on this subject, we must keep in mind, nearly 80 percent of incarcerated women are mothers.”\u003c/p>\n\u003cp>Harris has authored legislation to give incarcerated mothers in the federal prison system — and their kids — more rights.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The San Francisco Sheriff’s Department does more than many jail systems — for example, they let new moms pump their breast milk for their kids. But for the inmates in jail, they just want to be home with their kids.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Dr. Carolyn Sufrin is sitting before a classroom reading a passage from her book, “Jailcare.”\u003c/p>\n\u003cp>Based on her experience as an obstetrician inside San Francisco’s jail, Sufrin is relating a passage about an inmate who recently gave birth in jail.\u003c/p>\n\u003cp>“She said to me, ‘I mean, my worst day in jail is way better than my best day on the streets.’ I had heard Kima say this before, but each time the comparison emerged, I had to pause to digest it: My worst day in jail is better than my best day on the streets. It was a profound statement,” Sufrin read.\u003c/p>\n\u003cp>As Sufrin was reading, Jamesa had to rush out of the classroom, into an adjacent bathroom, to throw up. She’s 11 weeks pregnant. She’s also, like all the students in this classroom, an inmate at San Francisco’s women’s jail — because of that, we’re using only her first name.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘The idea jail can be a site of caregiving, or of safety and a place that some women might sometimes desire. … That’s really troubling and problematic.’\u003ccite>Carolyn Sufrin\u003c/cite>\u003c/aside>\n\u003cp>Jamesa is 25 and has a 4-year-old son at home, but said she’s never been pregnant in jail before. And, she said, it’s scary.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I don’t want to have my baby in jail, ’cause I would like to go home with my baby — I got to go home with my first son, when I had him, I never was in jail or nothing, so I got to go home with my baby. I don’t want to feel that detachment, only get three days and then from the hospital I have to go to jail and my baby gotta go somewhere else,” she said.\u003c/p>\n\u003cp>Sufrin is here to hear these stories. She’s made this her life’s work, after she delivered a baby from a shackled inmate in Pennsylvania during her medical training. Sufrin says she was shocked — and decided she wanted to work with incarcerated women.\u003c/p>\n\u003cp>From 2007 to 2013, she worked inside the San Francisco County Jail — as an ob/gyn and then doing research for a Ph.D. in medical anthropology. Her book is based on that research, and the paradoxical nature of finding support while being incarcerated.\u003c/p>\n\u003cp>“The idea jail can be a site of caregiving, or of safety or of home and a place that some women might sometimes desire, like I said, that’s really troubling and problematic,” she said.\u003c/p>\n\u003cfigure id=\"attachment_11591987\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11591987\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/07/SufrinReads-800x1038.jpg\" alt=\"Dr. Carolyn Sufrin reads to female inmates at San Francisco Jail from her book.\" width=\"800\" height=\"1038\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/07/SufrinReads-800x1038.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/07/SufrinReads-160x208.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/07/SufrinReads-1020x1323.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/07/SufrinReads.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/07/SufrinReads-1180x1530.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/07/SufrinReads-960x1245.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/07/SufrinReads-240x311.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/07/SufrinReads-375x486.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/07/SufrinReads-520x674.jpg 520w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Carolyn Sufrin reads to female inmates at San Francisco County Jail from her book. \u003ccite>(Marisa Lagos/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sufrin tells the women that to some people this may indicate the system’s working — because women are getting some medical care.\u003c/p>\n\u003cp>“But to read this depiction of the safety net of jail in such a practical and also fatalistic way, it ignores the punishment, and the putative structures from which this caregiving arises. It claims to see glimmer of home in fundamentally flawed system,” she said.\u003c/p>\n\u003cp>Her message is that something is deeply wrong with our society if jail is where women — particularly poor women of color — get the most consistent medical care. The students seem to agree, but they say this is about more than just pregnancy.\u003c/p>\n\u003cp>Jamesa said the baby growing in her belly isn’t the only child she’s thinking about: Since her first son was born, they’ve been inseparable — and that being there for him is the most important thing to her.\u003c/p>\n\u003cp>“My son is all I got. I don’t got my mama — I was in foster care. She’s around, I know her, but that ain’t my mama, she just had me,” she said. “It hurt hecka bad to know I can’t be with my baby every day.”\u003c/p>\n\u003cp>Tonnette, another inmate, says she’s never been pregnant in jail. But she is missing her 5-year-old son, who she talks to on the phone as much as she can.\u003c/p>\n\u003cp>“He has been going through this for years to the point that he’s like, all right, and that makes me feel bad — not him crying but him understanding about what I’m going through. At 5 years old, that’s kinda heavy on me,” she said.\u003c/p>\n\u003cp>The women say there’s another excruciating thing about being separated from your kids — the chance you might lose custody of them while you’re locked up.\u003c/p>\n\u003cp>Shanti, 29, said she was in jail a year ago when she got papers informing her that her son’s grandmother was trying to take full custody of him.\u003c/p>\n\u003cp>“She just took him. I asked her to hold my son until I get my life together, and have a place to live,” she said. “So I was crying, because she took my son, and they took me out our of class, to a holding cell, then I am talking about committing suicide.”\u003c/p>\n\u003cp>Shanti said a female deputy eventually came and talked to her, calming her down. But she said the default in these situations, when you’re behind bars, is to be put in a cell alone, not supported.\u003c/p>\n\u003cp>The issue of pregnant women and mothers in prisons and jails was recently tackled by California Sen. Kamala Harris in a speech before a bipartisan criminal justice reform group in Washington, D.C.\u003c/p>\n\u003cp>“Right now, there are women who are shackled while they are pregnant and in some states, while they give birth. That’s wrong,” Harris said. “What impacts a mother impacts a child. Because the fact is on this subject, we must keep in mind, nearly 80 percent of incarcerated women are mothers.”\u003c/p>\n\u003cp>Harris has authored legislation to give incarcerated mothers in the federal prison system — and their kids — more rights.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The San Francisco Sheriff’s Department does more than many jail systems — for example, they let new moms pump their breast milk for their kids. But for the inmates in jail, they just want to be home with their kids.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>A last-ditch effort by struggling Senate Republicans to dismantle a few key provisions of the Affordable Care Act — an approach known as “skinny repeal” — failed in a dramatic fashion early Friday morning, around 1:30 EDT. The 49-51 vote was a major disappointment for the GOP, but a great relief for the state’s Democrats.\u003c/p>\n\u003cp>“Health care is a matter of life and death. It affects every person in this country,” said Sen. \u003ca href=\"https://www.feinstein.senate.gov/public/\" target=\"_blank\" rel=\"noopener noreferrer\">Dianne Feinstein\u003c/a> (D-California) in a statement she released less than an hour after the vote.\u003c/p>\n\u003cp>Feinstein lambasted Republicans for their secretive process, which bypassed the usual committees and public hearings.\u003c/p>\n\u003cp>“Their closed process, which shut out doctors, patients, families, hospitals, health plans and advocates, yielded terrible bill after terrible bill,” she said.\u003c/p>\n\u003cp>In California, which eagerly embraced the ACA and erected a resilient insurance exchange known as “\u003ca href=\"http://www.coveredca.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Covered California\u003c/a>,” the relief was particularly strong on Friday.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Under “skinny repeal,” 700,000 fewer Californians would been covered through individual plans sold on the exchange, according to a Covered California statement. An additional 300,000 Californians were expected to drop out of Medi-Cal due to the elimination of the individual mandate.\u003c/p>\n\u003cp>[contextly_sidebar id=”XsNSDpLjXrZDgcH6ktvPhh8huwRkIzCQ”]\u003c/p>\n\u003cp>“Covered California and the Medi-Cal expansion are safe for now, and we can feel more secure knowing that our families, friends and employees won’t lose their health insurance,” said Jonathan Greer, an independent health insurance broker in Oakland.\u003c/p>\n\u003cp>Greer said watching the prolonged legislative battle in D.C. was agonizing: “It was like watching a good friend or relative suffer in the hospital, not knowing if they would recover.”\u003c/p>\n\u003cp>California’s Democrats applauded Sen. John McCain’s \u003ca href=\"https://www.mccain.senate.gov/public/index.cfm/press-releases?ID=A952CCCA-66D2-4570-9D57-514561BF3D4D\" target=\"_blank\" rel=\"noopener noreferrer\">call\u003c/a> for a return to bipartisanship after his thumbs-down “no” vote.\u003c/p>\n\u003cp>“I could not agree more, ” said \u003ca href=\"https://bera.house.gov/\" target=\"_blank\" rel=\"noopener noreferrer\">congressman Ami Bera\u003c/a> (D-Elk Grove). Bera, an internist. He’s one of two Democratic doctors in Congress. Earlier this month, Bera pushed an \u003ca href=\"https://newdemocratcoalition-himes.house.gov/media-center/press-releases/new-democrat-coalition-healthcare-task-force-leads-release-of-market\" target=\"_blank\" rel=\"noopener noreferrer\">alternate plan\u003c/a> to improve the Affordable Care Act, which now has the support of more than 80 House Democrats.\u003c/p>\n\u003cp>“We are ready and willing to come to the table with solutions,” Bera said. “I hope to work with my Republican colleagues in the coming weeks to put patients first, cut costs, and increase the number of people insured.”\u003c/p>\n\u003cp>Nearly 3.7 million individuals have health coverage through the ACA’s Medi-Cal expansion, and more than 1.4 million people are insured through Covered California.\u003c/p>\n\u003cp>California has experienced the largest decline in its uninsured rate in the country — dropping from 17.2 percent in 2013 to 7.1 percent in 2016.\u003c/p>\n\u003cp>But attempts to undermine the effectiveness of the Affordable Care Act could continue, said Sandra R. Hernández, president and CEO of the \u003ca href=\"http://www.chcf.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Health Care Foundation\u003c/a>.\u003c/p>\n\u003cp>“Danger still lies ahead,” she \u003ca href=\"http://www.chcf.org/media/press-releases/2017/aca-law-land\" target=\"_blank\" rel=\"noopener noreferrer\">warned\u003c/a>. “They will try to make enrollment more difficult, and cut back on public outreach. We especially need to keep a bright light on the budget and appropriations process and on tax reform efforts.”\u003c/p>\n\u003cp>Hernández predicts there will also be more attempts to slash funding for Medicaid and other medical safety-net programs.\u003c/p>\n\u003cp>But Rep. \u003ca href=\"https://calvert.house.gov/district/\" target=\"_blank\" rel=\"noopener noreferrer\">Ken Calvert\u003c/a> (R-Riverside County) says the status quo is a problem too big to ignore. “Despite political drama in the Senate, we must not lose sight of the fact that Obamacare premiums continue to rise and health insurance providers are dropping out of exchanges across the country.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Calvert urged Congress to keep working to provide Americans with the relief they need.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A last-ditch effort by struggling Senate Republicans to dismantle a few key provisions of the Affordable Care Act — an approach known as “skinny repeal” — failed in a dramatic fashion early Friday morning, around 1:30 EDT. The 49-51 vote was a major disappointment for the GOP, but a great relief for the state’s Democrats.\u003c/p>\n\u003cp>“Health care is a matter of life and death. It affects every person in this country,” said Sen. \u003ca href=\"https://www.feinstein.senate.gov/public/\" target=\"_blank\" rel=\"noopener noreferrer\">Dianne Feinstein\u003c/a> (D-California) in a statement she released less than an hour after the vote.\u003c/p>\n\u003cp>Feinstein lambasted Republicans for their secretive process, which bypassed the usual committees and public hearings.\u003c/p>\n\u003cp>“Their closed process, which shut out doctors, patients, families, hospitals, health plans and advocates, yielded terrible bill after terrible bill,” she said.\u003c/p>\n\u003cp>In California, which eagerly embraced the ACA and erected a resilient insurance exchange known as “\u003ca href=\"http://www.coveredca.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Covered California\u003c/a>,” the relief was particularly strong on Friday.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Under “skinny repeal,” 700,000 fewer Californians would been covered through individual plans sold on the exchange, according to a Covered California statement. An additional 300,000 Californians were expected to drop out of Medi-Cal due to the elimination of the individual mandate.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“Covered California and the Medi-Cal expansion are safe for now, and we can feel more secure knowing that our families, friends and employees won’t lose their health insurance,” said Jonathan Greer, an independent health insurance broker in Oakland.\u003c/p>\n\u003cp>Greer said watching the prolonged legislative battle in D.C. was agonizing: “It was like watching a good friend or relative suffer in the hospital, not knowing if they would recover.”\u003c/p>\n\u003cp>California’s Democrats applauded Sen. John McCain’s \u003ca href=\"https://www.mccain.senate.gov/public/index.cfm/press-releases?ID=A952CCCA-66D2-4570-9D57-514561BF3D4D\" target=\"_blank\" rel=\"noopener noreferrer\">call\u003c/a> for a return to bipartisanship after his thumbs-down “no” vote.\u003c/p>\n\u003cp>“I could not agree more, ” said \u003ca href=\"https://bera.house.gov/\" target=\"_blank\" rel=\"noopener noreferrer\">congressman Ami Bera\u003c/a> (D-Elk Grove). Bera, an internist. He’s one of two Democratic doctors in Congress. Earlier this month, Bera pushed an \u003ca href=\"https://newdemocratcoalition-himes.house.gov/media-center/press-releases/new-democrat-coalition-healthcare-task-force-leads-release-of-market\" target=\"_blank\" rel=\"noopener noreferrer\">alternate plan\u003c/a> to improve the Affordable Care Act, which now has the support of more than 80 House Democrats.\u003c/p>\n\u003cp>“We are ready and willing to come to the table with solutions,” Bera said. “I hope to work with my Republican colleagues in the coming weeks to put patients first, cut costs, and increase the number of people insured.”\u003c/p>\n\u003cp>Nearly 3.7 million individuals have health coverage through the ACA’s Medi-Cal expansion, and more than 1.4 million people are insured through Covered California.\u003c/p>\n\u003cp>California has experienced the largest decline in its uninsured rate in the country — dropping from 17.2 percent in 2013 to 7.1 percent in 2016.\u003c/p>\n\u003cp>But attempts to undermine the effectiveness of the Affordable Care Act could continue, said Sandra R. Hernández, president and CEO of the \u003ca href=\"http://www.chcf.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Health Care Foundation\u003c/a>.\u003c/p>\n\u003cp>“Danger still lies ahead,” she \u003ca href=\"http://www.chcf.org/media/press-releases/2017/aca-law-land\" target=\"_blank\" rel=\"noopener noreferrer\">warned\u003c/a>. “They will try to make enrollment more difficult, and cut back on public outreach. We especially need to keep a bright light on the budget and appropriations process and on tax reform efforts.”\u003c/p>\n\u003cp>Hernández predicts there will also be more attempts to slash funding for Medicaid and other medical safety-net programs.\u003c/p>\n\u003cp>But Rep. \u003ca href=\"https://calvert.house.gov/district/\" target=\"_blank\" rel=\"noopener noreferrer\">Ken Calvert\u003c/a> (R-Riverside County) says the status quo is a problem too big to ignore. “Despite political drama in the Senate, we must not lose sight of the fact that Obamacare premiums continue to rise and health insurance providers are dropping out of exchanges across the country.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Calvert urged Congress to keep working to provide Americans with the relief they need.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Northern California has many attractions, but the fact that it’s prime tick habitat isn’t one of them.\u003c/p>\n\u003cp>Adding to the angst surrounding outdoor activities is that tick hotspots are unevenly distributed on a patchy landscape.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘Medicine has the tendency to want a vaccine or a clear antibiotic silver bullet, and I don’t think the Lyme system gives us that luxury.’\u003ccite>Nate Nieto, University of Northern Arizona\u003c/cite>\u003c/aside>\n\u003cp>One moment you’re strolling through redwood forests, the next through oak forests, and a couple of hours later you may come across scenic chaparral. While on this iconic hike, you probably don’t realize that you’ve moved through both high- and low-risk Lyme disease areas. The question is, do you know where you are most at risk?\u003c/p>\n\u003cp>The answer is in the oak forest where layers of rich leaf litter are a kind of Club Med for ticks.\u003c/p>\n\u003cp>\u003cstrong>It’s Always Tick Season\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Tick season” exists year-round in northern California. The highest risk is in the spring and early summer due to an abundance of juvenile ticks, known as nymphs (the most virulent life-stage). However, peak diagnosis time extends into July, because it can take a few weeks to realize that you have the disease.\u003c/p>\n\u003cp>Summer is also particularly dangerous for Lyme disease because that’s when people spend the most time outside, and many of the most beautiful hiking areas tend to be tick-ridden.\u003c/p>\n\u003cfigure id=\"attachment_1870758\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1870758\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2017/07/Tick-on-Leaf_Shutterstock_99641744_-e1500680859219-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-on-Leaf_Shutterstock_99641744_-e1500680859219-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-on-Leaf_Shutterstock_99641744_-e1500680859219-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-on-Leaf_Shutterstock_99641744_-e1500680859219-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-on-Leaf_Shutterstock_99641744_-e1500680859219-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-on-Leaf_Shutterstock_99641744_-e1500680859219-1920x1280.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-on-Leaf_Shutterstock_99641744_-e1500680859219-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-on-Leaf_Shutterstock_99641744_-e1500680859219-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-on-Leaf_Shutterstock_99641744_-e1500680859219-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-on-Leaf_Shutterstock_99641744_-e1500680859219-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-on-Leaf_Shutterstock_99641744_-e1500680859219-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">It’s always tick season in Northern California. Peak season is spring and early summer. \u003ccite>(Bay Area Lyme Foundation)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Most people associate Lyme disease with the Northeastern U.S. and the upper Midwest, and for \u003ca href=\"https://www.cdc.gov/lyme/stats/maps.html\">good reason\u003c/a>; the vast majority of cases are reported there, due mostly to the fact that the landscape is blanketed with prime tick habitat. On the west coast, the risk is real, but it’s different.\u003c/p>\n\u003caside class=\"alignright\">\u003cstrong>How to prevent a tick bite in the first place.\u003c/strong>\n\u003cul>\n\u003cli>\u003cstrong>Dress the part\u003c/strong>: Ticks tend to like to climb upwards, so wear full-length pants, tucked into your socks, and a full length shirt, tucked into your pants\u003c/li>\n\u003cli>\u003cstrong>Pesticide options\u003c/strong>: Chemical tick-repellents or acaricides can be very effective at low dosages. Be sure to read manufacturer’s instructions carefully.\u003c/li>\n\u003cli>\u003cstrong>Clean your body and clothes\u003c/strong>: Take a shower once you get home from a hike and throw your clothes in a hot dryer for a 1-hour cycle.\u003c/li>\n\u003cli>\u003cstrong>Check your pets and yourself\u003c/strong>: Perform a thorough tick check when you get home. Ticks can travel into your house on dogs and cats.\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>“There are definitely patches in California where the risk is just as high as the East –it’s just not the same spatial extent,” says Dan Salkeld, research scientist at Colorado State University.\u003c/p>\n\u003cp>The overall abundance of Lyme ticks is relatively low on the West Coast; however, the risk is spread unevenly. Hikers can move from high-risk area to a low-risk area and never know it.\u003c/p>\n\u003cp>In California, “You can be in one valley and rates of Lyme can be as high as in upstate New York, Connecticut or Rhode Island,” says Nate Nieto, a microbiologist at Northern Arizona University in Flagstaff. “Then you go over one ridge, the habitat changes completely –and there’s nothing,”\u003c/p>\n\u003cp>Part of what puts Californians at risk is a lack of awareness — among the public and even among doctors. Much of the research and public health information is based on east coast ecology and may not apply to the West.\u003c/p>\n\u003cp>For many Californian physicians, Lyme disease is just not on the radar, even though according to the \u003ca href=\"http://www.bayarealyme.org/\">Bay Area Lyme Foundation\u003c/a>, Lyme-infected ticks have been located in 42 of California’s 58 counties (highest incidence were in Trinity, Humbolt and Mendocino as of 2014). About 100 cases of Lyme disease are reported in California each year, but according to Supervising Public Health Biologist Kerry Padgett of the state Department of Public Health, the disease is likely more widespread.\u003c/p>\n\u003cp>“There is an under-diagnosis and under-reporting of Lyme disease in California,” says Padgett.\u003c/p>\n\u003cp>\u003cstrong>How Ticks Make Us Sick\u003c/strong>\u003c/p>\n\u003cp>Lyme disease is caused by a microscopic spiral-shaped bacteria called \u003cem>borrelia burgdorferi\u003c/em>. On the west coast, these Lyme disease-causing bacteria live inside the guts of the western blacklegged tick and can travel into the blood streams of bitten animals.Ticks generally live for two or three years. They are born Lyme-free, and will contract or transmit Lyme during feeding, once during each of their three life stages.\u003c/p>\n\u003cfigure id=\"attachment_1870913\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1870913\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2017/07/lizard-with-ticks-closer-up-800x572.jpg\" alt=\"\" width=\"800\" height=\"572\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/lizard-with-ticks-closer-up-800x572.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/lizard-with-ticks-closer-up-160x114.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/lizard-with-ticks-closer-up-768x549.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/lizard-with-ticks-closer-up-240x172.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/lizard-with-ticks-closer-up-375x268.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/lizard-with-ticks-closer-up-520x372.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/lizard-with-ticks-closer-up.jpg 898w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Blue-bellied lizards are our friends. Their blood actually cures infected ticks of Lyme disease. The “grapes” in this lizard’s ear are all feeding ticks. \u003ccite>(Ervic Aquino)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>When a Lyme-infected tick bites, it typically takes 36-48 hours for the bacteria to make the journey from the tick’s gut to their mouth and into the blood of their host. The process can take as little as 24 hours.\u003c/p>\n\u003cp>Only 15-20 percent of backlegged ticks contain Lyme disease during their nymph stage, and that number is much lower, 1-2 percent, in adults.\u003c/p>\n\u003cp>\u003cstrong>A Forest Full of Frenemies\u003c/strong>\u003c/p>\n\u003cp>To determine disease risk of a particular place, researchers look to some of the tick’s favorite foods.\u003c/p>\n\u003cp>The most common reservoir of Lyme disease — the species that initially infects ticks — is the western gray squirrel.\u003c/p>\n\u003cp>So avoid gray squirrel habitat and you’re safe? Not so fast.\u003c/p>\n\u003cp>Enter the blue-bellied lizard (also known as the western fence lizard), which is naturally immune to Lyme disease, and has special proteins in its blood that will cleanse infected ticks of the pathogen.\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch3>What to do if you find a tick on you:\u003c/h3>\n\u003cfigure>\n\u003cfigure id=\"attachment_1870759\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1870759 size-medium\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2017/07/Tick-sizes_Nate_larger-1-800x515.jpg\" alt=\"\" width=\"800\" height=\"515\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-sizes_Nate_larger-1-800x515.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-sizes_Nate_larger-1-160x103.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-sizes_Nate_larger-1-768x494.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-sizes_Nate_larger-1-1020x656.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-sizes_Nate_larger-1-1180x759.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-sizes_Nate_larger-1-960x618.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-sizes_Nate_larger-1-240x154.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-sizes_Nate_larger-1-375x241.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-sizes_Nate_larger-1-520x335.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-sizes_Nate_larger-1.jpg 1200w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Adult (left) and nymph (right) western blacklegged ticks. \u003ccite>(Bay Area Lyme Foundation)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003c/figure>\n\u003cp>\u003cstrong>If you find a tick on your body, don’t panic! Remove the tick and keep track of what happens.\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>Is the tick feeding? That is, is the tick embedded in the skin?\u003c/li>\n\u003cli>If the tick is embedded, slowly and steadily, with even pressure, remove the entire tick by pulling it straight out with a pair of tweezers. Do not jerk or twist the tick. Remove any mouthparts that break off during removal. Then, if possible, save the tick in a jar or plastic bag. DO NOT try to kill the tick with oil or matches while it’s feeding. (If you do, it will release the contents of its gut into you.)\u003c/li>\n\u003cli>Clean the bite area with rubbing alcohol or soap and warm water.\u003c/li>\n\u003cli>How long did it feed? If it’s less than 36 hours, there’s a high probability that you are safe.\u003c/li>\n\u003cli>Pay attention to your symptoms. If in 6-to-12 days, you have any kind of fever, go and see a doctor.\u003c/li>\n\u003cli>A bulls-eye rash around the tick bite is a sure-fire way to know if you’ve contracted Lyme, but this symptom only shows up in 50-70 percent of cases. Other symptoms include headache, fatigue, and skin rash.\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>So, a tick could feed on a squirrel and contract Lyme, which could then be neutralized when it bites a lizard.\u003c/p>\n\u003cp>“If you go into dense black oak woodland, which is prime habitat for ticks and squirrels, we find a higher proportion of infected ticks,” explains Salkeld. “However, if you move into a broken clearing with more light, you’re going to find more lizards, and the prevalence of Lyme goes down.”\u003c/p>\n\u003cp>Lyme disease involves many different species and is ecologically complex, which makes it a notoriously difficult problem to solve for researchers and public health officials.\u003c/p>\n\u003cp>“Medicine has the tendency to want a vaccine or a clear antibiotic silver bullet, and I don’t think the Lyme system gives us that luxury,” says Nieto.\u003c/p>\n\u003cp>“Lyme disease is something that we call, in the science world, a complex system, meaning that there’s a bunch going on here,” he continues. “ there’s a bunch of hosts, there’s a bunch of vectors, and there’s a bunch of pathogens, and that makes things difficult.”\u003c/p>\n\u003cp>\u003cstrong>Mapping a Pathogen\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>California’s diverse landscape and the complex interplay among species makes predicting Lyme tricky. However, the greatest risk posed to Californians might be a lack of awareness. Doctors here are less likely to suspect Lyme when patients come in with characteristic symptoms.\u003c/p>\n\u003cp>“I have talked to physicians who say that they are not aware of Lyme disease in California,” says Salkeld.\u003c/p>\n\u003cp>Organizations, such as the Bay Area Lyme Foundation, along with researchers like Nieto and Salkeld, are working to change the narrative and build the necessary evidence to make doctors aware of the scale of the problem. The foundation has a \u003ca href=\"http://www.bayarealyme.org/blog/bay-area-lyme-foundation-offers-free-tick-testing-nationwide/\">program\u003c/a> offering free tick testing nationwide, which aims to map tick-borne diseases across the country by encouraging concerned citizens to send in samples.\u003c/p>\n\u003cp>“We’re working on gathering real empirical data to show that Lyme is in the ecosystems of the West Coast,” says Nieto, “We’re getting clinical samples, ecological [tick] samples, and wildlife host samples…so we can change the educational paradigm within the medical schools and say, ‘It’s not just the Northeast and upper Midwest’—it’s in California too.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“I think Californians should be aware of ticks, and the risks of tick-borne diseases, but the fear of disease should not keep them from enjoying the great outdoors,” adds Padgett. “I really do feel it’s possible to stay tick-safe while recreating and spending time outside.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Northern California has many attractions, but the fact that it’s prime tick habitat isn’t one of them.\u003c/p>\n\u003cp>Adding to the angst surrounding outdoor activities is that tick hotspots are unevenly distributed on a patchy landscape.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘Medicine has the tendency to want a vaccine or a clear antibiotic silver bullet, and I don’t think the Lyme system gives us that luxury.’\u003ccite>Nate Nieto, University of Northern Arizona\u003c/cite>\u003c/aside>\n\u003cp>One moment you’re strolling through redwood forests, the next through oak forests, and a couple of hours later you may come across scenic chaparral. While on this iconic hike, you probably don’t realize that you’ve moved through both high- and low-risk Lyme disease areas. The question is, do you know where you are most at risk?\u003c/p>\n\u003cp>The answer is in the oak forest where layers of rich leaf litter are a kind of Club Med for ticks.\u003c/p>\n\u003cp>\u003cstrong>It’s Always Tick Season\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Tick season” exists year-round in northern California. The highest risk is in the spring and early summer due to an abundance of juvenile ticks, known as nymphs (the most virulent life-stage). However, peak diagnosis time extends into July, because it can take a few weeks to realize that you have the disease.\u003c/p>\n\u003cp>Summer is also particularly dangerous for Lyme disease because that’s when people spend the most time outside, and many of the most beautiful hiking areas tend to be tick-ridden.\u003c/p>\n\u003cfigure id=\"attachment_1870758\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1870758\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2017/07/Tick-on-Leaf_Shutterstock_99641744_-e1500680859219-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-on-Leaf_Shutterstock_99641744_-e1500680859219-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-on-Leaf_Shutterstock_99641744_-e1500680859219-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-on-Leaf_Shutterstock_99641744_-e1500680859219-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-on-Leaf_Shutterstock_99641744_-e1500680859219-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-on-Leaf_Shutterstock_99641744_-e1500680859219-1920x1280.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-on-Leaf_Shutterstock_99641744_-e1500680859219-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-on-Leaf_Shutterstock_99641744_-e1500680859219-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-on-Leaf_Shutterstock_99641744_-e1500680859219-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-on-Leaf_Shutterstock_99641744_-e1500680859219-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-on-Leaf_Shutterstock_99641744_-e1500680859219-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">It’s always tick season in Northern California. Peak season is spring and early summer. \u003ccite>(Bay Area Lyme Foundation)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Most people associate Lyme disease with the Northeastern U.S. and the upper Midwest, and for \u003ca href=\"https://www.cdc.gov/lyme/stats/maps.html\">good reason\u003c/a>; the vast majority of cases are reported there, due mostly to the fact that the landscape is blanketed with prime tick habitat. On the west coast, the risk is real, but it’s different.\u003c/p>\n\u003caside class=\"alignright\">\u003cstrong>How to prevent a tick bite in the first place.\u003c/strong>\n\u003cul>\n\u003cli>\u003cstrong>Dress the part\u003c/strong>: Ticks tend to like to climb upwards, so wear full-length pants, tucked into your socks, and a full length shirt, tucked into your pants\u003c/li>\n\u003cli>\u003cstrong>Pesticide options\u003c/strong>: Chemical tick-repellents or acaricides can be very effective at low dosages. Be sure to read manufacturer’s instructions carefully.\u003c/li>\n\u003cli>\u003cstrong>Clean your body and clothes\u003c/strong>: Take a shower once you get home from a hike and throw your clothes in a hot dryer for a 1-hour cycle.\u003c/li>\n\u003cli>\u003cstrong>Check your pets and yourself\u003c/strong>: Perform a thorough tick check when you get home. Ticks can travel into your house on dogs and cats.\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>“There are definitely patches in California where the risk is just as high as the East –it’s just not the same spatial extent,” says Dan Salkeld, research scientist at Colorado State University.\u003c/p>\n\u003cp>The overall abundance of Lyme ticks is relatively low on the West Coast; however, the risk is spread unevenly. Hikers can move from high-risk area to a low-risk area and never know it.\u003c/p>\n\u003cp>In California, “You can be in one valley and rates of Lyme can be as high as in upstate New York, Connecticut or Rhode Island,” says Nate Nieto, a microbiologist at Northern Arizona University in Flagstaff. “Then you go over one ridge, the habitat changes completely –and there’s nothing,”\u003c/p>\n\u003cp>Part of what puts Californians at risk is a lack of awareness — among the public and even among doctors. Much of the research and public health information is based on east coast ecology and may not apply to the West.\u003c/p>\n\u003cp>For many Californian physicians, Lyme disease is just not on the radar, even though according to the \u003ca href=\"http://www.bayarealyme.org/\">Bay Area Lyme Foundation\u003c/a>, Lyme-infected ticks have been located in 42 of California’s 58 counties (highest incidence were in Trinity, Humbolt and Mendocino as of 2014). About 100 cases of Lyme disease are reported in California each year, but according to Supervising Public Health Biologist Kerry Padgett of the state Department of Public Health, the disease is likely more widespread.\u003c/p>\n\u003cp>“There is an under-diagnosis and under-reporting of Lyme disease in California,” says Padgett.\u003c/p>\n\u003cp>\u003cstrong>How Ticks Make Us Sick\u003c/strong>\u003c/p>\n\u003cp>Lyme disease is caused by a microscopic spiral-shaped bacteria called \u003cem>borrelia burgdorferi\u003c/em>. On the west coast, these Lyme disease-causing bacteria live inside the guts of the western blacklegged tick and can travel into the blood streams of bitten animals.Ticks generally live for two or three years. They are born Lyme-free, and will contract or transmit Lyme during feeding, once during each of their three life stages.\u003c/p>\n\u003cfigure id=\"attachment_1870913\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1870913\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2017/07/lizard-with-ticks-closer-up-800x572.jpg\" alt=\"\" width=\"800\" height=\"572\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/lizard-with-ticks-closer-up-800x572.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/lizard-with-ticks-closer-up-160x114.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/lizard-with-ticks-closer-up-768x549.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/lizard-with-ticks-closer-up-240x172.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/lizard-with-ticks-closer-up-375x268.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/lizard-with-ticks-closer-up-520x372.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/lizard-with-ticks-closer-up.jpg 898w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Blue-bellied lizards are our friends. Their blood actually cures infected ticks of Lyme disease. The “grapes” in this lizard’s ear are all feeding ticks. \u003ccite>(Ervic Aquino)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>When a Lyme-infected tick bites, it typically takes 36-48 hours for the bacteria to make the journey from the tick’s gut to their mouth and into the blood of their host. The process can take as little as 24 hours.\u003c/p>\n\u003cp>Only 15-20 percent of backlegged ticks contain Lyme disease during their nymph stage, and that number is much lower, 1-2 percent, in adults.\u003c/p>\n\u003cp>\u003cstrong>A Forest Full of Frenemies\u003c/strong>\u003c/p>\n\u003cp>To determine disease risk of a particular place, researchers look to some of the tick’s favorite foods.\u003c/p>\n\u003cp>The most common reservoir of Lyme disease — the species that initially infects ticks — is the western gray squirrel.\u003c/p>\n\u003cp>So avoid gray squirrel habitat and you’re safe? Not so fast.\u003c/p>\n\u003cp>Enter the blue-bellied lizard (also known as the western fence lizard), which is naturally immune to Lyme disease, and has special proteins in its blood that will cleanse infected ticks of the pathogen.\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch3>What to do if you find a tick on you:\u003c/h3>\n\u003cfigure>\n\u003cfigure id=\"attachment_1870759\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1870759 size-medium\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2017/07/Tick-sizes_Nate_larger-1-800x515.jpg\" alt=\"\" width=\"800\" height=\"515\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-sizes_Nate_larger-1-800x515.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-sizes_Nate_larger-1-160x103.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-sizes_Nate_larger-1-768x494.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-sizes_Nate_larger-1-1020x656.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-sizes_Nate_larger-1-1180x759.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-sizes_Nate_larger-1-960x618.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-sizes_Nate_larger-1-240x154.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-sizes_Nate_larger-1-375x241.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-sizes_Nate_larger-1-520x335.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/07/Tick-sizes_Nate_larger-1.jpg 1200w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Adult (left) and nymph (right) western blacklegged ticks. \u003ccite>(Bay Area Lyme Foundation)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003c/figure>\n\u003cp>\u003cstrong>If you find a tick on your body, don’t panic! Remove the tick and keep track of what happens.\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>Is the tick feeding? That is, is the tick embedded in the skin?\u003c/li>\n\u003cli>If the tick is embedded, slowly and steadily, with even pressure, remove the entire tick by pulling it straight out with a pair of tweezers. Do not jerk or twist the tick. Remove any mouthparts that break off during removal. Then, if possible, save the tick in a jar or plastic bag. DO NOT try to kill the tick with oil or matches while it’s feeding. (If you do, it will release the contents of its gut into you.)\u003c/li>\n\u003cli>Clean the bite area with rubbing alcohol or soap and warm water.\u003c/li>\n\u003cli>How long did it feed? If it’s less than 36 hours, there’s a high probability that you are safe.\u003c/li>\n\u003cli>Pay attention to your symptoms. If in 6-to-12 days, you have any kind of fever, go and see a doctor.\u003c/li>\n\u003cli>A bulls-eye rash around the tick bite is a sure-fire way to know if you’ve contracted Lyme, but this symptom only shows up in 50-70 percent of cases. Other symptoms include headache, fatigue, and skin rash.\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>So, a tick could feed on a squirrel and contract Lyme, which could then be neutralized when it bites a lizard.\u003c/p>\n\u003cp>“If you go into dense black oak woodland, which is prime habitat for ticks and squirrels, we find a higher proportion of infected ticks,” explains Salkeld. “However, if you move into a broken clearing with more light, you’re going to find more lizards, and the prevalence of Lyme goes down.”\u003c/p>\n\u003cp>Lyme disease involves many different species and is ecologically complex, which makes it a notoriously difficult problem to solve for researchers and public health officials.\u003c/p>\n\u003cp>“Medicine has the tendency to want a vaccine or a clear antibiotic silver bullet, and I don’t think the Lyme system gives us that luxury,” says Nieto.\u003c/p>\n\u003cp>“Lyme disease is something that we call, in the science world, a complex system, meaning that there’s a bunch going on here,” he continues. “ there’s a bunch of hosts, there’s a bunch of vectors, and there’s a bunch of pathogens, and that makes things difficult.”\u003c/p>\n\u003cp>\u003cstrong>Mapping a Pathogen\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>California’s diverse landscape and the complex interplay among species makes predicting Lyme tricky. However, the greatest risk posed to Californians might be a lack of awareness. Doctors here are less likely to suspect Lyme when patients come in with characteristic symptoms.\u003c/p>\n\u003cp>“I have talked to physicians who say that they are not aware of Lyme disease in California,” says Salkeld.\u003c/p>\n\u003cp>Organizations, such as the Bay Area Lyme Foundation, along with researchers like Nieto and Salkeld, are working to change the narrative and build the necessary evidence to make doctors aware of the scale of the problem. The foundation has a \u003ca href=\"http://www.bayarealyme.org/blog/bay-area-lyme-foundation-offers-free-tick-testing-nationwide/\">program\u003c/a> offering free tick testing nationwide, which aims to map tick-borne diseases across the country by encouraging concerned citizens to send in samples.\u003c/p>\n\u003cp>“We’re working on gathering real empirical data to show that Lyme is in the ecosystems of the West Coast,” says Nieto, “We’re getting clinical samples, ecological [tick] samples, and wildlife host samples…so we can change the educational paradigm within the medical schools and say, ‘It’s not just the Northeast and upper Midwest’—it’s in California too.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I think Californians should be aware of ticks, and the risks of tick-borne diseases, but the fear of disease should not keep them from enjoying the great outdoors,” adds Padgett. “I really do feel it’s possible to stay tick-safe while recreating and spending time outside.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>WASHINGTON — After seven years of emphatic campaign promises, Senate Republicans demonstrated Wednesday they don’t have the stomach to repeal Obamacare when it really counts, as the Senate voted 55-45 to reject legislation undoing major portions of Barack Obama’s law without replacing it.\u003c/p>\n\u003cp>Seven Republicans joined all Democrats in rejecting an amendment by Rand Paul of Kentucky that would have repealed most of former President Obama’s health care law, with a two-year delay but no replacement. Congress passed nearly identical legislation in 2015 and sent it to Obama, who unsurprisingly vetoed it.\u003c/p>\n\u003cp>Yet this time, with a president in the White House who says he’s itching to sign the bill, the measure failed on the Senate floor.\u003c/p>\n\u003cp>The Congressional Budget Office has estimated that repealing Obamacare without replacing it would cost more than 30 million Americans their insurance coverage, and that was a key factor in driving away a handful of Republican senators, more than Majority Leader Mitch McConnell could lose in the closely divided Senate.\u003c/p>\n\u003cp>[contextly_sidebar id=”q4yDkDTS4BBB2H9GInIvL8b05XGzSxEH”]\u003c/p>\n\u003cp>The result frustrated other GOP senators, some of whom expressed disbelief that their colleagues would flip-flop on legislation they had voted for only two years ago and long promised to voters. Of the current Republican senators, only moderate Susan Collins of Maine opposed the 2015 repeal bill.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I think everybody in there, maybe except for one senator, promised their supporters, their voters that they supported repeal of Obamacare,” said Ron Johnson of Wisconsin. “A lot of them said ‘root and branch.’ Now, we’re so far away from that. I’d just remind my colleagues, remember what you promised your voters.”\u003c/p>\n\u003cp>Yet the outcome was no shock in a Senate that’s already shown that unity is elusive when it comes to dealing with Obamacare. The real-world implications of repeal have proved sobering to GOP senators answering to voters who have come to rely on expanded insurance coverage under the law.\u003c/p>\n\u003cp>What the party’s senators will end up agreeing on instead is far from clear. Yet they plunged forward with debate toward their unknown goal, pressured by an impatient president. By week’s end Republicans hope to reach agreement among themselves, and eventually with the House, on some kind of repeal and replacement of the Obama law they have reviled for so long.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>One possibility taking shape in talks among senators was a “skinny repeal” that would abolish just a few of the key elements of Obama’s law, including mandates that everyone purchase insurance and taxes that all GOP senators can agree to oppose.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>WASHINGTON — After seven years of emphatic campaign promises, Senate Republicans demonstrated Wednesday they don’t have the stomach to repeal Obamacare when it really counts, as the Senate voted 55-45 to reject legislation undoing major portions of Barack Obama’s law without replacing it.\u003c/p>\n\u003cp>Seven Republicans joined all Democrats in rejecting an amendment by Rand Paul of Kentucky that would have repealed most of former President Obama’s health care law, with a two-year delay but no replacement. Congress passed nearly identical legislation in 2015 and sent it to Obama, who unsurprisingly vetoed it.\u003c/p>\n\u003cp>Yet this time, with a president in the White House who says he’s itching to sign the bill, the measure failed on the Senate floor.\u003c/p>\n\u003cp>The Congressional Budget Office has estimated that repealing Obamacare without replacing it would cost more than 30 million Americans their insurance coverage, and that was a key factor in driving away a handful of Republican senators, more than Majority Leader Mitch McConnell could lose in the closely divided Senate.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The result frustrated other GOP senators, some of whom expressed disbelief that their colleagues would flip-flop on legislation they had voted for only two years ago and long promised to voters. Of the current Republican senators, only moderate Susan Collins of Maine opposed the 2015 repeal bill.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I think everybody in there, maybe except for one senator, promised their supporters, their voters that they supported repeal of Obamacare,” said Ron Johnson of Wisconsin. “A lot of them said ‘root and branch.’ Now, we’re so far away from that. I’d just remind my colleagues, remember what you promised your voters.”\u003c/p>\n\u003cp>Yet the outcome was no shock in a Senate that’s already shown that unity is elusive when it comes to dealing with Obamacare. The real-world implications of repeal have proved sobering to GOP senators answering to voters who have come to rely on expanded insurance coverage under the law.\u003c/p>\n\u003cp>What the party’s senators will end up agreeing on instead is far from clear. Yet they plunged forward with debate toward their unknown goal, pressured by an impatient president. By week’s end Republicans hope to reach agreement among themselves, and eventually with the House, on some kind of repeal and replacement of the Obama law they have reviled for so long.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>One possibility taking shape in talks among senators was a “skinny repeal” that would abolish just a few of the key elements of Obama’s law, including mandates that everyone purchase insurance and taxes that all GOP senators can agree to oppose.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "On Precipice of Senate Vote, East Bay Health Clinic Fears for Thousands of Patients",
"title": "On Precipice of Senate Vote, East Bay Health Clinic Fears for Thousands of Patients",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>\u003cspan style=\"font-weight: 400\">U.S. senators voted 51-50 on Tuesday to begin debate on a controversial health care bill that could unwind the 7-year-old Affordable Care Act, and possibly revamp the way Medicaid has been funded for the past 52 years. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The GOP leaders have not determined exactly \u003ca href=\"https://www.vox.com/policy-and-politics/2017/7/25/16027526/senate-health-care-bill-debate-explained\" target=\"_blank\" rel=\"noopener noreferrer\">what version\u003c/a> of the bill will be brought up for a vote after 20 hours of scheduled debate. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But two of the bills being considered would cut federal funding for Medicaid, the insurance program for low-income adults and children, pregnant women and people with disabilities. Since 1965, Medicaid has been administered by the states, but paid for through a combination of state and federal funds. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">In California, the program is called Medi-Cal, and it covers one in three Californians. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Doctors, nurses and staff members at \u003c/span>\u003ca href=\"http://www.tvhc.org/\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan style=\"font-weight: 400\">Tiburcio Vasquez Health Center\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> (TVHC) in Hayward have been speaking with KQED over the past month about how the proposed cuts of billions of dollars for Medi-Cal would affect the clinic's work as the safety-net provider of last resort for vulnerable patients. \u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Both [bills] would be just terrible for our patients,\" said Chief Medical Officer Dr. Porshia Mack, after Tuesday's \"motion to proceed\" vote. \"If it’s 'repeal and delay,' there’s no guarantee that they’d come up with a bill to cover those people that would lose insurance.”\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>'Less people will have coverage. Bottom line.' \u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_358426\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003cimg class=\"wp-image-358426\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/07/RS26075_David-B-Vliet-NCB-pic-qut-1020x1096.jpg\" alt=\"David B. Vliet is the Chief Executive Officer of Tiburcio Vasquez Health Center. He says if Obamacare is dismantled, less people will have health coverage.\" width=\"300\" height=\"322\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/07/RS26075_David-B-Vliet-NCB-pic-qut-1020x1096.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/RS26075_David-B-Vliet-NCB-pic-qut-160x172.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/RS26075_David-B-Vliet-NCB-pic-qut-800x860.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/RS26075_David-B-Vliet-NCB-pic-qut-768x825.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/RS26075_David-B-Vliet-NCB-pic-qut-1180x1268.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/RS26075_David-B-Vliet-NCB-pic-qut-960x1032.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/RS26075_David-B-Vliet-NCB-pic-qut-240x258.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/RS26075_David-B-Vliet-NCB-pic-qut-375x403.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/RS26075_David-B-Vliet-NCB-pic-qut-520x559.jpg 520w\" sizes=\"(max-width: 300px) 100vw, 300px\">\u003cfigcaption class=\"wp-caption-text\">David B. Vliet is the chief executive officer of Tiburcio Vasquez Health Center. He says if Obamacare is dismantled, fewer people will have health coverage.\u003c/figcaption>\u003c/figure>\n\u003cp>Recently, KQED health reporter Laura Klivans sat down with TVHC’s CEO to learn more about the day-to-day work of a large urban community health center and how potential cuts to Medi-Cal could affect that.\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This interview was edited for brevity and clarity.\u003c/span>\u003c/i>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>Name:\u003c/strong> David B. Vliet\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>Title:\u003c/strong> Chief executive officer at Tiburcio Vasquez Health Center, a federally supported clinic with locations in Hayward, Union City and Fremont. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Q: Tell me a bit about the scope of the programs here.\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>A:\u003c/strong> We are pretty much a typical, run-of-the-mill community health center. We are \u003c/span>\u003ca href=\"https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/fqhcfactsheet.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan style=\"font-weight: 400\">federally qualified\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, which essentially compels us to take care of any member of the community that needs health care without regard to their ability to pay. We have pediatrics, internal medicine, family practice, women's health and dental. We also have a very large WIC — \u003c/span>\u003cspan style=\"font-weight: 400\">\u003ca href=\"https://www.fns.usda.gov/wic/women-infants-and-children-wic\" target=\"_blank\" rel=\"noopener noreferrer\">Women, Infants, and Children\u003c/a> —\u003c/span>\u003cspan style=\"font-weight: 400\"> program. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Q: Can you tell me a little bit about your own background and how you ended up as the CEO of Tiburcio Vasquez Health Center?\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>A:\u003c/strong> This is a movement that goes back to the civil rights movement. So we have a large number of people who have been in this work for a long time. I'm relatively new to the community health center world. I have about 16 years.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">I got here because having lived in Mexico as a younger man, I saw a very desperate need for health care. I wanted to actually have my own mobile clinic that would go into the rural areas of Florida to deliver health care, like a bus that was outfitted. And very long story short, I decided that if I was going to raise money to do that I’d have to get an undergraduate degree in that area. I sort of slipstreamed into health administration in Florida. Then I moved to Texas, where I was introduced in 2002 to the community health center model, and fell in love with it. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">In Austin, Texas, I ran the \u003c/span>\u003ca href=\"http://communitycaretx.org/\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan style=\"font-weight: 400\">community health centers\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> for about 10 years. I learned that this is really important, rewarding work because we get to impact the health outcomes of the community and see people be well. A lot of people will walk around with their diabetes out of control or slight depression or a toothache. And the fact that we're able to address that in a systematic way, to me is very exciting. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Q: Coming from Texas to a state like California, what are some of the things you've noticed about how health care is different at a community clinic level? \u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>A:\u003c/strong> Similar to Travis County [where Austin, Texas, is located], Alameda County is also very progressive. And the community’s very committed to serving people even without documentation, because there is a return on investment when you do that. The overall cost of care longitudinally is reduced when you take care of people \u003c/span>\u003ci>\u003cspan style=\"font-weight: 400\">when\u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\"> they need to be taken care of. So I think there are a lot of similarities, but the political atmosphere certainly is much different in Texas.\u003c/span>\u003c/p>\n\u003cp>\u003cb>Q: What do you find to be unique about Tiburcio Vasquez? \u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>A:\u003c/strong> We began our health care journey back in the early '70s taking care of families that were busy making America great in agriculture, in the fields. As their families grew and they got ill, we were there in a very simple form. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">[Community Health Centers] take care of around \u003c/span>\u003ca href=\"http://www.kff.org/report-section/community-health-centers-recent-growth-and-the-role-of-the-aca-issue-brief/\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan style=\"font-weight: 400\">24 million\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> patients across the United States. We're a significant safety-net model and we've enjoyed bipartisan support for many years.\u003c/span>\u003c/p>\n\u003cp>\u003cb>Q: How have the additional dollars from the Medi-Cal expansion helped Tiburcio Vasquez?\u003c/b>\u003c/p>\n\u003cp>\u003cstrong>A:\u003c/strong> We opened up a new health center in San Leandro. We're able to add exam rooms, and add dental chairs, and hire staff, and then see more patients. But there were dollars that did other things, [for example], the conversion to the electronic health record so that we're no longer on paper charts.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">If those [Medi-Cal dollars] go away, we will continue to have to take care of communities whether the funding is there or not. Those dollars really do have a return on investment, in that when we are able to make sure that Mr. Smith or Mrs. Rodriguez doesn't show up in the ER with tooth pain, everyone in the community enjoys lower costs because of that.\u003c/span>\u003c/p>\n\u003cp>\u003cb>Q: If the ACA gets dismantled, what's the impact going to be for Tiburcio Vasquez? \u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>A: \u003c/strong>Less people will have coverage. Bottom line. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Health centers are here, and have been for 50-odd years. We have funding from the federal government and have enjoyed bipartisan support. But that has not always been enough. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The Medicaid expansion assures -- particularly for adults who were not covered previously, working adults -- they're able to come in here and get preventive care. If there is a reduction in Medicaid, some of those folks in our county could be pushed off Medicaid and will probably go back on some sort of county plan. \u003c/span>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">At our health center, roughly 5,000 folks that did not have coverage before currently have Medicaid. That number will go away under the contraction of Medicaid under the proposed new bill. \u003c/span>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan style=\"font-weight: 400\">U.S. senators voted 51-50 on Tuesday to begin debate on a controversial health care bill that could unwind the 7-year-old Affordable Care Act, and possibly revamp the way Medicaid has been funded for the past 52 years. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The GOP leaders have not determined exactly \u003ca href=\"https://www.vox.com/policy-and-politics/2017/7/25/16027526/senate-health-care-bill-debate-explained\" target=\"_blank\" rel=\"noopener noreferrer\">what version\u003c/a> of the bill will be brought up for a vote after 20 hours of scheduled debate. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But two of the bills being considered would cut federal funding for Medicaid, the insurance program for low-income adults and children, pregnant women and people with disabilities. Since 1965, Medicaid has been administered by the states, but paid for through a combination of state and federal funds. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">In California, the program is called Medi-Cal, and it covers one in three Californians. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Doctors, nurses and staff members at \u003c/span>\u003ca href=\"http://www.tvhc.org/\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan style=\"font-weight: 400\">Tiburcio Vasquez Health Center\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> (TVHC) in Hayward have been speaking with KQED over the past month about how the proposed cuts of billions of dollars for Medi-Cal would affect the clinic's work as the safety-net provider of last resort for vulnerable patients. \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Both [bills] would be just terrible for our patients,\" said Chief Medical Officer Dr. Porshia Mack, after Tuesday's \"motion to proceed\" vote. \"If it’s 'repeal and delay,' there’s no guarantee that they’d come up with a bill to cover those people that would lose insurance.”\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>'Less people will have coverage. Bottom line.' \u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_358426\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003cimg class=\"wp-image-358426\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/07/RS26075_David-B-Vliet-NCB-pic-qut-1020x1096.jpg\" alt=\"David B. Vliet is the Chief Executive Officer of Tiburcio Vasquez Health Center. He says if Obamacare is dismantled, less people will have health coverage.\" width=\"300\" height=\"322\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/07/RS26075_David-B-Vliet-NCB-pic-qut-1020x1096.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/RS26075_David-B-Vliet-NCB-pic-qut-160x172.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/RS26075_David-B-Vliet-NCB-pic-qut-800x860.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/RS26075_David-B-Vliet-NCB-pic-qut-768x825.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/RS26075_David-B-Vliet-NCB-pic-qut-1180x1268.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/RS26075_David-B-Vliet-NCB-pic-qut-960x1032.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/RS26075_David-B-Vliet-NCB-pic-qut-240x258.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/RS26075_David-B-Vliet-NCB-pic-qut-375x403.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/RS26075_David-B-Vliet-NCB-pic-qut-520x559.jpg 520w\" sizes=\"(max-width: 300px) 100vw, 300px\">\u003cfigcaption class=\"wp-caption-text\">David B. Vliet is the chief executive officer of Tiburcio Vasquez Health Center. He says if Obamacare is dismantled, fewer people will have health coverage.\u003c/figcaption>\u003c/figure>\n\u003cp>Recently, KQED health reporter Laura Klivans sat down with TVHC’s CEO to learn more about the day-to-day work of a large urban community health center and how potential cuts to Medi-Cal could affect that.\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This interview was edited for brevity and clarity.\u003c/span>\u003c/i>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>Name:\u003c/strong> David B. Vliet\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>Title:\u003c/strong> Chief executive officer at Tiburcio Vasquez Health Center, a federally supported clinic with locations in Hayward, Union City and Fremont. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Q: Tell me a bit about the scope of the programs here.\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>A:\u003c/strong> We are pretty much a typical, run-of-the-mill community health center. We are \u003c/span>\u003ca href=\"https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/fqhcfactsheet.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan style=\"font-weight: 400\">federally qualified\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, which essentially compels us to take care of any member of the community that needs health care without regard to their ability to pay. We have pediatrics, internal medicine, family practice, women's health and dental. We also have a very large WIC — \u003c/span>\u003cspan style=\"font-weight: 400\">\u003ca href=\"https://www.fns.usda.gov/wic/women-infants-and-children-wic\" target=\"_blank\" rel=\"noopener noreferrer\">Women, Infants, and Children\u003c/a> —\u003c/span>\u003cspan style=\"font-weight: 400\"> program. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Q: Can you tell me a little bit about your own background and how you ended up as the CEO of Tiburcio Vasquez Health Center?\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>A:\u003c/strong> This is a movement that goes back to the civil rights movement. So we have a large number of people who have been in this work for a long time. I'm relatively new to the community health center world. I have about 16 years.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">I got here because having lived in Mexico as a younger man, I saw a very desperate need for health care. I wanted to actually have my own mobile clinic that would go into the rural areas of Florida to deliver health care, like a bus that was outfitted. And very long story short, I decided that if I was going to raise money to do that I’d have to get an undergraduate degree in that area. I sort of slipstreamed into health administration in Florida. Then I moved to Texas, where I was introduced in 2002 to the community health center model, and fell in love with it. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">In Austin, Texas, I ran the \u003c/span>\u003ca href=\"http://communitycaretx.org/\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan style=\"font-weight: 400\">community health centers\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> for about 10 years. I learned that this is really important, rewarding work because we get to impact the health outcomes of the community and see people be well. A lot of people will walk around with their diabetes out of control or slight depression or a toothache. And the fact that we're able to address that in a systematic way, to me is very exciting. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Q: Coming from Texas to a state like California, what are some of the things you've noticed about how health care is different at a community clinic level? \u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>A:\u003c/strong> Similar to Travis County [where Austin, Texas, is located], Alameda County is also very progressive. And the community’s very committed to serving people even without documentation, because there is a return on investment when you do that. The overall cost of care longitudinally is reduced when you take care of people \u003c/span>\u003ci>\u003cspan style=\"font-weight: 400\">when\u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\"> they need to be taken care of. So I think there are a lot of similarities, but the political atmosphere certainly is much different in Texas.\u003c/span>\u003c/p>\n\u003cp>\u003cb>Q: What do you find to be unique about Tiburcio Vasquez? \u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>A:\u003c/strong> We began our health care journey back in the early '70s taking care of families that were busy making America great in agriculture, in the fields. As their families grew and they got ill, we were there in a very simple form. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">[Community Health Centers] take care of around \u003c/span>\u003ca href=\"http://www.kff.org/report-section/community-health-centers-recent-growth-and-the-role-of-the-aca-issue-brief/\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan style=\"font-weight: 400\">24 million\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> patients across the United States. We're a significant safety-net model and we've enjoyed bipartisan support for many years.\u003c/span>\u003c/p>\n\u003cp>\u003cb>Q: How have the additional dollars from the Medi-Cal expansion helped Tiburcio Vasquez?\u003c/b>\u003c/p>\n\u003cp>\u003cstrong>A:\u003c/strong> We opened up a new health center in San Leandro. We're able to add exam rooms, and add dental chairs, and hire staff, and then see more patients. But there were dollars that did other things, [for example], the conversion to the electronic health record so that we're no longer on paper charts.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">If those [Medi-Cal dollars] go away, we will continue to have to take care of communities whether the funding is there or not. Those dollars really do have a return on investment, in that when we are able to make sure that Mr. Smith or Mrs. Rodriguez doesn't show up in the ER with tooth pain, everyone in the community enjoys lower costs because of that.\u003c/span>\u003c/p>\n\u003cp>\u003cb>Q: If the ACA gets dismantled, what's the impact going to be for Tiburcio Vasquez? \u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>A: \u003c/strong>Less people will have coverage. Bottom line. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Health centers are here, and have been for 50-odd years. We have funding from the federal government and have enjoyed bipartisan support. But that has not always been enough. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The Medicaid expansion assures -- particularly for adults who were not covered previously, working adults -- they're able to come in here and get preventive care. If there is a reduction in Medicaid, some of those folks in our county could be pushed off Medicaid and will probably go back on some sort of county plan. \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">At our health center, roughly 5,000 folks that did not have coverage before currently have Medicaid. That number will go away under the contraction of Medicaid under the proposed new bill. \u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cstrong>Update at 4:05 p.m. ET\u003c/strong>\u003c/p>\n\u003cp>Sen. John McCain, diagnosed with a deadly form of brain cancer just five days ago, returned to applause on the Senate floor Tuesday, where he cast a crucial vote to move forward on repeal of the Affordable Care Act and urged his colleagues to regain their sense of bipartisan cooperation.\u003c/p>\n\u003cp>However, the longtime Arizona senator, two-time presidential candidate and perhaps America’s most famous former prisoner of war, warned that he “will not vote for this bill as it is today,” describing it as “a shell.”\u003c/p>\n\u003cp>McCain said he would attend the Senate for a few days and then go home to Arizona to recuperate.\u003c/p>\n\u003cp>“I have every intention of returning here to give you all reason to regret the nice things you said about me,” he told his fellow senators, addressing the outpouring of support he’s received since announcing his diagnosis.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It was a remarkable moment, to see McCain, whose daughter described him poetically as a “warrior at dusk,” take his place again in the “world’s greatest deliberative body,” where he has represented his Southwestern state for 30 years.\u003c/p>\n\u003cp>McCain, with surgical stitches clearly visible above his left eye, admonished both Republicans and Democrats to work together in the old way and to stop trying to make laws “behind closed doors.”\u003c/p>\n\u003cp>He acknowledged that it was easy to fall victim to the urge to win instead of doing what is right. “Merely preventing your political opponents from getting what they want isn’t very inspiring,” he said.\u003c/p>\n\u003cp>And, he advised strongly: “Stop listening to the bombastic loudmouths on the television, radio and internet. The hell with them!”\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=Cw4RqZAKa5A\u003c/p>\n\u003cp>Meanwhile, McCain’s vote, along with a tiebreaker from Vice President Mike Pence, gave Republicans the 51 votes they needed for the “motion to proceed.”\u003c/p>\n\u003cp>A motion to proceed is what it sounds like — a measure to allow debate to begin. There will be 20 hours of debate, which will expire Wednesday, NPR’s Susan Davis reports.\u003c/p>\n\u003cp>Republicans could only lose two votes for a majority without any Democratic support. Sens. Susan Collins, R-Maine, and Lisa Murkowski, R-Alaska, both voted no.\u003c/p>\n\u003cp>Beyond the motion-to-proceed vote and the ensuing debate, no one is quite sure — not even Republicans — what of substance the GOP will try to pass to overhaul health care, which affects roughly one-sixth of the U.S. economy.\u003c/p>\n\u003cp>Senate Majority Leader Mitch McConnell, of Kentucky, promised to bring a full repeal of the Affordable Care Act with a two-year delay to the floor, which President Trump seemed to be on board with. But, up to this point, the votes aren’t there for that approach; too many Republicans have come out publicly opposing the idea.\u003c/p>\n\u003cp>So then what? If the full repeal isn’t brought to the floor, or if it fails, then it’s on to the Senate’s version of no-holds barred — a “vote-o-rama,” where anyone can bring any amendment to the floor and have it voted on.\u003c/p>\n\u003cp>That would be kind of like doing the work normally done for months in committees out on the Senate floor in a matter of hours and days.\u003c/p>\n\u003cp>[contextly_sidebar id=”A1BV4vIZp3nWCZPcR9pkrpepufcyYqww”]\u003c/p>\n\u003cp>This is just the latest chapter in Republicans’ difficulty replacing the ACA, also known as Obamacare. Legislatively, they have been plagued by starts and stops during the Trump presidency, unable to get their differing ideological factions on the same page.\u003c/p>\n\u003cp>“Obamacare is the law of the land,” House Speaker Paul Ryan, R-Wis., declared after the House’s health care flameout months ago.\u003c/p>\n\u003cp>But, through arm twisting and legislative tweaks, the House eventually passed a version that tinkered with the ACA. The Congressional Budget Office said the law would increase the number of uninsured by tens of millions, especially because of how it would change Medicaid.\u003c/p>\n\u003cp>Nonetheless it was a political victory, if only a lead at halftime. It was greeted by Bud Lights in the House and a Rose Garden celebration with the president of the United States. There was no “45” jersey with GOP on the front and “Trump” on the back, but there might as well have been.\u003c/p>\n\u003cp>One would have thought a new law had been signed. It hadn’t. The House version was headed to the Senate, where it would certainly change and have to be reconciled with the House.\u003c/p>\n\u003cp>Back to the drawing board.\u003c/p>\n\u003cp>Nearly three months later, that Rose Garden ceremony remains the high point for Republicans. The GOP has not been able to gather the votes in the Senate — and that has started to really rankle Trump. His irritation was evident during his appearance Monday at the Boy Scouts National Jamboree in West Virginia.\u003c/p>\n\u003cp>“As the Scout law says, a Scout is trustworthy, loyal,” Trump said. He added, “We could use some more loyalty, I will tell you that.”\u003c/p>\n\u003cp>Speaking of Health and Human Services Secretary Tom Price, who was on stage with him, Trump said, “Hopefully he’s going to get the votes tomorrow to start our path toward killing this horrible thing known as Obamacare that’s really hurting us.”\u003c/p>\n\u003cp>Trump spoke of Price as if he were McConnell, as if he had some control over whipping the votes on health care. Price wasn’t even a senator before joining Trump’s Cabinet; he was a member of the House from Georgia.\u003c/p>\n\u003cp>He went on: “By the way, are you going to get the votes? He better get them. He better get them. Oh, he better. Otherwise, I’ll say, ‘Tom, you’re fired.’ I’ll get somebody.”\u003c/p>\n\u003cp>Then Trump turned to Price, smiling, as if to say, “Only kidding.”\u003c/p>\n\u003cp>Or maybe not. That came on the same day he called his attorney general, Jeff Sessions, “beleaguered.”\u003c/p>\n\u003cp>On Tuesday morning, he tweeted criticism of Sessions, calling him “weak” on Hillary Clinton and “leakers” from the intelligence community.\u003c/p>\n\u003cp>https://twitter.com/realDonaldTrump/status/889790429398528000\u003c/p>\n\u003cp>Speaking to the Scouts, Trump wasn’t quite done yet: “He better get Sen. [Shelley Moore] Capito to vote for it. He better get the other senators to vote for it. It’s time.”\u003c/p>\n\u003cp>At that time, Capito, a West Virginia Republican, was one of the holdouts on voting for what Republicans have so far proposed when it comes to health care. She was one of a dozen or so senators who had not committed to even voting for the motion to proceed. (During Tuesday’s vote, she did support the motion.)\u003c/p>\n\u003cp>The Boy Scouts is supposed to be an apolitical organization, and after the speech, the group put out a statement saying it does not endorse any candidate.\u003c/p>\n\u003cp>Trump has begun referring to Republicans as “they” and “you” (“they” promised to repeal and replace Obamacare for seven years; “you” didn’t do it). It’s a remarkable effort to separate himself from the party he is supposed to lead.\u003c/p>\n\u003cp>He tweeted that any senator who votes against the motion to proceed is for Obamacare.\u003c/p>\n\u003cp>And he seemed to threaten them politically.\u003c/p>\n\u003cp>https://twitter.com/realDonaldTrump/status/889599425458327552\u003c/p>\n\u003cp>Where any of this goes is anyone’s guess. But as a nation watches a new president who is blowing through with Twitter maelstroms and appears ready to politically fire in all directions, the Senate paused for a few moments Tuesday to recognize a man in McCain who means something very different.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>And then it was back to the wind — with Trump, speaking immediately after McCain’s remarks on the Senate floor, about how no Democrats had voted in favor of the Republican effort to undo Obamacare and reaffirming his recent negative comments about Sessions.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=John+McCain+Makes+Dramatic+Return+Amid+Political+Storm&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Update at 4:05 p.m. ET\u003c/strong>\u003c/p>\n\u003cp>Sen. John McCain, diagnosed with a deadly form of brain cancer just five days ago, returned to applause on the Senate floor Tuesday, where he cast a crucial vote to move forward on repeal of the Affordable Care Act and urged his colleagues to regain their sense of bipartisan cooperation.\u003c/p>\n\u003cp>However, the longtime Arizona senator, two-time presidential candidate and perhaps America’s most famous former prisoner of war, warned that he “will not vote for this bill as it is today,” describing it as “a shell.”\u003c/p>\n\u003cp>McCain said he would attend the Senate for a few days and then go home to Arizona to recuperate.\u003c/p>\n\u003cp>“I have every intention of returning here to give you all reason to regret the nice things you said about me,” he told his fellow senators, addressing the outpouring of support he’s received since announcing his diagnosis.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It was a remarkable moment, to see McCain, whose daughter described him poetically as a “warrior at dusk,” take his place again in the “world’s greatest deliberative body,” where he has represented his Southwestern state for 30 years.\u003c/p>\n\u003cp>McCain, with surgical stitches clearly visible above his left eye, admonished both Republicans and Democrats to work together in the old way and to stop trying to make laws “behind closed doors.”\u003c/p>\n\u003cp>He acknowledged that it was easy to fall victim to the urge to win instead of doing what is right. “Merely preventing your political opponents from getting what they want isn’t very inspiring,” he said.\u003c/p>\n\u003cp>And, he advised strongly: “Stop listening to the bombastic loudmouths on the television, radio and internet. The hell with 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/Cw4RqZAKa5A'\n title='//www.youtube.com/embed/Cw4RqZAKa5A'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>Meanwhile, McCain’s vote, along with a tiebreaker from Vice President Mike Pence, gave Republicans the 51 votes they needed for the “motion to proceed.”\u003c/p>\n\u003cp>A motion to proceed is what it sounds like — a measure to allow debate to begin. There will be 20 hours of debate, which will expire Wednesday, NPR’s Susan Davis reports.\u003c/p>\n\u003cp>Republicans could only lose two votes for a majority without any Democratic support. Sens. Susan Collins, R-Maine, and Lisa Murkowski, R-Alaska, both voted no.\u003c/p>\n\u003cp>Beyond the motion-to-proceed vote and the ensuing debate, no one is quite sure — not even Republicans — what of substance the GOP will try to pass to overhaul health care, which affects roughly one-sixth of the U.S. economy.\u003c/p>\n\u003cp>Senate Majority Leader Mitch McConnell, of Kentucky, promised to bring a full repeal of the Affordable Care Act with a two-year delay to the floor, which President Trump seemed to be on board with. But, up to this point, the votes aren’t there for that approach; too many Republicans have come out publicly opposing the idea.\u003c/p>\n\u003cp>So then what? If the full repeal isn’t brought to the floor, or if it fails, then it’s on to the Senate’s version of no-holds barred — a “vote-o-rama,” where anyone can bring any amendment to the floor and have it voted on.\u003c/p>\n\u003cp>That would be kind of like doing the work normally done for months in committees out on the Senate floor in a matter of hours and days.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>This is just the latest chapter in Republicans’ difficulty replacing the ACA, also known as Obamacare. Legislatively, they have been plagued by starts and stops during the Trump presidency, unable to get their differing ideological factions on the same page.\u003c/p>\n\u003cp>“Obamacare is the law of the land,” House Speaker Paul Ryan, R-Wis., declared after the House’s health care flameout months ago.\u003c/p>\n\u003cp>But, through arm twisting and legislative tweaks, the House eventually passed a version that tinkered with the ACA. The Congressional Budget Office said the law would increase the number of uninsured by tens of millions, especially because of how it would change Medicaid.\u003c/p>\n\u003cp>Nonetheless it was a political victory, if only a lead at halftime. It was greeted by Bud Lights in the House and a Rose Garden celebration with the president of the United States. There was no “45” jersey with GOP on the front and “Trump” on the back, but there might as well have been.\u003c/p>\n\u003cp>One would have thought a new law had been signed. It hadn’t. The House version was headed to the Senate, where it would certainly change and have to be reconciled with the House.\u003c/p>\n\u003cp>Back to the drawing board.\u003c/p>\n\u003cp>Nearly three months later, that Rose Garden ceremony remains the high point for Republicans. The GOP has not been able to gather the votes in the Senate — and that has started to really rankle Trump. His irritation was evident during his appearance Monday at the Boy Scouts National Jamboree in West Virginia.\u003c/p>\n\u003cp>“As the Scout law says, a Scout is trustworthy, loyal,” Trump said. He added, “We could use some more loyalty, I will tell you that.”\u003c/p>\n\u003cp>Speaking of Health and Human Services Secretary Tom Price, who was on stage with him, Trump said, “Hopefully he’s going to get the votes tomorrow to start our path toward killing this horrible thing known as Obamacare that’s really hurting us.”\u003c/p>\n\u003cp>Trump spoke of Price as if he were McConnell, as if he had some control over whipping the votes on health care. Price wasn’t even a senator before joining Trump’s Cabinet; he was a member of the House from Georgia.\u003c/p>\n\u003cp>He went on: “By the way, are you going to get the votes? He better get them. He better get them. Oh, he better. 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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>Speaking to the Scouts, Trump wasn’t quite done yet: “He better get Sen. [Shelley Moore] Capito to vote for it. He better get the other senators to vote for it. It’s time.”\u003c/p>\n\u003cp>At that time, Capito, a West Virginia Republican, was one of the holdouts on voting for what Republicans have so far proposed when it comes to health care. She was one of a dozen or so senators who had not committed to even voting for the motion to proceed. (During Tuesday’s vote, she did support the motion.)\u003c/p>\n\u003cp>The Boy Scouts is supposed to be an apolitical organization, and after the speech, the group put out a statement saying it does not endorse any candidate.\u003c/p>\n\u003cp>Trump has begun referring to Republicans as “they” and “you” (“they” promised to repeal and replace Obamacare for seven years; “you” didn’t do it). It’s a remarkable effort to separate himself from the party he is supposed to lead.\u003c/p>\n\u003cp>He tweeted that any senator who votes against the motion to proceed is for Obamacare.\u003c/p>\n\u003cp>And he seemed to threaten them politically.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>Where any of this goes is anyone’s guess. But as a nation watches a new president who is blowing through with Twitter maelstroms and appears ready to politically fire in all directions, the Senate paused for a few moments Tuesday to recognize a man in McCain who means something very different.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And then it was back to the wind — with Trump, speaking immediately after McCain’s remarks on the Senate floor, about how no Democrats had voted in favor of the Republican effort to undo Obamacare and reaffirming his recent negative comments about Sessions.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=John+McCain+Makes+Dramatic+Return+Amid+Political+Storm&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"slug": "scientists-are-releasing-20-million-mosquitoes-in-fresno-county",
"title": "Scientists Are Releasing 20 Million Mosquitoes in Fresno County",
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"headTitle": "Scientists Are Releasing 20 Million Mosquitoes in Fresno County | KQED",
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"content": "\u003cp>This summer, scientists in California are releasing 20 million mosquitoes in an effort to shrink the population of mosquitoes that can carry diseases.\u003c/p>\n\u003cp>It sounds counterintuitive. But the plan is to release millions of sterile male mosquitoes, which will then mate with wild female mosquitoes. The eggs the females lay won’t hatch, researchers say.\u003c/p>\n\u003cp>The project is called \u003ca href=\"https://blog.verily.com/2017/07/debug-fresno-our-first-us-field-study.html\">Debug Fresno\u003c/a> and it’s being undertaken by Verily, a subsidiary of Alphabet, Google’s holding company. It’s the company’s first field study involving sterile mosquitoes in the U.S.\u003c/p>\n\u003cp>Scientists say the goal is to cut the population of \u003cem>Aedes aegypti\u003c/em> mosquitoes — the species responsible for spreading Zika, dengue and chikungunya. \u003cem>A. aegypti\u003c/em> have been present in California’s Central Valley since 2013 and have been a problem in Fresno County.\u003c/p>\n\u003cp>“It’s a terrible nuisance, a terrible biting nuisance. It’s changed the way people can enjoy their backyard and it’s a threat for disease transmission,” Steve Mulligan of Fresno County’s Consolidated Mosquito Abatement District told \u003ca href=\"https://www.washingtonpost.com/news/to-your-health/wp/2017/07/19/scientists-plan-to-trick-zika-carrying-mosquitoes-into-breeding-themselves-out-of-existence/?utm_term=.488aede6eedb\">The Washington Post\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Each week for 20 weeks, the company plans to release 1 million of the sterile, non-biting male mosquitoes in two neighborhoods in Fresno County. The male mosquitoes are bred and infected with \u003cem>Wolbachia\u003c/em>, a bacterium that is “naturally found in at least 40 percent of all insect species,” according to \u003ca href=\"http://www.the-scientist.com/?articles.view/articleNo/46021/title/Bacterium-Blocks-Zika-s-Spread/\">The Scientist magazine\u003c/a>, though it’s normally not found in \u003cem>A. aegypti\u003c/em>.\u003c/p>\n\u003cp>“Over time, we hope to see a steep decline in the presence of \u003cem>Aedes aegypti\u003c/em> in these communities,” Verily says in a statement.\u003c/p>\n\u003cp>In a phenomenon called cytoplasmic incompatibility, “matings between \u003cem>Wolbachia\u003c/em>-infected males and uninfected females results in embryo lethality or low hatch rates,” William Sullivan and Scott L. O’Neill \u003ca href=\"http://www.nature.com/nature/journal/v543/n7644/fig_tab/nature21509_F1.html\">write in the journal Nature\u003c/a>. “Because the effect of \u003cem>Wolbachia\u003c/em> infection on insect reproduction favours the survival of \u003cem>Wolbachia\u003c/em>-infected females over uninfected females, \u003cem>Wolbachia\u003c/em> can rapidly spread through an insect population.”\u003c/p>\n\u003cp>\u003cem>Wolbachia\u003c/em> also helps mosquitoes to avoid carrying diseases like Zika in the first place. \u003cem>A. aegypti\u003c/em> “carrying \u003cem>Wolbachia\u003c/em> bacteria were highly resistant to Zika virus infection, and were unable to transmit the virus via their saliva,” \u003ca href=\"http://www.the-scientist.com/?articles.view/articleNo/46021/title/Bacterium-Blocks-Zika-s-Spread/\">The Scientist writes\u003c/a>, citing a 2016 study in Brazil.\u003c/p>\n\u003cp>The magazine says the bacterium “is not known” to infect humans.\u003c/p>\n\u003cp>Verily is partnering in the project with the Kentucky-based company MosquitoMate and the Consolidated Mosquito Abatement District of Fresno County. They plan to study the \u003cem>A. aegypti\u003c/em> population density and number of eggs hatching in the experimental areas and compare to control neighborhoods to measure the experiment’s effectiveness.\u003c/p>\n\u003cp>It’s not the first time the bacteria-carrying mosquitoes have been released into the wild in the U.S.\u003c/p>\n\u003cp>MosquitoMate and the Florida Keys Mosquito Control District \u003ca href=\"http://fkmcd.maps.arcgis.com/apps/MapJournal/index.html?appid=d8c2b636e93b40b4b940e6042ef286c6\">released 75,000\u003c/a> \u003cem>Wolbachia\u003c/em>-carrying mosquitoes each week for several weeks this spring in the Florida Keys.\u003c/p>\n\u003cp>Last year in Fresno, MosquitoMate and county officials released \u003ca href=\"https://www.theverge.com/2017/7/14/15972950/mosquitoes-google-alphabet-verily-debug-wolbachia-bacteria-fresno-california\">about 800,000\u003c/a> of the mosquitoes. This experiment is a 25-fold increase on that.\u003c/p>\n\u003cp>Verily says it developed “automated mass rearing and sex-sorting processes,” which enable it to breed and release so many of the mosquitoes in such a short time.\u003c/p>\n\u003cp>\u003cem>A. aegypti\u003c/em> is an invasive species to Fresno County, and officials told the \u003cem>Post\u003c/em> they don’t predict an impact on the local ecosystem from reducing or eliminating it.\u003c/p>\n\u003cp>The method Verily is using to cut the mosquito population differs from the experiment the British company Oxitec proposed last year in the Florida Keys. In contrast to the mosquitoes being infected by bacteria, Oxitec has released males that are genetically modified with “a gene that causes the mosquito’s offspring to die in the first two to three days of life,” according to \u003ca href=\"https://www.dallasnews.com/news/zika-virus/2017/07/14/genetically-engineered-mosquitoes-wipe-zika-dallas-county-oppose-local-trials\">The Dallas Morning News\u003c/a>. Many Florida Keys residents \u003ca href=\"http://www.npr.org/sections/health-shots/2016/11/20/502717253/florida-keys-approves-trial-of-genetically-modified-mosquitoes-to-fight-zika\">bitterly opposed\u003c/a> the proposed experiment last year; some Texas residents are reacting similarly to a proposed trial there, the \u003cem>Morning News\u003c/em> reports.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>From the spring to the fall of 2016, \u003ca href=\"https://www.cdc.gov/media/releases/2017/s0620-virus-carrying-mosquitoes.html\">38 additional counties\u003c/a> in the U.S. reported evidence of the \u003cem>A. aegypti\u003c/em> mosquito, according to the Centers for Disease Control and Prevention. Since the beginning of 2015, \u003ca href=\"https://www.cdc.gov/zika/reporting/case-counts.html\">more than 5,300\u003c/a> symptomatic cases of Zika were reported to the CDC in the U.S., though the vast majority stemmed from people traveling to affected areas. As of Wednesday, the agency said there were \u003ca href=\"https://www.cdc.gov/zika/reporting/2017-case-counts.html\">no reported cases\u003c/a> of people getting Zika in the U.S. this year “through presumed local mosquito-borne transmission.”\u003c/p>\n\n",
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"excerpt": "Scientists plan to release millions of sterile male mosquitoes in California, hoping for a \"steep decline\" in species that carries Zika.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>This summer, scientists in California are releasing 20 million mosquitoes in an effort to shrink the population of mosquitoes that can carry diseases.\u003c/p>\n\u003cp>It sounds counterintuitive. But the plan is to release millions of sterile male mosquitoes, which will then mate with wild female mosquitoes. The eggs the females lay won’t hatch, researchers say.\u003c/p>\n\u003cp>The project is called \u003ca href=\"https://blog.verily.com/2017/07/debug-fresno-our-first-us-field-study.html\">Debug Fresno\u003c/a> and it’s being undertaken by Verily, a subsidiary of Alphabet, Google’s holding company. It’s the company’s first field study involving sterile mosquitoes in the U.S.\u003c/p>\n\u003cp>Scientists say the goal is to cut the population of \u003cem>Aedes aegypti\u003c/em> mosquitoes — the species responsible for spreading Zika, dengue and chikungunya. \u003cem>A. aegypti\u003c/em> have been present in California’s Central Valley since 2013 and have been a problem in Fresno County.\u003c/p>\n\u003cp>“It’s a terrible nuisance, a terrible biting nuisance. It’s changed the way people can enjoy their backyard and it’s a threat for disease transmission,” Steve Mulligan of Fresno County’s Consolidated Mosquito Abatement District told \u003ca href=\"https://www.washingtonpost.com/news/to-your-health/wp/2017/07/19/scientists-plan-to-trick-zika-carrying-mosquitoes-into-breeding-themselves-out-of-existence/?utm_term=.488aede6eedb\">The Washington Post\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Each week for 20 weeks, the company plans to release 1 million of the sterile, non-biting male mosquitoes in two neighborhoods in Fresno County. The male mosquitoes are bred and infected with \u003cem>Wolbachia\u003c/em>, a bacterium that is “naturally found in at least 40 percent of all insect species,” according to \u003ca href=\"http://www.the-scientist.com/?articles.view/articleNo/46021/title/Bacterium-Blocks-Zika-s-Spread/\">The Scientist magazine\u003c/a>, though it’s normally not found in \u003cem>A. aegypti\u003c/em>.\u003c/p>\n\u003cp>“Over time, we hope to see a steep decline in the presence of \u003cem>Aedes aegypti\u003c/em> in these communities,” Verily says in a statement.\u003c/p>\n\u003cp>In a phenomenon called cytoplasmic incompatibility, “matings between \u003cem>Wolbachia\u003c/em>-infected males and uninfected females results in embryo lethality or low hatch rates,” William Sullivan and Scott L. O’Neill \u003ca href=\"http://www.nature.com/nature/journal/v543/n7644/fig_tab/nature21509_F1.html\">write in the journal Nature\u003c/a>. “Because the effect of \u003cem>Wolbachia\u003c/em> infection on insect reproduction favours the survival of \u003cem>Wolbachia\u003c/em>-infected females over uninfected females, \u003cem>Wolbachia\u003c/em> can rapidly spread through an insect population.”\u003c/p>\n\u003cp>\u003cem>Wolbachia\u003c/em> also helps mosquitoes to avoid carrying diseases like Zika in the first place. \u003cem>A. aegypti\u003c/em> “carrying \u003cem>Wolbachia\u003c/em> bacteria were highly resistant to Zika virus infection, and were unable to transmit the virus via their saliva,” \u003ca href=\"http://www.the-scientist.com/?articles.view/articleNo/46021/title/Bacterium-Blocks-Zika-s-Spread/\">The Scientist writes\u003c/a>, citing a 2016 study in Brazil.\u003c/p>\n\u003cp>The magazine says the bacterium “is not known” to infect humans.\u003c/p>\n\u003cp>Verily is partnering in the project with the Kentucky-based company MosquitoMate and the Consolidated Mosquito Abatement District of Fresno County. They plan to study the \u003cem>A. aegypti\u003c/em> population density and number of eggs hatching in the experimental areas and compare to control neighborhoods to measure the experiment’s effectiveness.\u003c/p>\n\u003cp>It’s not the first time the bacteria-carrying mosquitoes have been released into the wild in the U.S.\u003c/p>\n\u003cp>MosquitoMate and the Florida Keys Mosquito Control District \u003ca href=\"http://fkmcd.maps.arcgis.com/apps/MapJournal/index.html?appid=d8c2b636e93b40b4b940e6042ef286c6\">released 75,000\u003c/a> \u003cem>Wolbachia\u003c/em>-carrying mosquitoes each week for several weeks this spring in the Florida Keys.\u003c/p>\n\u003cp>Last year in Fresno, MosquitoMate and county officials released \u003ca href=\"https://www.theverge.com/2017/7/14/15972950/mosquitoes-google-alphabet-verily-debug-wolbachia-bacteria-fresno-california\">about 800,000\u003c/a> of the mosquitoes. This experiment is a 25-fold increase on that.\u003c/p>\n\u003cp>Verily says it developed “automated mass rearing and sex-sorting processes,” which enable it to breed and release so many of the mosquitoes in such a short time.\u003c/p>\n\u003cp>\u003cem>A. aegypti\u003c/em> is an invasive species to Fresno County, and officials told the \u003cem>Post\u003c/em> they don’t predict an impact on the local ecosystem from reducing or eliminating it.\u003c/p>\n\u003cp>The method Verily is using to cut the mosquito population differs from the experiment the British company Oxitec proposed last year in the Florida Keys. In contrast to the mosquitoes being infected by bacteria, Oxitec has released males that are genetically modified with “a gene that causes the mosquito’s offspring to die in the first two to three days of life,” according to \u003ca href=\"https://www.dallasnews.com/news/zika-virus/2017/07/14/genetically-engineered-mosquitoes-wipe-zika-dallas-county-oppose-local-trials\">The Dallas Morning News\u003c/a>. Many Florida Keys residents \u003ca href=\"http://www.npr.org/sections/health-shots/2016/11/20/502717253/florida-keys-approves-trial-of-genetically-modified-mosquitoes-to-fight-zika\">bitterly opposed\u003c/a> the proposed experiment last year; some Texas residents are reacting similarly to a proposed trial there, the \u003cem>Morning News\u003c/em> reports.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>From the spring to the fall of 2016, \u003ca href=\"https://www.cdc.gov/media/releases/2017/s0620-virus-carrying-mosquitoes.html\">38 additional counties\u003c/a> in the U.S. reported evidence of the \u003cem>A. aegypti\u003c/em> mosquito, according to the Centers for Disease Control and Prevention. Since the beginning of 2015, \u003ca href=\"https://www.cdc.gov/zika/reporting/case-counts.html\">more than 5,300\u003c/a> symptomatic cases of Zika were reported to the CDC in the U.S., though the vast majority stemmed from people traveling to affected areas. As of Wednesday, the agency said there were \u003ca href=\"https://www.cdc.gov/zika/reporting/2017-case-counts.html\">no reported cases\u003c/a> of people getting Zika in the U.S. this year “through presumed local mosquito-borne transmission.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"id": "code-switch-life-kit",
"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"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.",
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"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.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"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",
"subscribe": {
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
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},
"fresh-air": {
"id": "fresh-air",
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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"
},
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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.",
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"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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},
"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"
}
},
"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": {
"site": "news",
"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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"rss": "https://feeds.npr.org/510360/podcast.xml"
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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",
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"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",
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"officialWebsiteLink": "/podcasts/politicalbreakdown",
"meta": {
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"source": "kqed",
"order": 5
},
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