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"content": "\u003cp>As \u003ca href=\"https://www.kqed.org/news/12059890/kaiser-strike-hits-several-bay-area-locations-as-thousands-walk-off-the-job\">tens of thousands of Kaiser Permanente health care employees\u003c/a> approach the end of a five-day, multi-state walkout on Sunday, both sides said they’ll return to the bargaining table over the central dispute: how much of the union’s pay-hike demands the nonprofit’s executives will agree to.\u003c/p>\n\u003cp>The stakes are high for Kaiser, the \u003ca href=\"https://about.kaiserpermanente.org/expertise-and-impact/public-policy/our-impact/news-perspectives-on-public-policy-california#:~:text=Kaiser%20Permanente%20was%20founded%20in,with%20many%20top%2Drated%20hospitals.\">largest private employer\u003c/a> in the state. The national contract, \u003ca href=\"https://www.kqed.org/news/12059551/california-kaiser-health-care-workers-reaching-breaking-point-set-to-strike-next-week\">months in negotiation\u003c/a> with the Alliance of Healthcare Unions, covers nearly 61,000 nurses, physician assistants, pharmacists and other frontline workers — about a third of Kaiser’s workforce — though roughly a quarter of those represented declined to go on strike.\u003c/p>\n\u003cp>Experts say the organization must tread carefully in talks amid rising costs and economic headwinds.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We remain committed to reaching an agreement, if possible, that provides strong wage increases that are sustainable while balancing our obligation to deliver high-quality care that remains affordable,” Kaiser said in a statement.\u003c/p>\n\u003cp>The two sides appear close on paper. The Alliance seeks a 25% wage boost over four years for employees, it said are underpaid. Kaiser, which maintains that workers already earn above-market wages, has drawn the line at 21.5%. The difference, which adds up to roughly $300 million a year in salary costs, is what Kaiser said could force it to raise rates among its 12.6 million members, most of them in California.\u003c/p>\n\u003cp>“It’s the traditional labor-management battle,” said Dr. Robert Pearl, a former top executive at Kaiser who now teaches at Stanford University’s medicine and business schools. “My own view is that’s not the best thing for patients, this strike … It’s a sign of failure to not be able to work together for the good of all.”\u003c/p>\n\u003cfigure id=\"attachment_12059848\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12059848\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-04-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-04-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-04-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-04-KQED-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Workers strike outside of the Kaiser Permanente Oakland Medical Center in Oakland on Oct. 14, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Since Tuesday, Kaiser has hired thousands of temporary nurses, clinicians and other staff to minimize disruptions in California, Hawaii and Oregon. In Northern California, only 3% of all appointments, surgeries and procedures were rescheduled, according to Kaiser. Medical centers, offices and pharmacies remain open.\u003c/p>\n\u003cp>The walkout caused more disruptions in Southern California, temporarily closing pharmacies in Riverside and Ventura Canyon, as well as laboratories and target clinics in San Bernardino and Riverside. The union said dozens of pharmacies were shuttered in Los Angeles, Orange, Kern and other counties. Ambulances were diverted from Kaiser to nearby hospitals in Irvine and San Diego, according to picketers.\u003c/p>\n\u003cp>Temporary nurses and other professionals brought in from across the country posted on social media about being stranded in buses and hotels for many hours. Their staffing company, AMN Healthcare, later apologized over “logistical and communication breakdowns over the last few days [that] created regrettable delays, stress, and confusion for the AMN teams supporting the Kaiser Permanente strike in SoCal,” according to a letter shared with KQED.[aside postID=news_12059890 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-03-KQED-1.jpg']The company did not respond to requests for comment but offered a $1,200 bonus for those who covered out-of-pocket travel or lodging expenses.\u003c/p>\n\u003cp>Union representatives maintain that Kaiser, which has expanded to other states in recent years, can meet their demands given its profits and an estimated $66 billion in reserves. Workers say colleagues are leaving for better pay and lighter workloads, straining those who remain.\u003c/p>\n\u003cp>“They’re sitting on a lot of money. And that money seems to be not meant for their staff that are currently out here today,” said Jeff Cathcart, a nurse anesthetist at Kaiser San Francisco who is in the union’s bargaining team and joined the picket line outside the Oakland Medical Center. “This pay increase is pretty vital.”\u003c/p>\n\u003cp>Union leaders say many workers accepted smaller raises during the pandemic and need to catch up with inflation and the high cost of living. Their latest proposal would boost wages by 9% in the first year, 5% in the second, 7% in the third and 4% in the fourth.\u003c/p>\n\u003cp>“Kaiser Permanente can absolutely not only afford it based off of the money they have in the bank and the revenues they have coming in — I would say that Kaiser Permanente cannot afford not to do it,” said Jane Carter, research director for the United Nurses Associations of California/Union of Health Care Professionals, the largest of 23 unions in the Alliance.\u003c/p>\n\u003cfigure id=\"attachment_12059845\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12059845\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-01-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-01-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-01-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-01-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Workers strike outside of the Kaiser Permanente Oakland Medical Center in Oakland on Oct. 14, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“If they want to continue to be the standard bearer and the gold standard of care delivery in this country, then they have to make sure that they pay to get the healthcare professionals that can properly do the care,” she said.\u003c/p>\n\u003cp>Kaiser’s top Medicare rating fell from five stars in 2023 to 4.5 last year, which the union blames on staffing shortages. The drop matters because five-star plans receive higher government payments and can enroll members for longer each year.\u003c/p>\n\u003cp>Kaiser Permanente was founded in California in 1945. As a nonprofit, Kaiser said it reinvests most of its insurance income into its hospital and clinic operations, instead of generating returns for shareholders as for-profit companies aim to do. Its 3% operating income margin — about $2 billion in the first half of this year — is lower than that of other major health systems.\u003c/p>\n\u003cp>That makes its warning that higher wages could lead to higher consumer costs plausible, said Joanne Spetz, a health economist and labor expert at UCSF.\u003c/p>\n\u003cp>“They don’t have as much wiggle room as one might think when you look at how large their operating revenue and expenses are,” said Spetz, noting Kaiser’s 2024 operating revenue of $115.8 billion and expenses of $115.2 billion, a \u003ca href=\"https://about.kaiserpermanente.org/news/press-release-archive/kaiser-foundation-health-plan-hospitals-risant-health-report-2024-financial-results\">0.5%\u003c/a> income margin.\u003c/p>\n\u003cfigure id=\"attachment_12060095\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12060095\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-05-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-05-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-05-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-05-KQED-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Workers strike outside of the Kaiser Permanente Oakland Medical Center in Oakland on Oct. 14, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Kaiser claims that its $66 billion in reserves are earmarked for employee pensions, building maintenance and other obligations and financial stability. Organizations of its size — with 180,000 employees across eight states and Washington, D.C., should have a financial cushion to weather unexpected challenges, according to Pearl.\u003c/p>\n\u003cp>“Let’s say the markets will go into a recession for the next five years. You can’t build the hospitals you need. You can’t buy the machines that you need. So you want to make sure you have reserves,” Pearl said. “If I were the CEO of the whole organization, I would basically say my job is to make sure I never have to compromise care and never tell a worker I can’t pay you.”\u003c/p>\n\u003cp>Kaiser said any wage hikes for Alliance members must come from the operating income, not investments. The union disputes that, accusing Kaiser of hoarding cash while expanding. Kaiser acquired hospital systems in Pennsylvania and North Carolina in recent years and announced an expansion to Nevada next year.\u003c/p>\n\u003cfigure id=\"attachment_11963409\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11963409\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED.jpg\" alt='A large modern building with the words \"Kaiser Permanente\" across the top.' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Kaiser Permanente Oakland Medical Center in Oakland on Oct. 4, 2023. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Traditionally seen as a West Coast institution, Kaiser is now seeking national influence against competitors such as Amazon, CVS and Walmart, which are spending billions to buy health care companies, according to Pearl.\u003c/p>\n\u003cp>“If you don’t have a national presence, it’s hard to convince legislators to pass laws that are gonna be better for the members of Kaiser Permanente,” he said. “I don’t mean the providers, I mean the patients of Kaiser Permanente.”\u003c/p>\n\u003cp>The negotiations come as the Trump administration moves to restrict Medicare eligibility and Congress debates whether to renew subsidies central to the current government funding fight. Without them, health insurance prices are expected to rise for lower- and middle-income families. Kaiser could face reduced earnings as consumers drop coverage, Spetz said.\u003c/p>\n\u003cp>“They might also be concerned that they’re going to have some increased costs that could come from emergency care,” she said. “I suspect that losing revenue because of people dropping health insurance is the much bigger risk for them.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>As \u003ca href=\"https://www.kqed.org/news/12059890/kaiser-strike-hits-several-bay-area-locations-as-thousands-walk-off-the-job\">tens of thousands of Kaiser Permanente health care employees\u003c/a> approach the end of a five-day, multi-state walkout on Sunday, both sides said they’ll return to the bargaining table over the central dispute: how much of the union’s pay-hike demands the nonprofit’s executives will agree to.\u003c/p>\n\u003cp>The stakes are high for Kaiser, the \u003ca href=\"https://about.kaiserpermanente.org/expertise-and-impact/public-policy/our-impact/news-perspectives-on-public-policy-california#:~:text=Kaiser%20Permanente%20was%20founded%20in,with%20many%20top%2Drated%20hospitals.\">largest private employer\u003c/a> in the state. The national contract, \u003ca href=\"https://www.kqed.org/news/12059551/california-kaiser-health-care-workers-reaching-breaking-point-set-to-strike-next-week\">months in negotiation\u003c/a> with the Alliance of Healthcare Unions, covers nearly 61,000 nurses, physician assistants, pharmacists and other frontline workers — about a third of Kaiser’s workforce — though roughly a quarter of those represented declined to go on strike.\u003c/p>\n\u003cp>Experts say the organization must tread carefully in talks amid rising costs and economic headwinds.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We remain committed to reaching an agreement, if possible, that provides strong wage increases that are sustainable while balancing our obligation to deliver high-quality care that remains affordable,” Kaiser said in a statement.\u003c/p>\n\u003cp>The two sides appear close on paper. The Alliance seeks a 25% wage boost over four years for employees, it said are underpaid. Kaiser, which maintains that workers already earn above-market wages, has drawn the line at 21.5%. The difference, which adds up to roughly $300 million a year in salary costs, is what Kaiser said could force it to raise rates among its 12.6 million members, most of them in California.\u003c/p>\n\u003cp>“It’s the traditional labor-management battle,” said Dr. Robert Pearl, a former top executive at Kaiser who now teaches at Stanford University’s medicine and business schools. “My own view is that’s not the best thing for patients, this strike … It’s a sign of failure to not be able to work together for the good of all.”\u003c/p>\n\u003cfigure id=\"attachment_12059848\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12059848\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-04-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-04-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-04-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-04-KQED-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Workers strike outside of the Kaiser Permanente Oakland Medical Center in Oakland on Oct. 14, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Since Tuesday, Kaiser has hired thousands of temporary nurses, clinicians and other staff to minimize disruptions in California, Hawaii and Oregon. In Northern California, only 3% of all appointments, surgeries and procedures were rescheduled, according to Kaiser. Medical centers, offices and pharmacies remain open.\u003c/p>\n\u003cp>The walkout caused more disruptions in Southern California, temporarily closing pharmacies in Riverside and Ventura Canyon, as well as laboratories and target clinics in San Bernardino and Riverside. The union said dozens of pharmacies were shuttered in Los Angeles, Orange, Kern and other counties. Ambulances were diverted from Kaiser to nearby hospitals in Irvine and San Diego, according to picketers.\u003c/p>\n\u003cp>Temporary nurses and other professionals brought in from across the country posted on social media about being stranded in buses and hotels for many hours. Their staffing company, AMN Healthcare, later apologized over “logistical and communication breakdowns over the last few days [that] created regrettable delays, stress, and confusion for the AMN teams supporting the Kaiser Permanente strike in SoCal,” according to a letter shared with KQED.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The company did not respond to requests for comment but offered a $1,200 bonus for those who covered out-of-pocket travel or lodging expenses.\u003c/p>\n\u003cp>Union representatives maintain that Kaiser, which has expanded to other states in recent years, can meet their demands given its profits and an estimated $66 billion in reserves. Workers say colleagues are leaving for better pay and lighter workloads, straining those who remain.\u003c/p>\n\u003cp>“They’re sitting on a lot of money. And that money seems to be not meant for their staff that are currently out here today,” said Jeff Cathcart, a nurse anesthetist at Kaiser San Francisco who is in the union’s bargaining team and joined the picket line outside the Oakland Medical Center. “This pay increase is pretty vital.”\u003c/p>\n\u003cp>Union leaders say many workers accepted smaller raises during the pandemic and need to catch up with inflation and the high cost of living. Their latest proposal would boost wages by 9% in the first year, 5% in the second, 7% in the third and 4% in the fourth.\u003c/p>\n\u003cp>“Kaiser Permanente can absolutely not only afford it based off of the money they have in the bank and the revenues they have coming in — I would say that Kaiser Permanente cannot afford not to do it,” said Jane Carter, research director for the United Nurses Associations of California/Union of Health Care Professionals, the largest of 23 unions in the Alliance.\u003c/p>\n\u003cfigure id=\"attachment_12059845\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12059845\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-01-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-01-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-01-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-01-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Workers strike outside of the Kaiser Permanente Oakland Medical Center in Oakland on Oct. 14, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“If they want to continue to be the standard bearer and the gold standard of care delivery in this country, then they have to make sure that they pay to get the healthcare professionals that can properly do the care,” she said.\u003c/p>\n\u003cp>Kaiser’s top Medicare rating fell from five stars in 2023 to 4.5 last year, which the union blames on staffing shortages. The drop matters because five-star plans receive higher government payments and can enroll members for longer each year.\u003c/p>\n\u003cp>Kaiser Permanente was founded in California in 1945. As a nonprofit, Kaiser said it reinvests most of its insurance income into its hospital and clinic operations, instead of generating returns for shareholders as for-profit companies aim to do. Its 3% operating income margin — about $2 billion in the first half of this year — is lower than that of other major health systems.\u003c/p>\n\u003cp>That makes its warning that higher wages could lead to higher consumer costs plausible, said Joanne Spetz, a health economist and labor expert at UCSF.\u003c/p>\n\u003cp>“They don’t have as much wiggle room as one might think when you look at how large their operating revenue and expenses are,” said Spetz, noting Kaiser’s 2024 operating revenue of $115.8 billion and expenses of $115.2 billion, a \u003ca href=\"https://about.kaiserpermanente.org/news/press-release-archive/kaiser-foundation-health-plan-hospitals-risant-health-report-2024-financial-results\">0.5%\u003c/a> income margin.\u003c/p>\n\u003cfigure id=\"attachment_12060095\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12060095\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-05-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-05-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-05-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-05-KQED-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Workers strike outside of the Kaiser Permanente Oakland Medical Center in Oakland on Oct. 14, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Kaiser claims that its $66 billion in reserves are earmarked for employee pensions, building maintenance and other obligations and financial stability. Organizations of its size — with 180,000 employees across eight states and Washington, D.C., should have a financial cushion to weather unexpected challenges, according to Pearl.\u003c/p>\n\u003cp>“Let’s say the markets will go into a recession for the next five years. You can’t build the hospitals you need. You can’t buy the machines that you need. So you want to make sure you have reserves,” Pearl said. “If I were the CEO of the whole organization, I would basically say my job is to make sure I never have to compromise care and never tell a worker I can’t pay you.”\u003c/p>\n\u003cp>Kaiser said any wage hikes for Alliance members must come from the operating income, not investments. The union disputes that, accusing Kaiser of hoarding cash while expanding. Kaiser acquired hospital systems in Pennsylvania and North Carolina in recent years and announced an expansion to Nevada next year.\u003c/p>\n\u003cfigure id=\"attachment_11963409\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11963409\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED.jpg\" alt='A large modern building with the words \"Kaiser Permanente\" across the top.' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Kaiser Permanente Oakland Medical Center in Oakland on Oct. 4, 2023. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Traditionally seen as a West Coast institution, Kaiser is now seeking national influence against competitors such as Amazon, CVS and Walmart, which are spending billions to buy health care companies, according to Pearl.\u003c/p>\n\u003cp>“If you don’t have a national presence, it’s hard to convince legislators to pass laws that are gonna be better for the members of Kaiser Permanente,” he said. “I don’t mean the providers, I mean the patients of Kaiser Permanente.”\u003c/p>\n\u003cp>The negotiations come as the Trump administration moves to restrict Medicare eligibility and Congress debates whether to renew subsidies central to the current government funding fight. Without them, health insurance prices are expected to rise for lower- and middle-income families. Kaiser could face reduced earnings as consumers drop coverage, Spetz said.\u003c/p>\n\u003cp>“They might also be concerned that they’re going to have some increased costs that could come from emergency care,” she said. “I suspect that losing revenue because of people dropping health insurance is the much bigger risk for them.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "mpox-cases-clade-i-southern-california",
"title": "3 Cases of More Severe Mpox Strain Found in California — Here's What to Know",
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"content": "\u003cp>Three new cases of clade I mpox — the more severe strain of the disease formerly known as “\u003ca href=\"https://www.kqed.org/monkeypox\">monkeypox\u003c/a>” responsible for outbreaks in Central and Eastern Africa \u003cspan style=\"font-weight: 400;\">— have been identified \u003c/span>in Southern California, according to the California Department of Public Health.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdph.ca.gov/Programs/OPA/Pages/NR25-015.aspx\">In a statement on Friday\u003c/a>, CDPH said they’d worked with local public health officials in Long Beach and Los Angeles County to identify these cases, which were not related to each other. “This is the first time clade I cases without a history of international travel have been reported in California or the United States,” CDPH said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>CDPH said that all three cases in Southern California “required hospitalization,” and the patients are now recovering.\u003c/p>\n\u003cp>The agency urged anyone who might be at heightened risk from mpox to seek out a \u003ca href=\"#find-mpox-vaccine-near-me\">free vaccine against the disease \u003c/a>as soon as possible, if they haven’t already been vaccinated, noting that ” for either clade, vaccination lowers the chances of getting mpox and having severe disease.”\u003c/p>\n\u003cp>\u003cstrong>Jump straight to: \u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#find-mpox-vaccine-near-me\">Who’s eligible for an mpox vaccine in the Bay Area?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#who-can-get-mpox-clade-i-ii\">Who can get clade I and clade II mpox?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#mpox-monkeypox-symptoms\">What are the symptoms of clade I and clade II mpox?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>State health officials also said they’re conducting contact tracing around the Southern California cases and will continue to work with local health departments on surveillance — “and with the CDC as they are available during \u003ca href=\"https://www.kqed.org/news/tag/government-shutdown\">the federal government shutdown\u003c/a>.”\u003c/p>\n\u003cp>On Monday, a spokesperson for CDPH said that the agency was continuing to work “with available staff at CDC” on their mpox response, but warned of “delays in coordination and communication” that “will put our communities at greater risk and reduce CDPH’s and local health jurisdictions’ ability to respond to a potentially larger outbreak.”\u003c/p>\n\u003cp>Dr. Julia Janssen, deputy director of the San Francisco Department of Public Health’s HIV/STI Prevention and Control Branch, confirmed that “thus far, we have had no clade I mpox cases reported in San Francisco, and we’re continuing to monitor the situation in Southern California closely.”\u003c/p>\n\u003cp>Keep reading for what you need to know about mpox amid news of these three new clade I mpox cases in the state.\u003c/p>\n\u003ch2>What is clade I mpox?\u003c/h2>\n\u003cp>As the name suggests, mpox is related to the smallpox virus but is generally less severe and far less contagious than smallpox, \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/mpox.aspx\">according to CDPH\u003c/a>. In addition to fever, chills, headache and muscle pain, mpox can cause a painful rash — also known as lesions — that appears on many parts of the body.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/12014961/the-first-us-clade-i-mpox-case-has-been-found-in-the-bay-area-heres-what-to-know\">Clade I mpox has caused widespread disease and even death\u003c/a> in countries including the Democratic Republic of the Congo (DRC), which was the epicenter of the ongoing outbreak in 2024. It’s a different strain than clade II mpox, which is the kind \u003ca href=\"https://www.kqed.org/news/11919070/monkeypox-in-the-bay-area-from-symptoms-to-how-to-find-a-vaccine-heres-what-we-know\">that caused an outbreak in the Bay Area in 2022\u003c/a>, and that’s been circulating at low levels since.\u003c/p>\n\u003ch2>\u003ca id=\"who-can-get-mpox-clade-i-ii\">\u003c/a>Who can get clade I — and clade II— mpox?\u003c/h2>\n\u003cp>Anyone can get mpox, which spreads mainly through close physical contact, including sex.\u003c/p>\n\u003cp>But past clade II outbreaks in the U.S. have particularly affected gay and bisexual men, along with trans and nonbinary people who have sex with men.[aside postID=news_12052382 hero='https://ww2.kqed.org/app/uploads/sites/10/2023/11/GettyImages-1408879341-qut-1020x765.jpg']And these new clade I cases in Southern California being unrelated to each other — and in people who hadn’t traveled to affected regions — now indicates “that person-to-person community spread of clade I mpox is occurring in California, primarily impacting communities of gay and bisexual men, and other men who have sex with men, as well as their social networks,” CDPH said.\u003c/p>\n\u003cp>According to \u003ca href=\"https://www.cdc.gov/monkeypox/outbreaks/2023/index.html\">the Centers for Disease Control and Prevention’s website\u003c/a>, which was last updated on Sept. 15, only six cases of clade I mpox have been reported in the U.S. — all in people who had recently traveled to countries affected by a clade I outbreak. \u003ca href=\"https://www.kqed.org/news/12014961/the-first-us-clade-i-mpox-case-has-been-found-in-the-bay-area-heres-what-to-know\">The first U.S clade I case\u003c/a> was detected in San Mateo County in November 2024.\u003c/p>\n\u003cp>According to CDPH, the risk of clade I mpox to the general public remains low right now. “Casual contact, like one might have in an airplane, office, or store, is unlikely to spread mpox,” the agency said.\u003c/p>\n\u003ch2>\u003ca id=\"mpox-monkeypox-symptoms\">\u003c/a>What should I know about the symptoms of mpox?\u003c/h2>\n\u003cp>\u003cstrong>Mpox spreads through physical contact\u003c/strong>\u003c/p>\n\u003cp>The mpox virus spreads through close — usually skin-to-skin — contact with someone who is infected. This could be direct contact with the infectious rashes or scabs someone with mpox develops, scabs, having intimate physical contact with someone who has mpox, such as kissing, cuddling or sex.\u003c/p>\n\u003cp>Coming into contact with infected bodily fluids or items that have been touched by rashes or fluids from an infected person can also expose you to the virus.\u003c/p>\n\u003cfigure id=\"attachment_11949273\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11949273\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/05/RS65506_GettyImages-1428290091-1-qut.jpg\" alt=\"Small circular patterns float in a dense, thick brown substance.\" width=\"1920\" height=\"1523\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/05/RS65506_GettyImages-1428290091-1-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/05/RS65506_GettyImages-1428290091-1-qut-800x635.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/05/RS65506_GettyImages-1428290091-1-qut-1020x809.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/05/RS65506_GettyImages-1428290091-1-qut-160x127.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/05/RS65506_GettyImages-1428290091-1-qut-1536x1218.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Colorized transmission electron micrograph of mpox virus particles (orange) found within an infected cell (brown) cultured in a laboratory. \u003ccite>(NIH-NIAID/Image Point FR/BSIP/Universal Images Group via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In 2024, UCSF infectious disease expert Dr. Peter Chin-Hong issued a reminder that infection still “requires close skin-to-skin contact or intensive household contact — so you can’t get it from Muni or from yoga, or from going to Trader Joe’s.”\u003c/p>\n\u003cp>“It’s still very hard to get mpox, even from somebody with active lesions,” he said.\u003c/p>\n\u003cp>\u003cstrong>Mpox symptoms don’t start straight away after exposure\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdc.gov/poxvirus/mpox/symptoms/index.html\">Mpox can have a long incubation period\u003c/a> — that is, the time between when you’re exposed to mpox and when you start to develop symptoms.\u003c/p>\n\u003cp>This period can range from as short as three days and as long as 17 days (almost three weeks), according to the CDC.\u003c/p>\n\u003cp>\u003cstrong>Mpox symptoms and affected areas can be varied\u003c/strong>\u003c/p>\n\u003cp>The symptoms of clade I and clade II mpox are similar, SFDPH’s Janssen said, and they can often start as flu-like conditions — which is worth bearing in mind as \u003ca href=\"https://www.kqed.org/news/12045979/nimbus-nb181-covid-variant-symptoms-razor-blade-throat-incubation-period-testing\">the Bay Area comes down from another COVID-19 wave\u003c/a>.[aside postID=news_12056934 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/gettyimages-2235563712.jpeg']The mpox virus also appears as a rash or sores or spots that can resemble pimples or blisters on the skin anywhere on the body, including the face, inside the mouth, hands, feet, chest, genitals and anus. These spots often start as red, flat spots that then become bumps before the bumps become filled with pus and turn into scabs when they break. These symptoms can be extremely painful.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdc.gov/poxvirus/mpox/symptoms/index.html\">If you’re unsure about recognizing an mpox rash, the CDC has a photo guide\u003c/a>.\u003c/p>\n\u003cp>If you suspect you might have mpox symptoms — even if they’re subtle — see your health care provider right away or \u003ca href=\"https://www.sf.gov/get-mpox-vaccines-testing-and-medicine\">consult one of SFPDH’s clinics for mpox testing\u003c/a>. See more on \u003ca href=\"https://sf.gov/information/mpox\">what to do if you suspect you have mpox\u003c/a>.\u003c/p>\n\u003ch2>I’ve already got my mpox vaccine. Should I seek out a booster now?\u003c/h2>\n\u003cp>\u003ca href=\"https://www.cdc.gov/monkeypox/hcp/vaccine-considerations/vaccination-overview.html\">There’s no current recommendation\u003c/a> for a booster dose of the mpox vaccine.\u003c/p>\n\u003ch2>Will the mpox vaccine protect me against both strains of mpox?\u003c/h2>\n\u003cp>Yes, confirmed Janssen: “The mpox vaccine protects against both clades: clade I and clade II.”\u003c/p>\n\u003ch2>\u003ca id=\"find-mpox-vaccine-near-me\">\u003c/a>Who’s eligible for a new mpox vaccine in the Bay Area?\u003c/h2>\n\u003cp>The vaccine currently available in the U.S. (brand name: Jynneos) is a two-dose series, with roughly a month between doses. Maximal immunity will be built two weeks after your second dose. If you only got one dose previously, go ahead and seek out your second dose ASAP.\u003c/p>\n\u003cp>The CDC recommends the two-dose mpox vaccine to gay and bisexual men and other men who have sex with men, as well as transgender, nonbinary or gender-diverse people who in the past 6 months, have had, or anticipate having:\u003c/p>\n\u003cul>\n\u003cli>More than one sexual partner and/or\u003c/li>\n\u003cli>A new diagnosis of one or more sexually transmitted infections.\u003c/li>\n\u003c/ul>\n\u003cp>The CDC’s vaccine recommendations also include anyone who has had sex at a commercial sex venue like a sex club or bathhouse. \u003ca href=\"https://www.cdc.gov/monkeypox/hcp/vaccine-considerations/vaccination-overview.html\">See the full mpox vaccine eligibility recommendations from the CDC\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"https://www.sf.gov/get-mpox-vaccines-testing-and-treatment\">San Francisco additionally recommends vaccination\u003c/a> for anyone living with HIV, anyone taking PrEP or who’s eligible to take it and sex workers. SFDPH also recommends it for anyone who has sex “at a large event in a geographic area where mpox virus transmission is occurring, or has a sex partner with any of the stated risks,” Janssen said earlier in 2025.\u003c/p>\n\u003cp>\u003cstrong>Will the mpox vaccine stop me getting mpox entirely?\u003c/strong>\u003c/p>\n\u003cp>Like the COVID-19 vaccine, the mpox vaccine can’t prevent all infections.\u003c/p>\n\u003cp>Janssen told KQED earlier this year that while fewer than 1% of people who are fully vaccinated have been diagnosed with the disease, “no vaccine is 100% effective” — “and while mpox infection after vaccination is rare, it does occur.”\u003c/p>\n\u003cfigure id=\"attachment_11988132\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11988132\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/GettyImages-1412778743.jpg\" alt=\"\" width=\"1920\" height=\"1315\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/GettyImages-1412778743.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/GettyImages-1412778743-800x548.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/GettyImages-1412778743-1020x699.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/GettyImages-1412778743-160x110.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/GettyImages-1412778743-1536x1052.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A pharmacist prepares a dose of the Jynneos mpox vaccine at a pop-up vaccination clinic opened by the Los Angeles County Department of Public Health at the West Hollywood Library on Aug. 3, 2022, in West Hollywood, California. \u003ccite>(Mario Tama/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But even if someone who’s fully vaccinated with Jynneos \u003cem>does\u003c/em> get infected with mpox, she said, “those cases are typically mild.”\u003c/p>\n\u003cp>In other words, like the COVID-19 shot, the mpox vaccine makes it far more likely that any infection you get is far less severe than it would have been if you hadn’t been vaccinated.\u003c/p>\n\u003cp>And the difference between suffering from severe mpox versus a mild case can be considerable, as attested to by the \u003ca href=\"https://www.nytimes.com/2022/07/18/nyregion/new-york-monkeypox-vaccine.html\">“excruciating” symptoms reported during the early days of the 2022 U.S. outbreak\u003c/a>, when most patients hadn’t yet been offered the mpox vaccine. ”\u003c/p>\n\u003cp>\u003cstrong>Travel and mpox vaccination\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdc.gov/mpox/vaccines/index.html\">The CDC has updated its vaccination recommendations\u003c/a> to extend to people traveling to countries with clade I \u003cem>and\u003c/em> clade II outbreaks.\u003c/p>\n\u003cp>As of Sept. 15, these countries with clade I outbreaks include Burundi, Central African Republic, Democratic Republic of the Congo, Ethiopia, Kenya, Malawi, Mozambique, Republic of the Congo, Rwanda, South Sudan, Tanzania, Uganda and Zambia. Countries with new clade II outbreaks include Liberia and Sierra Leone.\u003c/p>\n\u003cp>The agency recommends getting both doses of the vaccine “if you anticipate experiencing any of the following” while traveling to these countries:\u003c/p>\n\u003cul>\n\u003cli>Sex with a new partner\u003c/li>\n\u003cli>Sex at a commercial sex venue, such as a sex club or bathhouse\u003c/li>\n\u003cli>Sex in exchange for money, goods, drugs or other trade\u003c/li>\n\u003cli>Sex in association with a large public event, such as a rave, party or festival.\u003c/li>\n\u003c/ul>\n\u003cp>The mpox vaccine was also originally only available for people aged 18 and older, but in 2022, the Food and Drug Administration (FDA) issued an emergency-use authorization that allows providers to also give the vaccine to young people under 18 who are “determined to be at high risk” of infection.\u003c/p>\n\u003ch2>\u003ca id=\"find-mpox-vaccine-near-me\">\u003c/a>Where can I find an mpox vaccine near me?\u003c/h2>\n\u003cp>If you have a regular health care provider, SFDPH recommends you ask them first about getting the mpox vaccine. Your vaccine will be free, but you may be charged a regular copay for seeing your provider.\u003c/p>\n\u003cp>If you’re eligible for the vaccine, your health insurance should cover the costs \u003ca href=\"https://www.cdc.gov/monkeypox/hcp/vaccine-considerations/vaccination-overview.html\">thanks to the CDC’s recommendations\u003c/a>. If you don’t have a regular health care provider or insurance, you can find the mpox vaccine free at clinics around the Bay Area. You can opt to schedule an appointment or choose a walk-in clinic, depending on what works best for you.\u003c/p>\n\u003cp>(As with the COVID-19 vaccine, receiving an mpox vaccine won’t make you \u003ca href=\"https://documentedny.com/2021/04/04/public-charge-rule-explained/\">a public charge\u003c/a> or affect any future immigration processes you may enter into, and you won’t be asked about your immigration status to receive the mpox vaccine.)\u003c/p>\n\u003cp>\u003cstrong>If you live in or near San Francisco:\u003c/strong>\u003c/p>\n\u003cp>See \u003ca href=\"https://www.sf.gov/get-mpox-vaccines-testing-and-treatment\">a full list of mpox vaccine sites near you in San Francisco\u003c/a>. SFDPH confirms that you don’t have to be a city resident in San Francisco to get vaccinated for mpox.\u003c/p>\n\u003cp>\u003cstrong>Mpox vaccination sites elsewhere in the Bay Area and California:\u003c/strong>\u003c/p>\n\u003cp>Find an mpox vaccine clinic near you using \u003ca href=\"https://myturn.ca.gov/\">the state’s myturn.ca.gov site.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Getting an mpox vaccine at a pharmacy:\u003c/strong>\u003c/p>\n\u003cp>Some pharmacies offer mpox vaccination appointments online, along with other vaccines like COVID-19 and flu. But if you choose this route, you’ll be asked for insurance details — and it’s important to verify with your insurer \u003cem>ahead\u003c/em> of time that they’ll cover the cost of an mpox vaccine at a pharmacy like CVS or Walgreens, as the out-of-pocket costs you’ll be quoted may be steep. If you find your insurance doesn’t fully cover the cost, \u003ca href=\"https://www.sf.gov/get-mpox-vaccines-testing-and-treatment\">SFDPH said you can seek your vaccine at one of their clinics “while supplies last.”\u003c/a>\u003c/p>\n\u003cp>If you get your health care through a health system like Kaiser Permanente, it’s unlikely you’ll be able to get your mpox vaccine covered by insurance at a pharmacy like CVS or Walgreens — the way you can’t get your COVID-19 or flu shot covered by Kaiser at a pharmacy either — and may have to seek it directly from a Kaiser provider.\u003c/p>\n\u003cp>If you’re able to make an appointment online at a pharmacy for your mpox vaccine, you should consider calling that location ahead of time to verify that they do indeed have supply in stock.\u003c/p>\n\u003cp>\u003cem>This story includes reporting from KQED’s Billy Cruz, Carlos Cabrera-Lomelí and Nisa Khan.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "With three new cases of a more severe mpox strain detected in Southern California, here's what to know about symptoms, where to find an mpox vaccine and the difference between the two strains.\r\n\r\n\r\n\r\n\r\n\r\n",
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"title": "3 Cases of More Severe Mpox Strain Found in California — Here's What to Know | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Three new cases of clade I mpox — the more severe strain of the disease formerly known as “\u003ca href=\"https://www.kqed.org/monkeypox\">monkeypox\u003c/a>” responsible for outbreaks in Central and Eastern Africa \u003cspan style=\"font-weight: 400;\">— have been identified \u003c/span>in Southern California, according to the California Department of Public Health.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdph.ca.gov/Programs/OPA/Pages/NR25-015.aspx\">In a statement on Friday\u003c/a>, CDPH said they’d worked with local public health officials in Long Beach and Los Angeles County to identify these cases, which were not related to each other. “This is the first time clade I cases without a history of international travel have been reported in California or the United States,” CDPH said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>CDPH said that all three cases in Southern California “required hospitalization,” and the patients are now recovering.\u003c/p>\n\u003cp>The agency urged anyone who might be at heightened risk from mpox to seek out a \u003ca href=\"#find-mpox-vaccine-near-me\">free vaccine against the disease \u003c/a>as soon as possible, if they haven’t already been vaccinated, noting that ” for either clade, vaccination lowers the chances of getting mpox and having severe disease.”\u003c/p>\n\u003cp>\u003cstrong>Jump straight to: \u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#find-mpox-vaccine-near-me\">Who’s eligible for an mpox vaccine in the Bay Area?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#who-can-get-mpox-clade-i-ii\">Who can get clade I and clade II mpox?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#mpox-monkeypox-symptoms\">What are the symptoms of clade I and clade II mpox?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>State health officials also said they’re conducting contact tracing around the Southern California cases and will continue to work with local health departments on surveillance — “and with the CDC as they are available during \u003ca href=\"https://www.kqed.org/news/tag/government-shutdown\">the federal government shutdown\u003c/a>.”\u003c/p>\n\u003cp>On Monday, a spokesperson for CDPH said that the agency was continuing to work “with available staff at CDC” on their mpox response, but warned of “delays in coordination and communication” that “will put our communities at greater risk and reduce CDPH’s and local health jurisdictions’ ability to respond to a potentially larger outbreak.”\u003c/p>\n\u003cp>Dr. Julia Janssen, deputy director of the San Francisco Department of Public Health’s HIV/STI Prevention and Control Branch, confirmed that “thus far, we have had no clade I mpox cases reported in San Francisco, and we’re continuing to monitor the situation in Southern California closely.”\u003c/p>\n\u003cp>Keep reading for what you need to know about mpox amid news of these three new clade I mpox cases in the state.\u003c/p>\n\u003ch2>What is clade I mpox?\u003c/h2>\n\u003cp>As the name suggests, mpox is related to the smallpox virus but is generally less severe and far less contagious than smallpox, \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/mpox.aspx\">according to CDPH\u003c/a>. In addition to fever, chills, headache and muscle pain, mpox can cause a painful rash — also known as lesions — that appears on many parts of the body.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/12014961/the-first-us-clade-i-mpox-case-has-been-found-in-the-bay-area-heres-what-to-know\">Clade I mpox has caused widespread disease and even death\u003c/a> in countries including the Democratic Republic of the Congo (DRC), which was the epicenter of the ongoing outbreak in 2024. It’s a different strain than clade II mpox, which is the kind \u003ca href=\"https://www.kqed.org/news/11919070/monkeypox-in-the-bay-area-from-symptoms-to-how-to-find-a-vaccine-heres-what-we-know\">that caused an outbreak in the Bay Area in 2022\u003c/a>, and that’s been circulating at low levels since.\u003c/p>\n\u003ch2>\u003ca id=\"who-can-get-mpox-clade-i-ii\">\u003c/a>Who can get clade I — and clade II— mpox?\u003c/h2>\n\u003cp>Anyone can get mpox, which spreads mainly through close physical contact, including sex.\u003c/p>\n\u003cp>But past clade II outbreaks in the U.S. have particularly affected gay and bisexual men, along with trans and nonbinary people who have sex with men.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>And these new clade I cases in Southern California being unrelated to each other — and in people who hadn’t traveled to affected regions — now indicates “that person-to-person community spread of clade I mpox is occurring in California, primarily impacting communities of gay and bisexual men, and other men who have sex with men, as well as their social networks,” CDPH said.\u003c/p>\n\u003cp>According to \u003ca href=\"https://www.cdc.gov/monkeypox/outbreaks/2023/index.html\">the Centers for Disease Control and Prevention’s website\u003c/a>, which was last updated on Sept. 15, only six cases of clade I mpox have been reported in the U.S. — all in people who had recently traveled to countries affected by a clade I outbreak. \u003ca href=\"https://www.kqed.org/news/12014961/the-first-us-clade-i-mpox-case-has-been-found-in-the-bay-area-heres-what-to-know\">The first U.S clade I case\u003c/a> was detected in San Mateo County in November 2024.\u003c/p>\n\u003cp>According to CDPH, the risk of clade I mpox to the general public remains low right now. “Casual contact, like one might have in an airplane, office, or store, is unlikely to spread mpox,” the agency said.\u003c/p>\n\u003ch2>\u003ca id=\"mpox-monkeypox-symptoms\">\u003c/a>What should I know about the symptoms of mpox?\u003c/h2>\n\u003cp>\u003cstrong>Mpox spreads through physical contact\u003c/strong>\u003c/p>\n\u003cp>The mpox virus spreads through close — usually skin-to-skin — contact with someone who is infected. This could be direct contact with the infectious rashes or scabs someone with mpox develops, scabs, having intimate physical contact with someone who has mpox, such as kissing, cuddling or sex.\u003c/p>\n\u003cp>Coming into contact with infected bodily fluids or items that have been touched by rashes or fluids from an infected person can also expose you to the virus.\u003c/p>\n\u003cfigure id=\"attachment_11949273\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11949273\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/05/RS65506_GettyImages-1428290091-1-qut.jpg\" alt=\"Small circular patterns float in a dense, thick brown substance.\" width=\"1920\" height=\"1523\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/05/RS65506_GettyImages-1428290091-1-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/05/RS65506_GettyImages-1428290091-1-qut-800x635.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/05/RS65506_GettyImages-1428290091-1-qut-1020x809.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/05/RS65506_GettyImages-1428290091-1-qut-160x127.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/05/RS65506_GettyImages-1428290091-1-qut-1536x1218.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Colorized transmission electron micrograph of mpox virus particles (orange) found within an infected cell (brown) cultured in a laboratory. \u003ccite>(NIH-NIAID/Image Point FR/BSIP/Universal Images Group via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In 2024, UCSF infectious disease expert Dr. Peter Chin-Hong issued a reminder that infection still “requires close skin-to-skin contact or intensive household contact — so you can’t get it from Muni or from yoga, or from going to Trader Joe’s.”\u003c/p>\n\u003cp>“It’s still very hard to get mpox, even from somebody with active lesions,” he said.\u003c/p>\n\u003cp>\u003cstrong>Mpox symptoms don’t start straight away after exposure\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdc.gov/poxvirus/mpox/symptoms/index.html\">Mpox can have a long incubation period\u003c/a> — that is, the time between when you’re exposed to mpox and when you start to develop symptoms.\u003c/p>\n\u003cp>This period can range from as short as three days and as long as 17 days (almost three weeks), according to the CDC.\u003c/p>\n\u003cp>\u003cstrong>Mpox symptoms and affected areas can be varied\u003c/strong>\u003c/p>\n\u003cp>The symptoms of clade I and clade II mpox are similar, SFDPH’s Janssen said, and they can often start as flu-like conditions — which is worth bearing in mind as \u003ca href=\"https://www.kqed.org/news/12045979/nimbus-nb181-covid-variant-symptoms-razor-blade-throat-incubation-period-testing\">the Bay Area comes down from another COVID-19 wave\u003c/a>.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The mpox virus also appears as a rash or sores or spots that can resemble pimples or blisters on the skin anywhere on the body, including the face, inside the mouth, hands, feet, chest, genitals and anus. These spots often start as red, flat spots that then become bumps before the bumps become filled with pus and turn into scabs when they break. These symptoms can be extremely painful.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdc.gov/poxvirus/mpox/symptoms/index.html\">If you’re unsure about recognizing an mpox rash, the CDC has a photo guide\u003c/a>.\u003c/p>\n\u003cp>If you suspect you might have mpox symptoms — even if they’re subtle — see your health care provider right away or \u003ca href=\"https://www.sf.gov/get-mpox-vaccines-testing-and-medicine\">consult one of SFPDH’s clinics for mpox testing\u003c/a>. See more on \u003ca href=\"https://sf.gov/information/mpox\">what to do if you suspect you have mpox\u003c/a>.\u003c/p>\n\u003ch2>I’ve already got my mpox vaccine. Should I seek out a booster now?\u003c/h2>\n\u003cp>\u003ca href=\"https://www.cdc.gov/monkeypox/hcp/vaccine-considerations/vaccination-overview.html\">There’s no current recommendation\u003c/a> for a booster dose of the mpox vaccine.\u003c/p>\n\u003ch2>Will the mpox vaccine protect me against both strains of mpox?\u003c/h2>\n\u003cp>Yes, confirmed Janssen: “The mpox vaccine protects against both clades: clade I and clade II.”\u003c/p>\n\u003ch2>\u003ca id=\"find-mpox-vaccine-near-me\">\u003c/a>Who’s eligible for a new mpox vaccine in the Bay Area?\u003c/h2>\n\u003cp>The vaccine currently available in the U.S. (brand name: Jynneos) is a two-dose series, with roughly a month between doses. Maximal immunity will be built two weeks after your second dose. If you only got one dose previously, go ahead and seek out your second dose ASAP.\u003c/p>\n\u003cp>The CDC recommends the two-dose mpox vaccine to gay and bisexual men and other men who have sex with men, as well as transgender, nonbinary or gender-diverse people who in the past 6 months, have had, or anticipate having:\u003c/p>\n\u003cul>\n\u003cli>More than one sexual partner and/or\u003c/li>\n\u003cli>A new diagnosis of one or more sexually transmitted infections.\u003c/li>\n\u003c/ul>\n\u003cp>The CDC’s vaccine recommendations also include anyone who has had sex at a commercial sex venue like a sex club or bathhouse. \u003ca href=\"https://www.cdc.gov/monkeypox/hcp/vaccine-considerations/vaccination-overview.html\">See the full mpox vaccine eligibility recommendations from the CDC\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"https://www.sf.gov/get-mpox-vaccines-testing-and-treatment\">San Francisco additionally recommends vaccination\u003c/a> for anyone living with HIV, anyone taking PrEP or who’s eligible to take it and sex workers. SFDPH also recommends it for anyone who has sex “at a large event in a geographic area where mpox virus transmission is occurring, or has a sex partner with any of the stated risks,” Janssen said earlier in 2025.\u003c/p>\n\u003cp>\u003cstrong>Will the mpox vaccine stop me getting mpox entirely?\u003c/strong>\u003c/p>\n\u003cp>Like the COVID-19 vaccine, the mpox vaccine can’t prevent all infections.\u003c/p>\n\u003cp>Janssen told KQED earlier this year that while fewer than 1% of people who are fully vaccinated have been diagnosed with the disease, “no vaccine is 100% effective” — “and while mpox infection after vaccination is rare, it does occur.”\u003c/p>\n\u003cfigure id=\"attachment_11988132\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11988132\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/GettyImages-1412778743.jpg\" alt=\"\" width=\"1920\" height=\"1315\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/GettyImages-1412778743.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/GettyImages-1412778743-800x548.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/GettyImages-1412778743-1020x699.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/GettyImages-1412778743-160x110.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/GettyImages-1412778743-1536x1052.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A pharmacist prepares a dose of the Jynneos mpox vaccine at a pop-up vaccination clinic opened by the Los Angeles County Department of Public Health at the West Hollywood Library on Aug. 3, 2022, in West Hollywood, California. \u003ccite>(Mario Tama/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But even if someone who’s fully vaccinated with Jynneos \u003cem>does\u003c/em> get infected with mpox, she said, “those cases are typically mild.”\u003c/p>\n\u003cp>In other words, like the COVID-19 shot, the mpox vaccine makes it far more likely that any infection you get is far less severe than it would have been if you hadn’t been vaccinated.\u003c/p>\n\u003cp>And the difference between suffering from severe mpox versus a mild case can be considerable, as attested to by the \u003ca href=\"https://www.nytimes.com/2022/07/18/nyregion/new-york-monkeypox-vaccine.html\">“excruciating” symptoms reported during the early days of the 2022 U.S. outbreak\u003c/a>, when most patients hadn’t yet been offered the mpox vaccine. ”\u003c/p>\n\u003cp>\u003cstrong>Travel and mpox vaccination\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdc.gov/mpox/vaccines/index.html\">The CDC has updated its vaccination recommendations\u003c/a> to extend to people traveling to countries with clade I \u003cem>and\u003c/em> clade II outbreaks.\u003c/p>\n\u003cp>As of Sept. 15, these countries with clade I outbreaks include Burundi, Central African Republic, Democratic Republic of the Congo, Ethiopia, Kenya, Malawi, Mozambique, Republic of the Congo, Rwanda, South Sudan, Tanzania, Uganda and Zambia. Countries with new clade II outbreaks include Liberia and Sierra Leone.\u003c/p>\n\u003cp>The agency recommends getting both doses of the vaccine “if you anticipate experiencing any of the following” while traveling to these countries:\u003c/p>\n\u003cul>\n\u003cli>Sex with a new partner\u003c/li>\n\u003cli>Sex at a commercial sex venue, such as a sex club or bathhouse\u003c/li>\n\u003cli>Sex in exchange for money, goods, drugs or other trade\u003c/li>\n\u003cli>Sex in association with a large public event, such as a rave, party or festival.\u003c/li>\n\u003c/ul>\n\u003cp>The mpox vaccine was also originally only available for people aged 18 and older, but in 2022, the Food and Drug Administration (FDA) issued an emergency-use authorization that allows providers to also give the vaccine to young people under 18 who are “determined to be at high risk” of infection.\u003c/p>\n\u003ch2>\u003ca id=\"find-mpox-vaccine-near-me\">\u003c/a>Where can I find an mpox vaccine near me?\u003c/h2>\n\u003cp>If you have a regular health care provider, SFDPH recommends you ask them first about getting the mpox vaccine. Your vaccine will be free, but you may be charged a regular copay for seeing your provider.\u003c/p>\n\u003cp>If you’re eligible for the vaccine, your health insurance should cover the costs \u003ca href=\"https://www.cdc.gov/monkeypox/hcp/vaccine-considerations/vaccination-overview.html\">thanks to the CDC’s recommendations\u003c/a>. If you don’t have a regular health care provider or insurance, you can find the mpox vaccine free at clinics around the Bay Area. You can opt to schedule an appointment or choose a walk-in clinic, depending on what works best for you.\u003c/p>\n\u003cp>(As with the COVID-19 vaccine, receiving an mpox vaccine won’t make you \u003ca href=\"https://documentedny.com/2021/04/04/public-charge-rule-explained/\">a public charge\u003c/a> or affect any future immigration processes you may enter into, and you won’t be asked about your immigration status to receive the mpox vaccine.)\u003c/p>\n\u003cp>\u003cstrong>If you live in or near San Francisco:\u003c/strong>\u003c/p>\n\u003cp>See \u003ca href=\"https://www.sf.gov/get-mpox-vaccines-testing-and-treatment\">a full list of mpox vaccine sites near you in San Francisco\u003c/a>. SFDPH confirms that you don’t have to be a city resident in San Francisco to get vaccinated for mpox.\u003c/p>\n\u003cp>\u003cstrong>Mpox vaccination sites elsewhere in the Bay Area and California:\u003c/strong>\u003c/p>\n\u003cp>Find an mpox vaccine clinic near you using \u003ca href=\"https://myturn.ca.gov/\">the state’s myturn.ca.gov site.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Getting an mpox vaccine at a pharmacy:\u003c/strong>\u003c/p>\n\u003cp>Some pharmacies offer mpox vaccination appointments online, along with other vaccines like COVID-19 and flu. But if you choose this route, you’ll be asked for insurance details — and it’s important to verify with your insurer \u003cem>ahead\u003c/em> of time that they’ll cover the cost of an mpox vaccine at a pharmacy like CVS or Walgreens, as the out-of-pocket costs you’ll be quoted may be steep. If you find your insurance doesn’t fully cover the cost, \u003ca href=\"https://www.sf.gov/get-mpox-vaccines-testing-and-treatment\">SFDPH said you can seek your vaccine at one of their clinics “while supplies last.”\u003c/a>\u003c/p>\n\u003cp>If you get your health care through a health system like Kaiser Permanente, it’s unlikely you’ll be able to get your mpox vaccine covered by insurance at a pharmacy like CVS or Walgreens — the way you can’t get your COVID-19 or flu shot covered by Kaiser at a pharmacy either — and may have to seek it directly from a Kaiser provider.\u003c/p>\n\u003cp>If you’re able to make an appointment online at a pharmacy for your mpox vaccine, you should consider calling that location ahead of time to verify that they do indeed have supply in stock.\u003c/p>\n\u003cp>\u003cem>This story includes reporting from KQED’s Billy Cruz, Carlos Cabrera-Lomelí and Nisa Khan.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Opponents of a sales tax measure on the November ballot have accused Santa Clara County leaders of improperly urging a yes vote on \u003ca href=\"https://www.kqed.org/measure-a\">Measure A\u003c/a>, through a taxpayer-funded mailer sent to every household in the county.\u003c/p>\n\u003cp>At issue is a letter from Santa Clara County Executive James Williams to residents that warned local hospitals and clinics could close as a result of the federal budget cuts approved by President Donald Trump earlier this year. The letter arrived in mailboxes last week — just as \u003ca href=\"https://www.kqed.org/news/12058418/santa-clara-county-sales-tax-measure-a-pitched-to-offset-deep-medicaid-cuts-measure-a\">voters are deciding on Measure A\u003c/a>, a 0.625% sales tax increase touted by county leaders as a way to keep hospitals open and soften the blow of those federal cuts.\u003c/p>\n\u003cp>“It’s a covert, sleight of hand campaign that they’re running,” said Rishi Kumar, a former Saratoga councilmember who is chairing the No on Measure A campaign. “They are spending taxpayer dollars trying to influence people with messaging, which is a doom-and-gloom messaging about health care.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Kumar said the campaign was considering legal action against the county, which is barred from using public resources to promote or oppose any measure on the ballot.\u003c/p>\n\u003cp>In an interview, Williams defended the mailer as part of a legal information campaign and said the county has a responsibility to tell residents about such a large drop in revenue.\u003c/p>\n\u003cp>“We are in a fiscal crisis that’s been caused by these federal cuts,” Williams said. “That’s something that people need to know about.”\u003c/p>\n\u003cfigure id=\"attachment_12058485\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12058485\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00613_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00613_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00613_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00613_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A sign reads, “Vote yes on A, nurses and doctors agree,” outside Santa Clara Valley Medical Center in San José on Sept. 29, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>County officials estimate that the reductions to Medicaid (known as Medi-Cal in California) and SNAP food assistance included in the One Big Beautiful Bill Act will result in losses of over $1 billion annually to the county by the end of the decade. The Board of Supervisors \u003ca href=\"https://www.kqed.org/news/12051250/santa-clara-county-voters-could-pay-more-sales-tax-due-to-trump-cuts\">voted unanimously\u003c/a> in August to place Measure A on the ballot, which will raise an estimated $330 million a year.\u003c/p>\n\u003cp>Williams said the mailer cost roughly $250,000 to send to over 700,000 households in the county. Under the headline “An Important Update from Santa Clara County,” Williams wrote that “due to the federal Medi-Cal cuts, our County-run hospitals and clinics are at risk of closure.”\u003c/p>\n\u003cp>The county currently operates four public hospitals: O’Connor Hospital, Regional Medical Center and Valley Medical Center in San José, and Saint Louise Regional Hospital in Gilroy. The Yes on A campaign has \u003ca href=\"https://www.kqed.org/news/12059539/with-measure-a-santa-clara-county-hopes-to-keep-hospitals-afloat\">run on a message\u003c/a> of “Save Our Local Hospitals,” leaning heavily on the potential threat to these medical centers.[aside label=\"2025 California Special Election\" link1='https://www.kqed.org/measure-a,Learn about Measure A in Santa Clara County' hero=https://cdn.kqed.org/wp-content/uploads/2025/09/Aside-2025-Special-Election-Voter-Guide-Santa-Clara-County-Measure-A-1200x675-1.png]Local government officials are not allowed to use taxpayer dollars to explicitly advocate for or against a ballot measure or candidate, but they can provide residents with informational materials about issues on the ballot.\u003c/p>\n\u003cp>“This doesn’t even do that — it doesn’t mention the measure,” Williams said. “This is talking about the federal cuts, and we unquestionably have the ability to do that, but more importantly, the responsibility.”\u003c/p>\n\u003cp>California’s Supreme Court has ruled that judges should evaluate claims of illegal electioneering by analyzing whether the \u003ca href=\"https://scocal.stanford.edu/opinion/stanson-v-mott-27987\">“style, tenor, and timing”\u003c/a> of the communication makes it campaign-related or informational.\u003c/p>\n\u003cp>Davina Hurt, director of government ethics at the Markkula Center for Applied Ethics at Santa Clara University, said the Santa Clara County mailer “gets right up to the borderline” between ethical and unethical behavior.\u003c/p>\n\u003cp>“The timing and the tone truly matter,” she said. “And here, there are definitely language and words used that make you question whether this is more advocacy rather than informing.”\u003c/p>\n\u003cp>Hurt, the former mayor of Belmont, said it is also important to consider whether similar community updates are regularly sent to residents.\u003c/p>\n\u003cp>Williams said the county has generally provided updates alongside property tax bills. But he said the unprecedented nature of the federal cuts required broader communication — including the creation of a web page with information on the funding loss and multiple town hall meetings.\u003c/p>\n\u003cp>Still, Hurt said it’s important for government officials to take extra care when their messaging overlaps with an election issue.\u003c/p>\n\u003cp>“Even the perception of advocacy undermines confidence in the process,” she said.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Opponents of a sales tax measure on the November ballot have accused Santa Clara County leaders of improperly urging a yes vote on \u003ca href=\"https://www.kqed.org/measure-a\">Measure A\u003c/a>, through a taxpayer-funded mailer sent to every household in the county.\u003c/p>\n\u003cp>At issue is a letter from Santa Clara County Executive James Williams to residents that warned local hospitals and clinics could close as a result of the federal budget cuts approved by President Donald Trump earlier this year. The letter arrived in mailboxes last week — just as \u003ca href=\"https://www.kqed.org/news/12058418/santa-clara-county-sales-tax-measure-a-pitched-to-offset-deep-medicaid-cuts-measure-a\">voters are deciding on Measure A\u003c/a>, a 0.625% sales tax increase touted by county leaders as a way to keep hospitals open and soften the blow of those federal cuts.\u003c/p>\n\u003cp>“It’s a covert, sleight of hand campaign that they’re running,” said Rishi Kumar, a former Saratoga councilmember who is chairing the No on Measure A campaign. “They are spending taxpayer dollars trying to influence people with messaging, which is a doom-and-gloom messaging about health care.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Kumar said the campaign was considering legal action against the county, which is barred from using public resources to promote or oppose any measure on the ballot.\u003c/p>\n\u003cp>In an interview, Williams defended the mailer as part of a legal information campaign and said the county has a responsibility to tell residents about such a large drop in revenue.\u003c/p>\n\u003cp>“We are in a fiscal crisis that’s been caused by these federal cuts,” Williams said. “That’s something that people need to know about.”\u003c/p>\n\u003cfigure id=\"attachment_12058485\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12058485\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00613_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00613_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00613_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00613_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A sign reads, “Vote yes on A, nurses and doctors agree,” outside Santa Clara Valley Medical Center in San José on Sept. 29, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>County officials estimate that the reductions to Medicaid (known as Medi-Cal in California) and SNAP food assistance included in the One Big Beautiful Bill Act will result in losses of over $1 billion annually to the county by the end of the decade. The Board of Supervisors \u003ca href=\"https://www.kqed.org/news/12051250/santa-clara-county-voters-could-pay-more-sales-tax-due-to-trump-cuts\">voted unanimously\u003c/a> in August to place Measure A on the ballot, which will raise an estimated $330 million a year.\u003c/p>\n\u003cp>Williams said the mailer cost roughly $250,000 to send to over 700,000 households in the county. Under the headline “An Important Update from Santa Clara County,” Williams wrote that “due to the federal Medi-Cal cuts, our County-run hospitals and clinics are at risk of closure.”\u003c/p>\n\u003cp>The county currently operates four public hospitals: O’Connor Hospital, Regional Medical Center and Valley Medical Center in San José, and Saint Louise Regional Hospital in Gilroy. The Yes on A campaign has \u003ca href=\"https://www.kqed.org/news/12059539/with-measure-a-santa-clara-county-hopes-to-keep-hospitals-afloat\">run on a message\u003c/a> of “Save Our Local Hospitals,” leaning heavily on the potential threat to these medical centers.\u003c/p>\u003c/div>",
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"link1": "https://www.kqed.org/measure-a,Learn about Measure A in Santa Clara County",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Local government officials are not allowed to use taxpayer dollars to explicitly advocate for or against a ballot measure or candidate, but they can provide residents with informational materials about issues on the ballot.\u003c/p>\n\u003cp>“This doesn’t even do that — it doesn’t mention the measure,” Williams said. “This is talking about the federal cuts, and we unquestionably have the ability to do that, but more importantly, the responsibility.”\u003c/p>\n\u003cp>California’s Supreme Court has ruled that judges should evaluate claims of illegal electioneering by analyzing whether the \u003ca href=\"https://scocal.stanford.edu/opinion/stanson-v-mott-27987\">“style, tenor, and timing”\u003c/a> of the communication makes it campaign-related or informational.\u003c/p>\n\u003cp>Davina Hurt, director of government ethics at the Markkula Center for Applied Ethics at Santa Clara University, said the Santa Clara County mailer “gets right up to the borderline” between ethical and unethical behavior.\u003c/p>\n\u003cp>“The timing and the tone truly matter,” she said. “And here, there are definitely language and words used that make you question whether this is more advocacy rather than informing.”\u003c/p>\n\u003cp>Hurt, the former mayor of Belmont, said it is also important to consider whether similar community updates are regularly sent to residents.\u003c/p>\n\u003cp>Williams said the county has generally provided updates alongside property tax bills. But he said the unprecedented nature of the federal cuts required broader communication — including the creation of a web page with information on the funding loss and multiple town hall meetings.\u003c/p>\n\u003cp>Still, Hurt said it’s important for government officials to take extra care when their messaging overlaps with an election issue.\u003c/p>\n\u003cp>“Even the perception of advocacy undermines confidence in the process,” she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>California is joining 13 other states to create an alliance aimed at coordinating public health, Gov. \u003ca href=\"https://www.kqed.org/news/tag/gavin-newsom\">Gavin Newsom\u003c/a> announced Wednesday in a direct rebuke of the Trump administration and Health Secretary Robert F. Kennedy Jr.’s dramatic overhaul of the nation’s public health systems.\u003c/p>\n\u003cp>The move comes as public health experts grow increasingly concerned about Kennedy’s transformation of the Centers for Disease Control and Prevention, where he’s \u003ca href=\"https://www.kqed.org/news/12054282/its-been-a-week-of-chaos-at-the-cdc-here-are-5-things-to-know\">fired top officials\u003c/a>, \u003ca href=\"https://www.kqed.org/news/12051152/health-experts-alarmed-by-rfk-jr-s-frightening-cuts-to-mrna-vaccine-funding\">slashed research funding\u003c/a>, changed \u003ca href=\"https://www.kqed.org/news/12056934/rfk-jr-s-vaccine-panel-backs-away-from-plan-to-require-an-rx-for-a-covid-shot\">vaccine recommendations\u003c/a> and gutted the leadership of a key \u003ca href=\"https://www.kqed.org/forum/2010101910276/rfk-jr-stacks-key-federal-immunization-committee-with-vaccine-skeptics\">federal immunization committee\u003c/a> and replaced them with novices.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Newsom also noted the deep health care cuts President Trump and congressional Republicans have made this year in announcing the new alliance.\u003c/p>\n\u003cp>“The American people deserve a public health system that puts science before politics,” Newsom said in a statement. “As extremists try to weaponize the CDC and spread misinformation, we’re stepping up to coordinate across states, protect communities, and ensure decisions are driven by data, facts, and the health of the American people.”[aside postID=news_12059875 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-JESSICAALTMANPB-04-BL-KQED.jpg']The new partnership is meant to coordinate public health leadership to improve communication, share information and position states to respond quickly to new threats. It includes the governors of Washington, Oregon, Hawaii, Colorado, Illinois, Massachusetts, New York, New Jersey, Connecticut, Rhode Island, Delaware, Maryland and North Carolina, plus the U.S. territory of Guam.\u003c/p>\n\u003cp>It comes just weeks after Gov. Gavin Newsom also announced California would \u003ca href=\"https://www.kqed.org/news/12054491/in-rebuke-of-rfk-jr-the-west-coast-unites-on-vaccine-policy\">band together with Oregon and Washington\u003c/a> to issue vaccine recommendations \u003ca href=\"https://www.kqed.org/news/12056289/california-law-sets-states-own-vaccine-schedules-deepening-rift-with-cdc\">separate from the federal government’s\u003c/a>. That move came in response to the Trump administration’s \u003ca href=\"https://www.kqed.org/news/12056934/rfk-jr-s-vaccine-panel-backs-away-from-plan-to-require-an-rx-for-a-covid-shot\">inconsistent guidance\u003c/a> on vaccines.\u003c/p>\n\u003cp>Newsom called the new Governors Public Health Alliance, a nonpartisan hub, though all the participating governors are Democrats.\u003c/p>\n\u003cp>But he said the alliance is being financially supported by GovAct, a nonpartisan, nonprofit initiative whose advisory board includes both Democratic and Republican former governors.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California is joining 13 other states to create an alliance aimed at coordinating public health, Gov. \u003ca href=\"https://www.kqed.org/news/tag/gavin-newsom\">Gavin Newsom\u003c/a> announced Wednesday in a direct rebuke of the Trump administration and Health Secretary Robert F. Kennedy Jr.’s dramatic overhaul of the nation’s public health systems.\u003c/p>\n\u003cp>The move comes as public health experts grow increasingly concerned about Kennedy’s transformation of the Centers for Disease Control and Prevention, where he’s \u003ca href=\"https://www.kqed.org/news/12054282/its-been-a-week-of-chaos-at-the-cdc-here-are-5-things-to-know\">fired top officials\u003c/a>, \u003ca href=\"https://www.kqed.org/news/12051152/health-experts-alarmed-by-rfk-jr-s-frightening-cuts-to-mrna-vaccine-funding\">slashed research funding\u003c/a>, changed \u003ca href=\"https://www.kqed.org/news/12056934/rfk-jr-s-vaccine-panel-backs-away-from-plan-to-require-an-rx-for-a-covid-shot\">vaccine recommendations\u003c/a> and gutted the leadership of a key \u003ca href=\"https://www.kqed.org/forum/2010101910276/rfk-jr-stacks-key-federal-immunization-committee-with-vaccine-skeptics\">federal immunization committee\u003c/a> and replaced them with novices.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Newsom also noted the deep health care cuts President Trump and congressional Republicans have made this year in announcing the new alliance.\u003c/p>\n\u003cp>“The American people deserve a public health system that puts science before politics,” Newsom said in a statement. “As extremists try to weaponize the CDC and spread misinformation, we’re stepping up to coordinate across states, protect communities, and ensure decisions are driven by data, facts, and the health of the American people.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The new partnership is meant to coordinate public health leadership to improve communication, share information and position states to respond quickly to new threats. It includes the governors of Washington, Oregon, Hawaii, Colorado, Illinois, Massachusetts, New York, New Jersey, Connecticut, Rhode Island, Delaware, Maryland and North Carolina, plus the U.S. territory of Guam.\u003c/p>\n\u003cp>It comes just weeks after Gov. Gavin Newsom also announced California would \u003ca href=\"https://www.kqed.org/news/12054491/in-rebuke-of-rfk-jr-the-west-coast-unites-on-vaccine-policy\">band together with Oregon and Washington\u003c/a> to issue vaccine recommendations \u003ca href=\"https://www.kqed.org/news/12056289/california-law-sets-states-own-vaccine-schedules-deepening-rift-with-cdc\">separate from the federal government’s\u003c/a>. That move came in response to the Trump administration’s \u003ca href=\"https://www.kqed.org/news/12056934/rfk-jr-s-vaccine-panel-backs-away-from-plan-to-require-an-rx-for-a-covid-shot\">inconsistent guidance\u003c/a> on vaccines.\u003c/p>\n\u003cp>Newsom called the new Governors Public Health Alliance, a nonpartisan hub, though all the participating governors are Democrats.\u003c/p>\n\u003cp>But he said the alliance is being financially supported by GovAct, a nonpartisan, nonprofit initiative whose advisory board includes both Democratic and Republican former governors.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "in-the-face-of-abuse-she-chose-survival-and-now-helps-others-do-the-same",
"title": "In the Face of Abuse, She Chose Survival — and Now Helps Others Do the Same",
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"content": "\u003cp>\u003cem>Warning: This story contains graphic descriptions of violent domestic abuse.\u003c/em>\u003c/p>\n\u003cp>Jagbir Kang was soundly asleep next to her 4-month-old son when she was jolted awake by violent banging on her bedroom door in Fremont. She scooped her baby into her arms just as her husband forced his way in.\u003c/p>\n\u003cp>Earlier that night, Kang had called the police to report a family disturbance — \u003ca href=\"https://www.kqed.org/news/12043890/your-voice-matters-help-kqed-report-on-domestic-violence-in-the-bay-area\">her husband had hit her\u003c/a>. When officers arrived, they asked whether she wanted to press charges. Kang said no. They asked her if she needed a place to stay for the night, away from her husband. Again, she said no.\u003c/p>\n\u003cp>Kang, who was 28 and had been married for two years, said she had no intention of leaving. All she wanted was for the abuse to stop.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Domestic violence often goes unspoken in Asian communities, where stigma, family dynamics, immigration status and lack of culturally responsive services can make it especially difficult to seek help. Survivors like Kang say those layered pressures — along with the fear of losing family, support systems or legal status — kept them silent for years.\u003c/p>\n\u003cp>October is Domestic Violence Awareness Month — a time to center survivors’ voices and highlight the advocates and organizations building safer, more responsive communities. Across the Bay Area, that work continues year-round, led by people who believe healing and accountability can exist outside punishment and shame.\u003c/p>\n\u003cp>But a growing network of advocates and organizations are working to break through that silence and build support systems that meet survivors where they are.\u003c/p>\n\u003cp>Kang remembers her husband taking a fistful of her hair and slamming her head repeatedly against the wall. Bruises blossomed across her face, and the trauma caused temporary blindness in her left eye. Even as she screamed that she couldn’t see, he kept hitting her. When he wrapped his hands around her throat, Kang feared he wouldn’t stop until she was dead.\u003c/p>\n\u003cfigure id=\"attachment_12049967\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12049967\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-Project-Asian-Community-MD-09.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-Project-Asian-Community-MD-09.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-Project-Asian-Community-MD-09-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-Project-Asian-Community-MD-09-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jagbir Kang at her home in Fremont on July 25, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“It seemed like it was never-ending,” she said.\u003c/p>\n\u003cp>Kang, now 46, met her husband through an arranged introduction by her parents in March 2006. They married a few months later. The emotional and verbal abuse began almost immediately, Kang told KQED. By the time their son was born, it had escalated to physical violence. Kang said her husband never hurt their children, but they witnessed the verbal and emotional abuse.\u003c/p>\n\u003cp>She stayed with him for 13 years.\u003c/p>\n\u003cp>The day after the 2008 assault, when she spoke with doctors, she said she’d fallen on a hike. When her friends asked if she was OK, she reassured them that she was fine. She held onto hope that things would change — even when, deep down, she knew they would not.\u003c/p>\n\u003cp>It wasn’t until she was diagnosed with cancer that she decided to leave.\u003c/p>\n\u003cp>“I’m a very optimistic person, and I felt that he would change now that I’m diagnosed with an illness,” she said. “Actually, the abuse became worse after that, and I decided I couldn’t do it anymore … I worried about money and losing children, but then I was like, it’s OK.\u003c/p>\n\u003cp>“It’s still better, because I’ll be alive for my children. Otherwise, I’d be dead.”\u003c/p>\n\u003cp>For some Asian survivors, the decision to leave an abusive spouse or family member is fraught with fear — of community rejection, of losing immigration status or of being unable to access culturally competent services. [aside postID=news_12017701 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/DomesticViolenceGetty-1020x679.jpg']According to the Asian Pacific Institute on Gender-Based Violence, up to 55% of Asian women reported experiencing some form of intimate violence in their lifetimes. The rates vary across ethnic groups — Vietnamese, Indian, Chinese, Korean and others — but experts agree that underreporting is common and the true numbers are likely higher.\u003c/p>\n\u003cp>Mallika Kaur, director of the \u003ca href=\"https://www.law.berkeley.edu/experiential/domestic-violence-law-field-placement/\">Domestic Violence & Gender-Based Violence Practicum\u003c/a> at Berkeley Law, said that cultural expectations play a major role in keeping survivors silent.\u003c/p>\n\u003cp>Traditional gender norms can make it difficult for communities and families to engage in conversations about gender violence. If a woman has been repeatedly taught to follow her husband, she may feel uncertain about what will happen if she chooses to leave, Kaur said, adding that the fear and uncertainty caused by patriarchal standards is something survivors experience outside of Asian communities as well.\u003c/p>\n\u003cp>Kaur, who is also executive director of the Sikh Family Center, an organization focused on addressing gender-based violence nationwide, said survivors also fear backlash from their communities. For people whose entire support system is grounded in a tight-knit cultural or religious community, the risk of alienation is high.\u003c/p>\n\u003cp>“[Survivors] may not see a way of detangling themselves from their abusive partner without losing all sense of community,” Kaur said. “It can determine whether or not they’re going to speak about the abuse, seek separation or even distance themselves from the abusive party.”\u003c/p>\n\u003cp>After she left her husband, Kang said she felt shunned by people she once considered friends and family. In many South Asian communities, divorce carries a heavy stigma — not just for the individual, but for the entire family.\u003c/p>\n\u003cfigure id=\"attachment_12049965\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12049965\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITIES-MD-02-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITIES-MD-02-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITIES-MD-02-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITIES-MD-02-KQED-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jagbir Kang washes the dishes at her home in Fremont on July 25, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“People didn’t want me around,” Kang said. “They didn’t know what I was going through. I didn’t know what the cycle of abuse is. When I learned that this is the abuse cycle and that it’s going to repeat … I would tell my people. Nobody would listen. They don’t believe you.”\u003c/p>\n\u003cp>Abuse in Asian families isn’t always limited to partners.\u003c/p>\n\u003cp>According to a study by the \u003ca href=\"https://urldefense.com/v3/__https:/www.pewresearch.org/fact-tank/2018/04/05/a-record-64-million-americans-live-in-multigenerational-households/__;!!PIZeeW5wscynRQ!4zqR5oIOzB74vlPDWu0qAyoaIenZnvvH_6FmvZYl_zicNEe0XVsM-1q1xqPQl4l1tc8%24\">Pew Research Center\u003c/a>, 29% of Asian Americans lived in multigenerational households in 2016 — more so than any other ethnic group. Kaur said that in a country that emphasizes individualism, the dynamics of collectivist family structures are often misunderstood.\u003c/p>\n\u003cp>“We need to think beyond partner violence in these communities. In-law violence is something people at times cannot fully wrap their heads around,” she said. “Even if they don’t live in the same home, the family structure can often be so that these hooks and their say about what should or shouldn’t happen carries a lot of weight and determines somebody’s full lived reality in a marriage.”\u003c/p>\n\u003cp>Soon after Kang married, her in-laws moved in. She described her father-in-law as narcissistic and dangerous. Their presence, she said, made the abuse worse, and it only escalated after her mother-in-law died.\u003c/p>\n\u003cp>In some families, elders and community members can step in and provide support to survivors. In others, the presence of more relatives simply adds to the trauma.\u003c/p>\n\u003cp>Immigration status and financial instability also pose significant challenges. Shailaja Dixit, executive director of Narika, a Bay Area nonprofit that serves South Asian survivors, said many immigrant survivors are vulnerable because they rely on their abusers to manage documents or visas.\u003c/p>\n\u003cp>In other cases, a woman’s finances are controlled entirely by their husband. Some are forbidden to work. Others may work but not have access to their own wages, Dixit said. If the survivor chooses to leave, they risk falling into poverty or being left without any income.\u003c/p>\n\u003cp>“Not everybody is in a position to leave,” Dixit said.\u003c/p>\n\u003ch2>When culture meets care\u003c/h2>\n\u003cp>Saara Ahmed, a spokesperson for the \u003ca href=\"https://www.kqed.org/news/12045032/she-left-her-abuser-now-the-shelter-that-helped-her-is-losing-federal-funds-under-trump\">Asian Women’s Shelter\u003c/a> in San Francisco, said more needs to be done to create accessible, culturally responsive support systems for Asian survivors.\u003c/p>\n\u003cp>Each community and individual has different needs and traditional service providers are not always equipped to provide care in a survivor’s native language or to understand their cultural context, Ahmed said.\u003c/p>\n\u003cp>“It can be really difficult [for survivors] to access things like shelter and support and services when there is, in addition to the kind of existing taboos and stigmas that domestic violence survivors face, those added barriers of cultural understanding and language needs,” she said.\u003c/p>\n\u003cfigure id=\"attachment_12049968\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12049968\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITY-MD-10-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITY-MD-10-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITY-MD-10-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITY-MD-10-KQED-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jagbir Kang at her home in Fremont on July 25, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Asian Women’s Shelter was created in direct response to the gap in critical services for survivors, she said. In addition to providing clients with emergency housing, legal assistance, trauma counseling and financial assistance, the organization provides thousands of hours of language-specific case management each year.\u003c/p>\n\u003cp>Services are available in over 40 different languages, including Cantonese, Korean, Arabic, Indonesian, Khmer, Punjabi and Tagalog. The shelter also runs two outreach programs focused on Arab and Korean survivors who have experienced domestic violence or human trafficking.\u003c/p>\n\u003cp>Ahmed said the nonprofit is also engaged in outreach efforts to spread awareness about domestic abuse and other forms of gender-based violence through community events and partnerships. There are a lot of misunderstandings when it comes to domestic violence, she said, and part of the solution is teaching people about the different forms abuse can take and what the long-term repercussions are.\u003c/p>\n\u003cp>The shelter is part of the San Francisco Domestic Violence Consortium, a network of local service agencies.\u003c/p>\n\u003cp>“It’s important to have flexible models that make room for the uniqueness and individual needs of survivors,” she said. “Survivors face a lot of stigma, victim blaming and kind of overall societal and cultural misunderstandings and misrepresentations.”[aside postID=news_12045032 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/06/IMG_1050-2000x1500.jpg']Narika offers wraparound services as well, including shelter, transportation, financial counseling and legal aid, Dixit said. The organization also provides support groups Monday through Friday, giving survivors the opportunity to find community with others who have similar experiences. Dixit said Narika served more than 900 survivors last year and 500 since January.\u003c/p>\n\u003cp>She emphasized that even within South Asian communities, experiences vary widely. Within the South Asian diaspora, there are dozens of microcultures and ethnic groups, Dixit said. While domestic violence occurs in every community, each one experiences it differently and has a different understanding of what it looks like.\u003c/p>\n\u003cp>“I feel like one of the biggest things an organization can do is be hyper local, settle into the community and be willing to listen and spend time with survivors and community,” she said.\u003c/p>\n\u003cp>Kaur said it’s important to recognize the role that a person’s community can play in finding culturally sensitive solutions to combat abuse. She noted that the “cultural dog whistle” — the idea that certain forms of violence occur only in select communities and stem from their cultural beliefs and practices — can be counterproductive.\u003c/p>\n\u003cp>It overlooks the possibility that community members themselves may be the best defense against violence, especially when external entities such as law enforcement can also perpetuate harm, she said.\u003c/p>\n\u003cp>“It can sometimes be a first preference for survivors,” Kaur said. “Many survivors will talk about approaching somebody in the community, whether that be elders, in-laws, a mutual relative … How those people react can be really essential to the survivor’s sense of what’s happening to them.”\u003c/p>\n\u003ch2>Reclaiming life, rewriting legacy\u003c/h2>\n\u003cp>Kang’s healing has been long, but she now describes it as empowering. She turned to meditation, yoga and other forms of self-healing. She confided in close friends and family. She leaned into their love.\u003c/p>\n\u003cp>“I did a lot of things to recover. I basically held onto anything that I could at the time,” Kang shared, her voice filled with mirth. “It’s like pulling. You’re drowning, and you want to not drown.”\u003c/p>\n\u003cp>When she looks at her two sons, Kang said she is filled with pride at how far she’s come on her journey. Part of her growth was learning that violence is intergenerational, she added. Leaving her husband, she said, was the first step in breaking the cycle of intergenerational violence. She is alive because of her decision to separate herself from the abuse and choose healing, a process she documented in her book on post-traumatic growth titled, \u003cem>Blooming Through the Cracks\u003c/em>.\u003c/p>\n\u003cfigure id=\"attachment_12049966\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12049966\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITIES-MD-03-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITIES-MD-03-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITIES-MD-03-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITIES-MD-03-KQED-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jagbir Kang holds her book at her home in Fremont on July 25, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Kang said she was fortunate to have a strong support system at the time of her divorce. She also had U.S. citizenship, a good job and a home she owned. She acknowledged that not all survivors are in the same position.\u003c/p>\n\u003cp>After Kang’s separation, she received master’s degrees in psychology and counseling, respectively, from Harvard Extension School and Palo Alto University. In addition to her full-time role as a senior director of product management at tech company Cloudera, Kang also works as a therapist at a psychiatric hospital where she helps other survivors of domestic violence.\u003c/p>\n\u003cp>“I tell [survivors], ‘Your challenges are different from mine. My challenges were different from yours,’” she said. “If you’re a survivor, I cannot tell you that the same thing will happen to you as it happened to me … If you decide to stay, you can stay. We will do safety planning.”\u003c/p>\n\u003cp>“I will never stop advocating,” Kang continued. “I will never stop talking about this.”\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Editor’s note: \u003c/em>\u003c/strong>\u003cem>This is the first in a two-part series\u003c/em> \u003cem>that\u003c/em>\u003cem> is supported by the USC Annenberg Center for Health Journalism’s California Health Equity Fellowship. If you or someone you love needs immediate assistance addressing domestic violence, call the National Domestic Violence Hotline at 800-799-7233.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Warning: This story contains graphic descriptions of violent domestic abuse.\u003c/em>\u003c/p>\n\u003cp>Jagbir Kang was soundly asleep next to her 4-month-old son when she was jolted awake by violent banging on her bedroom door in Fremont. She scooped her baby into her arms just as her husband forced his way in.\u003c/p>\n\u003cp>Earlier that night, Kang had called the police to report a family disturbance — \u003ca href=\"https://www.kqed.org/news/12043890/your-voice-matters-help-kqed-report-on-domestic-violence-in-the-bay-area\">her husband had hit her\u003c/a>. When officers arrived, they asked whether she wanted to press charges. Kang said no. They asked her if she needed a place to stay for the night, away from her husband. Again, she said no.\u003c/p>\n\u003cp>Kang, who was 28 and had been married for two years, said she had no intention of leaving. All she wanted was for the abuse to stop.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Domestic violence often goes unspoken in Asian communities, where stigma, family dynamics, immigration status and lack of culturally responsive services can make it especially difficult to seek help. Survivors like Kang say those layered pressures — along with the fear of losing family, support systems or legal status — kept them silent for years.\u003c/p>\n\u003cp>October is Domestic Violence Awareness Month — a time to center survivors’ voices and highlight the advocates and organizations building safer, more responsive communities. Across the Bay Area, that work continues year-round, led by people who believe healing and accountability can exist outside punishment and shame.\u003c/p>\n\u003cp>But a growing network of advocates and organizations are working to break through that silence and build support systems that meet survivors where they are.\u003c/p>\n\u003cp>Kang remembers her husband taking a fistful of her hair and slamming her head repeatedly against the wall. Bruises blossomed across her face, and the trauma caused temporary blindness in her left eye. Even as she screamed that she couldn’t see, he kept hitting her. When he wrapped his hands around her throat, Kang feared he wouldn’t stop until she was dead.\u003c/p>\n\u003cfigure id=\"attachment_12049967\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12049967\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-Project-Asian-Community-MD-09.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-Project-Asian-Community-MD-09.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-Project-Asian-Community-MD-09-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-Project-Asian-Community-MD-09-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jagbir Kang at her home in Fremont on July 25, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“It seemed like it was never-ending,” she said.\u003c/p>\n\u003cp>Kang, now 46, met her husband through an arranged introduction by her parents in March 2006. They married a few months later. The emotional and verbal abuse began almost immediately, Kang told KQED. By the time their son was born, it had escalated to physical violence. Kang said her husband never hurt their children, but they witnessed the verbal and emotional abuse.\u003c/p>\n\u003cp>She stayed with him for 13 years.\u003c/p>\n\u003cp>The day after the 2008 assault, when she spoke with doctors, she said she’d fallen on a hike. When her friends asked if she was OK, she reassured them that she was fine. She held onto hope that things would change — even when, deep down, she knew they would not.\u003c/p>\n\u003cp>It wasn’t until she was diagnosed with cancer that she decided to leave.\u003c/p>\n\u003cp>“I’m a very optimistic person, and I felt that he would change now that I’m diagnosed with an illness,” she said. “Actually, the abuse became worse after that, and I decided I couldn’t do it anymore … I worried about money and losing children, but then I was like, it’s OK.\u003c/p>\n\u003cp>“It’s still better, because I’ll be alive for my children. Otherwise, I’d be dead.”\u003c/p>\n\u003cp>For some Asian survivors, the decision to leave an abusive spouse or family member is fraught with fear — of community rejection, of losing immigration status or of being unable to access culturally competent services. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>According to the Asian Pacific Institute on Gender-Based Violence, up to 55% of Asian women reported experiencing some form of intimate violence in their lifetimes. The rates vary across ethnic groups — Vietnamese, Indian, Chinese, Korean and others — but experts agree that underreporting is common and the true numbers are likely higher.\u003c/p>\n\u003cp>Mallika Kaur, director of the \u003ca href=\"https://www.law.berkeley.edu/experiential/domestic-violence-law-field-placement/\">Domestic Violence & Gender-Based Violence Practicum\u003c/a> at Berkeley Law, said that cultural expectations play a major role in keeping survivors silent.\u003c/p>\n\u003cp>Traditional gender norms can make it difficult for communities and families to engage in conversations about gender violence. If a woman has been repeatedly taught to follow her husband, she may feel uncertain about what will happen if she chooses to leave, Kaur said, adding that the fear and uncertainty caused by patriarchal standards is something survivors experience outside of Asian communities as well.\u003c/p>\n\u003cp>Kaur, who is also executive director of the Sikh Family Center, an organization focused on addressing gender-based violence nationwide, said survivors also fear backlash from their communities. For people whose entire support system is grounded in a tight-knit cultural or religious community, the risk of alienation is high.\u003c/p>\n\u003cp>“[Survivors] may not see a way of detangling themselves from their abusive partner without losing all sense of community,” Kaur said. “It can determine whether or not they’re going to speak about the abuse, seek separation or even distance themselves from the abusive party.”\u003c/p>\n\u003cp>After she left her husband, Kang said she felt shunned by people she once considered friends and family. In many South Asian communities, divorce carries a heavy stigma — not just for the individual, but for the entire family.\u003c/p>\n\u003cfigure id=\"attachment_12049965\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12049965\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITIES-MD-02-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITIES-MD-02-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITIES-MD-02-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITIES-MD-02-KQED-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jagbir Kang washes the dishes at her home in Fremont on July 25, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“People didn’t want me around,” Kang said. “They didn’t know what I was going through. I didn’t know what the cycle of abuse is. When I learned that this is the abuse cycle and that it’s going to repeat … I would tell my people. Nobody would listen. They don’t believe you.”\u003c/p>\n\u003cp>Abuse in Asian families isn’t always limited to partners.\u003c/p>\n\u003cp>According to a study by the \u003ca href=\"https://urldefense.com/v3/__https:/www.pewresearch.org/fact-tank/2018/04/05/a-record-64-million-americans-live-in-multigenerational-households/__;!!PIZeeW5wscynRQ!4zqR5oIOzB74vlPDWu0qAyoaIenZnvvH_6FmvZYl_zicNEe0XVsM-1q1xqPQl4l1tc8%24\">Pew Research Center\u003c/a>, 29% of Asian Americans lived in multigenerational households in 2016 — more so than any other ethnic group. Kaur said that in a country that emphasizes individualism, the dynamics of collectivist family structures are often misunderstood.\u003c/p>\n\u003cp>“We need to think beyond partner violence in these communities. In-law violence is something people at times cannot fully wrap their heads around,” she said. “Even if they don’t live in the same home, the family structure can often be so that these hooks and their say about what should or shouldn’t happen carries a lot of weight and determines somebody’s full lived reality in a marriage.”\u003c/p>\n\u003cp>Soon after Kang married, her in-laws moved in. She described her father-in-law as narcissistic and dangerous. Their presence, she said, made the abuse worse, and it only escalated after her mother-in-law died.\u003c/p>\n\u003cp>In some families, elders and community members can step in and provide support to survivors. In others, the presence of more relatives simply adds to the trauma.\u003c/p>\n\u003cp>Immigration status and financial instability also pose significant challenges. Shailaja Dixit, executive director of Narika, a Bay Area nonprofit that serves South Asian survivors, said many immigrant survivors are vulnerable because they rely on their abusers to manage documents or visas.\u003c/p>\n\u003cp>In other cases, a woman’s finances are controlled entirely by their husband. Some are forbidden to work. Others may work but not have access to their own wages, Dixit said. If the survivor chooses to leave, they risk falling into poverty or being left without any income.\u003c/p>\n\u003cp>“Not everybody is in a position to leave,” Dixit said.\u003c/p>\n\u003ch2>When culture meets care\u003c/h2>\n\u003cp>Saara Ahmed, a spokesperson for the \u003ca href=\"https://www.kqed.org/news/12045032/she-left-her-abuser-now-the-shelter-that-helped-her-is-losing-federal-funds-under-trump\">Asian Women’s Shelter\u003c/a> in San Francisco, said more needs to be done to create accessible, culturally responsive support systems for Asian survivors.\u003c/p>\n\u003cp>Each community and individual has different needs and traditional service providers are not always equipped to provide care in a survivor’s native language or to understand their cultural context, Ahmed said.\u003c/p>\n\u003cp>“It can be really difficult [for survivors] to access things like shelter and support and services when there is, in addition to the kind of existing taboos and stigmas that domestic violence survivors face, those added barriers of cultural understanding and language needs,” she said.\u003c/p>\n\u003cfigure id=\"attachment_12049968\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12049968\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITY-MD-10-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITY-MD-10-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITY-MD-10-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITY-MD-10-KQED-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jagbir Kang at her home in Fremont on July 25, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Asian Women’s Shelter was created in direct response to the gap in critical services for survivors, she said. In addition to providing clients with emergency housing, legal assistance, trauma counseling and financial assistance, the organization provides thousands of hours of language-specific case management each year.\u003c/p>\n\u003cp>Services are available in over 40 different languages, including Cantonese, Korean, Arabic, Indonesian, Khmer, Punjabi and Tagalog. The shelter also runs two outreach programs focused on Arab and Korean survivors who have experienced domestic violence or human trafficking.\u003c/p>\n\u003cp>Ahmed said the nonprofit is also engaged in outreach efforts to spread awareness about domestic abuse and other forms of gender-based violence through community events and partnerships. There are a lot of misunderstandings when it comes to domestic violence, she said, and part of the solution is teaching people about the different forms abuse can take and what the long-term repercussions are.\u003c/p>\n\u003cp>The shelter is part of the San Francisco Domestic Violence Consortium, a network of local service agencies.\u003c/p>\n\u003cp>“It’s important to have flexible models that make room for the uniqueness and individual needs of survivors,” she said. “Survivors face a lot of stigma, victim blaming and kind of overall societal and cultural misunderstandings and misrepresentations.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Narika offers wraparound services as well, including shelter, transportation, financial counseling and legal aid, Dixit said. The organization also provides support groups Monday through Friday, giving survivors the opportunity to find community with others who have similar experiences. Dixit said Narika served more than 900 survivors last year and 500 since January.\u003c/p>\n\u003cp>She emphasized that even within South Asian communities, experiences vary widely. Within the South Asian diaspora, there are dozens of microcultures and ethnic groups, Dixit said. While domestic violence occurs in every community, each one experiences it differently and has a different understanding of what it looks like.\u003c/p>\n\u003cp>“I feel like one of the biggest things an organization can do is be hyper local, settle into the community and be willing to listen and spend time with survivors and community,” she said.\u003c/p>\n\u003cp>Kaur said it’s important to recognize the role that a person’s community can play in finding culturally sensitive solutions to combat abuse. She noted that the “cultural dog whistle” — the idea that certain forms of violence occur only in select communities and stem from their cultural beliefs and practices — can be counterproductive.\u003c/p>\n\u003cp>It overlooks the possibility that community members themselves may be the best defense against violence, especially when external entities such as law enforcement can also perpetuate harm, she said.\u003c/p>\n\u003cp>“It can sometimes be a first preference for survivors,” Kaur said. “Many survivors will talk about approaching somebody in the community, whether that be elders, in-laws, a mutual relative … How those people react can be really essential to the survivor’s sense of what’s happening to them.”\u003c/p>\n\u003ch2>Reclaiming life, rewriting legacy\u003c/h2>\n\u003cp>Kang’s healing has been long, but she now describes it as empowering. She turned to meditation, yoga and other forms of self-healing. She confided in close friends and family. She leaned into their love.\u003c/p>\n\u003cp>“I did a lot of things to recover. I basically held onto anything that I could at the time,” Kang shared, her voice filled with mirth. “It’s like pulling. You’re drowning, and you want to not drown.”\u003c/p>\n\u003cp>When she looks at her two sons, Kang said she is filled with pride at how far she’s come on her journey. Part of her growth was learning that violence is intergenerational, she added. Leaving her husband, she said, was the first step in breaking the cycle of intergenerational violence. She is alive because of her decision to separate herself from the abuse and choose healing, a process she documented in her book on post-traumatic growth titled, \u003cem>Blooming Through the Cracks\u003c/em>.\u003c/p>\n\u003cfigure id=\"attachment_12049966\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12049966\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITIES-MD-03-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITIES-MD-03-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITIES-MD-03-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/250725-DV-PROJECT-ASIAN-COMMUNITIES-MD-03-KQED-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jagbir Kang holds her book at her home in Fremont on July 25, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Kang said she was fortunate to have a strong support system at the time of her divorce. She also had U.S. citizenship, a good job and a home she owned. She acknowledged that not all survivors are in the same position.\u003c/p>\n\u003cp>After Kang’s separation, she received master’s degrees in psychology and counseling, respectively, from Harvard Extension School and Palo Alto University. In addition to her full-time role as a senior director of product management at tech company Cloudera, Kang also works as a therapist at a psychiatric hospital where she helps other survivors of domestic violence.\u003c/p>\n\u003cp>“I tell [survivors], ‘Your challenges are different from mine. My challenges were different from yours,’” she said. “If you’re a survivor, I cannot tell you that the same thing will happen to you as it happened to me … If you decide to stay, you can stay. We will do safety planning.”\u003c/p>\n\u003cp>“I will never stop advocating,” Kang continued. “I will never stop talking about this.”\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Editor’s note: \u003c/em>\u003c/strong>\u003cem>This is the first in a two-part series\u003c/em> \u003cem>that\u003c/em>\u003cem> is supported by the USC Annenberg Center for Health Journalism’s California Health Equity Fellowship. If you or someone you love needs immediate assistance addressing domestic violence, call the National Domestic Violence Hotline at 800-799-7233.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Accidental overdose deaths in \u003ca href=\"https://www.kqed.org/news/tag/san-francisco\">San Francisco\u003c/a> have dropped to the lowest number so far this year.\u003c/p>\n\u003cp>According to the Department of Public Health, which puts out \u003ca href=\"https://media.api.sf.gov/documents/2025_10_OCME_Overdose_Report.pdf\">a monthly report\u003c/a> from the Office of the Chief Medical Examiner, 38 people died from accidental drug overdoses in September.\u003c/p>\n\u003cp>That’s 10 fewer deaths than the city recorded in August. It’s also the second-lowest number since the OCME started tracking overdose deaths in 2020.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“That’s still 38 too many people that have died of an overdose of a public health crisis and epidemic,” said Daniel Tsai, director of San Francisco’s Department of Public Health, at a press briefing on Tuesday. “But I want to say I am encouraged, I know we’re making real progress, and I and others here are not yet satisfied about where we are and the work that we continue to have to do.”\u003c/p>\n\u003cp>Tsai, who has been in the role since February, said the city’s newly integrated neighborhood street teams are helping. This initiative, announced by Mayor Daniel Lurie in March, consolidated outreach teams across multiple city departments that were often working toward the same goals, while siloed from each other.\u003c/p>\n\u003cfigure id=\"attachment_11958586\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11958586\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230818-NARCAN-AP-MR-KQED.jpg\" alt='A hand with painted finger nails holds a small white object with the words \"NARCAN NASAL SPRAY\" written on it.' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230818-NARCAN-AP-MR-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230818-NARCAN-AP-MR-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230818-NARCAN-AP-MR-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230818-NARCAN-AP-MR-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230818-NARCAN-AP-MR-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230818-NARCAN-AP-MR-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The overdose-reversal drug Narcan. \u003ccite>(Matt Rourke/AP Photo)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We are seeing a new level of collaboration between departments that’s actually allowing us to help get folks who many departments are engaging with many, many, many times quickly into services, into shelter, into care,” Tsai said.\u003c/p>\n\u003cp>The September numbers bring the total number of accidental overdose deaths in 2025 to 497 people, a slight improvement on 2024. At this time last year, the city had reported 508 overdose deaths.\u003c/p>\n\u003cp>Over 75% of the accidental overdose deaths in 2025 have involved fentanyl.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" title=\"San Francisco monthly drug overdose deaths in 2024 and 2025\" aria-label=\"Column Chart\" id=\"datawrapper-chart-ofGMP\" src=\"https://datawrapper.dwcdn.net/ofGMP/5/\" scrolling=\"no\" frameborder=\"0\" style=\"border: none;\" width=\"1106\" height=\"440\" data-external=\"1\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>Addressing the city’s fentanyl crisis has been a major priority for Lurie since his term began. The Board of Supervisors passed Lurie’s \u003ca href=\"https://www.kqed.org/news/12025495/luries-fentanyl-response-clears-san-francisco-board-of-supervisors\">fentanyl state of emergency ordinance\u003c/a> in January, allowing him to move faster when hiring and contracting services aimed at overdoses and homelessness.\u003c/p>\n\u003cp>The city was able to open a \u003ca href=\"https://www.kqed.org/news/12038376/tenderloin-welcomes-mental-health-clinic-demands-broader-city-action-on-homelessness\">drop-in mental health stabilization center\u003c/a> at 822 Geary St. faster than usual because of that ordinance. Up to 16 clients can stay at the center for as many as 23 hours. Tsai cited the stabilization center as a key touchpoint in the effort to lower overdose numbers.\u003c/p>\n\u003cp>“Once we can get somebody plugged into treatment,” he said, “we want to be able to help get them into the next place in their journey.”\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Accidental overdose deaths in \u003ca href=\"https://www.kqed.org/news/tag/san-francisco\">San Francisco\u003c/a> have dropped to the lowest number so far this year.\u003c/p>\n\u003cp>According to the Department of Public Health, which puts out \u003ca href=\"https://media.api.sf.gov/documents/2025_10_OCME_Overdose_Report.pdf\">a monthly report\u003c/a> from the Office of the Chief Medical Examiner, 38 people died from accidental drug overdoses in September.\u003c/p>\n\u003cp>That’s 10 fewer deaths than the city recorded in August. It’s also the second-lowest number since the OCME started tracking overdose deaths in 2020.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“That’s still 38 too many people that have died of an overdose of a public health crisis and epidemic,” said Daniel Tsai, director of San Francisco’s Department of Public Health, at a press briefing on Tuesday. “But I want to say I am encouraged, I know we’re making real progress, and I and others here are not yet satisfied about where we are and the work that we continue to have to do.”\u003c/p>\n\u003cp>Tsai, who has been in the role since February, said the city’s newly integrated neighborhood street teams are helping. This initiative, announced by Mayor Daniel Lurie in March, consolidated outreach teams across multiple city departments that were often working toward the same goals, while siloed from each other.\u003c/p>\n\u003cfigure id=\"attachment_11958586\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11958586\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230818-NARCAN-AP-MR-KQED.jpg\" alt='A hand with painted finger nails holds a small white object with the words \"NARCAN NASAL SPRAY\" written on it.' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230818-NARCAN-AP-MR-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230818-NARCAN-AP-MR-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230818-NARCAN-AP-MR-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230818-NARCAN-AP-MR-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230818-NARCAN-AP-MR-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230818-NARCAN-AP-MR-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The overdose-reversal drug Narcan. \u003ccite>(Matt Rourke/AP Photo)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We are seeing a new level of collaboration between departments that’s actually allowing us to help get folks who many departments are engaging with many, many, many times quickly into services, into shelter, into care,” Tsai said.\u003c/p>\n\u003cp>The September numbers bring the total number of accidental overdose deaths in 2025 to 497 people, a slight improvement on 2024. At this time last year, the city had reported 508 overdose deaths.\u003c/p>\n\u003cp>Over 75% of the accidental overdose deaths in 2025 have involved fentanyl.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" title=\"San Francisco monthly drug overdose deaths in 2024 and 2025\" aria-label=\"Column Chart\" id=\"datawrapper-chart-ofGMP\" src=\"https://datawrapper.dwcdn.net/ofGMP/5/\" scrolling=\"no\" frameborder=\"0\" style=\"border: none;\" width=\"1106\" height=\"440\" data-external=\"1\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>Addressing the city’s fentanyl crisis has been a major priority for Lurie since his term began. The Board of Supervisors passed Lurie’s \u003ca href=\"https://www.kqed.org/news/12025495/luries-fentanyl-response-clears-san-francisco-board-of-supervisors\">fentanyl state of emergency ordinance\u003c/a> in January, allowing him to move faster when hiring and contracting services aimed at overdoses and homelessness.\u003c/p>\n\u003cp>The city was able to open a \u003ca href=\"https://www.kqed.org/news/12038376/tenderloin-welcomes-mental-health-clinic-demands-broader-city-action-on-homelessness\">drop-in mental health stabilization center\u003c/a> at 822 Geary St. faster than usual because of that ordinance. Up to 16 clients can stay at the center for as many as 23 hours. Tsai cited the stabilization center as a key touchpoint in the effort to lower overdose numbers.\u003c/p>\n\u003cp>“Once we can get somebody plugged into treatment,” he said, “we want to be able to help get them into the next place in their journey.”\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/kaiser-permanente\">Kaiser Permanente\u003c/a> employees picketed outside several Bay Area locations on Tuesday, joining tens of thousands across multiple states in kicking off a planned \u003ca href=\"https://www.kqed.org/news/12059551/california-kaiser-health-care-workers-reaching-breaking-point-set-to-strike-next-week\">five-day strike\u003c/a> at the nonprofit health care organization.\u003c/p>\n\u003cp>Up to 46,000 workers represented by an alliance of unions plan to join picket lines throughout the week, demanding higher wages and increased staffing levels. The work stoppage, which is expected to end Sunday morning, could disrupt operations at hospitals, clinics and medical offices in California, Hawaii and Oregon.\u003c/p>\n\u003cp>The workers say soaring inflation has outpaced their wages, hurting retention rates and patient care.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We’re just wanting better patient care, better patient access. Also, we’re asking for [them to] pay us fairly,” said Lore Vanden Heuvel, a physical therapist based in Antioch.\u003c/p>\n\u003cp>Kaiser, which said it has already offered a “generous” wage hike, has been negotiating a new national contract since May with the Alliance of Healthcare Unions, a network of 23 unions that represent nearly 61,000 Kaiser employees. Some affiliated unions, including in the Bay Area, have been bargaining with the employer for longer, though not all of the unions involved in the ongoing contract negotiations are striking.\u003c/p>\n\u003cfigure id=\"attachment_12059851\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12059851\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-07-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-07-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-07-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-07-KQED-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Lore Vandenheuvel and other workers strike outside of the Kaiser Permanente Oakland Medical Center in Oakland on Oct. 14, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“The strike is designed to disrupt the lives of our patients — the very people we are all here to serve,” Kaiser \u003ca href=\"https://about.kaiserpermanente.org/who-we-are/labor-relations/alliance-national-bargaining/media-statements/our-statement-on-the-alliance-of-health-care-unions-strike\">said in a statement on Monday\u003c/a>, adding that the Oakland-based organization is prepared to maintain services for its patients, including about 8 million in California, by onboarding thousands of temporary nurses, clinicians and staff and reassigning others who have volunteered to work at strike locations.\u003c/p>\n\u003cp>Kaiser hospitals and most medical offices will remain open, but some appointments are being shifted to virtual settings. Certain elective surgeries and procedures could be rescheduled.\u003c/p>\n\u003cp>“For months, we’ve been preparing contingency plans to ensure our members will continue to receive safe, high-quality care,” Kaiser said. “We remain committed to an agreement that balances fair pay with affordable care.”[aside postID=news_12059551 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240422-NursesAI-29-BL-1020x680.jpg']Compensation has been a major sticking point in the negotiations between the Alliance of Healthcare Unions and Kaiser.\u003c/p>\n\u003cp>The alliance in May proposed a 38% wage increase over four years, though it has since lowered its ask to 25%. Kaiser’s most recent offer includes a 21.5% raise over four years, which it said builds on an already competitive pay scale. The proposal would improve health plans and retiree benefits for employees, according to Lionel Sims, the vice president of human resources for Kaiser Permanente in Northern California.\u003c/p>\n\u003cp>But union leaders say Kaiser’s offer does not sufficiently compensate for the much smaller raises workers agreed to during the COVID-19 pandemic, when Kaiser said it was struggling financially.\u003c/p>\n\u003cp>At the same time, Kaiser negotiated higher raises with other unions, according to Brian Mason, the representation director for one of the striking unions, the United Nurses Associations of California/Union of Health Care Professionals.\u003c/p>\n\u003cp>UNAC/UHCP, which represents about 31,000 registered nurses, pharmacists, physician assistants and other health care professionals largely based in California, said its members need larger pay bumps to catch up.\u003c/p>\n\u003cfigure id=\"attachment_12059848\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12059848\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-04-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-04-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-04-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-04-KQED-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Workers strike outside of the Kaiser Permanente Oakland Medical Center in Oakland on Oct. 14, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“They left us behind,” Mason said. “Now it’s our time. These are health care professionals who come to work every day who are committed to their patients and they’re out fighting for what they deserve.”\u003c/p>\n\u003cp>The alliance is also concerned that Kaiser’s proposal would actually cut some health benefits and pensions for some groups of workers, including physicians assistants, nurse anesthetists and midwives.\u003c/p>\n\u003cp>Without a significant increase in compensation, the unions said, Kaiser medical centers will continue to be understaffed.\u003c/p>\n\u003cp>“We’re lacking staffing left and right in all different disciplines and inpatient and outpatient everywhere,” Vanden Heuvel told KQED.\u003c/p>\n\u003cp>Jeff Cathcart, a certified registered nurse anesthetist who has been with Kaiser for 20 years, said that anesthetists have been bargaining for a contract for most of the two years since they unionized. In that time, they’ve lost more than 100 of their 400 CRNAs, he added.\u003c/p>\n\u003cp>“They’re leaving for better working conditions, an average increase in pay of about 25%,” Cathcart said. “When we have that problem with retention and recruitment, that leads to access to care issues for our patients. And that’s really what we’re out here fighting for.”\u003c/p>\n\u003cfigure id=\"attachment_12059850\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12059850\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-06-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-06-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-06-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-06-KQED-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Arezou Mansourian leads workers in chanting as they strike outside of the Kaiser Permanente Oakland Medical Center in Oakland on Oct. 14, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The short staffing is leading to burnout and hurting patient care by delaying appointment wait times, said Arezou Mansourian, who has worked as a physician assistant in orthopedics at Kaiser in Walnut Creek, Dublin and Antioch for 16 years.\u003c/p>\n\u003cp>“If you break your wrist, you’re going to have to wait one to two weeks to see us,” she told KQED. “Things like dermatology have six-month waits … you try to go in and even get your eyes checked, it’s three months; a colonoscopy, three to six months in most areas.”\u003c/p>\n\u003cp>“If you’re a post-op patient and need to be seen weekly, and your therapist has to tell you, ‘Sorry, I’m booking out for four weeks,’ that’s not really the best of care,” Vanden Heuvel added.\u003c/p>\n\u003cp>Kaiser has maintained that it meets or exceeds required state staffing levels.\u003c/p>\n\u003cp>Sims, the VP of human resources, said the unions’ focus on negotiating higher pay is disingenuous.\u003c/p>\n\u003cfigure id=\"attachment_12059845\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12059845\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-01-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-01-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-01-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-01-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Workers strike outside of the Kaiser Permanente Oakland Medical Center in Oakland on Oct. 14, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“They say their goal is to protect patients by ensuring better care and staffing, but the real issue is wages,” he told KQED last week in a statement. “Their claims about Kaiser Permanente’s quality and staffing don’t reflect the facts.”\u003c/p>\n\u003cp>Instead, Kaiser argues that offering a raise any higher than the 21.5% in its current proposal would force it to increase rates and potentially push people to “make the difficult choice to go without coverage.”\u003c/p>\n\u003cp>The union alliance said Kaiser maintains significant financial reserves, mostly accumulated during the pandemic, and posted higher operating revenue and income in the first half of 2025 than the same period last year.\u003c/p>\n\u003cp>Mason also pointed to the employer’s recent expansion into new states, \u003ca href=\"https://www.prnewswire.com/news-releases/kaiser-permanente-launches-in-nevada-in-2026-302552906.html\">partnering with Renown Health\u003c/a> in Nevada and purchasing medical groups on the East Coast.\u003c/p>\n\u003cp>“It’s kind of hard to feel sorry for Kaiser when they say they have to raise rates [while] they’re out buying new medical groups,” he said. “They’re sitting on a lot of money and that’s all profit that is made off the backs of the health care professionals who are currently on strike right now … that is a result of the work that they do.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/kaiser-permanente\">Kaiser Permanente\u003c/a> employees picketed outside several Bay Area locations on Tuesday, joining tens of thousands across multiple states in kicking off a planned \u003ca href=\"https://www.kqed.org/news/12059551/california-kaiser-health-care-workers-reaching-breaking-point-set-to-strike-next-week\">five-day strike\u003c/a> at the nonprofit health care organization.\u003c/p>\n\u003cp>Up to 46,000 workers represented by an alliance of unions plan to join picket lines throughout the week, demanding higher wages and increased staffing levels. The work stoppage, which is expected to end Sunday morning, could disrupt operations at hospitals, clinics and medical offices in California, Hawaii and Oregon.\u003c/p>\n\u003cp>The workers say soaring inflation has outpaced their wages, hurting retention rates and patient care.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We’re just wanting better patient care, better patient access. Also, we’re asking for [them to] pay us fairly,” said Lore Vanden Heuvel, a physical therapist based in Antioch.\u003c/p>\n\u003cp>Kaiser, which said it has already offered a “generous” wage hike, has been negotiating a new national contract since May with the Alliance of Healthcare Unions, a network of 23 unions that represent nearly 61,000 Kaiser employees. Some affiliated unions, including in the Bay Area, have been bargaining with the employer for longer, though not all of the unions involved in the ongoing contract negotiations are striking.\u003c/p>\n\u003cfigure id=\"attachment_12059851\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12059851\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-07-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-07-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-07-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-07-KQED-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Lore Vandenheuvel and other workers strike outside of the Kaiser Permanente Oakland Medical Center in Oakland on Oct. 14, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“The strike is designed to disrupt the lives of our patients — the very people we are all here to serve,” Kaiser \u003ca href=\"https://about.kaiserpermanente.org/who-we-are/labor-relations/alliance-national-bargaining/media-statements/our-statement-on-the-alliance-of-health-care-unions-strike\">said in a statement on Monday\u003c/a>, adding that the Oakland-based organization is prepared to maintain services for its patients, including about 8 million in California, by onboarding thousands of temporary nurses, clinicians and staff and reassigning others who have volunteered to work at strike locations.\u003c/p>\n\u003cp>Kaiser hospitals and most medical offices will remain open, but some appointments are being shifted to virtual settings. Certain elective surgeries and procedures could be rescheduled.\u003c/p>\n\u003cp>“For months, we’ve been preparing contingency plans to ensure our members will continue to receive safe, high-quality care,” Kaiser said. “We remain committed to an agreement that balances fair pay with affordable care.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Compensation has been a major sticking point in the negotiations between the Alliance of Healthcare Unions and Kaiser.\u003c/p>\n\u003cp>The alliance in May proposed a 38% wage increase over four years, though it has since lowered its ask to 25%. Kaiser’s most recent offer includes a 21.5% raise over four years, which it said builds on an already competitive pay scale. The proposal would improve health plans and retiree benefits for employees, according to Lionel Sims, the vice president of human resources for Kaiser Permanente in Northern California.\u003c/p>\n\u003cp>But union leaders say Kaiser’s offer does not sufficiently compensate for the much smaller raises workers agreed to during the COVID-19 pandemic, when Kaiser said it was struggling financially.\u003c/p>\n\u003cp>At the same time, Kaiser negotiated higher raises with other unions, according to Brian Mason, the representation director for one of the striking unions, the United Nurses Associations of California/Union of Health Care Professionals.\u003c/p>\n\u003cp>UNAC/UHCP, which represents about 31,000 registered nurses, pharmacists, physician assistants and other health care professionals largely based in California, said its members need larger pay bumps to catch up.\u003c/p>\n\u003cfigure id=\"attachment_12059848\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12059848\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-04-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-04-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-04-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-04-KQED-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Workers strike outside of the Kaiser Permanente Oakland Medical Center in Oakland on Oct. 14, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“They left us behind,” Mason said. “Now it’s our time. These are health care professionals who come to work every day who are committed to their patients and they’re out fighting for what they deserve.”\u003c/p>\n\u003cp>The alliance is also concerned that Kaiser’s proposal would actually cut some health benefits and pensions for some groups of workers, including physicians assistants, nurse anesthetists and midwives.\u003c/p>\n\u003cp>Without a significant increase in compensation, the unions said, Kaiser medical centers will continue to be understaffed.\u003c/p>\n\u003cp>“We’re lacking staffing left and right in all different disciplines and inpatient and outpatient everywhere,” Vanden Heuvel told KQED.\u003c/p>\n\u003cp>Jeff Cathcart, a certified registered nurse anesthetist who has been with Kaiser for 20 years, said that anesthetists have been bargaining for a contract for most of the two years since they unionized. In that time, they’ve lost more than 100 of their 400 CRNAs, he added.\u003c/p>\n\u003cp>“They’re leaving for better working conditions, an average increase in pay of about 25%,” Cathcart said. “When we have that problem with retention and recruitment, that leads to access to care issues for our patients. And that’s really what we’re out here fighting for.”\u003c/p>\n\u003cfigure id=\"attachment_12059850\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12059850\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-06-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-06-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-06-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-06-KQED-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Arezou Mansourian leads workers in chanting as they strike outside of the Kaiser Permanente Oakland Medical Center in Oakland on Oct. 14, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The short staffing is leading to burnout and hurting patient care by delaying appointment wait times, said Arezou Mansourian, who has worked as a physician assistant in orthopedics at Kaiser in Walnut Creek, Dublin and Antioch for 16 years.\u003c/p>\n\u003cp>“If you break your wrist, you’re going to have to wait one to two weeks to see us,” she told KQED. “Things like dermatology have six-month waits … you try to go in and even get your eyes checked, it’s three months; a colonoscopy, three to six months in most areas.”\u003c/p>\n\u003cp>“If you’re a post-op patient and need to be seen weekly, and your therapist has to tell you, ‘Sorry, I’m booking out for four weeks,’ that’s not really the best of care,” Vanden Heuvel added.\u003c/p>\n\u003cp>Kaiser has maintained that it meets or exceeds required state staffing levels.\u003c/p>\n\u003cp>Sims, the VP of human resources, said the unions’ focus on negotiating higher pay is disingenuous.\u003c/p>\n\u003cfigure id=\"attachment_12059845\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12059845\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-01-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-01-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-01-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/251014-KAISER-STRIKE-START-MD-01-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Workers strike outside of the Kaiser Permanente Oakland Medical Center in Oakland on Oct. 14, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“They say their goal is to protect patients by ensuring better care and staffing, but the real issue is wages,” he told KQED last week in a statement. “Their claims about Kaiser Permanente’s quality and staffing don’t reflect the facts.”\u003c/p>\n\u003cp>Instead, Kaiser argues that offering a raise any higher than the 21.5% in its current proposal would force it to increase rates and potentially push people to “make the difficult choice to go without coverage.”\u003c/p>\n\u003cp>The union alliance said Kaiser maintains significant financial reserves, mostly accumulated during the pandemic, and posted higher operating revenue and income in the first half of 2025 than the same period last year.\u003c/p>\n\u003cp>Mason also pointed to the employer’s recent expansion into new states, \u003ca href=\"https://www.prnewswire.com/news-releases/kaiser-permanente-launches-in-nevada-in-2026-302552906.html\">partnering with Renown Health\u003c/a> in Nevada and purchasing medical groups on the East Coast.\u003c/p>\n\u003cp>“It’s kind of hard to feel sorry for Kaiser when they say they have to raise rates [while] they’re out buying new medical groups,” he said. “They’re sitting on a lot of money and that’s all profit that is made off the backs of the health care professionals who are currently on strike right now … that is a result of the work that they do.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "California Kaiser Health Care Workers, Reaching ‘Breaking Point,’ Set to Strike Next Week",
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"content": "\u003cp>Tens of thousands of \u003ca href=\"https://www.kqed.org/news/tag/kaiser-permanente\">Kaiser Permanente\u003c/a> nurses and employees plan to walk off the job on Tuesday over wage and staffing level concerns that they say have been unaddressed as the healthcare organization’s operations expand.\u003c/p>\n\u003cp>The walkout, which is expected to last five days, could bring disruptions to dozens of clinics and hospitals in California and Hawaii, according to one of the unions launching the strike.\u003c/p>\n\u003cp>Representatives for Kaiser, which employs about 180,000 people in California, said that in the event of a work stoppage, impacted facilities will remain open. Physicians will continue to see patients aided by trained managers and contingency staff, including licensed temporary nurses.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We take any threat to services seriously, and our patients remain our priority,” Lionel Sims, vice president of human resources at Kaiser Permanente in Northern California, said in a statement.\u003c/p>\n\u003cp>The standoff comes as Kaiser unveiled another round of layoffs targeting hundreds of workers in the state, including 184 employees primarily in IT and food services in Northern California who were notified recently, the organization said. The job losses and walkout are not connected, according to Kaiser.\u003c/p>\n\u003cfigure id=\"attachment_11963409\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11963409\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED.jpg\" alt='A large modern building with the words \"Kaiser Permanente\" across the top.' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Kaiser Permanente Oakland Medical Center in Oakland on Oct. 4, 2023. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Since May, the Alliance of Healthcare Unions and Kaiser have been negotiating a new nationwide labor contract covering nearly 61,000 employees. Several of the 23 unions that form the Alliance notified Kaiser about their intent to strike, including the \u003ca href=\"https://url.us.m.mimecastprotect.com/s/_Hb6C829m0uQljg8unfPuyed-I?domain=zwly9k6z.r.us-east-1.awstrack.me\">United Nurses Associations of California/Union of Health Care Professionals\u003c/a>, which represents about 31,000 registered nurses, pharmacists, physician assistants and other health care professionals largely based in California.\u003c/p>\n\u003cp>Union officials said the walkout, which is set to end at 7 a.m. on Sunday, is necessary to protect patients and their caregivers, who are struggling with short staffing and stagnant wages and benefits, as many professionals lack pensions. They warned that Kaiser’s failure to sufficiently invest in its workforce is leading to delays in appointments, treatment and recovery for patients.\u003c/p>\n\u003cp>“Our patients are waiting longer, and our caregivers are stretched to the breaking point, and Kaiser executives are sitting on billions,” Joe Guzynski, executive director at UNAC/UHCP and a lead negotiator, said in a statement.\u003c/p>\n\u003cp>Staffing levels remain a top concern for hospital employees nationwide due to burnout and turnover, especially for nurses, according\u003ca href=\"https://www.kqed.org/news/12011878/thousands-of-uc-san-francisco-workers-are-preparing-to-strike\"> to experts\u003c/a>.[aside postID=news_12058930 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-15-KQED.jpg']Kaiser Permanente, headquartered in Oakland, posted $63.9 billion in operating revenue and nearly \u003ca href=\"https://about.kaiserpermanente.org/news/kaiser-permanente-and-risant-health-q2-2025-financial-update\">$2 billion\u003c/a> in operating income for the first half of 2025, slightly higher than for the same period last year. The health organization and its affiliates, with about 12.6 million members, have been \u003ca href=\"https://www.beckershospitalreview.com/finance/kaisers-risant-health-to-become-35b-system-in-5-years-14-things-to-know/\">acquiring hospital systems\u003c/a> in recent years, including in Pennsylvania and North Carolina.\u003c/p>\n\u003cp>Sims dismissed claims that Kaiser is putting the quality of patient care at risk, citing top ratings for its Medicare and commercial health plans. The threat of a walkout, he said, aims to pressure Kaiser to agree to union demands for a 25% pay increase over four years. The organization’s latest offer adds up to 21.5% and improves medical plans and retiree benefits, Sims said, showing that the private nonprofit health plan values its employees as it tries to keep care affordable for patients.\u003c/p>\n\u003cp>“They say their goal is to protect patients by ensuring better care and staffing, but the real issue is wages — they are demanding significantly higher increases than our 21.5% offer,” Sims said. “Their claims about Kaiser Permanente’s quality and staffing don’t reflect the facts.”\u003c/p>\n\u003cp>According to the employer, the organization meets and often exceeds California’s mandated nurse-to-patient ratios and staffing standards.\u003c/p>\n\u003cp>Kaiser’s offer includes gradual raises of 6.5% in 2025, 6.5% in 2026, 4% in 2027 and 3% in 2028, according \u003ca href=\"https://www.ahcunions.org/post/september-national-bargaining-update\">to the \u003c/a>Alliance. The union has proposed a boost of 13% in 2025, 6% in 2026, 4% in 2027 and 4% in 2028.\u003c/p>\n\u003cp>Peter Sidhu, UNAC/UHCP executive vice president, said the union agreed to much lower wage increases in contract negotiations during the COVID-19 pandemic, because Kaiser maintained it was struggling financially. As a result, he said, the union’s members were left behind as inflation soared and other employees who went on strike got bigger pay boosts.\u003c/p>\n\u003cp>“We’re not just negotiating for today’s needs. We’re negotiating for the inflation that our members have had,” Sidhu, who worked for Kaiser for more than 20 years as a critical care nurse, told KQED. “And during that time, we’ve lost a lot of staff. There’s been a mass exodus. So in order for us to catch up and be competitive in this market, we need more than what they’re offering.”\u003c/p>\n\u003cp>\u003cem>KQED’s \u003c/em>\u003ca href=\"https://www.kqed.org/author/kevinstark\">\u003cem>Kevin Stark \u003c/em>\u003c/a>\u003cem>contributed to this story.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Tens of thousands of \u003ca href=\"https://www.kqed.org/news/tag/kaiser-permanente\">Kaiser Permanente\u003c/a> nurses and employees plan to walk off the job on Tuesday over wage and staffing level concerns that they say have been unaddressed as the healthcare organization’s operations expand.\u003c/p>\n\u003cp>The walkout, which is expected to last five days, could bring disruptions to dozens of clinics and hospitals in California and Hawaii, according to one of the unions launching the strike.\u003c/p>\n\u003cp>Representatives for Kaiser, which employs about 180,000 people in California, said that in the event of a work stoppage, impacted facilities will remain open. Physicians will continue to see patients aided by trained managers and contingency staff, including licensed temporary nurses.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We take any threat to services seriously, and our patients remain our priority,” Lionel Sims, vice president of human resources at Kaiser Permanente in Northern California, said in a statement.\u003c/p>\n\u003cp>The standoff comes as Kaiser unveiled another round of layoffs targeting hundreds of workers in the state, including 184 employees primarily in IT and food services in Northern California who were notified recently, the organization said. The job losses and walkout are not connected, according to Kaiser.\u003c/p>\n\u003cfigure id=\"attachment_11963409\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11963409\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED.jpg\" alt='A large modern building with the words \"Kaiser Permanente\" across the top.' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Kaiser Permanente Oakland Medical Center in Oakland on Oct. 4, 2023. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Since May, the Alliance of Healthcare Unions and Kaiser have been negotiating a new nationwide labor contract covering nearly 61,000 employees. Several of the 23 unions that form the Alliance notified Kaiser about their intent to strike, including the \u003ca href=\"https://url.us.m.mimecastprotect.com/s/_Hb6C829m0uQljg8unfPuyed-I?domain=zwly9k6z.r.us-east-1.awstrack.me\">United Nurses Associations of California/Union of Health Care Professionals\u003c/a>, which represents about 31,000 registered nurses, pharmacists, physician assistants and other health care professionals largely based in California.\u003c/p>\n\u003cp>Union officials said the walkout, which is set to end at 7 a.m. on Sunday, is necessary to protect patients and their caregivers, who are struggling with short staffing and stagnant wages and benefits, as many professionals lack pensions. They warned that Kaiser’s failure to sufficiently invest in its workforce is leading to delays in appointments, treatment and recovery for patients.\u003c/p>\n\u003cp>“Our patients are waiting longer, and our caregivers are stretched to the breaking point, and Kaiser executives are sitting on billions,” Joe Guzynski, executive director at UNAC/UHCP and a lead negotiator, said in a statement.\u003c/p>\n\u003cp>Staffing levels remain a top concern for hospital employees nationwide due to burnout and turnover, especially for nurses, according\u003ca href=\"https://www.kqed.org/news/12011878/thousands-of-uc-san-francisco-workers-are-preparing-to-strike\"> to experts\u003c/a>.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Kaiser Permanente, headquartered in Oakland, posted $63.9 billion in operating revenue and nearly \u003ca href=\"https://about.kaiserpermanente.org/news/kaiser-permanente-and-risant-health-q2-2025-financial-update\">$2 billion\u003c/a> in operating income for the first half of 2025, slightly higher than for the same period last year. The health organization and its affiliates, with about 12.6 million members, have been \u003ca href=\"https://www.beckershospitalreview.com/finance/kaisers-risant-health-to-become-35b-system-in-5-years-14-things-to-know/\">acquiring hospital systems\u003c/a> in recent years, including in Pennsylvania and North Carolina.\u003c/p>\n\u003cp>Sims dismissed claims that Kaiser is putting the quality of patient care at risk, citing top ratings for its Medicare and commercial health plans. The threat of a walkout, he said, aims to pressure Kaiser to agree to union demands for a 25% pay increase over four years. The organization’s latest offer adds up to 21.5% and improves medical plans and retiree benefits, Sims said, showing that the private nonprofit health plan values its employees as it tries to keep care affordable for patients.\u003c/p>\n\u003cp>“They say their goal is to protect patients by ensuring better care and staffing, but the real issue is wages — they are demanding significantly higher increases than our 21.5% offer,” Sims said. “Their claims about Kaiser Permanente’s quality and staffing don’t reflect the facts.”\u003c/p>\n\u003cp>According to the employer, the organization meets and often exceeds California’s mandated nurse-to-patient ratios and staffing standards.\u003c/p>\n\u003cp>Kaiser’s offer includes gradual raises of 6.5% in 2025, 6.5% in 2026, 4% in 2027 and 3% in 2028, according \u003ca href=\"https://www.ahcunions.org/post/september-national-bargaining-update\">to the \u003c/a>Alliance. The union has proposed a boost of 13% in 2025, 6% in 2026, 4% in 2027 and 4% in 2028.\u003c/p>\n\u003cp>Peter Sidhu, UNAC/UHCP executive vice president, said the union agreed to much lower wage increases in contract negotiations during the COVID-19 pandemic, because Kaiser maintained it was struggling financially. As a result, he said, the union’s members were left behind as inflation soared and other employees who went on strike got bigger pay boosts.\u003c/p>\n\u003cp>“We’re not just negotiating for today’s needs. We’re negotiating for the inflation that our members have had,” Sidhu, who worked for Kaiser for more than 20 years as a critical care nurse, told KQED. “And during that time, we’ve lost a lot of staff. There’s been a mass exodus. So in order for us to catch up and be competitive in this market, we need more than what they’re offering.”\u003c/p>\n\u003cp>\u003cem>KQED’s \u003c/em>\u003ca href=\"https://www.kqed.org/author/kevinstark\">\u003cem>Kevin Stark \u003c/em>\u003c/a>\u003cem>contributed to this story.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003c!-- Creative Commons Attribution-NonCommercial-NoDerivatives https://creativecommons.org/licenses/by-nc-nd/4.0/ -->\u003c/p>\n\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>One of Gov. \u003ca href=\"https://www.kqed.org/news/tag/gavin-newsom\">Gavin Newsom\u003c/a>’s marquee mental health programs may broaden its reach despite persistent questions about the number of people it’s helping and whether it’s achieving the goals he set out for it \u003ca href=\"https://www.kqed.org/news/12007175/care-court-was-supposed-to-help-those-hardest-to-treat-heres-how-its-going\">when it launched\u003c/a>.\u003c/p>\n\u003cp>Newsom today signed a law that expands eligibility for CARE Court to include people who experience psychotic symptoms as a result of bipolar disorder. Under the law’s previous constraints, only people with schizophrenia and other limited psychotic disorders were eligible.\u003c/p>\n\u003cp>Newsom, in a written statement, called the law and its expansion an important part of his administration’s efforts to bring people with serious \u003ca href=\"https://www.kqed.org/news/tag/mental-health\">mental illness\u003c/a> into treatment.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“California doesn’t sit on the sidelines while people fall through the cracks,” he said. “We don’t stand by while people spiral on our sidewalks or cycle through emergency rooms and jail cells — we step up. We built CARE Court to connect people to treatment, dignity, and accountability — because care and accountability belong at the center of how we serve our communities.”\u003c/p>\n\u003cp>Newsom \u003ca href=\"https://calmatters.org/health/2022/03/newsom-california-mental-illness-treatment/\">introduced CARE Court in 2022\u003c/a>, creating a program that allows family members, first responders, doctors and others to petition the courts on behalf of people with severe psychosis who couldn’t care for themselves.\u003c/p>\n\u003cfigure id=\"attachment_12047982\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12047982\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Orange County Superior Court will technically house the local CARE Court, though judges say they will more likely hold meetings with patients at a more neutral site, like a conference room at the county health office. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Once a petition is accepted, individuals are presented with a voluntary treatment plan, which can include counseling, medication and housing. If they refuse, a judge can, in theory, order them to participate in a treatment plan.\u003c/p>\n\u003cp>Almost two years in, CARE Court has struggled to fulfill Newsom’s initial promises. A recent \u003ca href=\"https://calmatters.org/health/mental-health/2025/09/care-court-2025-data/\">CalMatters investigation\u003c/a> found that the program has so far reached a few hundred people, far short of the thousands originally projected.\u003c/p>\n\u003cp>The new law, by \u003ca href=\"https://calmatters.digitaldemocracy.org/legislators/thomas-umberg-165043\">Sen. Tom Umberg,\u003c/a> a Santa Ana Democrat, sailed through the Legislature with \u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260sb27\">nearly unanimous bipartisan support,\u003c/a> no votes against and just a handful of abstentions.[aside postID=news_12048062 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/Rodriguez_CARE_07_07_2025-1.jpg']“The beauty of CARE Court is that it holds both institutions and individuals accountable, ensures individuals get the care they need and gives judges a clear role in overseeing and guiding the process,” Umberg said in a written statement today. “This bill focuses on implementation by listening to and learning from counties about what’s working and what’s not, in order to meet the goals of the original CARE Court legislation.”\u003c/p>\n\u003cp>But the bill faced plenty of criticism in the community, with counties \u003ca href=\"https://www.abridged.org/news/low-use-program-mental-illness-homelessness/\">questioning how they will implement\u003c/a> an expanded program on a tight timeline and disability rights advocates raising concerns about the effectiveness of a program they consider “unimplementable.”\u003c/p>\n\u003cp>“We have to tell the truth,” said Lex Steppling, a founding member of All People’s Health Collective. “This is not workable. It’s not going to be workable. And I personally believe the cracks in the foundation are getting bigger and bigger and it’s going to collapse.”\u003c/p>\n\u003cp>Steppling saved his harshest criticism for “the state’s self-described ‘liberal and progressive’ politicians,” who he said were too afraid of the Newsom administration to oppose the bill.\u003c/p>\n\u003ch2>Wide estimates on CARE Court expansion\u003c/h2>\n\u003cp>Umberg’s legislation could expand CARE Court enrollment, though it’s unclear by how much. Umberg’s office doesn’t have an estimate of how many more people will be eligible for the program under the new parameters. San Diego County said the new rules could increase its numbers by anywhere from 3.5% to 48.1%.\u003c/p>\n\u003cp>“We’re trying to focus on the right populations,” Umberg said. “I do think it will expand it, but not dramatically.”\u003c/p>\n\u003cfigure id=\"attachment_11983393\" class=\"wp-caption aligncenter\" style=\"max-width: 1980px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11983393\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/GettyImages-1244278587-scaled-e1713477910867.jpg\" alt=\"\" width=\"1980\" height=\"1319\">\u003cfigcaption class=\"wp-caption-text\">California State Sen. Tom Umberg during the opening of Hope Center in Fullerton, California, on Oct. 27, 2022. \u003ccite>(Jeff Gritchen/MediaNews Group/Orange County Register via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Monica Porter Gilbert, a mental health policy advocate with Disability Rights California, said the lack of clear information from the state about how the program has been implemented thus far is a big part of the problem.\u003c/p>\n\u003cp>“It feels concerning to massively open the gates to expand eligibility for the program when we really have no evidence that the program is having a positive impact,” she said.\u003c/p>\n\u003cp>Umberg initially wanted to expand CARE Court in a way that would have made even more people eligible for it. An earlier draft of his legislation would have included all mood disorders with psychotic features. But critics, including the County Behavioral Health Directors Association, warned that “massive expansion” would lead to people flooding into CARE Court faster than counties could provide services. As a concession, Umberg eventually limited his bill to bipolar disorder.\u003c/p>\n\u003ch2>Newsom’s mental health overhaul\u003c/h2>\n\u003cp>In addition to expanding eligibility, Umberg’s bill also eliminates what he said are some “inefficiencies” from the CARE Court process. That includes combining two early court hearings into one, he said, thereby reducing the amount of time participants have to spend in court and saving administrative resources.[aside postID=news_12007420 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398-1020x691.jpg']The legislation also allows the criminal justice system to refer someone directly into CARE Court if they are charged with a crime and are deemed incompetent to stand trial.\u003c/p>\n\u003cp>Michelle Doty Cabrera, executive director of the California Behavioral Health Directors Association, said her organization opposed the new law. She worries that counties won’t have the staffing or housing resources necessary to handle an influx of people. And they are still working out kinks in a system that is still relatively new, she said.\u003c/p>\n\u003cp>At the same time, she said, county behavioral health departments are also pivoting to address dozens of other new initiatives, including Newsom’s 2024 \u003ca href=\"https://calmatters.org/health/mental-health/2025/06/prop-1-mental-health-awards/\">mental health housing bond\u003c/a> known as Proposition 1 as well as CalAIM, the governor’s overhaul of \u003ca href=\"https://calmatters.org/housing/homelessness/2024/12/calaim-federal-waivers/\">Medi-Cal for mental health services\u003c/a>.\u003c/p>\n\u003cp>“We need to allow counties to implement the very many things that have been put on the table,” she said.\u003c/p>\n\u003cp>\u003cem>This article was \u003ca href=\"https://calmatters.org/health/mental-health/2025/10/care-court-expansion-new-law/\">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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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c!-- Creative Commons Attribution-NonCommercial-NoDerivatives https://creativecommons.org/licenses/by-nc-nd/4.0/ -->\u003c/p>\n\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>One of Gov. \u003ca href=\"https://www.kqed.org/news/tag/gavin-newsom\">Gavin Newsom\u003c/a>’s marquee mental health programs may broaden its reach despite persistent questions about the number of people it’s helping and whether it’s achieving the goals he set out for it \u003ca href=\"https://www.kqed.org/news/12007175/care-court-was-supposed-to-help-those-hardest-to-treat-heres-how-its-going\">when it launched\u003c/a>.\u003c/p>\n\u003cp>Newsom today signed a law that expands eligibility for CARE Court to include people who experience psychotic symptoms as a result of bipolar disorder. Under the law’s previous constraints, only people with schizophrenia and other limited psychotic disorders were eligible.\u003c/p>\n\u003cp>Newsom, in a written statement, called the law and its expansion an important part of his administration’s efforts to bring people with serious \u003ca href=\"https://www.kqed.org/news/tag/mental-health\">mental illness\u003c/a> into treatment.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“California doesn’t sit on the sidelines while people fall through the cracks,” he said. “We don’t stand by while people spiral on our sidewalks or cycle through emergency rooms and jail cells — we step up. We built CARE Court to connect people to treatment, dignity, and accountability — because care and accountability belong at the center of how we serve our communities.”\u003c/p>\n\u003cp>Newsom \u003ca href=\"https://calmatters.org/health/2022/03/newsom-california-mental-illness-treatment/\">introduced CARE Court in 2022\u003c/a>, creating a program that allows family members, first responders, doctors and others to petition the courts on behalf of people with severe psychosis who couldn’t care for themselves.\u003c/p>\n\u003cfigure id=\"attachment_12047982\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12047982\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Orange County Superior Court will technically house the local CARE Court, though judges say they will more likely hold meetings with patients at a more neutral site, like a conference room at the county health office. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Once a petition is accepted, individuals are presented with a voluntary treatment plan, which can include counseling, medication and housing. If they refuse, a judge can, in theory, order them to participate in a treatment plan.\u003c/p>\n\u003cp>Almost two years in, CARE Court has struggled to fulfill Newsom’s initial promises. A recent \u003ca href=\"https://calmatters.org/health/mental-health/2025/09/care-court-2025-data/\">CalMatters investigation\u003c/a> found that the program has so far reached a few hundred people, far short of the thousands originally projected.\u003c/p>\n\u003cp>The new law, by \u003ca href=\"https://calmatters.digitaldemocracy.org/legislators/thomas-umberg-165043\">Sen. Tom Umberg,\u003c/a> a Santa Ana Democrat, sailed through the Legislature with \u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260sb27\">nearly unanimous bipartisan support,\u003c/a> no votes against and just a handful of abstentions.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“The beauty of CARE Court is that it holds both institutions and individuals accountable, ensures individuals get the care they need and gives judges a clear role in overseeing and guiding the process,” Umberg said in a written statement today. “This bill focuses on implementation by listening to and learning from counties about what’s working and what’s not, in order to meet the goals of the original CARE Court legislation.”\u003c/p>\n\u003cp>But the bill faced plenty of criticism in the community, with counties \u003ca href=\"https://www.abridged.org/news/low-use-program-mental-illness-homelessness/\">questioning how they will implement\u003c/a> an expanded program on a tight timeline and disability rights advocates raising concerns about the effectiveness of a program they consider “unimplementable.”\u003c/p>\n\u003cp>“We have to tell the truth,” said Lex Steppling, a founding member of All People’s Health Collective. “This is not workable. It’s not going to be workable. And I personally believe the cracks in the foundation are getting bigger and bigger and it’s going to collapse.”\u003c/p>\n\u003cp>Steppling saved his harshest criticism for “the state’s self-described ‘liberal and progressive’ politicians,” who he said were too afraid of the Newsom administration to oppose the bill.\u003c/p>\n\u003ch2>Wide estimates on CARE Court expansion\u003c/h2>\n\u003cp>Umberg’s legislation could expand CARE Court enrollment, though it’s unclear by how much. Umberg’s office doesn’t have an estimate of how many more people will be eligible for the program under the new parameters. San Diego County said the new rules could increase its numbers by anywhere from 3.5% to 48.1%.\u003c/p>\n\u003cp>“We’re trying to focus on the right populations,” Umberg said. “I do think it will expand it, but not dramatically.”\u003c/p>\n\u003cfigure id=\"attachment_11983393\" class=\"wp-caption aligncenter\" style=\"max-width: 1980px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11983393\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/GettyImages-1244278587-scaled-e1713477910867.jpg\" alt=\"\" width=\"1980\" height=\"1319\">\u003cfigcaption class=\"wp-caption-text\">California State Sen. Tom Umberg during the opening of Hope Center in Fullerton, California, on Oct. 27, 2022. \u003ccite>(Jeff Gritchen/MediaNews Group/Orange County Register via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Monica Porter Gilbert, a mental health policy advocate with Disability Rights California, said the lack of clear information from the state about how the program has been implemented thus far is a big part of the problem.\u003c/p>\n\u003cp>“It feels concerning to massively open the gates to expand eligibility for the program when we really have no evidence that the program is having a positive impact,” she said.\u003c/p>\n\u003cp>Umberg initially wanted to expand CARE Court in a way that would have made even more people eligible for it. An earlier draft of his legislation would have included all mood disorders with psychotic features. But critics, including the County Behavioral Health Directors Association, warned that “massive expansion” would lead to people flooding into CARE Court faster than counties could provide services. As a concession, Umberg eventually limited his bill to bipolar disorder.\u003c/p>\n\u003ch2>Newsom’s mental health overhaul\u003c/h2>\n\u003cp>In addition to expanding eligibility, Umberg’s bill also eliminates what he said are some “inefficiencies” from the CARE Court process. That includes combining two early court hearings into one, he said, thereby reducing the amount of time participants have to spend in court and saving administrative resources.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The legislation also allows the criminal justice system to refer someone directly into CARE Court if they are charged with a crime and are deemed incompetent to stand trial.\u003c/p>\n\u003cp>Michelle Doty Cabrera, executive director of the California Behavioral Health Directors Association, said her organization opposed the new law. She worries that counties won’t have the staffing or housing resources necessary to handle an influx of people. And they are still working out kinks in a system that is still relatively new, she said.\u003c/p>\n\u003cp>At the same time, she said, county behavioral health departments are also pivoting to address dozens of other new initiatives, including Newsom’s 2024 \u003ca href=\"https://calmatters.org/health/mental-health/2025/06/prop-1-mental-health-awards/\">mental health housing bond\u003c/a> known as Proposition 1 as well as CalAIM, the governor’s overhaul of \u003ca href=\"https://calmatters.org/housing/homelessness/2024/12/calaim-federal-waivers/\">Medi-Cal for mental health services\u003c/a>.\u003c/p>\n\u003cp>“We need to allow counties to implement the very many things that have been put on the table,” she said.\u003c/p>\n\u003cp>\u003cem>This article was \u003ca href=\"https://calmatters.org/health/mental-health/2025/10/care-court-expansion-new-law/\">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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"content": "\u003cp>A fall-themed Snoopy jazz playlist hums throughout the art studio, rising just above the soft scratching of brushes on canvas. One person uses purple paint to carefully outline Squidward, his fourth SpongeBob-themed painting. Another artist prefers to paint airplanes, having previously worked at the airport.\u003c/p>\n\u003cp>Ron Ansley’s specialty is abstract paintings, often inspired by Tiggy, his cat who passed away. Today, he’s using oil pastels to outline an illustration of plates and cups sprouting cactuses.\u003c/p>\n\u003cp>“Making art is what I call a relaxation stress breaker,” Ansley said. “Mostly, I just like to express myself in painting.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Ansley, 64, has autism and several physical disabilities, including deep vein thrombosis and cataracts. Since 2019, he’s been attending art classes three days a week at The Arc \u003ca href=\"https://www.kqed.org/news/tag/san-francisco\">San Francisco\u003c/a>. As the local chapter of the national Arc organization, the nonprofit serves about 800 adults with intellectual and developmental disabilities in the \u003ca href=\"https://www.kqed.org/news/tag/bay-area\">Bay Area\u003c/a>. In addition to art, music and cooking classes, The Arc helps clients find jobs, pursue higher education and navigate their health care.\u003c/p>\n\u003cp>Now, programs like these are at risk nationwide. When President Donald Trump signed into law his sweeping policy bill, dubbed the One Big Beautiful Bill, it included roughly $1 trillion in federal Medicaid cuts over the next decade.\u003c/p>\n\u003cfigure id=\"attachment_12057949\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12057949\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-2-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-2-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-2-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-2-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Ronald Albert Ansley, a student in ArtReach, shows his painting of glass vases in the art studio at the Arc in San Francisco on Sept. 23, 2025. \u003ccite>(Gina Castro/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Medicaid, called Medi-Cal in California, is best known for helping low-income people access health care, but it also funds services for people with disabilities.\u003c/p>\n\u003cp>The White House website claims Trump’s megabill \u003ca href=\"https://www.whitehouse.gov/articles/2025/06/myth-vs-fact-the-one-big-beautiful-bill/\">won’t impact Americans with disabilities\u003c/a>: “Rest assured, those with disabilities receiving Medicaid will receive no loss or change in coverage.”\u003c/p>\n\u003cp>Policy experts, however, say that while nothing in the bill specifically targets disability services, they’re unlikely to be left unscathed.\u003c/p>\n\u003cp>“Because people with disabilities are more likely to depend on Medi-Cal compared to the general population, we would argue that any cuts to this funding would disproportionately harm folks with a disability,” said Adriana Ramos-Yamamoto, a senior policy analyst at the California Budget and Policy Center. “They’re essentially destabilizing a whole program and system that supports these communities.”[aside postID=news_12058418 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00613_TV-KQED.jpg']The California Department of Health Care Services (DHCS) estimates the state could \u003ca href=\"https://ahea.assembly.ca.gov/system/files/2025-08/dhcs-slide-presentation.pdf\">lose $30 billion a year\u003c/a> in federal MediCal funding for the next decade. It falls to state legislators to close that gap when they take on next year’s budget.\u003c/p>\n\u003cp>Ramos-Yamamoto expects the state will drain money from a benefit known as home- and community-based care, which \u003ca href=\"https://www.dhcs.ca.gov/dataandstats/dashboards/Pages/LTSS-Dashboard.aspx\">serves more than 900,000 Californians\u003c/a>, according to 2022 data from DHCS.\u003c/p>\n\u003cp>Home- and community-based services are programs like those provided by The Arc, which allow people to live and work in their homes and communities rather than in institutions like nursing homes.\u003c/p>\n\u003cp>“During tough budget years, these home- and community-based services are at risk because they’re optional services and when budgets are tight, those are often times on the chopping block,” Ramos-Yamamoto said.\u003c/p>\n\u003cp>Federal law requires states to provide certain benefits, like nursing home services, to receive matching Medicaid dollars. Other benefits, like home- and community-based services, are considered optional. That means states can make changes to them — limiting enrollment, reducing benefits or cutting them entirely — when they face budgetary emergencies.\u003c/p>\n\u003cp>“During the Great Recession, just about every state in the country ended up cutting some of their home- and community-based services,” said William Dow, a professor at the UC Berkeley School of Public Health. “And these account for about half of the Medicaid optional service spending nationwide, and so they’re just ripe for cutting.”\u003c/p>\n\u003cfigure id=\"attachment_12057948\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12057948\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-1-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-1-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-1-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-1-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Wecley Borges, a student in ArtReach, paints in the art studio at the Arc in San Francisco on Sept. 23, 2025. \u003ccite>(Gina Castro/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In an email to KQED, the White House disputed that Medicaid changes will jeopardize home- and community-based services and pointed to a \u003ca href=\"https://www.kff.org/medicaid/health-provisions-in-the-2025-federal-budget-reconciliation-law/#2ca666ac-5d15-4454-8973-241566e22bb5\">provision in the bill\u003c/a> providing additional funding to expand access to this care.\u003c/p>\n\u003cp>However, Ramos-Yamamoto said it’s unlikely states will spend limited resources to make new investments in these services while facing billions of dollars in cuts elsewhere.\u003c/p>\n\u003cp>“Despite there being some promising revisions related to this HCBS expansion … it is really insignificant compared to the amount that Republicans in Congress and the Trump administration are cutting from Medicaid overall,” Ramos-Yamamoto said.\u003c/p>\n\u003cp>Kristen Pedersen, executive director of The Arc San Francisco, said even before these changes to Medicaid, disability services were underfunded. Most of The Arc’s programs have a 12-month waitlist with over 125 people waiting.[aside postID=news_12048636 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/npr.brightspotcdn-1020x680.jpg']“What’s really concerning for us is… knowing that funding is going to be sparse for a system that’s already pretty anemic as it is,” Pedersen said.\u003c/p>\n\u003cp>Pederson is most worried about their clients with complex needs, like Ansley.\u003c/p>\n\u003cp>“I think those folks are very much at risk of ending up in institutional settings,” she said. “As the funding depletes and you aren’t able to pay direct service workers for very skilled work that they do to support these individuals, I think that options are going to really decrease.”\u003c/p>\n\u003cp>In addition to attending art classes, Ansley lives at The Arc’s affordable housing project in San Francisco. He receives care from direct support professionals who take him to the grocery store and help him with his laundry, budgeting and medications.\u003c/p>\n\u003cp>For Ansley, the thought of losing his independent living services is terrifying.\u003c/p>\n\u003cp>“I’m an independent man. I just have to stay independent,” Ansley said. “I don’t want to end up in no nursing home. If I end up in a nursing home, I’m a nobody. I am just a number.”\u003c/p>\n\u003cp>Ansley also relies on a health advocate named Arlo Beckman, who takes him to doctor’s appointments and coordinates his health care services like insurance renewal. Beckman said that although home- and community-based care is deemed optional, it’s vital to people’s quality of life.\u003c/p>\n\u003cfigure id=\"attachment_12057950\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12057950\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-7-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-7-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-7-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-7-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Students Ruth Defoe, left, and Douglas Morales, right, work on art in the art studio at the Arc in San Francisco on Sept. 23, 2025. \u003ccite>(Gina Castro/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“In this world, we all consider in-home supportive services to be critical to our participants’ lives and their well-being,” Beckman said.\u003c/p>\n\u003cp>Many of The Arc’s clients rely on this support to hold jobs, volunteer in their communities and go to school. Any reductions in funding could mean less staff available for individualized services and even longer waitlists.\u003c/p>\n\u003cp>“I find that the clients that are more homebound are sad, more frequently struggle with mental health issues,” Beckman said. “I think we’re at a point where we understand how significantly being social and getting outside and just moving in general impacts both physical and mental health.”\u003c/p>\n\u003cp>Many of the changes to Medicaid don’t go into effect until after the 2026 midterm elections, but advocates are already pushing state leaders to uphold obligations as laid out in the \u003ca href=\"https://www.dds.ca.gov/transparency/laws-regulations/lanterman-act-and-related-laws/\">Lanterman Act\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_12057951\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12057951\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-9-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-9-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-9-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-9-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Drawers with art students’ names taped in ArtReach Studios at the Arc in San Francisco on Sept. 23, 2025. \u003ccite>(Gina Castro/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The landmark law, passed in California in 1969, ensures people with developmental disabilities have the support to live full and inclusive lives.\u003c/p>\n\u003cp>“We just want to make sure that the balancing of the budget isn’t done on the backs of people with disabilities,” Pedersen said.\u003c/p>\n\u003cp>To offset the impending damage of federal cuts, some health care advocates have proposed a \u003ca href=\"https://www.sacbee.com/news/politics-government/capitol-alert/article311855234.html\">ballot measure to raise taxes on the ultra-rich\u003c/a>.\u003c/p>\n\u003cp>Santa Clara County has already put the question before voters, placing a \u003ca href=\"https://www.kqed.org/news/12058418/santa-clara-county-sales-tax-measure-a-pitched-to-offset-deep-medicaid-cuts-measure-a\">sales tax measure on a November special election ballot\u003c/a> to support the county’s health care system.\u003c/p>\n\u003cfigure id=\"attachment_12057952\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12057952\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-11-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-11-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-11-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-11-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Ronald Albert Ansley poses for a portrait at the Arc in San Francisco on Sept. 23, 2025. \u003ccite>(Gina Castro/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Pedersen said her organization is also approaching 2026 gubernatorial candidates, asking them to make a campaign pledge to prioritize disability services.\u003c/p>\n\u003cp>“We don’t really have someone right now who’s taking up that mantle,” Pedersen said. “That’s something we’re really working on at The Arc California level and just educating our new legislators.”\u003c/p>\n\u003cp>For now, as they wait for state lawmakers to unveil their budget plan, the disability community has to sit with uncertainty and the fear of what’s to come.\u003c/p>\n\u003cp>“It’s like you have to choose: medicine or food. Medicine or art supplies. Medicine or laundry money. Medicine or bus rides. Medicine or paying your bills,” Ansley said. “It’s the worst thing that is going to ruin people’s physical health and their mental health. I don’t like it at all.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Medicaid helps pay for programs that allow disabled Californians to live and work in their homes and communities, rather than in institutions. But federal cuts might endanger those services.",
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"title": "For Californians With Disabilities, Medicaid Cuts Could Mean Losing Not Just Services — But Freedom | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A fall-themed Snoopy jazz playlist hums throughout the art studio, rising just above the soft scratching of brushes on canvas. One person uses purple paint to carefully outline Squidward, his fourth SpongeBob-themed painting. Another artist prefers to paint airplanes, having previously worked at the airport.\u003c/p>\n\u003cp>Ron Ansley’s specialty is abstract paintings, often inspired by Tiggy, his cat who passed away. Today, he’s using oil pastels to outline an illustration of plates and cups sprouting cactuses.\u003c/p>\n\u003cp>“Making art is what I call a relaxation stress breaker,” Ansley said. “Mostly, I just like to express myself in painting.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Ansley, 64, has autism and several physical disabilities, including deep vein thrombosis and cataracts. Since 2019, he’s been attending art classes three days a week at The Arc \u003ca href=\"https://www.kqed.org/news/tag/san-francisco\">San Francisco\u003c/a>. As the local chapter of the national Arc organization, the nonprofit serves about 800 adults with intellectual and developmental disabilities in the \u003ca href=\"https://www.kqed.org/news/tag/bay-area\">Bay Area\u003c/a>. In addition to art, music and cooking classes, The Arc helps clients find jobs, pursue higher education and navigate their health care.\u003c/p>\n\u003cp>Now, programs like these are at risk nationwide. When President Donald Trump signed into law his sweeping policy bill, dubbed the One Big Beautiful Bill, it included roughly $1 trillion in federal Medicaid cuts over the next decade.\u003c/p>\n\u003cfigure id=\"attachment_12057949\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12057949\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-2-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-2-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-2-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-2-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Ronald Albert Ansley, a student in ArtReach, shows his painting of glass vases in the art studio at the Arc in San Francisco on Sept. 23, 2025. \u003ccite>(Gina Castro/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Medicaid, called Medi-Cal in California, is best known for helping low-income people access health care, but it also funds services for people with disabilities.\u003c/p>\n\u003cp>The White House website claims Trump’s megabill \u003ca href=\"https://www.whitehouse.gov/articles/2025/06/myth-vs-fact-the-one-big-beautiful-bill/\">won’t impact Americans with disabilities\u003c/a>: “Rest assured, those with disabilities receiving Medicaid will receive no loss or change in coverage.”\u003c/p>\n\u003cp>Policy experts, however, say that while nothing in the bill specifically targets disability services, they’re unlikely to be left unscathed.\u003c/p>\n\u003cp>“Because people with disabilities are more likely to depend on Medi-Cal compared to the general population, we would argue that any cuts to this funding would disproportionately harm folks with a disability,” said Adriana Ramos-Yamamoto, a senior policy analyst at the California Budget and Policy Center. “They’re essentially destabilizing a whole program and system that supports these communities.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The California Department of Health Care Services (DHCS) estimates the state could \u003ca href=\"https://ahea.assembly.ca.gov/system/files/2025-08/dhcs-slide-presentation.pdf\">lose $30 billion a year\u003c/a> in federal MediCal funding for the next decade. It falls to state legislators to close that gap when they take on next year’s budget.\u003c/p>\n\u003cp>Ramos-Yamamoto expects the state will drain money from a benefit known as home- and community-based care, which \u003ca href=\"https://www.dhcs.ca.gov/dataandstats/dashboards/Pages/LTSS-Dashboard.aspx\">serves more than 900,000 Californians\u003c/a>, according to 2022 data from DHCS.\u003c/p>\n\u003cp>Home- and community-based services are programs like those provided by The Arc, which allow people to live and work in their homes and communities rather than in institutions like nursing homes.\u003c/p>\n\u003cp>“During tough budget years, these home- and community-based services are at risk because they’re optional services and when budgets are tight, those are often times on the chopping block,” Ramos-Yamamoto said.\u003c/p>\n\u003cp>Federal law requires states to provide certain benefits, like nursing home services, to receive matching Medicaid dollars. Other benefits, like home- and community-based services, are considered optional. That means states can make changes to them — limiting enrollment, reducing benefits or cutting them entirely — when they face budgetary emergencies.\u003c/p>\n\u003cp>“During the Great Recession, just about every state in the country ended up cutting some of their home- and community-based services,” said William Dow, a professor at the UC Berkeley School of Public Health. “And these account for about half of the Medicaid optional service spending nationwide, and so they’re just ripe for cutting.”\u003c/p>\n\u003cfigure id=\"attachment_12057948\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12057948\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-1-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-1-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-1-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-1-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Wecley Borges, a student in ArtReach, paints in the art studio at the Arc in San Francisco on Sept. 23, 2025. \u003ccite>(Gina Castro/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In an email to KQED, the White House disputed that Medicaid changes will jeopardize home- and community-based services and pointed to a \u003ca href=\"https://www.kff.org/medicaid/health-provisions-in-the-2025-federal-budget-reconciliation-law/#2ca666ac-5d15-4454-8973-241566e22bb5\">provision in the bill\u003c/a> providing additional funding to expand access to this care.\u003c/p>\n\u003cp>However, Ramos-Yamamoto said it’s unlikely states will spend limited resources to make new investments in these services while facing billions of dollars in cuts elsewhere.\u003c/p>\n\u003cp>“Despite there being some promising revisions related to this HCBS expansion … it is really insignificant compared to the amount that Republicans in Congress and the Trump administration are cutting from Medicaid overall,” Ramos-Yamamoto said.\u003c/p>\n\u003cp>Kristen Pedersen, executive director of The Arc San Francisco, said even before these changes to Medicaid, disability services were underfunded. Most of The Arc’s programs have a 12-month waitlist with over 125 people waiting.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“What’s really concerning for us is… knowing that funding is going to be sparse for a system that’s already pretty anemic as it is,” Pedersen said.\u003c/p>\n\u003cp>Pederson is most worried about their clients with complex needs, like Ansley.\u003c/p>\n\u003cp>“I think those folks are very much at risk of ending up in institutional settings,” she said. “As the funding depletes and you aren’t able to pay direct service workers for very skilled work that they do to support these individuals, I think that options are going to really decrease.”\u003c/p>\n\u003cp>In addition to attending art classes, Ansley lives at The Arc’s affordable housing project in San Francisco. He receives care from direct support professionals who take him to the grocery store and help him with his laundry, budgeting and medications.\u003c/p>\n\u003cp>For Ansley, the thought of losing his independent living services is terrifying.\u003c/p>\n\u003cp>“I’m an independent man. I just have to stay independent,” Ansley said. “I don’t want to end up in no nursing home. If I end up in a nursing home, I’m a nobody. I am just a number.”\u003c/p>\n\u003cp>Ansley also relies on a health advocate named Arlo Beckman, who takes him to doctor’s appointments and coordinates his health care services like insurance renewal. Beckman said that although home- and community-based care is deemed optional, it’s vital to people’s quality of life.\u003c/p>\n\u003cfigure id=\"attachment_12057950\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12057950\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-7-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-7-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-7-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-7-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Students Ruth Defoe, left, and Douglas Morales, right, work on art in the art studio at the Arc in San Francisco on Sept. 23, 2025. \u003ccite>(Gina Castro/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“In this world, we all consider in-home supportive services to be critical to our participants’ lives and their well-being,” Beckman said.\u003c/p>\n\u003cp>Many of The Arc’s clients rely on this support to hold jobs, volunteer in their communities and go to school. Any reductions in funding could mean less staff available for individualized services and even longer waitlists.\u003c/p>\n\u003cp>“I find that the clients that are more homebound are sad, more frequently struggle with mental health issues,” Beckman said. “I think we’re at a point where we understand how significantly being social and getting outside and just moving in general impacts both physical and mental health.”\u003c/p>\n\u003cp>Many of the changes to Medicaid don’t go into effect until after the 2026 midterm elections, but advocates are already pushing state leaders to uphold obligations as laid out in the \u003ca href=\"https://www.dds.ca.gov/transparency/laws-regulations/lanterman-act-and-related-laws/\">Lanterman Act\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_12057951\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12057951\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-9-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-9-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-9-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-9-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Drawers with art students’ names taped in ArtReach Studios at the Arc in San Francisco on Sept. 23, 2025. \u003ccite>(Gina Castro/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The landmark law, passed in California in 1969, ensures people with developmental disabilities have the support to live full and inclusive lives.\u003c/p>\n\u003cp>“We just want to make sure that the balancing of the budget isn’t done on the backs of people with disabilities,” Pedersen said.\u003c/p>\n\u003cp>To offset the impending damage of federal cuts, some health care advocates have proposed a \u003ca href=\"https://www.sacbee.com/news/politics-government/capitol-alert/article311855234.html\">ballot measure to raise taxes on the ultra-rich\u003c/a>.\u003c/p>\n\u003cp>Santa Clara County has already put the question before voters, placing a \u003ca href=\"https://www.kqed.org/news/12058418/santa-clara-county-sales-tax-measure-a-pitched-to-offset-deep-medicaid-cuts-measure-a\">sales tax measure on a November special election ballot\u003c/a> to support the county’s health care system.\u003c/p>\n\u003cfigure id=\"attachment_12057952\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12057952\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-11-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-11-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-11-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/20250923_MEDICAIDDISABILITY_GC-11-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Ronald Albert Ansley poses for a portrait at the Arc in San Francisco on Sept. 23, 2025. \u003ccite>(Gina Castro/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Pedersen said her organization is also approaching 2026 gubernatorial candidates, asking them to make a campaign pledge to prioritize disability services.\u003c/p>\n\u003cp>“We don’t really have someone right now who’s taking up that mantle,” Pedersen said. “That’s something we’re really working on at The Arc California level and just educating our new legislators.”\u003c/p>\n\u003cp>For now, as they wait for state lawmakers to unveil their budget plan, the disability community has to sit with uncertainty and the fear of what’s to come.\u003c/p>\n\u003cp>“It’s like you have to choose: medicine or food. Medicine or art supplies. Medicine or laundry money. Medicine or bus rides. Medicine or paying your bills,” Ansley said. “It’s the worst thing that is going to ruin people’s physical health and their mental health. I don’t like it at all.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>The sun was just rising over \u003ca href=\"https://www.kqed.org/news/tag/santa-clara-county\">Santa Clara\u003c/a> Valley Medical Center when nurse Emiko Rivera arrived to begin her shift at the hospital’s burn center.\u003c/p>\n\u003cp>As one of the few certified burn centers in Northern California, Rivera’s team treats patients from across the region, caring for their wounds while also providing counseling and support to help them return to their jobs or schools.\u003c/p>\n\u003cp>“Our burn patients come in and sometimes are with us for months at a time with their injuries,” she said. “As a burn nurse, it is being with them day by day, being with their families, providing support in addition to providing their care and building those relationships so that we can have a successful recovery.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Lately, a pall of uncertainty has spread over the sprawling Santa Clara Valley Medical Center campus. The One Big Beautiful Bill Act, signed by President Donald Trump in July, enacted \u003ca href=\"https://www.kqed.org/news/12033802/how-cuts-medicaid-republican-gains-california\">historic cuts\u003c/a> to Medicaid, the health care program for people with low incomes and disabilities. Medicaid — known as Medi-Cal in California — is the single largest revenue source for Santa Clara Valley Healthcare, the county health system that serves patients regardless of their ability to pay.\u003c/p>\n\u003cp>“The thing about burn injuries is that nobody is immune to a burn injury,” Rivera said. “It doesn’t matter if you are houseless or if you have millions of dollars. Everybody’s going to the same place, and that’s our burn center.”\u003c/p>\n\u003cfigure id=\"attachment_12058628\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12058628\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/EmikoRivera1.jpg\" alt=\"\" width=\"2000\" height=\"1500\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/EmikoRivera1.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/EmikoRivera1-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/EmikoRivera1-1536x1152.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Burn nurse Emiko Rivera treats patients at one of the region’s few certified burn centers. \u003ccite>(Guy Marzorati/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>For years, hospitals providing expensive emergency services to Medicaid patients have struggled to balance their books, especially in rural areas. But the latest federal cuts have spread the crisis to Silicon Valley, where local leaders are now \u003ca href=\"https://www.kqed.org/news/12051250/santa-clara-county-voters-could-pay-more-sales-tax-due-to-trump-cuts\">asking voters to provide a lifeline\u003c/a> in the form of Measure A, a sales tax increase on the ballot in November.\u003c/p>\n\u003cp>“This is the single largest revenue loss for the county organization, and therefore the services that we’re able to provide to the community, since the passage of Proposition 13,” Santa Clara County Executive James Williams told the Board of Supervisors in August.\u003c/p>\n\u003cp>The comparison to Proposition 13 is chilling for government finance officials. The 1978 ballot measure limited property tax increases and severely constricted local revenues. County leaders fear the Medicaid cuts could devastate California hospitals in the same way Proposition 13 decimated funding for the state’s public schools.[aside postID=news_12033802 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-14-KQED-1-1020x680.jpg']That’s especially true for public hospitals like Santa Clara Valley Medical Center. Facilities such as Zuckerberg San Francisco General Hospital and San Mateo Medical Center make up just 6% of hospitals in the state, but they operate more than half of California’s trauma and burn centers — and provide more than a third of hospital care for Medicaid patients or those without insurance, according to the California Association of Public Hospitals and Health Systems.\u003c/p>\n\u003cp>“The bottom line is this: Medicaid is the most significant revenue source for our health and hospital system,” Williams said.\u003c/p>\n\u003cp>After Williams’ warning, the Board of Supervisors voted unanimously to place Measure A on the Nov. 4 ballot.\u003c/p>\n\u003cp>The measure would raise the county sales tax by 0.625% for five years, bringing in an estimated $330 million annually. Supporters say that money is vital to avoid hospital closures, though it won’t make up for cuts projected to reach over $1 billion annually for Santa Clara County by the end of the decade.\u003c/p>\n\u003cp>Opponents of Measure A argue that the absence of federal support should force the county to re-evaluate whether it needs to operate four hospitals.\u003c/p>\n\u003ch2>Federal cuts reverberate statewide\u003c/h2>\n\u003cp>Across California, the Medicaid cuts are hitting struggling hospital systems.\u003c/p>\n\u003cp>Near Death Valley, the last hospital providing emergency care in southern Inyo County \u003ca href=\"https://calmatters.org/health/2025/09/inyo-hospital-closure-financial/\">has run out\u003c/a> of money. In Riverside, leaders of the Palo Verde Hospital recently \u003ca href=\"https://www.desertsun.com/story/news/health/2025/10/01/palo-verde-healthcare-district-files-for-bankruptcy-notifies-state-of-blythe-hospital-closure/86467143007/?gnt-cfr=1&gca-cat=p&gca-uir=true&gca-epti=z115501p117650c117650e006800v115501b0035xxd003565&gca-ft=147&gca-ds=sophi\">filed for bankruptcy\u003c/a>. And in Modoc County, the CEO of California’s smallest hospital, Surprise Valley Community Hospital, said its one emergency bed \u003ca href=\"https://www.chcf.org/resource/federal-medicaid-cuts-would-devastate-health-care-systems-californias-vast-rural-north/\">could close\u003c/a> because of the cuts.\u003c/p>\n\u003cfigure id=\"attachment_12058486\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12058486\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00662_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00662_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00662_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00662_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Santa Clara Valley Medical Center stands on 751 South Bascom Avenue in San José on Sept. 29, 2025. Nurses and doctors such as Emiko Rivera from Santa Clara Valley Medical Center are supporting Measure A, a sales tax to raise county revenue in the face of Medicaid cuts. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“There’s no magic way to print money to offset the federal government backing away from their promise to be a partner for those that are most fragile in our community,” said Graham Knaus, CEO of the California State Association of Counties. “It makes the whole system collapse, and that’s exactly what we’re starting to see — first in some of these rural areas, but it’s not going to be limited to those areas.”\u003c/p>\n\u003cp>The One Big Beautiful Bill Act, formally known as H.R. 1, requires adult Medicaid recipients to prove they are working, volunteering or going to school. County workers will have to process the new eligibility checks, adding workloads that could cost counties hundreds of millions of dollars annually, according to the California State Association of Counties.\u003c/p>\n\u003cp>If Medicaid recipients lose eligibility, as expected, counties such as Santa Clara will receive fewer direct payments and reimbursements for services. Additionally, the federal share of emergency services for certain undocumented adults without children will drop from 90% to 50%.\u003c/p>\n\u003cp>“That too will be upwards of a $200 million-plus cost shift,” Knaus said. “And in health settings where they’re barely making it today before all this is happening.”\u003c/p>\n\u003cp>He said many counties could backfill health care funding by cutting from other parts of their budgets. Other hospitals could limit services or close altogether.\u003c/p>\n\u003ch2>A fight to keep hospitals open\u003c/h2>\n\u003cp>In Santa Clara County, officials say Measure A is the only way to keep all four public hospitals and 13 clinics open.\u003c/p>\n\u003cp>“Other counties, their response to this — to close the budget gap — is to close down their hospitals, close down emergency departments,” Supervisor Betty Duong said. “This county cannot let that happen without a fight.”\u003c/p>\n\u003cp>Duong said cutbacks to Santa Clara Valley Healthcare could also strain private hospitals, which would suddenly face increased demand for emergency services.\u003c/p>\n\u003cfigure id=\"attachment_12032773\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12032773\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/20240324_SANTACLARAMEDICALSTRIKE_GC-20-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/20240324_SANTACLARAMEDICALSTRIKE_GC-20-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/20240324_SANTACLARAMEDICALSTRIKE_GC-20-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/20240324_SANTACLARAMEDICALSTRIKE_GC-20-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/20240324_SANTACLARAMEDICALSTRIKE_GC-20-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/20240324_SANTACLARAMEDICALSTRIKE_GC-20-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/20240324_SANTACLARAMEDICALSTRIKE_GC-20-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Santa Clara Valley Medical Center campus in San José on March 24, 2025. \u003ccite>(Gina Castro/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Measure A has been endorsed by dozens of South Bay elected officials and labor groups.\u003c/p>\n\u003cp>The Yes on A campaign has raised over $2 million, with the largest contribution of $300,000 coming from SEIU 521, the union representing county health care workers. The Silicon Valley Community Foundation, developer and philanthropist John Sobrato, and the Valley Physicians Group have also each contributed more than $200,000.\u003c/p>\n\u003cp>Those donations have funded a campaign leaning into anti-Trump messaging. A recent Yes on A mailer declared, “Trump’s Cuts = Local Crisis.” Supporters hope turnout for Proposition 50, the redistricting measure also on the November ballot, boosts Democratic participation in reliably blue Santa Clara County.\u003c/p>\n\u003cp>“It is a chance for the residents of this county to say, ‘Hey, federal administration, we’re not going to take this lying down,’” Duong said.[aside postID=news_12051250 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/20240324_SantaClaraMedicalStrike_GC-33_qed.jpg']Opponents question whether county leaders are bailing water out of a sinking ocean liner. Over the past six years, the county purchased three private hospitals on the brink of closure — O’Connor Hospital and \u003ca href=\"https://www.kqed.org/news/12001214/santa-clara-county-plans-to-buy-east-san-jose-hospital-to-reverse-cuts-to-care\">Regional Medical Center in San José\u003c/a> and St. Louise Regional Hospital in Gilroy — to prevent a loss of emergency access that would have sent patients streaming to Valley Medical Center.\u003c/p>\n\u003cp>But those purchases significantly ballooned county payroll costs, a \u003ca href=\"https://www.mercurynews.com/2024/09/14/4-charts-that-shows-how-california-counties-spent-45-billion-on-employees-last-year/\">Bay Area News Group analysis\u003c/a> found. And the expansion was predicated on federal Medicaid funding that no longer exists.\u003c/p>\n\u003cp>“We need to decide — do we need all four hospitals?” said Cupertino Mayor Liang Chao, who opposes Measure A.\u003c/p>\n\u003cp>Chao said a sales tax increase will fall disproportionately on lower-income residents, and as a general-purpose tax, the revenue could technically be spent for any purpose.\u003c/p>\n\u003cp>“They are saying [Measure A] is targeted for health care, but it could be spent on anything,” Chao said. “So that’s kind of not very honest.”\u003c/p>\n\u003cp>The campaign against Measure A has not reported any financial contributions, but several former mayors — including Lydia Kou of Palo Alto, Rishi Kumar of Saratoga and Liz Lawler of Monte Sereno — have aligned against it.\u003c/p>\n\u003cp>“I think this is like a knee-jerk reaction to something happening in the federal government,” Chao said. “It’s kind of taking advantage of the federal cut as an excuse to tax the voters, rather than really looking at how do we solve a problem.”\u003c/p>\n\u003cp>Meanwhile, nearby hospitals are already buckling. Hazel Hawkins Memorial Hospital in San Benito is teetering after a private buyer \u003ca href=\"https://www.hazelhawkins.com/news/2025/august/insight-health-steps-away-from-lease-to-purchase/\">backed away\u003c/a> from a rescue deal, citing uncertainty in the wake of federal cuts. Williams, the Santa Clara County executive, predicts that could push more patients to Santa Clara’s hospitals.\u003c/p>\n\u003cp>At Valley Med, a $40 million burn unit expansion is underway to expand the unit from eight beds to 14. Rivera, the nurse, said she’s worried about how the cuts will affect the unit she has worked in for the last 17 years.\u003c/p>\n\u003cp>“There’s a lot of unknowns right now and uncertainty,” Rivera said. “But we will all be directly impacted in some way.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The sun was just rising over \u003ca href=\"https://www.kqed.org/news/tag/santa-clara-county\">Santa Clara\u003c/a> Valley Medical Center when nurse Emiko Rivera arrived to begin her shift at the hospital’s burn center.\u003c/p>\n\u003cp>As one of the few certified burn centers in Northern California, Rivera’s team treats patients from across the region, caring for their wounds while also providing counseling and support to help them return to their jobs or schools.\u003c/p>\n\u003cp>“Our burn patients come in and sometimes are with us for months at a time with their injuries,” she said. “As a burn nurse, it is being with them day by day, being with their families, providing support in addition to providing their care and building those relationships so that we can have a successful recovery.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Lately, a pall of uncertainty has spread over the sprawling Santa Clara Valley Medical Center campus. The One Big Beautiful Bill Act, signed by President Donald Trump in July, enacted \u003ca href=\"https://www.kqed.org/news/12033802/how-cuts-medicaid-republican-gains-california\">historic cuts\u003c/a> to Medicaid, the health care program for people with low incomes and disabilities. Medicaid — known as Medi-Cal in California — is the single largest revenue source for Santa Clara Valley Healthcare, the county health system that serves patients regardless of their ability to pay.\u003c/p>\n\u003cp>“The thing about burn injuries is that nobody is immune to a burn injury,” Rivera said. “It doesn’t matter if you are houseless or if you have millions of dollars. Everybody’s going to the same place, and that’s our burn center.”\u003c/p>\n\u003cfigure id=\"attachment_12058628\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12058628\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/EmikoRivera1.jpg\" alt=\"\" width=\"2000\" height=\"1500\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/EmikoRivera1.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/EmikoRivera1-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/EmikoRivera1-1536x1152.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Burn nurse Emiko Rivera treats patients at one of the region’s few certified burn centers. \u003ccite>(Guy Marzorati/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>For years, hospitals providing expensive emergency services to Medicaid patients have struggled to balance their books, especially in rural areas. But the latest federal cuts have spread the crisis to Silicon Valley, where local leaders are now \u003ca href=\"https://www.kqed.org/news/12051250/santa-clara-county-voters-could-pay-more-sales-tax-due-to-trump-cuts\">asking voters to provide a lifeline\u003c/a> in the form of Measure A, a sales tax increase on the ballot in November.\u003c/p>\n\u003cp>“This is the single largest revenue loss for the county organization, and therefore the services that we’re able to provide to the community, since the passage of Proposition 13,” Santa Clara County Executive James Williams told the Board of Supervisors in August.\u003c/p>\n\u003cp>The comparison to Proposition 13 is chilling for government finance officials. The 1978 ballot measure limited property tax increases and severely constricted local revenues. County leaders fear the Medicaid cuts could devastate California hospitals in the same way Proposition 13 decimated funding for the state’s public schools.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>That’s especially true for public hospitals like Santa Clara Valley Medical Center. Facilities such as Zuckerberg San Francisco General Hospital and San Mateo Medical Center make up just 6% of hospitals in the state, but they operate more than half of California’s trauma and burn centers — and provide more than a third of hospital care for Medicaid patients or those without insurance, according to the California Association of Public Hospitals and Health Systems.\u003c/p>\n\u003cp>“The bottom line is this: Medicaid is the most significant revenue source for our health and hospital system,” Williams said.\u003c/p>\n\u003cp>After Williams’ warning, the Board of Supervisors voted unanimously to place Measure A on the Nov. 4 ballot.\u003c/p>\n\u003cp>The measure would raise the county sales tax by 0.625% for five years, bringing in an estimated $330 million annually. Supporters say that money is vital to avoid hospital closures, though it won’t make up for cuts projected to reach over $1 billion annually for Santa Clara County by the end of the decade.\u003c/p>\n\u003cp>Opponents of Measure A argue that the absence of federal support should force the county to re-evaluate whether it needs to operate four hospitals.\u003c/p>\n\u003ch2>Federal cuts reverberate statewide\u003c/h2>\n\u003cp>Across California, the Medicaid cuts are hitting struggling hospital systems.\u003c/p>\n\u003cp>Near Death Valley, the last hospital providing emergency care in southern Inyo County \u003ca href=\"https://calmatters.org/health/2025/09/inyo-hospital-closure-financial/\">has run out\u003c/a> of money. In Riverside, leaders of the Palo Verde Hospital recently \u003ca href=\"https://www.desertsun.com/story/news/health/2025/10/01/palo-verde-healthcare-district-files-for-bankruptcy-notifies-state-of-blythe-hospital-closure/86467143007/?gnt-cfr=1&gca-cat=p&gca-uir=true&gca-epti=z115501p117650c117650e006800v115501b0035xxd003565&gca-ft=147&gca-ds=sophi\">filed for bankruptcy\u003c/a>. And in Modoc County, the CEO of California’s smallest hospital, Surprise Valley Community Hospital, said its one emergency bed \u003ca href=\"https://www.chcf.org/resource/federal-medicaid-cuts-would-devastate-health-care-systems-californias-vast-rural-north/\">could close\u003c/a> because of the cuts.\u003c/p>\n\u003cfigure id=\"attachment_12058486\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12058486\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00662_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00662_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00662_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00662_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Santa Clara Valley Medical Center stands on 751 South Bascom Avenue in San José on Sept. 29, 2025. Nurses and doctors such as Emiko Rivera from Santa Clara Valley Medical Center are supporting Measure A, a sales tax to raise county revenue in the face of Medicaid cuts. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“There’s no magic way to print money to offset the federal government backing away from their promise to be a partner for those that are most fragile in our community,” said Graham Knaus, CEO of the California State Association of Counties. “It makes the whole system collapse, and that’s exactly what we’re starting to see — first in some of these rural areas, but it’s not going to be limited to those areas.”\u003c/p>\n\u003cp>The One Big Beautiful Bill Act, formally known as H.R. 1, requires adult Medicaid recipients to prove they are working, volunteering or going to school. County workers will have to process the new eligibility checks, adding workloads that could cost counties hundreds of millions of dollars annually, according to the California State Association of Counties.\u003c/p>\n\u003cp>If Medicaid recipients lose eligibility, as expected, counties such as Santa Clara will receive fewer direct payments and reimbursements for services. Additionally, the federal share of emergency services for certain undocumented adults without children will drop from 90% to 50%.\u003c/p>\n\u003cp>“That too will be upwards of a $200 million-plus cost shift,” Knaus said. “And in health settings where they’re barely making it today before all this is happening.”\u003c/p>\n\u003cp>He said many counties could backfill health care funding by cutting from other parts of their budgets. Other hospitals could limit services or close altogether.\u003c/p>\n\u003ch2>A fight to keep hospitals open\u003c/h2>\n\u003cp>In Santa Clara County, officials say Measure A is the only way to keep all four public hospitals and 13 clinics open.\u003c/p>\n\u003cp>“Other counties, their response to this — to close the budget gap — is to close down their hospitals, close down emergency departments,” Supervisor Betty Duong said. “This county cannot let that happen without a fight.”\u003c/p>\n\u003cp>Duong said cutbacks to Santa Clara Valley Healthcare could also strain private hospitals, which would suddenly face increased demand for emergency services.\u003c/p>\n\u003cfigure id=\"attachment_12032773\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12032773\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/20240324_SANTACLARAMEDICALSTRIKE_GC-20-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/20240324_SANTACLARAMEDICALSTRIKE_GC-20-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/20240324_SANTACLARAMEDICALSTRIKE_GC-20-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/20240324_SANTACLARAMEDICALSTRIKE_GC-20-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/20240324_SANTACLARAMEDICALSTRIKE_GC-20-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/20240324_SANTACLARAMEDICALSTRIKE_GC-20-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/20240324_SANTACLARAMEDICALSTRIKE_GC-20-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Santa Clara Valley Medical Center campus in San José on March 24, 2025. \u003ccite>(Gina Castro/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Measure A has been endorsed by dozens of South Bay elected officials and labor groups.\u003c/p>\n\u003cp>The Yes on A campaign has raised over $2 million, with the largest contribution of $300,000 coming from SEIU 521, the union representing county health care workers. The Silicon Valley Community Foundation, developer and philanthropist John Sobrato, and the Valley Physicians Group have also each contributed more than $200,000.\u003c/p>\n\u003cp>Those donations have funded a campaign leaning into anti-Trump messaging. A recent Yes on A mailer declared, “Trump’s Cuts = Local Crisis.” Supporters hope turnout for Proposition 50, the redistricting measure also on the November ballot, boosts Democratic participation in reliably blue Santa Clara County.\u003c/p>\n\u003cp>“It is a chance for the residents of this county to say, ‘Hey, federal administration, we’re not going to take this lying down,’” Duong said.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Opponents question whether county leaders are bailing water out of a sinking ocean liner. Over the past six years, the county purchased three private hospitals on the brink of closure — O’Connor Hospital and \u003ca href=\"https://www.kqed.org/news/12001214/santa-clara-county-plans-to-buy-east-san-jose-hospital-to-reverse-cuts-to-care\">Regional Medical Center in San José\u003c/a> and St. Louise Regional Hospital in Gilroy — to prevent a loss of emergency access that would have sent patients streaming to Valley Medical Center.\u003c/p>\n\u003cp>But those purchases significantly ballooned county payroll costs, a \u003ca href=\"https://www.mercurynews.com/2024/09/14/4-charts-that-shows-how-california-counties-spent-45-billion-on-employees-last-year/\">Bay Area News Group analysis\u003c/a> found. And the expansion was predicated on federal Medicaid funding that no longer exists.\u003c/p>\n\u003cp>“We need to decide — do we need all four hospitals?” said Cupertino Mayor Liang Chao, who opposes Measure A.\u003c/p>\n\u003cp>Chao said a sales tax increase will fall disproportionately on lower-income residents, and as a general-purpose tax, the revenue could technically be spent for any purpose.\u003c/p>\n\u003cp>“They are saying [Measure A] is targeted for health care, but it could be spent on anything,” Chao said. “So that’s kind of not very honest.”\u003c/p>\n\u003cp>The campaign against Measure A has not reported any financial contributions, but several former mayors — including Lydia Kou of Palo Alto, Rishi Kumar of Saratoga and Liz Lawler of Monte Sereno — have aligned against it.\u003c/p>\n\u003cp>“I think this is like a knee-jerk reaction to something happening in the federal government,” Chao said. “It’s kind of taking advantage of the federal cut as an excuse to tax the voters, rather than really looking at how do we solve a problem.”\u003c/p>\n\u003cp>Meanwhile, nearby hospitals are already buckling. Hazel Hawkins Memorial Hospital in San Benito is teetering after a private buyer \u003ca href=\"https://www.hazelhawkins.com/news/2025/august/insight-health-steps-away-from-lease-to-purchase/\">backed away\u003c/a> from a rescue deal, citing uncertainty in the wake of federal cuts. Williams, the Santa Clara County executive, predicts that could push more patients to Santa Clara’s hospitals.\u003c/p>\n\u003cp>At Valley Med, a $40 million burn unit expansion is underway to expand the unit from eight beds to 14. Rivera, the nurse, said she’s worried about how the cuts will affect the unit she has worked in for the last 17 years.\u003c/p>\n\u003cp>“There’s a lot of unknowns right now and uncertainty,” Rivera said. “But we will all be directly impacted in some way.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "how-san-francisco-harm-reduction-strategies-are-changing-under-mayor-lurie",
"title": "How San Francisco's Harm Reduction Strategies Are Changing Under Mayor Lurie",
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"content": "\u003cp>Dimitri Clark is everywhere in his South of Market apartment building. Greeting residents in the lobby, checking in on floormates and keeping a door open for others to come by the tiny studio he shares with two affectionate terriers, Porcupine and Panda.\u003c/p>\n\u003cp>He’s doing it all to promote safer drug use and reduce overdoses as part of a broader public health program that the city is now expanding within permanent supportive housing buildings. But it comes as San Francisco is \u003ca href=\"https://www.kqed.org/news/12032239/overdoses-climb-lurie-orders-scaling-back-harm-reduction-programs\">scaling back other harm reduction programs\u003c/a>, and as high overdose rates in the city persist.\u003c/p>\n\u003cp>Nearly 460 people died of overdose from January to August 2025, according to the most recently available \u003ca href=\"https://www.sf.gov/data--preliminary-unintentional-drug-overdose-deaths\">public data\u003c/a>, putting the city on pace to exceed last year’s total.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“There are people who use drugs—that’s just part of human nature—and a lot of people want to isolate themselves, and that’s often when they’ll experience an overdose,” said Clark, who has been in recovery for about a year. “We talk to people about it, take the shame away.”\u003c/p>\n\u003cp>The city’s Public Health Department recently gave the peer responder program Clark is part of a boost: $600,000 over the next five years to expand its work in San Francisco.\u003c/p>\n\u003cfigure id=\"attachment_12053915\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12053915 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00371_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00371_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00371_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00371_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Dimitri Clark, a peer responder for Delivering Innovation in Supportive Housing, hugs his dog in his room at The Margot in San Francisco on Aug. 20, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As a peer responder, Clark guides neighbors through safer drug use practices and ways to prevent an overdose. For a couple of hours each week, he posts up in his building lobby to talk about overdose prevention and hands out safety supplies like oxygen masks, sanitizing wipes and information on how to get help for anyone ready—or even just curious—about quitting. He also frequently gives out \u003ca href=\"https://www.kqed.org/news/11947448/there-to-save-a-life-san-francisco-bars-fight-fentanyl-overdoses-with-narcan\">drug test kits and the opioid overdose-reversal medicine naloxone\u003c/a>.\u003c/p>\n\u003cp>The program started in 2021 with five people, including Clark, at his former South of Market residence, the Minna Lee. Overdoses were soaring during the pandemic, so the building’s service provider, a nonprofit called Delivering Innovation in Supportive Housing (DISH SF), decided to train residents with experience using drugs on life-saving strategies to help their neighbors.\u003c/p>\n\u003cp>Suddenly, overdoses at the Minna Lee began dropping.[aside postID=news_12038907 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/240109-SFCeasefireVote-10-BL_qed-1020x680.jpg']“We had multiple years of zero fatal overdoses at the Minna Lee, specifically due to, I would argue, that intervention,” said Mattie Loyce, senior manager of community development at DISH SF.\u003c/p>\n\u003cp>DISH SF has been training more peer responders ever since. This spring, 25 peer responders graduated from the program that is now operating in seven permanent supportive housing buildings.\u003c/p>\n\u003cp>To help incentivize residents to join, the program offers peer responders a $600 stipend. It’s hardly enough to cover a single month’s rent, but several members said the 14-week training program provided tools to change their own relationship to substances, help others and build confidence in other areas of their lives.\u003c/p>\n\u003cp>During the three-month training program, participants take classes on everything from how to respond to an overdose to where to direct people for treatment, as well as different substances’ potencies and effects on the mind and body.\u003c/p>\n\u003cp>“I actually didn’t know before I started this program how many overdoses were happening in our buildings,” said Nicole Flores, another peer responder in the program, who said she is still navigating her own relationship with drugs. “A lot of these resources I didn’t know were available, not just harm reduction supplies, but also wound care and other programs for our community.”\u003c/p>\n\u003cfigure id=\"attachment_12057624\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12057624\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/250826_sfharmreduction00450_TV_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/250826_sfharmreduction00450_TV_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/250826_sfharmreduction00450_TV_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/250826_sfharmreduction00450_TV_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Nicole Flores, a peer responder for Delivering Innovation in Supportive Housing, stands outside her unit at The Auburn in San Francisco on Aug. 20, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Peer responders have crafted overdose prevention safety plans with dozens of residents already. Harm reduction, a method backed by \u003ca href=\"https://www.cdc.gov/overdose-prevention/media/pdfs/OD2A-Case-Studies-Harm-Reduction-508.pdf\">scientific research\u003c/a> to reduce overdose risk and other negative consequences of drug use, is just one element of the city’s approach. San Francisco also sends medical professionals into supportive housing buildings to \u003ca href=\"https://www.kqed.org/news/11945418/san-francisco-has-doubled-participants-of-this-opioid-treatment-heres-why\">deliver drug treatment\u003c/a> options like buprenorphine, a medication that can reduce opioid cravings and withdrawal.\u003c/p>\n\u003cp>“I would like for people to start looking at this community and seeing an asset, instead of seeing a problem, because there’s a lot of potential,” said Katie O’Bryant, manager of the peer responder program. “There’s lot of transferable skills that people learn in this lifestyle that can be replicated for all kinds of good in other instances.”\u003c/p>\n\u003cp>Mayor Daniel Lurie made reducing overdoses, and particularly the most visible street-level drug use and dealing, a central part of his campaign. As part of the mayor’s “Breaking the Cycle” initiative, the city has opened a stabilization center at \u003ca href=\"https://www.kqed.org/news/12038376/tenderloin-welcomes-mental-health-clinic-demands-broader-city-action-on-homelessness\">822 Geary\u003c/a> St., reorganized street response teams and increased policing of outdoor drug use and dealing.[aside postID=news_12034214 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250218-SFDowntown-07-BL_qed-1020x680.jpg']Last spring, Lurie \u003ca href=\"https://www.kqed.org/news/12034214/san-francisco-ends-health-programs-for-drug-users-not-active-in-treatment\">controversially ended public health programs\u003c/a> that handed out clean smoking supplies to drug users on the street, and the city now requires people to participate in counseling in order to obtain any safer drug use supplies, like clean needles, from city-funded public health providers.\u003c/p>\n\u003cp>Critics of the city’s approach to harm reduction applauded the shift, including Stanford professor Keith Humphreys, \u003ca href=\"https://www.kqed.org/forum/2010101909499/san-francisco-scales-back-harm-reduction-policy\">who told KQED\u003c/a> it previously had not done enough to connect people to treatment.\u003c/p>\n\u003cp>One group of anonymous residents is \u003ca href=\"https://storage.courtlistener.com/recap/gov.uscourts.cand.426452/gov.uscourts.cand.426452.101.0.pdf\">suing the city\u003c/a> over its harm reduction practices, saying they have led to litter and concentration of dangerous drug activity in neighborhoods like the Tenderloin.\u003c/p>\n\u003cp>Other addiction experts like Tyler TerMeer, who leads the San Francisco Aids Foundation, \u003ca href=\"https://www.kqed.org/forum/2010101909499/san-francisco-scales-back-harm-reduction-policy\">raised concern over the change\u003c/a>, however. He warned it could strip medically vulnerable people of connections to health workers and push drug users toward tainted supplies, increasing chances of disease spread, riskier use, like injection, or overdose.\u003c/p>\n\u003cp>Fatal overdoses have slightly decreased in recent months, after several months of increasing, according to \u003ca href=\"https://www.sf.gov/data--preliminary-unintentional-drug-overdose-deaths\">city data\u003c/a>. It’s good news, yet addiction treatment providers are raising concerns about other changes they’re noticing after the city cut back on outdoor harm reduction efforts.\u003c/p>\n\u003cfigure id=\"attachment_12053919\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12053919\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00459_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00459_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00459_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00459_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Opioid emergency kits containing Narcan are placed throughout The Auburn in San Francisco on Aug. 20, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Our clients are letting us know that when it’s harder to get smoking supplies, they feel a pressure to inject or share equipment. It’s not large numbers, but we have been hearing that,” said Anna Berg, director of the Harm Reduction Therapy Center. She said the center is also handing out far less naloxone now that they distribute at fewer street-based sites following the policy change.\u003c/p>\n\u003cp>The residential peer responder program happens mostly indoors and is one area where San Francisco is investing more in harm reduction.\u003c/p>\n\u003cp>Berg has clients in treatment who are also participants in the city’s peer responder program, who tell her it works.\u003c/p>\n\u003cp>“They really take it seriously,” Berg said. “These are the kinds of interventions that really work; you need community and to lead with care and support in as many places as possible.”\u003c/p>\n\u003cp>For Flores, who has been in and out of rehabilitation programs, \u003ca href=\"https://www.kqed.org/news/12034006/san-francisco-mans-housing-struggle-relapse-put-him-back-on-streets\">strict abstinence-based requirements made it harder\u003c/a> to work through already difficult relapse periods. Having access to housing allowed her to stabilize, something she said was positively life-changing, but it didn’t wipe away her challenges with drug use.\u003c/p>\n\u003cfigure id=\"attachment_12053920\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12053920\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00466_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00466_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00466_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00466_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Auburn, a housing project under Delivering Innovation in Supportive Housing, is located in SoMa in San Francisco on Aug. 20, 2025. San Francisco has scaled back harm reduction programs, but in housing units such as The Margot, the city is expanding access to harm reduction efforts. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Abstinence-based programs don’t make it easy for people to reach out,” during a relapse, Flores said. “And I think that this peer responder program does make it feel very safe to reach out in those circumstances, to just come hang out in the same room so that somebody’s there if they overdose.”\u003c/p>\n\u003cp>Rob Hoffman of the city’s Office of Overdose Prevention said the goal of growing the peer responder program is “to leverage the community to connect with other people and break down isolation.”\u003c/p>\n\u003cp>That’s already beginning to happen, and people like Flores and Clark are saving lives.\u003c/p>\n\u003cp>“I know of two of our clients who have successfully reversed overdoses as part of that program,” Berg said.\u003c/p>\n\u003cp>Flores met one of her floormates after stepping into the role. She’s helped treat his wounds and said she’ll sometimes go over to his room while he is using drugs to offer support if something goes awry.\u003c/p>\n\u003cfigure id=\"attachment_12053916\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12053916\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00397_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00397_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00397_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00397_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Minna Lee, a housing project under Delivering Innovation in Supportive Housing, is located in SoMa in San Francisco on Aug. 20, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“He has vision problems and other health problems, and just the knowledge that I’ve gained from helping him has been helpful in other areas of my life, too,” Flores said. “It means a lot to me that people trust me enough to come in. I would consider him one of my best friends now.”\u003c/p>\n\u003cp>Clark has occasionally given out clean needles when someone needs them. But due to legal and political challenges, the peer responder program does not fund the distribution of safe-use supplies like needles and does not describe its work as drug-use supervision. Peers themselves entirely lead those efforts..\u003c/p>\n\u003cp>“This program focuses specifically on overdose prevention, and the supplies we give out are CPR masks, naloxone and linkage to care. But the safer-use supplies, that is, the direct advocacy of peers themselves,” said Loyce, with DISH SF. “We don’t give that out, but you know we also support their inclination toward whatever types of resources they want to carry for themselves.”\u003c/p>\n\u003cp>Lurie’s changes this year aren’t the first time the city has pulled back on harm reduction, an approach pioneered in San Francisco during the AIDS crisis. In 2021, the city pulled the plug on a \u003ca href=\"https://www.kqed.org/news/11915870/inside-san-franciscos-tenderloin-center-that-serves-hundreds-every-day\">safe consumption site\u003c/a> following legal concerns and complaints from neighbors and local businesses over long lines outside the facility, which was located in United Nations Plaza.\u003c/p>\n\u003cfigure id=\"attachment_12053923\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12053923\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00241_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00241_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00241_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00241_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Dimitri Clark, a peer responder for Delivering Innovation in Supportive Housing, sets up his distribution station at The Margot in San Francisco on Aug. 20, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Thousands of people visited the site for support. More than 300 overdoses were reversed at the facility, and no one died of an overdose on site during the program’s nearly 10-month run.\u003c/p>\n\u003cp>Berg said the disparity between what peer responders are allowed to do with the program and what neighbors come to them needing reveals a gap in the continuum of care.\u003c/p>\n\u003cp>“We have safe consumption sites all over the place, they’re just not necessarily sanctioned. It is things like neighbors looking out for each other. That is not a new concept. And the reason it sticks around is that it works,” Berg said. “What would it be like to allow people to do things that work? How many people are we losing every month in San Francisco? How many of those folks, if they had somebody there, could have a different outcome?”\u003c/p>\n\u003cp>For Clark, a simple tool is being around when someone needs him.\u003c/p>\n\u003cp>“What’s so nice about this is it’s not forceful,” Clark said. “It’s the isolation, you know, and fundamentally we have to overcome that.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Dimitri Clark is everywhere in his South of Market apartment building. Greeting residents in the lobby, checking in on floormates and keeping a door open for others to come by the tiny studio he shares with two affectionate terriers, Porcupine and Panda.\u003c/p>\n\u003cp>He’s doing it all to promote safer drug use and reduce overdoses as part of a broader public health program that the city is now expanding within permanent supportive housing buildings. But it comes as San Francisco is \u003ca href=\"https://www.kqed.org/news/12032239/overdoses-climb-lurie-orders-scaling-back-harm-reduction-programs\">scaling back other harm reduction programs\u003c/a>, and as high overdose rates in the city persist.\u003c/p>\n\u003cp>Nearly 460 people died of overdose from January to August 2025, according to the most recently available \u003ca href=\"https://www.sf.gov/data--preliminary-unintentional-drug-overdose-deaths\">public data\u003c/a>, putting the city on pace to exceed last year’s total.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“There are people who use drugs—that’s just part of human nature—and a lot of people want to isolate themselves, and that’s often when they’ll experience an overdose,” said Clark, who has been in recovery for about a year. “We talk to people about it, take the shame away.”\u003c/p>\n\u003cp>The city’s Public Health Department recently gave the peer responder program Clark is part of a boost: $600,000 over the next five years to expand its work in San Francisco.\u003c/p>\n\u003cfigure id=\"attachment_12053915\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12053915 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00371_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00371_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00371_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00371_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Dimitri Clark, a peer responder for Delivering Innovation in Supportive Housing, hugs his dog in his room at The Margot in San Francisco on Aug. 20, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As a peer responder, Clark guides neighbors through safer drug use practices and ways to prevent an overdose. For a couple of hours each week, he posts up in his building lobby to talk about overdose prevention and hands out safety supplies like oxygen masks, sanitizing wipes and information on how to get help for anyone ready—or even just curious—about quitting. He also frequently gives out \u003ca href=\"https://www.kqed.org/news/11947448/there-to-save-a-life-san-francisco-bars-fight-fentanyl-overdoses-with-narcan\">drug test kits and the opioid overdose-reversal medicine naloxone\u003c/a>.\u003c/p>\n\u003cp>The program started in 2021 with five people, including Clark, at his former South of Market residence, the Minna Lee. Overdoses were soaring during the pandemic, so the building’s service provider, a nonprofit called Delivering Innovation in Supportive Housing (DISH SF), decided to train residents with experience using drugs on life-saving strategies to help their neighbors.\u003c/p>\n\u003cp>Suddenly, overdoses at the Minna Lee began dropping.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“We had multiple years of zero fatal overdoses at the Minna Lee, specifically due to, I would argue, that intervention,” said Mattie Loyce, senior manager of community development at DISH SF.\u003c/p>\n\u003cp>DISH SF has been training more peer responders ever since. This spring, 25 peer responders graduated from the program that is now operating in seven permanent supportive housing buildings.\u003c/p>\n\u003cp>To help incentivize residents to join, the program offers peer responders a $600 stipend. It’s hardly enough to cover a single month’s rent, but several members said the 14-week training program provided tools to change their own relationship to substances, help others and build confidence in other areas of their lives.\u003c/p>\n\u003cp>During the three-month training program, participants take classes on everything from how to respond to an overdose to where to direct people for treatment, as well as different substances’ potencies and effects on the mind and body.\u003c/p>\n\u003cp>“I actually didn’t know before I started this program how many overdoses were happening in our buildings,” said Nicole Flores, another peer responder in the program, who said she is still navigating her own relationship with drugs. “A lot of these resources I didn’t know were available, not just harm reduction supplies, but also wound care and other programs for our community.”\u003c/p>\n\u003cfigure id=\"attachment_12057624\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12057624\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/250826_sfharmreduction00450_TV_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/250826_sfharmreduction00450_TV_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/250826_sfharmreduction00450_TV_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/250826_sfharmreduction00450_TV_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Nicole Flores, a peer responder for Delivering Innovation in Supportive Housing, stands outside her unit at The Auburn in San Francisco on Aug. 20, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Peer responders have crafted overdose prevention safety plans with dozens of residents already. Harm reduction, a method backed by \u003ca href=\"https://www.cdc.gov/overdose-prevention/media/pdfs/OD2A-Case-Studies-Harm-Reduction-508.pdf\">scientific research\u003c/a> to reduce overdose risk and other negative consequences of drug use, is just one element of the city’s approach. San Francisco also sends medical professionals into supportive housing buildings to \u003ca href=\"https://www.kqed.org/news/11945418/san-francisco-has-doubled-participants-of-this-opioid-treatment-heres-why\">deliver drug treatment\u003c/a> options like buprenorphine, a medication that can reduce opioid cravings and withdrawal.\u003c/p>\n\u003cp>“I would like for people to start looking at this community and seeing an asset, instead of seeing a problem, because there’s a lot of potential,” said Katie O’Bryant, manager of the peer responder program. “There’s lot of transferable skills that people learn in this lifestyle that can be replicated for all kinds of good in other instances.”\u003c/p>\n\u003cp>Mayor Daniel Lurie made reducing overdoses, and particularly the most visible street-level drug use and dealing, a central part of his campaign. As part of the mayor’s “Breaking the Cycle” initiative, the city has opened a stabilization center at \u003ca href=\"https://www.kqed.org/news/12038376/tenderloin-welcomes-mental-health-clinic-demands-broader-city-action-on-homelessness\">822 Geary\u003c/a> St., reorganized street response teams and increased policing of outdoor drug use and dealing.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Last spring, Lurie \u003ca href=\"https://www.kqed.org/news/12034214/san-francisco-ends-health-programs-for-drug-users-not-active-in-treatment\">controversially ended public health programs\u003c/a> that handed out clean smoking supplies to drug users on the street, and the city now requires people to participate in counseling in order to obtain any safer drug use supplies, like clean needles, from city-funded public health providers.\u003c/p>\n\u003cp>Critics of the city’s approach to harm reduction applauded the shift, including Stanford professor Keith Humphreys, \u003ca href=\"https://www.kqed.org/forum/2010101909499/san-francisco-scales-back-harm-reduction-policy\">who told KQED\u003c/a> it previously had not done enough to connect people to treatment.\u003c/p>\n\u003cp>One group of anonymous residents is \u003ca href=\"https://storage.courtlistener.com/recap/gov.uscourts.cand.426452/gov.uscourts.cand.426452.101.0.pdf\">suing the city\u003c/a> over its harm reduction practices, saying they have led to litter and concentration of dangerous drug activity in neighborhoods like the Tenderloin.\u003c/p>\n\u003cp>Other addiction experts like Tyler TerMeer, who leads the San Francisco Aids Foundation, \u003ca href=\"https://www.kqed.org/forum/2010101909499/san-francisco-scales-back-harm-reduction-policy\">raised concern over the change\u003c/a>, however. He warned it could strip medically vulnerable people of connections to health workers and push drug users toward tainted supplies, increasing chances of disease spread, riskier use, like injection, or overdose.\u003c/p>\n\u003cp>Fatal overdoses have slightly decreased in recent months, after several months of increasing, according to \u003ca href=\"https://www.sf.gov/data--preliminary-unintentional-drug-overdose-deaths\">city data\u003c/a>. It’s good news, yet addiction treatment providers are raising concerns about other changes they’re noticing after the city cut back on outdoor harm reduction efforts.\u003c/p>\n\u003cfigure id=\"attachment_12053919\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12053919\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00459_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00459_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00459_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00459_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Opioid emergency kits containing Narcan are placed throughout The Auburn in San Francisco on Aug. 20, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Our clients are letting us know that when it’s harder to get smoking supplies, they feel a pressure to inject or share equipment. It’s not large numbers, but we have been hearing that,” said Anna Berg, director of the Harm Reduction Therapy Center. She said the center is also handing out far less naloxone now that they distribute at fewer street-based sites following the policy change.\u003c/p>\n\u003cp>The residential peer responder program happens mostly indoors and is one area where San Francisco is investing more in harm reduction.\u003c/p>\n\u003cp>Berg has clients in treatment who are also participants in the city’s peer responder program, who tell her it works.\u003c/p>\n\u003cp>“They really take it seriously,” Berg said. “These are the kinds of interventions that really work; you need community and to lead with care and support in as many places as possible.”\u003c/p>\n\u003cp>For Flores, who has been in and out of rehabilitation programs, \u003ca href=\"https://www.kqed.org/news/12034006/san-francisco-mans-housing-struggle-relapse-put-him-back-on-streets\">strict abstinence-based requirements made it harder\u003c/a> to work through already difficult relapse periods. Having access to housing allowed her to stabilize, something she said was positively life-changing, but it didn’t wipe away her challenges with drug use.\u003c/p>\n\u003cfigure id=\"attachment_12053920\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12053920\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00466_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00466_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00466_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00466_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Auburn, a housing project under Delivering Innovation in Supportive Housing, is located in SoMa in San Francisco on Aug. 20, 2025. San Francisco has scaled back harm reduction programs, but in housing units such as The Margot, the city is expanding access to harm reduction efforts. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Abstinence-based programs don’t make it easy for people to reach out,” during a relapse, Flores said. “And I think that this peer responder program does make it feel very safe to reach out in those circumstances, to just come hang out in the same room so that somebody’s there if they overdose.”\u003c/p>\n\u003cp>Rob Hoffman of the city’s Office of Overdose Prevention said the goal of growing the peer responder program is “to leverage the community to connect with other people and break down isolation.”\u003c/p>\n\u003cp>That’s already beginning to happen, and people like Flores and Clark are saving lives.\u003c/p>\n\u003cp>“I know of two of our clients who have successfully reversed overdoses as part of that program,” Berg said.\u003c/p>\n\u003cp>Flores met one of her floormates after stepping into the role. She’s helped treat his wounds and said she’ll sometimes go over to his room while he is using drugs to offer support if something goes awry.\u003c/p>\n\u003cfigure id=\"attachment_12053916\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12053916\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00397_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00397_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00397_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00397_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Minna Lee, a housing project under Delivering Innovation in Supportive Housing, is located in SoMa in San Francisco on Aug. 20, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“He has vision problems and other health problems, and just the knowledge that I’ve gained from helping him has been helpful in other areas of my life, too,” Flores said. “It means a lot to me that people trust me enough to come in. I would consider him one of my best friends now.”\u003c/p>\n\u003cp>Clark has occasionally given out clean needles when someone needs them. But due to legal and political challenges, the peer responder program does not fund the distribution of safe-use supplies like needles and does not describe its work as drug-use supervision. Peers themselves entirely lead those efforts..\u003c/p>\n\u003cp>“This program focuses specifically on overdose prevention, and the supplies we give out are CPR masks, naloxone and linkage to care. But the safer-use supplies, that is, the direct advocacy of peers themselves,” said Loyce, with DISH SF. “We don’t give that out, but you know we also support their inclination toward whatever types of resources they want to carry for themselves.”\u003c/p>\n\u003cp>Lurie’s changes this year aren’t the first time the city has pulled back on harm reduction, an approach pioneered in San Francisco during the AIDS crisis. In 2021, the city pulled the plug on a \u003ca href=\"https://www.kqed.org/news/11915870/inside-san-franciscos-tenderloin-center-that-serves-hundreds-every-day\">safe consumption site\u003c/a> following legal concerns and complaints from neighbors and local businesses over long lines outside the facility, which was located in United Nations Plaza.\u003c/p>\n\u003cfigure id=\"attachment_12053923\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12053923\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00241_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00241_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00241_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00241_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Dimitri Clark, a peer responder for Delivering Innovation in Supportive Housing, sets up his distribution station at The Margot in San Francisco on Aug. 20, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Thousands of people visited the site for support. More than 300 overdoses were reversed at the facility, and no one died of an overdose on site during the program’s nearly 10-month run.\u003c/p>\n\u003cp>Berg said the disparity between what peer responders are allowed to do with the program and what neighbors come to them needing reveals a gap in the continuum of care.\u003c/p>\n\u003cp>“We have safe consumption sites all over the place, they’re just not necessarily sanctioned. It is things like neighbors looking out for each other. That is not a new concept. And the reason it sticks around is that it works,” Berg said. “What would it be like to allow people to do things that work? How many people are we losing every month in San Francisco? How many of those folks, if they had somebody there, could have a different outcome?”\u003c/p>\n\u003cp>For Clark, a simple tool is being around when someone needs him.\u003c/p>\n\u003cp>“What’s so nice about this is it’s not forceful,” Clark said. “It’s the isolation, you know, and fundamentally we have to overcome that.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"mindshift": {
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 12
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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},
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"pri-the-world": {
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"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
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