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"content": "\u003cp>Zynners repent.\u003c/p>\n\u003cp>San Francisco secured a $1 million settlement with a retailer it accused of using online sales to \u003ca href=\"https://www.kqed.org/news/12002998/san-francisco-breaks-the-zyn-ternet-with-lawsuit-against-flavored-nicotine-sales\">flout the city’s ban\u003c/a> on flavored nicotine pouches, the city attorney announced Thursday.\u003c/p>\n\u003cp>The agreement, reached in October, requires the Los Angeles-based Lucy Goods Inc. to stop shipments of its products to San Francisco. The company is the fourth — along with Rogue Holdings LLC, Swisher International Inc. and Northerner Scandinavia Inc., all of which settled last year — named in a 2024 lawsuit against online sellers accused of violating state and local law and appealing to young people with fruity, minty flavors.\u003c/p>\n\u003cp>“The popularity of flavored nicotine pouches has skyrocketed, and we cannot risk hooking a new generation of young people on tobacco products,” City Attorney David Chiu said in a statement. “Online tobacco retailers are not above our laws and cannot ship banned products into our city.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The judgment also requires all four companies to prohibit the use of San Francisco addresses in shipping or billing address fields, and post clear language on their websites stating that flavored tobacco products may not be sold in San Francisco. Between the four defendants, the lawsuit netted the city nearly $4 million in penalties and fees.\u003c/p>\n\u003cp>Lucy Goods did not respond to a request for comment in time for publication.\u003c/p>\n\u003cp>The settlement is the latest in the city’s ongoing battle against flavored tobacco and other addictive products. San Francisco’s 2019 comprehensive ban on the sale of all flavored e-cigarettes and menthols included nicotine pouches in the legal definition of a “tobacco product.” A 2020 study \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S2352853220300134\">found\u003c/a> that the ban significantly reduced overall flavored tobacco use among people ages 18 to 34.\u003c/p>\n\u003cp>More recently, the popularity of Zyns and other nicotine pouches has grown as an alternative to smoking and vaping, especially among younger users, according to \u003ca href=\"https://keck.usc.edu/news/use-of-nicotine-pouches-increases-significantly-among-u-s-teens/\">research published last year\u003c/a> by a team at the USC Keck School of Medicine.[aside postID=news_12002998 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/ZynNicotinPouchesAP-1020x680.jpg']According to the 2023 California Youth Tobacco Survey, most high school respondents who used tobacco reported using flavored tobacco products, and nicotine pouches were the second-most common form of tobacco use among eighth-graders. Experts say the proliferation of flavored tobacco products, which are more attractive to young people, has threatened decades of progress in reducing youth tobacco use.\u003c/p>\n\u003cp>Zyn, a Swedish brand of nicotine pouches that has dominated the market, has been around for a decade and was initially marketed to help users kick smoking habits.\u003c/p>\n\u003cp>The pillow-shaped pouches, which sit in the mouth between the gum and lip, deliver a head rush or buzz as the bloodstream absorbs the nicotine. The products come in round plastic containers that resemble Ice Breakers mints, and often in a variety of fruit or mint flavors.\u003c/p>\n\u003cp>Philip Morris International acquired Zyn in 2022 as part of the tobacco giant’s pivot to smokeless products. Though the pouches don’t contain cancer-causing tobacco, nicotine is addictive, and experts have raised alarm bells about the consequences of nicotine exposure to developing adolescent brains.\u003c/p>\n\u003cp>Some of the hype has been attributed to the role of “\u003ca href=\"https://www.theguardian.com/business/2024/feb/12/meet-the-zynfluencers-how-nicotine-pouches-ignited-a-new-culture-war\">Zynfluencers\u003c/a>,” social media accounts that promote or meme the products’ use. The content, which skews to young men, links the products to masculinity, productivity and skepticism of the medical health establishment.\u003c/p>\n\u003cp>Right-wing media personality Tucker Carlson, who previously called himself a “Zyn power user” — recently launched his own brand of nicotine pouches, after Zyn said Carlson’s \u003ca href=\"https://www.politico.com/news/magazine/2025/02/07/tucker-carlson-nicotine-pouches-00200455\">claims\u003c/a> about the company’s products were not backed up by science.\u003c/p>\n\u003cp>The San Francisco settlement was announced the day after California \u003ca href=\"https://www.cspdailynews.com/tobacco/california-unveils-unflavored-tobacco-list-enforce-flavored-tobacco-ban\">unveiled\u003c/a> a list of tobacco products that can be legally sold in the state, following a statewide flavored tobacco ban in 2020 that voters upheld in a 2022 referendum.\u003c/p>\n\u003cp>Supervisor Shamann Walton said in a statement that the settlement sends “a clear message that San Francisco will enforce its flavored tobacco ban and hold corporations accountable.”\u003c/p>\n\u003cp>“Flavored nicotine products are designed to attract young people, and we cannot allow online retailers to bypass local protections and put another generation at risk,” he said.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Zynners repent.\u003c/p>\n\u003cp>San Francisco secured a $1 million settlement with a retailer it accused of using online sales to \u003ca href=\"https://www.kqed.org/news/12002998/san-francisco-breaks-the-zyn-ternet-with-lawsuit-against-flavored-nicotine-sales\">flout the city’s ban\u003c/a> on flavored nicotine pouches, the city attorney announced Thursday.\u003c/p>\n\u003cp>The agreement, reached in October, requires the Los Angeles-based Lucy Goods Inc. to stop shipments of its products to San Francisco. The company is the fourth — along with Rogue Holdings LLC, Swisher International Inc. and Northerner Scandinavia Inc., all of which settled last year — named in a 2024 lawsuit against online sellers accused of violating state and local law and appealing to young people with fruity, minty flavors.\u003c/p>\n\u003cp>“The popularity of flavored nicotine pouches has skyrocketed, and we cannot risk hooking a new generation of young people on tobacco products,” City Attorney David Chiu said in a statement. “Online tobacco retailers are not above our laws and cannot ship banned products into our city.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The judgment also requires all four companies to prohibit the use of San Francisco addresses in shipping or billing address fields, and post clear language on their websites stating that flavored tobacco products may not be sold in San Francisco. Between the four defendants, the lawsuit netted the city nearly $4 million in penalties and fees.\u003c/p>\n\u003cp>Lucy Goods did not respond to a request for comment in time for publication.\u003c/p>\n\u003cp>The settlement is the latest in the city’s ongoing battle against flavored tobacco and other addictive products. San Francisco’s 2019 comprehensive ban on the sale of all flavored e-cigarettes and menthols included nicotine pouches in the legal definition of a “tobacco product.” A 2020 study \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S2352853220300134\">found\u003c/a> that the ban significantly reduced overall flavored tobacco use among people ages 18 to 34.\u003c/p>\n\u003cp>More recently, the popularity of Zyns and other nicotine pouches has grown as an alternative to smoking and vaping, especially among younger users, according to \u003ca href=\"https://keck.usc.edu/news/use-of-nicotine-pouches-increases-significantly-among-u-s-teens/\">research published last year\u003c/a> by a team at the USC Keck School of Medicine.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>According to the 2023 California Youth Tobacco Survey, most high school respondents who used tobacco reported using flavored tobacco products, and nicotine pouches were the second-most common form of tobacco use among eighth-graders. Experts say the proliferation of flavored tobacco products, which are more attractive to young people, has threatened decades of progress in reducing youth tobacco use.\u003c/p>\n\u003cp>Zyn, a Swedish brand of nicotine pouches that has dominated the market, has been around for a decade and was initially marketed to help users kick smoking habits.\u003c/p>\n\u003cp>The pillow-shaped pouches, which sit in the mouth between the gum and lip, deliver a head rush or buzz as the bloodstream absorbs the nicotine. The products come in round plastic containers that resemble Ice Breakers mints, and often in a variety of fruit or mint flavors.\u003c/p>\n\u003cp>Philip Morris International acquired Zyn in 2022 as part of the tobacco giant’s pivot to smokeless products. Though the pouches don’t contain cancer-causing tobacco, nicotine is addictive, and experts have raised alarm bells about the consequences of nicotine exposure to developing adolescent brains.\u003c/p>\n\u003cp>Some of the hype has been attributed to the role of “\u003ca href=\"https://www.theguardian.com/business/2024/feb/12/meet-the-zynfluencers-how-nicotine-pouches-ignited-a-new-culture-war\">Zynfluencers\u003c/a>,” social media accounts that promote or meme the products’ use. The content, which skews to young men, links the products to masculinity, productivity and skepticism of the medical health establishment.\u003c/p>\n\u003cp>Right-wing media personality Tucker Carlson, who previously called himself a “Zyn power user” — recently launched his own brand of nicotine pouches, after Zyn said Carlson’s \u003ca href=\"https://www.politico.com/news/magazine/2025/02/07/tucker-carlson-nicotine-pouches-00200455\">claims\u003c/a> about the company’s products were not backed up by science.\u003c/p>\n\u003cp>The San Francisco settlement was announced the day after California \u003ca href=\"https://www.cspdailynews.com/tobacco/california-unveils-unflavored-tobacco-list-enforce-flavored-tobacco-ban\">unveiled\u003c/a> a list of tobacco products that can be legally sold in the state, following a statewide flavored tobacco ban in 2020 that voters upheld in a 2022 referendum.\u003c/p>\n\u003cp>Supervisor Shamann Walton said in a statement that the settlement sends “a clear message that San Francisco will enforce its flavored tobacco ban and hold corporations accountable.”\u003c/p>\n\u003cp>“Flavored nicotine products are designed to attract young people, and we cannot allow online retailers to bypass local protections and put another generation at risk,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>The \u003ca href=\"https://www.kqed.org/news/tag/united-states\">U.S.\u003c/a> took the unprecedented step Monday of dropping the number of \u003ca href=\"https://www.kqed.org/healthnews\">vaccines\u003c/a> it recommends for every child — cutting protection against a half-dozen diseases in a move slammed by the nation’s pediatricians.\u003c/p>\n\u003cp>The overhaul is effective immediately, meaning that the Centers for Disease Control and Prevention will now recommend vaccines against 11 diseases. What’s no longer broadly recommended is protection against \u003ca href=\"https://apnews.com/article/us-flu-cases-cdc-subclade-k-29cc5a68eb100585c8e0dbd2ec47b3eb\">flu\u003c/a>, rotavirus, hepatitis A, hepatitis B, some forms of meningitis or RSV. Instead, protections against those diseases are only recommended for certain groups deemed high-risk, or if their doctors recommend them in what’s called “shared decision-making.”\u003c/p>\n\u003cp>Trump administration officials said the overhaul, a move long sought by Health Secretary Robert F. Kennedy Jr., won’t result in families who want the vaccines losing access to them, and said insurance will continue to pay. But medical experts said the move increases confusion for parents and could increase preventable diseases.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The change came after President Donald Trump in December \u003ca href=\"https://www.whitehouse.gov/presidential-actions/2025/12/aligning-united-states-core-childhood-vaccine-recommendations-with-best-practices-from-peer-developed-countries/\">asked the U.S. Department of Health\u003c/a> and Human Services to review how peer nations approach vaccine recommendations and consider revising its guidance to align with theirs.\u003c/p>\n\u003cp>HHS said its comparison to 20 peer nations found that the U.S. was an “outlier” in both the number of vaccinations and the number of doses it recommended to all children. Officials with the agency framed the change as a way to increase public trust by recommending only the most important vaccinations for children to receive.[aside postID=news_12068387 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04242019_measles-vaccination-california-legislature-qut-1020x679.jpg']Among those left on the recommended-for-everyone list are measles, whooping cough, polio, tetanus, chickenpox and HPV.\u003c/p>\n\u003cp>“This decision protects children, respects families, and rebuilds trust in public health,” Kennedy said in a statement Monday.\u003c/p>\n\u003cp>Medical experts disagreed, saying the change without public discussion or a transparent review of the data would put children at risk.\u003c/p>\n\u003cp>Dr. Sean O’Leary of the American Academy of Pediatrics said countries carefully consider vaccine recommendations based on levels of disease in their populations and their health systems.\u003c/p>\n\u003cp>“You can’t just copy and paste public health and that’s what they seem to be doing here,” said O’Leary. “Literally children’s health and children’s lives are at stake.”\u003c/p>\n\u003cp>The new guidance also reduces the number of recommended vaccine doses against human papillomavirus from two or three shots to one for most children, depending on age.\u003c/p>\n\u003cp>The decision was made without input from an advisory committee that typically consults on the vaccine schedule, said senior officials at HHS. The officials spoke on the condition of anonymity because they weren’t authorized to discuss the changes publicly.\u003c/p>\n\u003cp>“Abandoning recommendations for vaccines that prevent influenza, hepatitis and rotavirus, and changing the recommendation for HPV without a public process to weigh the risks and benefits, will lead to more hospitalizations and preventable deaths among American children,” said Michael Osterholm of the Vaccine Integrity Project, based at the University of Minnesota.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The \u003ca href=\"https://www.kqed.org/news/tag/united-states\">U.S.\u003c/a> took the unprecedented step Monday of dropping the number of \u003ca href=\"https://www.kqed.org/healthnews\">vaccines\u003c/a> it recommends for every child — cutting protection against a half-dozen diseases in a move slammed by the nation’s pediatricians.\u003c/p>\n\u003cp>The overhaul is effective immediately, meaning that the Centers for Disease Control and Prevention will now recommend vaccines against 11 diseases. What’s no longer broadly recommended is protection against \u003ca href=\"https://apnews.com/article/us-flu-cases-cdc-subclade-k-29cc5a68eb100585c8e0dbd2ec47b3eb\">flu\u003c/a>, rotavirus, hepatitis A, hepatitis B, some forms of meningitis or RSV. Instead, protections against those diseases are only recommended for certain groups deemed high-risk, or if their doctors recommend them in what’s called “shared decision-making.”\u003c/p>\n\u003cp>Trump administration officials said the overhaul, a move long sought by Health Secretary Robert F. Kennedy Jr., won’t result in families who want the vaccines losing access to them, and said insurance will continue to pay. But medical experts said the move increases confusion for parents and could increase preventable diseases.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The change came after President Donald Trump in December \u003ca href=\"https://www.whitehouse.gov/presidential-actions/2025/12/aligning-united-states-core-childhood-vaccine-recommendations-with-best-practices-from-peer-developed-countries/\">asked the U.S. Department of Health\u003c/a> and Human Services to review how peer nations approach vaccine recommendations and consider revising its guidance to align with theirs.\u003c/p>\n\u003cp>HHS said its comparison to 20 peer nations found that the U.S. was an “outlier” in both the number of vaccinations and the number of doses it recommended to all children. Officials with the agency framed the change as a way to increase public trust by recommending only the most important vaccinations for children to receive.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Among those left on the recommended-for-everyone list are measles, whooping cough, polio, tetanus, chickenpox and HPV.\u003c/p>\n\u003cp>“This decision protects children, respects families, and rebuilds trust in public health,” Kennedy said in a statement Monday.\u003c/p>\n\u003cp>Medical experts disagreed, saying the change without public discussion or a transparent review of the data would put children at risk.\u003c/p>\n\u003cp>Dr. Sean O’Leary of the American Academy of Pediatrics said countries carefully consider vaccine recommendations based on levels of disease in their populations and their health systems.\u003c/p>\n\u003cp>“You can’t just copy and paste public health and that’s what they seem to be doing here,” said O’Leary. “Literally children’s health and children’s lives are at stake.”\u003c/p>\n\u003cp>The new guidance also reduces the number of recommended vaccine doses against human papillomavirus from two or three shots to one for most children, depending on age.\u003c/p>\n\u003cp>The decision was made without input from an advisory committee that typically consults on the vaccine schedule, said senior officials at HHS. The officials spoke on the condition of anonymity because they weren’t authorized to discuss the changes publicly.\u003c/p>\n\u003cp>“Abandoning recommendations for vaccines that prevent influenza, hepatitis and rotavirus, and changing the recommendation for HPV without a public process to weigh the risks and benefits, will lead to more hospitalizations and preventable deaths among American children,” said Michael Osterholm of the Vaccine Integrity Project, based at the University of Minnesota.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003ca href=\"https://www.kqed.org/news/12069360/tengo-diabetes-precio-insulina-california-2026\">\u003cem>Leer en español\u003c/em>\u003c/a>\u003c/p>\n\u003cp>As of January, California is the first state in the country to partner with a nonprofit to \u003ca href=\"https://www.kqed.org/science/1998855/california-will-offer-deeply-discounted-insulin-in-january\">develop, produce and sell its own insulin\u003c/a> as a solution to the \u003ca href=\"https://diabetes.org/tools-resources/affordable-insulin\">widespread unaffordability\u003c/a> of the life-saving hormone that helps the body \u003ca href=\"https://diabetes.org/health-wellness/medication/insulin-basics\">process or store\u003c/a> blood sugar from food.\u003c/p>\n\u003cp>The nonprofit Civica will develop a CalRx Insulin Glargine pen — referred to as “biosimilar insulin,” meaning it references a U.S. Food & Drug Administration-approved product and has no “\u003ca href=\"https://calrx.ca.gov/biosimilar-insulin-initiative/\">clinically meaningful differences\u003c/a> from their reference product in terms of safety, purity, and potency.”\u003c/p>\n\u003cp>This CalRx pen can be substituted for Lantus and other branded insulin glargine, according to a spokesperson from the state’s Department of Health Care Access and Information (HCAI).\u003c/p>\n\u003cp>“California didn’t wait for the pharmaceutical industry to do the right thing — we took matters into our own hands,” Gov. Gavin Newsom said in an \u003ca href=\"https://www.gov.ca.gov/2025/10/16/governor-newsom-announces-affordable-calrx-insulin-11-a-pen-will-soon-be-available-for-purchase/\">October news release\u003c/a> about the CalRx insulin. “No Californian should ever have to ration insulin or go into debt to stay alive — and I won’t stop until health care costs are crushed for everyone.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The initiative could provide major financial relief for \u003ca href=\"https://healthpolicy.ucla.edu/our-work/diabetes\">nearly 3.5 million Californians\u003c/a> who have been diagnosed with diabetes, a majority of whom have Type II diabetes — where the body cannot use insulin correctly. Type 1 is when the body produces little to no insulin.\u003c/p>\n\u003cp>\u003ca href=\"https://diabetes.org/health-wellness/medication/insulin-basics\">Type 1 or Type 2 diabetes\u003c/a> can impact \u003ca href=\"https://www.uvahealth.com/conditions/diabetes-types\">energy levels and organ functions\u003c/a>. Insulin shots — or, in some cases, diabetes pills — help with major body functions. The \u003ca href=\"https://www.cdc.gov/diabetes/php/data-research/index.html\">National Diabetes Statistics Report\u003c/a> found that 38.4 million people have diabetes — almost 12% of the country’s population.\u003c/p>\n\u003cp>Read on to learn more about changes to the price of insulin in California, how prescriptions will work and where to find more resources.\u003c/p>\n\u003ch2>What is the predicted price of CalRx Insulin?\u003c/h2>\n\u003cp>Difficulty accessing affordable insulin — specifically buying it — in America is a well-documented and \u003ca href=\"https://www.forbes.com/sites/brucelee/2022/11/12/fake-eli-lilly-twitter-account-claims-insulin-is-free-stock-falls-43/\">widespread issue\u003c/a> due to a market \u003ca href=\"https://medicine.yale.edu/news-article/the-price-of-insulin-a-qanda-with-kasia-lipska/\">dominated by three major companies\u003c/a>.\u003c/p>\n\u003cp>Insulin is \u003ca href=\"https://medicine.yale.edu/news-article/the-price-of-insulin-a-qanda-with-kasia-lipska/\">seven to 10 times more expensive in the United States\u003c/a> compared to other countries, despite being affordable to produce, according to a 2023 article by the Yale School of Medicine. In fact, it explains that “the same vial of insulin that cost $21 in the U.S. in 1996 now costs upward of $250.”[aside postID=science_1998855 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/GettyImages-1408757206.jpg']CalRx aims to be another competitor in the field by introducing a lower-cost alternative — and possibly put “pressure on other manufacturers to \u003ca href=\"https://calrx.ca.gov/biosimilar-insulin-initiative/\">lower their prices\u003c/a> as well.”\u003c/p>\n\u003cp>\u003ca href=\"https://calrx.ca.gov/biosimilar-insulin-initiative/\">According to the state and Civica\u003c/a>, the suggested retail price is:\u003c/p>\n\u003cul>\n\u003cli>No more than $30 for a 10mL vial of insulin\u003c/li>\n\u003cli>No more than $55 for a 5-pack of 3 mL pens\u003c/li>\n\u003c/ul>\n\u003cp>According to the HCAI spokesperson in an email to KQED, the “out-of-pocket cost may be lower, depending on insurance coverage.”\u003c/p>\n\u003cp>Advocates for people with diabetes see the production as a win.\u003c/p>\n\u003cp>“We look forward to the rollout of CalRx® insulin in January,” said Christine Fallabel, director of state government affairs at the American Diabetes Association, in an email to KQED. “Any meaningful step to improve insulin affordability and provide additional options is a win for people with diabetes.”\u003c/p>\n\u003cp>Fallabel also pointed to the \u003ca href=\"https://legiscan.com/CA/text/SB40/id/3030089\">recent passage of Senate Bill 40\u003c/a> — which prohibits high copayments for a month’s supply of insulin — as another state decision that helps with accessibility.\u003c/p>\n\u003cfigure id=\"attachment_12068562\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12068562\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/GavinNewsomInsulinAP.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/GavinNewsomInsulinAP.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/GavinNewsomInsulinAP-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/GavinNewsomInsulinAP-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">California Gov. Gavin Newsom announces CalRx-branded insulin glargine pens during a news conference Oct. 16, 2025, at Cedars-Sinai’s Mark Goodson Pharmacy in Los Angeles. (AP Photo/Damian Dovarganes)\u003c/figcaption>\u003c/figure>\n\u003ch2>What should I do if I am paying more than $55?\u003c/h2>\n\u003cp>According to the HCAI spokesperson, “CalRx and Civica cannot mandate the final price to the consumer as this would conflict with antitrust and competition law.”\u003c/p>\n\u003cp>But the spokesperson stated in the email that Civica is planning to include a QR code on the side of the boxes, so consumers can report if they have paid more than $55 for the product.\u003c/p>\n\u003cp>“At which point Civica would contact the pharmacy for remediation,” the spokesperson said.\u003c/p>\n\u003ch2>Where can I get CalRx insulin? Do I need a prescription?\u003c/h2>\n\u003cp>You \u003ca href=\"https://calrx.ca.gov/\">do not need to apply\u003c/a> to access the new insulin, and there are no eligibility requirements. You \u003ca href=\"https://calrx.ca.gov/biosimilar-insulin-initiative/\">do not need insurance\u003c/a>.\u003c/p>\n\u003cp>“Broad wholesale distribution will allow any California pharmacy to order CalRx insulin glargine,” the state explained in the email. Mail-order pharmacy outreach is still ongoing.\u003c/p>\n\u003cp>People interested in the CalRx insulin can “ask their pharmacist or doctor if they can switch their prescription to CalRx insulin glargine,” continued the HCAI spokesperson. Since the CalRx insulin is interchangeable with other brand names, you would \u003ca href=\"https://calrx.ca.gov/biosimilar-insulin-initiative/\">not need a new doctor’s prescription\u003c/a>.\u003c/p>\n\u003cp>“Health plans will be responsible for communicating about CalRx insulin glargine with their provider and patient networks,” HCAI said.\u003c/p>\n\u003ch2>Can people in other states access it?\u003c/h2>\n\u003cp>According to the HCAI spokesperson, “Yes, Civica Rx’s glargine insulin will be available in other states under \u003ca href=\"https://civicarx.org/\">Civica Rx’s label\u003c/a>.”\u003c/p>\n\u003cp>Where can I learn more information?\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://calrx.ca.gov/\">CalRx website\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://calrx.ca.gov/uploads/2025/10/CalRx_Fact-Sheet.pdf\">CalRx fact sheet\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://diabetes.org/about-us/center-information\">American Diabetes Association’s Center for Information\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://diabetes.org/about-us/center-information\">Insulin Basics for Diabetes\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://civicainsulin.org/\">Civica Insulin\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.t1international.com/media/assets/file/Sept_2022_Update_-_T1International_Affordability_Resources.pdf\">T1International\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cem>KQED’s \u003ca href=\"https://www.kqed.org/author/adembosky\">April Dembosky\u003c/a> contributed to this report\u003c/em>.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"https://www.kqed.org/news/12069360/tengo-diabetes-precio-insulina-california-2026\">\u003cem>Leer en español\u003c/em>\u003c/a>\u003c/p>\n\u003cp>As of January, California is the first state in the country to partner with a nonprofit to \u003ca href=\"https://www.kqed.org/science/1998855/california-will-offer-deeply-discounted-insulin-in-january\">develop, produce and sell its own insulin\u003c/a> as a solution to the \u003ca href=\"https://diabetes.org/tools-resources/affordable-insulin\">widespread unaffordability\u003c/a> of the life-saving hormone that helps the body \u003ca href=\"https://diabetes.org/health-wellness/medication/insulin-basics\">process or store\u003c/a> blood sugar from food.\u003c/p>\n\u003cp>The nonprofit Civica will develop a CalRx Insulin Glargine pen — referred to as “biosimilar insulin,” meaning it references a U.S. Food & Drug Administration-approved product and has no “\u003ca href=\"https://calrx.ca.gov/biosimilar-insulin-initiative/\">clinically meaningful differences\u003c/a> from their reference product in terms of safety, purity, and potency.”\u003c/p>\n\u003cp>This CalRx pen can be substituted for Lantus and other branded insulin glargine, according to a spokesperson from the state’s Department of Health Care Access and Information (HCAI).\u003c/p>\n\u003cp>“California didn’t wait for the pharmaceutical industry to do the right thing — we took matters into our own hands,” Gov. Gavin Newsom said in an \u003ca href=\"https://www.gov.ca.gov/2025/10/16/governor-newsom-announces-affordable-calrx-insulin-11-a-pen-will-soon-be-available-for-purchase/\">October news release\u003c/a> about the CalRx insulin. “No Californian should ever have to ration insulin or go into debt to stay alive — and I won’t stop until health care costs are crushed for everyone.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The initiative could provide major financial relief for \u003ca href=\"https://healthpolicy.ucla.edu/our-work/diabetes\">nearly 3.5 million Californians\u003c/a> who have been diagnosed with diabetes, a majority of whom have Type II diabetes — where the body cannot use insulin correctly. Type 1 is when the body produces little to no insulin.\u003c/p>\n\u003cp>\u003ca href=\"https://diabetes.org/health-wellness/medication/insulin-basics\">Type 1 or Type 2 diabetes\u003c/a> can impact \u003ca href=\"https://www.uvahealth.com/conditions/diabetes-types\">energy levels and organ functions\u003c/a>. Insulin shots — or, in some cases, diabetes pills — help with major body functions. The \u003ca href=\"https://www.cdc.gov/diabetes/php/data-research/index.html\">National Diabetes Statistics Report\u003c/a> found that 38.4 million people have diabetes — almost 12% of the country’s population.\u003c/p>\n\u003cp>Read on to learn more about changes to the price of insulin in California, how prescriptions will work and where to find more resources.\u003c/p>\n\u003ch2>What is the predicted price of CalRx Insulin?\u003c/h2>\n\u003cp>Difficulty accessing affordable insulin — specifically buying it — in America is a well-documented and \u003ca href=\"https://www.forbes.com/sites/brucelee/2022/11/12/fake-eli-lilly-twitter-account-claims-insulin-is-free-stock-falls-43/\">widespread issue\u003c/a> due to a market \u003ca href=\"https://medicine.yale.edu/news-article/the-price-of-insulin-a-qanda-with-kasia-lipska/\">dominated by three major companies\u003c/a>.\u003c/p>\n\u003cp>Insulin is \u003ca href=\"https://medicine.yale.edu/news-article/the-price-of-insulin-a-qanda-with-kasia-lipska/\">seven to 10 times more expensive in the United States\u003c/a> compared to other countries, despite being affordable to produce, according to a 2023 article by the Yale School of Medicine. In fact, it explains that “the same vial of insulin that cost $21 in the U.S. in 1996 now costs upward of $250.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>CalRx aims to be another competitor in the field by introducing a lower-cost alternative — and possibly put “pressure on other manufacturers to \u003ca href=\"https://calrx.ca.gov/biosimilar-insulin-initiative/\">lower their prices\u003c/a> as well.”\u003c/p>\n\u003cp>\u003ca href=\"https://calrx.ca.gov/biosimilar-insulin-initiative/\">According to the state and Civica\u003c/a>, the suggested retail price is:\u003c/p>\n\u003cul>\n\u003cli>No more than $30 for a 10mL vial of insulin\u003c/li>\n\u003cli>No more than $55 for a 5-pack of 3 mL pens\u003c/li>\n\u003c/ul>\n\u003cp>According to the HCAI spokesperson in an email to KQED, the “out-of-pocket cost may be lower, depending on insurance coverage.”\u003c/p>\n\u003cp>Advocates for people with diabetes see the production as a win.\u003c/p>\n\u003cp>“We look forward to the rollout of CalRx® insulin in January,” said Christine Fallabel, director of state government affairs at the American Diabetes Association, in an email to KQED. “Any meaningful step to improve insulin affordability and provide additional options is a win for people with diabetes.”\u003c/p>\n\u003cp>Fallabel also pointed to the \u003ca href=\"https://legiscan.com/CA/text/SB40/id/3030089\">recent passage of Senate Bill 40\u003c/a> — which prohibits high copayments for a month’s supply of insulin — as another state decision that helps with accessibility.\u003c/p>\n\u003cfigure id=\"attachment_12068562\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12068562\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/GavinNewsomInsulinAP.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/GavinNewsomInsulinAP.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/GavinNewsomInsulinAP-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/GavinNewsomInsulinAP-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">California Gov. Gavin Newsom announces CalRx-branded insulin glargine pens during a news conference Oct. 16, 2025, at Cedars-Sinai’s Mark Goodson Pharmacy in Los Angeles. (AP Photo/Damian Dovarganes)\u003c/figcaption>\u003c/figure>\n\u003ch2>What should I do if I am paying more than $55?\u003c/h2>\n\u003cp>According to the HCAI spokesperson, “CalRx and Civica cannot mandate the final price to the consumer as this would conflict with antitrust and competition law.”\u003c/p>\n\u003cp>But the spokesperson stated in the email that Civica is planning to include a QR code on the side of the boxes, so consumers can report if they have paid more than $55 for the product.\u003c/p>\n\u003cp>“At which point Civica would contact the pharmacy for remediation,” the spokesperson said.\u003c/p>\n\u003ch2>Where can I get CalRx insulin? Do I need a prescription?\u003c/h2>\n\u003cp>You \u003ca href=\"https://calrx.ca.gov/\">do not need to apply\u003c/a> to access the new insulin, and there are no eligibility requirements. You \u003ca href=\"https://calrx.ca.gov/biosimilar-insulin-initiative/\">do not need insurance\u003c/a>.\u003c/p>\n\u003cp>“Broad wholesale distribution will allow any California pharmacy to order CalRx insulin glargine,” the state explained in the email. Mail-order pharmacy outreach is still ongoing.\u003c/p>\n\u003cp>People interested in the CalRx insulin can “ask their pharmacist or doctor if they can switch their prescription to CalRx insulin glargine,” continued the HCAI spokesperson. Since the CalRx insulin is interchangeable with other brand names, you would \u003ca href=\"https://calrx.ca.gov/biosimilar-insulin-initiative/\">not need a new doctor’s prescription\u003c/a>.\u003c/p>\n\u003cp>“Health plans will be responsible for communicating about CalRx insulin glargine with their provider and patient networks,” HCAI said.\u003c/p>\n\u003ch2>Can people in other states access it?\u003c/h2>\n\u003cp>According to the HCAI spokesperson, “Yes, Civica Rx’s glargine insulin will be available in other states under \u003ca href=\"https://civicarx.org/\">Civica Rx’s label\u003c/a>.”\u003c/p>\n\u003cp>Where can I learn more information?\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://calrx.ca.gov/\">CalRx website\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://calrx.ca.gov/uploads/2025/10/CalRx_Fact-Sheet.pdf\">CalRx fact sheet\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://diabetes.org/about-us/center-information\">American Diabetes Association’s Center for Information\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://diabetes.org/about-us/center-information\">Insulin Basics for Diabetes\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://civicainsulin.org/\">Civica Insulin\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.t1international.com/media/assets/file/Sept_2022_Update_-_T1International_Affordability_Resources.pdf\">T1International\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cem>KQED’s \u003ca href=\"https://www.kqed.org/author/adembosky\">April Dembosky\u003c/a> contributed to this report\u003c/em>.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "she-goes-to-police-calls-in-a-prius-its-part-of-new-approach-to-mental-health-emergencies",
"title": "She Goes to Police Calls in a Prius. It's Part of New Approach to Mental Health Emergencies",
"publishDate": 1766923252,
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"headTitle": "She Goes to Police Calls in a Prius. It’s Part of New Approach to Mental Health Emergencies | KQED",
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"content": "\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://calmatters.org/\">CalMatters\u003c/a>. \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/\">Sign up\u003c/a> for their newsletters.\u003c/em>\u003c/p>\n\u003cp>Briana Fair, a mental health clinician with the \u003ca href=\"https://www.kqed.org/news/tag/san-mateo\">San Mateo\u003c/a> Police Department, received a dozen voicemails from the same distressed caller over a single weekend this month.\u003c/p>\n\u003cp>She knew the voice. It was her client, saying that a celebrity has been hacking her phone, that she needed help moving into a different apartment and why was the process taking so long?\u003c/p>\n\u003cp>“Normally, she won’t call like this unless she’s starting to get towards a crisis,” Fair said.\u003c/p>\n\u003cp>If Fair keeps her close, it will ensure she is connected with the services she needs and prevent her from calling 911 dispatch, reducing the possibility of a full-blown crisis involving officers or unnecessary hospitalizations.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I fill in the gaps,” said Fair. “It’s just a matter of getting her the right supports.”\u003c/p>\n\u003cp>It’s working, according to a \u003ca href=\"https://www.nature.com/articles/s41562-025-02339-7\">new study of San Mateo County’s efforts\u003c/a> from Stanford’s John W. Gardner Center for Youth and Their Communities, which found that pairing \u003ca href=\"https://calmatters.org/justice/2022/03/mental-health-crisis-police/\">law enforcement officers with mental health clinicians\u003c/a> reduces the likelihood of costlier and more intrusive interventions.\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/121525-San-Mateo-RideAlong-MO-CM-15-1024x682.jpg\" alt=\"A close-up shows a person with short, tightly curled hair leaning forward and listening intently to another person whose back is in the foreground. Their face is partially lit, with a focused, serious expression, while a blurred laptop screen and desk items appear in the background, suggesting a work or interview setting.\">\u003cfigcaption>Briana Fair assists a client at the client’s apartment in San Mateo, after the client made multiple calls to her over the weekend, on Dec. 15, 2025. Photo by Manuel Orbegozo for CalMatters\u003c/figcaption>\u003c/figure>\n\u003cp>Fair was hired four years ago as part of a program to pilot this approach, also known as a “co-responder model,” across San Mateo County’s four largest cities — Daly City, San Mateo, Redwood City and South San Francisco. The idea was to free up police officers and provide alternatives to incarceration and hospital emergency rooms for people in a \u003ca href=\"https://calmatters.org/tag/mental-health/\">mental health crisis\u003c/a>. Since then, the model has rolled out to police departments in nearly every city in the county.\u003c/p>\n\u003cp>Researchers behind the Stanford study found the co-responder model decreased involuntary psychiatric holds by approximately 17% and reduced the likelihood of future mental health 911 calls among the four pilot cities. The hold allows a hospital to keep someone for up to 72 hours to determine if they are a danger to themselves or others. Given the reduction of roughly 370 involuntary psychiatric holds over the course of two years, researchers Tom Dee and Jaymes Pyne estimated an annual cost savings of roughly $300,000 to $800,000.[aside postID=news_12066395 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/San-Francisco-General-Hospital-Getty.jpg']“We’ve got to look to alternatives and really understand that police are not the best equipped to handle mental health crisis situations,” said San Mateo County Executive Officer Mike Callagy, who proposed the pilot after seeing cases that resulted in officers using force and in lawsuits.\u003c/p>\n\u003cp>During each visit with her client, Fair tries to help her check something off a list of things that have been bothering her. Today, they’re sitting next to one another as they call California’s social services department to ask about in-home care. They’re placed on hold and after five minutes, her client lets out a deep sigh.\u003c/p>\n\u003cp>“I know, it’s a lot,” Fair said. “That’s why I’m here.”\u003c/p>\n\u003cp>As jazz music plays in the background of the call, Fair picks up a bottle of dry shampoo from the desk, reads the label aloud and asks her how she likes it. She brought the product over during one of their last visits — a bandaid solution that she devised because her client was having trouble bathing herself.\u003c/p>\n\u003cp>“Have you tried it yet?” she asks. “Want me to spray it for you? Brush it first.”\u003c/p>\n\u003cp>Her client takes her hair out of its ponytail, brushes it with her fingers and runs her hands along the part. Fair stands up from her chair, shakes the bottle and mists it over her head.\u003c/p>\n\u003cp>“Does it feel better?” she asks.\u003c/p>\n\u003cp>“Yes, but you sprayed it in my mouth,” her client says, letting out a big laugh. “It feels fresh.”\u003c/p>\n\u003ch2>Rising number of mental health calls\u003c/h2>\n\u003cp>Stanford’s research adds to a \u003ca href=\"https://psychiatryonline.org/doi/10.1176/appi.ps.20240003\">growing body of evidence\u003c/a> about the positive impact of alternative first response programs, which have proliferated across the country amid calls for police reform in the aftermath of George Floyd’s murder in 2020. Those reforms are so nascent that not much is known about them, Dee said, and his study is one of a handful that provides a credible evaluation.\u003c/p>\n\u003cp>“This is a common-sense reform with a great deal of promise,” he said. “That being said, it’s not a cut-and-paste kind of reform. There are serious design and implementation details that matter for realizing the promise of these sorts of initiatives.”\u003c/p>\n\u003cfigure>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/121525-San-Mateo-RideAlong-MO-CM-03-1024x682.jpg\" alt=\"A motion-blurred street scene shows a uniformed officer moving quickly near an intersection, with another person partially visible nearby. A stop sign and street sign appear in the background alongside residential buildings and trees, conveying a sense of sudden movement and urgency.\">\u003c/figure>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/121525-San-Mateo-RideAlong-MO-CM-09-1024x682.jpg\" alt=\"Three people walk together across a residential street, including two uniformed police officers and a third person in plain clothes who gestures while speaking. Parked police vehicles line the curb behind them, and apartment buildings and trees with autumn leaves frame the scene in daylight.\">\u003c/figure>\u003cfigcaption>\u003cstrong>First: \u003c/strong>Briana Fair, San Mateo Police Department’s first-ever mental health clinician, responds to a mental health related 911 call that involved two police officers and resulted in no arrests, in San Mateo, on Dec. 15, 2025. \u003cstrong>Last: \u003c/strong>Police officers Dylan Kayzar, left, Jared Rogge, and mental health clinician Briana Fair chat after responding to a mental health related 911 call in San Mateo, on Dec. 15, 2025. Photos by Manuel Orbegozo for CalMatters\u003c/figcaption>\u003c/figure>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/121525-San-Mateo-RideAlong-MO-CM-01-1024x682.jpg\" alt=\"A person sits in the front seat of a car, shown in profile, with short curly hair softly lit by dim light from outside the vehicle. The interior is mostly dark, with the headrest, window frame, and a blurred structure visible beyond the window, creating a quiet, contemplative mood.\">\u003cfigcaption>Briana Fair, San Mateo Police Department’s first-ever mental health clinician, prepares to respond to a mental health-related 911 call in San Mateo on Dec. 15, 2025. Photo by Manuel Orbegozo for CalMatters\u003c/figcaption>\u003c/figure>\n\u003cp>Some of those details include having buy-in from the police, training dispatchers on how to triage calls, and integrating mental health staff.\u003c/p>\n\u003cp>San Mateo Police Chief Ed Barberini said it was a “risky proposition” when his agency decided to participate in the pilot program, worrying that his officers would push back. But mental health calls were on the rise, he said, and without clinical expertise, police officers were being put in a difficult position. That sentiment has been shared by law enforcement agencies across the state, some of which have recently \u003ca href=\"https://calmatters.org/health/mental-health/2025/04/mental-health-crisis-california-police-response/\">distanced themselves from mental health calls\u003c/a>.[aside postID=science_1999700 hero='https://cdn.kqed.org/wp-content/uploads/sites/35/2025/12/251211-DEATHCAPMUSHROOMS-10-BL-KQED.jpg']“We recognized that we were triaging problems and just finding short-term solutions,” said Barberini. “I’m pleasantly surprised with how things have turned out.”\u003c/p>\n\u003cp>Prior to the pilot program, San Mateo police officers who responded to mental health 911 calls had to decide whether to send the person to the hospital for a 72-hour involuntary hold, arrest them, or leave them to their own devices. By pairing them with a clinician, the agency has been able to provide safety planning, follow-up calls and connections to community partners for people in mental health crises.\u003c/p>\n\u003cp>Mariela Ruiz-Angel, director of Alternative Response Initiatives at Georgetown Law’s Center for Innovations in Community Safety, said a co-responder model is fantastic — but it’s just the beginning of what a progressive city looks like.\u003c/p>\n\u003cp>“This is really about evolving to a level in which we don’t have to send out cops or fire for basic-level need calls,” she said. “The idea was never about taking cops out of the equation altogether. The idea was that we don’t have to center them as the main response of 911. We don’t have to make public safety about cops. Public safety is about the appropriate response.”\u003c/p>\n\u003ch2>De-escalating a family feud\u003c/h2>\n\u003cp>The pilot program cost approximately $1.5 million over the course of two years, split between the county and the four participating cities. Once it ended, the San Mateo Police Department — an agency consisting of 116 sworn officers — converted Fair’s role to a permanent position as the agency’s first-ever mental health clinician. The city is also using grant money to employ an additional mental health clinician part-time. Every other participating city has also found a way to sustain its program.\u003c/p>\n\u003cp>On a Monday morning, Fair responds to emails from police officers who have asked her to follow up with people they interacted with over the weekend. This time of year has been busy, Fair says, because the holidays can be lonely. In the last week alone, she’s had to respond to a variety of crises: evaluating a kid who had an interrupted suicide attempt and responding to a transgender youth who wanted to stab themselves.\u003c/p>\n\u003cp>A radio sits next to her desk. She pauses to listen more intently as a dispatcher relays information about a person who thinks they’re being followed by a federal agent. A family member called in to report the episode. A few minutes later, Fair slings her backpack over her arm, sticks the radio in her pocket and quickly winds her way through the hallway to the garage. In the backseat of her county car – a white Toyota Prius – is a bulletproof vest, which she says she rarely uses.\u003c/p>\n\u003cp>Outside an apartment complex, Fair pulls over and turns on her flashers. The process, also referred to as “staging,” is when she parks two blocks away so police officers, who have already arrived, can vet the scene to make sure it’s safe for her arrival.\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/121525-San-Mateo-RideAlong-MO-CM-31-1024x682.jpg\" alt=\"A person with short, curly hair sits indoors near a window, hands clasped in their lap, with a calm expression. Sunlight falls across part of their face and shoulder, while the rest of the room remains in shadow. Small potted plants sit on a ledge beside them, and shelves with framed items and greenery are visible in the softly lit background.\">\u003cfigcaption>As the San Mateo Police Department’s first mental health clinician, Briana Fair connects people experiencing mental health crises with services to help prevent unnecessary hospitalizations or police involvement in San Mateo, on Dec. 15, 2025. Photo by Manuel Orbegozo for CalMatters\u003c/figcaption>\u003c/figure>\n\u003cp>A few minutes later, she opens the car door and jogs over in her black Nikes and tan cargo pants. An officer introduces her to the family and from there, Fair’s work unfolds. She moves back and forth between the family and their loved one, who’s sitting across the street on a bench, as she collects information from both parties: Is there a mental health history? What kind of substances have they used before? Are they currently receiving any treatment? Have they been hospitalized before? Did they make any threats? What do you want to see happen today?\u003c/p>\n\u003cp>After 10 minutes, Fair pulls one of the officers aside to let him know that the person doesn’t need to be hospitalized. “Let’s safety plan,” she tells him. It’s what the agency does if they receive a call that doesn’t rise to the level of an involuntary psychiatric hold. At that point, officers say, they’re “just playing peacemaker.”\u003c/p>\n\u003cp>Fair huddles beside the family to explain that the situation is no longer a police matter or a mental health crisis, but rather, a family matter. Still, she doesn’t want to leave them feeling alone. They create a “safety plan” that everyone can get on board with so that, as she later explains, “We don’t get another call in 10 minutes because they’re arguing down the street.”\u003c/p>\n\u003cp>“We get calls like this — where it sounds like it’s going to be wild — and then we get here and it’s just a family matter,” she said. “It happens.”\u003c/p>\n\u003cp>\u003cem>Cayla Mihalovich is a California Local News fellow. \u003c/em>\u003c/p>\n\u003cp>\u003cem>This article was \u003ca href=\"https://calmatters.org/justice/2025/12/police-mental-health-emergencies/\">originally published on CalMatters\u003c/a> and was republished under the \u003ca href=\"https://creativecommons.org/licenses/by-nc-nd/4.0/\">Creative Commons Attribution-NonCommercial-NoDerivatives\u003c/a> license.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "San Mateo adopted a new approach to mental health 911 calls by pairing police with mental health clinicians. Researchers found that it reduced the number of future mental health emergency calls and involuntary psychiatric holds by roughly 17%.\r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://calmatters.org/\">CalMatters\u003c/a>. \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/\">Sign up\u003c/a> for their newsletters.\u003c/em>\u003c/p>\n\u003cp>Briana Fair, a mental health clinician with the \u003ca href=\"https://www.kqed.org/news/tag/san-mateo\">San Mateo\u003c/a> Police Department, received a dozen voicemails from the same distressed caller over a single weekend this month.\u003c/p>\n\u003cp>She knew the voice. It was her client, saying that a celebrity has been hacking her phone, that she needed help moving into a different apartment and why was the process taking so long?\u003c/p>\n\u003cp>“Normally, she won’t call like this unless she’s starting to get towards a crisis,” Fair said.\u003c/p>\n\u003cp>If Fair keeps her close, it will ensure she is connected with the services she needs and prevent her from calling 911 dispatch, reducing the possibility of a full-blown crisis involving officers or unnecessary hospitalizations.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I fill in the gaps,” said Fair. “It’s just a matter of getting her the right supports.”\u003c/p>\n\u003cp>It’s working, according to a \u003ca href=\"https://www.nature.com/articles/s41562-025-02339-7\">new study of San Mateo County’s efforts\u003c/a> from Stanford’s John W. Gardner Center for Youth and Their Communities, which found that pairing \u003ca href=\"https://calmatters.org/justice/2022/03/mental-health-crisis-police/\">law enforcement officers with mental health clinicians\u003c/a> reduces the likelihood of costlier and more intrusive interventions.\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/121525-San-Mateo-RideAlong-MO-CM-15-1024x682.jpg\" alt=\"A close-up shows a person with short, tightly curled hair leaning forward and listening intently to another person whose back is in the foreground. Their face is partially lit, with a focused, serious expression, while a blurred laptop screen and desk items appear in the background, suggesting a work or interview setting.\">\u003cfigcaption>Briana Fair assists a client at the client’s apartment in San Mateo, after the client made multiple calls to her over the weekend, on Dec. 15, 2025. Photo by Manuel Orbegozo for CalMatters\u003c/figcaption>\u003c/figure>\n\u003cp>Fair was hired four years ago as part of a program to pilot this approach, also known as a “co-responder model,” across San Mateo County’s four largest cities — Daly City, San Mateo, Redwood City and South San Francisco. The idea was to free up police officers and provide alternatives to incarceration and hospital emergency rooms for people in a \u003ca href=\"https://calmatters.org/tag/mental-health/\">mental health crisis\u003c/a>. Since then, the model has rolled out to police departments in nearly every city in the county.\u003c/p>\n\u003cp>Researchers behind the Stanford study found the co-responder model decreased involuntary psychiatric holds by approximately 17% and reduced the likelihood of future mental health 911 calls among the four pilot cities. The hold allows a hospital to keep someone for up to 72 hours to determine if they are a danger to themselves or others. Given the reduction of roughly 370 involuntary psychiatric holds over the course of two years, researchers Tom Dee and Jaymes Pyne estimated an annual cost savings of roughly $300,000 to $800,000.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“We’ve got to look to alternatives and really understand that police are not the best equipped to handle mental health crisis situations,” said San Mateo County Executive Officer Mike Callagy, who proposed the pilot after seeing cases that resulted in officers using force and in lawsuits.\u003c/p>\n\u003cp>During each visit with her client, Fair tries to help her check something off a list of things that have been bothering her. Today, they’re sitting next to one another as they call California’s social services department to ask about in-home care. They’re placed on hold and after five minutes, her client lets out a deep sigh.\u003c/p>\n\u003cp>“I know, it’s a lot,” Fair said. “That’s why I’m here.”\u003c/p>\n\u003cp>As jazz music plays in the background of the call, Fair picks up a bottle of dry shampoo from the desk, reads the label aloud and asks her how she likes it. She brought the product over during one of their last visits — a bandaid solution that she devised because her client was having trouble bathing herself.\u003c/p>\n\u003cp>“Have you tried it yet?” she asks. “Want me to spray it for you? Brush it first.”\u003c/p>\n\u003cp>Her client takes her hair out of its ponytail, brushes it with her fingers and runs her hands along the part. Fair stands up from her chair, shakes the bottle and mists it over her head.\u003c/p>\n\u003cp>“Does it feel better?” she asks.\u003c/p>\n\u003cp>“Yes, but you sprayed it in my mouth,” her client says, letting out a big laugh. “It feels fresh.”\u003c/p>\n\u003ch2>Rising number of mental health calls\u003c/h2>\n\u003cp>Stanford’s research adds to a \u003ca href=\"https://psychiatryonline.org/doi/10.1176/appi.ps.20240003\">growing body of evidence\u003c/a> about the positive impact of alternative first response programs, which have proliferated across the country amid calls for police reform in the aftermath of George Floyd’s murder in 2020. Those reforms are so nascent that not much is known about them, Dee said, and his study is one of a handful that provides a credible evaluation.\u003c/p>\n\u003cp>“This is a common-sense reform with a great deal of promise,” he said. “That being said, it’s not a cut-and-paste kind of reform. There are serious design and implementation details that matter for realizing the promise of these sorts of initiatives.”\u003c/p>\n\u003cfigure>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/121525-San-Mateo-RideAlong-MO-CM-03-1024x682.jpg\" alt=\"A motion-blurred street scene shows a uniformed officer moving quickly near an intersection, with another person partially visible nearby. A stop sign and street sign appear in the background alongside residential buildings and trees, conveying a sense of sudden movement and urgency.\">\u003c/figure>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/121525-San-Mateo-RideAlong-MO-CM-09-1024x682.jpg\" alt=\"Three people walk together across a residential street, including two uniformed police officers and a third person in plain clothes who gestures while speaking. Parked police vehicles line the curb behind them, and apartment buildings and trees with autumn leaves frame the scene in daylight.\">\u003c/figure>\u003cfigcaption>\u003cstrong>First: \u003c/strong>Briana Fair, San Mateo Police Department’s first-ever mental health clinician, responds to a mental health related 911 call that involved two police officers and resulted in no arrests, in San Mateo, on Dec. 15, 2025. \u003cstrong>Last: \u003c/strong>Police officers Dylan Kayzar, left, Jared Rogge, and mental health clinician Briana Fair chat after responding to a mental health related 911 call in San Mateo, on Dec. 15, 2025. Photos by Manuel Orbegozo for CalMatters\u003c/figcaption>\u003c/figure>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/121525-San-Mateo-RideAlong-MO-CM-01-1024x682.jpg\" alt=\"A person sits in the front seat of a car, shown in profile, with short curly hair softly lit by dim light from outside the vehicle. The interior is mostly dark, with the headrest, window frame, and a blurred structure visible beyond the window, creating a quiet, contemplative mood.\">\u003cfigcaption>Briana Fair, San Mateo Police Department’s first-ever mental health clinician, prepares to respond to a mental health-related 911 call in San Mateo on Dec. 15, 2025. Photo by Manuel Orbegozo for CalMatters\u003c/figcaption>\u003c/figure>\n\u003cp>Some of those details include having buy-in from the police, training dispatchers on how to triage calls, and integrating mental health staff.\u003c/p>\n\u003cp>San Mateo Police Chief Ed Barberini said it was a “risky proposition” when his agency decided to participate in the pilot program, worrying that his officers would push back. But mental health calls were on the rise, he said, and without clinical expertise, police officers were being put in a difficult position. That sentiment has been shared by law enforcement agencies across the state, some of which have recently \u003ca href=\"https://calmatters.org/health/mental-health/2025/04/mental-health-crisis-california-police-response/\">distanced themselves from mental health calls\u003c/a>.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“We recognized that we were triaging problems and just finding short-term solutions,” said Barberini. “I’m pleasantly surprised with how things have turned out.”\u003c/p>\n\u003cp>Prior to the pilot program, San Mateo police officers who responded to mental health 911 calls had to decide whether to send the person to the hospital for a 72-hour involuntary hold, arrest them, or leave them to their own devices. By pairing them with a clinician, the agency has been able to provide safety planning, follow-up calls and connections to community partners for people in mental health crises.\u003c/p>\n\u003cp>Mariela Ruiz-Angel, director of Alternative Response Initiatives at Georgetown Law’s Center for Innovations in Community Safety, said a co-responder model is fantastic — but it’s just the beginning of what a progressive city looks like.\u003c/p>\n\u003cp>“This is really about evolving to a level in which we don’t have to send out cops or fire for basic-level need calls,” she said. “The idea was never about taking cops out of the equation altogether. The idea was that we don’t have to center them as the main response of 911. We don’t have to make public safety about cops. Public safety is about the appropriate response.”\u003c/p>\n\u003ch2>De-escalating a family feud\u003c/h2>\n\u003cp>The pilot program cost approximately $1.5 million over the course of two years, split between the county and the four participating cities. Once it ended, the San Mateo Police Department — an agency consisting of 116 sworn officers — converted Fair’s role to a permanent position as the agency’s first-ever mental health clinician. The city is also using grant money to employ an additional mental health clinician part-time. Every other participating city has also found a way to sustain its program.\u003c/p>\n\u003cp>On a Monday morning, Fair responds to emails from police officers who have asked her to follow up with people they interacted with over the weekend. This time of year has been busy, Fair says, because the holidays can be lonely. In the last week alone, she’s had to respond to a variety of crises: evaluating a kid who had an interrupted suicide attempt and responding to a transgender youth who wanted to stab themselves.\u003c/p>\n\u003cp>A radio sits next to her desk. She pauses to listen more intently as a dispatcher relays information about a person who thinks they’re being followed by a federal agent. A family member called in to report the episode. A few minutes later, Fair slings her backpack over her arm, sticks the radio in her pocket and quickly winds her way through the hallway to the garage. In the backseat of her county car – a white Toyota Prius – is a bulletproof vest, which she says she rarely uses.\u003c/p>\n\u003cp>Outside an apartment complex, Fair pulls over and turns on her flashers. The process, also referred to as “staging,” is when she parks two blocks away so police officers, who have already arrived, can vet the scene to make sure it’s safe for her arrival.\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/121525-San-Mateo-RideAlong-MO-CM-31-1024x682.jpg\" alt=\"A person with short, curly hair sits indoors near a window, hands clasped in their lap, with a calm expression. Sunlight falls across part of their face and shoulder, while the rest of the room remains in shadow. Small potted plants sit on a ledge beside them, and shelves with framed items and greenery are visible in the softly lit background.\">\u003cfigcaption>As the San Mateo Police Department’s first mental health clinician, Briana Fair connects people experiencing mental health crises with services to help prevent unnecessary hospitalizations or police involvement in San Mateo, on Dec. 15, 2025. Photo by Manuel Orbegozo for CalMatters\u003c/figcaption>\u003c/figure>\n\u003cp>A few minutes later, she opens the car door and jogs over in her black Nikes and tan cargo pants. An officer introduces her to the family and from there, Fair’s work unfolds. She moves back and forth between the family and their loved one, who’s sitting across the street on a bench, as she collects information from both parties: Is there a mental health history? What kind of substances have they used before? Are they currently receiving any treatment? Have they been hospitalized before? Did they make any threats? What do you want to see happen today?\u003c/p>\n\u003cp>After 10 minutes, Fair pulls one of the officers aside to let him know that the person doesn’t need to be hospitalized. “Let’s safety plan,” she tells him. It’s what the agency does if they receive a call that doesn’t rise to the level of an involuntary psychiatric hold. At that point, officers say, they’re “just playing peacemaker.”\u003c/p>\n\u003cp>Fair huddles beside the family to explain that the situation is no longer a police matter or a mental health crisis, but rather, a family matter. Still, she doesn’t want to leave them feeling alone. They create a “safety plan” that everyone can get on board with so that, as she later explains, “We don’t get another call in 10 minutes because they’re arguing down the street.”\u003c/p>\n\u003cp>“We get calls like this — where it sounds like it’s going to be wild — and then we get here and it’s just a family matter,” she said. “It happens.”\u003c/p>\n\u003cp>\u003cem>Cayla Mihalovich is a California Local News fellow. \u003c/em>\u003c/p>\n\u003cp>\u003cem>This article was \u003ca href=\"https://calmatters.org/justice/2025/12/police-mental-health-emergencies/\">originally published on CalMatters\u003c/a> and was republished under the \u003ca href=\"https://creativecommons.org/licenses/by-nc-nd/4.0/\">Creative Commons Attribution-NonCommercial-NoDerivatives\u003c/a> license.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "remembering-papa-northern-californias-elderly-face-hidden-epidemic-of-gun-suicides",
"title": "Remembering Papa: Northern California’s Elderly Face Hidden Epidemic of Gun Suicides",
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"content": "\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://calmatters.org/\">CalMatters\u003c/a>. \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/\">Sign up\u003c/a> for their newsletters.\u003c/em>\u003c/p>\n\u003cp>By the early afternoon of her 59th birthday, Kelly Frost had a \u003ca href=\"https://www.kqed.org/healthnews\">sinking feeling\u003c/a> in the pit of her stomach. She had lunch with girlfriends near her home in Douglas City — a rural community nestled among the ponderosa pines of the \u003ca href=\"https://www.kqed.org/news/tag/shasta-county\">Shasta\u003c/a>–\u003ca href=\"https://www.kqed.org/science/1942299/onetime-enemies-over-logging-are-now-a-community-to-prevent-wildfire\">Trinity National Forest\u003c/a> in Northern California. But she kept thinking about her “Daddy-o,” Jeffrey Butler, her 81-year-old father. He was not returning her calls.\u003c/p>\n\u003cp>As she drove home around 4 p.m., she stopped to check in on him. Her dad lived in a two-bedroom cabin just up the road from her place. “I was kind of feeling angry with him because he hadn’t answered all day,” Frost said.\u003c/p>\n\u003cp>When she opened the door, she glanced at the “Papa chair,” his favorite recliner, the spot where she usually found him. He wasn’t there. That’s when she noticed his feet on the kitchen floor. He was slumped over on his right side, a pool of blood around his head.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Frost’s first thought was that her dad had taken a fall. She blew an air horn that she and her dad kept around in case they ever needed help. A neighbor met her promptly, and it was he who noticed the revolver.\u003c/p>\n\u003cp>“He said, ‘No, Kel, there’s a gun on the counter,’ and then I realized that he had shot himself,” Frost said.\u003c/p>\n\u003cp>Butler died on Dec. 18, 2024 from a self-inflicted gunshot to the head. His death is part of a dark reality — a public health crisis that often goes overlooked: older adults are increasingly turning to guns to end their lives.\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/120425_Trinity-Guns_SO_38-1024x695.jpg\" alt=\"\">\u003cfigcaption>A motel in Douglas City on Dec. 4, 2025. Photo by Salvador Ochoa for CalMatters\u003c/figcaption>\u003c/figure>\n\u003cp>In California, 5,825 adults aged 70 or older died by gun suicide between 2009 and 2023, according to mortality data from the Centers for Disease Control and Prevention \u003ca href=\"https://datahub.thetrace.org/dataset/gun-suicides-older-americans/\">provided by the Gun Violence Data Hub\u003c/a>. The numbers are especially stark among older white men in rural areas.\u003c/p>\n\u003cp>In Trinity County – population just over 15,600 – at least eight men 70 or older, including Butler, died from an apparent firearm suicide between 2020 and 2024, incident reports from the Trinity County Sheriff’s office show.\u003c/p>\n\u003cp>Trinity County isn’t alone. Rural Northern California counties have some of the nation’s highest rates of gun suicides among older adults. Over the course of 15 years, the gun suicide rate of adults 70 and older in Trinity, Tehama, Plumas, Lassen, Glenn, Calaveras, and Amador was 35.6 deaths per 100,000, more than triple the statewide rate.\u003c/p>\n\u003cdiv style=\"min-height:624px\" id=\"datawrapper-vis-lOl3X\">\u003cimg decoding=\"async\" src=\"https://datawrapper.dwcdn.net/lOl3X/full.png\" alt=\"Rural counties have the highest rates of suicide by firearm among seniors (Bar Chart)\">\u003c/div>\n\u003cp>Across the country, adults over 70 have the highest suicide rate of any age group. Experts say these deaths may get little attention because society empathizes with struggling older adults who want to control how their lives end.\u003c/p>\n\u003cp>“I think we sometimes don’t talk about them because I think people sort of brush it off as like, it’s understandable or it’s not preventable, and I think that’s the real piece of the narrative that we need to change,” said Dr. Emmy Betz, an emergency medicine doctor and a firearm injury prevention expert at the University of Colorado School of Medicine.\u003c/p>\n\u003cp>Behind the deaths are a number of factors, according to research and law enforcement incident reports. These include loneliness and social isolation, depression, financial struggles, illness and pain, and feeling like a burden.\u003c/p>\n\u003cp>In rural areas, easier access to guns is also a key contributor.\u003c/p>\n\u003ch2>Unresolved pain\u003c/h2>\n\u003cp>For more than a year before his death, Butler had been in pain. It radiated through his abdomen, making the simple act of urinating an ordeal, Frost said. Last year, in February, a CT scan revealed the problem: a crystal blockage in his urethra. He found a urologist in Redding, one county over. Each visit to the specialist required navigating the hour-long descent down Highway 299, scenic but winding. Frost drove him to the appointments.\u003c/p>\n\u003cp>A Bay Area native with Oklahoma roots, Butler had retired early to Trinity County, nearly 40 years ago. He had worked for large companies, including Hanes and Hostess, and done well in the stock market. Alongside the Trinity River, renowned for its steelhead trout and salmon, he bought cabins for himself and his daughter.[aside postID=news_12065708 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250325-ApartmentsonWestside-06-BL_qed-1020x680.jpg']\u003c/p>\n\u003cp>It’s here where Frost’s kids grew up. Butler’s granddaughter Michaela Frost grew up to be a horse lover like her Papa. His grandson Jake Ritter said he could spend hours talking and fishing with his grandfather. His Papa was happiest fishing.\u003c/p>\n\u003cp>But the last months of his life brought Butler little joy.\u003c/p>\n\u003cp>In July of 2024, Butler had surgery in Redding to remove the blockage in his urethra. But the pain and discomfort continued through the summer. In September, he was admitted for three days to the emergency room in nearby Weaverville with a severe urinary tract infection. Frost said that during this time she tried to call her dad’s urologist several times to reschedule a follow-up appointment he missed while in the hospital, but she could only reach an answering machine.\u003c/p>\n\u003cp>Butler’s physician assistant in Weaverville called several times too, but no luck, Frost said. The physician assistant “literally threw her hands in the air and said, ‘I can’t get any response.’” That was one of the few times Frost saw her dad cry. “My dad never cried. He was a cowboy.”\u003c/p>\n\u003cp>After his death, first responders found an undated note in Butler’s home. It began:\u003c/p>\n\u003cp>The pain???????\u003cbr>\n!!!!!!!!!!\u003cbr>\nTo much to stand\u003cbr>\nNo Help\u003c/p>\n\u003cp>By mid-fall, the infections, desperation and heavy antibiotics use were changing her dad’s mental state, Frost said. He wasn’t interested in fishing. Or watching his 49ers. Or spending time with his wild mustang, Spade, or with the guys down at the Tangle Blue Saloon, where he would order a shot of whisky with a coke back.\u003c/p>\n\u003cp>His cabin grew darker; he no longer drew his camo-print curtains open. Frost estimates that in the span of about a year, Butler lost almost 100 pounds, transforming him from a stout 230-pound man to a fragile version of himself.\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/120425_Trinity-Guns_SO_03-1024x683.jpg\" alt=\"\">\u003cfigcaption>Kelly Frost and her father’s horse in Douglas City on Dec. 4, 2025. Photo by Salvador Ochoa for CalMatters\u003c/figcaption>\u003c/figure>\n\u003cfigure>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/120425_Trinity-Guns_SO_41-1024x682.jpg\" alt=\"\">\u003c/figure>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/120425_Trinity-Guns_SO_31-1024x701.jpg\" alt=\"\">\u003c/figure>\u003cfigcaption>\u003cstrong>First:\u003c/strong> Kelly Frost points to a photograph of her dad, Jeffrey Butler. \u003cstrong>Last:\u003c/strong> A collection of Jeffrey Butler photographs on a table at Kelly Frost’s home in Douglas City on Dec. 4, 2025. Photos by Salvador Ochoa for CalMatters\u003c/figcaption>\u003c/figure>\n\u003cp>Older adults are likely to plan suicide more carefully, and their attempts are more likely to be fatal, according to the National Council on Aging. In California, older women are more likely to overdose, while most older men will use guns, according to state public health data.\u003c/p>\n\u003cp>Pain and health issues are a common thread among older adults who die by gun suicide. State data show that 55% of people 70 and over who died this way had a contributing physical health problem, and 27% had a diagnosed mental health condition.\u003c/p>\n\u003cdiv id=\"datawrapper-vis-KyQjs\" style=\"min-height: 539px\">\u003cimg decoding=\"async\" src=\"https://datawrapper.dwcdn.net/KyQjs/full.png\" alt=\"Many older adults who died by gun suicide had a contributing physical health problem (Range Plot)\">\u003c/div>\n\u003cp>Among the eight older men that died by gun suicide in Trinity County between 2020 and 2024, two struggled with respiratory conditions. One had recently discovered a bladder tumor. One man’s antidepressants were found near his body, and another had reportedly been speaking about suicide for some time but did not meet the requirements for an involuntary psychiatric hold, according to incident reports.\u003c/p>\n\u003ch2>The rural divide\u003c/h2>\n\u003cp>Trinity County holds a deep beauty: the rush of the Trinity River, the rising fog on a chilly morning, the sprawling pines that make the rugged mountain sides their home.\u003c/p>\n\u003cp>But large supermarkets are a county over, a steep and twisty road away. And so is most of the medical care.\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/120425_Trinity-Guns_SO_05-1024x683.jpg\" alt=\"\">\u003cfigcaption>Clouds sweep the sky in Trinity County on Dec. 4, 2025. Photo by Salvador Ochoa for CalMatters\u003c/figcaption>\u003c/figure>\n\u003cp>“We have more limited access to essential services and resources compared to the rest of California,” said Cathy Tillman, a health services program manager at Trinity County Health and Human Services. “We have to travel further for all services, which plays a role in the ability for people to get their needs met.”\u003c/p>\n\u003cp>California’s rural counties have more older residents: about 25% compared to the state average of around 17%, according to the SCAN Foundation, an advocacy and research organization for older adults. By 2040, the 85-and-older population in rural California is \u003ca href=\"https://www.thescanfoundation.org/resource/aging-in-rural-california-policy-brief-series-on-long-term-care-health-and-housing/\">expected to grow 50 times faster\u003c/a> than the working age population. But access to medical and social services for seniors lag significantly when compared to larger, urban regions.\u003c/p>\n\u003cp>Trinity County has one 25-bed hospital, and a handful of clinics, largely in Weaverville, the county seat. But even reaching Weaverville from other Trinity County communities could take 30 minutes to an hour. For anything more specialized, residents here usually travel an hour to Redding, or two hours for providers in Eureka and Chico. With a small population, Trinity County can’t easily support specialists — like a neurologist or urologist — setting up practice.\u003c/p>\n\u003cp>Going further for care means people often miss appointments, or delay them, and live longer with pain.\u003c/p>\n\u003cp>Arina Erwin, deputy director of the county’s health and human services agency, said even some general practitioners who come to Trinity don’t stay long.\u003c/p>\n\u003cp>“Living in a small community and a frontier community can be a challenge on its own,” Erwin said. Doctors and specialists have student loans to repay, making cities where they can earn a significantly higher income seem more attractive. For years, the hospital and clinics in Trinity have \u003ca href=\"https://krcrtv.com/news/local/trinity-hospital-in-decade-long-struggle-to-hire-doctors\">reported trouble replacing retiring doctors\u003c/a>. Even virtual care here can be a challenge, because broadband is spotty, especially in pockets with only a few dozen residents, Erwin said.\u003c/p>\n\u003cp>People who live in rural areas also foster a cultural barrier — a rural spirit of sorts. Tillman said they tend to be more independent, and used to doing things on their own terms; they may also be less likely to seek help.\u003c/p>\n\u003cp>Frost said that sounds familiar. She saw first-hand how her proud, self-reliant, sometimes stubborn father lost his independence as the pain took hold.\u003c/p>\n\u003ch2>Remembering Papa\u003c/h2>\n\u003cp>In Frost’s living room – with the sun shining through the large windows on a December afternoon – memories of Butler, called Papa by his grandkids, stirred both laughter and tears.\u003c/p>\n\u003cfigure>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/120425_Trinity-Guns_SO_19-1024x683.jpg\" alt=\"\">\u003c/figure>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/120425_Trinity-Guns_SO_06-1024x758.jpg\" alt=\"\">\u003c/figure>\u003cfigcaption>\u003cstrong>First:\u003c/strong> A photograph of Jeffrey Butler is displayed next to holiday items at Kelly Frost’s home. \u003cstrong>Last:\u003c/strong> Jake Ritter takes a moment to remember his grandfather, Jeffrey Butler in Douglas City on Dec. 4, 2025. Photos by Salvador Ochoa for CalMatters\u003c/figcaption>\u003c/figure>\n\u003cp>As a kid, grandson Jake Ritter would get up before sunrise to go fishing with his Papa — sometimes begrudgingly — but by lunchtime they’d be happily eating their catch. He remembers cruising on Butler’s riding lawnmower and watching old westerns with him.\u003c/p>\n\u003cp>Ritter and his sister, Michaela, loved listening to his stories, like the time he shot a bobcat as it launched toward him while he was out deer hunting. He had the bobcat stuffed to prove it. Or how, as a teen in San Pablo, Butler chased and tackled a man trying to rob the Lucky store where he worked. The family still has the news clipping.\u003c/p>\n\u003cp>Michaela is glad her papa got to meet her first-born, Blake, and wishes her three-month-old, Daniella, could have as well.\u003c/p>\n\u003cp>Butler’s suicide left his family in turmoil and with so many questions. Ritter felt angry at his papa for the way he decided to go. Why do this on his mom’s birthday? Frost often wonders: What were her dad’s last thoughts?\u003c/p>\n\u003cp>After a suicide, families are more likely to experience a complicated grieving process, with feelings of guilt, confusion, shame, anger and trauma, research shows.\u003c/p>\n\u003cp>In the year since Butler’s death, Frost’s family has largely relied on each other through their grief. Ritter said his anger at his grandfather has subsided; he is now coming to terms with his Papa’s decision.\u003c/p>\n\u003cp>“I’m sad that he didn’t get the help that he needed, and I’m sad that he felt so strongly that this is the road that he chose,” Ritter said.\u003c/p>\n\u003cp>Frost said she gave herself a year to navigate the feelings on her own, but now with the encouragement of friends is considering seeking professional help.\u003c/p>\n\u003ch2>Warning signs and storing guns\u003c/h2>\n\u003cp>In Trinity County, health officials are preparing to launch an injury and suicide prevention program, said Tillman, the county health services program manager. A big component of the county’s strategy will be education to help reduce the stigmas associated with suicide and mental health. Tillman said the plan is to find and train trusted messengers in the small pockets where people live.\u003c/p>\n\u003cp>Dr. Amy Barnhorst, a psychiatrist and associate director of the \u003ca href=\"https://cvp.ucdavis.edu/\">Centers for Violence Prevention\u003c/a> at UC Davis, said that recognizing a sense of independence and self-reliance common to rural communities is essential to prevention programs. Education around safe gun storage is also key, she added.\u003c/p>\n\u003cp>“You can’t discount the fact that having access to a firearm, period, all other things being equal, increases the risk that somebody will die by suicide by a factor of more than three,” Barnhorst said.\u003c/p>\n\u003cp>She helps lead a state-funded curriculum at UC Davis called \u003ca href=\"https://www.bulletpointsproject.org/\">The BulletPoints Project\u003c/a>, which trains health providers on how to identify at-risk patients and speak to them about gun safety.\u003c/p>\n\u003cp>The project also trains people applying for and renewing concealed carry weapon permits. Under state law, that category of gun owners must complete at least an hour of mental health training.\u003c/p>\n\u003cp>The course aims to help these gun owners identify a mental health crisis. People who already own guns – like Jeff Butler – never had to take a course like this.\u003c/p>\n\u003cp>Kelly Frost said she doesn’t know if her dad would have accepted mental health help. It was not something they talked about. His will to live wrestled in the words found in his house, the note she still clings closely to. It ends:\u003c/p>\n\u003cp>What would you do?\u003cbr>\nEnd it???\u003cbr>\nThe pain not life\u003c/p>\n\u003cp>Since her dad’s passing, Frost has had many sleepless nights, pondering questions and thoughts. She feels she tried her best to get him care, but wishes access had been easier. What signs did she miss? But mostly: Why hadn’t she taken away the guns?\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/120425_Trinity-Guns_SO_28-1024x683.jpg\" alt=\"\">\u003cfigcaption>Kelly Frost is reflected in a mirror next to Jeffrey Butler’s fishing poles in Douglas City on Dec. 4, 2025. Photo by Salvador Ochoa for CalMatters\u003c/figcaption>\u003c/figure>\n\u003cp>Growing up around guns, it never crossed her mind that her Daddy-o would one day turn his revolver on himself.\u003c/p>\n\u003cp>“Had I known that he was capable of this, I probably would have worked a little harder to make sure that the guns were not accessible,” Frost said.\u003c/p>\n\u003cp>This Dec. 18, the one year anniversary of Butler’s death and Frost’s 60th birthday, she had a shot of Canadian whisky from the last bottle she gave him. His guns are now in a safe.\u003c/p>\n\u003cp>\u003cem>\u003cstrong>If you are having suicidal thoughts, you can get help from the National Suicide Prevention Lifeline by calling 988 or visiting \u003c/strong>\u003c/em>\u003ca href=\"https://suicidepreventionlifeline.org/\">\u003cstrong>\u003cem>https://suicidepreventionlifeline.org\u003c/em>\u003c/strong>\u003c/a>\u003c/p>\n\u003cp>\u003cem>Data shared by the \u003c/em>\u003ca href=\"https://datahub.thetrace.org/dataset/gun-suicides-older-americans/\">\u003cem>Gun Violence Data Hub\u003c/em>\u003c/a>\u003cem> by The Trace. Data analysis and visualizations by Natasha Uzcátegui-Liggett. Additional reporting by Aaron Mendelson. \u003c/em>\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.\u003c/em>\u003c/p>\n\u003cp>\u003cem>This article was \u003ca href=\"https://calmatters.org/health/2025/12/trinity-county-gun-suicide-rural/\">originally published on CalMatters\u003c/a> and was republished under the \u003ca href=\"https://creativecommons.org/licenses/by-nc-nd/4.0/\">Creative Commons Attribution-NonCommercial-NoDerivatives\u003c/a> license.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Senior Californians in rural communities are dying by suicide at troubling rates—struggling with pain, cut off from doctors and mental health care, with guns at hand. Access to care and safety planning would help, experts say.\r\n",
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"title": "Remembering Papa: Northern California’s Elderly Face Hidden Epidemic of Gun Suicides | KQED",
"description": "Senior Californians in rural communities are dying by suicide at troubling rates—struggling with pain, cut off from doctors and mental health care, with guns at hand. Access to care and safety planning would help, experts say.\r\n",
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"headline": "Remembering Papa: Northern California’s Elderly Face Hidden Epidemic of Gun Suicides",
"datePublished": "2025-12-27T04:00:02-08:00",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://calmatters.org/\">CalMatters\u003c/a>. \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/\">Sign up\u003c/a> for their newsletters.\u003c/em>\u003c/p>\n\u003cp>By the early afternoon of her 59th birthday, Kelly Frost had a \u003ca href=\"https://www.kqed.org/healthnews\">sinking feeling\u003c/a> in the pit of her stomach. She had lunch with girlfriends near her home in Douglas City — a rural community nestled among the ponderosa pines of the \u003ca href=\"https://www.kqed.org/news/tag/shasta-county\">Shasta\u003c/a>–\u003ca href=\"https://www.kqed.org/science/1942299/onetime-enemies-over-logging-are-now-a-community-to-prevent-wildfire\">Trinity National Forest\u003c/a> in Northern California. But she kept thinking about her “Daddy-o,” Jeffrey Butler, her 81-year-old father. He was not returning her calls.\u003c/p>\n\u003cp>As she drove home around 4 p.m., she stopped to check in on him. Her dad lived in a two-bedroom cabin just up the road from her place. “I was kind of feeling angry with him because he hadn’t answered all day,” Frost said.\u003c/p>\n\u003cp>When she opened the door, she glanced at the “Papa chair,” his favorite recliner, the spot where she usually found him. He wasn’t there. That’s when she noticed his feet on the kitchen floor. He was slumped over on his right side, a pool of blood around his head.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Frost’s first thought was that her dad had taken a fall. She blew an air horn that she and her dad kept around in case they ever needed help. A neighbor met her promptly, and it was he who noticed the revolver.\u003c/p>\n\u003cp>“He said, ‘No, Kel, there’s a gun on the counter,’ and then I realized that he had shot himself,” Frost said.\u003c/p>\n\u003cp>Butler died on Dec. 18, 2024 from a self-inflicted gunshot to the head. His death is part of a dark reality — a public health crisis that often goes overlooked: older adults are increasingly turning to guns to end their lives.\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/120425_Trinity-Guns_SO_38-1024x695.jpg\" alt=\"\">\u003cfigcaption>A motel in Douglas City on Dec. 4, 2025. Photo by Salvador Ochoa for CalMatters\u003c/figcaption>\u003c/figure>\n\u003cp>In California, 5,825 adults aged 70 or older died by gun suicide between 2009 and 2023, according to mortality data from the Centers for Disease Control and Prevention \u003ca href=\"https://datahub.thetrace.org/dataset/gun-suicides-older-americans/\">provided by the Gun Violence Data Hub\u003c/a>. The numbers are especially stark among older white men in rural areas.\u003c/p>\n\u003cp>In Trinity County – population just over 15,600 – at least eight men 70 or older, including Butler, died from an apparent firearm suicide between 2020 and 2024, incident reports from the Trinity County Sheriff’s office show.\u003c/p>\n\u003cp>Trinity County isn’t alone. Rural Northern California counties have some of the nation’s highest rates of gun suicides among older adults. Over the course of 15 years, the gun suicide rate of adults 70 and older in Trinity, Tehama, Plumas, Lassen, Glenn, Calaveras, and Amador was 35.6 deaths per 100,000, more than triple the statewide rate.\u003c/p>\n\u003cdiv style=\"min-height:624px\" id=\"datawrapper-vis-lOl3X\">\u003cimg decoding=\"async\" src=\"https://datawrapper.dwcdn.net/lOl3X/full.png\" alt=\"Rural counties have the highest rates of suicide by firearm among seniors (Bar Chart)\">\u003c/div>\n\u003cp>Across the country, adults over 70 have the highest suicide rate of any age group. Experts say these deaths may get little attention because society empathizes with struggling older adults who want to control how their lives end.\u003c/p>\n\u003cp>“I think we sometimes don’t talk about them because I think people sort of brush it off as like, it’s understandable or it’s not preventable, and I think that’s the real piece of the narrative that we need to change,” said Dr. Emmy Betz, an emergency medicine doctor and a firearm injury prevention expert at the University of Colorado School of Medicine.\u003c/p>\n\u003cp>Behind the deaths are a number of factors, according to research and law enforcement incident reports. These include loneliness and social isolation, depression, financial struggles, illness and pain, and feeling like a burden.\u003c/p>\n\u003cp>In rural areas, easier access to guns is also a key contributor.\u003c/p>\n\u003ch2>Unresolved pain\u003c/h2>\n\u003cp>For more than a year before his death, Butler had been in pain. It radiated through his abdomen, making the simple act of urinating an ordeal, Frost said. Last year, in February, a CT scan revealed the problem: a crystal blockage in his urethra. He found a urologist in Redding, one county over. Each visit to the specialist required navigating the hour-long descent down Highway 299, scenic but winding. Frost drove him to the appointments.\u003c/p>\n\u003cp>A Bay Area native with Oklahoma roots, Butler had retired early to Trinity County, nearly 40 years ago. He had worked for large companies, including Hanes and Hostess, and done well in the stock market. Alongside the Trinity River, renowned for its steelhead trout and salmon, he bought cabins for himself and his daughter.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It’s here where Frost’s kids grew up. Butler’s granddaughter Michaela Frost grew up to be a horse lover like her Papa. His grandson Jake Ritter said he could spend hours talking and fishing with his grandfather. His Papa was happiest fishing.\u003c/p>\n\u003cp>But the last months of his life brought Butler little joy.\u003c/p>\n\u003cp>In July of 2024, Butler had surgery in Redding to remove the blockage in his urethra. But the pain and discomfort continued through the summer. In September, he was admitted for three days to the emergency room in nearby Weaverville with a severe urinary tract infection. Frost said that during this time she tried to call her dad’s urologist several times to reschedule a follow-up appointment he missed while in the hospital, but she could only reach an answering machine.\u003c/p>\n\u003cp>Butler’s physician assistant in Weaverville called several times too, but no luck, Frost said. The physician assistant “literally threw her hands in the air and said, ‘I can’t get any response.’” That was one of the few times Frost saw her dad cry. “My dad never cried. He was a cowboy.”\u003c/p>\n\u003cp>After his death, first responders found an undated note in Butler’s home. It began:\u003c/p>\n\u003cp>The pain???????\u003cbr>\n!!!!!!!!!!\u003cbr>\nTo much to stand\u003cbr>\nNo Help\u003c/p>\n\u003cp>By mid-fall, the infections, desperation and heavy antibiotics use were changing her dad’s mental state, Frost said. He wasn’t interested in fishing. Or watching his 49ers. Or spending time with his wild mustang, Spade, or with the guys down at the Tangle Blue Saloon, where he would order a shot of whisky with a coke back.\u003c/p>\n\u003cp>His cabin grew darker; he no longer drew his camo-print curtains open. Frost estimates that in the span of about a year, Butler lost almost 100 pounds, transforming him from a stout 230-pound man to a fragile version of himself.\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/120425_Trinity-Guns_SO_03-1024x683.jpg\" alt=\"\">\u003cfigcaption>Kelly Frost and her father’s horse in Douglas City on Dec. 4, 2025. Photo by Salvador Ochoa for CalMatters\u003c/figcaption>\u003c/figure>\n\u003cfigure>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/120425_Trinity-Guns_SO_41-1024x682.jpg\" alt=\"\">\u003c/figure>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/120425_Trinity-Guns_SO_31-1024x701.jpg\" alt=\"\">\u003c/figure>\u003cfigcaption>\u003cstrong>First:\u003c/strong> Kelly Frost points to a photograph of her dad, Jeffrey Butler. \u003cstrong>Last:\u003c/strong> A collection of Jeffrey Butler photographs on a table at Kelly Frost’s home in Douglas City on Dec. 4, 2025. Photos by Salvador Ochoa for CalMatters\u003c/figcaption>\u003c/figure>\n\u003cp>Older adults are likely to plan suicide more carefully, and their attempts are more likely to be fatal, according to the National Council on Aging. In California, older women are more likely to overdose, while most older men will use guns, according to state public health data.\u003c/p>\n\u003cp>Pain and health issues are a common thread among older adults who die by gun suicide. State data show that 55% of people 70 and over who died this way had a contributing physical health problem, and 27% had a diagnosed mental health condition.\u003c/p>\n\u003cdiv id=\"datawrapper-vis-KyQjs\" style=\"min-height: 539px\">\u003cimg decoding=\"async\" src=\"https://datawrapper.dwcdn.net/KyQjs/full.png\" alt=\"Many older adults who died by gun suicide had a contributing physical health problem (Range Plot)\">\u003c/div>\n\u003cp>Among the eight older men that died by gun suicide in Trinity County between 2020 and 2024, two struggled with respiratory conditions. One had recently discovered a bladder tumor. One man’s antidepressants were found near his body, and another had reportedly been speaking about suicide for some time but did not meet the requirements for an involuntary psychiatric hold, according to incident reports.\u003c/p>\n\u003ch2>The rural divide\u003c/h2>\n\u003cp>Trinity County holds a deep beauty: the rush of the Trinity River, the rising fog on a chilly morning, the sprawling pines that make the rugged mountain sides their home.\u003c/p>\n\u003cp>But large supermarkets are a county over, a steep and twisty road away. And so is most of the medical care.\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/120425_Trinity-Guns_SO_05-1024x683.jpg\" alt=\"\">\u003cfigcaption>Clouds sweep the sky in Trinity County on Dec. 4, 2025. Photo by Salvador Ochoa for CalMatters\u003c/figcaption>\u003c/figure>\n\u003cp>“We have more limited access to essential services and resources compared to the rest of California,” said Cathy Tillman, a health services program manager at Trinity County Health and Human Services. “We have to travel further for all services, which plays a role in the ability for people to get their needs met.”\u003c/p>\n\u003cp>California’s rural counties have more older residents: about 25% compared to the state average of around 17%, according to the SCAN Foundation, an advocacy and research organization for older adults. By 2040, the 85-and-older population in rural California is \u003ca href=\"https://www.thescanfoundation.org/resource/aging-in-rural-california-policy-brief-series-on-long-term-care-health-and-housing/\">expected to grow 50 times faster\u003c/a> than the working age population. But access to medical and social services for seniors lag significantly when compared to larger, urban regions.\u003c/p>\n\u003cp>Trinity County has one 25-bed hospital, and a handful of clinics, largely in Weaverville, the county seat. But even reaching Weaverville from other Trinity County communities could take 30 minutes to an hour. For anything more specialized, residents here usually travel an hour to Redding, or two hours for providers in Eureka and Chico. With a small population, Trinity County can’t easily support specialists — like a neurologist or urologist — setting up practice.\u003c/p>\n\u003cp>Going further for care means people often miss appointments, or delay them, and live longer with pain.\u003c/p>\n\u003cp>Arina Erwin, deputy director of the county’s health and human services agency, said even some general practitioners who come to Trinity don’t stay long.\u003c/p>\n\u003cp>“Living in a small community and a frontier community can be a challenge on its own,” Erwin said. Doctors and specialists have student loans to repay, making cities where they can earn a significantly higher income seem more attractive. For years, the hospital and clinics in Trinity have \u003ca href=\"https://krcrtv.com/news/local/trinity-hospital-in-decade-long-struggle-to-hire-doctors\">reported trouble replacing retiring doctors\u003c/a>. Even virtual care here can be a challenge, because broadband is spotty, especially in pockets with only a few dozen residents, Erwin said.\u003c/p>\n\u003cp>People who live in rural areas also foster a cultural barrier — a rural spirit of sorts. Tillman said they tend to be more independent, and used to doing things on their own terms; they may also be less likely to seek help.\u003c/p>\n\u003cp>Frost said that sounds familiar. She saw first-hand how her proud, self-reliant, sometimes stubborn father lost his independence as the pain took hold.\u003c/p>\n\u003ch2>Remembering Papa\u003c/h2>\n\u003cp>In Frost’s living room – with the sun shining through the large windows on a December afternoon – memories of Butler, called Papa by his grandkids, stirred both laughter and tears.\u003c/p>\n\u003cfigure>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/120425_Trinity-Guns_SO_19-1024x683.jpg\" alt=\"\">\u003c/figure>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/120425_Trinity-Guns_SO_06-1024x758.jpg\" alt=\"\">\u003c/figure>\u003cfigcaption>\u003cstrong>First:\u003c/strong> A photograph of Jeffrey Butler is displayed next to holiday items at Kelly Frost’s home. \u003cstrong>Last:\u003c/strong> Jake Ritter takes a moment to remember his grandfather, Jeffrey Butler in Douglas City on Dec. 4, 2025. Photos by Salvador Ochoa for CalMatters\u003c/figcaption>\u003c/figure>\n\u003cp>As a kid, grandson Jake Ritter would get up before sunrise to go fishing with his Papa — sometimes begrudgingly — but by lunchtime they’d be happily eating their catch. He remembers cruising on Butler’s riding lawnmower and watching old westerns with him.\u003c/p>\n\u003cp>Ritter and his sister, Michaela, loved listening to his stories, like the time he shot a bobcat as it launched toward him while he was out deer hunting. He had the bobcat stuffed to prove it. Or how, as a teen in San Pablo, Butler chased and tackled a man trying to rob the Lucky store where he worked. The family still has the news clipping.\u003c/p>\n\u003cp>Michaela is glad her papa got to meet her first-born, Blake, and wishes her three-month-old, Daniella, could have as well.\u003c/p>\n\u003cp>Butler’s suicide left his family in turmoil and with so many questions. Ritter felt angry at his papa for the way he decided to go. Why do this on his mom’s birthday? Frost often wonders: What were her dad’s last thoughts?\u003c/p>\n\u003cp>After a suicide, families are more likely to experience a complicated grieving process, with feelings of guilt, confusion, shame, anger and trauma, research shows.\u003c/p>\n\u003cp>In the year since Butler’s death, Frost’s family has largely relied on each other through their grief. Ritter said his anger at his grandfather has subsided; he is now coming to terms with his Papa’s decision.\u003c/p>\n\u003cp>“I’m sad that he didn’t get the help that he needed, and I’m sad that he felt so strongly that this is the road that he chose,” Ritter said.\u003c/p>\n\u003cp>Frost said she gave herself a year to navigate the feelings on her own, but now with the encouragement of friends is considering seeking professional help.\u003c/p>\n\u003ch2>Warning signs and storing guns\u003c/h2>\n\u003cp>In Trinity County, health officials are preparing to launch an injury and suicide prevention program, said Tillman, the county health services program manager. A big component of the county’s strategy will be education to help reduce the stigmas associated with suicide and mental health. Tillman said the plan is to find and train trusted messengers in the small pockets where people live.\u003c/p>\n\u003cp>Dr. Amy Barnhorst, a psychiatrist and associate director of the \u003ca href=\"https://cvp.ucdavis.edu/\">Centers for Violence Prevention\u003c/a> at UC Davis, said that recognizing a sense of independence and self-reliance common to rural communities is essential to prevention programs. Education around safe gun storage is also key, she added.\u003c/p>\n\u003cp>“You can’t discount the fact that having access to a firearm, period, all other things being equal, increases the risk that somebody will die by suicide by a factor of more than three,” Barnhorst said.\u003c/p>\n\u003cp>She helps lead a state-funded curriculum at UC Davis called \u003ca href=\"https://www.bulletpointsproject.org/\">The BulletPoints Project\u003c/a>, which trains health providers on how to identify at-risk patients and speak to them about gun safety.\u003c/p>\n\u003cp>The project also trains people applying for and renewing concealed carry weapon permits. Under state law, that category of gun owners must complete at least an hour of mental health training.\u003c/p>\n\u003cp>The course aims to help these gun owners identify a mental health crisis. People who already own guns – like Jeff Butler – never had to take a course like this.\u003c/p>\n\u003cp>Kelly Frost said she doesn’t know if her dad would have accepted mental health help. It was not something they talked about. His will to live wrestled in the words found in his house, the note she still clings closely to. It ends:\u003c/p>\n\u003cp>What would you do?\u003cbr>\nEnd it???\u003cbr>\nThe pain not life\u003c/p>\n\u003cp>Since her dad’s passing, Frost has had many sleepless nights, pondering questions and thoughts. She feels she tried her best to get him care, but wishes access had been easier. What signs did she miss? But mostly: Why hadn’t she taken away the guns?\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/12/120425_Trinity-Guns_SO_28-1024x683.jpg\" alt=\"\">\u003cfigcaption>Kelly Frost is reflected in a mirror next to Jeffrey Butler’s fishing poles in Douglas City on Dec. 4, 2025. Photo by Salvador Ochoa for CalMatters\u003c/figcaption>\u003c/figure>\n\u003cp>Growing up around guns, it never crossed her mind that her Daddy-o would one day turn his revolver on himself.\u003c/p>\n\u003cp>“Had I known that he was capable of this, I probably would have worked a little harder to make sure that the guns were not accessible,” Frost said.\u003c/p>\n\u003cp>This Dec. 18, the one year anniversary of Butler’s death and Frost’s 60th birthday, she had a shot of Canadian whisky from the last bottle she gave him. His guns are now in a safe.\u003c/p>\n\u003cp>\u003cem>\u003cstrong>If you are having suicidal thoughts, you can get help from the National Suicide Prevention Lifeline by calling 988 or visiting \u003c/strong>\u003c/em>\u003ca href=\"https://suicidepreventionlifeline.org/\">\u003cstrong>\u003cem>https://suicidepreventionlifeline.org\u003c/em>\u003c/strong>\u003c/a>\u003c/p>\n\u003cp>\u003cem>Data shared by the \u003c/em>\u003ca href=\"https://datahub.thetrace.org/dataset/gun-suicides-older-americans/\">\u003cem>Gun Violence Data Hub\u003c/em>\u003c/a>\u003cem> by The Trace. Data analysis and visualizations by Natasha Uzcátegui-Liggett. Additional reporting by Aaron Mendelson. \u003c/em>\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.\u003c/em>\u003c/p>\n\u003cp>\u003cem>This article was \u003ca href=\"https://calmatters.org/health/2025/12/trinity-county-gun-suicide-rural/\">originally published on CalMatters\u003c/a> and was republished under the \u003ca href=\"https://creativecommons.org/licenses/by-nc-nd/4.0/\">Creative Commons Attribution-NonCommercial-NoDerivatives\u003c/a> license.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "south-bay-lawmaker-slams-trump-admins-1-6-million-hepatitis-b-study-in-west-africa",
"title": "South Bay Lawmaker Slams Trump Admin’s $1.6 Million Hepatitis B Study in West Africa",
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"content": "\u003cp>A \u003ca href=\"https://www.kqed.org/news/tag/zoe-lofgren\">Bay Area lawmaker\u003c/a> slammed a Trump administration plan to conduct research on the Hepatitis B vaccine on infants in Guinea-Bissau, where nearly one in five adults lives with the virus.\u003c/p>\n\u003cp> The grant, awarded to a group of Danish scientists with ties to the anti-vaccine movement, will fund a five-year randomized control trial in the West African nation. According to the House Science, Space, and Technology Committee, 14,000 newborns will either receive the vaccine at birth or after a six-week delay to compare health outcomes.\u003c/p>\n\u003cp>South Bay Rep. Zoe Lofgren (D-San José) called the decision to approve the $1.6 million dollar study — which followed the Centers for Disease Control and Prevention rollback of newborn Hepatitis B vaccine recommendations last week — “deplorable” and a “new low.” \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In a statement released Friday, Lofgren alleged the study is being used to promote U.S. Health Secretary Robert F. Kennedy Jr.’s “anti-vaccine agenda.”\u003c/p>\n\u003cp>“To withhold a lifesaving vaccine from babies across the globe to promote your anti-vaccine agenda at home is deplorable,” Lofgren said. “How has it come to this? RFK Jr. must be stopped.”\u003c/p>\n\u003cp>Since 1991, the CDC recommended newborns receive the Hepatitis B vaccine within 24 hours of birth. \u003c/p>\n\u003cfigure id=\"attachment_11901022\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981.jpg\" alt=\"\" width=\"1024\" height=\"683\" class=\"size-full wp-image-11901022\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981.jpg 1024w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981-160x107.jpg 160w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rep. Zoe Lofgren (D-CA) speaks at a news conference at the U.S. Capitol on Sept. 21, 2021 in Washington, DC. \u003ccite>(Kevin Dietsch/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In an email, U.S. Department of Health and Human Services spokesperson Emily G. Hilliard defended the award as an independent study designed to fill “evidence gaps” regarding the “broader health effects” of the vaccine. Hilliard noted that because Guinea-Bissau does not plan to officially introduce the birth dose until 2027, the infants not receiving the shot are still receiving the “current standard of care.”\u003c/p>\n\u003cp>Local medical experts, however, say the science behind the birth dose is already settled. Dr. Jake Scott, an infectious disease specialist at Stanford University, said waiting six weeks to vaccinate newborns in a region where Hepatitis B is common will lead to “preventable infections.”\u003c/p>\n\u003cp>According to Scott, infants infected at birth have about a 90% chance of developing chronic hepatitis, which can lead to liver failure and cancer. He said the administration is attempting to “manufacture doubt” to justify the recent rollbacks.[aside postID=news_12068383 hero='https://ww2.kqed.org/app/uploads/sites/10/2020/04/001_KQED_Oakland_HighlandHospital_041152020-1020x680.jpg']“They’re doing that to generate evidence for a policy they have already implemented,” Scott said. “It’s clearly going to cause far more harm than any benefits.”\u003c/p>\n\u003cp>Scott estimated that if the birth dose is successfully rolled back on a larger scale, it could lead to 1,400 additional chronic pediatric infections and nearly 500 preventable deaths annually.\u003c/p>\n\u003cp>According to background information from the House Science Committee staff, the research group did not apply for an award through a standard competitive process; instead, staff said Kennedy specifically sought out the researchers.\u003c/p>\n\u003cp>“The typical way of going about it is to put out a request for proposal … and fund the most rigorous study,” Arthur Reingold, a former professor of epidemiology at UC Berkeley and a former Chief of the Respiratory Diseases Branch at the CDC, said. “Obviously, that was not done in this case.”\u003c/p>\n\u003cp>Reingold added that without a detailed study protocol, it is impossible to know if the trial can actually measure the “broader health effects” HHS claims to be looking for. He warned that if a study lacks the statistical power to answer important questions, it is a “waste of money.”\u003c/p>\n\u003cp>The House Science Committee stated it is considering all oversight options, though staff noted their authority is currently limited by their status in the Minority.\u003c/p>\n\u003cp>\u003c/p>\n",
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"title": "South Bay Lawmaker Slams Trump Admin’s $1.6 Million Hepatitis B Study in West Africa | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A \u003ca href=\"https://www.kqed.org/news/tag/zoe-lofgren\">Bay Area lawmaker\u003c/a> slammed a Trump administration plan to conduct research on the Hepatitis B vaccine on infants in Guinea-Bissau, where nearly one in five adults lives with the virus.\u003c/p>\n\u003cp> The grant, awarded to a group of Danish scientists with ties to the anti-vaccine movement, will fund a five-year randomized control trial in the West African nation. According to the House Science, Space, and Technology Committee, 14,000 newborns will either receive the vaccine at birth or after a six-week delay to compare health outcomes.\u003c/p>\n\u003cp>South Bay Rep. Zoe Lofgren (D-San José) called the decision to approve the $1.6 million dollar study — which followed the Centers for Disease Control and Prevention rollback of newborn Hepatitis B vaccine recommendations last week — “deplorable” and a “new low.” \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In a statement released Friday, Lofgren alleged the study is being used to promote U.S. Health Secretary Robert F. Kennedy Jr.’s “anti-vaccine agenda.”\u003c/p>\n\u003cp>“To withhold a lifesaving vaccine from babies across the globe to promote your anti-vaccine agenda at home is deplorable,” Lofgren said. “How has it come to this? RFK Jr. must be stopped.”\u003c/p>\n\u003cp>Since 1991, the CDC recommended newborns receive the Hepatitis B vaccine within 24 hours of birth. \u003c/p>\n\u003cfigure id=\"attachment_11901022\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981.jpg\" alt=\"\" width=\"1024\" height=\"683\" class=\"size-full wp-image-11901022\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981.jpg 1024w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/01/GettyImages-1341705981-160x107.jpg 160w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rep. Zoe Lofgren (D-CA) speaks at a news conference at the U.S. Capitol on Sept. 21, 2021 in Washington, DC. \u003ccite>(Kevin Dietsch/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In an email, U.S. Department of Health and Human Services spokesperson Emily G. Hilliard defended the award as an independent study designed to fill “evidence gaps” regarding the “broader health effects” of the vaccine. Hilliard noted that because Guinea-Bissau does not plan to officially introduce the birth dose until 2027, the infants not receiving the shot are still receiving the “current standard of care.”\u003c/p>\n\u003cp>Local medical experts, however, say the science behind the birth dose is already settled. Dr. Jake Scott, an infectious disease specialist at Stanford University, said waiting six weeks to vaccinate newborns in a region where Hepatitis B is common will lead to “preventable infections.”\u003c/p>\n\u003cp>According to Scott, infants infected at birth have about a 90% chance of developing chronic hepatitis, which can lead to liver failure and cancer. He said the administration is attempting to “manufacture doubt” to justify the recent rollbacks.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“They’re doing that to generate evidence for a policy they have already implemented,” Scott said. “It’s clearly going to cause far more harm than any benefits.”\u003c/p>\n\u003cp>Scott estimated that if the birth dose is successfully rolled back on a larger scale, it could lead to 1,400 additional chronic pediatric infections and nearly 500 preventable deaths annually.\u003c/p>\n\u003cp>According to background information from the House Science Committee staff, the research group did not apply for an award through a standard competitive process; instead, staff said Kennedy specifically sought out the researchers.\u003c/p>\n\u003cp>“The typical way of going about it is to put out a request for proposal … and fund the most rigorous study,” Arthur Reingold, a former professor of epidemiology at UC Berkeley and a former Chief of the Respiratory Diseases Branch at the CDC, said. “Obviously, that was not done in this case.”\u003c/p>\n\u003cp>Reingold added that without a detailed study protocol, it is impossible to know if the trial can actually measure the “broader health effects” HHS claims to be looking for. He warned that if a study lacks the statistical power to answer important questions, it is a “waste of money.”\u003c/p>\n\u003cp>The House Science Committee stated it is considering all oversight options, though staff noted their authority is currently limited by their status in the Minority.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>In anticipation of the Trump administration’s \u003ca href=\"https://www.kqed.org/news/12047647/trumps-health-law-spurs-big-medi-cal-changes-what-californians-need-to-know\">major cuts to Medicaid\u003c/a>, \u003ca href=\"https://www.kqed.org/healthnews\">the Alameda Health System\u003c/a>, which runs public hospitals and clinics throughout the East Bay, is planning to lay off nearly 300 people in January.\u003c/p>\n\u003cp>It’s one of many healthcare systems around the state and nation threatened as a result of significant expected losses in revenue from Medicaid, the nation’s insurance system for lower-income people, known as Medi-Cal in California. \u003c/p>\n\u003cp>However, some union employees of the health system have said layoff notices, which are expected on Jan. 6, are premature, as the financial impacts of the cuts have yet to be felt. \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I think they’re bowing to pressures before those pressures have actually come into play,” Reilly Gardine, a clinical dietitian at Wilma Chan Highland Hospital Campus in Oakland, told KQED on Monday. “And I think they’re not being creative enough in figuring out alternative ways for funding.”\u003c/p>\n\u003cp>The health system, in an emailed statement to KQED, said it expects to lose “more than $100 million annually by 2030,” due to H.R. 1, the tax and spending bill President Donald Trump refers to as “Big” and “Beautiful.”\u003c/p>\n\u003cfigure id=\"attachment_11891411\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1.jpg\" alt=\"\" width=\"1920\" height=\"1280\" class=\"size-full wp-image-11891411\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Monish Ullal speaks with patient Jay Flohr at Highland Hospital in Oakland on Oct. 6, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The total annual budget for AHS is roughly $1.4 billion, according to its budget documents. The system could face an additional potential $60 million in cuts annually in the coming years due to cuts to federal funding that allows states to pay hospitals who treat a large share of Medi-Cal patients, officials said. \u003c/p>\n\u003cp>“AHS projects that cash will run out by approximately August of 2026 without immediate action,” the statement said. “In order to be proactive and ensure that AHS can continue to provide a range of emergency and comprehensive care, AHS has made the painful decision to reduce some services, reduce its workforce, and eliminate certain programs.”\u003c/p>\n\u003cp>Veronica Palacios, an eligibility specialist, and a chapter leader with labor union SEIU 1021, said workers have not been given a clear reason why the cuts need to be made now. \u003c/p>\n\u003cp>“Because if it’s being done right now and it’s not necessarily needed at this point, it sounds like you’re purposely cutting services to the community. Why do that?” Palacios said.[aside postID=news_12067733 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-1262848052-1020x680.jpg']The cuts were initially planned to go out on Dec. 24, which Gardine called “insulting,” and which Palacios said sows chaos among workers when they should be spending time with family during the holidays. \u003c/p>\n\u003cp>In what appeared to be a response to pressure from union members, the health system said late Monday it would delay the notices until Jan. 6. \u003c/p>\n\u003cp>Palacios said the layoff notices will send workers into “damage-control” mode. \u003c/p>\n\u003cp>“How am I going to support my family, how am I going to survive? Can I get another job if this is happening with our health care system? Is this happening throughout the state of California?” she said, reflecting her colleagues’ concerns. “They’re stressed out, they’re worried, they’re afraid of what the what ifs.” \u003c/p>\n\u003cp>The health system said the 296 people it needs to lay off will be from “departments and disciplines across the system including management, support and administrative services, and clinical care,” and that those that are affected will have access to job search assistance and resume writing guidance. Some will receive severance packages. \u003c/p>\n\u003cp>“AHS leadership continues to pursue multiple strategies to restore funding and strengthen sustainability,” the agency’s statement said. “We are working in partnership with federal, state and county leaders to hopefully mitigate these adverse conditions.”\u003c/p>\n\u003cp>Gardine said before resorting to layoffs, executives at AHS should take pay cuts, and explore other options, such as ending leases at pricey office buildings in downtown and the Jack London areas of Oakland. The system should also consider hiring more permanent staff instead of relying on traveling contractors. \u003c/p>\n\u003cp>“The resources are there, the state of California is an incredibly wealthy state. So, the fact that we are cutting essential services for our most vulnerable communities is completely outrageous,” Gardine said. “I think we have a huge fight ahead and that I think there’s a lot of us who are ready to start fighting.” \u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I think they’re bowing to pressures before those pressures have actually come into play,” Reilly Gardine, a clinical dietitian at Wilma Chan Highland Hospital Campus in Oakland, told KQED on Monday. “And I think they’re not being creative enough in figuring out alternative ways for funding.”\u003c/p>\n\u003cp>The health system, in an emailed statement to KQED, said it expects to lose “more than $100 million annually by 2030,” due to H.R. 1, the tax and spending bill President Donald Trump refers to as “Big” and “Beautiful.”\u003c/p>\n\u003cfigure id=\"attachment_11891411\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1.jpg\" alt=\"\" width=\"1920\" height=\"1280\" class=\"size-full wp-image-11891411\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51824_066_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Monish Ullal speaks with patient Jay Flohr at Highland Hospital in Oakland on Oct. 6, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The total annual budget for AHS is roughly $1.4 billion, according to its budget documents. The system could face an additional potential $60 million in cuts annually in the coming years due to cuts to federal funding that allows states to pay hospitals who treat a large share of Medi-Cal patients, officials said. \u003c/p>\n\u003cp>“AHS projects that cash will run out by approximately August of 2026 without immediate action,” the statement said. “In order to be proactive and ensure that AHS can continue to provide a range of emergency and comprehensive care, AHS has made the painful decision to reduce some services, reduce its workforce, and eliminate certain programs.”\u003c/p>\n\u003cp>Veronica Palacios, an eligibility specialist, and a chapter leader with labor union SEIU 1021, said workers have not been given a clear reason why the cuts need to be made now. \u003c/p>\n\u003cp>“Because if it’s being done right now and it’s not necessarily needed at this point, it sounds like you’re purposely cutting services to the community. Why do that?” Palacios said.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The cuts were initially planned to go out on Dec. 24, which Gardine called “insulting,” and which Palacios said sows chaos among workers when they should be spending time with family during the holidays. \u003c/p>\n\u003cp>In what appeared to be a response to pressure from union members, the health system said late Monday it would delay the notices until Jan. 6. \u003c/p>\n\u003cp>Palacios said the layoff notices will send workers into “damage-control” mode. \u003c/p>\n\u003cp>“How am I going to support my family, how am I going to survive? Can I get another job if this is happening with our health care system? Is this happening throughout the state of California?” she said, reflecting her colleagues’ concerns. “They’re stressed out, they’re worried, they’re afraid of what the what ifs.” \u003c/p>\n\u003cp>The health system said the 296 people it needs to lay off will be from “departments and disciplines across the system including management, support and administrative services, and clinical care,” and that those that are affected will have access to job search assistance and resume writing guidance. Some will receive severance packages. \u003c/p>\n\u003cp>“AHS leadership continues to pursue multiple strategies to restore funding and strengthen sustainability,” the agency’s statement said. “We are working in partnership with federal, state and county leaders to hopefully mitigate these adverse conditions.”\u003c/p>\n\u003cp>Gardine said before resorting to layoffs, executives at AHS should take pay cuts, and explore other options, such as ending leases at pricey office buildings in downtown and the Jack London areas of Oakland. The system should also consider hiring more permanent staff instead of relying on traveling contractors. \u003c/p>\n\u003cp>“The resources are there, the state of California is an incredibly wealthy state. So, the fact that we are cutting essential services for our most vulnerable communities is completely outrageous,” Gardine said. “I think we have a huge fight ahead and that I think there’s a lot of us who are ready to start fighting.” \u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/flu\">Flu\u003c/a> season is back in \u003ca href=\"https://www.kqed.org/news/tag/san-francisco\">San Francisco\u003c/a>.\u003c/p>\n\u003cp>According to data released Wednesday by the city’s Department of Public Health, the rate of tests positive for influenza reached 5% as of Dec. 6.\u003c/p>\n\u003cp>Though cases are still low overall, they are on the rise — and the state’s respiratory virus dashboard indicates hospitalizations are “expected to increase.” Dr. Farrell Tobolowsky, an infectious disease physician for the city’s Public Health Department, said the holidays are prime time for gathering with loved ones and sharing germs.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We suspect that this is definitely a time where there will be risk of transmission. We also know that people gather with people from other parts of the country where flu activity may actually be higher than it is in California at this time,” Tobolowsky said.\u003c/p>\n\u003cp>Earlier this year, the state \u003ca href=\"https://www.kqed.org/news/12028312/californias-worst-flu-season-years-may-finally-easing\">recorded one of its worst flu seasons\u003c/a> on record. Early mild symptoms can include a fever, runny nose, cough, body aches, sore throat or fatigue. More severe symptoms include vomiting and diarrhea.\u003c/p>\n\u003cp>Historically, these seasonal upticks of the flu can last for weeks to months. According to Dr. Tobolowsky, cases are lower than they’ve been at this time of year in the past, meaning the winter flu season could simply be beginning later than expected.[aside postID=news_12027283 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/02/GettyImages-1720991107-1020x680.jpg']Older adults, infants and toddlers, and people with chronic medical conditions are most at-risk for complications associated with the illness.\u003c/p>\n\u003cp>SFDPH recommended the 2025-2026 shot for anyone over six months old who has not already received it. Experts usually suggest that \u003ca href=\"https://www.kqed.org/news/12027283/forgot-your-flu-vaccine-with-historic-infections-its-not-too-late-for-a-shot\">people get their shot in the fall,\u003c/a> ahead of the coming season’s peak. You can find \u003ca href=\"https://www.sf.gov/get-vaccinated-against-covid-19-flu-and-rsv\">access \u003c/a>to a vaccine here, and many local pharmacies accommodate walk-ins.\u003c/p>\n\u003cp>SFDPH also suggests the use of high-quality masks — especially if you’re sick — but also beneficial even when you’re not. KN95 masks have been proven to lower the risk of spreading respiratory illnesses, and all mask types are especially recommended in crowded indoor spaces.\u003c/p>\n\u003cp>And as usual, the SFDPH urges good hygiene practices such as washing your hands frequently with soap and water, and using alcohol-based hand sanitizers.\u003c/p>\n\u003cp>While sick, it’s important to stay home from school or work until symptoms resolve. Being fever-free for 24 hours without fever-reducing medication is a good indicator of when to return to ease back into your typical routine.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/flu\">Flu\u003c/a> season is back in \u003ca href=\"https://www.kqed.org/news/tag/san-francisco\">San Francisco\u003c/a>.\u003c/p>\n\u003cp>According to data released Wednesday by the city’s Department of Public Health, the rate of tests positive for influenza reached 5% as of Dec. 6.\u003c/p>\n\u003cp>Though cases are still low overall, they are on the rise — and the state’s respiratory virus dashboard indicates hospitalizations are “expected to increase.” Dr. Farrell Tobolowsky, an infectious disease physician for the city’s Public Health Department, said the holidays are prime time for gathering with loved ones and sharing germs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We suspect that this is definitely a time where there will be risk of transmission. We also know that people gather with people from other parts of the country where flu activity may actually be higher than it is in California at this time,” Tobolowsky said.\u003c/p>\n\u003cp>Earlier this year, the state \u003ca href=\"https://www.kqed.org/news/12028312/californias-worst-flu-season-years-may-finally-easing\">recorded one of its worst flu seasons\u003c/a> on record. Early mild symptoms can include a fever, runny nose, cough, body aches, sore throat or fatigue. More severe symptoms include vomiting and diarrhea.\u003c/p>\n\u003cp>Historically, these seasonal upticks of the flu can last for weeks to months. According to Dr. Tobolowsky, cases are lower than they’ve been at this time of year in the past, meaning the winter flu season could simply be beginning later than expected.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Older adults, infants and toddlers, and people with chronic medical conditions are most at-risk for complications associated with the illness.\u003c/p>\n\u003cp>SFDPH recommended the 2025-2026 shot for anyone over six months old who has not already received it. Experts usually suggest that \u003ca href=\"https://www.kqed.org/news/12027283/forgot-your-flu-vaccine-with-historic-infections-its-not-too-late-for-a-shot\">people get their shot in the fall,\u003c/a> ahead of the coming season’s peak. You can find \u003ca href=\"https://www.sf.gov/get-vaccinated-against-covid-19-flu-and-rsv\">access \u003c/a>to a vaccine here, and many local pharmacies accommodate walk-ins.\u003c/p>\n\u003cp>SFDPH also suggests the use of high-quality masks — especially if you’re sick — but also beneficial even when you’re not. KN95 masks have been proven to lower the risk of spreading respiratory illnesses, and all mask types are especially recommended in crowded indoor spaces.\u003c/p>\n\u003cp>And as usual, the SFDPH urges good hygiene practices such as washing your hands frequently with soap and water, and using alcohol-based hand sanitizers.\u003c/p>\n\u003cp>While sick, it’s important to stay home from school or work until symptoms resolve. Being fever-free for 24 hours without fever-reducing medication is a good indicator of when to return to ease back into your typical routine.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "sutter-healths-trans-youth-care-hasnt-stopped-parents-say-but-trump-wants-a-ban",
"title": "Sutter Health’s Trans Youth Care Hasn’t Stopped, Parents Say, but Trump Wants a Ban",
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"headTitle": "Sutter Health’s Trans Youth Care Hasn’t Stopped, Parents Say, but Trump Wants a Ban | KQED",
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"content": "\u003cp>After families were informed last month that Sutter Health planned to join a growing list of health care providers \u003ca href=\"https://www.kqed.org/news/12065480/its-just-cruel-bay-area-parents-say-sutter-health-is-set-to-halt-trans-youth-care\">limiting gender-affirming care for minors\u003c/a>, some say the Northern California-based network is reversing course, despite mounting pressure from the federal government.\u003c/p>\n\u003cp>But the temporary reprieve is shaky, according to East Bay mother Nikki, whose 14-year-old son relies on a Sutter doctor for frequent, steady care. The Trump administration on Thursday announced funding restrictions that could effectively \u003ca href=\"https://www.npr.org/sections/shots-health-news/2025/12/18/nx-s1-5647789/transgender-gender-affirming-care-rfk-jr-dr-oz-trump\">halt all pediatric gender-affirming care\u003c/a>, and Nikki worries the move could push Sutter to backtrack — and make it nearly impossible to find a provider.\u003c/p>\n\u003cp>“I’m trying really hard to hold on to the victory of this last week and a half or so that this care has not stopped,” she told KQED. “But that unforeseeable future weighs heavily on my husband and I. We do our best to shelter our children, but this is the world intruding upon our lives and the government trying to make decisions for us.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In November, Nikki, who asked to be identified by only her first name for fear of retribution against her and her son’s caregiver, was informed that his care would be discontinued just weeks later, on Dec. 10. Several other families with transgender children said their doctors had relayed similar messages.\u003c/p>\n\u003cp>But last week, according to Nikki, her son’s doctor said the hospital network appeared to reverse course and would no longer stop offering treatments on that date.\u003c/p>\n\u003cp>In a statement, Sutter said it was working to ensure compliance with recent federal actions affecting gender-affirming care for patients under 19.\u003c/p>\n\u003cfigure id=\"attachment_11980957\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11980957\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">The Sutter Health CPMC Davies Campus in San Francisco on Feb. 8, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Sutter-aligned physicians are engaging directly with their patients to have open and thoughtful conversations and to determine individual care plans that will meet anticipated requirements,” the nonprofit hospital network said, adding that gender-affirming surgeries for young patients had previously ceased. “We continue to support careful, patient-centered discussions with appropriate resources and guidance.”\u003c/p>\n\u003cp>Nikki said she’s still waiting for her son’s future appointments to be rescheduled after they were canceled last month, but she’s heard from other families that they’ve been able to get back on their caregivers’ calendars.\u003c/p>\n\u003cp>Still, she said, the last few weeks have been extremely nerve-wracking as she and other families awaited pending federal policy moves that would essentially ban gender-affirming care for youth, even in states where it’s legal.\u003c/p>\n\u003cp>That came Thursday morning, when Health Secretary Robert F. Kennedy Jr. and Medicaid Administrator Dr. Mehmet Oz announced two new rules.[aside postID=news_12065480 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/20250725_KaiserTransProtest_GC-1_qed.jpg']The first would prevent hospitals and doctors from receiving Medicaid reimbursements for gender-affirming care for children. Medicaid offers health coverage to millions of low-income Americans. The second would go further, blocking all funding from Medicaid and Medicare, which covers older people and those with disabilities, for medical centers that provide gender-affirming care to youth.\u003c/p>\n\u003cp>Hospitals rely heavily on Medicaid and Medicare funding to operate — combined, the two federal programs covered about 45% of spending on hospital care in 2023, \u003ca href=\"https://www.kff.org/health-costs/key-facts-about-hospitals/?entry=national-hospital-spending-spending-by-payer\">according to the health policy research organization KFF\u003c/a>.\u003c/p>\n\u003cp>The proposed rules have to go through a 60-day period during which the public can weigh in, and they are likely to face legal challenges; the American Civil Liberties Union has already said it plans to sue.\u003c/p>\n\u003cp>If they’re finalized, though, Nikki worries that it will become nearly impossible to find a doctor who offers the care her son needs.\u003c/p>\n\u003cp>“Then what am I going to do to find a physician? Who are those physicians?” Nikki asked.\u003c/p>\n\u003cp>That’s because other major networks have already moved to limit gender-affirming care in light of the Trump administration’s crackdown. In June, Stanford Medicine paused gender-affirming surgeries and stopped providing prescriptions for puberty blockers to young people, and Kaiser Permanente halted surgical care in July.\u003c/p>\n\u003cfigure id=\"attachment_12049926\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12049926\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/20250725_KaiserTransProtest_GC-31_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/20250725_KaiserTransProtest_GC-31_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/20250725_KaiserTransProtest_GC-31_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/20250725_KaiserTransProtest_GC-31_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Calder Storm waves a transgender flag at a rally and vigil, honoring transgender patients affected by Kaiser’s decision to halt gender-affirming care to minors, outside of Kaiser Permanente on July 25, 2025. \u003ccite>(Gina Castro/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nikki called the president’s efforts to withhold funding from caregivers who provide gender affirming care “financial sabotage.”\u003c/p>\n\u003cp>“It’s terrifying,” she said. “It feels completely helpless and hopeless.”\u003c/p>\n\u003cp>She’s been searching for a new provider who doesn’t rely on federal funding since the initial word last month from her Sutter doctor, but she hasn’t found one yet. The threat that her son’s care could be stopped with just days or weeks of notice is especially worrisome, she said, because of how time sensitive it is.\u003c/p>\n\u003cp>He takes a weekly testosterone shot, which has to be picked up one dose at a time, and re-prescribed every six months, due to their insurance coverage.\u003c/p>\n\u003cp>Right now, he’s out of refills. He’s still within his normal dose cycle, Nikki said, but if he’s unable to get a new prescription within days and falls behind, the effects will be pretty immediately noticeable.\u003c/p>\n\u003cp>While she thinks he’ll be able to see his Sutter caregiver for a prescription this time, if that option goes away in the future, “I’m, for lack of a word, shit out of luck,” Nikki said.\u003c/p>\n\u003cp>\u003cem>KQED’s \u003c/em>\u003ca href=\"https://www.kqed.org/author/nnavarro\">\u003cem>Natalia Navarro\u003c/em>\u003c/a>\u003cem> contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"title": "Sutter Health’s Trans Youth Care Hasn’t Stopped, Parents Say, but Trump Wants a Ban | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>After families were informed last month that Sutter Health planned to join a growing list of health care providers \u003ca href=\"https://www.kqed.org/news/12065480/its-just-cruel-bay-area-parents-say-sutter-health-is-set-to-halt-trans-youth-care\">limiting gender-affirming care for minors\u003c/a>, some say the Northern California-based network is reversing course, despite mounting pressure from the federal government.\u003c/p>\n\u003cp>But the temporary reprieve is shaky, according to East Bay mother Nikki, whose 14-year-old son relies on a Sutter doctor for frequent, steady care. The Trump administration on Thursday announced funding restrictions that could effectively \u003ca href=\"https://www.npr.org/sections/shots-health-news/2025/12/18/nx-s1-5647789/transgender-gender-affirming-care-rfk-jr-dr-oz-trump\">halt all pediatric gender-affirming care\u003c/a>, and Nikki worries the move could push Sutter to backtrack — and make it nearly impossible to find a provider.\u003c/p>\n\u003cp>“I’m trying really hard to hold on to the victory of this last week and a half or so that this care has not stopped,” she told KQED. “But that unforeseeable future weighs heavily on my husband and I. We do our best to shelter our children, but this is the world intruding upon our lives and the government trying to make decisions for us.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In November, Nikki, who asked to be identified by only her first name for fear of retribution against her and her son’s caregiver, was informed that his care would be discontinued just weeks later, on Dec. 10. Several other families with transgender children said their doctors had relayed similar messages.\u003c/p>\n\u003cp>But last week, according to Nikki, her son’s doctor said the hospital network appeared to reverse course and would no longer stop offering treatments on that date.\u003c/p>\n\u003cp>In a statement, Sutter said it was working to ensure compliance with recent federal actions affecting gender-affirming care for patients under 19.\u003c/p>\n\u003cfigure id=\"attachment_11980957\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11980957\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240208-HospitalViolence-11-BL_qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">The Sutter Health CPMC Davies Campus in San Francisco on Feb. 8, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Sutter-aligned physicians are engaging directly with their patients to have open and thoughtful conversations and to determine individual care plans that will meet anticipated requirements,” the nonprofit hospital network said, adding that gender-affirming surgeries for young patients had previously ceased. “We continue to support careful, patient-centered discussions with appropriate resources and guidance.”\u003c/p>\n\u003cp>Nikki said she’s still waiting for her son’s future appointments to be rescheduled after they were canceled last month, but she’s heard from other families that they’ve been able to get back on their caregivers’ calendars.\u003c/p>\n\u003cp>Still, she said, the last few weeks have been extremely nerve-wracking as she and other families awaited pending federal policy moves that would essentially ban gender-affirming care for youth, even in states where it’s legal.\u003c/p>\n\u003cp>That came Thursday morning, when Health Secretary Robert F. Kennedy Jr. and Medicaid Administrator Dr. Mehmet Oz announced two new rules.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The first would prevent hospitals and doctors from receiving Medicaid reimbursements for gender-affirming care for children. Medicaid offers health coverage to millions of low-income Americans. The second would go further, blocking all funding from Medicaid and Medicare, which covers older people and those with disabilities, for medical centers that provide gender-affirming care to youth.\u003c/p>\n\u003cp>Hospitals rely heavily on Medicaid and Medicare funding to operate — combined, the two federal programs covered about 45% of spending on hospital care in 2023, \u003ca href=\"https://www.kff.org/health-costs/key-facts-about-hospitals/?entry=national-hospital-spending-spending-by-payer\">according to the health policy research organization KFF\u003c/a>.\u003c/p>\n\u003cp>The proposed rules have to go through a 60-day period during which the public can weigh in, and they are likely to face legal challenges; the American Civil Liberties Union has already said it plans to sue.\u003c/p>\n\u003cp>If they’re finalized, though, Nikki worries that it will become nearly impossible to find a doctor who offers the care her son needs.\u003c/p>\n\u003cp>“Then what am I going to do to find a physician? Who are those physicians?” Nikki asked.\u003c/p>\n\u003cp>That’s because other major networks have already moved to limit gender-affirming care in light of the Trump administration’s crackdown. In June, Stanford Medicine paused gender-affirming surgeries and stopped providing prescriptions for puberty blockers to young people, and Kaiser Permanente halted surgical care in July.\u003c/p>\n\u003cfigure id=\"attachment_12049926\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12049926\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/20250725_KaiserTransProtest_GC-31_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/20250725_KaiserTransProtest_GC-31_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/20250725_KaiserTransProtest_GC-31_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/20250725_KaiserTransProtest_GC-31_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Calder Storm waves a transgender flag at a rally and vigil, honoring transgender patients affected by Kaiser’s decision to halt gender-affirming care to minors, outside of Kaiser Permanente on July 25, 2025. \u003ccite>(Gina Castro/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nikki called the president’s efforts to withhold funding from caregivers who provide gender affirming care “financial sabotage.”\u003c/p>\n\u003cp>“It’s terrifying,” she said. “It feels completely helpless and hopeless.”\u003c/p>\n\u003cp>She’s been searching for a new provider who doesn’t rely on federal funding since the initial word last month from her Sutter doctor, but she hasn’t found one yet. The threat that her son’s care could be stopped with just days or weeks of notice is especially worrisome, she said, because of how time sensitive it is.\u003c/p>\n\u003cp>He takes a weekly testosterone shot, which has to be picked up one dose at a time, and re-prescribed every six months, due to their insurance coverage.\u003c/p>\n\u003cp>Right now, he’s out of refills. He’s still within his normal dose cycle, Nikki said, but if he’s unable to get a new prescription within days and falls behind, the effects will be pretty immediately noticeable.\u003c/p>\n\u003cp>While she thinks he’ll be able to see his Sutter caregiver for a prescription this time, if that option goes away in the future, “I’m, for lack of a word, shit out of luck,” Nikki said.\u003c/p>\n\u003cp>\u003cem>KQED’s \u003c/em>\u003ca href=\"https://www.kqed.org/author/nnavarro\">\u003cem>Natalia Navarro\u003c/em>\u003c/a>\u003cem> contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"title": "Doctors Petition California to Ban Countertop Material Linked to Deadly Disease",
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"content": "\u003cp>A medical association has petitioned California to prohibit the use of a \u003ca href=\"https://www.kqed.org/news/12064693/california-doctors-urge-ban-on-engineered-stone-as-silicosis-cases-surge\">popular countertop construction material\u003c/a> linked to an aggressive lung disease disabling and killing stoneworkers. The campaign escalated pressure on the state to follow Australia, which became the first country to ban engineered stone last year after facing a similar health crisis.\u003c/p>\n\u003cp>California has the U.S.’s strictest regulations to prevent workers from inhaling toxic silica dust — generated by the cutting, polishing and grinding of engineered stone slabs to make kitchen countertops, bathroom vanities, fireplace surfaces and other products. Most countertop fabrication shops, however, don’t have the money or capacity to comply with the rules, leaving thousands of stonecutters at risk of contracting silicosis, according to the Western Occupational & Environmental Medical Association.\u003c/p>\n\u003cp>“The evidence is now clear that engineered stone containing crystalline silica is too toxic to fabricate and install safely, and education and enforcement alone will not be sufficient to curtail the escalating occupational health emergency caused by this product,” WOEMA’s Dec. 12 letter to regulators said. The association represents more than 600 occupational safety physicians and other experts in seven western states.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The doctors requested that the state body that adopts new job safety rules to start the process to ban all fabrication and installation tasks on engineered stone containing more than 1% crystalline silica, similar to Australia’s policy.\u003c/p>\n\u003cp>The Occupational Safety and Health Standards Board, which declined to comment on WOEMA’s letter, has up to six months to review and decide. The proposal is likely to face stiff opposition from manufacturers, distributors and fabricators of engineered stone, also known as quartz or artificial stone.\u003c/p>\n\u003cp>Artificial stone represents a growing multibillion-dollar market in the U.S., with increasing demand expected in California due to the rebuilding effort in Los Angeles after the massive fires in January 2025. More than half of the silicosis cases in the state are located in Los Angeles County.\u003c/p>\n\u003cfigure id=\"attachment_12033047\" class=\"wp-caption aligncenter\" style=\"max-width: 1999px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12033047\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/231017-StonecutterSilicosis-002-BL_qed.jpg\" alt=\"\" width=\"1999\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/231017-StonecutterSilicosis-002-BL_qed.jpg 1999w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/231017-StonecutterSilicosis-002-BL_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/231017-StonecutterSilicosis-002-BL_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/231017-StonecutterSilicosis-002-BL_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/231017-StonecutterSilicosis-002-BL_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/231017-StonecutterSilicosis-002-BL_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 1999px) 100vw, 1999px\">\u003cfigcaption class=\"wp-caption-text\">A stone fabricator places his hand on a table that he cut at his home in San Francisco on Oct. 17, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Laurie Weber, who directs the International Surface Fabricators Association, said Australia’s model is not directly transferable to the U.S. economy, and that more research is needed to understand what would happen if hundreds of small and mid-size fabrication businesses suddenly had to stop working with their primary material.\u003c/p>\n\u003cp>“ISFA does not believe a ban is the answer. The problem is not the material. The problem is employers ignoring the law and a lack of enforcement resources to ensure compliance,” Weber said in a statement. “Before California considers a prohibition that would reshape an entire segment of the construction economy, we respectfully request clarity on how WOEMA determined that engineered stone cannot be fabricated safely — even in shops fully compliant with Cal/OSHA’s existing silica standard.”\u003c/p>\n\u003cp>ISFA and others in the industry instead support a licensing program, in which only shops certified to handle artificial stone following regulations have access to it. A \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202520260SB20\">recent law\u003c/a> signed by Gov. Gavin Newsom that addresses the rise of silicosis through education and enforcement initially included a certification system — but that component was removed from the final draft.\u003c/p>\n\u003cp>About 450 silicosis cases have been \u003ca href=\"https://www.cdph.ca.gov/Programs/CCDPHP/DEODC/OHB/Pages/essdashboard.aspx\">confirmed\u003c/a> among stoneworkers in California since 2019, and regulators expect the numbers could rise to between 1,000 and 1,500 within the next decade. Nearly all of those sick are Latino men, many immigrants lacking permanent legal status, who didn’t know about the hazards of working on crystalline silica products. Twenty-five stoneworkers died, and dozens received lung transplants, according to the California Department of Public Health.[aside postID=news_12064693 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/251115-DEADLY-LUNG-DISEASE-MD-01-KQED-1.jpg']\u003c/p>\n\u003cp>“As long as this dangerous material remains available and is purchased and used in California, it’s inevitable that people will continue to be exposed and die,” Robert Blink, an occupational medicine doctor in San Francisco and former WOEMA president, told KQED. “There’s always resistance to change. But when you’ve got something this dangerous out there that’s literally killing people … we’ve got to stop this from going up. This is not a time for small measures, frankly.”\u003c/p>\n\u003cp>Engineered stone can contain more than 90% crystalline silica, much more than natural stones such as marble. The factory-made material’s popularity has skyrocketed because it is stain-resistant, produced in attractive colors and designs and is often cheaper than natural stones. But many consumers are unaware of the hazards that artificial stone dust poses to the workers who shape and install their countertops.\u003c/p>\n\u003cp>Growing scientific evidence has shown that the silica dust released by the material is so toxic that small amounts of exposure are enough to make workers sick. The tiny airborne particles can penetrate filter masks and lodge in the lungs, causing progressive scarring and injury in workers, some as young as their 20s.\u003c/p>\n\u003cp>Dozens of silicosis cases have also been reported by doctors in Illinois, Utah, Colorado, Massachusetts, as well as other states that are not tracking the disease as systematically as California’s public health authorities. Those figures are widely believed to be underreported. Israel, Spain and other countries have also seen a surge in silicosis tied to engineered stone. Medical experts in the UK are urging authorities to prohibit the use of the material.\u003c/p>\n\u003cp>James Nevin, an attorney at Brayton Purcell, a firm that represents hundreds of sick workers suing major manufacturers and distributors of artificial stone, said clients are located in 16 other states, including New York, Nevada, Florida, Kentucky and Hawaii.\u003c/p>\n\u003cfigure id=\"attachment_12033303\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12033303\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/StonecutterGetty.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/StonecutterGetty.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/StonecutterGetty-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/StonecutterGetty-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/StonecutterGetty-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/StonecutterGetty-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/StonecutterGetty-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A stone countertop fabricator’s hands are covered in dust at a shop on Oct. 31, 2023, in Sun Valley, California. Inhaling fine particles can contribute to silicosis. \u003ccite>(Brian van der Brug/Los Angeles Times via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>California currently bans the dry cutting of engineered stone and mandates the use of wet methods — machines that submerge or cover the material’s surface with water to suppress dust. Employers are also required to implement local exhaust ventilation, ensure employees wear powered air-purifying respirators and take other measures.\u003c/p>\n\u003cp>But Cal/OSHA inspectors have found most of the 120 shops they’ve visited in the last two years were violating the rules, which fabricators and doctors consider too expensive and challenging for many employers to follow. California has about 4,600 countertop fabrication workers.\u003c/p>\n\u003cp>Major manufacturers, such as Israel-based Caesarstone, did not immediately return requests for comment on the California ban proposal, but publicly opposed a prohibition in Australia. A spokesperson for Cosentino, a company headquartered in Spain, also declined to comment, but told KQED last month that silicosis is preventable when proper safety and health measures are in place to protect workers.\u003c/p>\n\u003cp>Both companies, which face hundreds of lawsuits by workers claiming silica-related injuries in the U.S. and other countries, have developed crystalline silica-free products for the Australian market but continue to sell high-silica engineered stone in the U.S.[aside postID=news_12066901 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/251115-DEADLY-LUNG-DISEASE-MD-04-KQED-2.jpg']\u003c/p>\n\u003cp>Doctors who’ve followed the issue argue that the safer alternatives have similar qualities, appearance and cost to traditional engineered stone and could be made immediately available in California, without significant economic consequences for fabrication businesses.\u003c/p>\n\u003cp>Policymakers have publicly expressed dismay at the rising number of silicosis cases in the state, but have not favored a prohibition so far. Occupational Safety and Health Standards Board Chair Joseph Alioto Jr. said that the state should focus its resources on expanding Cal/OSHA enforcement of current silica regulations. Alioto recommended the agency partner with local public health departments and district attorneys to assist with investigations.\u003c/p>\n\u003cp>“We currently have a regulation to do stuff. We just need to get out into the field and do it,” said Alioto, an attorney in San Francisco, during a Nov. 20 meeting. “We just need boots on the ground to police this.”\u003c/p>\n\u003cp>Newsom’s office declined to comment on his stance on a ban on artificial stone, referring questions to the Public Health Department. An agency spokesperson said that they are tracking the silicosis situation closely.\u003c/p>\n\u003cp>Lopez, a 43-year-old former stonecutter who was diagnosed with silicosis last year, said he believes removing hazardous artificial stone from fabrication shops could save lives. The once-active father of four is now confined to his East Bay home, waiting for a double lung transplant, unable to work and reliant on an oxygen supply machine to breathe.\u003c/p>\n\u003cp>“If I’d known about the seriousness of this disease from the beginning, I wouldn’t have worked in this field, in the stone industry, because I wouldn’t have wanted to get sick like I am now,” said Lopez, an immigrant who lacks permanent legal status, who cut countertops in California for decades. KQED is withholding his full name because he fears losing medical care if federal authorities arrest him.\u003c/p>\n\u003cp>“If they have the possibility of selling other products that contain zero silica, that would be better, so that people don’t get sick,” he said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A medical association has petitioned California to prohibit the use of a \u003ca href=\"https://www.kqed.org/news/12064693/california-doctors-urge-ban-on-engineered-stone-as-silicosis-cases-surge\">popular countertop construction material\u003c/a> linked to an aggressive lung disease disabling and killing stoneworkers. The campaign escalated pressure on the state to follow Australia, which became the first country to ban engineered stone last year after facing a similar health crisis.\u003c/p>\n\u003cp>California has the U.S.’s strictest regulations to prevent workers from inhaling toxic silica dust — generated by the cutting, polishing and grinding of engineered stone slabs to make kitchen countertops, bathroom vanities, fireplace surfaces and other products. Most countertop fabrication shops, however, don’t have the money or capacity to comply with the rules, leaving thousands of stonecutters at risk of contracting silicosis, according to the Western Occupational & Environmental Medical Association.\u003c/p>\n\u003cp>“The evidence is now clear that engineered stone containing crystalline silica is too toxic to fabricate and install safely, and education and enforcement alone will not be sufficient to curtail the escalating occupational health emergency caused by this product,” WOEMA’s Dec. 12 letter to regulators said. The association represents more than 600 occupational safety physicians and other experts in seven western states.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The doctors requested that the state body that adopts new job safety rules to start the process to ban all fabrication and installation tasks on engineered stone containing more than 1% crystalline silica, similar to Australia’s policy.\u003c/p>\n\u003cp>The Occupational Safety and Health Standards Board, which declined to comment on WOEMA’s letter, has up to six months to review and decide. The proposal is likely to face stiff opposition from manufacturers, distributors and fabricators of engineered stone, also known as quartz or artificial stone.\u003c/p>\n\u003cp>Artificial stone represents a growing multibillion-dollar market in the U.S., with increasing demand expected in California due to the rebuilding effort in Los Angeles after the massive fires in January 2025. More than half of the silicosis cases in the state are located in Los Angeles County.\u003c/p>\n\u003cfigure id=\"attachment_12033047\" class=\"wp-caption aligncenter\" style=\"max-width: 1999px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12033047\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/231017-StonecutterSilicosis-002-BL_qed.jpg\" alt=\"\" width=\"1999\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/231017-StonecutterSilicosis-002-BL_qed.jpg 1999w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/231017-StonecutterSilicosis-002-BL_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/231017-StonecutterSilicosis-002-BL_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/231017-StonecutterSilicosis-002-BL_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/231017-StonecutterSilicosis-002-BL_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/231017-StonecutterSilicosis-002-BL_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 1999px) 100vw, 1999px\">\u003cfigcaption class=\"wp-caption-text\">A stone fabricator places his hand on a table that he cut at his home in San Francisco on Oct. 17, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Laurie Weber, who directs the International Surface Fabricators Association, said Australia’s model is not directly transferable to the U.S. economy, and that more research is needed to understand what would happen if hundreds of small and mid-size fabrication businesses suddenly had to stop working with their primary material.\u003c/p>\n\u003cp>“ISFA does not believe a ban is the answer. The problem is not the material. The problem is employers ignoring the law and a lack of enforcement resources to ensure compliance,” Weber said in a statement. “Before California considers a prohibition that would reshape an entire segment of the construction economy, we respectfully request clarity on how WOEMA determined that engineered stone cannot be fabricated safely — even in shops fully compliant with Cal/OSHA’s existing silica standard.”\u003c/p>\n\u003cp>ISFA and others in the industry instead support a licensing program, in which only shops certified to handle artificial stone following regulations have access to it. A \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202520260SB20\">recent law\u003c/a> signed by Gov. Gavin Newsom that addresses the rise of silicosis through education and enforcement initially included a certification system — but that component was removed from the final draft.\u003c/p>\n\u003cp>About 450 silicosis cases have been \u003ca href=\"https://www.cdph.ca.gov/Programs/CCDPHP/DEODC/OHB/Pages/essdashboard.aspx\">confirmed\u003c/a> among stoneworkers in California since 2019, and regulators expect the numbers could rise to between 1,000 and 1,500 within the next decade. Nearly all of those sick are Latino men, many immigrants lacking permanent legal status, who didn’t know about the hazards of working on crystalline silica products. Twenty-five stoneworkers died, and dozens received lung transplants, according to the California Department of Public Health.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“As long as this dangerous material remains available and is purchased and used in California, it’s inevitable that people will continue to be exposed and die,” Robert Blink, an occupational medicine doctor in San Francisco and former WOEMA president, told KQED. “There’s always resistance to change. But when you’ve got something this dangerous out there that’s literally killing people … we’ve got to stop this from going up. This is not a time for small measures, frankly.”\u003c/p>\n\u003cp>Engineered stone can contain more than 90% crystalline silica, much more than natural stones such as marble. The factory-made material’s popularity has skyrocketed because it is stain-resistant, produced in attractive colors and designs and is often cheaper than natural stones. But many consumers are unaware of the hazards that artificial stone dust poses to the workers who shape and install their countertops.\u003c/p>\n\u003cp>Growing scientific evidence has shown that the silica dust released by the material is so toxic that small amounts of exposure are enough to make workers sick. The tiny airborne particles can penetrate filter masks and lodge in the lungs, causing progressive scarring and injury in workers, some as young as their 20s.\u003c/p>\n\u003cp>Dozens of silicosis cases have also been reported by doctors in Illinois, Utah, Colorado, Massachusetts, as well as other states that are not tracking the disease as systematically as California’s public health authorities. Those figures are widely believed to be underreported. Israel, Spain and other countries have also seen a surge in silicosis tied to engineered stone. Medical experts in the UK are urging authorities to prohibit the use of the material.\u003c/p>\n\u003cp>James Nevin, an attorney at Brayton Purcell, a firm that represents hundreds of sick workers suing major manufacturers and distributors of artificial stone, said clients are located in 16 other states, including New York, Nevada, Florida, Kentucky and Hawaii.\u003c/p>\n\u003cfigure id=\"attachment_12033303\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12033303\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/StonecutterGetty.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/StonecutterGetty.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/StonecutterGetty-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/StonecutterGetty-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/StonecutterGetty-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/StonecutterGetty-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/StonecutterGetty-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A stone countertop fabricator’s hands are covered in dust at a shop on Oct. 31, 2023, in Sun Valley, California. Inhaling fine particles can contribute to silicosis. \u003ccite>(Brian van der Brug/Los Angeles Times via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>California currently bans the dry cutting of engineered stone and mandates the use of wet methods — machines that submerge or cover the material’s surface with water to suppress dust. Employers are also required to implement local exhaust ventilation, ensure employees wear powered air-purifying respirators and take other measures.\u003c/p>\n\u003cp>But Cal/OSHA inspectors have found most of the 120 shops they’ve visited in the last two years were violating the rules, which fabricators and doctors consider too expensive and challenging for many employers to follow. California has about 4,600 countertop fabrication workers.\u003c/p>\n\u003cp>Major manufacturers, such as Israel-based Caesarstone, did not immediately return requests for comment on the California ban proposal, but publicly opposed a prohibition in Australia. A spokesperson for Cosentino, a company headquartered in Spain, also declined to comment, but told KQED last month that silicosis is preventable when proper safety and health measures are in place to protect workers.\u003c/p>\n\u003cp>Both companies, which face hundreds of lawsuits by workers claiming silica-related injuries in the U.S. and other countries, have developed crystalline silica-free products for the Australian market but continue to sell high-silica engineered stone in the U.S.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Doctors who’ve followed the issue argue that the safer alternatives have similar qualities, appearance and cost to traditional engineered stone and could be made immediately available in California, without significant economic consequences for fabrication businesses.\u003c/p>\n\u003cp>Policymakers have publicly expressed dismay at the rising number of silicosis cases in the state, but have not favored a prohibition so far. Occupational Safety and Health Standards Board Chair Joseph Alioto Jr. said that the state should focus its resources on expanding Cal/OSHA enforcement of current silica regulations. Alioto recommended the agency partner with local public health departments and district attorneys to assist with investigations.\u003c/p>\n\u003cp>“We currently have a regulation to do stuff. We just need to get out into the field and do it,” said Alioto, an attorney in San Francisco, during a Nov. 20 meeting. “We just need boots on the ground to police this.”\u003c/p>\n\u003cp>Newsom’s office declined to comment on his stance on a ban on artificial stone, referring questions to the Public Health Department. An agency spokesperson said that they are tracking the silicosis situation closely.\u003c/p>\n\u003cp>Lopez, a 43-year-old former stonecutter who was diagnosed with silicosis last year, said he believes removing hazardous artificial stone from fabrication shops could save lives. The once-active father of four is now confined to his East Bay home, waiting for a double lung transplant, unable to work and reliant on an oxygen supply machine to breathe.\u003c/p>\n\u003cp>“If I’d known about the seriousness of this disease from the beginning, I wouldn’t have worked in this field, in the stone industry, because I wouldn’t have wanted to get sick like I am now,” said Lopez, an immigrant who lacks permanent legal status, who cut countertops in California for decades. KQED is withholding his full name because he fears losing medical care if federal authorities arrest him.\u003c/p>\n\u003cp>“If they have the possibility of selling other products that contain zero silica, that would be better, so that people don’t get sick,” he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "CDPH: Don’t Eat This Brand of ‘Magic Mushroom’ Gummies, Chocolates and Syrups",
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"content": "\u003cp>The \u003ca href=\"https://www.kqed.org/news/tag/california-department-of-public-health\">California Department of Public Health\u003c/a> on Thursday warned residents not to use a line of “magic mushroom” products sold online and at smoke shops throughout the state, which they’ve determined contain illegal and dangerous psychedelic compounds.\u003c/p>\n\u003cp>The state agency said they’ve discovered that some of the mushroom chocolate bars, syrups and gummies made by TRE House, a Los Angeles-based company that also makes THC and hemp “recreational products,” contain an equivalent of the illegal psychedelic psilocin.\u003c/p>\n\u003cp>“These food products have the potential to cause severe adverse health effects, including hospitalization and even death,” CDPH said in a statement. “The risk of misuse, overuse, or negative interactions with other medications is high, especially without oversight or consultation with medical professionals.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>While psychedelics have been decriminalized in two states and \u003ca href=\"https://www.kqed.org/news/11752455/oakland-becomes-second-u-s-city-to-legalize-magic-mushrooms\">some California cities\u003c/a>, and there’s growing momentum to widen \u003ca href=\"https://www.kqed.org/science/1982857/magic-mushrooms-may-treat-depression-but-hurdles-to-psilocybin-access-abound\">medical\u003c/a> and \u003ca href=\"https://www.gq-magazine.co.uk/lifestyle/article/magic-mushroom-the-great-shroom-boom\">recreational use\u003c/a>, so-called “magic mushrooms,” and their synthetic variants, remain illegal.\u003c/p>\n\u003cp>TRE House’s line of mushroom products, which they say “may cause psychotropic effects,” contains a “Magic Mushroom Microdose Blend” and “Proprietary Nootropic Mushroom Blend.” The ingredients listed online for its magic mushroom gummies don’t include psychedelics, but include a form of gabapentin, along with a variety of mushrooms that could be found in most health food stores, like lion’s mane, chaga and cordyceps.\u003c/p>\n\u003cfigure id=\"attachment_12066862\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12066862\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/TRE-House-1-scaled-e1765498264942.jpeg\" alt=\"\" width=\"2000\" height=\"1061\">\u003cfigcaption class=\"wp-caption-text\">The California Department of Public Health found that TRE House’s Milk Chocolate bar, along with other products, contains illegal and potentially dangerous psychedelic compounds. \u003ccite>(Courtesy of the California Department of Public Health.)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>TRE House’s \u003ca href=\"https://trehouse.com/lab-reports/\">publicly-posted lab reports\u003c/a> from as recently as Dec. 8 say no psilocin and psilocybin, another illegal psychedelic, were detected in mushroom gummies, syrups, chocolates and vapes.\u003c/p>\n\u003cp>But the CDPH said its laboratory testing found that products contained two illegal analogues of psilocin: 4-Acetoxy-DET and 4-Acetoxy-DMT, as well as synthetic mushroom-based psychoactive drugs. The compounds are considered Schedule 1 drugs by the Drug Enforcement Administration.\u003c/p>\n\u003cp>TRE House did not immediately respond to a request for comment.[aside postID=news_12066441 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/LEDE-Amanita-phalloides-Bay-Area-2016-1.jpg']Dr. John Gray, associate director of UC Davis’s Institute for Psychedelics and Neurotherapeutics, said it’s possible that CDPH could be cracking down on TRE House specifically because of their use of artificial compounds, since synthetics are often easier to regulate.\u003c/p>\n\u003cp>Officials said that no illnesses associated with the products have been reported, but that “individuals looking for psychedelic mushroom products for therapeutic effects run the risk of serious or life-threatening illness.”\u003c/p>\n\u003cp>The packaging of the products as syrups and sweets could also be dangerous for children, who might view them as regular candies and chocolates, according to CDPH.\u003c/p>\n\u003cp>The form can make it easy for children and adults to overdo it: edibles are often dosed by one square of chocolate or a single gummy, compared to a whole bar or bag you might eat as a snack.\u003c/p>\n\u003cp>While many of these products are considered medically safe in small amounts, they can increase heart rate and blood pressure, body temperature and the risk of serotonin syndrome for people on serotonin-based prescription drugs if overused.\u003c/p>\n\u003cp>CDPH said it is investigating TRE House and its manufacturers, and that more than 1,000 lbs of the brand’s products have been destroyed. The company could face civil or criminal penalties pending further investigation.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The \u003ca href=\"https://www.kqed.org/news/tag/california-department-of-public-health\">California Department of Public Health\u003c/a> on Thursday warned residents not to use a line of “magic mushroom” products sold online and at smoke shops throughout the state, which they’ve determined contain illegal and dangerous psychedelic compounds.\u003c/p>\n\u003cp>The state agency said they’ve discovered that some of the mushroom chocolate bars, syrups and gummies made by TRE House, a Los Angeles-based company that also makes THC and hemp “recreational products,” contain an equivalent of the illegal psychedelic psilocin.\u003c/p>\n\u003cp>“These food products have the potential to cause severe adverse health effects, including hospitalization and even death,” CDPH said in a statement. “The risk of misuse, overuse, or negative interactions with other medications is high, especially without oversight or consultation with medical professionals.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>While psychedelics have been decriminalized in two states and \u003ca href=\"https://www.kqed.org/news/11752455/oakland-becomes-second-u-s-city-to-legalize-magic-mushrooms\">some California cities\u003c/a>, and there’s growing momentum to widen \u003ca href=\"https://www.kqed.org/science/1982857/magic-mushrooms-may-treat-depression-but-hurdles-to-psilocybin-access-abound\">medical\u003c/a> and \u003ca href=\"https://www.gq-magazine.co.uk/lifestyle/article/magic-mushroom-the-great-shroom-boom\">recreational use\u003c/a>, so-called “magic mushrooms,” and their synthetic variants, remain illegal.\u003c/p>\n\u003cp>TRE House’s line of mushroom products, which they say “may cause psychotropic effects,” contains a “Magic Mushroom Microdose Blend” and “Proprietary Nootropic Mushroom Blend.” The ingredients listed online for its magic mushroom gummies don’t include psychedelics, but include a form of gabapentin, along with a variety of mushrooms that could be found in most health food stores, like lion’s mane, chaga and cordyceps.\u003c/p>\n\u003cfigure id=\"attachment_12066862\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12066862\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/TRE-House-1-scaled-e1765498264942.jpeg\" alt=\"\" width=\"2000\" height=\"1061\">\u003cfigcaption class=\"wp-caption-text\">The California Department of Public Health found that TRE House’s Milk Chocolate bar, along with other products, contains illegal and potentially dangerous psychedelic compounds. \u003ccite>(Courtesy of the California Department of Public Health.)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>TRE House’s \u003ca href=\"https://trehouse.com/lab-reports/\">publicly-posted lab reports\u003c/a> from as recently as Dec. 8 say no psilocin and psilocybin, another illegal psychedelic, were detected in mushroom gummies, syrups, chocolates and vapes.\u003c/p>\n\u003cp>But the CDPH said its laboratory testing found that products contained two illegal analogues of psilocin: 4-Acetoxy-DET and 4-Acetoxy-DMT, as well as synthetic mushroom-based psychoactive drugs. The compounds are considered Schedule 1 drugs by the Drug Enforcement Administration.\u003c/p>\n\u003cp>TRE House did not immediately respond to a request for comment.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Dr. John Gray, associate director of UC Davis’s Institute for Psychedelics and Neurotherapeutics, said it’s possible that CDPH could be cracking down on TRE House specifically because of their use of artificial compounds, since synthetics are often easier to regulate.\u003c/p>\n\u003cp>Officials said that no illnesses associated with the products have been reported, but that “individuals looking for psychedelic mushroom products for therapeutic effects run the risk of serious or life-threatening illness.”\u003c/p>\n\u003cp>The packaging of the products as syrups and sweets could also be dangerous for children, who might view them as regular candies and chocolates, according to CDPH.\u003c/p>\n\u003cp>The form can make it easy for children and adults to overdo it: edibles are often dosed by one square of chocolate or a single gummy, compared to a whole bar or bag you might eat as a snack.\u003c/p>\n\u003cp>While many of these products are considered medically safe in small amounts, they can increase heart rate and blood pressure, body temperature and the risk of serotonin syndrome for people on serotonin-based prescription drugs if overused.\u003c/p>\n\u003cp>CDPH said it is investigating TRE House and its manufacturers, and that more than 1,000 lbs of the brand’s products have been destroyed. The company could face civil or criminal penalties pending further investigation.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"soldout": {
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