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"content": "\u003cp>Santa Clara County officials are leading the way on a new state initiative to provide Medi-Cal benefits to people incarcerated in county lockups as they prepare to reenter society, part of an effort to improve health outcomes in underserved communities.\u003c/p>\n\u003cp>The \u003ca href=\"https://calmatters.org/health/2022/02/california-medi-cal-reform/\">new program\u003c/a>, known as the Justice-Involved Reentry Initiative, is one part of the state’s push to better streamline and integrate Medi-Cal with other social and health services across California. Through the reentry program, people in jails and youth correctional facilities can now enroll in Medi-Cal 90 days before their release.\u003c/p>\n\u003cp>All counties in California must implement the program by October 2025, but Santa Clara County, along with Inyo and Yuba counties, were among the first to gain approval from the state to begin the work.\u003c/p>\n\u003cp>During the 90-day period, county health agencies, which oversee care for incarcerated people, can work with those preparing for reentry to develop plans for uninterrupted medical care and mental health support.\u003c/p>\n\u003cp>“This means that gains that were made while in custody through mental health services, drug addiction treatment and support for chronic health conditions will not be lost when people leave custody,” county Board of Supervisors President Susan Ellenberg said during a news conference on Tuesday, to mark the county enrolling more than 100 people in the program.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“In short, this initiative will make these residents healthier and our entire community safer.”\u003c/p>\n\u003cp>Ellenberg said about 70% of people in county correctional facilities, a disproportionate number of whom are people of color, are struggling with chronic health issues, mental illness or substance-use disorders.\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"medi-cal\"]“Very often, the triggering behavior or action that lands them in custody was one of those health-related issues or social determinants of health,” she said in an interview. “So being able to address those while they’re in custody is really significant, but only will have a lasting effect if we continue it.”\u003c/p>\n\u003cp>Program participants are also offered case management support for up to one year after their release to help navigate the complex web of available government, private market and nonprofit-provided services.\u003c/p>\n\u003cp>“The medical system, behavioral health systems, as well as connecting them to other services like housing, food, transportation, other things that you need, the fundamentals to be able to manage your health well,” Michelle de la Calle, director of system integration for Santa Clara Valley Healthcare, said in an interview.\u003c/p>\n\u003cp>Dr. Clifford Wang, the interim director of custody health services for the county, said people leaving county facilities would be given a supply of their medications in hand, as well as any needed medical equipment, such as walkers, canes or wheelchairs.\u003c/p>\n\u003cp>“Once you leave custody, you’re thinking about, ‘where am I going to live, where am I going to get my next meal,’ and you may not pick up your prescriptions,” Wang said. “So it’s a bridge, and it’s lessening the burden on them. One less thing they might have to worry about when they get out in the immediate sense.”\u003c/p>\n\u003cp>People who are trying to rebuild their lives face many challenges “including housing instability, homelessness and barriers to gainful employment,” said Ky Le, a deputy county executive.\u003c/p>\n\u003cp>Le said this latest initiative will augment the work the county has already done to provide reentry resource centers, employment programs and peer counseling services.\u003c/p>\n\u003cp>Ellenberg said she’s happy Santa Clara County is “at the vanguard again” for programs and initiatives that help “build a carceral system that is as least traumatizing as possible, as most rehabilitative as possible.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I look forward to learning about the lives that will be improved as a result of this program,” she said.\u003c/p>\n\n",
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"content": "\u003cp>The director of California’s mental health commission traveled to London this summer courtesy of a state vendor while he was helping to prevent a \u003ca href=\"https://sbud.senate.ca.gov/system/files/2024-06/all-departments-vote-only-items-05.30.2024-outcomes.pdf\">$360 million budget cut\u003c/a> that would have defunded the company’s contract.\u003c/p>\n\u003cp>Emails and calendars reviewed by KFF Health News show Toby Ewing, executive director of the Mental Health Services Oversight and Accountability Commission, made efforts to protect funding for Kooth, a London-based digital mental health company the state hired to develop a virtual tool to help tackle its youth mental health crisis. Ewing pressed key legislative staffers to maintain its contract, even as Democratic Gov. Gavin Newsom and lawmakers proposed cuts in the face of California’s $45 billion deficit.\u003c/p>\n\u003cp>When Ewing and three commissioners — Mara Madrigal-Weiss, the commission chair; Bill Brown; and Steve Carnevale — left for London in June, Ewing wasn’t sure whether he had saved Kooth’s funding. On the second day of their trip, \u003ca href=\"https://www.documentcloud.org/documents/25244584-copy-of-trailer-emails-2\">staff informed him\u003c/a> that lawmakers had \u003ca href=\"https://www.documentcloud.org/documents/25244583-copy-of-trailer-bills-email\">restored the money\u003c/a>.\u003c/p>\n\u003cp>A few days later, \u003ca href=\"https://www.documentcloud.org/documents/25244587-more-kooth-lobbying?responsive=1&title=1\">he emailed\u003c/a> Kooth Chief Operating Officer Kate Newhouse suggestions he had shared with Assembly and Senate staff to improve Kooth’s youth teletherapy app. “We expect you to be involved in whatever we dream up,” Ewing wrote to Newhouse in another email.\u003c/p>\n\u003cp>It’s unclear why Kooth picked up a $15,000 tab for state officials to travel to London. It’s also unclear why Ewing pushed to protect its app from a spending cut. The commission is a 16-member independent body appointed by various elected officials to help ensure funds from a millionaires tax are used appropriately and effectively by counties for mental health services. Kooth’s contract is with the Department of Health Care Services, which is separate from the commission.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[aside label='Related Coverage' tag='health']\u003c/p>\n\u003cp>Last year, Kooth signed a four-year contract worth \u003ca href=\"https://www.documentcloud.org/documents/25245478-kooth_contract_4260-2220555_final-1-5?responsive=1&title=1\">$271 \u003c/a>\u003cspan style=\"margin: 0px;padding: 0px\">\u003ca href=\"https://www.documentcloud.org/documents/25245478-kooth_contract_4260-2220555_final-1-5?responsive=1&title=1\" target=\"_blank\" rel=\"noopener\">million \u003c/a>to\u003c/span> \u003ca href=\"https://solunaapp.com/\">create Soluna\u003c/a>, a free mental health app for California users ages 13 to 25. The app, \u003ca href=\"https://www.hellobrightline.com/brightlifekids/\">along with another\u003c/a>, by the company Brightline, for younger users, launched in January to fill a need for young Californians and their families to access professional telehealth free of charge. It’s one component of Newsom’s \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2022/08/KidsMentalHealthMasterPlan_8.18.22.pdf\">$4.7 billion\u003c/a> youth mental health plan.\u003c/p>\n\u003cp>Ewing, who reports to the commission, started in 2015 and earned $175,026 in 2023, according to \u003ca href=\"https://www.sacbee.com/news/databases/state-pay/article229468549.html\">The Sacramento Bee\u003c/a>. He was placed on \u003ca href=\"https://mhsoac.ca.gov/connect/commission-meetings/commission-meeting-september-11-2024/\">paid administrative leave\u003c/a> in September pending an investigation. Commission chief counsel Sandra Gallardo said the commission does not comment on personnel matters. Ewing did not respond to requests for comment.\u003c/p>\n\u003cp>Three commission employees filed whistleblower complaints against Ewing in September with the California State Auditor. They spoke with KFF Health News on the condition that their names not be used due to fears of workplace retaliation. They say Ewing’s conduct advancing a private company’s agenda as a public official crossed a line.\u003c/p>\n\u003cp>\u003ca href=\"https://mhsoac.ca.gov/wp-content/uploads/October-24_Agenda_Teleconference_FINAL.pdf\">The agenda\u003c/a> for Thursday’s commission meeting listed a personnel matter to be discussed in closed session. The whistleblowers said Ewing is the subject of the discussion.\u003c/p>\n\u003cp>Madrigal-Weiss said she couldn’t comment on Ewing’s actions. However, she said the commission supports virtual mental health resources for youth.\u003c/p>\n\u003cp>“These resources are less expensive and have proven valuable for youth, especially those who struggle to access services in typical brick-and-mortar spaces,” said Madrigal-Weiss, who is also executive director of student wellness and school culture for the San Diego County Office of Education.\u003c/p>\n\u003cp>Brown and Carnevale didn’t respond to requests for comment.\u003c/p>\n\u003cp>Kooth is committed to advancing youth access to behavioral health services, said Caroline Curran of Metis Communications, a public relations firm representing Kooth.\u003c/p>\n\u003cp>“As a leader in youth behavioral health services with over 20 years of experience in the United Kingdom and the United States, we regularly convene sector-leading organizations to facilitate learning through sharing expertise and diverse perspectives on youth behavioral health,” Curran said.\u003c/p>\n\u003cp>As KFF Health News \u003ca href=\"https://kffhealthnews.org/news/article/california-youth-teletherapy-apps-rollout-slow/\">reported in April\u003c/a>, the Kooth and Brightline app rollouts have been slow, with few children using them. In May, Newsom proposed a $140 million budget cut. DHCS Director Michelle Baass said in \u003ca href=\"https://digitaldemocracy.calmatters.org/hearings/257973\">a hearing\u003c/a> that it was due to low use but that the state expects more users to come on board over time, according to CalMatters’ Digital Democracy tool.\u003c/p>\n\u003cp>She told lawmakers on May 16 that roughly 20,000 of the state’s more than 12.6 million children and young adults had registered on the apps, and they had been used for only about 2,800 coaching sessions.\u003c/p>\n\u003cp>State Sen. Caroline Menjivar (D-Van Nuys) asked Baass at the hearing whether “there’s room to get out” of the contract altogether. Senators later \u003ca href=\"https://sbud.senate.ca.gov/system/files/2024-06/all-departments-vote-only-items-05.30.2024-outcomes.pdf\">voted unanimously\u003c/a> to cut the entire platform budget to save the state $360 million.\u003c/p>\n\u003cp>Ewing \u003ca href=\"https://www.documentcloud.org/documents/25245061-toby-kooth-text_redacted\">texted a colleague\u003c/a> on June 3: “Kooth is freaking out. Is the cut coming from the Admin or the Leg.? Do we know if it’s a done deal?”\u003c/p>\n\u003cp>[documentcloud url=\"https://www.documentcloud.org/documents/25245061-toby-kooth-text_redacted\"]\u003c/p>\n\u003cp>State \u003ca href=\"https://cal-access.sos.ca.gov/Lobbying/Employers/Detail.aspx?id=1465784&view=activity\">lobbying records\u003c/a> show Kooth has paid around $100,000 this year to the firm Capital Advocacy. At the same time, Ewing’s emails and calendars show that he pushed for Kooth’s funding to be retained. For instance, his June 4 calendar shows he was scheduled to \u003ca href=\"https://www.documentcloud.org/documents/25245592-kooth-toby-meeting-2?responsive=1&title=1\">meet with Laura Tully\u003c/a>, an executive from Kooth USA, at a coffee shop near the Capitol.\u003c/p>\n\u003cp>The next day, a whistleblower said, Ewing \u003ca href=\"https://www.documentcloud.org/documents/25245593-senate-meeting-1?responsive=1&title=1\">met with\u003c/a> key Senate staff members: Scott Ogus, deputy staff director of the Senate Budget and Fiscal Review Committee, and Marjorie Swartz, a consultant for Senate President Pro Tempore Mike McGuire. They said Ewing also discussed Kooth’s contract that week with Rosielyn Pulmano, a health policy consultant for Assembly Speaker Robert Rivas.\u003c/p>\n\u003cp>“Toby kept saying that ‘California has to have a digital strategy,’” recalled the whistleblower, who attended both meetings. “He kept pushing Marjorie and Scott, saying that he would give them ideas to make the platform better.”\u003c/p>\n\u003cp>Ewing \u003ca href=\"https://www.documentcloud.org/documents/25244582-copy-of-toby-kooth-suggestions-email?responsive=1&title=1\">emailed ideas\u003c/a> to the legislative aides on June 10 and 12.\u003c/p>\n\u003cp>About two weeks later, he and the commissioners left for the seven-day trip to the U.K. According to documents filed with the state \u003ca href=\"https://www.documentcloud.org/documents/25245068-london-fppc-801-payment-to-agency-report\">Fair Political Practices Commission\u003c/a>, receipts, and emails reviewed by KFF Health News, Kooth covered the costs of four-star hotels, meals, train tickets, and international flights.\u003c/p>\n\u003cp>Public disclosure forms show Kooth paid expenses for Ewing, Madrigal-Weiss, and Brown. The forms do not show the company paid for Carnevale’s travel.\u003c/p>\n\u003cp>Under California law, state officials generally must report travel payments to the FPPC, which Ewing and his fellow commissioners did.\u003c/p>\n\u003cp>Kooth postponed a mental health investment \u003ca href=\"https://www.documentcloud.org/documents/25244589-uk-brain-capital-summit\">conference in London\u003c/a> in June, emails and documents show, but then organized \u003ca href=\"https://www.documentcloud.org/documents/25246512-london-schedule-1\">new events\u003c/a> for the California commissioners to attend instead.\u003c/p>\n\u003cp>On May 23, Newhouse informed Carnevale and Ewing \u003ca href=\"https://www.documentcloud.org/documents/25244586-london-trip-postponement?responsive=1&title=1\">in an email\u003c/a> that Kooth needed to postpone the planned June event. Carnevale, a venture capitalist, described the news as “disappointing for all,” especially “because we have already booked trips, including family members of Commissioners who were planning to turn this into a holiday.”\u003c/p>\n\u003cp>Acknowledging the disruption, Newhouse told Carnevale that she “would like to think creatively as to whether we could try to arrange a meeting where you can talk about the CYBHI,” referring to Newsom’s Children and Youth Behavioral Health Initiative.\u003c/p>\n\u003cp>“I know, though, from our conversation, that we need to cover the ‘purpose’ of your trip and not sure what is possible or not,” she wrote.\u003c/p>\n\u003cp>Curran, the Kooth spokesperson, said the company “adapted by holding a knowledge exchange between representatives from international policy institutes, research foundations, and nonprofit organizations.”\u003c/p>\n\u003cp>Madrigal-Weiss defended the trip, which she said included meetings with “members of the government, service providers, education, and finance” who shared ideas on how “to enhance funds for public mental health needs” through private and philanthropic partnerships.\u003c/p>\n\u003cp>One of the whistleblowers said many of the commissioners back in California were not aware of the trip until their colleagues were halfway across the world. Sami Gallegos, a spokesperson for the California Health and Human Services Agency, said the Department of Health Care Services did not participate in the travel.\u003c/p>\n\u003cp>Ewing was put on leave before Kooth’s \u003ca href=\"https://www.linkedin.com/posts/mindspark360_brain-capital-uk-summit-ugcPost-7249487039157420032-wT6q/?utm_source=share&utm_medium=member_ios\">rescheduled conference\u003c/a> this month in London.\u003c/p>\n\u003cp>Although it’s not unusual for state officials to travel overseas — often on the dime of private entities — it doesn’t look good, said Sean McMorris, a government ethics expert with California Common Cause, a nonprofit government watchdog group.\u003c/p>\n\u003cp>“It looks like undue influence,” McMorris said. “I think a lot of people would view something like this as a way to curry favor. You can connect the dots.”\u003c/p>\n\u003cp>Kooth has similarly gifted travel to state officials in Pennsylvania, where it had a $3 million contract with 30 school districts. In each case, Kooth invited the officials to speak to highlight their work. Pennsylvania has informed Kooth it intends to terminate the contract.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This article was produced by \u003c/em>\u003ca href=\"https://kffhealthnews.org/about-us\">\u003cem>KFF Health News\u003c/em>\u003c/a>\u003cem>, which publishes \u003c/em>\u003ca href=\"http://www.californiahealthline.org/\">\u003cem>California Healthline\u003c/em>\u003c/a>\u003cem>, an editorially independent service of the \u003c/em>\u003ca href=\"http://www.chcf.org/\">\u003cem>California Health Care Foundation\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Toby Ewing, executive director of the California Mental Health Services Oversight and Accountability Commission, is on administrative leave after emails show he fought to preserve the company's state contract and was then flown to their London offices.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The director of California’s mental health commission traveled to London this summer courtesy of a state vendor while he was helping to prevent a \u003ca href=\"https://sbud.senate.ca.gov/system/files/2024-06/all-departments-vote-only-items-05.30.2024-outcomes.pdf\">$360 million budget cut\u003c/a> that would have defunded the company’s contract.\u003c/p>\n\u003cp>Emails and calendars reviewed by KFF Health News show Toby Ewing, executive director of the Mental Health Services Oversight and Accountability Commission, made efforts to protect funding for Kooth, a London-based digital mental health company the state hired to develop a virtual tool to help tackle its youth mental health crisis. Ewing pressed key legislative staffers to maintain its contract, even as Democratic Gov. Gavin Newsom and lawmakers proposed cuts in the face of California’s $45 billion deficit.\u003c/p>\n\u003cp>When Ewing and three commissioners — Mara Madrigal-Weiss, the commission chair; Bill Brown; and Steve Carnevale — left for London in June, Ewing wasn’t sure whether he had saved Kooth’s funding. On the second day of their trip, \u003ca href=\"https://www.documentcloud.org/documents/25244584-copy-of-trailer-emails-2\">staff informed him\u003c/a> that lawmakers had \u003ca href=\"https://www.documentcloud.org/documents/25244583-copy-of-trailer-bills-email\">restored the money\u003c/a>.\u003c/p>\n\u003cp>A few days later, \u003ca href=\"https://www.documentcloud.org/documents/25244587-more-kooth-lobbying?responsive=1&title=1\">he emailed\u003c/a> Kooth Chief Operating Officer Kate Newhouse suggestions he had shared with Assembly and Senate staff to improve Kooth’s youth teletherapy app. “We expect you to be involved in whatever we dream up,” Ewing wrote to Newhouse in another email.\u003c/p>\n\u003cp>It’s unclear why Kooth picked up a $15,000 tab for state officials to travel to London. It’s also unclear why Ewing pushed to protect its app from a spending cut. The commission is a 16-member independent body appointed by various elected officials to help ensure funds from a millionaires tax are used appropriately and effectively by counties for mental health services. Kooth’s contract is with the Department of Health Care Services, which is separate from the commission.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Last year, Kooth signed a four-year contract worth \u003ca href=\"https://www.documentcloud.org/documents/25245478-kooth_contract_4260-2220555_final-1-5?responsive=1&title=1\">$271 \u003c/a>\u003cspan style=\"margin: 0px;padding: 0px\">\u003ca href=\"https://www.documentcloud.org/documents/25245478-kooth_contract_4260-2220555_final-1-5?responsive=1&title=1\" target=\"_blank\" rel=\"noopener\">million \u003c/a>to\u003c/span> \u003ca href=\"https://solunaapp.com/\">create Soluna\u003c/a>, a free mental health app for California users ages 13 to 25. The app, \u003ca href=\"https://www.hellobrightline.com/brightlifekids/\">along with another\u003c/a>, by the company Brightline, for younger users, launched in January to fill a need for young Californians and their families to access professional telehealth free of charge. It’s one component of Newsom’s \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2022/08/KidsMentalHealthMasterPlan_8.18.22.pdf\">$4.7 billion\u003c/a> youth mental health plan.\u003c/p>\n\u003cp>Ewing, who reports to the commission, started in 2015 and earned $175,026 in 2023, according to \u003ca href=\"https://www.sacbee.com/news/databases/state-pay/article229468549.html\">The Sacramento Bee\u003c/a>. He was placed on \u003ca href=\"https://mhsoac.ca.gov/connect/commission-meetings/commission-meeting-september-11-2024/\">paid administrative leave\u003c/a> in September pending an investigation. Commission chief counsel Sandra Gallardo said the commission does not comment on personnel matters. Ewing did not respond to requests for comment.\u003c/p>\n\u003cp>Three commission employees filed whistleblower complaints against Ewing in September with the California State Auditor. They spoke with KFF Health News on the condition that their names not be used due to fears of workplace retaliation. They say Ewing’s conduct advancing a private company’s agenda as a public official crossed a line.\u003c/p>\n\u003cp>\u003ca href=\"https://mhsoac.ca.gov/wp-content/uploads/October-24_Agenda_Teleconference_FINAL.pdf\">The agenda\u003c/a> for Thursday’s commission meeting listed a personnel matter to be discussed in closed session. The whistleblowers said Ewing is the subject of the discussion.\u003c/p>\n\u003cp>Madrigal-Weiss said she couldn’t comment on Ewing’s actions. However, she said the commission supports virtual mental health resources for youth.\u003c/p>\n\u003cp>“These resources are less expensive and have proven valuable for youth, especially those who struggle to access services in typical brick-and-mortar spaces,” said Madrigal-Weiss, who is also executive director of student wellness and school culture for the San Diego County Office of Education.\u003c/p>\n\u003cp>Brown and Carnevale didn’t respond to requests for comment.\u003c/p>\n\u003cp>Kooth is committed to advancing youth access to behavioral health services, said Caroline Curran of Metis Communications, a public relations firm representing Kooth.\u003c/p>\n\u003cp>“As a leader in youth behavioral health services with over 20 years of experience in the United Kingdom and the United States, we regularly convene sector-leading organizations to facilitate learning through sharing expertise and diverse perspectives on youth behavioral health,” Curran said.\u003c/p>\n\u003cp>As KFF Health News \u003ca href=\"https://kffhealthnews.org/news/article/california-youth-teletherapy-apps-rollout-slow/\">reported in April\u003c/a>, the Kooth and Brightline app rollouts have been slow, with few children using them. In May, Newsom proposed a $140 million budget cut. DHCS Director Michelle Baass said in \u003ca href=\"https://digitaldemocracy.calmatters.org/hearings/257973\">a hearing\u003c/a> that it was due to low use but that the state expects more users to come on board over time, according to CalMatters’ Digital Democracy tool.\u003c/p>\n\u003cp>She told lawmakers on May 16 that roughly 20,000 of the state’s more than 12.6 million children and young adults had registered on the apps, and they had been used for only about 2,800 coaching sessions.\u003c/p>\n\u003cp>State Sen. Caroline Menjivar (D-Van Nuys) asked Baass at the hearing whether “there’s room to get out” of the contract altogether. Senators later \u003ca href=\"https://sbud.senate.ca.gov/system/files/2024-06/all-departments-vote-only-items-05.30.2024-outcomes.pdf\">voted unanimously\u003c/a> to cut the entire platform budget to save the state $360 million.\u003c/p>\n\u003cp>Ewing \u003ca href=\"https://www.documentcloud.org/documents/25245061-toby-kooth-text_redacted\">texted a colleague\u003c/a> on June 3: “Kooth is freaking out. Is the cut coming from the Admin or the Leg.? Do we know if it’s a done deal?”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>State \u003ca href=\"https://cal-access.sos.ca.gov/Lobbying/Employers/Detail.aspx?id=1465784&view=activity\">lobbying records\u003c/a> show Kooth has paid around $100,000 this year to the firm Capital Advocacy. At the same time, Ewing’s emails and calendars show that he pushed for Kooth’s funding to be retained. For instance, his June 4 calendar shows he was scheduled to \u003ca href=\"https://www.documentcloud.org/documents/25245592-kooth-toby-meeting-2?responsive=1&title=1\">meet with Laura Tully\u003c/a>, an executive from Kooth USA, at a coffee shop near the Capitol.\u003c/p>\n\u003cp>The next day, a whistleblower said, Ewing \u003ca href=\"https://www.documentcloud.org/documents/25245593-senate-meeting-1?responsive=1&title=1\">met with\u003c/a> key Senate staff members: Scott Ogus, deputy staff director of the Senate Budget and Fiscal Review Committee, and Marjorie Swartz, a consultant for Senate President Pro Tempore Mike McGuire. They said Ewing also discussed Kooth’s contract that week with Rosielyn Pulmano, a health policy consultant for Assembly Speaker Robert Rivas.\u003c/p>\n\u003cp>“Toby kept saying that ‘California has to have a digital strategy,’” recalled the whistleblower, who attended both meetings. “He kept pushing Marjorie and Scott, saying that he would give them ideas to make the platform better.”\u003c/p>\n\u003cp>Ewing \u003ca href=\"https://www.documentcloud.org/documents/25244582-copy-of-toby-kooth-suggestions-email?responsive=1&title=1\">emailed ideas\u003c/a> to the legislative aides on June 10 and 12.\u003c/p>\n\u003cp>About two weeks later, he and the commissioners left for the seven-day trip to the U.K. According to documents filed with the state \u003ca href=\"https://www.documentcloud.org/documents/25245068-london-fppc-801-payment-to-agency-report\">Fair Political Practices Commission\u003c/a>, receipts, and emails reviewed by KFF Health News, Kooth covered the costs of four-star hotels, meals, train tickets, and international flights.\u003c/p>\n\u003cp>Public disclosure forms show Kooth paid expenses for Ewing, Madrigal-Weiss, and Brown. The forms do not show the company paid for Carnevale’s travel.\u003c/p>\n\u003cp>Under California law, state officials generally must report travel payments to the FPPC, which Ewing and his fellow commissioners did.\u003c/p>\n\u003cp>Kooth postponed a mental health investment \u003ca href=\"https://www.documentcloud.org/documents/25244589-uk-brain-capital-summit\">conference in London\u003c/a> in June, emails and documents show, but then organized \u003ca href=\"https://www.documentcloud.org/documents/25246512-london-schedule-1\">new events\u003c/a> for the California commissioners to attend instead.\u003c/p>\n\u003cp>On May 23, Newhouse informed Carnevale and Ewing \u003ca href=\"https://www.documentcloud.org/documents/25244586-london-trip-postponement?responsive=1&title=1\">in an email\u003c/a> that Kooth needed to postpone the planned June event. Carnevale, a venture capitalist, described the news as “disappointing for all,” especially “because we have already booked trips, including family members of Commissioners who were planning to turn this into a holiday.”\u003c/p>\n\u003cp>Acknowledging the disruption, Newhouse told Carnevale that she “would like to think creatively as to whether we could try to arrange a meeting where you can talk about the CYBHI,” referring to Newsom’s Children and Youth Behavioral Health Initiative.\u003c/p>\n\u003cp>“I know, though, from our conversation, that we need to cover the ‘purpose’ of your trip and not sure what is possible or not,” she wrote.\u003c/p>\n\u003cp>Curran, the Kooth spokesperson, said the company “adapted by holding a knowledge exchange between representatives from international policy institutes, research foundations, and nonprofit organizations.”\u003c/p>\n\u003cp>Madrigal-Weiss defended the trip, which she said included meetings with “members of the government, service providers, education, and finance” who shared ideas on how “to enhance funds for public mental health needs” through private and philanthropic partnerships.\u003c/p>\n\u003cp>One of the whistleblowers said many of the commissioners back in California were not aware of the trip until their colleagues were halfway across the world. Sami Gallegos, a spokesperson for the California Health and Human Services Agency, said the Department of Health Care Services did not participate in the travel.\u003c/p>\n\u003cp>Ewing was put on leave before Kooth’s \u003ca href=\"https://www.linkedin.com/posts/mindspark360_brain-capital-uk-summit-ugcPost-7249487039157420032-wT6q/?utm_source=share&utm_medium=member_ios\">rescheduled conference\u003c/a> this month in London.\u003c/p>\n\u003cp>Although it’s not unusual for state officials to travel overseas — often on the dime of private entities — it doesn’t look good, said Sean McMorris, a government ethics expert with California Common Cause, a nonprofit government watchdog group.\u003c/p>\n\u003cp>“It looks like undue influence,” McMorris said. “I think a lot of people would view something like this as a way to curry favor. You can connect the dots.”\u003c/p>\n\u003cp>Kooth has similarly gifted travel to state officials in Pennsylvania, where it had a $3 million contract with 30 school districts. In each case, Kooth invited the officials to speak to highlight their work. Pennsylvania has informed Kooth it intends to terminate the contract.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This article was produced by \u003c/em>\u003ca href=\"https://kffhealthnews.org/about-us\">\u003cem>KFF Health News\u003c/em>\u003c/a>\u003cem>, which publishes \u003c/em>\u003ca href=\"http://www.californiahealthline.org/\">\u003cem>California Healthline\u003c/em>\u003c/a>\u003cem>, an editorially independent service of the \u003c/em>\u003ca href=\"http://www.chcf.org/\">\u003cem>California Health Care Foundation\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Biden Administration Proposes New Rule to Make Over-the-Counter Birth Control Free",
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"content": "\u003cp>The Biden administration is proposing a rule that would expand access to contraceptive products, including making over-the-counter birth control and condoms free for the first time for women of reproductive age who have private health insurance.\u003c/p>\n\u003cp>Under the proposal by the U.S. Department of Health and Human Services (HHS), Labor Department and Treasury Department, which the administration announced on Monday, health insurance companies would be required to cover all recommended over-the-counter contraception products, such as condoms, spermicide and emergency contraception, without a prescription and at no cost, according to senior administration officials.\u003c/p>\n\u003cp>It would also require private health insurance providers to notify recipients about the covered over-the-counter products.\u003c/p>\n\u003cp>The proposed rule comes as the Biden administration seeks to expand access to contraceptives and as other reproductive health, including access to abortion, has become a central issue in the \u003ca href=\"https://www.npr.org/2024/09/20/g-s1-23971/harris-abortion-preventable-deaths-georgia\">2024 presidential election campaign\u003c/a>. Republican-led states have restricted access to abortion since the Supreme Court overturned Roe v. Wade in 2022. \u003ca href=\"https://www.npr.org/sections/health-shots/2024/05/22/1252771024/state-abortion-laws-2024-election\">About half of states\u003c/a> now ban or severely restrict abortion, which has coincided with \u003ca href=\"https://www.npr.org/transcripts/nx-s1-5020324\">steep declines\u003c/a> in prescriptions for birth control and emergency contraception in those states.\u003c/p>\n\u003cp>HHS Secretary Xavier Becerra said when health care insurers impose burdensome administrative or cost-sharing requirements for services, “access to contraceptives become even more difficult.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We have heard from women who need a specific brand of birth control but the cost of their prescription isn’t covered by their health insurance. We have made clear that in all 50 states, the Affordable Care Act guarantees coverage of women’s preventive services without cost sharing, including all birth control methods approved by the Food and Drug Administration,” Becerra told reporters. “This proposed rule will build on the progress we have already made under the Affordable Care Act to help ensure that more women can access the contraceptive services they need without out-of-pocket costs.”\u003c/p>\n\u003cp>[aside label=\"more on reproductive health\" tag=\"reproductive-health\"]The products would be able to be accessed the same way prescription medicines are accessed, such as at the pharmacy counter, according to senior administration officials. Getting the products through reimbursement would also be an option, depending on the health insurance plan, officials said.\u003cbr>\nBirth control became available to those with insurance without a copay because of the Affordable Care Act, but that required a prescription.\u003c/p>\n\u003cp>In July 2023, a daily oral birth control pill, Opill, \u003ca href=\"https://www.npr.org/2023/07/13/1187460902/opill-fda-approve-otc-birth-control-pill\" target=\"1187460902\" rel=\"noopener\">became the first over-the-counter birth control pill\u003c/a> to be approved by the Food and Drug Administration. It became \u003ca href=\"https://www.npr.org/sections/health-shots/2024/03/04/1235404522/opill-over-counter-birth-control-pill-contraceptive-shop\" target=\"1235404522\" rel=\"noopener\">available for purchase online\u003c/a> in March and can be purchased for $19.99.\u003c/p>\n\u003cp>The Biden administration in January \u003ca href=\"https://www.whitehouse.gov/briefing-room/statements-releases/2024/01/22/fact-sheet-white-house-task-force-on-reproductive-healthcare-access-announces-new-actions-and-marks-the-51st-anniversary-of-roe-v-wade/\">announced several actions\u003c/a> aimed at strengthening access to abortion and contraceptives, including the Office of Personnel Management issuing guidance to insurers that will expand access to contraception for federal workers, families and retirees.\u003c/p>\n\u003cp>There will be a comment period on the proposed rule, and if approved, it could go into effect in 2025, according to senior administration officials.\u003c/p>\n\u003cp>However, if former President Donald Trump wins the election, he could reverse the rule.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>NPR’s Sydney Lupkin and Bill Chappell contributed to this report.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Biden administration is proposing a rule that would expand access to contraceptive products, including making over-the-counter birth control and condoms free for the first time for women of reproductive age who have private health insurance.\u003c/p>\n\u003cp>Under the proposal by the U.S. Department of Health and Human Services (HHS), Labor Department and Treasury Department, which the administration announced on Monday, health insurance companies would be required to cover all recommended over-the-counter contraception products, such as condoms, spermicide and emergency contraception, without a prescription and at no cost, according to senior administration officials.\u003c/p>\n\u003cp>It would also require private health insurance providers to notify recipients about the covered over-the-counter products.\u003c/p>\n\u003cp>The proposed rule comes as the Biden administration seeks to expand access to contraceptives and as other reproductive health, including access to abortion, has become a central issue in the \u003ca href=\"https://www.npr.org/2024/09/20/g-s1-23971/harris-abortion-preventable-deaths-georgia\">2024 presidential election campaign\u003c/a>. Republican-led states have restricted access to abortion since the Supreme Court overturned Roe v. Wade in 2022. \u003ca href=\"https://www.npr.org/sections/health-shots/2024/05/22/1252771024/state-abortion-laws-2024-election\">About half of states\u003c/a> now ban or severely restrict abortion, which has coincided with \u003ca href=\"https://www.npr.org/transcripts/nx-s1-5020324\">steep declines\u003c/a> in prescriptions for birth control and emergency contraception in those states.\u003c/p>\n\u003cp>HHS Secretary Xavier Becerra said when health care insurers impose burdensome administrative or cost-sharing requirements for services, “access to contraceptives become even more difficult.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The products would be able to be accessed the same way prescription medicines are accessed, such as at the pharmacy counter, according to senior administration officials. Getting the products through reimbursement would also be an option, depending on the health insurance plan, officials said.\u003cbr>\nBirth control became available to those with insurance without a copay because of the Affordable Care Act, but that required a prescription.\u003c/p>\n\u003cp>In July 2023, a daily oral birth control pill, Opill, \u003ca href=\"https://www.npr.org/2023/07/13/1187460902/opill-fda-approve-otc-birth-control-pill\" target=\"1187460902\" rel=\"noopener\">became the first over-the-counter birth control pill\u003c/a> to be approved by the Food and Drug Administration. It became \u003ca href=\"https://www.npr.org/sections/health-shots/2024/03/04/1235404522/opill-over-counter-birth-control-pill-contraceptive-shop\" target=\"1235404522\" rel=\"noopener\">available for purchase online\u003c/a> in March and can be purchased for $19.99.\u003c/p>\n\u003cp>The Biden administration in January \u003ca href=\"https://www.whitehouse.gov/briefing-room/statements-releases/2024/01/22/fact-sheet-white-house-task-force-on-reproductive-healthcare-access-announces-new-actions-and-marks-the-51st-anniversary-of-roe-v-wade/\">announced several actions\u003c/a> aimed at strengthening access to abortion and contraceptives, including the Office of Personnel Management issuing guidance to insurers that will expand access to contraception for federal workers, families and retirees.\u003c/p>\n\u003cp>There will be a comment period on the proposed rule, and if approved, it could go into effect in 2025, according to senior administration officials.\u003c/p>\n\u003cp>However, if former President Donald Trump wins the election, he could reverse the rule.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>NPR’s Sydney Lupkin and Bill Chappell contributed to this report.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "alameda-hospital-among-those-scrambling-to-meet-earthquake-retrofit-deadline",
"title": "Alameda Hospital Among Those Scrambling to Meet Earthquake Retrofit Deadline",
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"content": "\u003cp>More than half of the 410 hospitals in California have at least one building that likely wouldn’t be able to operate after a major earthquake hit their region, and with many institutions claiming they don’t have the money to meet a 2030 legal deadline for earthquake retrofits, the state is now granting relief to some while ramping up pressure on others to get the work done.\u003c/p>\n\u003cp>Gov. Gavin Newsom in September vetoed legislation championed by the California Hospital Association that would have allowed all hospitals to apply for an extension of the deadline for up to five years. Instead, the Democratic governor signed a more narrowly tailored bill that allows small, rural, or “distressed” hospitals to get an extension of up to three years.\u003c/p>\n\u003cp>“It’s an expensive thing and a complicated thing for hospitals — independent hospitals in particular,” said Elizabeth Mahler, an associate chief medical officer for Alameda Health System, which is undertaking a $25 million retrofit of its hospital in Alameda.\u003c/p>\n\u003cp>The debate over how seismically safe California hospitals should be dates to the 1971 Sylmar quake near Los Angeles, which prompted a law requiring new hospitals to be built to withstand an earthquake and continue operating. In 1994, after the magnitude 6.7 Northridge quake killed at least 57 people, lawmakers required existing facilities to be upgraded.\u003c/p>\n\u003cp>The two laws have left California hospitals with two sets of standards to meet. The first — which originally had a deadline of 2008 but was pushed to 2020 — required hospital buildings to stay standing after an earthquake. About 20 facilities have yet to meet that requirement for at least one of their buildings, although some have received extensions from the state.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Many more — 674 buildings spread across 251 licensed hospitals — do not meet the second set of standards, which require hospital facilities to remain functional in the event of a major earthquake. That work is supposed to be done by 2030.\u003c/p>\n\u003cp>“The importance of it is hard to argue with,” said Jonathan Stewart, a professor at UCLA’s Samueli School of Engineering, citing a 2023 earthquake in Turkey that damaged or destroyed multiple hospitals. “There were a number of hospitals that were intact but not usable. That’s better than a collapsed structure. But still not what you need at a time of emergency like that.”\u003c/p>\n\u003cp>The influential hospital industry has unsuccessfully lobbied lawmakers for years to extend the 2030 deadline, though the state has granted various extensions to specific facilities. Newsom’s signature on one of the three bills addressing the issue this year represents a partial victory for the industry.\u003c/p>\n\u003cp>Hospital administrators have long complained about the steep cost of seismic retrofits.\u003c/p>\n\u003cp>“While hospitals are working to meet these requirements, many will simply not make the 2030 deadline and be forced by state law to close,” wrote Carmela Coyle, president and CEO of the California Hospital Association, in a letter to Newsom before he vetoed the CHA bill. A \u003ca href=\"https://www.rand.org/news/press/2019/03/28.html\">2019 Rand Corp. study\u003c/a> paid for by the CHA pinned the price of meeting the 2030 standards at between $34 billion and $143 billion statewide.\u003c/p>\n\u003cp>[aside label='Related Coverage' tag='health']\u003c/p>\n\u003cp>Labor unions representing nurses and other medical workers, however, say the hospitals have had plenty of time to get their buildings into compliance and that most have the money to do so.\u003c/p>\n\u003cp>“They’ve had 30 years to do this,” Cathy Kennedy, a nurse in Roseville and one of the presidents of the California Nurses Association, said in an interview prior to the governor’s action. “We are kicking the can down the road year after year, and unfortunately, lives are going to be lost.”\u003c/p>\n\u003cp>In his veto message on the CHA bill, Newsom wrote that a blanket five-year extension wasn’t justified and that any extension “should be limited in scope, granted only on a case-by-case basis to hospitals with demonstrated need and a clear path to compliance, and in combination with strong accountability and enforcement mechanisms.”\u003c/p>\n\u003cp>He also vetoed a bill directed specifically at helping several hospitals operated by Providence, a Catholic hospital chain.\u003c/p>\n\u003cp>But he signed a third bill, which allows small, rural, and “critical access” hospitals, and some others, to apply for a three-year extension and directs the Department of Health Care Access and Information to offer them “technical assistance” in meeting the deadline.\u003c/p>\n\u003cp>The state designates 37 hospitals as providing “critical access,” while 56 are considered “small,” meaning they have fewer than 50 beds, 59 are considered “rural,” and 32 are “district” hospitals, meaning special government entities fund them called “health care districts.” They can seek a three-year extension as long as they submit a seismic compliance plan and identify milestones for implementing it.\u003c/p>\n\u003cp>Debi Stebbins, executive director of the Alameda Health Care District, which owns the Alameda Hospital buildings, said small hospitals face a big challenge. Even though Alameda is very close to San Francisco and Oakland, the tunnels, bridges, and ferries that connect it to the mainland could easily be shut in an emergency, making the island’s hospital a lifeline.\u003c/p>\n\u003cp>“It’s an unfunded mandate,” Stebbins said of the state’s 2030 deadline.\u003c/p>\n\u003cp>The Rand study estimated the average cost of a retrofit at \u003ca href=\"https://www.rand.org/pubs/research_reports/RR3059.html\">more than $92 million\u003c/a> per building, but the amount could vary greatly depending on whether it’s a building that houses hospital beds.\u003c/p>\n\u003cp>Small and rural hospitals can get some aid from the state via grants financed by the California Electronic Cigarette Excise Tax, but HCAI spokesperson Andrew DiLuccia said it would yield just $2-3 million total annually. He added that the Small and Rural Hospital Relief Program has also received a one-time infusion of $50 million from a tax on health insurers to help with the seismic work.\u003c/p>\n\u003cp>Labor unions and critics of the extensions often point to the large profits that some hospitals reap: A California Health Care Foundation report published in August found that California’s hospitals made $3.2 billion in profit during the first quarter of 2024. The study notes that there “continues to be wide variation in financial performance among hospitals, with the bottom quartile showing a net income margin of -5%, compared to +13% for the top quartile.”\u003c/p>\n\u003cp>Stebbins has had to help her district figure out a plan.\u003c/p>\n\u003cfigure id=\"attachment_11937937\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11937937\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/010323-ALAMEDA-HOSPITAL-MHN-05-CM-2-copy-800x533.jpg\" alt='A beige building with \"Alameda Hospital\" written on it in blue lettering and a carpark in the foreground.' width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/010323-ALAMEDA-HOSPITAL-MHN-05-CM-2-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/010323-ALAMEDA-HOSPITAL-MHN-05-CM-2-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/010323-ALAMEDA-HOSPITAL-MHN-05-CM-2-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/010323-ALAMEDA-HOSPITAL-MHN-05-CM-2-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/010323-ALAMEDA-HOSPITAL-MHN-05-CM-2-copy.jpg 1568w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A view of Alameda Hospital, which serves the city of Alameda, on Jan. 3, 2023. Alameda Hospital sought a 2-year extension for seismic retrofits in 2022, but Gov. Gavin Newsom vetoed it. \u003ccite>(Martin do Nascimento for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>After Newsom vetoed a bill in 2022 that would have granted an extension on the seismic retrofit deadline specifically for Alameda Hospital, the hospital system and its partner health care district used parcel tax money to help back \u003ca href=\"https://www.alamedahealthsystem.org/alameda-hospital-seismic-updates-and-faqs/\">a loan\u003c/a>.\u003c/p>\n\u003cp>The cost to retrofit will be about $25 million, and the system is also investing millions more into other projects, such as a new skilled nursing facility. The construction work is set to be completed in 2027.\u003c/p>\n\u003cp>“No one wants things crashing in an earthquake or anything else, but at the same time, it’s a burden,” Mahler, the Alameda Health System associate chief medical officer, said. “How do we make sure that they get what they need to stay open?”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This article was produced by \u003c/em>\u003ca href=\"https://kffhealthnews.org/about-us\">\u003cem>KFF Health News\u003c/em>\u003c/a>\u003cem>, which publishes \u003c/em>\u003ca href=\"http://www.californiahealthline.org/\">\u003cem>California Healthline\u003c/em>\u003c/a>\u003cem>, an editorially independent service of the \u003c/em>\u003ca href=\"http://www.chcf.org/\">\u003cem>California Health Care Foundation\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Alameda Health System's facility is among the California hospitals that would take major damage during a large earthquake, as state lawmakers pressure hospital systems to meet a 2030 deadline for retrofits.",
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"title": "Alameda Hospital Among Those Scrambling to Meet Earthquake Retrofit Deadline | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>More than half of the 410 hospitals in California have at least one building that likely wouldn’t be able to operate after a major earthquake hit their region, and with many institutions claiming they don’t have the money to meet a 2030 legal deadline for earthquake retrofits, the state is now granting relief to some while ramping up pressure on others to get the work done.\u003c/p>\n\u003cp>Gov. Gavin Newsom in September vetoed legislation championed by the California Hospital Association that would have allowed all hospitals to apply for an extension of the deadline for up to five years. Instead, the Democratic governor signed a more narrowly tailored bill that allows small, rural, or “distressed” hospitals to get an extension of up to three years.\u003c/p>\n\u003cp>“It’s an expensive thing and a complicated thing for hospitals — independent hospitals in particular,” said Elizabeth Mahler, an associate chief medical officer for Alameda Health System, which is undertaking a $25 million retrofit of its hospital in Alameda.\u003c/p>\n\u003cp>The debate over how seismically safe California hospitals should be dates to the 1971 Sylmar quake near Los Angeles, which prompted a law requiring new hospitals to be built to withstand an earthquake and continue operating. In 1994, after the magnitude 6.7 Northridge quake killed at least 57 people, lawmakers required existing facilities to be upgraded.\u003c/p>\n\u003cp>The two laws have left California hospitals with two sets of standards to meet. The first — which originally had a deadline of 2008 but was pushed to 2020 — required hospital buildings to stay standing after an earthquake. About 20 facilities have yet to meet that requirement for at least one of their buildings, although some have received extensions from the state.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Many more — 674 buildings spread across 251 licensed hospitals — do not meet the second set of standards, which require hospital facilities to remain functional in the event of a major earthquake. That work is supposed to be done by 2030.\u003c/p>\n\u003cp>“The importance of it is hard to argue with,” said Jonathan Stewart, a professor at UCLA’s Samueli School of Engineering, citing a 2023 earthquake in Turkey that damaged or destroyed multiple hospitals. “There were a number of hospitals that were intact but not usable. That’s better than a collapsed structure. But still not what you need at a time of emergency like that.”\u003c/p>\n\u003cp>The influential hospital industry has unsuccessfully lobbied lawmakers for years to extend the 2030 deadline, though the state has granted various extensions to specific facilities. Newsom’s signature on one of the three bills addressing the issue this year represents a partial victory for the industry.\u003c/p>\n\u003cp>Hospital administrators have long complained about the steep cost of seismic retrofits.\u003c/p>\n\u003cp>“While hospitals are working to meet these requirements, many will simply not make the 2030 deadline and be forced by state law to close,” wrote Carmela Coyle, president and CEO of the California Hospital Association, in a letter to Newsom before he vetoed the CHA bill. A \u003ca href=\"https://www.rand.org/news/press/2019/03/28.html\">2019 Rand Corp. study\u003c/a> paid for by the CHA pinned the price of meeting the 2030 standards at between $34 billion and $143 billion statewide.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Labor unions representing nurses and other medical workers, however, say the hospitals have had plenty of time to get their buildings into compliance and that most have the money to do so.\u003c/p>\n\u003cp>“They’ve had 30 years to do this,” Cathy Kennedy, a nurse in Roseville and one of the presidents of the California Nurses Association, said in an interview prior to the governor’s action. “We are kicking the can down the road year after year, and unfortunately, lives are going to be lost.”\u003c/p>\n\u003cp>In his veto message on the CHA bill, Newsom wrote that a blanket five-year extension wasn’t justified and that any extension “should be limited in scope, granted only on a case-by-case basis to hospitals with demonstrated need and a clear path to compliance, and in combination with strong accountability and enforcement mechanisms.”\u003c/p>\n\u003cp>He also vetoed a bill directed specifically at helping several hospitals operated by Providence, a Catholic hospital chain.\u003c/p>\n\u003cp>But he signed a third bill, which allows small, rural, and “critical access” hospitals, and some others, to apply for a three-year extension and directs the Department of Health Care Access and Information to offer them “technical assistance” in meeting the deadline.\u003c/p>\n\u003cp>The state designates 37 hospitals as providing “critical access,” while 56 are considered “small,” meaning they have fewer than 50 beds, 59 are considered “rural,” and 32 are “district” hospitals, meaning special government entities fund them called “health care districts.” They can seek a three-year extension as long as they submit a seismic compliance plan and identify milestones for implementing it.\u003c/p>\n\u003cp>Debi Stebbins, executive director of the Alameda Health Care District, which owns the Alameda Hospital buildings, said small hospitals face a big challenge. Even though Alameda is very close to San Francisco and Oakland, the tunnels, bridges, and ferries that connect it to the mainland could easily be shut in an emergency, making the island’s hospital a lifeline.\u003c/p>\n\u003cp>“It’s an unfunded mandate,” Stebbins said of the state’s 2030 deadline.\u003c/p>\n\u003cp>The Rand study estimated the average cost of a retrofit at \u003ca href=\"https://www.rand.org/pubs/research_reports/RR3059.html\">more than $92 million\u003c/a> per building, but the amount could vary greatly depending on whether it’s a building that houses hospital beds.\u003c/p>\n\u003cp>Small and rural hospitals can get some aid from the state via grants financed by the California Electronic Cigarette Excise Tax, but HCAI spokesperson Andrew DiLuccia said it would yield just $2-3 million total annually. He added that the Small and Rural Hospital Relief Program has also received a one-time infusion of $50 million from a tax on health insurers to help with the seismic work.\u003c/p>\n\u003cp>Labor unions and critics of the extensions often point to the large profits that some hospitals reap: A California Health Care Foundation report published in August found that California’s hospitals made $3.2 billion in profit during the first quarter of 2024. The study notes that there “continues to be wide variation in financial performance among hospitals, with the bottom quartile showing a net income margin of -5%, compared to +13% for the top quartile.”\u003c/p>\n\u003cp>Stebbins has had to help her district figure out a plan.\u003c/p>\n\u003cfigure id=\"attachment_11937937\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11937937\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/010323-ALAMEDA-HOSPITAL-MHN-05-CM-2-copy-800x533.jpg\" alt='A beige building with \"Alameda Hospital\" written on it in blue lettering and a carpark in the foreground.' width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/010323-ALAMEDA-HOSPITAL-MHN-05-CM-2-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/010323-ALAMEDA-HOSPITAL-MHN-05-CM-2-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/010323-ALAMEDA-HOSPITAL-MHN-05-CM-2-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/010323-ALAMEDA-HOSPITAL-MHN-05-CM-2-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/010323-ALAMEDA-HOSPITAL-MHN-05-CM-2-copy.jpg 1568w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A view of Alameda Hospital, which serves the city of Alameda, on Jan. 3, 2023. Alameda Hospital sought a 2-year extension for seismic retrofits in 2022, but Gov. Gavin Newsom vetoed it. \u003ccite>(Martin do Nascimento for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>After Newsom vetoed a bill in 2022 that would have granted an extension on the seismic retrofit deadline specifically for Alameda Hospital, the hospital system and its partner health care district used parcel tax money to help back \u003ca href=\"https://www.alamedahealthsystem.org/alameda-hospital-seismic-updates-and-faqs/\">a loan\u003c/a>.\u003c/p>\n\u003cp>The cost to retrofit will be about $25 million, and the system is also investing millions more into other projects, such as a new skilled nursing facility. The construction work is set to be completed in 2027.\u003c/p>\n\u003cp>“No one wants things crashing in an earthquake or anything else, but at the same time, it’s a burden,” Mahler, the Alameda Health System associate chief medical officer, said. “How do we make sure that they get what they need to stay open?”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This article was produced by \u003c/em>\u003ca href=\"https://kffhealthnews.org/about-us\">\u003cem>KFF Health News\u003c/em>\u003c/a>\u003cem>, which publishes \u003c/em>\u003ca href=\"http://www.californiahealthline.org/\">\u003cem>California Healthline\u003c/em>\u003c/a>\u003cem>, an editorially independent service of the \u003c/em>\u003ca href=\"http://www.chcf.org/\">\u003cem>California Health Care Foundation\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "californias-native-americans-can-soon-get-traditional-healing-covered-by-medi-cal",
"title": "California’s Native Americans Can Soon Get Traditional Healing Covered by Medi-Cal",
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"headTitle": "California’s Native Americans Can Soon Get Traditional Healing Covered by Medi-Cal | KQED",
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"content": "\u003cp>Emery Tahy of San Francisco knows firsthand the struggles of \u003ca href=\"https://www.kqed.org/news/tag/addiction-treatment\">addiction and recovery\u003c/a> — a journey that, for him, is intertwined with his experience as a Native American.\u003c/p>\n\u003cp>In his twenties, Tahy landed on the streets of Phoenix, battling severe depression and alcohol-induced seizures. About four years ago, Tahy said, he was on the brink of suicide when his siblings intervened and petitioned for court-ordered treatment.\u003c/p>\n\u003cp>While Tahy was detoxing in a psychiatric ward, he learned about the \u003ca href=\"https://www.friendshiphousesf.org/\">Friendship House\u003c/a>, a Native-led recovery treatment program in San Francisco. As soon as he was released from the Arizona hospital, he headed to California.\u003c/p>\n\u003cp>“I knew immediately that I was in the right place,” said Tahy, 43. “A traditional practitioner did prayers for me. They shared some songs with me. They put me in the sweat lodge, and I could identify with those ceremonies. And from that day moving forward, I was able to reconnect to my spiritual and cultural upbringing.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Now, for the first time, \u003ca href=\"https://www.kqed.org/news/tag/medi-cal\">Medi-Cal\u003c/a> is set to cover traditional health practices such as music therapy, sweat lodges and dancing to help the state’s Native American communities battle addiction to drugs and alcohol.\u003c/p>\n\u003cp>The Medi-Cal expansion will cover two new \u003ca href=\"https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/ca-calaim-dmnstrn-appvl-10162024.pdf\" target=\"_blank\" rel=\"noopener\">categories of intervention\u003c/a>. People suffering from a substance use disorder can seek therapy from traditional healers who offer ceremonial rituals, or they can work with trusted figures within tribal communities, such as elected officials or spiritual leaders who offer psychological support, trauma counseling and recovery guidance.\u003c/p>\n\u003cp>California is home to the largest \u003ca href=\"https://www.kqed.org/news/tag/native-americans\">Native American\u003c/a> population in the U.S., and Gov. Gavin Newsom said in a press release announcing the expansion this week that the state is “committed to healing the \u003ca href=\"https://www.kqed.org/news/12009426/the-brutal-story-behind-californias-new-native-american-genocide-education-law\">historical wounds inflicted on tribes\u003c/a>, including the health disparities Native communities face.”\u003c/p>\n\u003cfigure id=\"attachment_12009971\" class=\"wp-caption alignright\" style=\"max-width: 1333px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12009971\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241017-EMERY-TAHY-PHOTO-KQED.jpg\" alt=\"\" width=\"1333\" height=\"2000\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241017-EMERY-TAHY-PHOTO-KQED.jpg 1333w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241017-EMERY-TAHY-PHOTO-KQED-800x1200.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241017-EMERY-TAHY-PHOTO-KQED-1020x1530.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241017-EMERY-TAHY-PHOTO-KQED-160x240.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241017-EMERY-TAHY-PHOTO-KQED-1024x1536.jpg 1024w\" sizes=\"auto, (max-width: 1333px) 100vw, 1333px\">\u003cfigcaption class=\"wp-caption-text\">Emery Tahy found healing in the Friendship House, a Native-led recovery treatment program in San Francisco. \u003ccite>(Courtesy of Maira Garcia and AJ Aguilar/Native American Health Center)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Tahy’s battle with alcoholism began when he was a small child. He said he took his first sip of beer when he was 4, surrounded by parents, uncles, aunts and grandparents who all drank heavily on the Navajo Nation.\u003c/p>\n\u003cp>“I’m a full-blooded American Indian,” Tahy said, recounting the difficulties he faced in his youth. “Growing up, I was subjected to a lot of prejudice, racism and segregation. I didn’t have any pride in who I was. I feel like drugs and alcohol were a way to cope with that shame. Alcohol helped me socialize and gave me courage.”\u003c/p>\n\u003cp>During his teenage years, Tahy drank and began dabbling in marijuana, cocaine and crystal meth. All the while, he said, his family instilled a meaningful relationship to his culture.\u003c/p>\n\u003cp>“I was always encouraged by my grandparents, on my mom’s side, to learn and be connected to traditional Navajo ways of life,” Tahy said. “There was a deep connection to family, land and ceremonial activities connected to seasonal changes.”\u003c/p>\n\u003cp>Tahy’s story is not unique. Native American communities suffer from some of the \u003ca href=\"https://americanaddictioncenters.org/addiction-statistics/native-americans\">highest rates\u003c/a> of substance abuse and overdose deaths in the country, and health experts have long argued that Western medicine alone cannot adequately treat substance use disorders in Native American populations.\u003c/p>\n\u003cp>The crisis is compounded by centuries of historical trauma, which is why the U.S. Centers for Medicare & Medicaid Services is also \u003ca href=\"https://www.cms.gov/newsroom/press-releases/biden-harris-administration-takes-groundbreaking-action-expand-health-care-access-covering\">offering coverage\u003c/a> for tribal communities in Arizona, New Mexico and Oregon.\u003c/p>\n\u003cp>Roselyn Tso, who directs the federal Indian Health Service, has championed this work and said that “these practices have sustained our people’s health for generations and continue to serve as a vital link between culture, science and wellness in many of our communities.”\u003c/p>\n\u003ch2>Bridging two worlds: Tradition and modern medicine\u003c/h2>\n\u003cp>While clinical approaches like detox, medication-assisted treatment and behavioral therapy are essential to treating substance use disorders, they often fail to address the cultural and spiritual needs of Native patients.\u003c/p>\n\u003cp>“Traditional practices are, by nature, holistic,” said Damian Chase-Begay, a researcher focused on American Indian health at the University of Montana. “They are treating the person physically, mentally, spiritually and emotionally. They benefit the whole being, not just the physical symptoms.”\u003c/p>\n\u003cp>For years, healthcare practitioners dedicated to Indigenous communities struggled with the limitations of what insurance would cover. Medi-Cal, the state’s Medicaid program for low-income residents, reimburses for medical prescriptions or talk therapy, but traditional healing methods were often excluded from coverage, leaving many Native American patients without access to treatments that aligned with their cultural values.\u003c/p>\n\u003cp>“What California is now covering under Medi-Cal is exactly what our Native communities have been asking to be covered for years,” Chase-Begay said. “This kind of support, had it been in place, could have helped stop some intergenerational trauma and substance use years ago. I’m so thrilled that it’s in place now, but it’s long overdue.”\u003c/p>\n\u003cp>[aside postID=news_12009555 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241014-GREAT-REDWOOD-TRAIL-AW-01-1020x764.jpg']\u003c/p>\n\u003cp>\u003ca href=\"https://ncuih.org/wp-content/uploads/03.25.24-FINAL-design-of-2023-TH-Report.pdf\">Studies\u003c/a> have shown that integrating cultural practices into addiction treatment can lead to higher engagement and more positive recovery outcomes, though most of the current research is qualitative, not quantitative.\u003c/p>\n\u003cp>The new Medi-Cal policy is set to take effect next year, with Indian Health Service providers in qualifying counties able to request reimbursement for these services starting in January.\u003c/p>\n\u003cp>“It is vital that we honor our traditional ways of healing,” said Kiana Maillet, a licensed therapist in San Diego and a member of the Lone Pine Paiute-Shoshone Tribe. “Traditional healing is deeply ingrained in our cultures. Without it, we are missing a piece of who we are.”\u003c/p>\n\u003cp>As for Tahy, he hasn’t touched a drop of alcohol since starting therapy at Friendship House.\u003c/p>\n\u003cp>He now holds a full-time job as an evaluator for the Native American Health Center in San Francisco. Soon, he will complete a master’s degree in American Indian studies. And, a few months ago, he completed the San Francisco marathon.\u003c/p>\n\u003cp>\u003c/p>\n",
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"title": "California’s Native Americans Can Soon Get Traditional Healing Covered by Medi-Cal | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Emery Tahy of San Francisco knows firsthand the struggles of \u003ca href=\"https://www.kqed.org/news/tag/addiction-treatment\">addiction and recovery\u003c/a> — a journey that, for him, is intertwined with his experience as a Native American.\u003c/p>\n\u003cp>In his twenties, Tahy landed on the streets of Phoenix, battling severe depression and alcohol-induced seizures. About four years ago, Tahy said, he was on the brink of suicide when his siblings intervened and petitioned for court-ordered treatment.\u003c/p>\n\u003cp>While Tahy was detoxing in a psychiatric ward, he learned about the \u003ca href=\"https://www.friendshiphousesf.org/\">Friendship House\u003c/a>, a Native-led recovery treatment program in San Francisco. As soon as he was released from the Arizona hospital, he headed to California.\u003c/p>\n\u003cp>“I knew immediately that I was in the right place,” said Tahy, 43. “A traditional practitioner did prayers for me. They shared some songs with me. They put me in the sweat lodge, and I could identify with those ceremonies. And from that day moving forward, I was able to reconnect to my spiritual and cultural upbringing.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Now, for the first time, \u003ca href=\"https://www.kqed.org/news/tag/medi-cal\">Medi-Cal\u003c/a> is set to cover traditional health practices such as music therapy, sweat lodges and dancing to help the state’s Native American communities battle addiction to drugs and alcohol.\u003c/p>\n\u003cp>The Medi-Cal expansion will cover two new \u003ca href=\"https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/ca-calaim-dmnstrn-appvl-10162024.pdf\" target=\"_blank\" rel=\"noopener\">categories of intervention\u003c/a>. People suffering from a substance use disorder can seek therapy from traditional healers who offer ceremonial rituals, or they can work with trusted figures within tribal communities, such as elected officials or spiritual leaders who offer psychological support, trauma counseling and recovery guidance.\u003c/p>\n\u003cp>California is home to the largest \u003ca href=\"https://www.kqed.org/news/tag/native-americans\">Native American\u003c/a> population in the U.S., and Gov. Gavin Newsom said in a press release announcing the expansion this week that the state is “committed to healing the \u003ca href=\"https://www.kqed.org/news/12009426/the-brutal-story-behind-californias-new-native-american-genocide-education-law\">historical wounds inflicted on tribes\u003c/a>, including the health disparities Native communities face.”\u003c/p>\n\u003cfigure id=\"attachment_12009971\" class=\"wp-caption alignright\" style=\"max-width: 1333px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12009971\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241017-EMERY-TAHY-PHOTO-KQED.jpg\" alt=\"\" width=\"1333\" height=\"2000\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241017-EMERY-TAHY-PHOTO-KQED.jpg 1333w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241017-EMERY-TAHY-PHOTO-KQED-800x1200.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241017-EMERY-TAHY-PHOTO-KQED-1020x1530.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241017-EMERY-TAHY-PHOTO-KQED-160x240.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241017-EMERY-TAHY-PHOTO-KQED-1024x1536.jpg 1024w\" sizes=\"auto, (max-width: 1333px) 100vw, 1333px\">\u003cfigcaption class=\"wp-caption-text\">Emery Tahy found healing in the Friendship House, a Native-led recovery treatment program in San Francisco. \u003ccite>(Courtesy of Maira Garcia and AJ Aguilar/Native American Health Center)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Tahy’s battle with alcoholism began when he was a small child. He said he took his first sip of beer when he was 4, surrounded by parents, uncles, aunts and grandparents who all drank heavily on the Navajo Nation.\u003c/p>\n\u003cp>“I’m a full-blooded American Indian,” Tahy said, recounting the difficulties he faced in his youth. “Growing up, I was subjected to a lot of prejudice, racism and segregation. I didn’t have any pride in who I was. I feel like drugs and alcohol were a way to cope with that shame. Alcohol helped me socialize and gave me courage.”\u003c/p>\n\u003cp>During his teenage years, Tahy drank and began dabbling in marijuana, cocaine and crystal meth. All the while, he said, his family instilled a meaningful relationship to his culture.\u003c/p>\n\u003cp>“I was always encouraged by my grandparents, on my mom’s side, to learn and be connected to traditional Navajo ways of life,” Tahy said. “There was a deep connection to family, land and ceremonial activities connected to seasonal changes.”\u003c/p>\n\u003cp>Tahy’s story is not unique. Native American communities suffer from some of the \u003ca href=\"https://americanaddictioncenters.org/addiction-statistics/native-americans\">highest rates\u003c/a> of substance abuse and overdose deaths in the country, and health experts have long argued that Western medicine alone cannot adequately treat substance use disorders in Native American populations.\u003c/p>\n\u003cp>The crisis is compounded by centuries of historical trauma, which is why the U.S. Centers for Medicare & Medicaid Services is also \u003ca href=\"https://www.cms.gov/newsroom/press-releases/biden-harris-administration-takes-groundbreaking-action-expand-health-care-access-covering\">offering coverage\u003c/a> for tribal communities in Arizona, New Mexico and Oregon.\u003c/p>\n\u003cp>Roselyn Tso, who directs the federal Indian Health Service, has championed this work and said that “these practices have sustained our people’s health for generations and continue to serve as a vital link between culture, science and wellness in many of our communities.”\u003c/p>\n\u003ch2>Bridging two worlds: Tradition and modern medicine\u003c/h2>\n\u003cp>While clinical approaches like detox, medication-assisted treatment and behavioral therapy are essential to treating substance use disorders, they often fail to address the cultural and spiritual needs of Native patients.\u003c/p>\n\u003cp>“Traditional practices are, by nature, holistic,” said Damian Chase-Begay, a researcher focused on American Indian health at the University of Montana. “They are treating the person physically, mentally, spiritually and emotionally. They benefit the whole being, not just the physical symptoms.”\u003c/p>\n\u003cp>For years, healthcare practitioners dedicated to Indigenous communities struggled with the limitations of what insurance would cover. Medi-Cal, the state’s Medicaid program for low-income residents, reimburses for medical prescriptions or talk therapy, but traditional healing methods were often excluded from coverage, leaving many Native American patients without access to treatments that aligned with their cultural values.\u003c/p>\n\u003cp>“What California is now covering under Medi-Cal is exactly what our Native communities have been asking to be covered for years,” Chase-Begay said. “This kind of support, had it been in place, could have helped stop some intergenerational trauma and substance use years ago. I’m so thrilled that it’s in place now, but it’s long overdue.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://ncuih.org/wp-content/uploads/03.25.24-FINAL-design-of-2023-TH-Report.pdf\">Studies\u003c/a> have shown that integrating cultural practices into addiction treatment can lead to higher engagement and more positive recovery outcomes, though most of the current research is qualitative, not quantitative.\u003c/p>\n\u003cp>The new Medi-Cal policy is set to take effect next year, with Indian Health Service providers in qualifying counties able to request reimbursement for these services starting in January.\u003c/p>\n\u003cp>“It is vital that we honor our traditional ways of healing,” said Kiana Maillet, a licensed therapist in San Diego and a member of the Lone Pine Paiute-Shoshone Tribe. “Traditional healing is deeply ingrained in our cultures. Without it, we are missing a piece of who we are.”\u003c/p>\n\u003cp>As for Tahy, he hasn’t touched a drop of alcohol since starting therapy at Friendship House.\u003c/p>\n\u003cp>He now holds a full-time job as an evaluator for the Native American Health Center in San Francisco. Soon, he will complete a master’s degree in American Indian studies. And, a few months ago, he completed the San Francisco marathon.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"title": "Why Getting Your 2024 COVID and Flu Shots Before Halloween Is a Good Idea",
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"content": "\u003cp>If you haven’t yet sought out your updated COVID-19 vaccine — or your flu shot — now might be a good time.\u003c/p>\n\u003cp>That’s because, after a lengthy COVID-19 surge this summer that lasted twice as long as 2023’s summer swell, the Bay Area is now about to enter the winter respiratory virus season.\u003c/p>\n\u003cp>In August, \u003ca href=\"https://www.kqed.org/news/12001396/where-can-i-get-new-covid-vaccine-near-me-2024\">the updated 2024 COVID-19 vaccine was made available to everyone age 6 months and over\u003c/a>, with shots from manufacturers Pfizer, Moderna and most recently, Novavax. These COVID-19 vaccines are now provided as annual fall vaccines, alongside the yearly flu shot, updated to target the latest strains and timed in order to offer maximum protection against the predicted winter surge of these viruses.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>All of which means if you haven’t gotten either your COVID-19 or flu shot yet at this stage in the fall, seeking them out in the next few weeks is a good idea. Keep reading for what you need to know about fall vaccines, including the best time to get them, what to do if you got COVID-19 this summer and more.\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Jump straight to: \u003ca href=\"#covidbayarea\">If I got COVID this summer, when should I get my vaccine?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003ch2>When is the best time to get my COVID and flu shot?\u003c/h2>\n\u003cp>The recommendations medical professionals make about when to get a COVID-19 or flu shot are based on:\u003c/p>\n\u003cul>\n\u003cli>The fact that it takes about two weeks after you get vaccinated for antibodies to develop and provide protection against the virus\u003c/li>\n\u003cli>When levels of the virus are predicted to rise that year\u003c/li>\n\u003c/ul>\n\u003cp>\u003cstrong>Getting your COVID shot\u003c/strong>\u003c/p>\n\u003cp>Last year, the Bay Area’s fall and winter COVID-19 surge began in late October, according to Stanford University’s WastewaterSCAN team, which monitors levels of the virus in local sewage. And when it comes to the timing of your COVID-19 shot, you want to aim for what UCSF infectious disease expert Dr. Peter Chin-Hong called “the Goldilocks moment.”\u003c/p>\n\u003cp>“You don’t want to get it too soon because your antibodies might wane just when you need it the most,” Chin-Hong said. “And you don’t want to get it too late because you want to prevent infection. So generally, by Halloween or mid to late October is when most people say the right time is.”\u003c/p>\n\u003cp>[aside postID=news_12001396]\u003c/p>\n\u003cp>The reason for this, explained Chin-Hong, is to ensure you get your full immunity ahead of the busy holiday season, from trick-or-treating at Halloween to holiday travel, Thanksgiving and beyond.\u003c/p>\n\u003cp>With your vaccine, “you not only get protection against serious disease, hospitalization and death, but you get a little bit of a buffer against infection itself,” Chin-Hong said. “So that if you want to have peace of mind while doing all of these things, it’s probably a good idea to peak your antibodies just when people are getting together again.”\u003c/p>\n\u003cp>\u003cstrong>Getting your flu shot\u003c/strong>\u003c/p>\n\u003cp>The Centers for Disease Control and Prevention estimates that last year’s flu season caused between 17,000 and 100,000 deaths and up to 900,000 hospitalizations. Typically, flu season starts in November and peaks around January or February, Chin-Hong said.\u003c/p>\n\u003cp>The CDC recommends that \u003ca href=\"https://www.cdc.gov/flu/prevention/index.html\">everyone 6 months and older get an annual flu vaccine “ideally by the end of October.”\u003c/a> Chin-Hong told KQED that his “optimal sweet point” for getting this shot is “sometime before Halloween” — but that if you see flu cases start to rise earlier, you should hustle to seek out your flu shot even sooner.\u003c/p>\n\u003ch2>Can I get my COVID and my flu shot at the same time?\u003c/h2>\n\u003cp>Yes — it’s totally fine and safe to get your flu shot at the same time as your new COVID-19 vaccine, and you’ll find many pharmacies offer appointments where you can get multiple vaccines at the same time.\u003c/p>\n\u003cp>A caveat: if you’re trying to schedule vaccinations for a child, the CDC advised in 2023 that you first talk to your pediatrician about the best schedule for the COVID-19 and flu vaccines (and now the RSV — respiratory syncytial virus — preventive treatment, too).\u003c/p>\n\u003ch2>\u003ca id=\"covidbayarea\">\u003c/a>I got COVID over the summer. Do I still need a COVID shot?\u003c/h2>\n\u003cp>Yes, Chin-Hong said — although make sure you’re not getting a shot too soon after having COVID-19.\u003c/p>\n\u003cp>That’s because “after getting infected with COVID, in general, you have a force field for around three months,” Chin-Hong said, meaning your infection will give you a good level of immunity against getting COVID-19 again during that period.\u003c/p>\n\u003cp>That said, this immunity will wane, Chin-Hong said, so having “a little bit of a buffer” is something to consider. This means getting your COVID-19 shot even after two months “won’t be a bad idea if it coincides with the time when we expect COVID to come back.”\u003c/p>\n\u003ch2>Where can I get my COVID and flu shot?\u003c/h2>\n\u003cp>For full information on \u003ca href=\"https://www.kqed.org/news/12001396/where-can-i-get-new-covid-vaccine-near-me-2024\">how to find an updated 2024 COVID-19 shot, read our guide\u003c/a>. If you have health insurance, the cost of your COVID-19 vaccine should be fully covered.\u003c/p>\n\u003cp>[aside postID=news_12006600]\u003c/p>\n\u003cp>To learn more about where to find a flu shot with or without insurance, \u003ca href=\"https://www.kqed.org/news/11961649/when-should-i-get-2023-flu-shot-safe-with-new-covid-vaccine-rsv#flushotnearme\">read our 2023 guide to locations offering flu vaccination around the Bay Area\u003c/a>.\u003c/p>\n\u003cp>Remember that many locations — including pharmacies — will offer appointments where you can get both vaccines at the same time.\u003c/p>\n\u003ch2>What about RSV? Should I get a vaccine for that?\u003c/h2>\n\u003cp>The CDC said that while RSV “does not usually cause severe illness in healthy adults and children,” older adults and infants younger than six months of age are especially at risk of becoming “very sick and may need to be hospitalized.”\u003c/p>\n\u003cp>The \u003ca href=\"https://www.cdc.gov/vaccines/vpd/rsv/index.html\">vaccine against RSV is accordingly recommended by the CDC for infants, young children and adults ages 60 and older\u003c/a>, as well as for pregnant people.\u003c/p>\n\u003cp>The virus spreads in the fall and winter like other respiratory viruses and “usually peaks in December and January,” according to the agency, which recommends that \u003ca href=\"https://www.cdc.gov/rsv/hcp/vaccine-clinical-guidance/older-adults.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fvaccines%2Fvpd%2Frsv%2Fhcp%2Folder-adults-faqs.html\">vaccination against RSV “will have the most benefit if administered in late summer or early fall\u003c/a> [August through October], just before the RSV season.”\u003c/p>\n\u003cp>Speak to your health care provider about getting the RSV vaccine, when might be the best time for you and whether to get it alongside other vaccines. And as ever, if you’re trying to schedule your kid’s vaccinations, \u003ca href=\"https://www.npr.org/sections/health-shots/2023/09/13/1198803134/covid-boosters-updated-vaccines-fda-cdc\">the CDC advises that you first talk to your pediatrician\u003c/a> about the best schedule for the COVID-19, flu and RSV vaccines.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>All of which means if you haven’t gotten either your COVID-19 or flu shot yet at this stage in the fall, seeking them out in the next few weeks is a good idea. Keep reading for what you need to know about fall vaccines, including the best time to get them, what to do if you got COVID-19 this summer and more.\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Jump straight to: \u003ca href=\"#covidbayarea\">If I got COVID this summer, when should I get my vaccine?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003ch2>When is the best time to get my COVID and flu shot?\u003c/h2>\n\u003cp>The recommendations medical professionals make about when to get a COVID-19 or flu shot are based on:\u003c/p>\n\u003cul>\n\u003cli>The fact that it takes about two weeks after you get vaccinated for antibodies to develop and provide protection against the virus\u003c/li>\n\u003cli>When levels of the virus are predicted to rise that year\u003c/li>\n\u003c/ul>\n\u003cp>\u003cstrong>Getting your COVID shot\u003c/strong>\u003c/p>\n\u003cp>Last year, the Bay Area’s fall and winter COVID-19 surge began in late October, according to Stanford University’s WastewaterSCAN team, which monitors levels of the virus in local sewage. And when it comes to the timing of your COVID-19 shot, you want to aim for what UCSF infectious disease expert Dr. Peter Chin-Hong called “the Goldilocks moment.”\u003c/p>\n\u003cp>“You don’t want to get it too soon because your antibodies might wane just when you need it the most,” Chin-Hong said. “And you don’t want to get it too late because you want to prevent infection. So generally, by Halloween or mid to late October is when most people say the right time is.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The reason for this, explained Chin-Hong, is to ensure you get your full immunity ahead of the busy holiday season, from trick-or-treating at Halloween to holiday travel, Thanksgiving and beyond.\u003c/p>\n\u003cp>With your vaccine, “you not only get protection against serious disease, hospitalization and death, but you get a little bit of a buffer against infection itself,” Chin-Hong said. “So that if you want to have peace of mind while doing all of these things, it’s probably a good idea to peak your antibodies just when people are getting together again.”\u003c/p>\n\u003cp>\u003cstrong>Getting your flu shot\u003c/strong>\u003c/p>\n\u003cp>The Centers for Disease Control and Prevention estimates that last year’s flu season caused between 17,000 and 100,000 deaths and up to 900,000 hospitalizations. Typically, flu season starts in November and peaks around January or February, Chin-Hong said.\u003c/p>\n\u003cp>The CDC recommends that \u003ca href=\"https://www.cdc.gov/flu/prevention/index.html\">everyone 6 months and older get an annual flu vaccine “ideally by the end of October.”\u003c/a> Chin-Hong told KQED that his “optimal sweet point” for getting this shot is “sometime before Halloween” — but that if you see flu cases start to rise earlier, you should hustle to seek out your flu shot even sooner.\u003c/p>\n\u003ch2>Can I get my COVID and my flu shot at the same time?\u003c/h2>\n\u003cp>Yes — it’s totally fine and safe to get your flu shot at the same time as your new COVID-19 vaccine, and you’ll find many pharmacies offer appointments where you can get multiple vaccines at the same time.\u003c/p>\n\u003cp>A caveat: if you’re trying to schedule vaccinations for a child, the CDC advised in 2023 that you first talk to your pediatrician about the best schedule for the COVID-19 and flu vaccines (and now the RSV — respiratory syncytial virus — preventive treatment, too).\u003c/p>\n\u003ch2>\u003ca id=\"covidbayarea\">\u003c/a>I got COVID over the summer. Do I still need a COVID shot?\u003c/h2>\n\u003cp>Yes, Chin-Hong said — although make sure you’re not getting a shot too soon after having COVID-19.\u003c/p>\n\u003cp>That’s because “after getting infected with COVID, in general, you have a force field for around three months,” Chin-Hong said, meaning your infection will give you a good level of immunity against getting COVID-19 again during that period.\u003c/p>\n\u003cp>That said, this immunity will wane, Chin-Hong said, so having “a little bit of a buffer” is something to consider. This means getting your COVID-19 shot even after two months “won’t be a bad idea if it coincides with the time when we expect COVID to come back.”\u003c/p>\n\u003ch2>Where can I get my COVID and flu shot?\u003c/h2>\n\u003cp>For full information on \u003ca href=\"https://www.kqed.org/news/12001396/where-can-i-get-new-covid-vaccine-near-me-2024\">how to find an updated 2024 COVID-19 shot, read our guide\u003c/a>. If you have health insurance, the cost of your COVID-19 vaccine should be fully covered.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>To learn more about where to find a flu shot with or without insurance, \u003ca href=\"https://www.kqed.org/news/11961649/when-should-i-get-2023-flu-shot-safe-with-new-covid-vaccine-rsv#flushotnearme\">read our 2023 guide to locations offering flu vaccination around the Bay Area\u003c/a>.\u003c/p>\n\u003cp>Remember that many locations — including pharmacies — will offer appointments where you can get both vaccines at the same time.\u003c/p>\n\u003ch2>What about RSV? Should I get a vaccine for that?\u003c/h2>\n\u003cp>The CDC said that while RSV “does not usually cause severe illness in healthy adults and children,” older adults and infants younger than six months of age are especially at risk of becoming “very sick and may need to be hospitalized.”\u003c/p>\n\u003cp>The \u003ca href=\"https://www.cdc.gov/vaccines/vpd/rsv/index.html\">vaccine against RSV is accordingly recommended by the CDC for infants, young children and adults ages 60 and older\u003c/a>, as well as for pregnant people.\u003c/p>\n\u003cp>The virus spreads in the fall and winter like other respiratory viruses and “usually peaks in December and January,” according to the agency, which recommends that \u003ca href=\"https://www.cdc.gov/rsv/hcp/vaccine-clinical-guidance/older-adults.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fvaccines%2Fvpd%2Frsv%2Fhcp%2Folder-adults-faqs.html\">vaccination against RSV “will have the most benefit if administered in late summer or early fall\u003c/a> [August through October], just before the RSV season.”\u003c/p>\n\u003cp>Speak to your health care provider about getting the RSV vaccine, when might be the best time for you and whether to get it alongside other vaccines. And as ever, if you’re trying to schedule your kid’s vaccinations, \u003ca href=\"https://www.npr.org/sections/health-shots/2023/09/13/1198803134/covid-boosters-updated-vaccines-fda-cdc\">the CDC advises that you first talk to your pediatrician\u003c/a> about the best schedule for the COVID-19, flu and RSV vaccines.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Cristina Cortez keeps two fuzzy blankets and pillows in her car to nap during lunch breaks in the parking lot of the hospital where she works. On a recent afternoon, she opened her trunk to reveal instant ramen packages, a gym bag with clean clothes and soft plush toys her kids gave her so she wouldn’t feel alone.\u003c/p>\n\u003cp>The mother of three doesn’t have enough time to sleep, see her family or cook meals because she commutes, often seven days a week, between two demanding \u003ca href=\"https://www.kqed.org/news/tag/health-care\">health care\u003c/a> jobs to make ends meet.\u003c/p>\n\u003cp>“What hurts me the most, is being away from my family, having to do that with the cost of everything. It’s just so expensive,” said Cortez, 44, a Los Banos resident who starts work as a dialysis technician at 4:30 a.m. in Gilroy, 30 miles south of San José.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>She picks shifts up as a medical assistant at a hospital emergency room in the afternoons or overnight in nearby Hollister, where she was raised. She’s trying to make enough money to afford to move her family back there.\u003c/p>\n\u003cp>“It’s just been really, really hard,” she said.\u003c/p>\n\u003cfigure id=\"attachment_12009757\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12009757\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Cristina Cortez, a dialysis technician, organizes items in her trunk outside Satellite Healthcare in Gilroy on Oct. 16, 2024. Due to working double shifts and having a long commute, Cortez carries a blanket and pillow to nap in her car, noodles for when she doesn’t have time for lunch, and two stuffed animals given to her by her children that remind her of them. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Cortez is one of hundreds of thousands of health care workers expected to see paycheck raises thanks to a California law that went into effect Wednesday. After months of delays, the mandated minimum wage increase, the first in the United States to target the health care industry, aims to alleviate workforce shortages and improve patient care. The raises could help health employers recruit and retain workers in often tough, frontline jobs.\u003c/p>\n\u003cp>The \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240SB525\">law\u003c/a> requires most health care employers to gradually boost their lowest wage to reach $25 an hour in the coming years. According to the \u003ca href=\"https://www.dir.ca.gov/dlse/Health-Care-Worker-Minimum-Wage-FAQ.htm\">phased-in schedule\u003c/a>, large health systems must pay at least $25 an hour by mid-2026. Smaller ones will have more time to increase the pay of nursing assistants, pharmacy technicians, janitors, receptionists and other positions.\u003c/p>\n\u003cp>“This is a well-deserved increase,” said Tia Orr, executive director of the Service Employees International Union California, which sponsored SB 525. “This is going to prove to be more beneficial for patients, more beneficial for California, and hugely beneficial to the workers who sacrifice their lives literally every single day to provide us the health care that we all need.”\u003c/p>\n\u003cp>About 350,000 health care employees, most of them people of color and women, are projected to see an annual average increase of $6,400 in the first year of the policy, according to an \u003ca href=\"https://laborcenter.berkeley.edu/wp-content/uploads/2024/02/california-health-care-minimum-wage-new-estimates-february-2024.pdf\">analysis\u003c/a> by the UC Berkeley Labor Center. In earlier estimates, the labor center calculated up to 426,000 people would be impacted, but that figure included workers at skilled nursing facilities who are currently not covered by the law, according to Laurel Lucia, who directs the center’s health care program.\u003c/p>\n\u003cp>California already \u003ca href=\"https://www.kqed.org/news/12007150/californias-20-fast-food-minimum-wage-sees-no-job-loss-slight-price-hikes\">mandates most fast-food employers\u003c/a> pay at least $20 an hour. Fast food, as well as the retail industry, often compete with health care for workers, said Bianca Frogner, who directs the Center for Health Workforce Studies at the University of Washington School of Medicine.\u003c/p>\n\u003cp>“It gives health care maybe a fighting chance against other industries that might be raising wages and are competing for workers,” Frogner, a health economist, said.\u003c/p>\n\u003cfigure id=\"attachment_12009760\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12009760\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Cristina Cortez, a dialysis technician, displays a Dialysis Workers United sticker on her shirt of Satellite Healthcare in Gilroy on Oct. 16, 2024, where she and fellow health care workers were protesting unfair labor practices. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Gov. Gavin Newsom signed SB 525 last fall, with an original implementation date of June 1. However, Newsom and lawmakers agreed to \u003ca href=\"https://www.kqed.org/news/11992165/why-the-budget-deal-delaying-the-health-care-minimum-wage-hike-is-not-as-big-as-you-might-think\">defer the measure twice\u003c/a> due to concerns that costs would exacerbate a state budget deficit.\u003c/p>\n\u003cp>Cortez said she was crushed by the delays and kept checking social media for updates from the governor on whether the Oct. 16 implementation date would stick. Earning more at her dialysis job, she said, will allow her to spend time with her children. She said she might cry when she finally sees a paycheck from her employer, Satellite Healthcare, reflecting the raise.\u003c/p>\n\u003cp>“Going from $20 to $23 from one month to the next is, like, to me winning a lotto because, yeah, it’s $3, but that’s going to make a big difference for me and my family,” Cortez said.\u003c/p>\n\u003cfigure id=\"attachment_12009759\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12009759\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Cristina Cortez, a dialysis technician, speaks with a colleague outside of Satellite Healthcare in Gilroy on Oct. 16, 2024, where she and fellow health care workers were protesting unfair labor practices. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A long list of health care employers initially opposed the measure because they worried about how to pay for it. Some said that raising their wage floor could lead to cuts in jobs or services. But many ended up supporting the bill — or withdrew their opposition — after weighing in on amendments that gave them additional time to adjust to a more expensive payroll.\u003c/p>\n\u003cp>Most research on minimum wage increases shows they do not lead to big job losses, as opponents often argue. Some health care employers may initially reduce hours or lay off employees, but those measures will likely be temporary, according to Frogner.\u003c/p>\n\u003cp>“I’m hoping that in the long run, as they see the phased-in approach of wages, that they can build that into their plan, into the future,” she said. “So it might be a very short-term challenge for a long-term gain.”\u003c/p>\n\u003cp>The law has already had a big impact on some workplaces.\u003c/p>\n\u003cfigure id=\"attachment_12009756\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12009756\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Cristina Cortez, a dialysis technician, organizes the extra uniform in her trunk outside Satellite Healthcare in Gilroy on Oct. 16, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Scripps Health, which provides a significant amount of free or discounted medical care at its four hospitals and dozens of outpatient centers in San Diego, adjusted pay for more than half of its nearly \u003ca href=\"https://www.scripps.org/about-us/who-we-are\">17,000 employees\u003c/a>, spokesperson Steve Carpowich said.\u003c/p>\n\u003cp>Only about 700 of those workers earned below the now required $23 an hour for large health employers, but Scripps also raised wages for others to “ensure fair pay and equity.” The move will cost Scripps about $20 million in the first year of the law’s implementation, Carpowich said.\u003c/p>\n\u003cp>“Scripps having to absorb the cost of this unfunded mandate comes against a backdrop of serious financial challenges for health systems,” he said in a statement. “These include government and commercial insurance payers whose reimbursements often don’t cover the cost of the care we provide; increased costs for supplies, pharmaceuticals and energy; and other unfunded government mandates, like SB 1953, the Seismic Safety Act.”\u003c/p>\n\u003cp>[aside postID=news_12007779 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-04-KQED-1020x680.jpg']\u003c/p>\n\u003cp>Large medical systems that serve more patients with private health insurance might have an easier time negotiating for higher rates to cover costs, according to Frogner and other health workforce experts. Community health centers, by comparison, rely heavily on more fixed reimbursements from Medi-Cal, the state’s public health insurance program.\u003c/p>\n\u003cp>Under the law, community and rural health clinics may apply to delay having to raise their wage floor. The Department of Industrial Relations, which issues the waivers, did not immediately respond to questions about how many clinics have applied for or received them.\u003c/p>\n\u003cp>The Newsom administration is considering changes to Medi-Cal rates as part of the budget process, but updates won’t be known until January, said H.D. Palmer, a spokesperson with the Department of Finance.\u003c/p>\n\u003cp>In its latest estimate, the department calculated the law would cost the state $1.4 billion in its first year and more later on, including higher Medi-Cal reimbursements for providers and wage hikes for about 26,000 state employees.\u003c/p>\n\u003cp>Katie Thompson, chief human resources officer at Clinica Sierra Vista, said the organization is dedicated to providing affordable health care to its primarily low-income patients in Fresno and Kern counties. To stay afloat, the community clinic, which started paying hundreds of its employees at least $21 per hour in May, hopes the state will increase Medi-Cal service rates.\u003c/p>\n\u003cp>“We’re not able to increase prices, nor do we want to,” Thompson said. “We do expect payments eventually to match the financial pressures that we are seeing. However, immediate state financial support is crucial.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Cristina Cortez keeps two fuzzy blankets and pillows in her car to nap during lunch breaks in the parking lot of the hospital where she works. On a recent afternoon, she opened her trunk to reveal instant ramen packages, a gym bag with clean clothes and soft plush toys her kids gave her so she wouldn’t feel alone.\u003c/p>\n\u003cp>The mother of three doesn’t have enough time to sleep, see her family or cook meals because she commutes, often seven days a week, between two demanding \u003ca href=\"https://www.kqed.org/news/tag/health-care\">health care\u003c/a> jobs to make ends meet.\u003c/p>\n\u003cp>“What hurts me the most, is being away from my family, having to do that with the cost of everything. It’s just so expensive,” said Cortez, 44, a Los Banos resident who starts work as a dialysis technician at 4:30 a.m. in Gilroy, 30 miles south of San José.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>She picks shifts up as a medical assistant at a hospital emergency room in the afternoons or overnight in nearby Hollister, where she was raised. She’s trying to make enough money to afford to move her family back there.\u003c/p>\n\u003cp>“It’s just been really, really hard,” she said.\u003c/p>\n\u003cfigure id=\"attachment_12009757\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12009757\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Cristina Cortez, a dialysis technician, organizes items in her trunk outside Satellite Healthcare in Gilroy on Oct. 16, 2024. Due to working double shifts and having a long commute, Cortez carries a blanket and pillow to nap in her car, noodles for when she doesn’t have time for lunch, and two stuffed animals given to her by her children that remind her of them. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Cortez is one of hundreds of thousands of health care workers expected to see paycheck raises thanks to a California law that went into effect Wednesday. After months of delays, the mandated minimum wage increase, the first in the United States to target the health care industry, aims to alleviate workforce shortages and improve patient care. The raises could help health employers recruit and retain workers in often tough, frontline jobs.\u003c/p>\n\u003cp>The \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240SB525\">law\u003c/a> requires most health care employers to gradually boost their lowest wage to reach $25 an hour in the coming years. According to the \u003ca href=\"https://www.dir.ca.gov/dlse/Health-Care-Worker-Minimum-Wage-FAQ.htm\">phased-in schedule\u003c/a>, large health systems must pay at least $25 an hour by mid-2026. Smaller ones will have more time to increase the pay of nursing assistants, pharmacy technicians, janitors, receptionists and other positions.\u003c/p>\n\u003cp>“This is a well-deserved increase,” said Tia Orr, executive director of the Service Employees International Union California, which sponsored SB 525. “This is going to prove to be more beneficial for patients, more beneficial for California, and hugely beneficial to the workers who sacrifice their lives literally every single day to provide us the health care that we all need.”\u003c/p>\n\u003cp>About 350,000 health care employees, most of them people of color and women, are projected to see an annual average increase of $6,400 in the first year of the policy, according to an \u003ca href=\"https://laborcenter.berkeley.edu/wp-content/uploads/2024/02/california-health-care-minimum-wage-new-estimates-february-2024.pdf\">analysis\u003c/a> by the UC Berkeley Labor Center. In earlier estimates, the labor center calculated up to 426,000 people would be impacted, but that figure included workers at skilled nursing facilities who are currently not covered by the law, according to Laurel Lucia, who directs the center’s health care program.\u003c/p>\n\u003cp>California already \u003ca href=\"https://www.kqed.org/news/12007150/californias-20-fast-food-minimum-wage-sees-no-job-loss-slight-price-hikes\">mandates most fast-food employers\u003c/a> pay at least $20 an hour. Fast food, as well as the retail industry, often compete with health care for workers, said Bianca Frogner, who directs the Center for Health Workforce Studies at the University of Washington School of Medicine.\u003c/p>\n\u003cp>“It gives health care maybe a fighting chance against other industries that might be raising wages and are competing for workers,” Frogner, a health economist, said.\u003c/p>\n\u003cfigure id=\"attachment_12009760\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12009760\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Cristina Cortez, a dialysis technician, displays a Dialysis Workers United sticker on her shirt of Satellite Healthcare in Gilroy on Oct. 16, 2024, where she and fellow health care workers were protesting unfair labor practices. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Gov. Gavin Newsom signed SB 525 last fall, with an original implementation date of June 1. However, Newsom and lawmakers agreed to \u003ca href=\"https://www.kqed.org/news/11992165/why-the-budget-deal-delaying-the-health-care-minimum-wage-hike-is-not-as-big-as-you-might-think\">defer the measure twice\u003c/a> due to concerns that costs would exacerbate a state budget deficit.\u003c/p>\n\u003cp>Cortez said she was crushed by the delays and kept checking social media for updates from the governor on whether the Oct. 16 implementation date would stick. Earning more at her dialysis job, she said, will allow her to spend time with her children. She said she might cry when she finally sees a paycheck from her employer, Satellite Healthcare, reflecting the raise.\u003c/p>\n\u003cp>“Going from $20 to $23 from one month to the next is, like, to me winning a lotto because, yeah, it’s $3, but that’s going to make a big difference for me and my family,” Cortez said.\u003c/p>\n\u003cfigure id=\"attachment_12009759\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12009759\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Cristina Cortez, a dialysis technician, speaks with a colleague outside of Satellite Healthcare in Gilroy on Oct. 16, 2024, where she and fellow health care workers were protesting unfair labor practices. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A long list of health care employers initially opposed the measure because they worried about how to pay for it. Some said that raising their wage floor could lead to cuts in jobs or services. But many ended up supporting the bill — or withdrew their opposition — after weighing in on amendments that gave them additional time to adjust to a more expensive payroll.\u003c/p>\n\u003cp>Most research on minimum wage increases shows they do not lead to big job losses, as opponents often argue. Some health care employers may initially reduce hours or lay off employees, but those measures will likely be temporary, according to Frogner.\u003c/p>\n\u003cp>“I’m hoping that in the long run, as they see the phased-in approach of wages, that they can build that into their plan, into the future,” she said. “So it might be a very short-term challenge for a long-term gain.”\u003c/p>\n\u003cp>The law has already had a big impact on some workplaces.\u003c/p>\n\u003cfigure id=\"attachment_12009756\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12009756\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Cristina Cortez, a dialysis technician, organizes the extra uniform in her trunk outside Satellite Healthcare in Gilroy on Oct. 16, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Scripps Health, which provides a significant amount of free or discounted medical care at its four hospitals and dozens of outpatient centers in San Diego, adjusted pay for more than half of its nearly \u003ca href=\"https://www.scripps.org/about-us/who-we-are\">17,000 employees\u003c/a>, spokesperson Steve Carpowich said.\u003c/p>\n\u003cp>Only about 700 of those workers earned below the now required $23 an hour for large health employers, but Scripps also raised wages for others to “ensure fair pay and equity.” The move will cost Scripps about $20 million in the first year of the law’s implementation, Carpowich said.\u003c/p>\n\u003cp>“Scripps having to absorb the cost of this unfunded mandate comes against a backdrop of serious financial challenges for health systems,” he said in a statement. “These include government and commercial insurance payers whose reimbursements often don’t cover the cost of the care we provide; increased costs for supplies, pharmaceuticals and energy; and other unfunded government mandates, like SB 1953, the Seismic Safety Act.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Large medical systems that serve more patients with private health insurance might have an easier time negotiating for higher rates to cover costs, according to Frogner and other health workforce experts. Community health centers, by comparison, rely heavily on more fixed reimbursements from Medi-Cal, the state’s public health insurance program.\u003c/p>\n\u003cp>Under the law, community and rural health clinics may apply to delay having to raise their wage floor. The Department of Industrial Relations, which issues the waivers, did not immediately respond to questions about how many clinics have applied for or received them.\u003c/p>\n\u003cp>The Newsom administration is considering changes to Medi-Cal rates as part of the budget process, but updates won’t be known until January, said H.D. Palmer, a spokesperson with the Department of Finance.\u003c/p>\n\u003cp>In its latest estimate, the department calculated the law would cost the state $1.4 billion in its first year and more later on, including higher Medi-Cal reimbursements for providers and wage hikes for about 26,000 state employees.\u003c/p>\n\u003cp>Katie Thompson, chief human resources officer at Clinica Sierra Vista, said the organization is dedicated to providing affordable health care to its primarily low-income patients in Fresno and Kern counties. To stay afloat, the community clinic, which started paying hundreds of its employees at least $21 per hour in May, hopes the state will increase Medi-Cal service rates.\u003c/p>\n\u003cp>“We’re not able to increase prices, nor do we want to,” Thompson said. “We do expect payments eventually to match the financial pressures that we are seeing. However, immediate state financial support is crucial.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "forced-sterilization-survivors-undertake-own-healing-after-feeling-silenced-again-by-state",
"title": "Forced Sterilization Survivors Undertake Own Healing After Feeling 'Silenced Again' by State",
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"headTitle": "Forced Sterilization Survivors Undertake Own Healing After Feeling ‘Silenced Again’ by State | KQED",
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"content": "\u003cp>\u003cem>This story was originally published in April 2024. The audio was first broadcast Oct. 11, 2024. Since the story first published, the compensation board has now approved a total of 118 applicants. It has denied 432 – or roughly 75% – of applicants. State agencies have now spent roughly $180,000 on memorials to survivors of state-sponsored sterilization. Dr. James Heinrich passed away in January 2024.Gov. Gavin Newsom \u003ca href=\"https://www.kqed.org/news/12008246/i-would-have-been-a-great-mom-california-finally-pays-reparations-to-woman-it-sterilized\">signed a bill on Sept. 30 \u003c/a>that gives more time to survivors of state-sponsored sterilization to appeal their case if they were denied reparations. They have until Jan. 1, 2025 to file an appeal.\u003c/em>\u003c/p>\n\u003cp>\u003cem>Listen to this and more in-depth storytelling by subscribing to \u003ca href=\"https://www.kqed.org/californiareportmagazine\">The California Report Magazine podcast\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>[dropcap]O[/dropcap]ne morning last spring, Moonlight Pulido called on rituals drawn from her Native American spirituality to confront a painful experience.\u003c/p>\n\u003cp>She stepped outside of her home in Carson, California, and lit a bundle of white sage that she keeps in an abalone shell by the back door. Pulido, who is Apache, fanned the smoke around her with a feather.\u003c/p>\n\u003cp>She was preparing to make quilt squares for a project to honor people who were \u003ca href=\"https://www.kqed.org/news/11965926/survivors-of-californias-forced-sterilization-denied-reparations\">forcibly sterilized at state prisons in California\u003c/a>. A survivor herself, she said she was searching for a way to release the hurt and heartache.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In 2005, while she was incarcerated at Valley State Prison in California’s Central Valley, a doctor ordered a hysterectomy without her consent.\u003c/p>\n\u003cp>“This guy really thought that he could play God and decide who was worthy and who wasn’t,” Pulido said.\u003c/p>\n\u003cp>Pulido, 59, was released in 2022. She spends her days caring for her mother, who has dementia. She also works in her stepfather’s appliance repair shop and volunteers with advocacy organizations.\u003c/p>\n\u003cp>In February 2023, she learned that one of the organizations she volunteers for, the California Coalition for Women Prisoners, or CCWP, was organizing a memorial quilt for prison sterilization survivors. She said it was an opportunity to let go of her animosity.\u003c/p>\n\u003cp>“Even though he took something that I can never get back, my spirit still felt free to heal and move on,” Pulido said.\u003c/p>\n\u003cp>Advocates and survivors say the quilt is a response to widespread disappointment over California’s implementation of a 2021 reparations law intended to make amends for a shameful chapter of the state’s history. The historic legislation allocated $4.5 million in reparative compensation to survivors who were forcibly sterilized in state prisons, state-run hospitals, homes and institutions.\u003c/p>\n\u003cp>Pulido is one of 573 people who applied. Her application was approved, and she received $35,000. However, as of March 5, just 115 applicants had been approved. The two-year program has been criticized by dozens of advocates, including CCWP and even those who drafted the bill, because of the interpretation of the reparations law. Roughly 70% of applicants were rejected.\u003c/p>\n\u003cp>[aside label=\"more reparations stories\" postID=\"news_12008246,news_11965926\"]The law also distributed $1 million between three state agencies to commission memorials that mark the harm caused by forced or involuntary sterilizations. The process required consultation with survivors and advocates. However, a review of the state’s memorialization efforts by UC Berkeley’s Investigative Reporting Program and KQED revealed that after making minimal progress in its first year the state rewrote its contracts to eliminate community engagement requirements that it had apparently failed to meet.\u003c/p>\n\u003cp>This story’s reporting is based on multiple public records requests, more than 600 pages of documents, and interviews with lawmakers, public officials and prison representatives. In interviews, advocates and survivors told KQED they feel excluded and disrespected.\u003c/p>\n\u003cp>“[The memorialization process] echoes what we saw across the whole program, which was a following of the letter of the law and not the spirit of the law,” said Jennifer James, an associate professor of sociology at UCSF and member of CCWP.\u003c/p>\n\u003ch2>‘Revictimized and silenced again’\u003c/h2>\n\u003cp>The memorial funding went to the three state agencies that allowed the forced sterilizations to occur: the California Department of Corrections and Rehabilitation, the California Department of State Hospitals and the California Department of Developmental Services. The agencies were charged with leading a collaborative memorialization process that would “acknowledge the wrongful sterilization of thousands of vulnerable people,” according to the legislation.\u003c/p>\n\u003cp>In their 2022 contracts with the California Victim Compensation Board, which oversees the reparations program, the state agencies were required to hold regular meetings, submit quarterly progress reports and create project teams that included survivors and advocates. Roughly one year later, the agencies had not fulfilled any of those requirements.\u003c/p>\n\u003cp>Instead of being held accountable by the compensation board, the agency’s contracts with the compensation board were rewritten.\u003c/p>\n\u003cp>The revised contracts reduced opportunities for community participation and transparency, according to KQED’s analysis of the original and revised contracts. For example, the requirement for agencies, survivors and advocates to meet “weekly or monthly to discuss and finalize the design, location and language that will appear on the markers or plaques” was deleted, as was the stipulation for agencies to provide quarterly reports.\u003c/p>\n\u003cp>When asked about the changes to the memorialization contracts, the compensation board said in a statement that “the contracts were amended to better reflect the roles and responsibilities of each department as described in state law. CalVCB’s statutory role is strictly fiduciary.”\u003c/p>\n\u003cp>Additionally, the funds originally earmarked for memorials have been almost cut in half to $550,000. It’s unclear how any unspent money will be used.\u003c/p>\n\u003cp>The state allocated $7.5 million to the two-year program, with $4.5 million earmarked for compensation, $1 million for memorialization and $2 million for program administration and outreach. Each individual whose application is approved receives $15,000. A second and final payment of $20,000, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240SB143\">signed into law by Gov. Gavin Newsom\u003c/a> in September 2023, will be processed by October. Up to $1 million of any remaining compensation funds could be extended for survivors if legislation is passed in the next few years.\u003c/p>\n\u003cp>When reparations advocates passed the legislation, they envisioned a collaborative and reparative process with the state where survivors, activists and community members could shape a memorial using the artists and materials they selected. Now advocates and survivors like Kelli Dillon, an advisor of the reparations bill, say they feel cheated.\u003c/p>\n\u003cp>“We thought we were going to be in partnership [with these agencies], and we were totally revictimized and silenced again,” said Dillon, who was coercively sterilized in 2001 at Central California Women’s Facility and was approved for reparations.\u003c/p>\n\u003cfigure id=\"attachment_11976953\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11976953\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">After feeling dismissed by the state, forced sterilization survivors and advocates created their own memorialization project: a quilt centered around a theme of healing and growth. \u003ccite>(Kathryn Styer Martínez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Records show that CDCR contracted Boules Consulting in July 2022 at $100 an hour to facilitate 30 hours of meetings between the agencies and the community, but only one meeting was held. Three days before it took place, the compensation board invited the eight survivors whose applications had been approved.\u003c/p>\n\u003cp>The meeting was a critical turning point. There was a tense back and forth between agency representatives and advocates, who shut down the meeting because only two survivors could attend on such short notice. A survivor-centered memorialization process, advocates argued, was contingent on meaningful outreach, opportunities for participation, inclusivity and accessibility.\u003c/p>\n\u003cp>Agency representatives postponed the meeting so more survivors could attend. Instead, according to records obtained through a public records request, CDCR’s Chief of Legislative Affairs, Sydney Tanimoto, emailed Boules Consulting to say there had been a “change of plans.” CDCR would move to a survey format instead of virtual meetings.\u003c/p>\n\u003cp>“The Administration pivoted to a survey model to address accessibility concerns raised by stakeholders as part of the initial stakeholder meeting,” Terri Hardy, a CDCR press secretary, said in a statement to KQED.\u003c/p>\n\u003cp>Survivors and advocates were deeply troubled by the decision.\u003c/p>\n\u003cp>“It could have been a historic moment where people who were greatly harmed could have gained a form of reparation through the process and that was lost,” said Cynthia Chandler, an attorney in Alameda County District Attorney Pamela Price’s office who helped draft the reparations law. “That can’t possibly happen through a survey.”\u003c/p>\n\u003cp>A short questionnaire was sent to a dozen advocates and survivors to assess their visual, auditory and language needs to participate in the survey process. Advocates with expertise in disability rights who had attended the meeting were not consulted, according to Silvia Yee, public policy director at Disability Rights Education and Defense Fund.\u003c/p>\n\u003cp>The first survey related to the design, location and language of the memorials was sent to 24 survivors whose applications had been approved. Based on six responses, the consultant wrote a final recommendation report suggesting the memorial be placed in front of the state capital and CDCR headquarters. A second survey, related to the language for the memorials was sent nearly five months later to 94 survivors. About a third responded.\u003c/p>\n\u003cp>Now, agencies say that they plan to install plaques, benches and gazebos at nine facilities where the sterilizations took place. As of March 26, the agencies had spent roughly $170,000. By the end of its contract, Boules Consulting had charged CDCR $9,900 for the work.\u003c/p>\n\u003cp>In response to KQED’s findings, the four state agencies sent a joint statement, saying that they “have worked together in partnership to meet and surpass the requirements established in the legislation.”\u003c/p>\n\u003cp>“All four departments recognized stakeholder input was a critical part of the process,” the statement continued. “Each department worked with CalVCB to actively engage in outreach efforts by using information collected and conducting targeted searches in hopes of reaching more survivors.”\u003c/p>\n\u003cp>Pulido said she never received a survey.\u003c/p>\n\u003cp>“It feels cold,” she said. “We should have been asked what kind of memorial we wanted.”\u003c/p>\n\u003cp>She said that if she had been asked, she would have replied that she’d like the memorial plaque to carry her name.\u003c/p>\n\u003cp>“I want them to know that I was victimized,” she said. “Remember me. Remember my fight and what I went through.”\u003c/p>\n\u003cp>Survivors of prison sterilization aren’t the only ones frustrated by the state’s memorialization efforts. Between 1909 and 1979, at least 20,000 Californians — disproportionately women and racial minorities — were forcibly sterilized while at state-run homes and hospitals.\u003c/p>\n\u003cp>The state’s memorialization plans don’t include any markers at Pacific Colony, a former state hospital. This upsets Stacy Cordova, whose great-aunt, Mary Franco, was sterilized when she was 13 at Pacific Colony in 1934. Franco had been institutionalized after being molested by a neighbor. She was labeled a “sex delinquent” and “low moron,” according to facility records reviewed by KQED.\u003c/p>\n\u003cp>Cordova said she never received a survey. “Why have I never been contacted?” she said. “It really makes me sad that this promise has gone unfulfilled.”\u003c/p>\n\u003cfigure id=\"attachment_11981912\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11981912\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Stacy Cordova, at her home in Azusa on Feb. 11, 2024, looks through records from Pacific Colony, where her great-aunt was forcibly sterilized in 1934 when she was 13. \u003ccite>(Cayla Mihalovich for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Cordova, a special education teacher who lives in Azusa, made her own memorial. She created a historical radio project titled “\u003ca href=\"http://www.americanhistoryeugenix.com/\">American History EugeniX\u003c/a>” to be used as a curriculum in high school and college classes. She will share the histories of people who were sterilized in the 1920s and 1930s based on eugenics records she found in the California State Archives. She hopes to launch the project this month.\u003c/p>\n\u003ch2>‘You have to gather stories’\u003c/h2>\n\u003cp>After the reparations law was passed, advocates and researchers tried to guard against the exclusion many now feel. They prepared a guidance document for the state agencies to follow as memorials were created, noting that including community input, specifically from survivors and their descendants, was crucial to the process.\u003c/p>\n\u003cp>An omission of survivor input, the document stated, “conveys not only an ugly message about state power, but ultimately will constitute a failure of contemporary agencies to properly acknowledge their role in past wrongs and harms.”\u003c/p>\n\u003cp>The document provided examples of memorialization projects from around the world, which are seen as successful because survivors were “active partners in the conceptualization and placement.” Advocates pointed to Los Angeles General Medical Center’s “Sobrevivir,” which recognizes hundreds of survivors who were forcibly sterilized at the hospital during the 1960s and 1970s.\u003c/p>\n\u003cp>Artist Phung Huynh made “Sobrevivir,” a monument with roses and praying hands etched into steel, with a budget of roughly $100,000. The flat disk is in the medical center’s courtyard. Huynh said she spent a year gathering input on what her piece should look like through open forums and correspondence with descendants of survivors and activists.\u003c/p>\n\u003cp>“You have to gather stories, be sensitive and thoughtful because it’s going to live in the community that it’s serving,” Huynh said of public art. “They have to feel like it represents who they are and the specific history that we’re trying to remember.”\u003c/p>\n\u003cp>[aside label='More Reparations Stories' postID='news_11981271,news_11975584,news_11961026']Alexandra Minna Stern, a UCLA humanities professor and the founder of the Sterilization and Social Justice Lab, helped draft the guidance document. She said the state has failed to engage survivors. Her lab has consulted on numerous memorialization efforts for survivors of eugenics-era sterilizations, including in Indiana and North Carolina.\u003c/p>\n\u003cp>“It’s frustrating to me that the state has taken over the memorialization efforts and turned it into plaques that will be [inscribed] with language they wrote and the coalition responded to,” Stern said. “Memorialization should be more than just plaques.”\u003c/p>\n\u003cp>After feeling dismissed by the state, survivors and advocates with CCWP met in January 2023 to discuss ideas for creating their own memorialization project. They landed on a memorial quilt centered around a theme of healing and growth.\u003c/p>\n\u003cp>“We are upset and angry,” said Diana Block, an advocate at CCWP. “But we chose to put our energy into developing something positive.”\u003c/p>\n\u003cp>They spent a year collecting handmade quilt squares from over 100 survivors and their supporters. Some advocates hosted quilt-making parties. Others who are currently incarcerated crocheted squares of their own.\u003c/p>\n\u003cp>Pulido sent her squares to Linda Evans, a formerly incarcerated quiltmaker and CCWP member, who assembled the 5-foot-long, 20-block quilt. It is bordered by red fabric and features images such as a lopsided heart, a peace sign and butterflies that envelop words like “hope” and “lies.”\u003c/p>\n\u003cp>The remaining squares will be assembled into an afghan by Chyrl Lamar, a formerly incarcerated CCWP member.\u003c/p>\n\u003cp>This spring, survivors and advocates of CCWP hope to bring the completed memorial quilt, called “Together We Rise, Together We Heal,” to the Central California Women’s Facility in Chowchilla, California, where many of the illegal sterilizations occurred. From there, the community-led memorial will travel around the country to libraries, prisons, museums and state capitals to serve as a centerpiece for education and conversation.\u003c/p>\n\u003cp>“History disappears,” Evans said. “If we don’t capture it and keep it in the present, we have a real danger of repeating terrible things that happened in the past.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Cayla Mihalovich is a reporter with the Investigative Reporting Program at the UC Berkeley Graduate School of Journalism.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>This story was originally published in April 2024. The audio was first broadcast Oct. 11, 2024. Since the story first published, the compensation board has now approved a total of 118 applicants. It has denied 432 – or roughly 75% – of applicants. State agencies have now spent roughly $180,000 on memorials to survivors of state-sponsored sterilization. Dr. James Heinrich passed away in January 2024.Gov. Gavin Newsom \u003ca href=\"https://www.kqed.org/news/12008246/i-would-have-been-a-great-mom-california-finally-pays-reparations-to-woman-it-sterilized\">signed a bill on Sept. 30 \u003c/a>that gives more time to survivors of state-sponsored sterilization to appeal their case if they were denied reparations. They have until Jan. 1, 2025 to file an appeal.\u003c/em>\u003c/p>\n\u003cp>\u003cem>Listen to this and more in-depth storytelling by subscribing to \u003ca href=\"https://www.kqed.org/californiareportmagazine\">The California Report Magazine podcast\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">O\u003c/span>\u003c/p>\u003cp>ne morning last spring, Moonlight Pulido called on rituals drawn from her Native American spirituality to confront a painful experience.\u003c/p>\n\u003cp>She stepped outside of her home in Carson, California, and lit a bundle of white sage that she keeps in an abalone shell by the back door. Pulido, who is Apache, fanned the smoke around her with a feather.\u003c/p>\n\u003cp>She was preparing to make quilt squares for a project to honor people who were \u003ca href=\"https://www.kqed.org/news/11965926/survivors-of-californias-forced-sterilization-denied-reparations\">forcibly sterilized at state prisons in California\u003c/a>. A survivor herself, she said she was searching for a way to release the hurt and heartache.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In 2005, while she was incarcerated at Valley State Prison in California’s Central Valley, a doctor ordered a hysterectomy without her consent.\u003c/p>\n\u003cp>“This guy really thought that he could play God and decide who was worthy and who wasn’t,” Pulido said.\u003c/p>\n\u003cp>Pulido, 59, was released in 2022. She spends her days caring for her mother, who has dementia. She also works in her stepfather’s appliance repair shop and volunteers with advocacy organizations.\u003c/p>\n\u003cp>In February 2023, she learned that one of the organizations she volunteers for, the California Coalition for Women Prisoners, or CCWP, was organizing a memorial quilt for prison sterilization survivors. She said it was an opportunity to let go of her animosity.\u003c/p>\n\u003cp>“Even though he took something that I can never get back, my spirit still felt free to heal and move on,” Pulido said.\u003c/p>\n\u003cp>Advocates and survivors say the quilt is a response to widespread disappointment over California’s implementation of a 2021 reparations law intended to make amends for a shameful chapter of the state’s history. The historic legislation allocated $4.5 million in reparative compensation to survivors who were forcibly sterilized in state prisons, state-run hospitals, homes and institutions.\u003c/p>\n\u003cp>Pulido is one of 573 people who applied. Her application was approved, and she received $35,000. However, as of March 5, just 115 applicants had been approved. The two-year program has been criticized by dozens of advocates, including CCWP and even those who drafted the bill, because of the interpretation of the reparations law. Roughly 70% of applicants were rejected.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The law also distributed $1 million between three state agencies to commission memorials that mark the harm caused by forced or involuntary sterilizations. The process required consultation with survivors and advocates. However, a review of the state’s memorialization efforts by UC Berkeley’s Investigative Reporting Program and KQED revealed that after making minimal progress in its first year the state rewrote its contracts to eliminate community engagement requirements that it had apparently failed to meet.\u003c/p>\n\u003cp>This story’s reporting is based on multiple public records requests, more than 600 pages of documents, and interviews with lawmakers, public officials and prison representatives. In interviews, advocates and survivors told KQED they feel excluded and disrespected.\u003c/p>\n\u003cp>“[The memorialization process] echoes what we saw across the whole program, which was a following of the letter of the law and not the spirit of the law,” said Jennifer James, an associate professor of sociology at UCSF and member of CCWP.\u003c/p>\n\u003ch2>‘Revictimized and silenced again’\u003c/h2>\n\u003cp>The memorial funding went to the three state agencies that allowed the forced sterilizations to occur: the California Department of Corrections and Rehabilitation, the California Department of State Hospitals and the California Department of Developmental Services. The agencies were charged with leading a collaborative memorialization process that would “acknowledge the wrongful sterilization of thousands of vulnerable people,” according to the legislation.\u003c/p>\n\u003cp>In their 2022 contracts with the California Victim Compensation Board, which oversees the reparations program, the state agencies were required to hold regular meetings, submit quarterly progress reports and create project teams that included survivors and advocates. Roughly one year later, the agencies had not fulfilled any of those requirements.\u003c/p>\n\u003cp>Instead of being held accountable by the compensation board, the agency’s contracts with the compensation board were rewritten.\u003c/p>\n\u003cp>The revised contracts reduced opportunities for community participation and transparency, according to KQED’s analysis of the original and revised contracts. For example, the requirement for agencies, survivors and advocates to meet “weekly or monthly to discuss and finalize the design, location and language that will appear on the markers or plaques” was deleted, as was the stipulation for agencies to provide quarterly reports.\u003c/p>\n\u003cp>When asked about the changes to the memorialization contracts, the compensation board said in a statement that “the contracts were amended to better reflect the roles and responsibilities of each department as described in state law. CalVCB’s statutory role is strictly fiduciary.”\u003c/p>\n\u003cp>Additionally, the funds originally earmarked for memorials have been almost cut in half to $550,000. It’s unclear how any unspent money will be used.\u003c/p>\n\u003cp>The state allocated $7.5 million to the two-year program, with $4.5 million earmarked for compensation, $1 million for memorialization and $2 million for program administration and outreach. Each individual whose application is approved receives $15,000. A second and final payment of $20,000, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240SB143\">signed into law by Gov. Gavin Newsom\u003c/a> in September 2023, will be processed by October. Up to $1 million of any remaining compensation funds could be extended for survivors if legislation is passed in the next few years.\u003c/p>\n\u003cp>When reparations advocates passed the legislation, they envisioned a collaborative and reparative process with the state where survivors, activists and community members could shape a memorial using the artists and materials they selected. Now advocates and survivors like Kelli Dillon, an advisor of the reparations bill, say they feel cheated.\u003c/p>\n\u003cp>“We thought we were going to be in partnership [with these agencies], and we were totally revictimized and silenced again,” said Dillon, who was coercively sterilized in 2001 at Central California Women’s Facility and was approved for reparations.\u003c/p>\n\u003cfigure id=\"attachment_11976953\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11976953\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">After feeling dismissed by the state, forced sterilization survivors and advocates created their own memorialization project: a quilt centered around a theme of healing and growth. \u003ccite>(Kathryn Styer Martínez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Records show that CDCR contracted Boules Consulting in July 2022 at $100 an hour to facilitate 30 hours of meetings between the agencies and the community, but only one meeting was held. Three days before it took place, the compensation board invited the eight survivors whose applications had been approved.\u003c/p>\n\u003cp>The meeting was a critical turning point. There was a tense back and forth between agency representatives and advocates, who shut down the meeting because only two survivors could attend on such short notice. A survivor-centered memorialization process, advocates argued, was contingent on meaningful outreach, opportunities for participation, inclusivity and accessibility.\u003c/p>\n\u003cp>Agency representatives postponed the meeting so more survivors could attend. Instead, according to records obtained through a public records request, CDCR’s Chief of Legislative Affairs, Sydney Tanimoto, emailed Boules Consulting to say there had been a “change of plans.” CDCR would move to a survey format instead of virtual meetings.\u003c/p>\n\u003cp>“The Administration pivoted to a survey model to address accessibility concerns raised by stakeholders as part of the initial stakeholder meeting,” Terri Hardy, a CDCR press secretary, said in a statement to KQED.\u003c/p>\n\u003cp>Survivors and advocates were deeply troubled by the decision.\u003c/p>\n\u003cp>“It could have been a historic moment where people who were greatly harmed could have gained a form of reparation through the process and that was lost,” said Cynthia Chandler, an attorney in Alameda County District Attorney Pamela Price’s office who helped draft the reparations law. “That can’t possibly happen through a survey.”\u003c/p>\n\u003cp>A short questionnaire was sent to a dozen advocates and survivors to assess their visual, auditory and language needs to participate in the survey process. Advocates with expertise in disability rights who had attended the meeting were not consulted, according to Silvia Yee, public policy director at Disability Rights Education and Defense Fund.\u003c/p>\n\u003cp>The first survey related to the design, location and language of the memorials was sent to 24 survivors whose applications had been approved. Based on six responses, the consultant wrote a final recommendation report suggesting the memorial be placed in front of the state capital and CDCR headquarters. A second survey, related to the language for the memorials was sent nearly five months later to 94 survivors. About a third responded.\u003c/p>\n\u003cp>Now, agencies say that they plan to install plaques, benches and gazebos at nine facilities where the sterilizations took place. As of March 26, the agencies had spent roughly $170,000. By the end of its contract, Boules Consulting had charged CDCR $9,900 for the work.\u003c/p>\n\u003cp>In response to KQED’s findings, the four state agencies sent a joint statement, saying that they “have worked together in partnership to meet and surpass the requirements established in the legislation.”\u003c/p>\n\u003cp>“All four departments recognized stakeholder input was a critical part of the process,” the statement continued. “Each department worked with CalVCB to actively engage in outreach efforts by using information collected and conducting targeted searches in hopes of reaching more survivors.”\u003c/p>\n\u003cp>Pulido said she never received a survey.\u003c/p>\n\u003cp>“It feels cold,” she said. “We should have been asked what kind of memorial we wanted.”\u003c/p>\n\u003cp>She said that if she had been asked, she would have replied that she’d like the memorial plaque to carry her name.\u003c/p>\n\u003cp>“I want them to know that I was victimized,” she said. “Remember me. Remember my fight and what I went through.”\u003c/p>\n\u003cp>Survivors of prison sterilization aren’t the only ones frustrated by the state’s memorialization efforts. Between 1909 and 1979, at least 20,000 Californians — disproportionately women and racial minorities — were forcibly sterilized while at state-run homes and hospitals.\u003c/p>\n\u003cp>The state’s memorialization plans don’t include any markers at Pacific Colony, a former state hospital. This upsets Stacy Cordova, whose great-aunt, Mary Franco, was sterilized when she was 13 at Pacific Colony in 1934. Franco had been institutionalized after being molested by a neighbor. She was labeled a “sex delinquent” and “low moron,” according to facility records reviewed by KQED.\u003c/p>\n\u003cp>Cordova said she never received a survey. “Why have I never been contacted?” she said. “It really makes me sad that this promise has gone unfulfilled.”\u003c/p>\n\u003cfigure id=\"attachment_11981912\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11981912\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Stacy Cordova, at her home in Azusa on Feb. 11, 2024, looks through records from Pacific Colony, where her great-aunt was forcibly sterilized in 1934 when she was 13. \u003ccite>(Cayla Mihalovich for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Cordova, a special education teacher who lives in Azusa, made her own memorial. She created a historical radio project titled “\u003ca href=\"http://www.americanhistoryeugenix.com/\">American History EugeniX\u003c/a>” to be used as a curriculum in high school and college classes. She will share the histories of people who were sterilized in the 1920s and 1930s based on eugenics records she found in the California State Archives. She hopes to launch the project this month.\u003c/p>\n\u003ch2>‘You have to gather stories’\u003c/h2>\n\u003cp>After the reparations law was passed, advocates and researchers tried to guard against the exclusion many now feel. They prepared a guidance document for the state agencies to follow as memorials were created, noting that including community input, specifically from survivors and their descendants, was crucial to the process.\u003c/p>\n\u003cp>An omission of survivor input, the document stated, “conveys not only an ugly message about state power, but ultimately will constitute a failure of contemporary agencies to properly acknowledge their role in past wrongs and harms.”\u003c/p>\n\u003cp>The document provided examples of memorialization projects from around the world, which are seen as successful because survivors were “active partners in the conceptualization and placement.” Advocates pointed to Los Angeles General Medical Center’s “Sobrevivir,” which recognizes hundreds of survivors who were forcibly sterilized at the hospital during the 1960s and 1970s.\u003c/p>\n\u003cp>Artist Phung Huynh made “Sobrevivir,” a monument with roses and praying hands etched into steel, with a budget of roughly $100,000. The flat disk is in the medical center’s courtyard. Huynh said she spent a year gathering input on what her piece should look like through open forums and correspondence with descendants of survivors and activists.\u003c/p>\n\u003cp>“You have to gather stories, be sensitive and thoughtful because it’s going to live in the community that it’s serving,” Huynh said of public art. “They have to feel like it represents who they are and the specific history that we’re trying to remember.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Alexandra Minna Stern, a UCLA humanities professor and the founder of the Sterilization and Social Justice Lab, helped draft the guidance document. She said the state has failed to engage survivors. Her lab has consulted on numerous memorialization efforts for survivors of eugenics-era sterilizations, including in Indiana and North Carolina.\u003c/p>\n\u003cp>“It’s frustrating to me that the state has taken over the memorialization efforts and turned it into plaques that will be [inscribed] with language they wrote and the coalition responded to,” Stern said. “Memorialization should be more than just plaques.”\u003c/p>\n\u003cp>After feeling dismissed by the state, survivors and advocates with CCWP met in January 2023 to discuss ideas for creating their own memorialization project. They landed on a memorial quilt centered around a theme of healing and growth.\u003c/p>\n\u003cp>“We are upset and angry,” said Diana Block, an advocate at CCWP. “But we chose to put our energy into developing something positive.”\u003c/p>\n\u003cp>They spent a year collecting handmade quilt squares from over 100 survivors and their supporters. Some advocates hosted quilt-making parties. Others who are currently incarcerated crocheted squares of their own.\u003c/p>\n\u003cp>Pulido sent her squares to Linda Evans, a formerly incarcerated quiltmaker and CCWP member, who assembled the 5-foot-long, 20-block quilt. It is bordered by red fabric and features images such as a lopsided heart, a peace sign and butterflies that envelop words like “hope” and “lies.”\u003c/p>\n\u003cp>The remaining squares will be assembled into an afghan by Chyrl Lamar, a formerly incarcerated CCWP member.\u003c/p>\n\u003cp>This spring, survivors and advocates of CCWP hope to bring the completed memorial quilt, called “Together We Rise, Together We Heal,” to the Central California Women’s Facility in Chowchilla, California, where many of the illegal sterilizations occurred. From there, the community-led memorial will travel around the country to libraries, prisons, museums and state capitals to serve as a centerpiece for education and conversation.\u003c/p>\n\u003cp>“History disappears,” Evans said. “If we don’t capture it and keep it in the present, we have a real danger of repeating terrible things that happened in the past.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Cayla Mihalovich is a reporter with the Investigative Reporting Program at the UC Berkeley Graduate School of Journalism.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "OUSD to Consider Using Entirety of Measure Y Funds to Address Campus Lead Crisis",
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"content": "\u003cp>The Oakland Unified Board of Education is reviewing a new proposal that would divert millions of dollars in unused funds from an infrastructure bond to address the lead \u003ca href=\"https://www.kqed.org/news/12002387/oakland-schools-official-calls-for-state-federal-help-after-lead-contamination-findings\">contamination\u003c/a> issue plaguing many of its schools.\u003c/p>\n\u003cp>Introduced to the board on Wednesday, the resolution proposes redirecting funding from Measure Y, a $35 million facilities bond passed by the city’s voters in 2020, to help address the problem.\u003c/p>\n\u003cp>It comes several months after district officials announced that elevated lead levels, well above the threshold set by the district, had \u003ca href=\"https://www.kqed.org/news/12002387/oakland-schools-official-calls-for-state-federal-help-after-lead-contamination-findings\">been detected in water sources\u003c/a> on the campuses of nearly two dozen schools.\u003c/p>\n\u003cp>On Sept. 30, a community coalition of students, teachers and parents rallied outside Oakland City Hall to protest what they called an unacceptable response from the district, which they said had taken far too long to notify families and was failing to address the issue with the urgency it deserved.\u003c/p>\n\u003cp>“Is this what our students deserve? Is that what should be allowed to happen? Does that show care for our students? No, it does not,” said Stuart Loebl, a teacher at Frick United Academy of Language — the campus with the highest lead levels — who urged the district to reprioritize the available funds.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Demonstrators also emphasized the potentially devastating health effects that can come from consuming elevated amounts of lead — such as brain and kidney damage, myalgia and other severe consequences.\u003c/p>\n\u003cp>Measure Y was initially intended for construction, demolition and renovation projects within the district, including major renovations to Skyline High School and Elmhurst Middle School and the demolition of the district’s abandoned headquarters near Lake Merritt. But none of those projects have started yet.\u003c/p>\n\u003cp>Board members Mike Hutchinson and Jorge Lerma, who authored the resolution, are proposing that the board amend the measure’s original spending plan, scrapping those projects and using the funding entirely for lead remediation.\u003c/p>\n\u003cp>[aside label=\"more on OUSD's lead crisis\" tag=\"ousd\"]The board is expected to vote on the resolution in the next two weeks.\u003c/p>\n\u003cp>“I am excited about the prospect of utilizing Measure Y funds for lead,” Loebl, the teacher, told KQED, emphasizing that this should be the district’s top infrastructure improvement priority. “This is a needed first step to address the crisis that is causing our students to be poisoned by lead in the water.”\u003c/p>\n\u003cp>But even if the board approves using the measure’s funds for lead treatment, it may not be enough to address the full scale of the problem — in a previous meeting, the district \u003ca href=\"https://www.kqed.org/news/12007326/lead-problems-in-oakland-schools-drinking-water-could-cost-over-50-million-to-fix\">estimated\u003c/a> that a complete remediation could cost as much as $53 million.\u003c/p>\n\u003cp>The board’s consideration of the proposal aligns with a landmark \u003ca href=\"https://www.nytimes.com/2024/10/08/climate/biden-epa-lead-pipes.html\">Biden administration announcement\u003c/a> on Tuesday, requiring virtually every water utility in the nation to install new pipes within the next 10 years.\u003c/p>\n\u003cp>Nate Landry, an OUSD parent and community organizer, says that if the board passes the resolution, he hopes the district will collaborate with his coalition in addressing the issue.\u003c/p>\n\u003cp>\u003cb>“\u003c/b>The question of what the actual remediation plan this measure pays for is something that I hope can be developed in partnership with the community,” he said. “That’s been a major focus of the demands that we released.”\u003c/p>\n\u003cp>Those demands include free blood testing for all OUSD students and employees, comprehensive testing of the soil and grass in playgrounds and other outdoor school areas, and an overhaul of water fixtures at all district schools. Coalition members have also urged the district to lower its threshold for shutting down a water source from 5 parts per billion to 0 parts.\u003c/p>\n\u003cp>Loebl, who attended Wednesday’s board meeting, has reservations about how the funds will be used, even if the proposal is approved.\u003c/p>\n\u003cp>“We shouldn’t be seeing this bond money being spent on filters,” Loebl said. “It should be spent on pipe repairs, on fixture replacements.”\u003c/p>\n\u003cp>Loebl and Landry also both expressed concerns that the district would not include the coalition in decisions about the use of the funds.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“It’s a true coalition in the sense that students are involved, teachers are involved, parents are involved. We have representatives from every union at OUSD who are involved,” Loebl said. “The idea that they might even consider doing any kind of lead legislation without consulting us would be a really big mistake.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Oakland Unified Board of Education is reviewing a new proposal that would divert millions of dollars in unused funds from an infrastructure bond to address the lead \u003ca href=\"https://www.kqed.org/news/12002387/oakland-schools-official-calls-for-state-federal-help-after-lead-contamination-findings\">contamination\u003c/a> issue plaguing many of its schools.\u003c/p>\n\u003cp>Introduced to the board on Wednesday, the resolution proposes redirecting funding from Measure Y, a $35 million facilities bond passed by the city’s voters in 2020, to help address the problem.\u003c/p>\n\u003cp>It comes several months after district officials announced that elevated lead levels, well above the threshold set by the district, had \u003ca href=\"https://www.kqed.org/news/12002387/oakland-schools-official-calls-for-state-federal-help-after-lead-contamination-findings\">been detected in water sources\u003c/a> on the campuses of nearly two dozen schools.\u003c/p>\n\u003cp>On Sept. 30, a community coalition of students, teachers and parents rallied outside Oakland City Hall to protest what they called an unacceptable response from the district, which they said had taken far too long to notify families and was failing to address the issue with the urgency it deserved.\u003c/p>\n\u003cp>“Is this what our students deserve? Is that what should be allowed to happen? Does that show care for our students? No, it does not,” said Stuart Loebl, a teacher at Frick United Academy of Language — the campus with the highest lead levels — who urged the district to reprioritize the available funds.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Demonstrators also emphasized the potentially devastating health effects that can come from consuming elevated amounts of lead — such as brain and kidney damage, myalgia and other severe consequences.\u003c/p>\n\u003cp>Measure Y was initially intended for construction, demolition and renovation projects within the district, including major renovations to Skyline High School and Elmhurst Middle School and the demolition of the district’s abandoned headquarters near Lake Merritt. But none of those projects have started yet.\u003c/p>\n\u003cp>Board members Mike Hutchinson and Jorge Lerma, who authored the resolution, are proposing that the board amend the measure’s original spending plan, scrapping those projects and using the funding entirely for lead remediation.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The board is expected to vote on the resolution in the next two weeks.\u003c/p>\n\u003cp>“I am excited about the prospect of utilizing Measure Y funds for lead,” Loebl, the teacher, told KQED, emphasizing that this should be the district’s top infrastructure improvement priority. “This is a needed first step to address the crisis that is causing our students to be poisoned by lead in the water.”\u003c/p>\n\u003cp>But even if the board approves using the measure’s funds for lead treatment, it may not be enough to address the full scale of the problem — in a previous meeting, the district \u003ca href=\"https://www.kqed.org/news/12007326/lead-problems-in-oakland-schools-drinking-water-could-cost-over-50-million-to-fix\">estimated\u003c/a> that a complete remediation could cost as much as $53 million.\u003c/p>\n\u003cp>The board’s consideration of the proposal aligns with a landmark \u003ca href=\"https://www.nytimes.com/2024/10/08/climate/biden-epa-lead-pipes.html\">Biden administration announcement\u003c/a> on Tuesday, requiring virtually every water utility in the nation to install new pipes within the next 10 years.\u003c/p>\n\u003cp>Nate Landry, an OUSD parent and community organizer, says that if the board passes the resolution, he hopes the district will collaborate with his coalition in addressing the issue.\u003c/p>\n\u003cp>\u003cb>“\u003c/b>The question of what the actual remediation plan this measure pays for is something that I hope can be developed in partnership with the community,” he said. “That’s been a major focus of the demands that we released.”\u003c/p>\n\u003cp>Those demands include free blood testing for all OUSD students and employees, comprehensive testing of the soil and grass in playgrounds and other outdoor school areas, and an overhaul of water fixtures at all district schools. Coalition members have also urged the district to lower its threshold for shutting down a water source from 5 parts per billion to 0 parts.\u003c/p>\n\u003cp>Loebl, who attended Wednesday’s board meeting, has reservations about how the funds will be used, even if the proposal is approved.\u003c/p>\n\u003cp>“We shouldn’t be seeing this bond money being spent on filters,” Loebl said. “It should be spent on pipe repairs, on fixture replacements.”\u003c/p>\n\u003cp>Loebl and Landry also both expressed concerns that the district would not include the coalition in decisions about the use of the funds.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“It’s a true coalition in the sense that students are involved, teachers are involved, parents are involved. We have representatives from every union at OUSD who are involved,” Loebl said. “The idea that they might even consider doing any kind of lead legislation without consulting us would be a really big mistake.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "proposition-35-aims-to-improve-health-care-for-low-income-californians-critics-warn-it-could-backfire",
"title": "Proposition 35 Aims to Improve Health Care for Low-Income Californians. Critics Warn it Could Backfire",
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"content": "\u003cp>Among the blitz of election ads flooding TV, social media and street corners, you won’t see any opposition to a \u003ca href=\"https://calmatters.org/politics/elections/2024/10/california-propositions-november-election/\" target=\"_blank\" rel=\"noreferrer noopener\">ballot measure\u003c/a> proposing to lock in billions of dollars to pay doctors more for treating low-income patients.\u003c/p>\n\u003cp>However, opponents of \u003ca href=\"https://calmatters.org/california-voter-guide-2024/propositions/prop-35-health-care-tax/\" target=\"_blank\" rel=\"noreferrer noopener\">Proposition 35\u003c/a> have a warning, even if they don’t have the money to pay for ads: The measure could backfire and cause the state to lose billions in federal funding.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/health/2024/07/medi-cal-mco-tax-initiative/\" target=\"_blank\" rel=\"noreferrer noopener\">Proposition 35 would take an existing tax on health insurance plans\u003c/a> and use the money to increase payment to doctors and other providers who see Medi-Cal patients. Its supporters have \u003ca href=\"https://powersearch.sos.ca.gov/advanced.php\" target=\"_blank\" rel=\"noreferrer noopener\">raised $50 million\u003c/a>, drawing from groups representing hospitals, doctors and insurers.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/tag/medi-cal/\" target=\"_blank\" rel=\"noreferrer noopener\">Medi-Cal\u003c/a>, the subsidized insurance plan serving some 14 million Californians, has ballooned in size over the past decade with increased eligibility and benefits. But those changes haven’t come with a commensurate increase in payment to doctors.\u003c/p>\n\u003cp>As a result, health care providers and advocates say too few doctors accept Medi-Cal, leaving patients with nowhere to turn.\u003c/p>\n\u003cp>According to the \u003ca href=\"https://www.ppic.org/publication/ppic-statewide-survey-californians-and-their-government-september-2024/\" target=\"_blank\" rel=\"noreferrer noopener\">Public Policy Institute of California\u003c/a>, the measure is leading and likely to pass.\u003c/p>\n\u003cp>However, opponents, represented by a small coalition of community health advocates, seniors and activists for good governance, say the details of the proposition put the state at risk of losing billions in federal funding.\u003c/p>\n\u003cp>That’s because the federal government, under both the Biden and Trump administrations, has warned California that its tax on health plans to fund Medi-Cal services takes unfair advantage of a loophole in federal regulations. The federal Centers for Medicare and Medicaid Services intends to close that loophole, \u003ca href=\"https://www.dhcs.ca.gov/Documents/CA-MCO-Tax-Waiver.pdf\">regulators wrote in a letter\u003c/a> to California officials late last year.\u003c/p>\n\u003cp>“This is the fatal flaw of this initiative,” said Kiran Savage-Sangwan, executive director of the California Pan-Ethnic Health Coalition, which is leading the opposition. “We can all have opinions on how to spend the money, but we have to raise the funds first.”\u003c/p>\n\u003cp>The problem, opponents say, lies in how California taxes health plans and how Proposition 35 limits changes in the future.\u003c/p>\n\u003cp>Right now, the Managed Care Organization Tax, also known as the MCO Tax, generates revenue for Medi-Cal by taxing health insurers that serve both Medi-Cal and commercially insured patients. The federal government gives California a dollar-for-dollar match to whatever the tax raises funds. For Proposition 35, that’s an estimated $7 billion to $8 billion annually through 2027.\u003c/p>\n\u003cp>However, California has historically placed the majority of the tax burden on Medi-Cal insurers and not commercial insurers. In its letter to state officials, federal regulators said Medi-Cal plans represent 50% of all insured people but bear “99% of the total tax burden.” That is at odds with the spirit of the law, which is meant to redistribute revenue from commercial insurers to Medi-Cal plans, regulators wrote.\u003c/p>\n\u003cp>Proposition 35 would cap the tax on commercial insurers at a minimal rate. Any attempts to modify the tax would have to go back to the ballot box or be approved by three-fourths of the Legislature. Opponents say that means federal rule changes requiring the commercial tax to be more equal to the Medi-Cal tax will force the state to reduce taxes on the Medi-Cal plans.\u003c/p>\n\u003cp>“The end result of that is when the federal government makes good on their promise to change the rules on this tax, the revenue we raise from this tax will be dramatically reduced, and we would leave billions of dollars on the table,” Savage-Sangwan said.\u003c/p>\n\u003cp>Proponents of the measure said this argument is false but did not provide details. They say Proposition 35 will make the Medi-Cal program more stable and higher rates will encourage more providers to see low-income patients.\u003c/p>\n\u003cp>California’s Medi-Cal reimbursement rates fall in the bottom third compared to all other states, according to the \u003ca href=\"https://www.kff.org/medicaid/state-indicator/medicaid-to-medicare-fee-index/?currentTimeframe=0&sortModel=%7B%22colId%22:%22All%20Services%22,%22sort%22:%22desc%22%7D\" target=\"_blank\" rel=\"noreferrer noopener\">Kaiser Family Foundation\u003c/a>, and \u003ca href=\"https://calmatters.org/health/2024/02/midwife-medi-cal/?series=no-deliveries-maternity-care\" target=\"_blank\" rel=\"noreferrer noopener\">rates for specific services like obstetrics\u003c/a> are among the lowest in the country.[aside label=\"2024 California Voter Guide\" link1='https://www.kqed.org/voterguide,Learn everything you need to cast an informed ballot for the 2024 general election' hero=https://cdn.kqed.org/wp-content/uploads/sites/80/2024/09/Aside-California-Voter-Guide-2024-General-Election-1200x1200-1.png]\u003c/p>\n\u003cp>“Prop. 35 is a critically needed investment to protect and expand access to care for Medi-Cal patients and all Californians,” said Molly Weedn, spokesperson for the Yes on Prop. 35 campaign, in a statement. “The principal purpose behind Prop. 35 is to provide stability and predictability… to address the significant shortfall of providers who can see Medi-Cal patients.”\u003c/p>\n\u003cp>The California Association of Health Plans said that it did not ask for the commercial tax cap in the proposition and that it has historically supported this tax structure to pay for Medi-Cal. A higher tax on commercial plans could increase premiums.\u003c/p>\n\u003ch2>Where is Gov. Newsom on Proposition 35?\u003c/h2>\n\u003cp>The largest donors to the yes campaign are the California Hospital Association, Global Medical Response, and the California Medical Association, which collectively donated $38 million. Opponents have raised no money, according to \u003ca href=\"https://powersearch.sos.ca.gov/advanced.php\" target=\"_blank\" rel=\"noreferrer noopener\">state campaign finance records\u003c/a>.\u003c/p>\n\u003cp>Gov. Gavin Newsom has not taken a formal stance on the measure, although he said at a press conference in July that he’s concerned about how it would lock in tax revenue for a single purpose. The state budget he signed that month shifted most of the tax revenue from the tax on health insurers into the general fund to pay for the Medi-Cal program.[aside label=\"From the 2024 Voter Guide\" link1='https://www.kqed.org/voterguide/california,Learn about the California Propositions' hero=https://cdn.kqed.org/wp-content/uploads/sites/80/2024/09/Aside-California-Propositions-2024-General-Election-1200x1200-1.png]\u003c/p>\n\u003cp>If voters approve Proposition 35, the state would face a $2.6 billion deficit in the current budget, which relies on the tax to fill in gaps. That deficit would increase to $11.9 billion over the next three budget cycles, according to an analysis from the Department of Finance.\u003c/p>\n\u003cp>“This initiative hamstrings our ability to have the kind of flexibility that’s required at the moment we’re living in. I haven’t come out publicly against it. But I’m implying a point of view. Perhaps you can read between those many, many lines,” \u003ca href=\"https://calmatters.org/newsletter/newsom-ballot-measures/\" target=\"_blank\" rel=\"noreferrer noopener\">Newsom said at the press conference\u003c/a>.\u003c/p>\n\u003cp>Newsom’s office did not respond to multiple requests on whether he would formally oppose the measure.\u003c/p>\n\u003cp>Savage-Sangwan said the opposition had not solicited any money for their campaign.\u003c/p>\n\u003cp>“We are using the very small megaphone that we do have to just get the facts out,” she said.\u003c/p>\n\u003ch2>Trade-offs in 2024 health care ballot measure\u003c/h2>\n\u003cp>The political split over Proposition 35 is unusual. The measure’s opponents are often on the same side as its supporters when it comes to health policy issues in the Capitol. But community health advocates say they’re speaking up because the future ramifications of the initiative are too risky.\u003c/p>\n\u003cp>“We want to make clear that the goals of the prop are goals we agree with. We recognize our providers in Medi-Cal are paid far too little, and that disproportionately impacts people of color, children of color especially,” said Mayra Alvarez, president of The Children’s Partnership, another opposing group.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Some lawmakers agree. During multiple budget hearings, Sen. Caroline Menjivar, a Democrat from Van Nuys, came to oppose the proposition in part because the industry organizations that negotiated who would get money from the tax left out “community providers” and those “who don’t have high-paid lobbyists.”\u003c/p>\n\u003cp>“By listening to those with boots on the ground, the legislature developed a plan to equitably address many Medi-Cal concerns over the next few years,” Menjivar said in a statement from the opposition campaign.\u003c/p>\n\u003cp>The tax is expected to generate more than $30 billion over the next four years. The budget Newsom signed puts most of the money in the state’s general spending account but sets aside roughly $2 billion to increase rates for services, including community health workers, private duty nursing, adult and children’s day centers and children at risk of \u003ca href=\"https://calmatters.org/health/2023/07/medi-cal-eligibility-california-review/\" target=\"_blank\" rel=\"noreferrer noopener\">automatic Medi-Cal disenrollment\u003c/a>. If Proposition 35 passes, different groups will get rate increases.\u003c/p>\n\u003cp>Weedn with the Yes on Prop. 35 campaign said the initiative won’t automatically cause cuts if it passes. It would be up to the Legislature to decide how to pay for the programs opponents are worried about, she said, and that the initiative provides about $2 billion of flexible dollars annually for legislative priorities.\u003c/p>\n\u003cp>\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15%E2%80%AFAM.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-12008728\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15%E2%80%AFAM.png\" alt='A screenshot of a graph that reads \"Which California health providers get rate increases under the MCO tax?\"' width=\"1258\" height=\"1346\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15 AM.png 1258w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15 AM-800x856.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15 AM-1020x1091.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15 AM-160x171.png 160w\" sizes=\"auto, (max-width: 1258px) 100vw, 1258px\">\u003c/a>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Proposition 35 would take an existing tax on health insurance plans and use the money to increase payment to doctors who see Medi-Cal patients. Critics say it could backfire and cause the state to lose billions in federal funding.",
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"title": "Proposition 35 Aims to Improve Health Care for Low-Income Californians. Critics Warn it Could Backfire | KQED",
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"headline": "Proposition 35 Aims to Improve Health Care for Low-Income Californians. Critics Warn it Could Backfire",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Among the blitz of election ads flooding TV, social media and street corners, you won’t see any opposition to a \u003ca href=\"https://calmatters.org/politics/elections/2024/10/california-propositions-november-election/\" target=\"_blank\" rel=\"noreferrer noopener\">ballot measure\u003c/a> proposing to lock in billions of dollars to pay doctors more for treating low-income patients.\u003c/p>\n\u003cp>However, opponents of \u003ca href=\"https://calmatters.org/california-voter-guide-2024/propositions/prop-35-health-care-tax/\" target=\"_blank\" rel=\"noreferrer noopener\">Proposition 35\u003c/a> have a warning, even if they don’t have the money to pay for ads: The measure could backfire and cause the state to lose billions in federal funding.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/health/2024/07/medi-cal-mco-tax-initiative/\" target=\"_blank\" rel=\"noreferrer noopener\">Proposition 35 would take an existing tax on health insurance plans\u003c/a> and use the money to increase payment to doctors and other providers who see Medi-Cal patients. Its supporters have \u003ca href=\"https://powersearch.sos.ca.gov/advanced.php\" target=\"_blank\" rel=\"noreferrer noopener\">raised $50 million\u003c/a>, drawing from groups representing hospitals, doctors and insurers.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/tag/medi-cal/\" target=\"_blank\" rel=\"noreferrer noopener\">Medi-Cal\u003c/a>, the subsidized insurance plan serving some 14 million Californians, has ballooned in size over the past decade with increased eligibility and benefits. But those changes haven’t come with a commensurate increase in payment to doctors.\u003c/p>\n\u003cp>As a result, health care providers and advocates say too few doctors accept Medi-Cal, leaving patients with nowhere to turn.\u003c/p>\n\u003cp>According to the \u003ca href=\"https://www.ppic.org/publication/ppic-statewide-survey-californians-and-their-government-september-2024/\" target=\"_blank\" rel=\"noreferrer noopener\">Public Policy Institute of California\u003c/a>, the measure is leading and likely to pass.\u003c/p>\n\u003cp>However, opponents, represented by a small coalition of community health advocates, seniors and activists for good governance, say the details of the proposition put the state at risk of losing billions in federal funding.\u003c/p>\n\u003cp>That’s because the federal government, under both the Biden and Trump administrations, has warned California that its tax on health plans to fund Medi-Cal services takes unfair advantage of a loophole in federal regulations. The federal Centers for Medicare and Medicaid Services intends to close that loophole, \u003ca href=\"https://www.dhcs.ca.gov/Documents/CA-MCO-Tax-Waiver.pdf\">regulators wrote in a letter\u003c/a> to California officials late last year.\u003c/p>\n\u003cp>“This is the fatal flaw of this initiative,” said Kiran Savage-Sangwan, executive director of the California Pan-Ethnic Health Coalition, which is leading the opposition. “We can all have opinions on how to spend the money, but we have to raise the funds first.”\u003c/p>\n\u003cp>The problem, opponents say, lies in how California taxes health plans and how Proposition 35 limits changes in the future.\u003c/p>\n\u003cp>Right now, the Managed Care Organization Tax, also known as the MCO Tax, generates revenue for Medi-Cal by taxing health insurers that serve both Medi-Cal and commercially insured patients. The federal government gives California a dollar-for-dollar match to whatever the tax raises funds. For Proposition 35, that’s an estimated $7 billion to $8 billion annually through 2027.\u003c/p>\n\u003cp>However, California has historically placed the majority of the tax burden on Medi-Cal insurers and not commercial insurers. In its letter to state officials, federal regulators said Medi-Cal plans represent 50% of all insured people but bear “99% of the total tax burden.” That is at odds with the spirit of the law, which is meant to redistribute revenue from commercial insurers to Medi-Cal plans, regulators wrote.\u003c/p>\n\u003cp>Proposition 35 would cap the tax on commercial insurers at a minimal rate. Any attempts to modify the tax would have to go back to the ballot box or be approved by three-fourths of the Legislature. Opponents say that means federal rule changes requiring the commercial tax to be more equal to the Medi-Cal tax will force the state to reduce taxes on the Medi-Cal plans.\u003c/p>\n\u003cp>“The end result of that is when the federal government makes good on their promise to change the rules on this tax, the revenue we raise from this tax will be dramatically reduced, and we would leave billions of dollars on the table,” Savage-Sangwan said.\u003c/p>\n\u003cp>Proponents of the measure said this argument is false but did not provide details. They say Proposition 35 will make the Medi-Cal program more stable and higher rates will encourage more providers to see low-income patients.\u003c/p>\n\u003cp>California’s Medi-Cal reimbursement rates fall in the bottom third compared to all other states, according to the \u003ca href=\"https://www.kff.org/medicaid/state-indicator/medicaid-to-medicare-fee-index/?currentTimeframe=0&sortModel=%7B%22colId%22:%22All%20Services%22,%22sort%22:%22desc%22%7D\" target=\"_blank\" rel=\"noreferrer noopener\">Kaiser Family Foundation\u003c/a>, and \u003ca href=\"https://calmatters.org/health/2024/02/midwife-medi-cal/?series=no-deliveries-maternity-care\" target=\"_blank\" rel=\"noreferrer noopener\">rates for specific services like obstetrics\u003c/a> are among the lowest in the country.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Prop. 35 is a critically needed investment to protect and expand access to care for Medi-Cal patients and all Californians,” said Molly Weedn, spokesperson for the Yes on Prop. 35 campaign, in a statement. “The principal purpose behind Prop. 35 is to provide stability and predictability… to address the significant shortfall of providers who can see Medi-Cal patients.”\u003c/p>\n\u003cp>The California Association of Health Plans said that it did not ask for the commercial tax cap in the proposition and that it has historically supported this tax structure to pay for Medi-Cal. A higher tax on commercial plans could increase premiums.\u003c/p>\n\u003ch2>Where is Gov. Newsom on Proposition 35?\u003c/h2>\n\u003cp>The largest donors to the yes campaign are the California Hospital Association, Global Medical Response, and the California Medical Association, which collectively donated $38 million. Opponents have raised no money, according to \u003ca href=\"https://powersearch.sos.ca.gov/advanced.php\" target=\"_blank\" rel=\"noreferrer noopener\">state campaign finance records\u003c/a>.\u003c/p>\n\u003cp>Gov. Gavin Newsom has not taken a formal stance on the measure, although he said at a press conference in July that he’s concerned about how it would lock in tax revenue for a single purpose. The state budget he signed that month shifted most of the tax revenue from the tax on health insurers into the general fund to pay for the Medi-Cal program.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>If voters approve Proposition 35, the state would face a $2.6 billion deficit in the current budget, which relies on the tax to fill in gaps. That deficit would increase to $11.9 billion over the next three budget cycles, according to an analysis from the Department of Finance.\u003c/p>\n\u003cp>“This initiative hamstrings our ability to have the kind of flexibility that’s required at the moment we’re living in. I haven’t come out publicly against it. But I’m implying a point of view. Perhaps you can read between those many, many lines,” \u003ca href=\"https://calmatters.org/newsletter/newsom-ballot-measures/\" target=\"_blank\" rel=\"noreferrer noopener\">Newsom said at the press conference\u003c/a>.\u003c/p>\n\u003cp>Newsom’s office did not respond to multiple requests on whether he would formally oppose the measure.\u003c/p>\n\u003cp>Savage-Sangwan said the opposition had not solicited any money for their campaign.\u003c/p>\n\u003cp>“We are using the very small megaphone that we do have to just get the facts out,” she said.\u003c/p>\n\u003ch2>Trade-offs in 2024 health care ballot measure\u003c/h2>\n\u003cp>The political split over Proposition 35 is unusual. The measure’s opponents are often on the same side as its supporters when it comes to health policy issues in the Capitol. But community health advocates say they’re speaking up because the future ramifications of the initiative are too risky.\u003c/p>\n\u003cp>“We want to make clear that the goals of the prop are goals we agree with. We recognize our providers in Medi-Cal are paid far too little, and that disproportionately impacts people of color, children of color especially,” said Mayra Alvarez, president of The Children’s Partnership, another opposing group.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Some lawmakers agree. During multiple budget hearings, Sen. Caroline Menjivar, a Democrat from Van Nuys, came to oppose the proposition in part because the industry organizations that negotiated who would get money from the tax left out “community providers” and those “who don’t have high-paid lobbyists.”\u003c/p>\n\u003cp>“By listening to those with boots on the ground, the legislature developed a plan to equitably address many Medi-Cal concerns over the next few years,” Menjivar said in a statement from the opposition campaign.\u003c/p>\n\u003cp>The tax is expected to generate more than $30 billion over the next four years. The budget Newsom signed puts most of the money in the state’s general spending account but sets aside roughly $2 billion to increase rates for services, including community health workers, private duty nursing, adult and children’s day centers and children at risk of \u003ca href=\"https://calmatters.org/health/2023/07/medi-cal-eligibility-california-review/\" target=\"_blank\" rel=\"noreferrer noopener\">automatic Medi-Cal disenrollment\u003c/a>. If Proposition 35 passes, different groups will get rate increases.\u003c/p>\n\u003cp>Weedn with the Yes on Prop. 35 campaign said the initiative won’t automatically cause cuts if it passes. It would be up to the Legislature to decide how to pay for the programs opponents are worried about, she said, and that the initiative provides about $2 billion of flexible dollars annually for legislative priorities.\u003c/p>\n\u003cp>\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15%E2%80%AFAM.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-12008728\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15%E2%80%AFAM.png\" alt='A screenshot of a graph that reads \"Which California health providers get rate increases under the MCO tax?\"' width=\"1258\" height=\"1346\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15 AM.png 1258w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15 AM-800x856.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15 AM-1020x1091.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15 AM-160x171.png 160w\" sizes=\"auto, (max-width: 1258px) 100vw, 1258px\">\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/california\">California\u003c/a> and New York are leading the charge of more than a dozen states suing\u003ca href=\"https://www.kqed.org/news/tag/tiktok\"> TikTok\u003c/a>, accusing the social media giant of designing addictive features to keep kids hooked on the platform.\u003c/p>\n\u003cp>The 81-page, heavily redacted complaint filed by California Attorney General Rob Bonta in Santa Clara County on Tuesday alleges that TikTok violated California’s Unfair Competition Law and False Advertising Law by collecting the personal information of young users. It also claims that the company’s scheme of purported safety features and tools misled the public about the app’s dangers and instead promoted harmful content to children.\u003c/p>\n\u003cp>Bonta and New York Attorney General Letitia Brown co-led the coalition of attorneys general from 13 states and the District of Columbia, with each filing its own lawsuit alleging that TikTok violated consumer laws and damaged the mental health of children.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Bonta’s office started investigating TikTok’s potential harms in 2022. California filed a similar lawsuit against Facebook’s parent company, Meta, last year.\u003c/p>\n\u003cp>In a Tuesday press conference at the San Francisco Public Library, Bonta called youth addiction “a key and central pillar to TikTok’s business model.”\u003c/p>\n\u003cp>“They specifically prey on young people’s vulnerabilities and their developing brains,” Bonta said. “They have an algorithm that’s designed to suck our kids in and keep them on.”\u003c/p>\n\u003cfigure id=\"attachment_12008466\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12008466\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty.jpg\" alt=\"\" width=\"2000\" height=\"1498\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty-800x599.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty-1020x764.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty-1536x1150.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty-1920x1438.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">California Attorney General Rob Bonta is leading a multi-state lawsuit against TikTok, accusing the company of exploiting and harming young users. Bonta filed the suit in Santa Clara County Superior Court and announced the action at San Francisco’s main library on Tuesday. \u003ccite>(Dan Kitwood/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Bonta outlined several features of the app that state regulators say harm the mental health of young people — especially girls — including beauty filters, infinite scrolling, push notifications and likes.\u003c/p>\n\u003cp>“The use of these features, which are manipulative and harmful, is intentional,” Bonta said.\u003c/p>\n\u003cp>TikTok spokesperson Jason Grosse told KQED the company strongly disagrees with the claims made by Bonta, which he called “inaccurate and misleading.”\u003c/p>\n\u003cp>“We’re proud of and remain deeply committed to the work we’ve done to protect teens, and we will continue to update and improve our product,” he said.\u003c/p>\n\u003cp>Grosse noted that the lawsuit followed more than two years of negotiations with the 12 states.\u003c/p>\n\u003cp>“It is incredibly disappointing they have taken this step rather than work with us on constructive solutions to industry-wide challenges,” he said.\u003c/p>\n\u003cp>[aside postID=news_11999273 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/TikTokGetty-1020x706.jpg']\u003c/p>\n\u003cp>TikTok faced Congressional scrutiny last year when CEO Shou Zi Chew was grilled by lawmakers about the safety and security of the immensely popular app. Chew testified that while the vast majority of TikTok users are over 18, the company has invested in measures to protect young people who use the app.\u003c/p>\n\u003cp>TikTok also faces legal threats at the federal level. In April, President Joe Biden signed into law legislation to ban or force a sale of TikTok by ByteDance, the app’s parent company. TikTok has 16 million users in California and an outsized influence in Silicon Valley, where it expanded its offices in San Jose earlier this year. According to California’s complaint, San Jose and neighboring Mountain View are “the hub” for the app’s Trust and Safety Team, which protects user data and is intended to specialize in youth safety.\u003c/p>\n\u003cp>A 2022 Pew Research Center \u003ca href=\"https://www.pewresearch.org/internet/2022/08/10/teens-social-media-and-technology-2022/\">report\u003c/a> found that 67% of U.S. teens ages 13-17 use TikTok, and 16% of all teens said they use the app almost constantly.\u003c/p>\n\u003cp>A \u003ca href=\"https://www.ucsf.edu/news/2024/10/428581/preteens-more-screen-time-tied-depression-anxiety-later\">UCSF study\u003c/a> published Monday found that for preteens, longer screen time increases the likelihood that nine- and 10-year-olds will develop symptoms of mental illness. The lead author, Dr. Jason Nagata, an associate professor of pediatrics at UCSF, pointed out that even though the minimum age requirement for social media use, including TikTok, is 13, the study found that two-thirds of the students had social media accounts.\u003c/p>\n\u003cp>“Robust age verification is not currently present, and many kids are able to lie about their age and get TikTok accounts,” Nagata said.\u003c/p>\n\u003cp>The UCSF study also found that the impact on mental health also varied by race, with Black and Asian youth reporting weaker associations between screen time use and mental health than their white peers.\u003c/p>\n\u003cp>“I think it is also possible that through social media, minority groups — whether it’s racial or ethnic minorities or even LGBT youth — may be able to connect with others on social media, even if they don’t have that community in their immediate in-person environment,” Nagata said.\u003c/p>\n\u003cp>\u003cem>KQED’s \u003ca href=\"https://www.kqed.org/author/lesleymcclurg\">Leslie McClurg\u003c/a> contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/california\">California\u003c/a> and New York are leading the charge of more than a dozen states suing\u003ca href=\"https://www.kqed.org/news/tag/tiktok\"> TikTok\u003c/a>, accusing the social media giant of designing addictive features to keep kids hooked on the platform.\u003c/p>\n\u003cp>The 81-page, heavily redacted complaint filed by California Attorney General Rob Bonta in Santa Clara County on Tuesday alleges that TikTok violated California’s Unfair Competition Law and False Advertising Law by collecting the personal information of young users. It also claims that the company’s scheme of purported safety features and tools misled the public about the app’s dangers and instead promoted harmful content to children.\u003c/p>\n\u003cp>Bonta and New York Attorney General Letitia Brown co-led the coalition of attorneys general from 13 states and the District of Columbia, with each filing its own lawsuit alleging that TikTok violated consumer laws and damaged the mental health of children.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Bonta’s office started investigating TikTok’s potential harms in 2022. California filed a similar lawsuit against Facebook’s parent company, Meta, last year.\u003c/p>\n\u003cp>In a Tuesday press conference at the San Francisco Public Library, Bonta called youth addiction “a key and central pillar to TikTok’s business model.”\u003c/p>\n\u003cp>“They specifically prey on young people’s vulnerabilities and their developing brains,” Bonta said. “They have an algorithm that’s designed to suck our kids in and keep them on.”\u003c/p>\n\u003cfigure id=\"attachment_12008466\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12008466\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty.jpg\" alt=\"\" width=\"2000\" height=\"1498\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty-800x599.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty-1020x764.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty-1536x1150.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty-1920x1438.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">California Attorney General Rob Bonta is leading a multi-state lawsuit against TikTok, accusing the company of exploiting and harming young users. Bonta filed the suit in Santa Clara County Superior Court and announced the action at San Francisco’s main library on Tuesday. \u003ccite>(Dan Kitwood/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Bonta outlined several features of the app that state regulators say harm the mental health of young people — especially girls — including beauty filters, infinite scrolling, push notifications and likes.\u003c/p>\n\u003cp>“The use of these features, which are manipulative and harmful, is intentional,” Bonta said.\u003c/p>\n\u003cp>TikTok spokesperson Jason Grosse told KQED the company strongly disagrees with the claims made by Bonta, which he called “inaccurate and misleading.”\u003c/p>\n\u003cp>“We’re proud of and remain deeply committed to the work we’ve done to protect teens, and we will continue to update and improve our product,” he said.\u003c/p>\n\u003cp>Grosse noted that the lawsuit followed more than two years of negotiations with the 12 states.\u003c/p>\n\u003cp>“It is incredibly disappointing they have taken this step rather than work with us on constructive solutions to industry-wide challenges,” he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>TikTok faced Congressional scrutiny last year when CEO Shou Zi Chew was grilled by lawmakers about the safety and security of the immensely popular app. Chew testified that while the vast majority of TikTok users are over 18, the company has invested in measures to protect young people who use the app.\u003c/p>\n\u003cp>TikTok also faces legal threats at the federal level. In April, President Joe Biden signed into law legislation to ban or force a sale of TikTok by ByteDance, the app’s parent company. TikTok has 16 million users in California and an outsized influence in Silicon Valley, where it expanded its offices in San Jose earlier this year. According to California’s complaint, San Jose and neighboring Mountain View are “the hub” for the app’s Trust and Safety Team, which protects user data and is intended to specialize in youth safety.\u003c/p>\n\u003cp>A 2022 Pew Research Center \u003ca href=\"https://www.pewresearch.org/internet/2022/08/10/teens-social-media-and-technology-2022/\">report\u003c/a> found that 67% of U.S. teens ages 13-17 use TikTok, and 16% of all teens said they use the app almost constantly.\u003c/p>\n\u003cp>A \u003ca href=\"https://www.ucsf.edu/news/2024/10/428581/preteens-more-screen-time-tied-depression-anxiety-later\">UCSF study\u003c/a> published Monday found that for preteens, longer screen time increases the likelihood that nine- and 10-year-olds will develop symptoms of mental illness. The lead author, Dr. Jason Nagata, an associate professor of pediatrics at UCSF, pointed out that even though the minimum age requirement for social media use, including TikTok, is 13, the study found that two-thirds of the students had social media accounts.\u003c/p>\n\u003cp>“Robust age verification is not currently present, and many kids are able to lie about their age and get TikTok accounts,” Nagata said.\u003c/p>\n\u003cp>The UCSF study also found that the impact on mental health also varied by race, with Black and Asian youth reporting weaker associations between screen time use and mental health than their white peers.\u003c/p>\n\u003cp>“I think it is also possible that through social media, minority groups — whether it’s racial or ethnic minorities or even LGBT youth — may be able to connect with others on social media, even if they don’t have that community in their immediate in-person environment,” Nagata said.\u003c/p>\n\u003cp>\u003cem>KQED’s \u003ca href=\"https://www.kqed.org/author/lesleymcclurg\">Leslie McClurg\u003c/a> contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "sf-frontline-workers-who-help-people-on-streets-in-shelters-call-for-fair-pay",
"title": "SF Frontline Workers Who Help People on Streets, In Shelters Call for Fair Pay",
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"content": "\u003cp>\u003cem>[\u003cstrong>Editor’s Note:\u003c/strong> This story was updated at 10:30 a.m. to clarify UCSF’s response to a KQED reporter’s questions about pay parity.]\u003c/em>\u003c/p>\n\u003cp>Brenna Alexander fills her backpack before her shift with granola bars, taxi vouchers and \u003ca href=\"https://www.kqed.org/news/tag/narcan\">Narcan\u003c/a>, the opioid overdose reversal medication.\u003c/p>\n\u003cp>The\u003ca href=\"https://www.kqed.org/news/tag/uc-san-francisco\"> UC San Francisco\u003c/a> clinical social worker then goes to single-room occupancy hotels in the city, knocking on doors and slowly gaining the trust of residents, many with mental health conditions, so she can help them stay housed.\u003c/p>\n\u003cp>Safety is always a concern.\u003c/p>\n\u003cp>Her colleagues on the roving teams in the Tenderloin and the Mission have witnessed stabbings and have been robbed, she said. They endure verbal abuse almost daily.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>UCSF “campus” social workers like Alexander earn about one-third less than employees with similar qualifications at the university’s large medical centers, according to the union that represents the employees. Many campus social workers, who treat non-hospitalized people in streets, shelters and outpatient clinics, say they feel discouraged and undervalued.\u003c/p>\n\u003cp>“We cannot show up for clients like we need to when we are burnt out and left to feel like the last priority,” said Alexander, 32. “This cannot be the way forward. Campus social workers deserve equitable compensation.”\u003c/p>\n\u003cfigure id=\"attachment_12007899\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007899\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Brenna Alexander speaks at a UPTE-CWA union meeting at UCSF on Oct. 3, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The pay disparity contributes to understaffing and burnout for a workforce that is critical to San Francisco’s response to substance abuse, homelessness and mental health crises, University Professional and Technical Employees members and officials said. As campus social workers quit their jobs for higher-paying positions at UCSF medical centers or elsewhere, disadvantaged patients are left languishing on growing waitlists.\u003c/p>\n\u003cp>At a town hall organized by UPTE on Oct. 3, dozens of clinical social workers booed loudly when speakers said colleagues at UCSF’s Parnassus, Mission Bay and other medical centers made 31% more on average per year.\u003c/p>\n\u003cp>The problem stems from UCSF hiring campus social workers at lower-paid job classifications, making it more difficult for these employees to move up, even when they have the same licensure and experience as higher-paid colleagues at medical centers and hospitals, according to salary data the union obtained from the public university.\u003c/p>\n\u003cfigure id=\"attachment_12007902\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007902\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">San Francisco Board of Supervisors President Aaron Peskin speaks at a UPTE-CWA union meeting at UCSF on Oct. 3, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>UCSF, the city’s second-largest employer, reported \u003ca href=\"https://www.ucsf.edu/about/ucsf-budget#:~:text=The%20second%2Dlargest%20employer%20in,the%20National%20Institutes%20of%20Health.\">$10.2 billion in revenue\u003c/a> in fiscal year 2022-2023. San Francisco has approved 13 contracts worth roughly $300 million with UCSF since 2017 for public health and homelessness services, according to a union analysis of records from the Controller’s Office. But that’s not a comprehensive list, so total city and county payments to the university could be higher.\u003c/p>\n\u003cp>Board of Supervisors President Aaron Peskin, who attended the town hall, said San Francisco must use its economic power to push for equitable pay at UCSF.\u003c/p>\n\u003cp>“If these people leave these jobs, it is just going to exacerbate the spiraling problem that we have on our streets,” said Peskin, a mayoral candidate who was one of seven supervisors to approve a \u003ca href=\"https://sfgov.legistar.com/LegislationDetail.aspx?ID=6869100&GUID=EF2B0D58-6D96-4440-A921-F95965BE1816\">resolution\u003c/a> last month urging the university to address the wage and advancement inequities.\u003c/p>\n\u003cp>“There’s rightfully a cry to address the abject misery we see on our streets,” he said. “We have to have these workers devote their lives and their professional training to making a difference, and it starts with making sure that they’re compensated appropriately.”\u003c/p>\n\u003cfigure id=\"attachment_12007898\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007898\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The audience applauds the speakers at a UPTE-CWA union meeting at UCSF on Oct. 3, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>UCSF failed to deliver services to help transition people into housing in at least one contract staffed by campus social workers, according to the San Francisco Department of Homelessness and Supportive Housing. In a \u003ca href=\"https://www.documentcloud.org/documents/25194948-department-of-homelessness-and-supportive-housing-letter-050224\">letter\u003c/a> sent to the Homelessness Oversight Commission in May, department staffers noted that the university had spent just 45% of a $1.5 million budget over two years of the contract.\u003c/p>\n\u003cp>“The underspending of funds can be attributed primarily to challenges in staff hiring, turnover and retention. Moreover, the constant flux in personnel led to noncompliance in service delivery,” Marion Sanders, the department’s chief deputy director, wrote.\u003c/p>\n\u003cp>[aside postID=news_12007119 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230828-ROB-BONTA-AP-MJS-KQED-1020x680.jpg']\u003c/p>\n\u003cp>Union officials said they are pushing for UCSF to offer fair pay and career progression, including by reclassifying employees into job titles that accurately reflect their credentials and work. UC and the union have been negotiating a new contract covering more than 18,000 employees since June.\u003c/p>\n\u003cp>The university’s most \u003ca href=\"https://www.universityofcalifornia.edu/press-room/uc-offers-historic-wage-increases-upte-represented-employees\">recent offer\u003c/a> includes raises of 5% starting in mid-2025, 3% in 2026 and up to 3% in 2027. The union \u003ca href=\"https://upte.org/updates/bargaining-update-5-uc-finally-makes-a-compensation-proposal-and-it-leaves-a-lot-to-be-desired\">countered\u003c/a> that the proposal doesn’t make up for inflation costs and shrinks some existing benefits.\u003c/p>\n\u003cp>UCSF forwarded KQED’s questions to the UC Office of the President, which declined to comment on specific questions about pay parity.\u003c/p>\n\u003cp>“UC is optimistic we’ll reach an agreement soon,” Heather Hansen, a spokesperson with the Office of the President, said in a statement. “As part of our negotiations, we have representatives from each of our campuses and health centers to collaborate to address union concerns and put forth meaningful proposals so that UPTE-represented members are recognized for their contributions.”\u003c/p>\n\u003cp>Differences in the daily tasks of campus and medical center social workers, as well as the sources of funding for each group, could impact their salaries, according to experts at the National Association of Social Workers and the Clinical Social Work Association.\u003c/p>\n\u003cp>Campus professionals often provide one-on-one psychotherapy services, while clinical social workers at hospitals coordinate the care of patients who are discharged, for instance. Medi-Cal, California’s public health insurance program, is an important source of funding for campus social work. Private insurance pays for a larger share of services at medical centers.\u003c/p>\n\u003cfigure id=\"attachment_12007895\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007895\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Matias Campos at a UPTE-CWA union meeting at UCSF on Oct. 3, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Matias Campos, UPTE’s statewide executive vice president, said that regardless of how UCSF crafts its budget, it can easily stop underpaying campus social workers in San Francisco. He pointed to UCSF’s construction of new hospitals in San Francisco and Oakland and the big raise in its chancellor’s pay to nearly \u003ca href=\"https://www.latimes.com/california/story/2024-09-20/uc-chancellors-get-big-raises\">$1.2 million\u003c/a> per year, which was approved last month.\u003c/p>\n\u003cp>“Why are these the priorities of a university and not fixing the inequities that they already have? The funds are there,” said Campos, a UCSF pharmacist who is part of the union’s bargaining team.\u003c/p>\n\u003cp>Another large health care employer, Kaiser Permanente, does not have significant compensation disparities among behavioral and social services employees with similar licensure requirements, according to the workers’ union, Service Employees International Union-United Healthcare Workers.\u003c/p>\n\u003cp>“Part of our contract negotiations with the Coalition of Kaiser Permanente Unions last year was to ensure wage parity amongst workers in various locations and settings,” said Renée Saldaña, a SEIU-UHW spokeswoman.\u003c/p>\n\u003cp>Juliette Suarez, a campus clinical social worker at UCSF for four years, said she was deeply bothered that choosing to provide therapy and other services at a small clinic in the Mission for people with severe trauma meant taking a pay cut.\u003c/p>\n\u003cp>The 31-year-old San Francisco native, who grew up in the Mission neighborhood, said she was priced out of the city. She would like to live closer to the community that she serves, but she can’t afford it.\u003c/p>\n\u003cp>“I’m in the red. I can’t afford a medical emergency as a health care provider,” said Suarez, who works at the UCSF Trauma Recovery Center. “I’ve seen colleagues that are struggling with the physical and emotional impacts of the stress and also the inability to fully afford taking care of themselves while they do this work.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "UCSF campus social workers who serve non-hospitalized individuals in streets, shelters, and outpatient clinics earn approximately one-third less than their counterparts at the university's large medical centers. This pay disparity has left many feeling discouraged and undervalued.",
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"title": "SF Frontline Workers Who Help People on Streets, In Shelters Call for Fair Pay | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>[\u003cstrong>Editor’s Note:\u003c/strong> This story was updated at 10:30 a.m. to clarify UCSF’s response to a KQED reporter’s questions about pay parity.]\u003c/em>\u003c/p>\n\u003cp>Brenna Alexander fills her backpack before her shift with granola bars, taxi vouchers and \u003ca href=\"https://www.kqed.org/news/tag/narcan\">Narcan\u003c/a>, the opioid overdose reversal medication.\u003c/p>\n\u003cp>The\u003ca href=\"https://www.kqed.org/news/tag/uc-san-francisco\"> UC San Francisco\u003c/a> clinical social worker then goes to single-room occupancy hotels in the city, knocking on doors and slowly gaining the trust of residents, many with mental health conditions, so she can help them stay housed.\u003c/p>\n\u003cp>Safety is always a concern.\u003c/p>\n\u003cp>Her colleagues on the roving teams in the Tenderloin and the Mission have witnessed stabbings and have been robbed, she said. They endure verbal abuse almost daily.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>UCSF “campus” social workers like Alexander earn about one-third less than employees with similar qualifications at the university’s large medical centers, according to the union that represents the employees. Many campus social workers, who treat non-hospitalized people in streets, shelters and outpatient clinics, say they feel discouraged and undervalued.\u003c/p>\n\u003cp>“We cannot show up for clients like we need to when we are burnt out and left to feel like the last priority,” said Alexander, 32. “This cannot be the way forward. Campus social workers deserve equitable compensation.”\u003c/p>\n\u003cfigure id=\"attachment_12007899\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007899\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Brenna Alexander speaks at a UPTE-CWA union meeting at UCSF on Oct. 3, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The pay disparity contributes to understaffing and burnout for a workforce that is critical to San Francisco’s response to substance abuse, homelessness and mental health crises, University Professional and Technical Employees members and officials said. As campus social workers quit their jobs for higher-paying positions at UCSF medical centers or elsewhere, disadvantaged patients are left languishing on growing waitlists.\u003c/p>\n\u003cp>At a town hall organized by UPTE on Oct. 3, dozens of clinical social workers booed loudly when speakers said colleagues at UCSF’s Parnassus, Mission Bay and other medical centers made 31% more on average per year.\u003c/p>\n\u003cp>The problem stems from UCSF hiring campus social workers at lower-paid job classifications, making it more difficult for these employees to move up, even when they have the same licensure and experience as higher-paid colleagues at medical centers and hospitals, according to salary data the union obtained from the public university.\u003c/p>\n\u003cfigure id=\"attachment_12007902\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007902\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">San Francisco Board of Supervisors President Aaron Peskin speaks at a UPTE-CWA union meeting at UCSF on Oct. 3, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>UCSF, the city’s second-largest employer, reported \u003ca href=\"https://www.ucsf.edu/about/ucsf-budget#:~:text=The%20second%2Dlargest%20employer%20in,the%20National%20Institutes%20of%20Health.\">$10.2 billion in revenue\u003c/a> in fiscal year 2022-2023. San Francisco has approved 13 contracts worth roughly $300 million with UCSF since 2017 for public health and homelessness services, according to a union analysis of records from the Controller’s Office. But that’s not a comprehensive list, so total city and county payments to the university could be higher.\u003c/p>\n\u003cp>Board of Supervisors President Aaron Peskin, who attended the town hall, said San Francisco must use its economic power to push for equitable pay at UCSF.\u003c/p>\n\u003cp>“If these people leave these jobs, it is just going to exacerbate the spiraling problem that we have on our streets,” said Peskin, a mayoral candidate who was one of seven supervisors to approve a \u003ca href=\"https://sfgov.legistar.com/LegislationDetail.aspx?ID=6869100&GUID=EF2B0D58-6D96-4440-A921-F95965BE1816\">resolution\u003c/a> last month urging the university to address the wage and advancement inequities.\u003c/p>\n\u003cp>“There’s rightfully a cry to address the abject misery we see on our streets,” he said. “We have to have these workers devote their lives and their professional training to making a difference, and it starts with making sure that they’re compensated appropriately.”\u003c/p>\n\u003cfigure id=\"attachment_12007898\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007898\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The audience applauds the speakers at a UPTE-CWA union meeting at UCSF on Oct. 3, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>UCSF failed to deliver services to help transition people into housing in at least one contract staffed by campus social workers, according to the San Francisco Department of Homelessness and Supportive Housing. In a \u003ca href=\"https://www.documentcloud.org/documents/25194948-department-of-homelessness-and-supportive-housing-letter-050224\">letter\u003c/a> sent to the Homelessness Oversight Commission in May, department staffers noted that the university had spent just 45% of a $1.5 million budget over two years of the contract.\u003c/p>\n\u003cp>“The underspending of funds can be attributed primarily to challenges in staff hiring, turnover and retention. Moreover, the constant flux in personnel led to noncompliance in service delivery,” Marion Sanders, the department’s chief deputy director, wrote.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Union officials said they are pushing for UCSF to offer fair pay and career progression, including by reclassifying employees into job titles that accurately reflect their credentials and work. UC and the union have been negotiating a new contract covering more than 18,000 employees since June.\u003c/p>\n\u003cp>The university’s most \u003ca href=\"https://www.universityofcalifornia.edu/press-room/uc-offers-historic-wage-increases-upte-represented-employees\">recent offer\u003c/a> includes raises of 5% starting in mid-2025, 3% in 2026 and up to 3% in 2027. The union \u003ca href=\"https://upte.org/updates/bargaining-update-5-uc-finally-makes-a-compensation-proposal-and-it-leaves-a-lot-to-be-desired\">countered\u003c/a> that the proposal doesn’t make up for inflation costs and shrinks some existing benefits.\u003c/p>\n\u003cp>UCSF forwarded KQED’s questions to the UC Office of the President, which declined to comment on specific questions about pay parity.\u003c/p>\n\u003cp>“UC is optimistic we’ll reach an agreement soon,” Heather Hansen, a spokesperson with the Office of the President, said in a statement. “As part of our negotiations, we have representatives from each of our campuses and health centers to collaborate to address union concerns and put forth meaningful proposals so that UPTE-represented members are recognized for their contributions.”\u003c/p>\n\u003cp>Differences in the daily tasks of campus and medical center social workers, as well as the sources of funding for each group, could impact their salaries, according to experts at the National Association of Social Workers and the Clinical Social Work Association.\u003c/p>\n\u003cp>Campus professionals often provide one-on-one psychotherapy services, while clinical social workers at hospitals coordinate the care of patients who are discharged, for instance. Medi-Cal, California’s public health insurance program, is an important source of funding for campus social work. Private insurance pays for a larger share of services at medical centers.\u003c/p>\n\u003cfigure id=\"attachment_12007895\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007895\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Matias Campos at a UPTE-CWA union meeting at UCSF on Oct. 3, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Matias Campos, UPTE’s statewide executive vice president, said that regardless of how UCSF crafts its budget, it can easily stop underpaying campus social workers in San Francisco. He pointed to UCSF’s construction of new hospitals in San Francisco and Oakland and the big raise in its chancellor’s pay to nearly \u003ca href=\"https://www.latimes.com/california/story/2024-09-20/uc-chancellors-get-big-raises\">$1.2 million\u003c/a> per year, which was approved last month.\u003c/p>\n\u003cp>“Why are these the priorities of a university and not fixing the inequities that they already have? The funds are there,” said Campos, a UCSF pharmacist who is part of the union’s bargaining team.\u003c/p>\n\u003cp>Another large health care employer, Kaiser Permanente, does not have significant compensation disparities among behavioral and social services employees with similar licensure requirements, according to the workers’ union, Service Employees International Union-United Healthcare Workers.\u003c/p>\n\u003cp>“Part of our contract negotiations with the Coalition of Kaiser Permanente Unions last year was to ensure wage parity amongst workers in various locations and settings,” said Renée Saldaña, a SEIU-UHW spokeswoman.\u003c/p>\n\u003cp>Juliette Suarez, a campus clinical social worker at UCSF for four years, said she was deeply bothered that choosing to provide therapy and other services at a small clinic in the Mission for people with severe trauma meant taking a pay cut.\u003c/p>\n\u003cp>The 31-year-old San Francisco native, who grew up in the Mission neighborhood, said she was priced out of the city. She would like to live closer to the community that she serves, but she can’t afford it.\u003c/p>\n\u003cp>“I’m in the red. I can’t afford a medical emergency as a health care provider,” said Suarez, who works at the UCSF Trauma Recovery Center. “I’ve seen colleagues that are struggling with the physical and emotional impacts of the stress and also the inability to fully afford taking care of themselves while they do this work.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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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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"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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"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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"radiolab": {
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},
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"info": "The Snap Judgment radio show and podcast mixes real stories with killer beats to produce cinematic, dramatic radio. Snap's musical brand of storytelling dares listeners to see the world through the eyes of another. This is storytelling... with a BEAT!! Snap first aired on public radio stations nationwide in July 2010. Today, Snap Judgment airs on over 450 public radio stations and is brought to the airwaves by KQED & PRX.",
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"soldout": {
"id": "soldout",
"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
"info": "Sold Out: Rethinking Housing in America",
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