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"content": "\u003cfigure id=\"attachment_20380\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/139551566.jpg\">\u003cimg class=\"size-large wp-image-20380\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/139551566-640x425.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Right now, drug labels appear only in English in California, yet 44 percent of Californians speak a language other than English at home. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Every Saturday morning, a steady stream of Chinese and Vietnamese patients line up at the Paul Hom Asian Clinic in Sacramento. Most of them speak little to no English.\u003c/p>\n\u003cp>Patient assistance director Danny Tao says people come here to get free medical consultations and drug prescriptions. But, he says that when patients take those prescriptions to be filled, they don’t understand the instructions on the label.\u003c/p>\n\u003cp>\"They go pick them up, and we don’t exactly know if they’re taking it or not -- or if they know how to take it,\" Tao said.\u003c!--more-->\u003c/p>\n\u003cp>Tao says drug labels at most pharmacies in California are printed only in English. That puts patients in danger of taking of any number or errors -- taking too much medication or not enough, taking it at the wrong time of day, and more. Such mistakes can cause serious harm or even death.\u003c/p>\n\u003cp>Tao says that for the drugs his clinic supplies directly, all have a bilingual label.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"It’s going to be English/Chinese or English/Vietnamese,\" he said. \"By the time they get home they know exactly how to take the medication, because it’s in their own language.\"\u003c/p>\n\u003cp>This week California's Board of Pharmacy will discuss new regulations that would require all pharmacies in California to provide translated labels on prescription drug bottles. Statewide, 44 percent of Californians speak a language other than English at home. \u003ca href=\"http://www.rxtran.com/pharmacy-translation-regulations/pharmacy-translation-regulations-new-york-state.html\" target=\"_blank\">New York approved a similar rule \u003c/a>last year to make it easier for non-English speakers to take their medications properly and avoid costly mistakes.\u003c/p>\n\u003cp>But the board’s executive officer Virginia Herold says the move is very controversial. For starters, there is a concern that requiring translated labels would require larger bottles of pills to fit all the text. But she says patients don’t like larger bottles.\u003c/p>\n\u003cp>\u003ciframe width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/160863705&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\">\u003c/iframe>\u003c/p>\n\u003cp>\"They decant the drug out of the large container, put it in a baggie or someplace else,\" Herold said. \"There you’ve separated the drug from the container, now the instructions on how to take it have been separated.\"\u003c/p>\n\u003cp>Pharmacists don’t like the proposal because they say it opens them to liability if there’s a mistake in the translation. Brian Warren is with the California Pharmacists Association.\u003c/p>\n\u003cp>\"If the label is translated into Russian and there’s an error, and I’m a pharmacist that does not speak Russian, I cannot verify that that error exists,\" Warren said.\u003c/p>\n\u003cp>At present, the state's board of pharmacy \u003ca href=\"http://www.pharmacy.ca.gov/publications/translations.shtml\" target=\"_blank\">includes on its website\u003c/a> translations of basic instructions such as \"take one pill at bedtime\" in five languages: Chinese, Russian, Spanish, Korean, and Vietnamese.\u003c/p>\n\u003cp>Proponents of translating labels say that concerns about the change are outweighed by the problems patients who speak limited English face under the status quo.\u003c/p>\n\u003cp>\"There’s a risk right now,\" said Sarah de Guia, director of government affairs for the California Pan Ethnic Health Network, an advocacy group. \"They can’t understand anything on their label because the label is not in their language.\"\u003c/p>\n\u003cp>De Guia says the expansion of insurance under the Affordable Care Act places more urgency on the issue.\u003c/p>\n\u003cp>\"You’re going to have 1.5 million more limited-English proficient individuals in the health care system now that the ACA has passed.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The discussions are in the earliest stages, and if new regulations go forward, many details need to be worked out, including how many languages press and who would have responsibility for translation.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20380\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/139551566.jpg\">\u003cimg class=\"size-large wp-image-20380\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/139551566-640x425.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Right now, drug labels appear only in English in California, yet 44 percent of Californians speak a language other than English at home. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Every Saturday morning, a steady stream of Chinese and Vietnamese patients line up at the Paul Hom Asian Clinic in Sacramento. Most of them speak little to no English.\u003c/p>\n\u003cp>Patient assistance director Danny Tao says people come here to get free medical consultations and drug prescriptions. But, he says that when patients take those prescriptions to be filled, they don’t understand the instructions on the label.\u003c/p>\n\u003cp>\"They go pick them up, and we don’t exactly know if they’re taking it or not -- or if they know how to take it,\" Tao said.\u003c!--more-->\u003c/p>\n\u003cp>Tao says drug labels at most pharmacies in California are printed only in English. That puts patients in danger of taking of any number or errors -- taking too much medication or not enough, taking it at the wrong time of day, and more. Such mistakes can cause serious harm or even death.\u003c/p>\n\u003cp>Tao says that for the drugs his clinic supplies directly, all have a bilingual label.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"It’s going to be English/Chinese or English/Vietnamese,\" he said. \"By the time they get home they know exactly how to take the medication, because it’s in their own language.\"\u003c/p>\n\u003cp>This week California's Board of Pharmacy will discuss new regulations that would require all pharmacies in California to provide translated labels on prescription drug bottles. Statewide, 44 percent of Californians speak a language other than English at home. \u003ca href=\"http://www.rxtran.com/pharmacy-translation-regulations/pharmacy-translation-regulations-new-york-state.html\" target=\"_blank\">New York approved a similar rule \u003c/a>last year to make it easier for non-English speakers to take their medications properly and avoid costly mistakes.\u003c/p>\n\u003cp>But the board’s executive officer Virginia Herold says the move is very controversial. For starters, there is a concern that requiring translated labels would require larger bottles of pills to fit all the text. But she says patients don’t like larger bottles.\u003c/p>\n\u003cp>\u003ciframe width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/160863705&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\">\u003c/iframe>\u003c/p>\n\u003cp>\"They decant the drug out of the large container, put it in a baggie or someplace else,\" Herold said. \"There you’ve separated the drug from the container, now the instructions on how to take it have been separated.\"\u003c/p>\n\u003cp>Pharmacists don’t like the proposal because they say it opens them to liability if there’s a mistake in the translation. Brian Warren is with the California Pharmacists Association.\u003c/p>\n\u003cp>\"If the label is translated into Russian and there’s an error, and I’m a pharmacist that does not speak Russian, I cannot verify that that error exists,\" Warren said.\u003c/p>\n\u003cp>At present, the state's board of pharmacy \u003ca href=\"http://www.pharmacy.ca.gov/publications/translations.shtml\" target=\"_blank\">includes on its website\u003c/a> translations of basic instructions such as \"take one pill at bedtime\" in five languages: Chinese, Russian, Spanish, Korean, and Vietnamese.\u003c/p>\n\u003cp>Proponents of translating labels say that concerns about the change are outweighed by the problems patients who speak limited English face under the status quo.\u003c/p>\n\u003cp>\"There’s a risk right now,\" said Sarah de Guia, director of government affairs for the California Pan Ethnic Health Network, an advocacy group. \"They can’t understand anything on their label because the label is not in their language.\"\u003c/p>\n\u003cp>De Guia says the expansion of insurance under the Affordable Care Act places more urgency on the issue.\u003c/p>\n\u003cp>\"You’re going to have 1.5 million more limited-English proficient individuals in the health care system now that the ACA has passed.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The discussions are in the earliest stages, and if new regulations go forward, many details need to be worked out, including how many languages press and who would have responsibility for translation.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Anthem Blue Cross Sued Over Covered California Doctor Networks",
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"content": "\u003cfigure id=\"attachment_17341\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/96525183-e1390846077644.jpg\">\u003cimg class=\"size-large wp-image-17341\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/96525183-640x426.jpg\" alt=\"The Anthem Blue Cross headquarters in Woodland Hills, California. (David McNew/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Anthem Blue Cross headquarters in Woodland Hills, California. (David McNew/Getty Images) \u003ccite>(David McNew/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Julie Appleby,\u003c/strong> \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2014/July/09/anthem-lawsuit-over-enrollment-practices.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Statewide insurance giant Anthem Blue Cross misled “millions of enrollees” about whether their doctors and hospitals were participating in its new plans, and failed to disclose that many policies wouldn’t cover care outside its approved network, according to a \u003ca href=\"http://media.khn.webfactional.com/html/anthem-lawsuit/Felser.pdf\" target=\"_blank\">class action lawsuit\u003c/a> filed Tuesday.\u003c/p>\n\u003caside class=\"pullquote alignleft\">As a result, many consumers are on the hook for thousands in medical bills, advocacy group says.\u003c/aside>\n\u003cp>As a result, many consumers have been left on the hook for thousands of dollars in medical bills, and have been unable to see their longtime doctors, alleges the suit by Consumer Watchdog based in Santa Monica.\u003c/p>\n\u003cp>Anthem spokesman Darrel Ng declined to comment directly on the lawsuit. He said Anthem has agreed to pay the claims of those who received treatment from inaccurately listed doctors during the first three months of the year.\u003c/p>\n\u003cp>However, that policy would not be extended for enrollees who discovered after March 31 that their doctors had been incorrectly listed, he said.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The suit says that Anthem, the state’s largest individual health insurer, delayed providing full information to consumers until it was too late for them to change coverage. Anthem also failed to disclose it had stopped offering any plans with out-of-network coverage in four of the state's biggest counties -- Los Angeles, Orange, San Francisco and San Diego, the suit says.\u003c/p>\n\u003cp>Anthem “intentionally misrepresented and concealed the limitations of their plans because it wanted a big market share,” said Jerry Flanagan of the consumer advocacy group. Co-counsel on the case is the Claremont law firm Shernoff Bidart Echeverria Bentley, which specializes in suing health insurers.\u003c/p>\n\u003cp>The suit comes as Consumer Watchdog helped put a measure on the November ballot that would give the state's insurance commissioner greater authority to veto rate increases.\u003c/p>\n\u003cp>Brought on behalf of Anthem enrollees who purchased individual coverage between Oct. 1, 2013 and March 31, 2014, the lawsuit reflects growing consumer pushback against so-called “narrow network” health plans, which are increasingly common, especially in the new online state and federal marketplaces. Anthem was a major player on California’s insurance exchange and the suit includes those who bought coverage online, as well as directly from the insurer.\u003c/p>\n\u003cp>Insurers have defended plans with limited provider networks as \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/11/28/why-narrow-networks-may-not-be-such-a-bad-idea/\" target=\"_blank\">a way of holding down premiums\u003c/a>. Many expected younger and healthier customers might be willing to give up broad access to providers for these lower costs.\u003c/p>\n\u003cp>But consumers are retaliating with lawsuits and complaints to state regulators. As a result of the rising complaints, state managed care regulators are investigating whether Anthem and, separately, Blue Shield of California, provided accurate information about the doctors and hospitals in their plans.\u003c/p>\n\u003cp>\u003cstrong>Six Enrollees' Stories\u003c/strong>\u003c/p>\n\u003cp>The Consumer Watchdog lawsuit names six Californians who purchased Anthem plans. Among them is Betsy Felser of Pasadena, who had coverage with Anthem for 20 years. Like hundreds of thousands of Anthem customers, she received a letter late last year stating that her preferred provider organization (PPO), which allows for in- and out-of-network care, was being cancelled, according to the lawsuit. The letter suggested a replacement Anthem plan “with the benefits you have come to count on.”\u003c/p>\n\u003cp>Before agreeing to switch, Felser, a physician, said she checked with five Anthem telephone representatives, making it clear she wanted to be in a PPO.\u003c/p>\n\u003cp>“I would never have gotten anything that wasn’t a PPO plan,” said Felser, 47, whose insurance also covers her young son. “They said they would give me the same coverage.”\u003c/p>\n\u003cp>She also checked Anthem’s website and the doctors she sees, including her son’s pediatrician, to make sure they were participating in the plans she was considering and was assured that they were, she said.\u003c/p>\n\u003cp>During those calls, none of Anthem’s representatives told Felser that the insurer was no longer offering PPOs in Los Angeles County, the lawsuit alleges. Nor did they tell her that the Anthem plans offered in her area would not cover care provided by out-of-network doctors or hospitals, according to the lawsuit.\u003c/p>\n\u003cp>When she received her identification cards, they were stamped with a PPO symbol. But when she tried to use the coverage, she found out her doctors – and her son’s pediatrician – were not in the network and that the plan was an exclusive provider organization (EPO), an extremely limited type of plan which pays nothing for out-of-network care.\u003c/p>\n\u003cp>“It pays zero, so I essentially have no coverage,” said Felser.\u003c/p>\n\u003cp>Anthem, while declining to comment on the Consumer Watchdog suit, had answered questions last week about an earlier lawsuit that raised similar issues.\u003c/p>\n\u003cp>Spokesman Ng said then that consumers were informed about what kind of plan they purchased, along with details about out-of-network benefits, in packets they received soon after enrolling. “All those materials clearly spelled out type of plan they were receiving,” he said.\u003c/p>\n\u003cp>But consumers would have to dig deep in a brochure on the Anthem website to find a footnote to a page 9 chart indicating that EPO plans have no out-of-network benefits.\u003c/p>\n\u003cp>Ng noted that Anthem’s EPO and PPO networks have the same doctors and hospitals for people with individual policies, although only the PPOs have out-of-network benefits. In recent weeks, Anthem said it has added 3,800 doctors to its networks.\u003c/p>\n\u003cp>\u003cstrong>'A Giant Mess'\u003c/strong>\u003c/p>\n\u003cp>As for the PPO symbol on identification cards, Ng said last week that it had been intended to protect consumers who sought emergency care out-of-state, in keeping with Blue Cross Blue Shield Association rules. Ng said Anthem recently got association approval to reissue the cards without the symbol.\u003c/p>\n\u003cp>But consumers say the damage was done. Josh Worth of Los Angeles said he was unable to get accurate information after receiving notice that his Anthem plan would be cancelled at the end of 2013. He said he called Anthem, as well as all the doctors he used — including his child’s pediatrician and his wife’s obstetrician — to be sure they were participating in the network.\u003c/p>\n\u003cp>“They all said, ‘yes, we’re going to be continuing to accept all Blue Cross PPOs,’ and that’s what I was told I was going to be getting,” said Worth, a 43-year-old graphic artist. In January, he said he enrolled his family in an Anthem plan with an $800 a month premium.\u003c/p>\n\u003cp>Worth received an ID card in late February that called his plan a “Pathway Tiered PPO,” according to the lawsuit. His son was born on March 31. Not long after, he said he began receiving bills from his wife’s obstetrician, who was not in the network. Nor was the baby’s pediatrician, he said.\u003c/p>\n\u003cp>As a result, he said he owes about $1,100 out of pocket for both. And although an Anthem telephone representative told him afterward that the hospital where his son was born was not in network, it actually is – and his bills there are being covered, he said.\u003c/p>\n\u003cp>“It’s a giant mess,” said Worth, who can’t switch plans until open enrollment resumes in the fall. “I was sold something I thought was one product, but when I used it, I found out it wasn’t. I’m not going to be going through Anthem again.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"BmR0WPZq6RSJcEntShDdrDz9FsVmJH8T\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_17341\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/96525183-e1390846077644.jpg\">\u003cimg class=\"size-large wp-image-17341\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/96525183-640x426.jpg\" alt=\"The Anthem Blue Cross headquarters in Woodland Hills, California. (David McNew/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Anthem Blue Cross headquarters in Woodland Hills, California. (David McNew/Getty Images) \u003ccite>(David McNew/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Julie Appleby,\u003c/strong> \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2014/July/09/anthem-lawsuit-over-enrollment-practices.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Statewide insurance giant Anthem Blue Cross misled “millions of enrollees” about whether their doctors and hospitals were participating in its new plans, and failed to disclose that many policies wouldn’t cover care outside its approved network, according to a \u003ca href=\"http://media.khn.webfactional.com/html/anthem-lawsuit/Felser.pdf\" target=\"_blank\">class action lawsuit\u003c/a> filed Tuesday.\u003c/p>\n\u003caside class=\"pullquote alignleft\">As a result, many consumers are on the hook for thousands in medical bills, advocacy group says.\u003c/aside>\n\u003cp>As a result, many consumers have been left on the hook for thousands of dollars in medical bills, and have been unable to see their longtime doctors, alleges the suit by Consumer Watchdog based in Santa Monica.\u003c/p>\n\u003cp>Anthem spokesman Darrel Ng declined to comment directly on the lawsuit. He said Anthem has agreed to pay the claims of those who received treatment from inaccurately listed doctors during the first three months of the year.\u003c/p>\n\u003cp>However, that policy would not be extended for enrollees who discovered after March 31 that their doctors had been incorrectly listed, he said.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The suit says that Anthem, the state’s largest individual health insurer, delayed providing full information to consumers until it was too late for them to change coverage. Anthem also failed to disclose it had stopped offering any plans with out-of-network coverage in four of the state's biggest counties -- Los Angeles, Orange, San Francisco and San Diego, the suit says.\u003c/p>\n\u003cp>Anthem “intentionally misrepresented and concealed the limitations of their plans because it wanted a big market share,” said Jerry Flanagan of the consumer advocacy group. Co-counsel on the case is the Claremont law firm Shernoff Bidart Echeverria Bentley, which specializes in suing health insurers.\u003c/p>\n\u003cp>The suit comes as Consumer Watchdog helped put a measure on the November ballot that would give the state's insurance commissioner greater authority to veto rate increases.\u003c/p>\n\u003cp>Brought on behalf of Anthem enrollees who purchased individual coverage between Oct. 1, 2013 and March 31, 2014, the lawsuit reflects growing consumer pushback against so-called “narrow network” health plans, which are increasingly common, especially in the new online state and federal marketplaces. Anthem was a major player on California’s insurance exchange and the suit includes those who bought coverage online, as well as directly from the insurer.\u003c/p>\n\u003cp>Insurers have defended plans with limited provider networks as \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/11/28/why-narrow-networks-may-not-be-such-a-bad-idea/\" target=\"_blank\">a way of holding down premiums\u003c/a>. Many expected younger and healthier customers might be willing to give up broad access to providers for these lower costs.\u003c/p>\n\u003cp>But consumers are retaliating with lawsuits and complaints to state regulators. As a result of the rising complaints, state managed care regulators are investigating whether Anthem and, separately, Blue Shield of California, provided accurate information about the doctors and hospitals in their plans.\u003c/p>\n\u003cp>\u003cstrong>Six Enrollees' Stories\u003c/strong>\u003c/p>\n\u003cp>The Consumer Watchdog lawsuit names six Californians who purchased Anthem plans. Among them is Betsy Felser of Pasadena, who had coverage with Anthem for 20 years. Like hundreds of thousands of Anthem customers, she received a letter late last year stating that her preferred provider organization (PPO), which allows for in- and out-of-network care, was being cancelled, according to the lawsuit. The letter suggested a replacement Anthem plan “with the benefits you have come to count on.”\u003c/p>\n\u003cp>Before agreeing to switch, Felser, a physician, said she checked with five Anthem telephone representatives, making it clear she wanted to be in a PPO.\u003c/p>\n\u003cp>“I would never have gotten anything that wasn’t a PPO plan,” said Felser, 47, whose insurance also covers her young son. “They said they would give me the same coverage.”\u003c/p>\n\u003cp>She also checked Anthem’s website and the doctors she sees, including her son’s pediatrician, to make sure they were participating in the plans she was considering and was assured that they were, she said.\u003c/p>\n\u003cp>During those calls, none of Anthem’s representatives told Felser that the insurer was no longer offering PPOs in Los Angeles County, the lawsuit alleges. Nor did they tell her that the Anthem plans offered in her area would not cover care provided by out-of-network doctors or hospitals, according to the lawsuit.\u003c/p>\n\u003cp>When she received her identification cards, they were stamped with a PPO symbol. But when she tried to use the coverage, she found out her doctors – and her son’s pediatrician – were not in the network and that the plan was an exclusive provider organization (EPO), an extremely limited type of plan which pays nothing for out-of-network care.\u003c/p>\n\u003cp>“It pays zero, so I essentially have no coverage,” said Felser.\u003c/p>\n\u003cp>Anthem, while declining to comment on the Consumer Watchdog suit, had answered questions last week about an earlier lawsuit that raised similar issues.\u003c/p>\n\u003cp>Spokesman Ng said then that consumers were informed about what kind of plan they purchased, along with details about out-of-network benefits, in packets they received soon after enrolling. “All those materials clearly spelled out type of plan they were receiving,” he said.\u003c/p>\n\u003cp>But consumers would have to dig deep in a brochure on the Anthem website to find a footnote to a page 9 chart indicating that EPO plans have no out-of-network benefits.\u003c/p>\n\u003cp>Ng noted that Anthem’s EPO and PPO networks have the same doctors and hospitals for people with individual policies, although only the PPOs have out-of-network benefits. In recent weeks, Anthem said it has added 3,800 doctors to its networks.\u003c/p>\n\u003cp>\u003cstrong>'A Giant Mess'\u003c/strong>\u003c/p>\n\u003cp>As for the PPO symbol on identification cards, Ng said last week that it had been intended to protect consumers who sought emergency care out-of-state, in keeping with Blue Cross Blue Shield Association rules. Ng said Anthem recently got association approval to reissue the cards without the symbol.\u003c/p>\n\u003cp>But consumers say the damage was done. Josh Worth of Los Angeles said he was unable to get accurate information after receiving notice that his Anthem plan would be cancelled at the end of 2013. He said he called Anthem, as well as all the doctors he used — including his child’s pediatrician and his wife’s obstetrician — to be sure they were participating in the network.\u003c/p>\n\u003cp>“They all said, ‘yes, we’re going to be continuing to accept all Blue Cross PPOs,’ and that’s what I was told I was going to be getting,” said Worth, a 43-year-old graphic artist. In January, he said he enrolled his family in an Anthem plan with an $800 a month premium.\u003c/p>\n\u003cp>Worth received an ID card in late February that called his plan a “Pathway Tiered PPO,” according to the lawsuit. His son was born on March 31. Not long after, he said he began receiving bills from his wife’s obstetrician, who was not in the network. Nor was the baby’s pediatrician, he said.\u003c/p>\n\u003cp>As a result, he said he owes about $1,100 out of pocket for both. And although an Anthem telephone representative told him afterward that the hospital where his son was born was not in network, it actually is – and his bills there are being covered, he said.\u003c/p>\n\u003cp>“It’s a giant mess,” said Worth, who can’t switch plans until open enrollment resumes in the fall. “I was sold something I thought was one product, but when I used it, I found out it wasn’t. I’m not going to be going through Anthem again.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Covered California Needs Better Outreach to Limited-English Speakers, Advocates Say",
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"content": "\u003cfigure id=\"attachment_16988\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/CoveredCA_Spanish-e1388775098705.jpg\">\u003cimg class=\"size-large wp-image-16988\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/CoveredCA_Spanish-640x480.jpg\" alt=\"A report from Berkeley's Greenlining Institute called on Covered California to make its enrollment website available in more languages than English and Spanish. \" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A report from Berkeley's Greenlining Institute called on Covered California to make its enrollment website available in more languages than English and Spanish.\u003c/figcaption>\u003c/figure>\n\u003cp>Covered California may have had strong overall enrollment, but people who do not speak English as a first language are underrepresented in the state's health insurance marketplace, according to an analysis from Berkeley's Greenlining Institute.\u003c/p>\n\u003cp>The\u003ca href=\"http://greenlining.org/wp-content/uploads/2014/06/iHealth-Report-print-friendly.pdf\" target=\"_blank\"> report \u003c/a>relied on Covered California data, which showed that 20 percent of enrollees do not speak English as a primary language. That's compared with\u003ca href=\"http://censusreporter.org/profiles/04000US06-california/\" target=\"_blank\"> 44 percent of Californians\u003c/a> overall.\u003c/p>\n\u003cp>\"We know California is a diverse state ethnically and linguistically,\" said Jordan Medina, a health policy fellow with Greenlining and lead author of the study. \"Moving forward, if the Affordable Care Act is going to work in California, we have to make sure those populations are represented in the health insurance marketplace.\"\u003c!--more-->\u003c/p>\n\u003cp>As part of its analysis, Greenlining interviewed certified enrollment counselors working to help people sign up for insurance through Covered California. While online sign-up was available in English and Spanish, people who spoke other languages had only printed material available. Counselors reported that they ran out of materials in at least some languages.\u003c/p>\n\u003cp>Counselors said they preferred helping people sign up by using the online portal, but since it was available only in English and Spanish, it slowed them down. A counselor with an agency that worked with Japanese-Americans told Greenlining, \"We tried to use the website, because that's what Covered California suggested we do, but the line-by-line translation with elderly Japanese-Americans made the process extremely tedious.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Greenlining called on Covered California to make the online sign-up available in the 13 most common languages spoken in California.\u003c/p>\n\u003cp>Covered California spokeswoman Anne Gonzales said the agency is looking into this, \"\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">\u003cspan class=\"Apple-style-span\">but there is no firm date on when that functionality will be added, or which languages will be added.\"\u003c/span>\u003c/span>\u003c/p>\n\u003cp>Problems with both the Spanish-language marketing campaign and the Spanish-language website were\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/02/17/missteps-in-covered-californias-marketing-campaign-to-latinos/\" target=\"_blank\"> widely reported\u003c/a> earlier this year, and Greenlining mentioned these issues. Gonzales pointed to a Spanish-language working group at Covered California that \"recalibrated and focused resources\" on making improvements in these areas. She said Covered California is currently reviewing its resources for Asian-language translations as well, including Mandarin, Korean, Vietnamese and Hmong.\u003c/p>\n\u003cp>Curiously, one of the major issues Greenlining pointed out has already been addressed by the Covered California board. In the first open enrollment period, certified enrollment counselors were paid $58 for every person they enrolled in a plan. But counselors told Greenlining that the fee did not compensate them for the level of work required.\u003c/p>\n\u003cp>Gonzales said that Covered California is \"moving away from that business model.\" During the first open enrollment, there was a division between outreach/education and enrollment. Covered California grantees doing educational events could not also sign people up for insurance.\u003c/p>\n\u003cp>That's changing now. Covered California is \u003ca href=\"http://board.coveredca.com/meetings/2014/6-19/PDFs/PPT%20-%20Covered%20California%20Policy%20and%20Action%20Items_June%2019,%202014.pdf\" target=\"_blank\">instituting a \"navigator\" mode\u003c/a>l and will award a total of $16.9 million in grants to organizations that will handle \"outreach, education and enrollment.\"\u003c/p>\n\u003cp>Greenlining also called on Covered California to move forward on hiring a diversity officer.\u003c/p>\n\u003cp>\"At the end of the day, this helps with accountability,\" Medina said. \"If you have someone whose sole responsibility it is to make sure that all materials -- whether that be on the Web or printed materials -- if there’s one person in charge of that, it makes it really easy for community groups to partner with Covered California to make sure it’s done in an equitable way.”\u003c/p>\n\u003cp>Greenlining credited Covered California, saying that the state \"led the nation in implementing the Affordable Care Act,\" but Medina also observed that the rollout was always expected to be a multi-year effort. \"As we move farther into implementation, Covered California is going to have to really pay attention to hard-to-reach groups,\" he said. \"That's particularly crucial to outreach to Californians who don't speak English well.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"N6YDe3GBE9KI5r58HlM0Xrvwzvipav7x\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16988\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/CoveredCA_Spanish-e1388775098705.jpg\">\u003cimg class=\"size-large wp-image-16988\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/CoveredCA_Spanish-640x480.jpg\" alt=\"A report from Berkeley's Greenlining Institute called on Covered California to make its enrollment website available in more languages than English and Spanish. \" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A report from Berkeley's Greenlining Institute called on Covered California to make its enrollment website available in more languages than English and Spanish.\u003c/figcaption>\u003c/figure>\n\u003cp>Covered California may have had strong overall enrollment, but people who do not speak English as a first language are underrepresented in the state's health insurance marketplace, according to an analysis from Berkeley's Greenlining Institute.\u003c/p>\n\u003cp>The\u003ca href=\"http://greenlining.org/wp-content/uploads/2014/06/iHealth-Report-print-friendly.pdf\" target=\"_blank\"> report \u003c/a>relied on Covered California data, which showed that 20 percent of enrollees do not speak English as a primary language. That's compared with\u003ca href=\"http://censusreporter.org/profiles/04000US06-california/\" target=\"_blank\"> 44 percent of Californians\u003c/a> overall.\u003c/p>\n\u003cp>\"We know California is a diverse state ethnically and linguistically,\" said Jordan Medina, a health policy fellow with Greenlining and lead author of the study. \"Moving forward, if the Affordable Care Act is going to work in California, we have to make sure those populations are represented in the health insurance marketplace.\"\u003c!--more-->\u003c/p>\n\u003cp>As part of its analysis, Greenlining interviewed certified enrollment counselors working to help people sign up for insurance through Covered California. While online sign-up was available in English and Spanish, people who spoke other languages had only printed material available. Counselors reported that they ran out of materials in at least some languages.\u003c/p>\n\u003cp>Counselors said they preferred helping people sign up by using the online portal, but since it was available only in English and Spanish, it slowed them down. A counselor with an agency that worked with Japanese-Americans told Greenlining, \"We tried to use the website, because that's what Covered California suggested we do, but the line-by-line translation with elderly Japanese-Americans made the process extremely tedious.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Greenlining called on Covered California to make the online sign-up available in the 13 most common languages spoken in California.\u003c/p>\n\u003cp>Covered California spokeswoman Anne Gonzales said the agency is looking into this, \"\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">\u003cspan class=\"Apple-style-span\">but there is no firm date on when that functionality will be added, or which languages will be added.\"\u003c/span>\u003c/span>\u003c/p>\n\u003cp>Problems with both the Spanish-language marketing campaign and the Spanish-language website were\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/02/17/missteps-in-covered-californias-marketing-campaign-to-latinos/\" target=\"_blank\"> widely reported\u003c/a> earlier this year, and Greenlining mentioned these issues. Gonzales pointed to a Spanish-language working group at Covered California that \"recalibrated and focused resources\" on making improvements in these areas. She said Covered California is currently reviewing its resources for Asian-language translations as well, including Mandarin, Korean, Vietnamese and Hmong.\u003c/p>\n\u003cp>Curiously, one of the major issues Greenlining pointed out has already been addressed by the Covered California board. In the first open enrollment period, certified enrollment counselors were paid $58 for every person they enrolled in a plan. But counselors told Greenlining that the fee did not compensate them for the level of work required.\u003c/p>\n\u003cp>Gonzales said that Covered California is \"moving away from that business model.\" During the first open enrollment, there was a division between outreach/education and enrollment. Covered California grantees doing educational events could not also sign people up for insurance.\u003c/p>\n\u003cp>That's changing now. Covered California is \u003ca href=\"http://board.coveredca.com/meetings/2014/6-19/PDFs/PPT%20-%20Covered%20California%20Policy%20and%20Action%20Items_June%2019,%202014.pdf\" target=\"_blank\">instituting a \"navigator\" mode\u003c/a>l and will award a total of $16.9 million in grants to organizations that will handle \"outreach, education and enrollment.\"\u003c/p>\n\u003cp>Greenlining also called on Covered California to move forward on hiring a diversity officer.\u003c/p>\n\u003cp>\"At the end of the day, this helps with accountability,\" Medina said. \"If you have someone whose sole responsibility it is to make sure that all materials -- whether that be on the Web or printed materials -- if there’s one person in charge of that, it makes it really easy for community groups to partner with Covered California to make sure it’s done in an equitable way.”\u003c/p>\n\u003cp>Greenlining credited Covered California, saying that the state \"led the nation in implementing the Affordable Care Act,\" but Medina also observed that the rollout was always expected to be a multi-year effort. \"As we move farther into implementation, Covered California is going to have to really pay attention to hard-to-reach groups,\" he said. \"That's particularly crucial to outreach to Californians who don't speak English well.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"N6YDe3GBE9KI5r58HlM0Xrvwzvipav7x\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Coordinated Care for Those Nearing Life's End — But Does It Save Money?",
"title": "Coordinated Care for Those Nearing Life's End — But Does It Save Money?",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_19725\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Bob_april-e1403652651481.jpg\">\u003cimg class=\"wp-image-19725 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Bob_april-e1403652651481-640x480.jpg\" alt=\"Sutter nurse Aileen Capuyan listens to Bob Martinez’s lungs. (April Dembosky/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sutter nurse Aileen Capuyan listens to Bob Martinez’s lungs. (April Dembosky/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Bob Martinez has been in the hospital so many times, the surgical staff treats him like a regular at a coffee shop.\u003c/p>\n\u003cp>“They all know me!” he says. “If I go in there today, they’d say, ‘How’re ya doing Mr. Martinez?' ”\u003c/p>\n\u003caside class=\"pullquote alignleft\">'I’m so sick and tired of being in hospitals. I don’t want to go back no more. I said, God, no more.'\u003c/aside>\n\u003cp>Martinez is 81, a long-retired life insurance salesman. In the last few years, he's had more than a dozen surgeries on his right leg, including a foot amputation, a casualty of severe diabetes. His heart disease has warranted almost half a dozen heart procedures. After one of his recent operations, he said he'd had enough.\u003c/p>\n\u003cp>“I’m so sick and tired of being in hospitals,” he says shaking his head. “I don’t want to go back no more. I said, God, no more. No more.”\u003c/p>\n\u003cp>That’s when hospital staff told him about a program through Sutter Health that would send people to take care of him at home. It’s called the Advanced Illness Management program, or AIM. It’s designed for people like Martinez who have multiple chronic illnesses.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It’s not hospice. That’s for people who doctors say have six months or less to live. This program is for the pre-hospice population, people estimated to be in the last 18 months of life. The AIM program assigns a team of doctors, nurses and social workers to help patients transition home after hospital stays, manage medication, and carefully coordinate care, at home and over the phone, to help keep patients out of the hospital.\u003c/p>\n\u003cp>Martinez’ nurse, Aileen Capuyan, and social worker, Ally Chu, come to his home in Oakland once a week.\u003c/p>\n\u003cp>“Are you coughing? Do you have any shortness of breath?” Capuyan asks as she listens to Martinez’s lungs.\u003c/p>\n\u003cp>He sits in the brown leather armchair in his living room while she takes his temperature and checks his blood pressure. Meanwhile, Chu is in the kitchen talking with Martinez's son, Jimmy, who takes care of him. Jimmy is making tamales. Then Capuyan and Chu switch.\u003c/p>\n\u003cp>Most of the visit is spent talking: about the pain in Martinez’s leg, how his dominoes game is going at the senior center, and about more sensitive things, like what happens when his health gets worse — what kind of care he wants at the end of life and what care he doesn’t want.\u003c/p>\n\u003cp>“I don’t want to be resuscitated,” Martinez says. “When my time comes — let it go.”\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/155994604&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>The founders of the AIM program hope that these ongoing visits build the kind of trust where patients can fully explore these questions. Chief program executive Betsy Gornet says this avoids rushed decisions that don’t capture a person’s real values.\u003c/p>\n\u003cp>“Spending fifteen minutes in a doctor's office or in an ICU in a crisis isn’t necessarily the way to do advanced care planning,” she says. “We do know that a dialogue over time does help foster the right kind of information.”\u003c/p>\n\u003cp>She says that means patients get the kind of care they want, and get help before their conditions reach a crisis level.\u003c/p>\n\u003cp>“We’ve been able to track very consistently a 30 percent reduction in emergency room visits by these patients, 70 to 80 percent reduction in ICU days, 50 percent reduction in hospitalizations,” she says.\u003c/p>\n\u003cp>That in turn has saved money.\u003c/p>\n\u003cp>“We’ve seen the total cost of care go down anywhere from $3,600 to $5,000 dollar per patient over the course of 90 days,” she says.\u003c/p>\n\u003cp>This is the kind of talk that has sparked fiery debates in Washington. Back in 2009, the idea of doctors even talking to their patients about their end-of-life wishes spurred fears of “\u003ca href=\"http://www.washingtonpost.com/wp-dyn/content/article/2009/07/31/AR2009073103148.html\" target=\"_blank\">death panels\u003c/a>” rationing care.\u003c/p>\n\u003cp>But today, the tone is shifting, according to health policy lobbyist Andrew MacPherson.\u003c/p>\n\u003cp>“We’re seeing a death of the death panels,” he says. “We’re in a totally new place today.”\u003c/p>\n\u003cp>[contextly_sidebar id=\"392e700af225e5a57a941f70d559db24\"]\u003c/p>\n\u003cp>He says lawmakers are having real bipartisan discussions about overhauling the American way of death, especially now that more and more politicians are shepherding their own parents through the end of life.\u003c/p>\n\u003cp>“It’s personal stories,” MacPherson says. “People's personal stories about their mother, about their father are really what bring folks to table to say, 'Look, we need to have a health care system that is responsive to patients’ values and preferences and wishes when they’re really seriously ill.' ”\u003c/p>\n\u003cp>He says officials in Washington are keeping an eye on the Sutter program as a model that might be replicated across the country. The Medicare program, which pays for health care for people over 65, gave the AIM program a $13 million grant from a fund created under the Affordable Care Act. In return, they want to see the program generate savings for Medicare of at least $29 million.\u003c/p>\n\u003cp>“The big question is whether or not it will pan out,” says Suzanne Delbanco, executive director of the nonprofit group Catalyst for Payment Reform.\u003c/p>\n\u003cp>The Medicare grants are one way the government is trying to move away from paying for health care on a fee-for-service basis, which Delbanco says incentivizes doctors to order more tests and procedures to drive up their revenues. Instead, interest is growing to develop more holistic payment models — things like “care management fees,” “bundled payments” and “shared savings” — that reward doctors based on the overall care they provide and outcomes where their patients ultimately get better.\u003c/p>\n\u003cp>“It’s almost as if we’re going from an a la carte menu to a pre-fixe meal where you pay a set amount for all your courses,” Delbanco says.\u003c/p>\n\u003cp>But there are two big unknowns.\u003c/p>\n\u003cp>First, it's not clear if these new models of care really will cost less in the long run. “We don’t know for sure whether or not financially it will end up being beneficial in an effort to curtail our health care costs,” Delbanco says.\u003c/p>\n\u003cp>Second, Sutter has to find a way to operate the AIM program that works for its own bottom line. When Sutter saves money for Medicare, by reducing hospitalizations and ER visits, it takes a financial hit on its own revenues. Many of the new services it provides to achieve those savings — the telephone coordination, some home care and some social work services — are not reimbursed under Medicare’s current payment system.\u003c/p>\n\u003cp>Sutter declined to reveal operation costs or budget figures for the AIM program, although the federal Agency for Healthcare Research and Quality reports it costs about $900 monthly, for each patient, on average.\u003c/p>\n\u003cp>AIM chief executive Betsy Gornet says the program does operate at a loss in some regions and has stayed afloat so far through foundation grants and investments from Sutter. But its goal this year, as part of the government grant, is to become self-sustaining, and to propose a new payment model for Medicare that balances savings for the government and still keeps its own program in business.\u003c/p>\n\u003cp>“We want to get the right care to the right patient at the right time,” Gornet says. “That will help save everybody’s resources.”\u003c/p>\n\u003cp>Gornet says the ultimate goal is to keep patients like Bob Martinez as comfortable and vibrant as possible until he reaches the end of his life.\u003c/p>\n\u003cp>Martinez says he's been thinking about death a lot lately, especially since his wife, Josie, died two years ago — at home, with her husband at her side.\u003c/p>\n\u003cp>“God’s got a plan for everybody, different plans,\" Martinez says. \"Some die at home. Some die in a hospital. I want to be home like she was. If it comes to that. But anyway, I’ll take it any way. I just want to be with her now.\"\u003c/p>\n\u003cp>Martinez died in May. He was at home, in his living room, surrounded by family.\u003c/p>\n\u003cp>\u003cem>This report was produced with support from \u003c/em>\u003cem>the MetLife Foundation Journalists in Aging Fellowships, a program of New America Media and the Gerontological Society of America.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"excerpt": "Medicare funded the program with a $13 million grant, but hopes for savings of $29 million. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19725\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Bob_april-e1403652651481.jpg\">\u003cimg class=\"wp-image-19725 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Bob_april-e1403652651481-640x480.jpg\" alt=\"Sutter nurse Aileen Capuyan listens to Bob Martinez’s lungs. (April Dembosky/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sutter nurse Aileen Capuyan listens to Bob Martinez’s lungs. (April Dembosky/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Bob Martinez has been in the hospital so many times, the surgical staff treats him like a regular at a coffee shop.\u003c/p>\n\u003cp>“They all know me!” he says. “If I go in there today, they’d say, ‘How’re ya doing Mr. Martinez?' ”\u003c/p>\n\u003caside class=\"pullquote alignleft\">'I’m so sick and tired of being in hospitals. I don’t want to go back no more. I said, God, no more.'\u003c/aside>\n\u003cp>Martinez is 81, a long-retired life insurance salesman. In the last few years, he's had more than a dozen surgeries on his right leg, including a foot amputation, a casualty of severe diabetes. His heart disease has warranted almost half a dozen heart procedures. After one of his recent operations, he said he'd had enough.\u003c/p>\n\u003cp>“I’m so sick and tired of being in hospitals,” he says shaking his head. “I don’t want to go back no more. I said, God, no more. No more.”\u003c/p>\n\u003cp>That’s when hospital staff told him about a program through Sutter Health that would send people to take care of him at home. It’s called the Advanced Illness Management program, or AIM. It’s designed for people like Martinez who have multiple chronic illnesses.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It’s not hospice. That’s for people who doctors say have six months or less to live. This program is for the pre-hospice population, people estimated to be in the last 18 months of life. The AIM program assigns a team of doctors, nurses and social workers to help patients transition home after hospital stays, manage medication, and carefully coordinate care, at home and over the phone, to help keep patients out of the hospital.\u003c/p>\n\u003cp>Martinez’ nurse, Aileen Capuyan, and social worker, Ally Chu, come to his home in Oakland once a week.\u003c/p>\n\u003cp>“Are you coughing? Do you have any shortness of breath?” Capuyan asks as she listens to Martinez’s lungs.\u003c/p>\n\u003cp>He sits in the brown leather armchair in his living room while she takes his temperature and checks his blood pressure. Meanwhile, Chu is in the kitchen talking with Martinez's son, Jimmy, who takes care of him. Jimmy is making tamales. Then Capuyan and Chu switch.\u003c/p>\n\u003cp>Most of the visit is spent talking: about the pain in Martinez’s leg, how his dominoes game is going at the senior center, and about more sensitive things, like what happens when his health gets worse — what kind of care he wants at the end of life and what care he doesn’t want.\u003c/p>\n\u003cp>“I don’t want to be resuscitated,” Martinez says. “When my time comes — let it go.”\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/155994604&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>The founders of the AIM program hope that these ongoing visits build the kind of trust where patients can fully explore these questions. Chief program executive Betsy Gornet says this avoids rushed decisions that don’t capture a person’s real values.\u003c/p>\n\u003cp>“Spending fifteen minutes in a doctor's office or in an ICU in a crisis isn’t necessarily the way to do advanced care planning,” she says. “We do know that a dialogue over time does help foster the right kind of information.”\u003c/p>\n\u003cp>She says that means patients get the kind of care they want, and get help before their conditions reach a crisis level.\u003c/p>\n\u003cp>“We’ve been able to track very consistently a 30 percent reduction in emergency room visits by these patients, 70 to 80 percent reduction in ICU days, 50 percent reduction in hospitalizations,” she says.\u003c/p>\n\u003cp>That in turn has saved money.\u003c/p>\n\u003cp>“We’ve seen the total cost of care go down anywhere from $3,600 to $5,000 dollar per patient over the course of 90 days,” she says.\u003c/p>\n\u003cp>This is the kind of talk that has sparked fiery debates in Washington. Back in 2009, the idea of doctors even talking to their patients about their end-of-life wishes spurred fears of “\u003ca href=\"http://www.washingtonpost.com/wp-dyn/content/article/2009/07/31/AR2009073103148.html\" target=\"_blank\">death panels\u003c/a>” rationing care.\u003c/p>\n\u003cp>But today, the tone is shifting, according to health policy lobbyist Andrew MacPherson.\u003c/p>\n\u003cp>“We’re seeing a death of the death panels,” he says. “We’re in a totally new place today.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>He says lawmakers are having real bipartisan discussions about overhauling the American way of death, especially now that more and more politicians are shepherding their own parents through the end of life.\u003c/p>\n\u003cp>“It’s personal stories,” MacPherson says. “People's personal stories about their mother, about their father are really what bring folks to table to say, 'Look, we need to have a health care system that is responsive to patients’ values and preferences and wishes when they’re really seriously ill.' ”\u003c/p>\n\u003cp>He says officials in Washington are keeping an eye on the Sutter program as a model that might be replicated across the country. The Medicare program, which pays for health care for people over 65, gave the AIM program a $13 million grant from a fund created under the Affordable Care Act. In return, they want to see the program generate savings for Medicare of at least $29 million.\u003c/p>\n\u003cp>“The big question is whether or not it will pan out,” says Suzanne Delbanco, executive director of the nonprofit group Catalyst for Payment Reform.\u003c/p>\n\u003cp>The Medicare grants are one way the government is trying to move away from paying for health care on a fee-for-service basis, which Delbanco says incentivizes doctors to order more tests and procedures to drive up their revenues. Instead, interest is growing to develop more holistic payment models — things like “care management fees,” “bundled payments” and “shared savings” — that reward doctors based on the overall care they provide and outcomes where their patients ultimately get better.\u003c/p>\n\u003cp>“It’s almost as if we’re going from an a la carte menu to a pre-fixe meal where you pay a set amount for all your courses,” Delbanco says.\u003c/p>\n\u003cp>But there are two big unknowns.\u003c/p>\n\u003cp>First, it's not clear if these new models of care really will cost less in the long run. “We don’t know for sure whether or not financially it will end up being beneficial in an effort to curtail our health care costs,” Delbanco says.\u003c/p>\n\u003cp>Second, Sutter has to find a way to operate the AIM program that works for its own bottom line. When Sutter saves money for Medicare, by reducing hospitalizations and ER visits, it takes a financial hit on its own revenues. Many of the new services it provides to achieve those savings — the telephone coordination, some home care and some social work services — are not reimbursed under Medicare’s current payment system.\u003c/p>\n\u003cp>Sutter declined to reveal operation costs or budget figures for the AIM program, although the federal Agency for Healthcare Research and Quality reports it costs about $900 monthly, for each patient, on average.\u003c/p>\n\u003cp>AIM chief executive Betsy Gornet says the program does operate at a loss in some regions and has stayed afloat so far through foundation grants and investments from Sutter. But its goal this year, as part of the government grant, is to become self-sustaining, and to propose a new payment model for Medicare that balances savings for the government and still keeps its own program in business.\u003c/p>\n\u003cp>“We want to get the right care to the right patient at the right time,” Gornet says. “That will help save everybody’s resources.”\u003c/p>\n\u003cp>Gornet says the ultimate goal is to keep patients like Bob Martinez as comfortable and vibrant as possible until he reaches the end of his life.\u003c/p>\n\u003cp>Martinez says he's been thinking about death a lot lately, especially since his wife, Josie, died two years ago — at home, with her husband at her side.\u003c/p>\n\u003cp>“God’s got a plan for everybody, different plans,\" Martinez says. \"Some die at home. Some die in a hospital. I want to be home like she was. If it comes to that. But anyway, I’ll take it any way. I just want to be with her now.\"\u003c/p>\n\u003cp>Martinez died in May. He was at home, in his living room, surrounded by family.\u003c/p>\n\u003cp>\u003cem>This report was produced with support from \u003c/em>\u003cem>the MetLife Foundation Journalists in Aging Fellowships, a program of New America Media and the Gerontological Society of America.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "KQED Launches 'PriceCheck' to Make Health Costs Transparent",
"title": "KQED Launches 'PriceCheck' to Make Health Costs Transparent",
"headTitle": "Price Check | State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_19661\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\">\u003cimg class=\"wp-image-19661 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/pricecheck-wname-2.jpg\" alt=\"(Photo: Getty Images)\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/06/pricecheck-wname-2.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/pricecheck-wname-2-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/pricecheck-wname-2-320x180.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Update June 30:\u003c/strong> Early PriceCheck data show\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/30/initial-mammogram-cost-comparisons-in-kqeds-pricecheck-project/\" target=\"_blank\"> Bay Area mammogram prices range from $125 to $801\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Original Post:\u003c/strong>\u003c/p>\n\u003cp>Say you're shopping for a new computer or a new car, and you want to get the best price. Within a matter of minutes on Google, you would have a pretty good idea of the price range for the product you want.\u003c/p>\n\u003cp>But in health care? Forget it.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Shining light on a system where the costs of the same procedure might range from $0 to $1,100. That's just one example.\u003c/aside>\n\u003cp>It's well known to health policy types, but less so to consumers, that health care prices are utterly lacking in transparency and wildly variable.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>If you've ever looked at a bill for a health care procedure -- and been astounded by the numbers you see -- or thought that you would like to find the best price on an elective procedure -- and been astounded that there's no easy way to compare prices -- KQED is launching a new project for you.\u003c/p>\n\u003cp>Today we bring you \"\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">Price Check\u003c/a>,\" a community-created guide to health costs. Since no database yet exists where consumers can easily look up costs, we're commencing the work of creating one. But we need your help.\u003c/p>\n\u003cp>This summer and into the fall, we're turning to you, our community, to share -- anonymously -- what you have paid for some common procedures. We're starting with mammograms. (More on \"why mammograms?\" in a moment.)\u003c!--more-->\u003c/p>\n\u003cp>We've created a tool to make it easy to share what you paid. \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">Visit the tool and take a look\u003c/a>. If you don't have insurance and pay out of pocket -- called self-pay -- you can enter that price. If you have insurance, you can submit both what your health insurance paid and your own co-pay charge, if any.\u003c/p>\n\u003cp>Once you've shared your costs, the tool will feed your information into a database so you can see how much mammograms cost elsewhere in the Bay Area and across California. Again, your submitted data are anonymous and confidential.\u003c/p>\n\u003cp>We want this project to have as much impact as possible, so we have teamed up with \u003ca href=\"http://www.scpr.org/blogs/health/2014/06/23/16873/join-pricecheck-help-make-health-care-costs-more-t/\" target=\"_blank\">KPCC\u003c/a>, our public radio friends in Southern California, and \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a New York City startup working to bring transparency to the health care marketplace.\u003c/p>\n\u003cp>We chose to start with mammograms, because it is a screening test that many women have at least every other year. Because it is a test that can be scheduled, women could, in theory, shop around for the best price. Yes, mammograms are covered as a preventive benefit under the Affordable Care Act, and patients are supposed to access them at no co-pay, but that doesn't always happen.\u003c/p>\n\u003caside class=\"pullquote alignright\">Learn more: \u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">read all our PriceCheck coverage\u003c/a>. \u003c/aside>\n\u003cp>ClearHealthCosts did a \u003ca href=\"http://clearhealthcosts.com/wnyc/how-much-do-birth-control-mammograms-cost/\" target=\"_blank\">pilot version of this project\u003c/a> with WNYC public radio in New York in 2012. They found that 25-30 percent of the 400 respondents were paying for their mammograms. That's because some of the women chose out-of-network providers, or they weren't insured, or the mammogram simply wasn't covered.\u003c/p>\n\u003cp>We'll be able to compare California data with what ClearHealthCosts learned with WNYC -- where \u003ca href=\"http://clearhealthcosts.com/blog/2013/07/how-much-does-a-mammogram-cost-the-takeaway-on-billing-from-our-wnyc-partnership/\" target=\"_blank\">women paid between $0 and $1,100 or more\u003c/a>.\u003c/p>\n\u003cp>In other sectors of the economy, people often equate higher cost with higher quality, but in health care there's not a correlation between price and quality. We think people want quality care at a fair price. But just as there is little transparency in health costs, there are few good measures of quality. We believe that shining a bright light on health costs helps to drive discussion about quality metrics.\u003c/p>\n\u003cp>We're just at the start of this project. Over the next four months, we'll sample other common procedures. We're grateful to the Knight Foundation for funding this project through a \u003ca href=\"http://www.knightfoundation.org/blogs/knightblog/2014/4/22/17-projects-receive-funding-through-knight-prototype-fund/\" target=\"_blank\">Prototype Fund grant\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Please join us! We'll report what you share with us as soon as we have stories to tell.\u003c/p>\n\n",
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"excerpt": "Health care prices are utterly lacking in transparency and wildly variable. Help KQED change that.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19661\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\">\u003cimg class=\"wp-image-19661 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/pricecheck-wname-2.jpg\" alt=\"(Photo: Getty Images)\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/06/pricecheck-wname-2.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/pricecheck-wname-2-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/pricecheck-wname-2-320x180.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Update June 30:\u003c/strong> Early PriceCheck data show\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/30/initial-mammogram-cost-comparisons-in-kqeds-pricecheck-project/\" target=\"_blank\"> Bay Area mammogram prices range from $125 to $801\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Original Post:\u003c/strong>\u003c/p>\n\u003cp>Say you're shopping for a new computer or a new car, and you want to get the best price. Within a matter of minutes on Google, you would have a pretty good idea of the price range for the product you want.\u003c/p>\n\u003cp>But in health care? Forget it.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Shining light on a system where the costs of the same procedure might range from $0 to $1,100. That's just one example.\u003c/aside>\n\u003cp>It's well known to health policy types, but less so to consumers, that health care prices are utterly lacking in transparency and wildly variable.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>If you've ever looked at a bill for a health care procedure -- and been astounded by the numbers you see -- or thought that you would like to find the best price on an elective procedure -- and been astounded that there's no easy way to compare prices -- KQED is launching a new project for you.\u003c/p>\n\u003cp>Today we bring you \"\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">Price Check\u003c/a>,\" a community-created guide to health costs. Since no database yet exists where consumers can easily look up costs, we're commencing the work of creating one. But we need your help.\u003c/p>\n\u003cp>This summer and into the fall, we're turning to you, our community, to share -- anonymously -- what you have paid for some common procedures. We're starting with mammograms. (More on \"why mammograms?\" in a moment.)\u003c!--more-->\u003c/p>\n\u003cp>We've created a tool to make it easy to share what you paid. \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">Visit the tool and take a look\u003c/a>. If you don't have insurance and pay out of pocket -- called self-pay -- you can enter that price. If you have insurance, you can submit both what your health insurance paid and your own co-pay charge, if any.\u003c/p>\n\u003cp>Once you've shared your costs, the tool will feed your information into a database so you can see how much mammograms cost elsewhere in the Bay Area and across California. Again, your submitted data are anonymous and confidential.\u003c/p>\n\u003cp>We want this project to have as much impact as possible, so we have teamed up with \u003ca href=\"http://www.scpr.org/blogs/health/2014/06/23/16873/join-pricecheck-help-make-health-care-costs-more-t/\" target=\"_blank\">KPCC\u003c/a>, our public radio friends in Southern California, and \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a New York City startup working to bring transparency to the health care marketplace.\u003c/p>\n\u003cp>We chose to start with mammograms, because it is a screening test that many women have at least every other year. Because it is a test that can be scheduled, women could, in theory, shop around for the best price. Yes, mammograms are covered as a preventive benefit under the Affordable Care Act, and patients are supposed to access them at no co-pay, but that doesn't always happen.\u003c/p>\n\u003caside class=\"pullquote alignright\">Learn more: \u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">read all our PriceCheck coverage\u003c/a>. \u003c/aside>\n\u003cp>ClearHealthCosts did a \u003ca href=\"http://clearhealthcosts.com/wnyc/how-much-do-birth-control-mammograms-cost/\" target=\"_blank\">pilot version of this project\u003c/a> with WNYC public radio in New York in 2012. They found that 25-30 percent of the 400 respondents were paying for their mammograms. That's because some of the women chose out-of-network providers, or they weren't insured, or the mammogram simply wasn't covered.\u003c/p>\n\u003cp>We'll be able to compare California data with what ClearHealthCosts learned with WNYC -- where \u003ca href=\"http://clearhealthcosts.com/blog/2013/07/how-much-does-a-mammogram-cost-the-takeaway-on-billing-from-our-wnyc-partnership/\" target=\"_blank\">women paid between $0 and $1,100 or more\u003c/a>.\u003c/p>\n\u003cp>In other sectors of the economy, people often equate higher cost with higher quality, but in health care there's not a correlation between price and quality. We think people want quality care at a fair price. But just as there is little transparency in health costs, there are few good measures of quality. We believe that shining a bright light on health costs helps to drive discussion about quality metrics.\u003c/p>\n\u003cp>We're just at the start of this project. Over the next four months, we'll sample other common procedures. We're grateful to the Knight Foundation for funding this project through a \u003ca href=\"http://www.knightfoundation.org/blogs/knightblog/2014/4/22/17-projects-receive-funding-through-knight-prototype-fund/\" target=\"_blank\">Prototype Fund grant\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Please join us! We'll report what you share with us as soon as we have stories to tell.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "In Alameda County, Leaving Jail Doesn't Have to Mean Losing Health Care",
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"content": "\u003cfigure id=\"attachment_19175\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/Screen-Shot-2014-05-19-at-10.24.13-AM.png\">\u003cimg class=\"size-large wp-image-19175\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/Screen-Shot-2014-05-19-at-10.24.13-AM-640x352.png\" alt=\"Rodrigo Salido, recently released from Santa Rita jail in Dublin, Calif., enrolls in Medi-Cal at Healthy Oakland clinic. (Courtesy: PBS NewsHour)\" width=\"640\" height=\"352\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rodrigo Salido, recently released from Santa Rita jail in Dublin, Calif., enrolls in Medi-Cal at Healthy Oakland clinic. (Courtesy: PBS NewsHour)\u003c/figcaption>\u003c/figure>\n\u003cp style=\"color: #000000\">\u003cstrong>By Sarah Varney,\u003c/strong> \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2014/May/16/inmates-leave-jail-retain-mental-health-care.aspx\" target=\"_blank\">Kaiser Health News and PBS NewsHour\u003c/a>\u003c/p>\n\u003cp style=\"color: #000000\">It's been two months since Rodrigo Salido left the maximum security wing at Santa Rita jail, about 40 miles east of San Francisco in Alameda County. It's also been two months since Salido had medication for his bipolar disorder.\u003c/p>\n\u003cp style=\"color: #000000\">\n\u003caside class=\"pullquote alignleft\">In Alameda County officials estimate 18,000 offenders in its two jails will now qualify for Medi-Cal.\u003c/aside>\n\u003c/p>\u003cp>A drug, Risperdal, prescribed by a jailhouse psychiatrist, had quelled Salido’s angry moods. “It helped me be more relaxed,” he said. “Not as much on the edge and feeling like everybody is out to get me.”\u003c/p>\n\u003cp style=\"color: #000000\">Now Salido, who served two years for burglary, assault and gang involvement, has no health insurance and until recently had few options for refilling his medication.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp style=\"color: #000000\">Many inmates leave county jails and state prisons with mental health problems and chronic physical ailments -- and no health coverage. Because they typically are not custodial parents, ex-offenders have long been ineligible for a public health insurance program aimed at kids, mothers and the disabled.\u003c!--more-->\u003c/p>\n\u003cp style=\"color: #000000\">But earlier this year, California and 25 other states, under a provision of the Affordable Care Act, opened up Medicaid to single and so-called “childless” adults. The change in eligibility criteria will extend Medicaid coverage to vast numbers of ex-offenders with very low incomes.\u003c/p>\n\u003cp style=\"color: #000000\">“Historically, 10 or 11 percent of folks in detention have been eligible for Medicaid,” said Alex Briscoe, health director for Alameda County. “That number is well over 90 percent as of January,” since the ACA took full effect.\u003c/p>\n\u003cp style=\"color: #000000\">[contextly_sidebar id=\"c4bac880693cbdd4b01c435155bec487\"]\u003c/p>\n\u003cp>Indeed, of those newly eligible under the Medicaid expansion, experts predict \u003ca style=\"color: #2262cc\" href=\"http://www.ncbi.nlm.nih.gov/pubmed/22566431\">one out of three\u003c/a> nationally will be former inmates or detainees. Health officials in Alameda County estimate 18,000 offenders in its two jails will now qualify. Recently, Rodrigo Salido began the process of enrolling in Medi-Cal, California's version of Medicaid, at a clinic, Healthy Oakland. He got a preliminary check up there, but once he gets his card will be able to visit a primary care doctor and see specialists.\u003c/p>\n\u003cp style=\"color: #000000\">Men and women involved in the criminal justice system are more likely to be sicker than the general population\u003cstrong>,\u003c/strong> with higher rates of diabetes, hypertension, depression, mood disorders and alcohol and drug addiction. Many have spent years -- perhaps their entire adult livens -- without health insurance and have medical conditions that must be stabilized when they’re incarcerated.\u003c/p>\n\u003cp style=\"color: #000000\">“They come to us in bad shape, and we get them as good as possible,” said Richard Lucia, the undersheriff for Alameda County.\u003c/p>\n\u003cp style=\"color: #000000\">At Santa Rita jail in Dublin, one of the largest detention facilities in the United States, the pharmacy dispenses some 350,000 prescription drugs each month and spends $28 million each year on medical and mental health services. But because recidivism rates are so high in Alameda County -- two out of three inmates re-offend -- the jails’ medical clinics often end up re-stabilizing the same inmates.\u003c/p>\n\u003cp style=\"color: #000000\">“They leave and they get in bad shape again,” said Lucia. “And they come back to us, and we fix them up again.”\u003c/p>\n\u003cdiv>\u003ca class=\"embedly-card\" href=\"https://www.youtube.com/watch?list=UU6ZFN9Tx6xh-skXCuRHCDpQ&v=rpOwkAsXXHM\">Former inmates stand to gain Medicaid under expansion\u003c/a>\u003c/div>\n\u003cp style=\"color: #000000\">The churning of sick offenders costs the county when inmates are in custody -- but it also strains public hospital budgets when they’re released. “When they do need care they come to our emergency department. They cost us between $600 and $800 a visit,” said Briscoe, the county health director. “The cost drivers on our system are intense.”\u003c/p>\n\u003cp style=\"color: #000000\">The Medicaid expansion, county officials contend, offers a rare opportunity to connect men and women with criminal records to ongoing medical and mental health services, and to directly reimburse the county’s general fund for medical care outside of correctional facilities.\u003c/p>\n\u003cp style=\"color: #000000\">While it remains against federal law to use Medicaid to pay for day-to-day medical care for inmates, the program, funded by federal and state dollars, will cover hospital stays longer than 24 hours. Those longer hospital visits often involve costly and complicated surgeries, and the county estimates it could save $3 to $5 million a year in off-site hospital care.\u003c/p>\n\u003cp style=\"color: #000000\">“That would shift the cost, essentially, from the county to the state or to the federal government,” said Undersheriff Lucia.\u003c/p>\n\u003cp style=\"color: #000000\">Over the last few months, a constellation of Alameda County agencies, including the sheriff’s office, public health and social services, have been feverishly working to create new protocols that will automatically enroll all eligible inmates into Medi-Cal. Other enrollment efforts are underway in Contra Costa, San Francisco, Solano and Lassen counties, and in Cook County, Illinois, the state of Washington and elsewhere.\u003c/p>\n\u003cp style=\"color: #000000\">The bureaucratic and technical challenges are immense: archaic information technology platforms must be re-tooled to share data with other county systems; arrested individuals often give false information about their marriage status, number of children, home address and income, foiling Medi-Cal eligibility background checks; and labor union rules permit only certain county workers to approve Medicaid applications.\u003c/p>\n\u003cp style=\"color: #000000\">Overcoming those obstacles is a priority, Alameda county officials said, not only because of the potential cost savings, but also because the Medi-Cal expansion offers a solid chance at reducing the county’s dismal recidivism rate. Several studies have shown that ex-inmates who have access to health care when they leave jail, especially mental health and substance abuse counseling, are less likely to re-offend.\u003c/p>\n\u003cp style=\"color: #000000\">Still, a Medi-Cal card is no panacea for troubled lives. “You can’t treat away the problems that face poor communities,” said Briscoe, the county health director. “It’s about a good job. It’s about a sense of belonging. It’s about a place to sleep, but healthcare can be a tool for social justice if it’s delivered effectively and creatively, and that’s why the Medicaid expansion is such a great opportunity for us.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Kaiser Health News (KHN) is a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19175\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/Screen-Shot-2014-05-19-at-10.24.13-AM.png\">\u003cimg class=\"size-large wp-image-19175\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/Screen-Shot-2014-05-19-at-10.24.13-AM-640x352.png\" alt=\"Rodrigo Salido, recently released from Santa Rita jail in Dublin, Calif., enrolls in Medi-Cal at Healthy Oakland clinic. (Courtesy: PBS NewsHour)\" width=\"640\" height=\"352\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rodrigo Salido, recently released from Santa Rita jail in Dublin, Calif., enrolls in Medi-Cal at Healthy Oakland clinic. (Courtesy: PBS NewsHour)\u003c/figcaption>\u003c/figure>\n\u003cp style=\"color: #000000\">\u003cstrong>By Sarah Varney,\u003c/strong> \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2014/May/16/inmates-leave-jail-retain-mental-health-care.aspx\" target=\"_blank\">Kaiser Health News and PBS NewsHour\u003c/a>\u003c/p>\n\u003cp style=\"color: #000000\">It's been two months since Rodrigo Salido left the maximum security wing at Santa Rita jail, about 40 miles east of San Francisco in Alameda County. It's also been two months since Salido had medication for his bipolar disorder.\u003c/p>\n\u003cp style=\"color: #000000\">\n\u003caside class=\"pullquote alignleft\">In Alameda County officials estimate 18,000 offenders in its two jails will now qualify for Medi-Cal.\u003c/aside>\n\u003c/p>\u003cp>A drug, Risperdal, prescribed by a jailhouse psychiatrist, had quelled Salido’s angry moods. “It helped me be more relaxed,” he said. “Not as much on the edge and feeling like everybody is out to get me.”\u003c/p>\n\u003cp style=\"color: #000000\">Now Salido, who served two years for burglary, assault and gang involvement, has no health insurance and until recently had few options for refilling his medication.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp style=\"color: #000000\">Many inmates leave county jails and state prisons with mental health problems and chronic physical ailments -- and no health coverage. Because they typically are not custodial parents, ex-offenders have long been ineligible for a public health insurance program aimed at kids, mothers and the disabled.\u003c!--more-->\u003c/p>\n\u003cp style=\"color: #000000\">But earlier this year, California and 25 other states, under a provision of the Affordable Care Act, opened up Medicaid to single and so-called “childless” adults. The change in eligibility criteria will extend Medicaid coverage to vast numbers of ex-offenders with very low incomes.\u003c/p>\n\u003cp style=\"color: #000000\">“Historically, 10 or 11 percent of folks in detention have been eligible for Medicaid,” said Alex Briscoe, health director for Alameda County. “That number is well over 90 percent as of January,” since the ACA took full effect.\u003c/p>\n\u003cp style=\"color: #000000\">\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Indeed, of those newly eligible under the Medicaid expansion, experts predict \u003ca style=\"color: #2262cc\" href=\"http://www.ncbi.nlm.nih.gov/pubmed/22566431\">one out of three\u003c/a> nationally will be former inmates or detainees. Health officials in Alameda County estimate 18,000 offenders in its two jails will now qualify. Recently, Rodrigo Salido began the process of enrolling in Medi-Cal, California's version of Medicaid, at a clinic, Healthy Oakland. He got a preliminary check up there, but once he gets his card will be able to visit a primary care doctor and see specialists.\u003c/p>\n\u003cp style=\"color: #000000\">Men and women involved in the criminal justice system are more likely to be sicker than the general population\u003cstrong>,\u003c/strong> with higher rates of diabetes, hypertension, depression, mood disorders and alcohol and drug addiction. Many have spent years -- perhaps their entire adult livens -- without health insurance and have medical conditions that must be stabilized when they’re incarcerated.\u003c/p>\n\u003cp style=\"color: #000000\">“They come to us in bad shape, and we get them as good as possible,” said Richard Lucia, the undersheriff for Alameda County.\u003c/p>\n\u003cp style=\"color: #000000\">At Santa Rita jail in Dublin, one of the largest detention facilities in the United States, the pharmacy dispenses some 350,000 prescription drugs each month and spends $28 million each year on medical and mental health services. But because recidivism rates are so high in Alameda County -- two out of three inmates re-offend -- the jails’ medical clinics often end up re-stabilizing the same inmates.\u003c/p>\n\u003cp style=\"color: #000000\">“They leave and they get in bad shape again,” said Lucia. “And they come back to us, and we fix them up again.”\u003c/p>\n\u003cdiv>\u003ca class=\"embedly-card\" href=\"https://www.youtube.com/watch?list=UU6ZFN9Tx6xh-skXCuRHCDpQ&v=rpOwkAsXXHM\">Former inmates stand to gain Medicaid under expansion\u003c/a>\u003c/div>\n\u003cp style=\"color: #000000\">The churning of sick offenders costs the county when inmates are in custody -- but it also strains public hospital budgets when they’re released. “When they do need care they come to our emergency department. They cost us between $600 and $800 a visit,” said Briscoe, the county health director. “The cost drivers on our system are intense.”\u003c/p>\n\u003cp style=\"color: #000000\">The Medicaid expansion, county officials contend, offers a rare opportunity to connect men and women with criminal records to ongoing medical and mental health services, and to directly reimburse the county’s general fund for medical care outside of correctional facilities.\u003c/p>\n\u003cp style=\"color: #000000\">While it remains against federal law to use Medicaid to pay for day-to-day medical care for inmates, the program, funded by federal and state dollars, will cover hospital stays longer than 24 hours. Those longer hospital visits often involve costly and complicated surgeries, and the county estimates it could save $3 to $5 million a year in off-site hospital care.\u003c/p>\n\u003cp style=\"color: #000000\">“That would shift the cost, essentially, from the county to the state or to the federal government,” said Undersheriff Lucia.\u003c/p>\n\u003cp style=\"color: #000000\">Over the last few months, a constellation of Alameda County agencies, including the sheriff’s office, public health and social services, have been feverishly working to create new protocols that will automatically enroll all eligible inmates into Medi-Cal. Other enrollment efforts are underway in Contra Costa, San Francisco, Solano and Lassen counties, and in Cook County, Illinois, the state of Washington and elsewhere.\u003c/p>\n\u003cp style=\"color: #000000\">The bureaucratic and technical challenges are immense: archaic information technology platforms must be re-tooled to share data with other county systems; arrested individuals often give false information about their marriage status, number of children, home address and income, foiling Medi-Cal eligibility background checks; and labor union rules permit only certain county workers to approve Medicaid applications.\u003c/p>\n\u003cp style=\"color: #000000\">Overcoming those obstacles is a priority, Alameda county officials said, not only because of the potential cost savings, but also because the Medi-Cal expansion offers a solid chance at reducing the county’s dismal recidivism rate. Several studies have shown that ex-inmates who have access to health care when they leave jail, especially mental health and substance abuse counseling, are less likely to re-offend.\u003c/p>\n\u003cp style=\"color: #000000\">Still, a Medi-Cal card is no panacea for troubled lives. “You can’t treat away the problems that face poor communities,” said Briscoe, the county health director. “It’s about a good job. It’s about a sense of belonging. It’s about a place to sleep, but healthcare can be a tool for social justice if it’s delivered effectively and creatively, and that’s why the Medicaid expansion is such a great opportunity for us.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Kaiser Health News (KHN) is a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "SEIU Teams Up with California Hospitals, Withdraws Ballot Initiatives",
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"content": "\u003cfigure id=\"attachment_19051\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/sb10069454g-001-e1399421017698.jpg\">\u003cimg class=\"size-large wp-image-19051\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/sb10069454g-001-640x480.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The California Hospital Association and Service Employees International Union say they have reached a \"unique agreement\" that will \"change the face of healthcare in California.\"\u003c/p>\n\u003cp>And in the process, the two ballot initiatives SEIU backed -- that would have put dramatic limits on both\u003ca href=\"http://www.sos.ca.gov/admin/press-releases/2014/db14-002.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+NewsUpdatesFromCaliforniaSecretaryOfStateDebraBowen+(News+Updates+from+California+Secretary+of+State+Debra+Bowen)\" target=\"_blank\"> hospital charges\u003c/a> and \u003ca href=\"http://www.sos.ca.gov/admin/press-releases/2014/db14-001.htm\" target=\"_blank\">CEO compensation\u003c/a> -- are being withdrawn.\u003c/p>\n\u003cp>The partnership was announced Tuesday morning, is effective immediately, and runs through December 31, 2017. In a long call with reporters, both sides emphasized what they called the centerpiece of the deal: a $100 million \"joint advocacy fund.\"\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>Major Goal is Raising Medi-Cal Rates\u003c/strong>\u003c/p>\n\u003cp>CHA president Duane Dauner said the parties \"will undertake the task of making sure that we fundamentally reform California's Medi-Cal program over the coming two years.\" Medi-Cal is the federal-state health program for people who are low income.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Specifically, both SEIU and the CHA seek to increase Medi-Cal reimbursement rates to providers, currently 49th in the country, a move that was good news to advocates.\u003c/p>\n\u003cp>\"We certainly support increasing Medi-Cal rates, because that improves access to care for the 8-plus million Californians in Medi-Cal right now,\" said Anthony Wright, executive director of Health Access. He noted that some 9 million Californians are now enrolled in Medi-Cal, in the wake of the expansion under the Affordable Care Act. \"All those folks need access to primary care providers and hospitals, to get the care they need, but that means paying a decent rate to providers.\"\u003c/p>\n\u003cp>But some people are curious what the union is getting out of this move. The details of the agreement will not be made public. Instead, the deal was summarized in a one-page press release. To Glenn Melnick, a health economist at USC, the potential overhaul of Medi-Cal is not where focus should lie.\u003c/p>\n\u003cp>\"The big news is that they're pulling those items off the ballot,\" he said. \"That's the big news. Why? I can't tell from this release.\"\u003c/p>\n\u003cp>Melnick called the initiative that would have regulated nonprofit hospital prices \"the nuclear option … it was tying hospital pricing to cost. That's a tremendously powerful threat.\"\u003c/p>\n\u003cp>But he noted that if such a measure would have passed, then hospitals would have had less revenue -- meaning they would have had less money to spend on wages and salaries of their employees.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/148382927&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Dave Regan, president and CEO of SEIU-United Healthcare Workers West, said that working to overhaul Medi-Cal might ensure a more stable future for workers. \"What do we get out of (the deal)? We get the opportunity to built the best health care system in America. We get to do it in collaboration with hospital providers, we get to offer our younger members an opportunity to help create a future that will offer them stable employment to retirement and then hopefully a secure retirement beyond that, and frankly, we don't have that right now.\"\u003c/p>\n\u003cp>Melnick did agree that higher Medi-Cal payments would potentially give hospitals more money to spend on their workforce. \"Sixty percent of budget is wages and salaries in a hospital,\" he said. \"If they have more, they'll spend it, because they're good at that.\"\u003c/p>\n\u003cp>In addition to SEIU and the California Hospital Association, other hospitals and health systems are parties to the deal which covers a majority of hospital beds in the state.\u003c/p>\n\u003cp>A spokesman with the state's Department of Health Care Services said they were reviewing the agreement and declined comment.\u003c/p>\n\u003cp>\u003cstrong>Harsh Criticism\u003c/strong>\u003c/p>\n\u003cp>In a joint release, three powerful unions in California harshly criticized the agreement, calling it \"an act of treason.\"\u003c/p>\n\u003cp>\"This agreement will undermine the rights of workers and will eliminate the union's watchdog role on behalf of patients,\" read the statement from the California Nurses Association, the National Union of Healthcare Workers and the AFL-CIO. It noted that it appeared that \"SEIU agreed to become a company union\" and chastised SEIU for refusing to release the details of the deal.\u003c/p>\n\u003cp>In the joint agreement, both the CHA and SEIU say they will seek \"legislation, regulations or voluntary compliance to address the issues raised in SEIU-UHW's two hospital ballot initiatives, which will not be pursued. This includes modernizing the hospital pricing system.\"\u003c/p>\n\u003cp>Wright, of Health Access, said hospital bills are often \"outrageous\" and might have \"no relationship to what insurers or government programs pay.\"\u003c/p>\n\u003cp>\"It's impossible to make apples-to-apples comparisons, it's impossible to get a handle on hospitals' pricing, the rhyme or reason of it.\"\u003c/p>\n\u003cp>The CHA's Dauner defended hospital price transparency, and insisted that \"anyone that wants to see what hospitals charge for anything is immediately available on the state's website.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>California recently\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/03/25/california-gets-an-f-for-health-care-price-transparency/\" target=\"_blank\"> received an \"F\"\u003c/a> in health care price transparency from the nonprofit Catalyst for Payment Reform.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19051\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/sb10069454g-001-e1399421017698.jpg\">\u003cimg class=\"size-large wp-image-19051\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/sb10069454g-001-640x480.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The California Hospital Association and Service Employees International Union say they have reached a \"unique agreement\" that will \"change the face of healthcare in California.\"\u003c/p>\n\u003cp>And in the process, the two ballot initiatives SEIU backed -- that would have put dramatic limits on both\u003ca href=\"http://www.sos.ca.gov/admin/press-releases/2014/db14-002.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+NewsUpdatesFromCaliforniaSecretaryOfStateDebraBowen+(News+Updates+from+California+Secretary+of+State+Debra+Bowen)\" target=\"_blank\"> hospital charges\u003c/a> and \u003ca href=\"http://www.sos.ca.gov/admin/press-releases/2014/db14-001.htm\" target=\"_blank\">CEO compensation\u003c/a> -- are being withdrawn.\u003c/p>\n\u003cp>The partnership was announced Tuesday morning, is effective immediately, and runs through December 31, 2017. In a long call with reporters, both sides emphasized what they called the centerpiece of the deal: a $100 million \"joint advocacy fund.\"\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>Major Goal is Raising Medi-Cal Rates\u003c/strong>\u003c/p>\n\u003cp>CHA president Duane Dauner said the parties \"will undertake the task of making sure that we fundamentally reform California's Medi-Cal program over the coming two years.\" Medi-Cal is the federal-state health program for people who are low income.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Specifically, both SEIU and the CHA seek to increase Medi-Cal reimbursement rates to providers, currently 49th in the country, a move that was good news to advocates.\u003c/p>\n\u003cp>\"We certainly support increasing Medi-Cal rates, because that improves access to care for the 8-plus million Californians in Medi-Cal right now,\" said Anthony Wright, executive director of Health Access. He noted that some 9 million Californians are now enrolled in Medi-Cal, in the wake of the expansion under the Affordable Care Act. \"All those folks need access to primary care providers and hospitals, to get the care they need, but that means paying a decent rate to providers.\"\u003c/p>\n\u003cp>But some people are curious what the union is getting out of this move. The details of the agreement will not be made public. Instead, the deal was summarized in a one-page press release. To Glenn Melnick, a health economist at USC, the potential overhaul of Medi-Cal is not where focus should lie.\u003c/p>\n\u003cp>\"The big news is that they're pulling those items off the ballot,\" he said. \"That's the big news. Why? I can't tell from this release.\"\u003c/p>\n\u003cp>Melnick called the initiative that would have regulated nonprofit hospital prices \"the nuclear option … it was tying hospital pricing to cost. That's a tremendously powerful threat.\"\u003c/p>\n\u003cp>But he noted that if such a measure would have passed, then hospitals would have had less revenue -- meaning they would have had less money to spend on wages and salaries of their employees.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/148382927&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Dave Regan, president and CEO of SEIU-United Healthcare Workers West, said that working to overhaul Medi-Cal might ensure a more stable future for workers. \"What do we get out of (the deal)? We get the opportunity to built the best health care system in America. We get to do it in collaboration with hospital providers, we get to offer our younger members an opportunity to help create a future that will offer them stable employment to retirement and then hopefully a secure retirement beyond that, and frankly, we don't have that right now.\"\u003c/p>\n\u003cp>Melnick did agree that higher Medi-Cal payments would potentially give hospitals more money to spend on their workforce. \"Sixty percent of budget is wages and salaries in a hospital,\" he said. \"If they have more, they'll spend it, because they're good at that.\"\u003c/p>\n\u003cp>In addition to SEIU and the California Hospital Association, other hospitals and health systems are parties to the deal which covers a majority of hospital beds in the state.\u003c/p>\n\u003cp>A spokesman with the state's Department of Health Care Services said they were reviewing the agreement and declined comment.\u003c/p>\n\u003cp>\u003cstrong>Harsh Criticism\u003c/strong>\u003c/p>\n\u003cp>In a joint release, three powerful unions in California harshly criticized the agreement, calling it \"an act of treason.\"\u003c/p>\n\u003cp>\"This agreement will undermine the rights of workers and will eliminate the union's watchdog role on behalf of patients,\" read the statement from the California Nurses Association, the National Union of Healthcare Workers and the AFL-CIO. It noted that it appeared that \"SEIU agreed to become a company union\" and chastised SEIU for refusing to release the details of the deal.\u003c/p>\n\u003cp>In the joint agreement, both the CHA and SEIU say they will seek \"legislation, regulations or voluntary compliance to address the issues raised in SEIU-UHW's two hospital ballot initiatives, which will not be pursued. This includes modernizing the hospital pricing system.\"\u003c/p>\n\u003cp>Wright, of Health Access, said hospital bills are often \"outrageous\" and might have \"no relationship to what insurers or government programs pay.\"\u003c/p>\n\u003cp>\"It's impossible to make apples-to-apples comparisons, it's impossible to get a handle on hospitals' pricing, the rhyme or reason of it.\"\u003c/p>\n\u003cp>The CHA's Dauner defended hospital price transparency, and insisted that \"anyone that wants to see what hospitals charge for anything is immediately available on the state's website.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>California recently\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/03/25/california-gets-an-f-for-health-care-price-transparency/\" target=\"_blank\"> received an \"F\"\u003c/a> in health care price transparency from the nonprofit Catalyst for Payment Reform.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "in-air-pollution-dispute-questions-over-who-benefits-who-pays-in-oakland-army-base-development",
"title": "Air Pollution Controversy Swirls Around Oakland Army Base Development",
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"content": "\u003caside class=\"aligncenter\"> [youtube http://www.youtube.com/watch?v=GrKwTm5jldE&w=640&h=360]\u003c/aside>\n\u003cp>Jahvonn Mair was only 4 when he was diagnosed last year with asthma. He’s still so tiny that his inhaler apparatus is half as big as his head, and his twice-daily doses have slipped into his everyday routine alongside watching cartoons and playing with a favorite stuffed monkey named George.\u003c/p>\n\u003cp>Jahvonn lives in West Oakland, a neighborhood clogged with air pollution from the surrounding freeways and the Port of Oakland. Residents here are twice as likely to go to the emergency room with asthma as people in Alameda County overall. They’re also more likely to die of cancer, heart disease or lung disease — all illnesses with known links to polluted air.\u003c/p>\n\u003cp>Now officials and activists are tussling over a massive development project underway right next door, at the decommissioned Oakland Army Base. The project promises to bring much-needed jobs and economic benefits to Oakland and beyond. But health officials fear it could worsen the already toxic air in West Oakland, sticking residents with more than their fair share of the burden.\u003c/p>\n\u003cp>\u003cstrong>Hope and Risk\u003c/strong>\u003c/p>\n\u003cp>Hopes for the remade former base, decommissioned in 1999, are high. The city and the port are turning about 300 acres of it into a \u003ca href=\"http://www.oaklandglobal.com/\">modern trade and logistics hub\u003c/a> right next to the current port.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Once it’s up and running in 2020, the new trade center will have an additional shipping terminal, a bigger rail yard and ample facilities for handling and sorting cargo. It will give the port area the capacity to handle hundreds of thousands more cargo containers each year. And the city predicts it will provide at least 2,000 new jobs, plus an economic boost reaching into the American Midwest.\u003c/p>\n\u003cp>“The Oakland Army Base was an economic engine for West Oakland especially, and Oakland and the region generally,” says Fred Blackwell, Oakland’s interim city administrator. “So the notion of bringing it back and having it be an economic engine for the neighborhood and the city once again … is pretty exciting.”\u003c/p>\n\u003cp>The need for jobs is real — in the city and in this neighborhood in particular. West Oakland’s unemployment rate is typically higher than the city’s overall, which dipped below 10 percent at the end of last year. With that in mind, city officials placed a job recruiting center for the Army Base project at 18th and Adeline streets, smack in the middle of West Oakland.\u003c/p>\n\u003cfigure id=\"attachment_134748\" class=\"wp-caption alignleft\" style=\"max-width: 319px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/04/trucks-west-oakland.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-134748\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/04/trucks-west-oakland-300x300.jpg\" alt=\"Every day at the Port of Oakland trucks line up for 7-8 hours waiting to unload their trucks onto the diesel ships. (Deborah Svoboda/KQED)\" width=\"319\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Every day at the Port of Oakland trucks line up for seven or eight hours waiting to unload their cargo onto the ships. (Deborah Svoboda/KQED) \u003ccite>( Deborah Svoboda/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>So what’s the potential harm?\u003c/p>\n\u003cp>Construction, which began last fall, will require heavy-duty diesel trucks and construction vehicles to make tens of thousands of trips to and from the site. And the new trade center will ultimately host a lot more freight activity than the port alone does today — all of which takes fuel.\u003c/p>\n\u003cp>Proponents point out that the impact will be somewhat offset by the efficiency of shifting more cargo from trucks to trains. Still, the project’s official \u003ca href=\"http://www.scribd.com/doc/221109312/Environmental-Impact-Report-on-Oakland-Army-Base-and-Air-Quality\">environmental analysis\u003c/a> predicts that it will “significantly and unavoidably” expose nearby residents to toxic air pollutants.\u003c/p>\n\u003cp>In a worst-case scenario, the analysis says the project could raise a West Oaklander’s lifetime risk of cancer by close to 100 cases per 1 million people.\u003c/p>\n\u003cp>That number might sound small. But local activists and health officials argue that West Oakland — a community that’s about half African-American and 85 percent nonwhite, where residents make about half the county’s average household income — is already bearing an unfair burden. Public health studies have found that the life expectancy for someone born and raised in West Oakland is at least 15 years less than someone born and raised in the Oakland Hills.\u003c/p>\n\u003cp>The health problems are not all because of air pollution. Still, David Vintze, the air quality planning manager at the Bay Area Air Quality Management District, says West Oakland can’t take any more.\u003c/p>\n\u003cp>“Our own studies have shown a two to three times increase in the amount of pollution in that community versus any other place in the Bay Area,” Vintze says. “That community is already too overburdened to be saturated with more particulate matter.”\u003c/p>\n\u003cp>Jahvonn lives in the Ironhorse apartment building on 14th Street, literally next door to Interstate 880 and directly across the freeway from the Army base. He calls his asthma attacks “heart attacks” and says they make his stomach hurt.\u003c/p>\n\u003cp>His mom, Charlotte Lynn, keeps him indoors more often since his diagnosis. When he does go outside, it’s often to the second-floor courtyard of his apartment building, where he and his friends ride bikes within direct view of the interstate. Many of them also have asthma.\u003c/p>\n\u003cp>Standing by the courtyard’s railing, Lynn watches one tractor-trailer truck after another drive by, leaving the port of today. “All you can see is trucks on the freeway,” she says. “That’s it, trucks, trucks, trucks. See? There’s another one.”\u003c/p>\n\u003cp>\u003cstrong>What Is Enough?\u003c/strong>\u003c/p>\n\u003cp>Health concerns notwithstanding, everyone, including Vintze, wants the Army base project to go on. What’s disputed is whether the city is doing enough to limit emissions and protect West Oakland residents such as Jahvonn.\u003c/p>\n\u003cp>Blackwell points to a thick \u003ca href=\"http://www.scribd.com/doc/221282783/Air-Pollution-Mitigation-Plan-for-Oakland-Army-Base-Redevelopment-Project\">air-quality plan\u003c/a>, dozens of pages long and required by state law, and says: “I think we have gone about as far as we can go to try to mitigate these issues while still having a viable project.”\u003c/p>\n\u003cp>Vintze, along with the Alameda County Public Health Department and local environmental activists, disagrees.\u003c/p>\n\u003cp>“There has to be some other things put into place in order to limit the impact of what they’re going to do,” says county Public Health Director Muntu Davis.\u003c/p>\n\u003cp>The city is doing more than the law demands in at least one regard, by requiring heavy construction vehicles, like backhoes, to install cleaner engine technology a year ahead of the state’s mandated schedule (though for some vehicles that’s still not for another two to four years).\u003c/p>\n\u003cp>But air quality and public health authorities wanted the city to go further. They \u003ca href=\"http://www.scribd.com/doc/221058904/BAAQMD-Letter-to-Oakland-7-22-13\">asked Oakland officials\u003c/a> to require diesel filters on all the trucks hauling materials to the construction site, as trucks serving the port must have. The \u003ca href=\"http://www.scribd.com/doc/221108341/Oakland-Response-Letter-to-BAAQMD-9-23-13\">city said no\u003c/a>. The City Council had voted to require that fully half the labor for this project come from Oakland, officials explained. And if they required expensive filters, they’d squeeze out too many small, independent Oakland truckers.\u003c/p>\n\u003cp>“The West Oakland community, it’s their health, it’s their life,” says Vintze. “It shouldn’t be minimized for profit.”\u003c/p>\n\u003cp>Phil Tagami is an Oakland native, CEO of California Capital and Investment Group, and the project developer. He points out that he’s already meeting or exceeding the legal requirements for air quality control, and calls the regulators who are complaining about the project “rogue individuals” who have become overzealous in their oversight role.\u003c/p>\n\u003cp>“There are a handful of shake-down people who want to ring the bell and argue and complain that something more can be done, but I haven’t seen them create many jobs,” he says. “Yelling at the rain is not going to make the rain stop.”\u003c/p>\n\u003cp>It is, indeed, not stopping. Vintze and others have basically given up on further changing the construction plans. Now they’re hoping to get stronger protections into the plan for trade center operations in 2020.\u003c/p>\n\u003cfigure id=\"attachment_134750\" class=\"wp-caption alignleft\" style=\"max-width: 650px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/04/inhalers.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-134750 size-full\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/04/inhalers.jpg\" alt=\"In Jahvonn Mair's preschool class of 22 students, 7 have been diagnosed with asthma and use an inhaler. Here they display their inhalers. From left to right, Akirah Armstrong, (behind) Adrian Kemp, RiJai Malone, Omarr Daniel (front), Jahvonn Mair and Sarquan Holland. (Deborah Svoboda/KQED)\" width=\"650\" height=\"452\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">In Jahvonn Mair’s preschool class of 22 students, seven have been diagnosed with asthma and use an inhaler. Here they display their inhalers. From left to right, Akirah Armstrong, (behind) Adrian Kemp, RiJai Malone, Omarr Daniel (front), Jahvonn Mair and Sarquan Holland. (Deborah Svoboda/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>“This community has suffered egregiously at the hands of the freight industry,” says Brian Beveridge, who lives in West Oakland and co-directs a local environmental group, the West Oakland Environmental Indicators Project. “We deserve better than to just be told, ‘Well, we’re all going to do the best we can not to break the law.’ ”\u003c/p>\n\u003cp>To soothe some community fears, the developer installed three air-quality monitors around West Oakland and \u003ca href=\"http://ngem.com/OAB_AQM/\">publishes the data\u003c/a> daily, online. One of the monitors is on the roof of Jahvonn Mair’s school, Prescott Elementary.\u003c/p>\n\u003cp>Even if pollution spikes, though, the city acknowledges that the devices aren’t precise enough to show whether the construction is the cause. And there’s nothing in writing that says what the developer must do to correct it. Instead, says Blackwell, the city administrator, the monitors’ main purpose is to tell if overall pollution in the neighborhood rises or falls over time.\u003c/p>\n\u003cp>\u003cstrong>The Unknowns\u003c/strong>\u003c/p>\n\u003cp>Tagami and other proponents argue that the project could actually pave the way for cleaner air in West Oakland in the long run. It’ll enable companies to handle more cargo on site, instead of trucking it around the region for processing. And it could bring electric power to some cranes and docked ships instead of having them burn diesel. In fact, the California Transportation Commission, which is putting up nearly half the cost of the $500 million project, based its grant in part on the promise of cleaner air.\u003c/p>\n\u003cp>Even so, it’s impossible to predict now whether those improvements will be enough to totally counteract the emissions coming from ships, trains and trucks moving many tons more cargo each year.\u003c/p>\n\u003cp>Beveridge says he hopes it will but — like the promise of economic benefits for West Oakland — he’ll believe it when he sees it.\u003c/p>\n\u003cp>“There’s an old saying. … A rising tide raises all boats,” he says. “That’s great if you have a boat. But if you don’t have a boat, a rising tide just sooner or later goes above your nose and you’re finished.”\u003c/p>\n\u003cp>For now, across the interstate, Charlotte Lynn keeps the windows closed to the traffic. She says she wants to move her son to a healthier place, but she earns just over $1,000 a month as a part-time certified nurse assistant, and the Oakland Housing Authority says it doesn’t have the money to move her right now. She’s applying to the Housing Authority for a medical exception.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“I want to move ASAP,” she says, an urgency in her voice. “I want to get out of here. … But there’s nothing I can do, I have to stay here. You know how they say some people get stuck in certain places? We’re stuck.”\u003c/p>\n\n",
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"title": "Air Pollution Controversy Swirls Around Oakland Army Base Development | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003caside class=\"aligncenter\"> \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/GrKwTm5jldE'\n title='//www.youtube.com/embed/GrKwTm5jldE'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003c/aside>\n\u003cp>Jahvonn Mair was only 4 when he was diagnosed last year with asthma. He’s still so tiny that his inhaler apparatus is half as big as his head, and his twice-daily doses have slipped into his everyday routine alongside watching cartoons and playing with a favorite stuffed monkey named George.\u003c/p>\n\u003cp>Jahvonn lives in West Oakland, a neighborhood clogged with air pollution from the surrounding freeways and the Port of Oakland. Residents here are twice as likely to go to the emergency room with asthma as people in Alameda County overall. They’re also more likely to die of cancer, heart disease or lung disease — all illnesses with known links to polluted air.\u003c/p>\n\u003cp>Now officials and activists are tussling over a massive development project underway right next door, at the decommissioned Oakland Army Base. The project promises to bring much-needed jobs and economic benefits to Oakland and beyond. But health officials fear it could worsen the already toxic air in West Oakland, sticking residents with more than their fair share of the burden.\u003c/p>\n\u003cp>\u003cstrong>Hope and Risk\u003c/strong>\u003c/p>\n\u003cp>Hopes for the remade former base, decommissioned in 1999, are high. The city and the port are turning about 300 acres of it into a \u003ca href=\"http://www.oaklandglobal.com/\">modern trade and logistics hub\u003c/a> right next to the current port.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Once it’s up and running in 2020, the new trade center will have an additional shipping terminal, a bigger rail yard and ample facilities for handling and sorting cargo. It will give the port area the capacity to handle hundreds of thousands more cargo containers each year. And the city predicts it will provide at least 2,000 new jobs, plus an economic boost reaching into the American Midwest.\u003c/p>\n\u003cp>“The Oakland Army Base was an economic engine for West Oakland especially, and Oakland and the region generally,” says Fred Blackwell, Oakland’s interim city administrator. “So the notion of bringing it back and having it be an economic engine for the neighborhood and the city once again … is pretty exciting.”\u003c/p>\n\u003cp>The need for jobs is real — in the city and in this neighborhood in particular. West Oakland’s unemployment rate is typically higher than the city’s overall, which dipped below 10 percent at the end of last year. With that in mind, city officials placed a job recruiting center for the Army Base project at 18th and Adeline streets, smack in the middle of West Oakland.\u003c/p>\n\u003cfigure id=\"attachment_134748\" class=\"wp-caption alignleft\" style=\"max-width: 319px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/04/trucks-west-oakland.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-134748\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/04/trucks-west-oakland-300x300.jpg\" alt=\"Every day at the Port of Oakland trucks line up for 7-8 hours waiting to unload their trucks onto the diesel ships. (Deborah Svoboda/KQED)\" width=\"319\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Every day at the Port of Oakland trucks line up for seven or eight hours waiting to unload their cargo onto the ships. (Deborah Svoboda/KQED) \u003ccite>( Deborah Svoboda/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>So what’s the potential harm?\u003c/p>\n\u003cp>Construction, which began last fall, will require heavy-duty diesel trucks and construction vehicles to make tens of thousands of trips to and from the site. And the new trade center will ultimately host a lot more freight activity than the port alone does today — all of which takes fuel.\u003c/p>\n\u003cp>Proponents point out that the impact will be somewhat offset by the efficiency of shifting more cargo from trucks to trains. Still, the project’s official \u003ca href=\"http://www.scribd.com/doc/221109312/Environmental-Impact-Report-on-Oakland-Army-Base-and-Air-Quality\">environmental analysis\u003c/a> predicts that it will “significantly and unavoidably” expose nearby residents to toxic air pollutants.\u003c/p>\n\u003cp>In a worst-case scenario, the analysis says the project could raise a West Oaklander’s lifetime risk of cancer by close to 100 cases per 1 million people.\u003c/p>\n\u003cp>That number might sound small. But local activists and health officials argue that West Oakland — a community that’s about half African-American and 85 percent nonwhite, where residents make about half the county’s average household income — is already bearing an unfair burden. Public health studies have found that the life expectancy for someone born and raised in West Oakland is at least 15 years less than someone born and raised in the Oakland Hills.\u003c/p>\n\u003cp>The health problems are not all because of air pollution. Still, David Vintze, the air quality planning manager at the Bay Area Air Quality Management District, says West Oakland can’t take any more.\u003c/p>\n\u003cp>“Our own studies have shown a two to three times increase in the amount of pollution in that community versus any other place in the Bay Area,” Vintze says. “That community is already too overburdened to be saturated with more particulate matter.”\u003c/p>\n\u003cp>Jahvonn lives in the Ironhorse apartment building on 14th Street, literally next door to Interstate 880 and directly across the freeway from the Army base. He calls his asthma attacks “heart attacks” and says they make his stomach hurt.\u003c/p>\n\u003cp>His mom, Charlotte Lynn, keeps him indoors more often since his diagnosis. When he does go outside, it’s often to the second-floor courtyard of his apartment building, where he and his friends ride bikes within direct view of the interstate. Many of them also have asthma.\u003c/p>\n\u003cp>Standing by the courtyard’s railing, Lynn watches one tractor-trailer truck after another drive by, leaving the port of today. “All you can see is trucks on the freeway,” she says. “That’s it, trucks, trucks, trucks. See? There’s another one.”\u003c/p>\n\u003cp>\u003cstrong>What Is Enough?\u003c/strong>\u003c/p>\n\u003cp>Health concerns notwithstanding, everyone, including Vintze, wants the Army base project to go on. What’s disputed is whether the city is doing enough to limit emissions and protect West Oakland residents such as Jahvonn.\u003c/p>\n\u003cp>Blackwell points to a thick \u003ca href=\"http://www.scribd.com/doc/221282783/Air-Pollution-Mitigation-Plan-for-Oakland-Army-Base-Redevelopment-Project\">air-quality plan\u003c/a>, dozens of pages long and required by state law, and says: “I think we have gone about as far as we can go to try to mitigate these issues while still having a viable project.”\u003c/p>\n\u003cp>Vintze, along with the Alameda County Public Health Department and local environmental activists, disagrees.\u003c/p>\n\u003cp>“There has to be some other things put into place in order to limit the impact of what they’re going to do,” says county Public Health Director Muntu Davis.\u003c/p>\n\u003cp>The city is doing more than the law demands in at least one regard, by requiring heavy construction vehicles, like backhoes, to install cleaner engine technology a year ahead of the state’s mandated schedule (though for some vehicles that’s still not for another two to four years).\u003c/p>\n\u003cp>But air quality and public health authorities wanted the city to go further. They \u003ca href=\"http://www.scribd.com/doc/221058904/BAAQMD-Letter-to-Oakland-7-22-13\">asked Oakland officials\u003c/a> to require diesel filters on all the trucks hauling materials to the construction site, as trucks serving the port must have. The \u003ca href=\"http://www.scribd.com/doc/221108341/Oakland-Response-Letter-to-BAAQMD-9-23-13\">city said no\u003c/a>. The City Council had voted to require that fully half the labor for this project come from Oakland, officials explained. And if they required expensive filters, they’d squeeze out too many small, independent Oakland truckers.\u003c/p>\n\u003cp>“The West Oakland community, it’s their health, it’s their life,” says Vintze. “It shouldn’t be minimized for profit.”\u003c/p>\n\u003cp>Phil Tagami is an Oakland native, CEO of California Capital and Investment Group, and the project developer. He points out that he’s already meeting or exceeding the legal requirements for air quality control, and calls the regulators who are complaining about the project “rogue individuals” who have become overzealous in their oversight role.\u003c/p>\n\u003cp>“There are a handful of shake-down people who want to ring the bell and argue and complain that something more can be done, but I haven’t seen them create many jobs,” he says. “Yelling at the rain is not going to make the rain stop.”\u003c/p>\n\u003cp>It is, indeed, not stopping. Vintze and others have basically given up on further changing the construction plans. Now they’re hoping to get stronger protections into the plan for trade center operations in 2020.\u003c/p>\n\u003cfigure id=\"attachment_134750\" class=\"wp-caption alignleft\" style=\"max-width: 650px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/04/inhalers.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-134750 size-full\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/04/inhalers.jpg\" alt=\"In Jahvonn Mair's preschool class of 22 students, 7 have been diagnosed with asthma and use an inhaler. Here they display their inhalers. From left to right, Akirah Armstrong, (behind) Adrian Kemp, RiJai Malone, Omarr Daniel (front), Jahvonn Mair and Sarquan Holland. (Deborah Svoboda/KQED)\" width=\"650\" height=\"452\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">In Jahvonn Mair’s preschool class of 22 students, seven have been diagnosed with asthma and use an inhaler. Here they display their inhalers. From left to right, Akirah Armstrong, (behind) Adrian Kemp, RiJai Malone, Omarr Daniel (front), Jahvonn Mair and Sarquan Holland. (Deborah Svoboda/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>“This community has suffered egregiously at the hands of the freight industry,” says Brian Beveridge, who lives in West Oakland and co-directs a local environmental group, the West Oakland Environmental Indicators Project. “We deserve better than to just be told, ‘Well, we’re all going to do the best we can not to break the law.’ ”\u003c/p>\n\u003cp>To soothe some community fears, the developer installed three air-quality monitors around West Oakland and \u003ca href=\"http://ngem.com/OAB_AQM/\">publishes the data\u003c/a> daily, online. One of the monitors is on the roof of Jahvonn Mair’s school, Prescott Elementary.\u003c/p>\n\u003cp>Even if pollution spikes, though, the city acknowledges that the devices aren’t precise enough to show whether the construction is the cause. And there’s nothing in writing that says what the developer must do to correct it. Instead, says Blackwell, the city administrator, the monitors’ main purpose is to tell if overall pollution in the neighborhood rises or falls over time.\u003c/p>\n\u003cp>\u003cstrong>The Unknowns\u003c/strong>\u003c/p>\n\u003cp>Tagami and other proponents argue that the project could actually pave the way for cleaner air in West Oakland in the long run. It’ll enable companies to handle more cargo on site, instead of trucking it around the region for processing. And it could bring electric power to some cranes and docked ships instead of having them burn diesel. In fact, the California Transportation Commission, which is putting up nearly half the cost of the $500 million project, based its grant in part on the promise of cleaner air.\u003c/p>\n\u003cp>Even so, it’s impossible to predict now whether those improvements will be enough to totally counteract the emissions coming from ships, trains and trucks moving many tons more cargo each year.\u003c/p>\n\u003cp>Beveridge says he hopes it will but — like the promise of economic benefits for West Oakland — he’ll believe it when he sees it.\u003c/p>\n\u003cp>“There’s an old saying. … A rising tide raises all boats,” he says. “That’s great if you have a boat. But if you don’t have a boat, a rising tide just sooner or later goes above your nose and you’re finished.”\u003c/p>\n\u003cp>For now, across the interstate, Charlotte Lynn keeps the windows closed to the traffic. She says she wants to move her son to a healthier place, but she earns just over $1,000 a month as a part-time certified nurse assistant, and the Oakland Housing Authority says it doesn’t have the money to move her right now. She’s applying to the Housing Authority for a medical exception.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I want to move ASAP,” she says, an urgency in her voice. “I want to get out of here. … But there’s nothing I can do, I have to stay here. You know how they say some people get stuck in certain places? We’re stuck.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_133493\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/04/tedagu.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-133493\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/04/tedagu-640x362.jpg\" alt=\"UC Berkeley football player Ted Agu, in image released by Cal. (GoldenBearSports.com)\" width=\"640\" height=\"362\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">UC Berkeley football player Ted Agu, in image released by Cal. (GoldenBearSports.com) \u003ccite>(GoldenBearSports.com)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Sara Hossaini\u003c/strong>\u003c/p>\n\u003cp>The Alameda County Coroner’s Office says 21-year-old UC Berkeley football player and pre-med student Ted Agu, who passed away in February after \u003ca href=\"http://ww2.kqed.org/news/2014/02/07/cal-football-player-dies-during-drill/\" target=\"_blank\" rel=\"noopener\">collapsing during a team training run\u003c/a>, had an inherited heart condition.\u003c/p>\n\u003cp>His official cause of death is hypertrophic cardiomyopathy, a rare, abnormal thickening of the heart muscle, which can make it harder for blood to leave the heart. The condition leads to cardiac arrest in less than 3 percent of people with the condition.\u003c/p>\n\u003cp>Dr. Kishor Avasarala, who specializes in sudden cardiac death risk at \u003ca href=\"http://www.childrenshospitaloakland.org/main/home.aspx\" target=\"_blank\" rel=\"noopener\">UCSF Benioff Children’s Hospital Oakland\u003c/a>, says Agu’s condition is a well-known cause of death for young athletes.\u003c/p>\n\u003cp>“In roughly 50 percent of cases, they could have no symptoms at all, and the very first symptom could be a cardiac arrest,” Dr. Avasarala said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Even though symptoms are rare, Avasarala says red flags can include unexplained fainting episodes — especially incidents related to exercise — and a family history of heart problems.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>While the university won’t comment on the coroner’s findings until a final report is released, a Cal Athletics spokesman says Agu “will forever be a beloved member of our Golden Bear family.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_133493\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/04/tedagu.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-133493\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/04/tedagu-640x362.jpg\" alt=\"UC Berkeley football player Ted Agu, in image released by Cal. (GoldenBearSports.com)\" width=\"640\" height=\"362\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">UC Berkeley football player Ted Agu, in image released by Cal. (GoldenBearSports.com) \u003ccite>(GoldenBearSports.com)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Sara Hossaini\u003c/strong>\u003c/p>\n\u003cp>The Alameda County Coroner’s Office says 21-year-old UC Berkeley football player and pre-med student Ted Agu, who passed away in February after \u003ca href=\"http://ww2.kqed.org/news/2014/02/07/cal-football-player-dies-during-drill/\" target=\"_blank\" rel=\"noopener\">collapsing during a team training run\u003c/a>, had an inherited heart condition.\u003c/p>\n\u003cp>His official cause of death is hypertrophic cardiomyopathy, a rare, abnormal thickening of the heart muscle, which can make it harder for blood to leave the heart. The condition leads to cardiac arrest in less than 3 percent of people with the condition.\u003c/p>\n\u003cp>Dr. Kishor Avasarala, who specializes in sudden cardiac death risk at \u003ca href=\"http://www.childrenshospitaloakland.org/main/home.aspx\" target=\"_blank\" rel=\"noopener\">UCSF Benioff Children’s Hospital Oakland\u003c/a>, says Agu’s condition is a well-known cause of death for young athletes.\u003c/p>\n\u003cp>“In roughly 50 percent of cases, they could have no symptoms at all, and the very first symptom could be a cardiac arrest,” Dr. Avasarala said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003ca href=\"http://jimfisher.edinboro.edu/\" target=\"_blank\" rel=\"noopener\">Jim Fisher\u003c/a>, a retired FBI agent and criminal justice professor emeritus at Pennsylvania’s Edinboro University, started wondering about officer-involved shootings in late 2010. He discovered there’s no national tracking of the shootings, which he believes are more common than when he was in the FBI decades ago. So, he decided to study them for a year in 2011.\u003c/p>\n\u003cp>“I noticed a lot of mentally ill people were shot, and a lot of people didn’t have guns,” Fisher said. “With regard to how these cases are investigated, if someone shoots a cop, I guarantee you a thorough investigation, but when a police officer shoots someone, you really can’t trust the result, and they’re really not that thorough.”\u003c/p>\n\u003cp>[contextly_sidebar id=”5ac40e12cf857685f25285a8c42b025d”]\u003c/p>\n\u003cp>Fisher found \u003ca href=\"http://jimfishertruecrime.blogspot.com/2012/01/police-involved-shootings-2011-annual.html\" target=\"_blank\" rel=\"noopener\">more than 1,000 incidents\u003c/a> nationwide of police shooting — and either wounding or killing — suspects in 2011. He said he had expected to find less than a third of that number.\u003c/p>\n\u003cp>“I was also surprised by the high percentage of justifications for the shootings under circumstances I consider questionable,” he said. “In other words, it seemed to me the police were killing people unnecessarily.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>California was the most deadly state in his findings, with 102 fatal police shootings. California cities took seven out of 17 places in Fisher’s list of cities with the highest number of officer-involved shootings per capita. And almost every case was closed without charges by police internal investigations and district attorney reviews.\u003c/p>\n\u003cp>Fisher said there’s no federal agency charged with overseeing police shootings, or holding police departments accountable for doing quality investigations. The state of California doesn’t even track basic data like the number of these shootings, and Fisher said no federal agency does either. He gathered the information for his study from media reports.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“The police essentially are investigating themselves, and the American public really doesn’t trust the results of an internal investigation that says, ‘We have cleared these officers,’ ” Fisher said. “Americans aren’t stupid.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"http://jimfisher.edinboro.edu/\" target=\"_blank\" rel=\"noopener\">Jim Fisher\u003c/a>, a retired FBI agent and criminal justice professor emeritus at Pennsylvania’s Edinboro University, started wondering about officer-involved shootings in late 2010. He discovered there’s no national tracking of the shootings, which he believes are more common than when he was in the FBI decades ago. So, he decided to study them for a year in 2011.\u003c/p>\n\u003cp>“I noticed a lot of mentally ill people were shot, and a lot of people didn’t have guns,” Fisher said. “With regard to how these cases are investigated, if someone shoots a cop, I guarantee you a thorough investigation, but when a police officer shoots someone, you really can’t trust the result, and they’re really not that thorough.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Fisher found \u003ca href=\"http://jimfishertruecrime.blogspot.com/2012/01/police-involved-shootings-2011-annual.html\" target=\"_blank\" rel=\"noopener\">more than 1,000 incidents\u003c/a> nationwide of police shooting — and either wounding or killing — suspects in 2011. He said he had expected to find less than a third of that number.\u003c/p>\n\u003cp>“I was also surprised by the high percentage of justifications for the shootings under circumstances I consider questionable,” he said. “In other words, it seemed to me the police were killing people unnecessarily.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>California was the most deadly state in his findings, with 102 fatal police shootings. California cities took seven out of 17 places in Fisher’s list of cities with the highest number of officer-involved shootings per capita. And almost every case was closed without charges by police internal investigations and district attorney reviews.\u003c/p>\n\u003cp>Fisher said there’s no federal agency charged with overseeing police shootings, or holding police departments accountable for doing quality investigations. The state of California doesn’t even track basic data like the number of these shootings, and Fisher said no federal agency does either. He gathered the information for his study from media reports.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“The police essentially are investigating themselves, and the American public really doesn’t trust the results of an internal investigation that says, ‘We have cleared these officers,’ ” Fisher said. “Americans aren’t stupid.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "San Francisco's Elderly Chinese Suffer from Nursing Home Closure",
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"content": "\u003cfigure id=\"attachment_18602\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/MissionBay-e1396976031755.jpg\">\u003cimg class=\"size-large wp-image-18602\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/MissionBay-640x480.jpg\" alt=\"Mission Bay Convalescent Hospital closed in February. (Vinnie Tong/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Mission Bay Convalescent Hospital was home to 35 elderly Chinese immigrants. Only two found a new place in San Francisco. Some have passed away since the move. (Vinnie Tong/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Vinnee Tong\u003c/strong>\u003c/p>\n\u003cp>Too often people don’t spend a lot of time thinking about who’s going to take care of them at the end of their life.\u003c/p>\n\u003cp>It’s not hard to imagine why: It’s scary and stirs up all kinds of emotion.\u003c/p>\n\u003caside class=\"pullquote alignleft\">People appreciated Mission Bay because it was familiar, geared to its Chinese-speaking residents.\u003c/aside>\n\u003cp>At the same time, financial pressures can make the whole topic even harder to deal with. For starters, if you need a bed in a home with full-time care, the decent ones are hard to find and cost a lot.\u003c/p>\n\u003cp>That’s why the closure of one small place in San Francisco’s Potrero Hill neighborhood is being felt so acutely. The Mission Bay Convalescent Hospital served a community of elderly Chinese, most of whom didn't speak English. Now the building’s been sold, its occupants scattered, and the city’s supply of affordable nursing home beds is even smaller.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Meanwhile, the families of these elders are helping their loved ones adjust to new and unfamiliar surroundings.\u003c/p>\n\u003cp>Jennifer Huey’s mom, Chu Huey, is 80 years old and now lives in Oakland at the McClure Convalescent Hospital. She has dementia and a slew of other medical problems. She lives her life bed-bound, so everything about her existence is determined by the care she gets at McClure.\u003c/p>\n\u003cp>Chu Huey moved from Mission Bay late last year. She’s one of 35 patients who left before the home closed its doors in February.\u003c/p>\n\u003cp>\u003cstrong>Shrinking Supply of Beds for Low-Income San Franciscans \u003c/strong>\u003c/p>\n\u003cp>Residents like Chu Huey appreciated Mission Bay partly because it was familiar: There were bulletin boards with handwritten notices in Chinese, wall calendars in the good-luck colors of red and gold, and when families brought Chinese food with them, patients were surrounded with the smells of home.\u003c/p>\n\u003cp>But Mission Bay was housed in an aging building -- first built in 1917 -- and it needed major upgrades, like fire sprinklers and disabled access.\u003c/p>\n\u003cp>Mission Bay housed only Medi-Cal patients, so its revenue was limited to the reimbursement it could get, which in 2013 was $185.39 per patient per day according to the state Department of Health Care Services.\u003c/p>\n\u003cp>In short, costs were growing faster than the reimbursements.\u003c/p>\n\u003cp>A lawyer for the owner, Bill Price, declined an interview request from KQED.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/143767118&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" frameborder=\"no\" scrolling=\"no\" width=\"100%\" height=\"166\">\u003c/iframe>\u003c/p>\n\u003cp>Benson Nadell is director of the San Francisco Long-Term Care Ombudsman Program, a federally-funded patient advocate.\u003c/p>\n\u003cp>Nadell says San Francisco is steadily losing low-income nursing home beds. He estimates 900 Medi-Cal beds have disappeared over the last 20 years -- about a third of the supply. None are being added.\u003c/p>\n\u003cp>\u003cstrong>“\u003c/strong>I was hoping when I first got contacted by the facility about closing, that somehow the city could have rallied around to save these beds,” Nadell said. “Because everyone in there is frail elderly from San Francisco, with families living in San Francisco.\"\u003c/p>\n\u003cp>But, Nadell said families had already received written notice early last fall that they’d have to leave. Given the demand for affordable beds, it became a real race to secure a spot elsewhere. The residents ended up quickly dispersing. Most of the patients at Mission Bay wanted to stay in the city. But out of 35 patients, only two were able to secure a spot in San Francisco.\u003c/p>\n\u003cp>\u003cstrong>Elderly Often Suffer \"Transfer Trauma\"\u003c/strong>\u003c/p>\n\u003cp>After moving, family members now have to travel farther to see loved ones, which means fewer visits. And some Mission Bay patients moved into nursing homes where few other patients or caregivers spoke their language.\u003c/p>\n\u003cp>Then there’s what’s called \"transfer trauma\" -- when a patient’s health suffers just from being moved. Jennifer Huey’s mother made half a dozen trips to the emergency room in the early weeks after her move out of Mission Bay.\u003c/p>\n\u003cp>Two other patients died shortly after they moved.\u003c/p>\n\u003cp>One is a 94-year-old woman who spoke only Cantonese and moved to a Kindred nursing home in Oakland at the end of October.\u003c/p>\n\u003cp>Her oldest son is still reeling with guilt. Tam, who only wanted to use his last name, is 74. He described getting a call from the new nursing home two weeks after his mom moved in.\u003c/p>\n\u003cp>“In the morning, they called and said she had a urinary tract infection,\" he said. \"The doctor had given her medicine and she had taken it. But then that night, they called and said they had to send her to the hospital.\"\u003c/p>\n\u003cp>That was November 11th.\u003c/p>\n\u003cp>Two days later, Tam went to Oakland to visit his mom in the hospital.\u003c/p>\n\u003cp>Early November 14th, she died.\u003c/p>\n\u003cp>Tam says Mission Bay’s closure affected his mother's health.\u003c/p>\n\u003cp>“Once she moved to Oakland, it was not as convenient for me to visit, so I couldn’t go as often,” he said. “My mom was close to me, more attached to me than my other siblings. Being that far away from me affected her mood.”\u003c/p>\n\u003cp>Jennifer Huey says the move has taken a real toll on patients like her mom, too. And she says Mission Bay’s closure is a loss for the city as a whole.\u003c/p>\n\u003cp>\u003cstrong>“\u003c/strong>The heart of it is, there has been nothing to replace what Mission Bay was to the Chinese community,” Huey said.\u003c/p>\n\u003cp>Nadell, the patient advocate, hopes the city has a way to prevent more nursing homes from closing or leaving the city, based on financial pressure alone.\u003c/p>\n\u003cp>\u003cstrong>“\u003c/strong>I feel that individuals should not be squeezed out of the system based solely on the financial profile,” he said. “San Francisco has an obligation to its old people.”\u003c/p>\n\u003cp>As for the building itself, a local real estate dealer bought it for $2.7 million dollars.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"FvoQj4Yjo4Qq9zcRdDb4AitBrLkGU822\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18602\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/MissionBay-e1396976031755.jpg\">\u003cimg class=\"size-large wp-image-18602\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/MissionBay-640x480.jpg\" alt=\"Mission Bay Convalescent Hospital closed in February. (Vinnie Tong/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Mission Bay Convalescent Hospital was home to 35 elderly Chinese immigrants. Only two found a new place in San Francisco. Some have passed away since the move. (Vinnie Tong/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Vinnee Tong\u003c/strong>\u003c/p>\n\u003cp>Too often people don’t spend a lot of time thinking about who’s going to take care of them at the end of their life.\u003c/p>\n\u003cp>It’s not hard to imagine why: It’s scary and stirs up all kinds of emotion.\u003c/p>\n\u003caside class=\"pullquote alignleft\">People appreciated Mission Bay because it was familiar, geared to its Chinese-speaking residents.\u003c/aside>\n\u003cp>At the same time, financial pressures can make the whole topic even harder to deal with. For starters, if you need a bed in a home with full-time care, the decent ones are hard to find and cost a lot.\u003c/p>\n\u003cp>That’s why the closure of one small place in San Francisco’s Potrero Hill neighborhood is being felt so acutely. The Mission Bay Convalescent Hospital served a community of elderly Chinese, most of whom didn't speak English. Now the building’s been sold, its occupants scattered, and the city’s supply of affordable nursing home beds is even smaller.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Meanwhile, the families of these elders are helping their loved ones adjust to new and unfamiliar surroundings.\u003c/p>\n\u003cp>Jennifer Huey’s mom, Chu Huey, is 80 years old and now lives in Oakland at the McClure Convalescent Hospital. She has dementia and a slew of other medical problems. She lives her life bed-bound, so everything about her existence is determined by the care she gets at McClure.\u003c/p>\n\u003cp>Chu Huey moved from Mission Bay late last year. She’s one of 35 patients who left before the home closed its doors in February.\u003c/p>\n\u003cp>\u003cstrong>Shrinking Supply of Beds for Low-Income San Franciscans \u003c/strong>\u003c/p>\n\u003cp>Residents like Chu Huey appreciated Mission Bay partly because it was familiar: There were bulletin boards with handwritten notices in Chinese, wall calendars in the good-luck colors of red and gold, and when families brought Chinese food with them, patients were surrounded with the smells of home.\u003c/p>\n\u003cp>But Mission Bay was housed in an aging building -- first built in 1917 -- and it needed major upgrades, like fire sprinklers and disabled access.\u003c/p>\n\u003cp>Mission Bay housed only Medi-Cal patients, so its revenue was limited to the reimbursement it could get, which in 2013 was $185.39 per patient per day according to the state Department of Health Care Services.\u003c/p>\n\u003cp>In short, costs were growing faster than the reimbursements.\u003c/p>\n\u003cp>A lawyer for the owner, Bill Price, declined an interview request from KQED.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/143767118&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" frameborder=\"no\" scrolling=\"no\" width=\"100%\" height=\"166\">\u003c/iframe>\u003c/p>\n\u003cp>Benson Nadell is director of the San Francisco Long-Term Care Ombudsman Program, a federally-funded patient advocate.\u003c/p>\n\u003cp>Nadell says San Francisco is steadily losing low-income nursing home beds. He estimates 900 Medi-Cal beds have disappeared over the last 20 years -- about a third of the supply. None are being added.\u003c/p>\n\u003cp>\u003cstrong>“\u003c/strong>I was hoping when I first got contacted by the facility about closing, that somehow the city could have rallied around to save these beds,” Nadell said. “Because everyone in there is frail elderly from San Francisco, with families living in San Francisco.\"\u003c/p>\n\u003cp>But, Nadell said families had already received written notice early last fall that they’d have to leave. Given the demand for affordable beds, it became a real race to secure a spot elsewhere. The residents ended up quickly dispersing. Most of the patients at Mission Bay wanted to stay in the city. But out of 35 patients, only two were able to secure a spot in San Francisco.\u003c/p>\n\u003cp>\u003cstrong>Elderly Often Suffer \"Transfer Trauma\"\u003c/strong>\u003c/p>\n\u003cp>After moving, family members now have to travel farther to see loved ones, which means fewer visits. And some Mission Bay patients moved into nursing homes where few other patients or caregivers spoke their language.\u003c/p>\n\u003cp>Then there’s what’s called \"transfer trauma\" -- when a patient’s health suffers just from being moved. Jennifer Huey’s mother made half a dozen trips to the emergency room in the early weeks after her move out of Mission Bay.\u003c/p>\n\u003cp>Two other patients died shortly after they moved.\u003c/p>\n\u003cp>One is a 94-year-old woman who spoke only Cantonese and moved to a Kindred nursing home in Oakland at the end of October.\u003c/p>\n\u003cp>Her oldest son is still reeling with guilt. Tam, who only wanted to use his last name, is 74. He described getting a call from the new nursing home two weeks after his mom moved in.\u003c/p>\n\u003cp>“In the morning, they called and said she had a urinary tract infection,\" he said. \"The doctor had given her medicine and she had taken it. But then that night, they called and said they had to send her to the hospital.\"\u003c/p>\n\u003cp>That was November 11th.\u003c/p>\n\u003cp>Two days later, Tam went to Oakland to visit his mom in the hospital.\u003c/p>\n\u003cp>Early November 14th, she died.\u003c/p>\n\u003cp>Tam says Mission Bay’s closure affected his mother's health.\u003c/p>\n\u003cp>“Once she moved to Oakland, it was not as convenient for me to visit, so I couldn’t go as often,” he said. “My mom was close to me, more attached to me than my other siblings. Being that far away from me affected her mood.”\u003c/p>\n\u003cp>Jennifer Huey says the move has taken a real toll on patients like her mom, too. And she says Mission Bay’s closure is a loss for the city as a whole.\u003c/p>\n\u003cp>\u003cstrong>“\u003c/strong>The heart of it is, there has been nothing to replace what Mission Bay was to the Chinese community,” Huey said.\u003c/p>\n\u003cp>Nadell, the patient advocate, hopes the city has a way to prevent more nursing homes from closing or leaving the city, based on financial pressure alone.\u003c/p>\n\u003cp>\u003cstrong>“\u003c/strong>I feel that individuals should not be squeezed out of the system based solely on the financial profile,” he said. “San Francisco has an obligation to its old people.”\u003c/p>\n\u003cp>As for the building itself, a local real estate dealer bought it for $2.7 million dollars.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"FvoQj4Yjo4Qq9zcRdDb4AitBrLkGU822\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cdiv>\n\u003cfigure id=\"attachment_18556\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/Jennifer-Glass-March-2013-chemo.jpg\">\u003cimg class=\"size-large wp-image-18556\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/Jennifer-Glass-March-2013-chemo-640x529.jpg\" alt=\"Jennifer Glass of San Mateo, undergoing chemotherapy last year for lung cancer. (Courtesy: Mary Thomas)\" width=\"640\" height=\"529\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jennifer Glass of San Mateo, undergoing chemotherapy last year for lung cancer. (Courtesy: Mary Thomas)\u003c/figcaption>\u003c/figure>\n\u003cp>A new campaign is underway to legalize physician-assisted suicide in California. Advocates launched a series of online ads last week to begin raising awareness. Still, it could take years for the effort to yield any results.\u003c/p>\n\u003c/div>\n\u003cdiv>\n\u003caside class=\"pullquote alignleft\">\"Having choice helps me feel I have some control.\" \u003c/aside>\n\u003cp>Since the early 1990s, lawmakers and activists have tried and failed several times to pass a death with dignity law in California. Under such a law doctors could prescribe lethal medications to patients who are terminally ill. Oregon and Washington permit the practice.\u003c/p>\n\u003cp>“California is a large state. It’s a politically complicated state,” says Barbara Coombs Lee, president of Compassion and Choices. Her advocacy group is leading the effort to try again to pass a law through the legislature or ballot proposition that would make aid in dying accessible in California.\u003c!--more-->\u003c/p>\n\u003cp>Coombs Lee says most people want the prescription not to take the drug -- but just to have it.\u003c/p>\n\u003cp>“It’s having the medication that gives them the sense of comfort and control, peace of mind. They call it their security blanket, their insurance policy,” she says.\u003c/p>\n\u003cp>That’s what it comes down to for San Mateo resident Jennifer Glass. When she was diagnosed with lung cancer last year, her mind immediately raced to a vision of a messy, chaotic death.\u003c/p>\n\u003cp>“The idea that my life is going to end was not so frightening to me,” she says. “The idea that I might drown in my own lung fluid while my family watches me suffer. That is terrifying.\u003c/p>\n\u003cp>Glass, 50, says at least having the option of controlling when and how she dies would bring her peace.\u003c/p>\n\u003cp>“There’s nothing that can prepare you for when you’re doctor looks you in the eye and tells you, 'you have cancer,'” she says. “But having choice helps me feel I have some control over a situation that is uncontrollable.”\u003c/p>\n\u003cp>Her cancer is being managed now. But with California’s fraught history over this issue, it will take some time to see results.\u003c/p>\n\u003cp>“The time is now,” says Coombs Lee. “We all together have made a commitment to see aid in dying accessible, transparent, available to Californians within five years.”\u003c/p>\n\u003c/div>\n\u003cp>[contextly_auto_sidebar id=\"Ivyr6AcIFcTADfQwgC7qu3U9hQk3lTTo\"]\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"officialWebsiteLink": "https://www.cityarts.net/",
"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
"site": "news",
"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
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"rss": "https://www.cityarts.net/feed/"
}
},
"closealltabs": {
"id": "closealltabs",
"title": "Close All Tabs",
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"info": "Close All Tabs breaks down how digital culture shapes our world through thoughtful insights and irreverent humor.",
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"officialWebsiteLink": "/podcasts/closealltabs",
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"order": 1
},
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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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"meta": {
"site": "radio",
"source": "npr"
},
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
"site": "news",
"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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}
},
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"source": "kqed",
"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"freakonomics-radio": {
"id": "freakonomics-radio",
"title": "Freakonomics Radio",
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"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"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/",
"rss": "https://feeds.feedburner.com/freakonomicsradio"
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},
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"id": "fresh-air",
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"link": "/radio/program/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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"rss": "https://feeds.npr.org/381444908/podcast.xml"
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"rss": "https://feeds.npr.org/510051/podcast.xml"
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},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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},
"how-i-built-this": {
"id": "how-i-built-this",
"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
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"source": "npr"
},
"link": "/radio/program/how-i-built-this",
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"npr": "https://rpb3r.app.goo.gl/3zxy",
"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",
"meta": {
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"order": 15
},
"link": "/podcasts/hyphenacion",
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"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED The Political Mind of Jerry Brown",
"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"source": "kqed",
"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/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/latino-usa",
"subscribe": {
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
}
},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Masters-of-Scale-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
"site": "radio",
"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
"subscribe": {
"apple": "http://mastersofscale.app.link/",
"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
"npr": "https://www.npr.org/podcasts/464615685/mind-shift-podcast",
"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
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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"
}
},
"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/",
"meta": {
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"source": "kqed",
"order": 14
},
"link": "/perspectives",
"subscribe": {
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"npr": "https://www.npr.org/podcasts/432309616/perspectives",
"rss": "https://ww2.kqed.org/perspectives/category/perspectives/feed/",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvcGVyc3BlY3RpdmVzL2NhdGVnb3J5L3BlcnNwZWN0aXZlcy9mZWVkLw"
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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",
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