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"content": "\u003cp>Stem cell clinics have popped up throughout California, promising cures and relief for arthritis, Alzheimer’s and other conditions through cutting-edge technologies. Some, however, are offering services that have not been approved by federal health regulators.\u003c/p>\n\u003cp>The U.S. Food and Drug Administration last week gained a significant court win against stem cell clinics that promote and administer unproven therapies.\u003c/p>\n\u003cp>A three-judge panel on \u003ca href=\"https://cdn.ca9.uscourts.gov/datastore/opinions/2024/09/27/22-56014.pdf\">the 9th U.S. Circuit Court of Appeals ruled (PDF)\u003c/a> that the FDA can regulate two affiliated Southern California stem cell clinics and their treatments after a lower court had exempted them from regulation.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The decision, experts say, reasserts the FDA’s authority over regenerative medicine at a time when clinics advertising these types of stem cell products are booming. Unproven therapies have led to \u003ca href=\"https://www.pewtrusts.org/en/research-and-analysis/issue-briefs/2021/06/harms-linked-to-unapproved-stem-cell-interventions-highlight-need-for-greater-fda-enforcement\">infections, disabilities and even death\u003c/a>, according to adverse reaction reports.\u003c/p>\n\u003cp>The case dates to 2018, when the FDA sued the California Stem Cell Treatment Center Inc., which has clinics in Rancho Mirage and Beverly Hills, for “improperly manufacturing and labeling” an unapproved product.\u003c/p>\n\u003cp>The FDA sought to stop the clinics from administering a so-called therapy that takes fat tissue from a patient to create a mixture of cells known as stromal vascular fraction. This is then injected back into the patient to treat a problem area, such as the knee for osteoarthritis.\u003c/p>\n\u003cp>“In recent years, clinics offering similar stem cell mixtures have proliferated despite concerns over whether such treatments are safe and effective,” one of the 9th Circuit judges wrote.\u003c/p>\n\u003cp>As stated in the appeals court ruling, the clinics advertised technology that could alleviate dozens of medical conditions, including arthritis, multiple sclerosis, Parkinson’s and heart problems, among others.\u003c/p>\n\u003cp>Because these treatments are not covered by insurance, people seeking these products pay tens of thousands of dollars out of pocket. A 12-treatment option could cost $41,500, the decision documents show.\u003c/p>\n\u003cp>The stem cell clinics countered that the treatment should be exempt from FDA oversight because it was more like a surgery than a new drug. \u003ca href=\"https://www.latimes.com/business/story/2022-08-31/federal-judge-tosses-lawsuit-targeting-stem-cell-clinic\">In 2022, a federal judge ruled in favor of the clinics\u003c/a> and the FDA appealed.\u003c/p>\n\u003cp>Experts say this most recent ruling strengthens the FDA’s authority over stem cell therapies and will help keep patients safe. It also \u003ca href=\"https://www.nbcnews.com/health/health-news/fda-wins-case-against-florida-stem-cell-clinic-harmed-three-n1013641\">matches the outcome of an earlier case\u003c/a> where the \u003ca href=\"https://www.justice.gov/opa/pr/florida-company-barred-using-experimental-stem-cell-drugs-patients\">FDA sued a Florida stem cell clinic\u003c/a> for administering a similar product and won, barring the clinic from selling such treatment.\u003c/p>\n\u003cp>“Now there is a coherent federal legal picture that this product can be regulated by the FDA as a drug. As a result, these cells cannot legally be used on patients by stem cell clinics without working with the agency first,” Paul Knoepfler, a professor of cell biology and human anatomy at the University of California, Davis, said via email. “Hundreds of clinics had been marketing them around the U.S. without FDA permission.”\u003c/p>\n\u003cp>An FDA spokesperson declined to comment on the ruling, saying the agency does not comment on ongoing litigation. Attorneys for the clinics did not return requests for comment.\u003c/p>\n\u003ch2>The landscape of stem cell therapies\u003c/h2>\n\u003cp>The FDA has issued multiple public warnings about stem cell treatments because of their popularity. In its notices, the FDA writes that \u003ca href=\"https://www.fda.gov/vaccines-blood-biologics/consumers-biologics/consumer-alert-regenerative-medicine-products-including-stem-cells-and-exosomes\">the only treatments approved for consumers\u003c/a> consist of blood-forming stem cells, which are used to fight certain cancers or blood disorders. The list of therapies ready for commercial use is short, experts say. Other types of stem cell treatments have been approved for clinical trials only.[aside label=\"Related Stories\" postID=\"news_12001344,news_12003006,news_12007157\"]Every drug and therapy approved in the U.S. has to first go through a rigorous and lengthy process that includes a clinical trial to prove it is both safe and effective.\u003c/p>\n\u003cp>“Please know that if you are being charged for these products or offered these products outside of a clinical trial, you are likely being deceived and offered a product illegally,” \u003ca href=\"https://www.fda.gov/vaccines-blood-biologics/consumers-biologics/important-patient-and-consumer-information-about-regenerative-medicine-therapies\">the FDA wrote in a warning\u003c/a> to consumers in 2021.\u003c/p>\n\u003cp>Unapproved stem cell products are not only illegal but also dangerous. In a high profile case, three elderly women went blind after receiving an unproven fat tissue-based stem cell treatment for macular degeneration at a Florida clinic, the same one that was later sued by the FDA. \u003ca href=\"https://www.statnews.com/2017/03/15/stem-cell-patients-blind-macular-degeneration/\">According to news reports\u003c/a> from when the case was first made public, the women sought treatments because they had difficulty reading fine print. After the procedures, the women suffered detached retinas, vision loss and bleeding inside the eye.\u003c/p>\n\u003ch2>‘You see them on billboards’\u003c/h2>\n\u003cp>The California Institute for Regenerative Medicine, the multibillion-dollar agency voters authorized in 2004 to fund stem cell research, also \u003ca href=\"https://www.cirm.ca.gov/participating-clinical-trial/\">warns on its website\u003c/a> against companies that promote “bogus therapies.”\u003c/p>\n\u003cp>“The general public knows that stem cells are a very important field that continues to develop, and they believe, as we certainly do, that they’re going to be the source of therapies and cures. The problem is these companies make it sound like we’re there already, and that’s just not the case,” said \u003ca href=\"https://www.cirm.ca.gov/about-cirm/cirm-leadership/\">Jonathan Thomas\u003c/a>, president of the agency.\u003c/p>\n\u003cp>Thomas said last week’s ruling is important because not only does it send a message to clinics that they can’t provide treatments without regulation, but it also gives a nod to researchers who are doing legitimate stem cell work and following the rules.\u003c/p>\n\u003cp>It’s also a warning for consumers, he said.\u003c/p>\n\u003cp>It is difficult to track these clinics advertising unapproved cures, so it is unclear how many are operating today. “We just know that they are proliferating because you see signs for them … you see them on billboards, you see ads, you see all sorts of things,” Thomas told CalMatters.\u003c/p>\n\u003cp>People who are considering a stem cell treatment should ask if the therapy has been approved by the FDA. Thomas said the public should be wary if a stem cell clinic says they are exempt from federal regulation. “Anytime you hear anything like that, I would say that’s a huge red flag,” he said.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The decision, experts say, reasserts the FDA’s authority over regenerative medicine at a time when clinics advertising these types of stem cell products are booming. Unproven therapies have led to \u003ca href=\"https://www.pewtrusts.org/en/research-and-analysis/issue-briefs/2021/06/harms-linked-to-unapproved-stem-cell-interventions-highlight-need-for-greater-fda-enforcement\">infections, disabilities and even death\u003c/a>, according to adverse reaction reports.\u003c/p>\n\u003cp>The case dates to 2018, when the FDA sued the California Stem Cell Treatment Center Inc., which has clinics in Rancho Mirage and Beverly Hills, for “improperly manufacturing and labeling” an unapproved product.\u003c/p>\n\u003cp>The FDA sought to stop the clinics from administering a so-called therapy that takes fat tissue from a patient to create a mixture of cells known as stromal vascular fraction. This is then injected back into the patient to treat a problem area, such as the knee for osteoarthritis.\u003c/p>\n\u003cp>“In recent years, clinics offering similar stem cell mixtures have proliferated despite concerns over whether such treatments are safe and effective,” one of the 9th Circuit judges wrote.\u003c/p>\n\u003cp>As stated in the appeals court ruling, the clinics advertised technology that could alleviate dozens of medical conditions, including arthritis, multiple sclerosis, Parkinson’s and heart problems, among others.\u003c/p>\n\u003cp>Because these treatments are not covered by insurance, people seeking these products pay tens of thousands of dollars out of pocket. A 12-treatment option could cost $41,500, the decision documents show.\u003c/p>\n\u003cp>The stem cell clinics countered that the treatment should be exempt from FDA oversight because it was more like a surgery than a new drug. \u003ca href=\"https://www.latimes.com/business/story/2022-08-31/federal-judge-tosses-lawsuit-targeting-stem-cell-clinic\">In 2022, a federal judge ruled in favor of the clinics\u003c/a> and the FDA appealed.\u003c/p>\n\u003cp>Experts say this most recent ruling strengthens the FDA’s authority over stem cell therapies and will help keep patients safe. It also \u003ca href=\"https://www.nbcnews.com/health/health-news/fda-wins-case-against-florida-stem-cell-clinic-harmed-three-n1013641\">matches the outcome of an earlier case\u003c/a> where the \u003ca href=\"https://www.justice.gov/opa/pr/florida-company-barred-using-experimental-stem-cell-drugs-patients\">FDA sued a Florida stem cell clinic\u003c/a> for administering a similar product and won, barring the clinic from selling such treatment.\u003c/p>\n\u003cp>“Now there is a coherent federal legal picture that this product can be regulated by the FDA as a drug. As a result, these cells cannot legally be used on patients by stem cell clinics without working with the agency first,” Paul Knoepfler, a professor of cell biology and human anatomy at the University of California, Davis, said via email. “Hundreds of clinics had been marketing them around the U.S. without FDA permission.”\u003c/p>\n\u003cp>An FDA spokesperson declined to comment on the ruling, saying the agency does not comment on ongoing litigation. Attorneys for the clinics did not return requests for comment.\u003c/p>\n\u003ch2>The landscape of stem cell therapies\u003c/h2>\n\u003cp>The FDA has issued multiple public warnings about stem cell treatments because of their popularity. In its notices, the FDA writes that \u003ca href=\"https://www.fda.gov/vaccines-blood-biologics/consumers-biologics/consumer-alert-regenerative-medicine-products-including-stem-cells-and-exosomes\">the only treatments approved for consumers\u003c/a> consist of blood-forming stem cells, which are used to fight certain cancers or blood disorders. The list of therapies ready for commercial use is short, experts say. Other types of stem cell treatments have been approved for clinical trials only.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Every drug and therapy approved in the U.S. has to first go through a rigorous and lengthy process that includes a clinical trial to prove it is both safe and effective.\u003c/p>\n\u003cp>“Please know that if you are being charged for these products or offered these products outside of a clinical trial, you are likely being deceived and offered a product illegally,” \u003ca href=\"https://www.fda.gov/vaccines-blood-biologics/consumers-biologics/important-patient-and-consumer-information-about-regenerative-medicine-therapies\">the FDA wrote in a warning\u003c/a> to consumers in 2021.\u003c/p>\n\u003cp>Unapproved stem cell products are not only illegal but also dangerous. In a high profile case, three elderly women went blind after receiving an unproven fat tissue-based stem cell treatment for macular degeneration at a Florida clinic, the same one that was later sued by the FDA. \u003ca href=\"https://www.statnews.com/2017/03/15/stem-cell-patients-blind-macular-degeneration/\">According to news reports\u003c/a> from when the case was first made public, the women sought treatments because they had difficulty reading fine print. After the procedures, the women suffered detached retinas, vision loss and bleeding inside the eye.\u003c/p>\n\u003ch2>‘You see them on billboards’\u003c/h2>\n\u003cp>The California Institute for Regenerative Medicine, the multibillion-dollar agency voters authorized in 2004 to fund stem cell research, also \u003ca href=\"https://www.cirm.ca.gov/participating-clinical-trial/\">warns on its website\u003c/a> against companies that promote “bogus therapies.”\u003c/p>\n\u003cp>“The general public knows that stem cells are a very important field that continues to develop, and they believe, as we certainly do, that they’re going to be the source of therapies and cures. The problem is these companies make it sound like we’re there already, and that’s just not the case,” said \u003ca href=\"https://www.cirm.ca.gov/about-cirm/cirm-leadership/\">Jonathan Thomas\u003c/a>, president of the agency.\u003c/p>\n\u003cp>Thomas said last week’s ruling is important because not only does it send a message to clinics that they can’t provide treatments without regulation, but it also gives a nod to researchers who are doing legitimate stem cell work and following the rules.\u003c/p>\n\u003cp>It’s also a warning for consumers, he said.\u003c/p>\n\u003cp>It is difficult to track these clinics advertising unapproved cures, so it is unclear how many are operating today. “We just know that they are proliferating because you see signs for them … you see them on billboards, you see ads, you see all sorts of things,” Thomas told CalMatters.\u003c/p>\n\u003cp>People who are considering a stem cell treatment should ask if the therapy has been approved by the FDA. Thomas said the public should be wary if a stem cell clinic says they are exempt from federal regulation. “Anytime you hear anything like that, I would say that’s a huge red flag,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>When we think about air pollution, most of us focus on its effects on our lungs and maybe our hearts. But new \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S1878929324000975?via%3Dihub\">research\u003c/a> reveals something more troubling: the air we breathe may affect \u003ca href=\"https://www.kqed.org/news/tag/children\">children’s\u003c/a> brains.\u003c/p>\n\u003cp>A team of \u003ca href=\"https://www.kqed.org/news/tag/uc-davis\">UC Davis\u003c/a> scientists systematically reviewed 40 different studies looking at how outdoor air pollution impacts the development of children’s brains. The research linked exposure to pollutants to changes in the brain. This includes differences in white matter, crucial for things like memory and learning, and even early signs of neurodegenerative diseases like Alzheimer’s.\u003c/p>\n\u003cp>“We’re seeing notable differences in brain outcomes between kids exposed to higher pollution levels and those with lower exposure,” said Camelia Hostinar, associate professor of psychology at UC Davis and the study’s corresponding author.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Children are especially vulnerable to air pollution for a few reasons. Their bodies and brains are still developing, and they breathe faster than adults, meaning they take in more air (and more pollutants) relative to their body size. And they spend a lot of time outside — whether that’s playing in the yard, walking to school, or just hanging out with friends. That outdoor time increases their exposure, particularly in cities or near freeways where pollution levels can spike.\u003c/p>\n\u003cp>“What should concern us in these studies and what they show is that fossil fuel pollution is literally damaging, not only things like the vasculature of infants and children’s brains but also what we call the cortical thickness, which is associated with cognitive capacities or cognitive deficits,” said Dr. Lisa Patel, a pediatrician for Stanford Children’s Health, who was not involved in the study.\u003c/p>\n\u003ch2>The impact of pollution on young brains\u003c/h2>\n\u003cp>Pollutants like fine particulate matter, what researchers refer to as PM2.5, and nitrogen dioxide from car exhaust, power plants and wildfires can penetrate deep into the lungs and bloodstream. From there, they can travel to the brain, where they can trigger inflammation, which contributes to cell loss within the central nervous system. This process may trigger \u003ca href=\"https://www.researchgate.net/publication/299999970_How_Air_Pollution_Alters_Brain_Development_The_Role_of_Neuroinflammation\">cognitive decline, an increased risk for dementia\u003c/a>, \u003ca href=\"https://www.sciencedirect.com/science/article/abs/pii/S0197018619305078\">autism\u003c/a> and \u003ca href=\"https://www.sciencedirect.com/science/article/abs/pii/S0013935119307273\">attention deficit hyperactivity disorder\u003c/a>.\u003c/p>\n\u003cp>The UC Davis research team examined studies primarily from the U.S., Mexico and Europe, with one each from Asia and Australia. Some used advanced imaging techniques like MRI scans, while others tested chemical compounds or even looked for signs of brain tumors.\u003c/p>\n\u003cp>[aside postID=news_12000147 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/iStock-515594796_qed-1020x680.jpg']\u003c/p>\n\u003cp>“These are observational studies, so we can’t definitively say air pollution causes these brain changes,” said Dr. John Balmes, a physician-scientist at UCSF and UC Berkeley, whose \u003ca href=\"https://ehp.niehs.nih.gov/doi/10.1289/EHP10812\">research\u003c/a> has shown links between early-life pollution exposure and reduced IQ by age 10. He was not involved in the UC Davis study. “But when so many studies show consistent results, the association becomes strong — strong enough to move toward causality.”\u003c/p>\n\u003cp>Researchers also looked at animal models to explore potential causal links. In these models, exposure to pollution led to brain changes similar to what’s observed in human children.\u003c/p>\n\u003cp>“Between what the animal models show, what these pathology results show, and what we know from the adult literature, connecting what we know from animal studies to humans is a reasonable assertion,” Patel said.\u003c/p>\n\u003ch2>Reducing the risks\u003c/h2>\n\u003cp>On days like Wednesday and Thursday, when the air district issues a Spare the Air Alert for the Bay Area due to unhealthy smog levels, health officials urge people, especially children and sensitive groups, to limit outdoor activities.\u003c/p>\n\u003cp>“Kids should probably not be exercising vigorously outside if they don’t have to,” Balmes said.\u003c/p>\n\u003cp>Patel suggested several other steps to reduce exposure to air pollution, particularly for children. Installing portable air purifiers in homes and schools can significantly improve indoor air quality, especially near high-traffic areas. If you’re looking for a new home, try to avoid areas near major roads or industrial zones. For those already living near pollution sources, weatherizing your home by sealing cracks and gaps to prevent dirty air from sneaking in.\u003c/p>\n\u003cp>The UC Davis researchers also encouraged other scientists to include air pollution data in studies related to brain health.\u003c/p>\n\u003cp>“Anyone researching brain development or health outcomes should be asking about air pollution exposure,” said Sally Hang, a Ph.D. student at UC Davis and the study’s first co-author. “It’s a simple yet critical factor that could deepen our understanding of how to protect future generations.”\u003c/p>\n\u003cp>As research mounts on connecting air pollution to poorer neurodevelopment, policymakers may need to rethink what they consider safe levels of pollution, particularly when it comes to the most vulnerable among us — our children.\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "Pollutants from cars and power plants can travel to children's brains, causing inflammation and potential long-term neurodevelopmental damage.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When we think about air pollution, most of us focus on its effects on our lungs and maybe our hearts. But new \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S1878929324000975?via%3Dihub\">research\u003c/a> reveals something more troubling: the air we breathe may affect \u003ca href=\"https://www.kqed.org/news/tag/children\">children’s\u003c/a> brains.\u003c/p>\n\u003cp>A team of \u003ca href=\"https://www.kqed.org/news/tag/uc-davis\">UC Davis\u003c/a> scientists systematically reviewed 40 different studies looking at how outdoor air pollution impacts the development of children’s brains. The research linked exposure to pollutants to changes in the brain. This includes differences in white matter, crucial for things like memory and learning, and even early signs of neurodegenerative diseases like Alzheimer’s.\u003c/p>\n\u003cp>“We’re seeing notable differences in brain outcomes between kids exposed to higher pollution levels and those with lower exposure,” said Camelia Hostinar, associate professor of psychology at UC Davis and the study’s corresponding author.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Children are especially vulnerable to air pollution for a few reasons. Their bodies and brains are still developing, and they breathe faster than adults, meaning they take in more air (and more pollutants) relative to their body size. And they spend a lot of time outside — whether that’s playing in the yard, walking to school, or just hanging out with friends. That outdoor time increases their exposure, particularly in cities or near freeways where pollution levels can spike.\u003c/p>\n\u003cp>“What should concern us in these studies and what they show is that fossil fuel pollution is literally damaging, not only things like the vasculature of infants and children’s brains but also what we call the cortical thickness, which is associated with cognitive capacities or cognitive deficits,” said Dr. Lisa Patel, a pediatrician for Stanford Children’s Health, who was not involved in the study.\u003c/p>\n\u003ch2>The impact of pollution on young brains\u003c/h2>\n\u003cp>Pollutants like fine particulate matter, what researchers refer to as PM2.5, and nitrogen dioxide from car exhaust, power plants and wildfires can penetrate deep into the lungs and bloodstream. From there, they can travel to the brain, where they can trigger inflammation, which contributes to cell loss within the central nervous system. This process may trigger \u003ca href=\"https://www.researchgate.net/publication/299999970_How_Air_Pollution_Alters_Brain_Development_The_Role_of_Neuroinflammation\">cognitive decline, an increased risk for dementia\u003c/a>, \u003ca href=\"https://www.sciencedirect.com/science/article/abs/pii/S0197018619305078\">autism\u003c/a> and \u003ca href=\"https://www.sciencedirect.com/science/article/abs/pii/S0013935119307273\">attention deficit hyperactivity disorder\u003c/a>.\u003c/p>\n\u003cp>The UC Davis research team examined studies primarily from the U.S., Mexico and Europe, with one each from Asia and Australia. Some used advanced imaging techniques like MRI scans, while others tested chemical compounds or even looked for signs of brain tumors.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“These are observational studies, so we can’t definitively say air pollution causes these brain changes,” said Dr. John Balmes, a physician-scientist at UCSF and UC Berkeley, whose \u003ca href=\"https://ehp.niehs.nih.gov/doi/10.1289/EHP10812\">research\u003c/a> has shown links between early-life pollution exposure and reduced IQ by age 10. He was not involved in the UC Davis study. “But when so many studies show consistent results, the association becomes strong — strong enough to move toward causality.”\u003c/p>\n\u003cp>Researchers also looked at animal models to explore potential causal links. In these models, exposure to pollution led to brain changes similar to what’s observed in human children.\u003c/p>\n\u003cp>“Between what the animal models show, what these pathology results show, and what we know from the adult literature, connecting what we know from animal studies to humans is a reasonable assertion,” Patel said.\u003c/p>\n\u003ch2>Reducing the risks\u003c/h2>\n\u003cp>On days like Wednesday and Thursday, when the air district issues a Spare the Air Alert for the Bay Area due to unhealthy smog levels, health officials urge people, especially children and sensitive groups, to limit outdoor activities.\u003c/p>\n\u003cp>“Kids should probably not be exercising vigorously outside if they don’t have to,” Balmes said.\u003c/p>\n\u003cp>Patel suggested several other steps to reduce exposure to air pollution, particularly for children. Installing portable air purifiers in homes and schools can significantly improve indoor air quality, especially near high-traffic areas. If you’re looking for a new home, try to avoid areas near major roads or industrial zones. For those already living near pollution sources, weatherizing your home by sealing cracks and gaps to prevent dirty air from sneaking in.\u003c/p>\n\u003cp>The UC Davis researchers also encouraged other scientists to include air pollution data in studies related to brain health.\u003c/p>\n\u003cp>“Anyone researching brain development or health outcomes should be asking about air pollution exposure,” said Sally Hang, a Ph.D. student at UC Davis and the study’s first co-author. “It’s a simple yet critical factor that could deepen our understanding of how to protect future generations.”\u003c/p>\n\u003cp>As research mounts on connecting air pollution to poorer neurodevelopment, policymakers may need to rethink what they consider safe levels of pollution, particularly when it comes to the most vulnerable among us — our children.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "more-california-immigrants-are-eligible-for-medi-cal-but-some-are-hesitant-to-enroll",
"title": "More California Immigrants Are Eligible For Medi-Cal, but Some Are Hesitant to Enroll",
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"headTitle": "More California Immigrants Are Eligible For Medi-Cal, but Some Are Hesitant to Enroll | KQED",
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"content": "\u003cp>\u003ci data-stringify-type=\"italic\">This story was produced by \u003ca href=\"https://www.eltimpano.org\">El Tímpano\u003c/a>\u003c/i>\u003ci data-stringify-type=\"italic\">, a bilingual nonprofit news outlet that amplifies the voices of Latino and Mayan immigrants in Oakland and the wider Bay Area. The original version of the story can be found \u003ca href=\"https://www.eltimpano.org/health/lingering-fears-over-past-immigration-policies-are-fueling-a-reluctance-to-enroll-in-medi-cal\">here\u003c/a>\u003c/i>\u003ci data-stringify-type=\"italic\">.\u003c/i>\u003c/p>\n\u003cp>[dropcap]O[/dropcap]n a bright and early morning in Pittsburg, two women position themselves tactically outside the La Superior Mercados between the extra-large charcoal grill for roasting chicken and the rows of yellow-trimmed grocery carts. The supermarket is frequented by the area’s Latino community and anyone trying to get in or out this morning must pass the women first and hear their sales pitch. Their product should be easy to sell: free to low-cost health insurance for people with low incomes. But often, a surprising answer to their question, “Can we sign you up for Medi-Cal?” is “no.”\u003c/p>\n\u003cp>The list of benefits a patient can receive with full-scope Medi-Cal for free or at low cost includes emergency services, maternity care, mental health and substance use disorder services, pediatric care, and more, the women explain to passers-by. Their enrollment services are offered for free through Monument Impact, a nonprofit organization in Contra Costa County that helps connect low-income immigrants to resources, they remind folks. Still, several of the shoppers, mostly Spanish-speaking Latinos, look at the women with skepticism as they make their pitch.\u003c/p>\n\u003cp>Medi-Cal expanded to include all qualifying adults regardless of immigration status in January 2024. This year’s expansion was the final phase of an eight-year effort to extend Medi-Cal to undocumented immigrants, first to children and pregnant women, then to children under 19, to young adults under 26, and to older adults over 50, as part of the state’s initiative to expand health care access to all Californians. The UC Berkeley Labor Center \u003ca href=\"https://laborcenter.berkeley.edu/californias-uninsured-in-2024/\">estimates\u003c/a> that close to one million undocumented Californians will have gained access to Medi-Cal through this expansion.\u003c/p>\n\u003cp>Judith Peralta and Mireya Robles said that at the start of the year, it was no problem engaging folks and encouraging them to sign up for the program. As \u003cem>promotoras de salud\u003c/em>, health promoters, Peralta and Robles serve as trusted messengers to connect their community to limited health insurance options available to low-income immigrants.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The first few months of the year, the women saw a rush to apply for Medi-Cal—hundreds of people in the community were ready to enroll. But in recent months, they’ve found convincing people to sign up more challenging. Many of the people they encounter either already have Medi-Cal, know they don’t meet the income requirements to qualify for the program, or, in many cases, brush them off with a kind but adamant “no.” They’re afraid of Medi-Cal, the women say.\u003c/p>\n\u003cp>“It’s often men who have more fear, they’ll tell us ‘no, no,’” Peralta said in Spanish. “Like they’ll say it has something to do with immigration or it has to do with the government. Like they don’t want to give their name.”\u003c/p>\n\u003cp>Distrust of government has long run deep in Latino immigrant communities but reached a low point in 2019. That’s when the Trump administration announced that using certain government benefits could prevent undocumented immigrants from ever qualifying for legal status. The Trump administration leaned on a category known as a “\u003ca href=\"https://www.uscis.gov/green-card/green-card-processes-and-procedures/public-charge/public-charge-resources\">public charge\u003c/a>” to institute these changes. A public charge is an unauthorized immigrant who is likely to become dependent on government benefits. A designation of public charge jeopardizes an immigrant’s chances of securing legal status in the U.S. Before 2019, only using cash assistance for income like Temporary Assistance for Needy Families or needing long-term institutionalized care paid for by the government meant risking a designation of public charge from an immigration official.\u003c/p>\n\u003cp>The Trump administration expanded public charge to include Medicaid, the Supplemental Nutrition Assistance Program, housing assistance, energy assistance, child-care subsidies, and other benefits, according to the Migration Policy Institute, a nonpartisan research organization. Overnight, what was once an obscure set of bureaucratic rules became a household concern.\u003c/p>\n\u003cfigure id=\"attachment_12007441\" class=\"wp-caption aligncenter\" style=\"max-width: 2560px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007441\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-scaled.jpg\" alt=\"Three women sit at a table together in a building with a man sitting in a chair across from them.\" width=\"2560\" height=\"1703\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-800x532.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-1536x1022.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-2048x1363.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-1920x1277.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Azucena Espinoza, a senior promotora at Monument Impact, registered walk-ins looking for help with their Medi-Cal application at Monument Impact’s offices in Antioch on Thursday, Sept. 5, 2024. \u003ccite>(Hiram Alejandro Durán for El Tímpano/CatchLight Local/Report for America corps member)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Before 2019, “I actually had no clue of even the words ‘public charge,’” said Janet Anwar, registration services manager at Tiburcio Vasquez Health Center, a nonprofit East Bay health clinic. “It wasn’t a common word in our community, not until then. It brought a lot of concerns to our patients because there was a lot of miscommunication as to what was public charge, how it impacts immigration cases.”\u003c/p>\n\u003cp>Though the Trump public charge rules were only in effect for a short period and were reversed officially at the start of the Biden administration, researchers and immigrant advocates said the changes caused a long-lasting “chilling effect.” Experts say the Trump 2024 campaign has so far not mentioned public charge in its immigration agenda, but undocumented immigrants in California remain afraid, and that fear is preventing people from applying for the newly expanded Medi-Cal benefits.\u003c/p>\n\u003cp>This better-safe-than-sorry mindset means that undocumented immigrants may go years without seeing a medical professional or end up with high out-of-pocket expenses when they do seek medical care. Without insurance, immigrants will \u003ca href=\"https://www.kff.org/racial-equity-and-health-policy/fact-sheet/key-facts-on-health-coverage-of-immigrants/\">delay care\u003c/a> until their health condition is no longer tolerable or go without care entirely.\u003c/p>\n\u003cp>“We saw it all,” Anwar said, describing the years that followed Trump’s changes to public charge. “We saw patients not wanting to come in, not even for their appointments, thinking that just getting the services for their health care was going to affect them.”\u003c/p>\n\u003cp>People were also afraid to apply for benefits for their U.S.-born children, she added. “They even thought that that was going to affect them in some sort of way.”\u003c/p>\n\u003cp>In an election year, with former President Donald Trump again on the ballot, many undocumented immigrants are expressing concern about a return of the expanded public charge rules and how the government might use their information should they apply for Medi-Cal without legal status.\u003c/p>\n\u003cp>“They are afraid no matter what,” Azucena Espinoza, a senior \u003cem>promotora\u003c/em> with Monument Impact, explained in Spanish. “They say, ‘For what reason do they want all this information about us? So that tomorrow or the day after, they can use it [against us]?’ And they are right to feel that way because we know it could be Donald Trump. We don’t know what will happen, right?”\u003c/p>\n\u003cfigure id=\"attachment_12007440\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007440\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-scaled.jpg\" alt=\"A headshot of a woman wearing earrings and a drew with flower designs.\" width=\"1920\" height=\"2560\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-scaled.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-800x1067.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-1020x1360.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-160x213.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-1152x1536.jpg 1152w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-1536x2048.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Azucena Espinoza, a senior promotora at Monument Impact, registered walk-ins looking for help with their Medi-Cal application at Monument Impact’s offices in Antioch on Thursday, Sept. 5, 2024. \u003ccite>(Hiram Alejandro Durán for El Tímpano/CatchLight Local/Report for America corps member)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>The ‘chilling effect’\u003c/h2>\n\u003cp>The concept of public charge has existed in U.S. immigration policy for \u003ca href=\"https://www.kff.org/racial-equity-and-health-policy/issue-brief/2022-changes-to-the-public-charge-inadmissibility-rule-and-the-implications-for-health-care/\">more than a century\u003c/a>. From 1999 to 2019, the share of undocumented immigrants who could be considered a public charge was 3%, according to the \u003ca href=\"https://latino.ucla.edu/research/lessons-2022-adult-medical-expansion/\">UCLA Latino Policy and Politics Institute\u003c/a> (LPPI), because the number of social programs an unauthorized immigrant would need to use in order to be deemed a public charge was limited. When the Trump administration expanded that list to include more social programs, the share of undocumented immigrants who could be considered a public charge rose to 47%.\u003c/p>\n\u003cp>Applications for Medicaid immediately declined following the Trump administration’s changes to public charge, according to the UCLA researchers. They found that 17% of undocumented immigrants avoided any public benefits enrollment in 2019. Mixed-status households also avoided applying for public benefits for fear of jeopardizing their undocumented loved ones, or immigrant parents of U.S.-born children avoided signing their children up for health benefits for fear it would negatively impact the family’s position in the country.\u003c/p>\n\u003cp>Though the Trump administration’s changes were challenged in court and ultimately were reversed in 2021, UCLA researchers have found evidence that the “chilling effect” lingers years later. When, in 2023, the UCLA researchers began studying California’s expansion of Medi-Cal to undocumented immigrants, fear of public charge came up again.\u003c/p>\n\u003cp>“Immigration status continues to be a barrier for folks to enroll in Medi-Cal,” said Lucía Félix Beltrán, senior research fellow at LPPI. “There is still a fair amount of work to be done around public charge. That’s where partnering with community organizations comes in. But even then it’s like, these decisions are made at the household level. It doesn’t matter how many organizations get involved or how many flyers you give out or how many briefs you publish. These decisions are made within households and that’s where it gets kind of tricky.”\u003c/p>\n\u003cp>In a statement to El Tímpano, a California Department of Health Care Services spokesperson said the agency is “unable to speculate about the potential impact of future public charge rule changes.” They added, however, that “California law strictly protects personal information, including immigration status, ensuring confidentiality for all applicants. If an individual does not have satisfactory immigration status and applies for Medi-Cal, California does not share their immigration status with the federal government, and the federal government does not have access to state-owned data.”\u003c/p>\n\u003ch2>Changing minds\u003c/h2>\n\u003cp>Changing minds when the perceived risk is so high is a challenge for the nonprofits tasked with informing community members about Medi-Cal and public charge.\u003c/p>\n\u003cp>The DHCS website includes \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/SPAN-Medi-Cal-Expansion-FAQ.pdf\">information in Spanish\u003c/a> that reminds interested Medi-Cal applicants that their information will not be shared with federal immigration enforcement agencies. All dollars spent on the expansion of Medi-Cal to undocumented people come from state funding. Regardless, other than long-term institutionalized care paid for by the government—nursing home or mental health institution care are examples, according to \u003ca href=\"https://www.uscis.gov/green-card/green-card-processes-and-procedures/public-charge/public-charge-resources\">U.S. Citizenship and Immigration Services\u003c/a>—Medi-Cal is exempt from the public charge rule. (According to DHCS, short-term institutional care like rehabilitation, respite care or treatment for behavioral or substance use disorder issues are not considered subject to public charge review).\u003c/p>\n\u003cp>However, for advice on navigating public charge and Medi-Cal, DHCS said to speak to certified nonprofit organizations—the agency cannot directly answer questions on this topic. Among those certified nonprofits is the Multicultural Institute, which provides immigrant families with health, immigration and labor resources at their three locations across the Bay Area.\u003c/p>\n\u003cp>The blocks surrounding the Multicultural Institute in Berkeley are lined with day laborers, immigrant men looking for whatever work they can find in construction or other household jobs. Outreach workers from the organization spend mornings canvassing the blocks to talk to the men and see what they might need, whether it’s food from their pantry or Medi-Cal coverage.\u003c/p>\n\u003cp>“We don’t have any lawyers here, but we do our best” to address public charge questions, said Daniela Gonzalez-Perez, Health and Engagement Manager at the Multicultural Institute, who added that they do still often hear concerns, the aftermath of what life was like during the Trump administration.\u003c/p>\n\u003cfigure id=\"attachment_12007438\" class=\"wp-caption aligncenter\" style=\"max-width: 2560px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007438\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-scaled.jpg\" alt=\"A woman with glasses and a white flowery shirt stands outside near plants.\" width=\"2560\" height=\"1703\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-800x532.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-1536x1022.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-2048x1363.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-1920x1277.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Daniela Gonzalez-Perez, Health and Engagement Manager at the Multicultural Institute says the community of immigrant families and individuals they serve worry about another Trump Administration, photographed on Thursday, Aug. 15, 2024. \u003ccite>(Hiram Alejandro Durán for El Tímpano/CatchLight Local/Report for America corps member)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>There was “a lot of fear of deportation, you know, just a fear of the reality that we were living in under Trump’s America and his hate or disdain for the immigrant community,” she said. “There’s a lot of uncertainty still of what would actually happen if they apply for benefits…If they are super, super concerned then we would refer them out to a partner organization that handles immigration cases.”\u003c/p>\n\u003cp>What many health and immigrant advocates hear frequently, according to interviews with El Tímpano, is that undocumented immigrants will avoid public benefits and delay seeing a doctor or medical professional for years, until their needs are dire and have to go to an emergency room.[aside postID=\"news_11998034,news_11991442\" label=\"Related Stories\"]\u003c/p>\n\u003cp>“There are people out there who said…that immigrants use way too much public benefits and it’s just not true based on the numbers,” said Valerie Lacarte, a senior policy analyst with the Migration Policy Institute who studied immigrant participation in government programs like Medicaid. When comparing low-income U.S. citizens with low-income non-citizens, usage of public benefits dips. In the vast majority of the U.S., most undocumented immigrants do not qualify for Medicaid—California is an exception. However, when comparing the U.S.-born low-income population and immigrants who are federally eligible for Medicaid, participation in the program was at 76% for citizens and 66% for non-citizens, \u003ca href=\"https://www.migrationpolicy.org/sites/default/files/publications/mpi-hsi_medicaid-brief_final.pdf\">according to MPI\u003c/a>. Fears of participating in government programs may depress participation, the researchers found.\u003c/p>\n\u003cp>Helping undocumented immigrants in California overcome that fear can be an uphill battle for the \u003cem>promotoras\u003c/em> tasked with connecting their community with Medi-Cal.\u003c/p>\n\u003cp>“There was a man who we were trying to get to sign up for Medi-Cal, and he said no because Trump will just take it away,” Robles said in Spanish, laughing about it with Peralta in front of the La Superior grocery store in Pittsburgh.\u003c/p>\n\u003cp>“Little by little, people start trusting us since they’ll see us so often,” she added. “At first it was like no one wanted to [enroll], like they didn’t trust us much. But now, since we’re out here so often…people will recognize us, and they’ll say, ‘Oh, you are the women from Medi-Cal’—they’ll recognize us and start sharing their problems.”\u003c/p>\n\u003cfigure id=\"attachment_12007442\" class=\"wp-caption aligncenter\" style=\"max-width: 2560px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007442\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-scaled.jpg\" alt=\"Two women wearing black t-shirts and hats talk to two men outside a building as another man walks past pushing a shopping cart.\" width=\"2560\" height=\"1703\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-800x532.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-1536x1022.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-2048x1363.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-1920x1277.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Mireya Robles and her colleague Judith Peralta distribute information to Spanish-speaking Latinos outside of La Superior Mercados in Pittsburg on Thursday, Sept. 5, 2024. Robles and her colleague listened to stories of personal health concerns, employment and income to help people determine what the best possible route to attaining health care coverage looks like in their individual situation. \u003ccite>(Hiram Alejandro Durán for El Tímpano/CatchLight Local/Report for America corps member)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Robles, herself undocumented, recently obtained Medi-Cal this year through the latest expansion of the program. She’ll often share her own experience with people who express fear over public charge.\u003c/p>\n\u003cp>“We’re here to convince them,” she said. “Look, this is very important for you, for your health…This doesn’t hurt, on the contrary, it helps.”\u003c/p>\n\u003cp>In many cases, their efforts are successful. A few miles away at the Monument Impact office in Antioch, Espinoza, the senior \u003cem>promotora\u003c/em> for the organization, helps to organize the day’s appointments for immigrants to sit with a member of the team and work on their Medi-Cal application together. Some of the people in the waiting room are walk-ins.\u003c/p>\n\u003cp>“There are some people who cannot be convinced,” Espinoza said, “but others can be.”\u003c/p>\n\u003cp>By the end of the day, 13 new people were enrolled in Medi-Cal.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Jasmine Aguilera is participating in the Journalism & Women Symposium’s Health Journalism Fellowship, supported by The Commonwealth Fund.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Though the restrictive Trump-era public charge rule is no longer in place, it’s left people wary of signing up for newly expanded health benefits.",
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"title": "More California Immigrants Are Eligible For Medi-Cal, but Some Are Hesitant to Enroll | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ci data-stringify-type=\"italic\">This story was produced by \u003ca href=\"https://www.eltimpano.org\">El Tímpano\u003c/a>\u003c/i>\u003ci data-stringify-type=\"italic\">, a bilingual nonprofit news outlet that amplifies the voices of Latino and Mayan immigrants in Oakland and the wider Bay Area. The original version of the story can be found \u003ca href=\"https://www.eltimpano.org/health/lingering-fears-over-past-immigration-policies-are-fueling-a-reluctance-to-enroll-in-medi-cal\">here\u003c/a>\u003c/i>\u003ci data-stringify-type=\"italic\">.\u003c/i>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">O\u003c/span>\u003c/p>\u003cp>n a bright and early morning in Pittsburg, two women position themselves tactically outside the La Superior Mercados between the extra-large charcoal grill for roasting chicken and the rows of yellow-trimmed grocery carts. The supermarket is frequented by the area’s Latino community and anyone trying to get in or out this morning must pass the women first and hear their sales pitch. Their product should be easy to sell: free to low-cost health insurance for people with low incomes. But often, a surprising answer to their question, “Can we sign you up for Medi-Cal?” is “no.”\u003c/p>\n\u003cp>The list of benefits a patient can receive with full-scope Medi-Cal for free or at low cost includes emergency services, maternity care, mental health and substance use disorder services, pediatric care, and more, the women explain to passers-by. Their enrollment services are offered for free through Monument Impact, a nonprofit organization in Contra Costa County that helps connect low-income immigrants to resources, they remind folks. Still, several of the shoppers, mostly Spanish-speaking Latinos, look at the women with skepticism as they make their pitch.\u003c/p>\n\u003cp>Medi-Cal expanded to include all qualifying adults regardless of immigration status in January 2024. This year’s expansion was the final phase of an eight-year effort to extend Medi-Cal to undocumented immigrants, first to children and pregnant women, then to children under 19, to young adults under 26, and to older adults over 50, as part of the state’s initiative to expand health care access to all Californians. The UC Berkeley Labor Center \u003ca href=\"https://laborcenter.berkeley.edu/californias-uninsured-in-2024/\">estimates\u003c/a> that close to one million undocumented Californians will have gained access to Medi-Cal through this expansion.\u003c/p>\n\u003cp>Judith Peralta and Mireya Robles said that at the start of the year, it was no problem engaging folks and encouraging them to sign up for the program. As \u003cem>promotoras de salud\u003c/em>, health promoters, Peralta and Robles serve as trusted messengers to connect their community to limited health insurance options available to low-income immigrants.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The first few months of the year, the women saw a rush to apply for Medi-Cal—hundreds of people in the community were ready to enroll. But in recent months, they’ve found convincing people to sign up more challenging. Many of the people they encounter either already have Medi-Cal, know they don’t meet the income requirements to qualify for the program, or, in many cases, brush them off with a kind but adamant “no.” They’re afraid of Medi-Cal, the women say.\u003c/p>\n\u003cp>“It’s often men who have more fear, they’ll tell us ‘no, no,’” Peralta said in Spanish. “Like they’ll say it has something to do with immigration or it has to do with the government. Like they don’t want to give their name.”\u003c/p>\n\u003cp>Distrust of government has long run deep in Latino immigrant communities but reached a low point in 2019. That’s when the Trump administration announced that using certain government benefits could prevent undocumented immigrants from ever qualifying for legal status. The Trump administration leaned on a category known as a “\u003ca href=\"https://www.uscis.gov/green-card/green-card-processes-and-procedures/public-charge/public-charge-resources\">public charge\u003c/a>” to institute these changes. A public charge is an unauthorized immigrant who is likely to become dependent on government benefits. A designation of public charge jeopardizes an immigrant’s chances of securing legal status in the U.S. Before 2019, only using cash assistance for income like Temporary Assistance for Needy Families or needing long-term institutionalized care paid for by the government meant risking a designation of public charge from an immigration official.\u003c/p>\n\u003cp>The Trump administration expanded public charge to include Medicaid, the Supplemental Nutrition Assistance Program, housing assistance, energy assistance, child-care subsidies, and other benefits, according to the Migration Policy Institute, a nonpartisan research organization. Overnight, what was once an obscure set of bureaucratic rules became a household concern.\u003c/p>\n\u003cfigure id=\"attachment_12007441\" class=\"wp-caption aligncenter\" style=\"max-width: 2560px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007441\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-scaled.jpg\" alt=\"Three women sit at a table together in a building with a man sitting in a chair across from them.\" width=\"2560\" height=\"1703\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-800x532.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-1536x1022.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-2048x1363.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-1920x1277.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Azucena Espinoza, a senior promotora at Monument Impact, registered walk-ins looking for help with their Medi-Cal application at Monument Impact’s offices in Antioch on Thursday, Sept. 5, 2024. \u003ccite>(Hiram Alejandro Durán for El Tímpano/CatchLight Local/Report for America corps member)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Before 2019, “I actually had no clue of even the words ‘public charge,’” said Janet Anwar, registration services manager at Tiburcio Vasquez Health Center, a nonprofit East Bay health clinic. “It wasn’t a common word in our community, not until then. It brought a lot of concerns to our patients because there was a lot of miscommunication as to what was public charge, how it impacts immigration cases.”\u003c/p>\n\u003cp>Though the Trump public charge rules were only in effect for a short period and were reversed officially at the start of the Biden administration, researchers and immigrant advocates said the changes caused a long-lasting “chilling effect.” Experts say the Trump 2024 campaign has so far not mentioned public charge in its immigration agenda, but undocumented immigrants in California remain afraid, and that fear is preventing people from applying for the newly expanded Medi-Cal benefits.\u003c/p>\n\u003cp>This better-safe-than-sorry mindset means that undocumented immigrants may go years without seeing a medical professional or end up with high out-of-pocket expenses when they do seek medical care. Without insurance, immigrants will \u003ca href=\"https://www.kff.org/racial-equity-and-health-policy/fact-sheet/key-facts-on-health-coverage-of-immigrants/\">delay care\u003c/a> until their health condition is no longer tolerable or go without care entirely.\u003c/p>\n\u003cp>“We saw it all,” Anwar said, describing the years that followed Trump’s changes to public charge. “We saw patients not wanting to come in, not even for their appointments, thinking that just getting the services for their health care was going to affect them.”\u003c/p>\n\u003cp>People were also afraid to apply for benefits for their U.S.-born children, she added. “They even thought that that was going to affect them in some sort of way.”\u003c/p>\n\u003cp>In an election year, with former President Donald Trump again on the ballot, many undocumented immigrants are expressing concern about a return of the expanded public charge rules and how the government might use their information should they apply for Medi-Cal without legal status.\u003c/p>\n\u003cp>“They are afraid no matter what,” Azucena Espinoza, a senior \u003cem>promotora\u003c/em> with Monument Impact, explained in Spanish. “They say, ‘For what reason do they want all this information about us? So that tomorrow or the day after, they can use it [against us]?’ And they are right to feel that way because we know it could be Donald Trump. We don’t know what will happen, right?”\u003c/p>\n\u003cfigure id=\"attachment_12007440\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007440\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-scaled.jpg\" alt=\"A headshot of a woman wearing earrings and a drew with flower designs.\" width=\"1920\" height=\"2560\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-scaled.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-800x1067.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-1020x1360.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-160x213.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-1152x1536.jpg 1152w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-1536x2048.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Azucena Espinoza, a senior promotora at Monument Impact, registered walk-ins looking for help with their Medi-Cal application at Monument Impact’s offices in Antioch on Thursday, Sept. 5, 2024. \u003ccite>(Hiram Alejandro Durán for El Tímpano/CatchLight Local/Report for America corps member)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>The ‘chilling effect’\u003c/h2>\n\u003cp>The concept of public charge has existed in U.S. immigration policy for \u003ca href=\"https://www.kff.org/racial-equity-and-health-policy/issue-brief/2022-changes-to-the-public-charge-inadmissibility-rule-and-the-implications-for-health-care/\">more than a century\u003c/a>. From 1999 to 2019, the share of undocumented immigrants who could be considered a public charge was 3%, according to the \u003ca href=\"https://latino.ucla.edu/research/lessons-2022-adult-medical-expansion/\">UCLA Latino Policy and Politics Institute\u003c/a> (LPPI), because the number of social programs an unauthorized immigrant would need to use in order to be deemed a public charge was limited. When the Trump administration expanded that list to include more social programs, the share of undocumented immigrants who could be considered a public charge rose to 47%.\u003c/p>\n\u003cp>Applications for Medicaid immediately declined following the Trump administration’s changes to public charge, according to the UCLA researchers. They found that 17% of undocumented immigrants avoided any public benefits enrollment in 2019. Mixed-status households also avoided applying for public benefits for fear of jeopardizing their undocumented loved ones, or immigrant parents of U.S.-born children avoided signing their children up for health benefits for fear it would negatively impact the family’s position in the country.\u003c/p>\n\u003cp>Though the Trump administration’s changes were challenged in court and ultimately were reversed in 2021, UCLA researchers have found evidence that the “chilling effect” lingers years later. When, in 2023, the UCLA researchers began studying California’s expansion of Medi-Cal to undocumented immigrants, fear of public charge came up again.\u003c/p>\n\u003cp>“Immigration status continues to be a barrier for folks to enroll in Medi-Cal,” said Lucía Félix Beltrán, senior research fellow at LPPI. “There is still a fair amount of work to be done around public charge. That’s where partnering with community organizations comes in. But even then it’s like, these decisions are made at the household level. It doesn’t matter how many organizations get involved or how many flyers you give out or how many briefs you publish. These decisions are made within households and that’s where it gets kind of tricky.”\u003c/p>\n\u003cp>In a statement to El Tímpano, a California Department of Health Care Services spokesperson said the agency is “unable to speculate about the potential impact of future public charge rule changes.” They added, however, that “California law strictly protects personal information, including immigration status, ensuring confidentiality for all applicants. If an individual does not have satisfactory immigration status and applies for Medi-Cal, California does not share their immigration status with the federal government, and the federal government does not have access to state-owned data.”\u003c/p>\n\u003ch2>Changing minds\u003c/h2>\n\u003cp>Changing minds when the perceived risk is so high is a challenge for the nonprofits tasked with informing community members about Medi-Cal and public charge.\u003c/p>\n\u003cp>The DHCS website includes \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/SPAN-Medi-Cal-Expansion-FAQ.pdf\">information in Spanish\u003c/a> that reminds interested Medi-Cal applicants that their information will not be shared with federal immigration enforcement agencies. All dollars spent on the expansion of Medi-Cal to undocumented people come from state funding. Regardless, other than long-term institutionalized care paid for by the government—nursing home or mental health institution care are examples, according to \u003ca href=\"https://www.uscis.gov/green-card/green-card-processes-and-procedures/public-charge/public-charge-resources\">U.S. Citizenship and Immigration Services\u003c/a>—Medi-Cal is exempt from the public charge rule. (According to DHCS, short-term institutional care like rehabilitation, respite care or treatment for behavioral or substance use disorder issues are not considered subject to public charge review).\u003c/p>\n\u003cp>However, for advice on navigating public charge and Medi-Cal, DHCS said to speak to certified nonprofit organizations—the agency cannot directly answer questions on this topic. Among those certified nonprofits is the Multicultural Institute, which provides immigrant families with health, immigration and labor resources at their three locations across the Bay Area.\u003c/p>\n\u003cp>The blocks surrounding the Multicultural Institute in Berkeley are lined with day laborers, immigrant men looking for whatever work they can find in construction or other household jobs. Outreach workers from the organization spend mornings canvassing the blocks to talk to the men and see what they might need, whether it’s food from their pantry or Medi-Cal coverage.\u003c/p>\n\u003cp>“We don’t have any lawyers here, but we do our best” to address public charge questions, said Daniela Gonzalez-Perez, Health and Engagement Manager at the Multicultural Institute, who added that they do still often hear concerns, the aftermath of what life was like during the Trump administration.\u003c/p>\n\u003cfigure id=\"attachment_12007438\" class=\"wp-caption aligncenter\" style=\"max-width: 2560px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007438\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-scaled.jpg\" alt=\"A woman with glasses and a white flowery shirt stands outside near plants.\" width=\"2560\" height=\"1703\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-800x532.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-1536x1022.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-2048x1363.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-1920x1277.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Daniela Gonzalez-Perez, Health and Engagement Manager at the Multicultural Institute says the community of immigrant families and individuals they serve worry about another Trump Administration, photographed on Thursday, Aug. 15, 2024. \u003ccite>(Hiram Alejandro Durán for El Tímpano/CatchLight Local/Report for America corps member)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>There was “a lot of fear of deportation, you know, just a fear of the reality that we were living in under Trump’s America and his hate or disdain for the immigrant community,” she said. “There’s a lot of uncertainty still of what would actually happen if they apply for benefits…If they are super, super concerned then we would refer them out to a partner organization that handles immigration cases.”\u003c/p>\n\u003cp>What many health and immigrant advocates hear frequently, according to interviews with El Tímpano, is that undocumented immigrants will avoid public benefits and delay seeing a doctor or medical professional for years, until their needs are dire and have to go to an emergency room.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“There are people out there who said…that immigrants use way too much public benefits and it’s just not true based on the numbers,” said Valerie Lacarte, a senior policy analyst with the Migration Policy Institute who studied immigrant participation in government programs like Medicaid. When comparing low-income U.S. citizens with low-income non-citizens, usage of public benefits dips. In the vast majority of the U.S., most undocumented immigrants do not qualify for Medicaid—California is an exception. However, when comparing the U.S.-born low-income population and immigrants who are federally eligible for Medicaid, participation in the program was at 76% for citizens and 66% for non-citizens, \u003ca href=\"https://www.migrationpolicy.org/sites/default/files/publications/mpi-hsi_medicaid-brief_final.pdf\">according to MPI\u003c/a>. Fears of participating in government programs may depress participation, the researchers found.\u003c/p>\n\u003cp>Helping undocumented immigrants in California overcome that fear can be an uphill battle for the \u003cem>promotoras\u003c/em> tasked with connecting their community with Medi-Cal.\u003c/p>\n\u003cp>“There was a man who we were trying to get to sign up for Medi-Cal, and he said no because Trump will just take it away,” Robles said in Spanish, laughing about it with Peralta in front of the La Superior grocery store in Pittsburgh.\u003c/p>\n\u003cp>“Little by little, people start trusting us since they’ll see us so often,” she added. “At first it was like no one wanted to [enroll], like they didn’t trust us much. But now, since we’re out here so often…people will recognize us, and they’ll say, ‘Oh, you are the women from Medi-Cal’—they’ll recognize us and start sharing their problems.”\u003c/p>\n\u003cfigure id=\"attachment_12007442\" class=\"wp-caption aligncenter\" style=\"max-width: 2560px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007442\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-scaled.jpg\" alt=\"Two women wearing black t-shirts and hats talk to two men outside a building as another man walks past pushing a shopping cart.\" width=\"2560\" height=\"1703\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-800x532.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-1536x1022.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-2048x1363.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-1920x1277.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Mireya Robles and her colleague Judith Peralta distribute information to Spanish-speaking Latinos outside of La Superior Mercados in Pittsburg on Thursday, Sept. 5, 2024. Robles and her colleague listened to stories of personal health concerns, employment and income to help people determine what the best possible route to attaining health care coverage looks like in their individual situation. \u003ccite>(Hiram Alejandro Durán for El Tímpano/CatchLight Local/Report for America corps member)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Robles, herself undocumented, recently obtained Medi-Cal this year through the latest expansion of the program. She’ll often share her own experience with people who express fear over public charge.\u003c/p>\n\u003cp>“We’re here to convince them,” she said. “Look, this is very important for you, for your health…This doesn’t hurt, on the contrary, it helps.”\u003c/p>\n\u003cp>In many cases, their efforts are successful. A few miles away at the Monument Impact office in Antioch, Espinoza, the senior \u003cem>promotora\u003c/em> for the organization, helps to organize the day’s appointments for immigrants to sit with a member of the team and work on their Medi-Cal application together. Some of the people in the waiting room are walk-ins.\u003c/p>\n\u003cp>“There are some people who cannot be convinced,” Espinoza said, “but others can be.”\u003c/p>\n\u003cp>By the end of the day, 13 new people were enrolled in Medi-Cal.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Jasmine Aguilera is participating in the Journalism & Women Symposium’s Health Journalism Fellowship, supported by The Commonwealth Fund.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "california-open-to-resolving-suit-against-catholic-hospital-over-emergency-abortion-care",
"title": "California Open to Resolving Suit Against Catholic Hospital Over Emergency Abortion Care",
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"content": "\u003cp>The state’s Department of Justice on Wednesday appeared to suggest it was open to settling its lawsuit against a Catholic hospital in \u003ca href=\"https://www.kqed.org/news/tag/northern-california\">Northern California\u003c/a> accused of denying a pregnant woman emergency abortion care.\u003c/p>\n\u003cp>Attorney General Rob Bonta announced the \u003ca href=\"https://www.kqed.org/news/12007119/california-sues-a-catholic-hospital-for-denying-patient-an-emergency-abortion\">lawsuit\u003c/a> on Monday, alleging that policy at Providence St. Joseph Hospital in Eureka prevented doctors from performing a potentially life-saving emergency abortion on Dr. Anna Nusslock, who was 15 weeks pregnant with twins when her water broke, so long as “fetal heart tones” were present.\u003c/p>\n\u003cp>Garry Olney, chief executive for Providence’s Northern California service area, apologized in a statement to employees, saying Nusslock’s treatment did not meet Providence’s “high standards for safe, quality, compassionate care.” A spokesperson pointed to the Catholic Church’s U.S. health care directives that allow for “operations, treatments, and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman” that cannot be safely postponed until the child is viable, “even if they will result in the death of the unborn child.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We are immediately revisiting our training, education and escalation processes in emergency medical situations to ensure that this does not happen again and to ensure that our care teams have the training and support they need to deliver the best possible care for each patient we serve,” Olney’s message reads.\u003c/p>\n\u003cp>The hospital did not clarify whether it has a policy that bans medical intervention when a fetal heartbeat can be detected unless the patient’s life is sufficiently at risk. According to the lawsuit, a doctor at Providence St. Joseph told Nusslock that she could not perform an in-clinic abortion procedure known as dilation and evacuation unless Nusslock’s life was at risk, nor could she induce contractions with misoprostol while the fetuses still had a heartbeat.\u003c/p>\n\u003cp>“If Providence is committed to changing its policies to comply with the law and ensuring this never happens again, our office is prepared to work constructively with them to resolve this litigation and to protect patients,” a spokesperson for the California Department of Justice said.\u003c/p>\n\u003cp>According to the lawsuit, Nusslock was experiencing contractions and bleeding and was told that her twins would not survive — and that her health would also be at risk if she did not receive an emergency abortion. But a Providence St. Joseph doctor, the suit alleges, told Nusslock the only care she could provide was expectant management or closely monitoring her symptoms for changes that would allow intervention. She suggested that Nusslock travel to another hospital to receive care.\u003c/p>\n\u003cp>[aside postID=news_12007157 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/GavinNewsomAP2-1020x680.jpg']\u003c/p>\n\u003cp>Nusslock ultimately drove — with towels and buckets, “in case something happen[ed] in the car” — to Mad River Community Hospital 12 miles away in Arcata, where a doctor performed an emergency abortion. They said Nusslock was “actively hemorrhaging” on the operating table.\u003c/p>\n\u003cp>The suit claims that though Providence “will ostensibly intervene” if a pregnant patient is “on the verge of death,” California law requires that, as a licensed facility, it must act in the event of serious injury or illness as well. It also alleges that Providence discriminates against pregnant patients by not giving them comprehensive emergency care as it would others.\u003c/p>\n\u003cp>The attorney general’s office said it believes that others might have had experiences similar to Nusslock, and is asking that they share their experiences with the Department of Justice.\u003c/p>\n\u003cp>“We don’t yet know the full scope of this problem or how many patients have suffered, but we do know that unless we act, this will happen again and again,” Bonta said.\u003c/p>\n\u003cp>He asked the court to issue an injunction prohibiting the hospital and its affiliates from violating the state laws it says required them to provide Nusslock with care, along with requiring them to pay monetary damages.\u003c/p>\n\u003cp>“Even in California, a champion for reproductive freedom, we are not immune from practices like the one we’re seeing today, and we will not stand by as it occurs,” Bonta said during a press conference on Monday. “We will take action as we’re doing today and move to end it immediately.”\u003c/p>\n\u003cp>\u003cem>KQED’s \u003ca href=\"https://www.kqed.org/author/carlysevern\">Carly Severn\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>The state’s Department of Justice on Wednesday appeared to suggest it was open to settling its lawsuit against a Catholic hospital in \u003ca href=\"https://www.kqed.org/news/tag/northern-california\">Northern California\u003c/a> accused of denying a pregnant woman emergency abortion care.\u003c/p>\n\u003cp>Attorney General Rob Bonta announced the \u003ca href=\"https://www.kqed.org/news/12007119/california-sues-a-catholic-hospital-for-denying-patient-an-emergency-abortion\">lawsuit\u003c/a> on Monday, alleging that policy at Providence St. Joseph Hospital in Eureka prevented doctors from performing a potentially life-saving emergency abortion on Dr. Anna Nusslock, who was 15 weeks pregnant with twins when her water broke, so long as “fetal heart tones” were present.\u003c/p>\n\u003cp>Garry Olney, chief executive for Providence’s Northern California service area, apologized in a statement to employees, saying Nusslock’s treatment did not meet Providence’s “high standards for safe, quality, compassionate care.” A spokesperson pointed to the Catholic Church’s U.S. health care directives that allow for “operations, treatments, and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman” that cannot be safely postponed until the child is viable, “even if they will result in the death of the unborn child.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We are immediately revisiting our training, education and escalation processes in emergency medical situations to ensure that this does not happen again and to ensure that our care teams have the training and support they need to deliver the best possible care for each patient we serve,” Olney’s message reads.\u003c/p>\n\u003cp>The hospital did not clarify whether it has a policy that bans medical intervention when a fetal heartbeat can be detected unless the patient’s life is sufficiently at risk. According to the lawsuit, a doctor at Providence St. Joseph told Nusslock that she could not perform an in-clinic abortion procedure known as dilation and evacuation unless Nusslock’s life was at risk, nor could she induce contractions with misoprostol while the fetuses still had a heartbeat.\u003c/p>\n\u003cp>“If Providence is committed to changing its policies to comply with the law and ensuring this never happens again, our office is prepared to work constructively with them to resolve this litigation and to protect patients,” a spokesperson for the California Department of Justice said.\u003c/p>\n\u003cp>According to the lawsuit, Nusslock was experiencing contractions and bleeding and was told that her twins would not survive — and that her health would also be at risk if she did not receive an emergency abortion. But a Providence St. Joseph doctor, the suit alleges, told Nusslock the only care she could provide was expectant management or closely monitoring her symptoms for changes that would allow intervention. She suggested that Nusslock travel to another hospital to receive care.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Nusslock ultimately drove — with towels and buckets, “in case something happen[ed] in the car” — to Mad River Community Hospital 12 miles away in Arcata, where a doctor performed an emergency abortion. They said Nusslock was “actively hemorrhaging” on the operating table.\u003c/p>\n\u003cp>The suit claims that though Providence “will ostensibly intervene” if a pregnant patient is “on the verge of death,” California law requires that, as a licensed facility, it must act in the event of serious injury or illness as well. It also alleges that Providence discriminates against pregnant patients by not giving them comprehensive emergency care as it would others.\u003c/p>\n\u003cp>The attorney general’s office said it believes that others might have had experiences similar to Nusslock, and is asking that they share their experiences with the Department of Justice.\u003c/p>\n\u003cp>“We don’t yet know the full scope of this problem or how many patients have suffered, but we do know that unless we act, this will happen again and again,” Bonta said.\u003c/p>\n\u003cp>He asked the court to issue an injunction prohibiting the hospital and its affiliates from violating the state laws it says required them to provide Nusslock with care, along with requiring them to pay monetary damages.\u003c/p>\n\u003cp>“Even in California, a champion for reproductive freedom, we are not immune from practices like the one we’re seeing today, and we will not stand by as it occurs,” Bonta said during a press conference on Monday. “We will take action as we’re doing today and move to end it immediately.”\u003c/p>\n\u003cp>\u003cem>KQED’s \u003ca href=\"https://www.kqed.org/author/carlysevern\">Carly Severn\u003c/a> contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/california\">California\u003c/a> is forging ahead with a series of new laws aimed at reducing overdose deaths, even as opioid overdose rates have started to decline slightly. The new measures signed by Gov. \u003ca href=\"https://www.kqed.org/news/tag/gavin-newsom\">Gavin Newsom\u003c/a> this week include expanded access to addiction treatment, life-saving overdose reversal medications, and more.\u003c/p>\n\u003cp>“California legislators have shown a serious commitment to addressing the fentanyl crisis,” said Dr. Keith Humphreys, a professor of psychiatry and behavioral sciences at Stanford University. While deaths remain higher than pre-pandemic levels, \u003ca href=\"https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm\">the Centers for Disease Control and Prevention\u003c/a> reports that fatal overdoses across the country have dropped to their lowest numbers in three years. California is just beginning to see a \u003ca href=\"https://skylab.cdph.ca.gov/ODdash/?tab=CA\">downward trend\u003c/a>.\u003c/p>\n\u003cp>The reasons for this shift remain unclear. “Why? The best answer is, ‘We don’t know,'” said Dr. Dan Ciccarone, a professor of addiction medicine at UCSF. “People will point to different interventions, whether it’s restoring public order, increasing access to naloxone, or expanding treatment options, but none of these happened swiftly or broadly enough to fully explain the drop.”\u003c/p>\n\u003cp>Fentanyl, the inexpensive opioid that’s 20–40 times stronger than heroin, has \u003ca href=\"https://www.kqed.org/news/11972898/2023-was-san-franciscos-deadliest-year-for-drug-overdoses-new-data-confirms\">flooded the drug market in San Francisco\u003c/a> and other cities in recent years, leading to record deaths.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It’s not just about one law — it’s a coordinated suite of policies focused on prevention, treatment, and harm reduction. As both an addiction researcher and a resident, I feel California is moving in the right direction,” Humphreys said.\u003c/p>\n\u003cp>Among the newly signed bills is \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240AB1842\">AB 1842\u003c/a>, which eliminates the need for insurers to require prior authorization before treating patients with opioid use disorder. Ciccarone called it a critical move, describing prior authorization as “a clinical barrier that frustrates both doctors and patients and ultimately stifles care.”\u003c/p>\n\u003cfigure id=\"attachment_11998108\" class=\"wp-caption aligncenter\" style=\"max-width: 1999px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11998108\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed.jpg\" alt=\"\" width=\"1999\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed.jpg 1999w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 1999px) 100vw, 1999px\">\u003cfigcaption class=\"wp-caption-text\">Contents of a harm reduction kit on June 17, 2024. The kit includes new syringes, fentanyl test strips and Narcan. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Another key piece of legislation, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB1976\">AB 1976\u003c/a>, will require businesses to stock naloxone, a medication that can instantly reverse opioid overdoses, in their first-aid kits by 2027. Meanwhile, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB1841\">AB 1841\u003c/a> will provide two doses of naloxone to resident advisors at public colleges in California.\u003c/p>\n\u003cp>Access to methadone, a medication used to treat opioid addiction, will also be broadened under \u003ca href=\"https://www.kqed.org/science/1992298/a-bay-area-lawmaker-pushes-to-expand-access-to-methadone\">AB 2115\u003c/a>, which allows patients to take home more doses and increases the number of practitioners permitted to prescribe it. Current regulations require most patients to visit clinics daily to receive a single dose.\u003c/p>\n\u003cp>“I support most of these bills and believe each will contribute in small but meaningful ways,” Ciccarone said. He singled out the elimination of prior authorization requirements as particularly impactful and praised the expansion of naloxone access into schools and workplaces as “a great package of ideas.”\u003c/p>\n\u003cp>Yet, Ciccarone noted the absence of a more controversial measure: supervised drug consumption sites, where individuals can use illicit drugs under the supervision of trained staff. \u003ca href=\"https://www.kqed.org/science/1979220/debate-heats-up-over-effort-to-pilot-safe-injection-sites-in-california\">Research\u003c/a> shows that such sites reduce hospitalizations, lower public costs, and save lives. Gov. Newsom vetoed a bill in 2022 that would have allowed a limited number of California cities to pilot these facilities.\u003c/p>\n\u003cp>[aside postID=news_12006134 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS57150_037_KQED_DABrookeJenkins_07072022-qut-1020x680.jpg']\u003c/p>\n\u003cp>“The most effective solutions are often the ones people fear the most,” Ciccarone said. “What we need now is the courage and political will to take bolder steps.”\u003c/p>\n\u003cp>Another critical policy gap, according to Humphreys, is the failure to pass a \u003ca href=\"https://legiscan.com/CA/text/AB3073/id/2966699\">bill\u003c/a> that would have mandated wastewater testing for illicit drugs. This measure died in committee earlier this year.\u003c/p>\n\u003cp>“Wastewater testing reveals where drugs are being used and what’s circulating in the community,” Humphreys said. “It’s an early warning system for dangerous substances, and it also shows whether investments in treatment, prevention, and law enforcement are actually making a difference.”\u003c/p>\n\u003cp>Last year, 7,748 Californians died from fentanyl overdoses, more than double the number just five years ago, according to the CDC. While the new laws represent significant progress, addiction experts caution that the road to reversing the opioid crisis remains long.\u003c/p>\n\u003cp>Several additional bills signed by Newsom are aimed at curbing fentanyl use and saving lives:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>AB 2429\u003c/strong>: Expands high school health education to include lessons on the dangers of fentanyl use.\u003c/li>\n\u003cli>\u003cstrong>AB 2136\u003c/strong>: Prevents law enforcement from arresting individuals who allow harm reduction service providers to test their drugs.\u003c/li>\n\u003cli>\u003cstrong>SB 997\u003c/strong>: Authorizes middle and high school students to carry naloxone and requires schools to stock and distribute fentanyl test strips.\u003c/li>\n\u003cli>\u003cstrong>SB 908\u003c/strong>: Directs the state’s health department to investigate fentanyl-related deaths among children ages 0 to 5.\u003c/li>\n\u003cli>\u003cstrong>SB 1468\u003c/strong>: Encourages providers to prescribe a three-day supply of narcotic medication to begin detoxification or maintenance treatment for people using opioids.\u003c/li>\n\u003cli>\u003cstrong>SB 910\u003c/strong>: Enhances programming, drug testing, and medication-assisted treatment for individuals in the criminal justice system.\u003c/li>\n\u003c/ul>\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> is forging ahead with a series of new laws aimed at reducing overdose deaths, even as opioid overdose rates have started to decline slightly. The new measures signed by Gov. \u003ca href=\"https://www.kqed.org/news/tag/gavin-newsom\">Gavin Newsom\u003c/a> this week include expanded access to addiction treatment, life-saving overdose reversal medications, and more.\u003c/p>\n\u003cp>“California legislators have shown a serious commitment to addressing the fentanyl crisis,” said Dr. Keith Humphreys, a professor of psychiatry and behavioral sciences at Stanford University. While deaths remain higher than pre-pandemic levels, \u003ca href=\"https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm\">the Centers for Disease Control and Prevention\u003c/a> reports that fatal overdoses across the country have dropped to their lowest numbers in three years. California is just beginning to see a \u003ca href=\"https://skylab.cdph.ca.gov/ODdash/?tab=CA\">downward trend\u003c/a>.\u003c/p>\n\u003cp>The reasons for this shift remain unclear. “Why? The best answer is, ‘We don’t know,'” said Dr. Dan Ciccarone, a professor of addiction medicine at UCSF. “People will point to different interventions, whether it’s restoring public order, increasing access to naloxone, or expanding treatment options, but none of these happened swiftly or broadly enough to fully explain the drop.”\u003c/p>\n\u003cp>Fentanyl, the inexpensive opioid that’s 20–40 times stronger than heroin, has \u003ca href=\"https://www.kqed.org/news/11972898/2023-was-san-franciscos-deadliest-year-for-drug-overdoses-new-data-confirms\">flooded the drug market in San Francisco\u003c/a> and other cities in recent years, leading to record deaths.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It’s not just about one law — it’s a coordinated suite of policies focused on prevention, treatment, and harm reduction. As both an addiction researcher and a resident, I feel California is moving in the right direction,” Humphreys said.\u003c/p>\n\u003cp>Among the newly signed bills is \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240AB1842\">AB 1842\u003c/a>, which eliminates the need for insurers to require prior authorization before treating patients with opioid use disorder. Ciccarone called it a critical move, describing prior authorization as “a clinical barrier that frustrates both doctors and patients and ultimately stifles care.”\u003c/p>\n\u003cfigure id=\"attachment_11998108\" class=\"wp-caption aligncenter\" style=\"max-width: 1999px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11998108\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed.jpg\" alt=\"\" width=\"1999\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed.jpg 1999w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 1999px) 100vw, 1999px\">\u003cfigcaption class=\"wp-caption-text\">Contents of a harm reduction kit on June 17, 2024. The kit includes new syringes, fentanyl test strips and Narcan. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Another key piece of legislation, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB1976\">AB 1976\u003c/a>, will require businesses to stock naloxone, a medication that can instantly reverse opioid overdoses, in their first-aid kits by 2027. Meanwhile, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB1841\">AB 1841\u003c/a> will provide two doses of naloxone to resident advisors at public colleges in California.\u003c/p>\n\u003cp>Access to methadone, a medication used to treat opioid addiction, will also be broadened under \u003ca href=\"https://www.kqed.org/science/1992298/a-bay-area-lawmaker-pushes-to-expand-access-to-methadone\">AB 2115\u003c/a>, which allows patients to take home more doses and increases the number of practitioners permitted to prescribe it. Current regulations require most patients to visit clinics daily to receive a single dose.\u003c/p>\n\u003cp>“I support most of these bills and believe each will contribute in small but meaningful ways,” Ciccarone said. He singled out the elimination of prior authorization requirements as particularly impactful and praised the expansion of naloxone access into schools and workplaces as “a great package of ideas.”\u003c/p>\n\u003cp>Yet, Ciccarone noted the absence of a more controversial measure: supervised drug consumption sites, where individuals can use illicit drugs under the supervision of trained staff. \u003ca href=\"https://www.kqed.org/science/1979220/debate-heats-up-over-effort-to-pilot-safe-injection-sites-in-california\">Research\u003c/a> shows that such sites reduce hospitalizations, lower public costs, and save lives. Gov. Newsom vetoed a bill in 2022 that would have allowed a limited number of California cities to pilot these facilities.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The most effective solutions are often the ones people fear the most,” Ciccarone said. “What we need now is the courage and political will to take bolder steps.”\u003c/p>\n\u003cp>Another critical policy gap, according to Humphreys, is the failure to pass a \u003ca href=\"https://legiscan.com/CA/text/AB3073/id/2966699\">bill\u003c/a> that would have mandated wastewater testing for illicit drugs. This measure died in committee earlier this year.\u003c/p>\n\u003cp>“Wastewater testing reveals where drugs are being used and what’s circulating in the community,” Humphreys said. “It’s an early warning system for dangerous substances, and it also shows whether investments in treatment, prevention, and law enforcement are actually making a difference.”\u003c/p>\n\u003cp>Last year, 7,748 Californians died from fentanyl overdoses, more than double the number just five years ago, according to the CDC. While the new laws represent significant progress, addiction experts caution that the road to reversing the opioid crisis remains long.\u003c/p>\n\u003cp>Several additional bills signed by Newsom are aimed at curbing fentanyl use and saving lives:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>AB 2429\u003c/strong>: Expands high school health education to include lessons on the dangers of fentanyl use.\u003c/li>\n\u003cli>\u003cstrong>AB 2136\u003c/strong>: Prevents law enforcement from arresting individuals who allow harm reduction service providers to test their drugs.\u003c/li>\n\u003cli>\u003cstrong>SB 997\u003c/strong>: Authorizes middle and high school students to carry naloxone and requires schools to stock and distribute fentanyl test strips.\u003c/li>\n\u003cli>\u003cstrong>SB 908\u003c/strong>: Directs the state’s health department to investigate fentanyl-related deaths among children ages 0 to 5.\u003c/li>\n\u003cli>\u003cstrong>SB 1468\u003c/strong>: Encourages providers to prescribe a three-day supply of narcotic medication to begin detoxification or maintenance treatment for people using opioids.\u003c/li>\n\u003cli>\u003cstrong>SB 910\u003c/strong>: Enhances programming, drug testing, and medication-assisted treatment for individuals in the criminal justice system.\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>As parents and educators call for stricter lead regulations in \u003ca href=\"https://www.kqed.org/news/12002387/oakland-schools-official-calls-for-state-federal-help-after-lead-contamination-findings\">Oakland schools\u003c/a>, district directors worry about the budget needed to remediate the issue — which could cost more than $50 million at the high end of estimates.\u003c/p>\n\u003cp>The costs were discussed at a Monday special meeting of the Oakland school board and the City Council’s Education Partnership Committee, where officials said the district was making progress in installing safe drinking sources and testing water fixtures after over 185 water sources across 22 Oakland schools tested above district limits for lead ahead of this school year.\u003c/p>\n\u003cp>Some of the tests were done as far back as April, but school communities did not find out that their \u003ca href=\"https://www.kqed.org/news/12000525/water-at-22-oakland-schools-tested-high-for-lead-its-no-surprise-parents-and-teachers-say\">water sources were contaminated\u003c/a> until Aug. 12 — the first week of the school year for the Oakland Unified School District.\u003c/p>\n\u003cp>Since then, the district has repaired the fixtures where lead was detected, started a \u003ca href=\"https://www.kqed.org/news/12002005/oakland-schools-vow-to-step-up-lead-testing-but-teachers-arent-convinced\">tiered system to test all schools’ fixtures\u003c/a> by the end of the year, and installed new water bottle filling stations. However, in the longer term, it will need to decide how often to test which fixtures and what additional repairs might be necessary.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The district is currently estimating that full remediation could cost between $16 million and $53 million, OUSD Chief Systems and Services Officer Preston Thomas said during the meeting.\u003c/p>\n\u003cp>“It’s kind of scary how much it costs,” Councilmember Dan Kalb said. “Thirty, $40, $50 million — that’s scary because people are drinking this water.”\u003c/p>\n\u003cp>Frustrated families think the district should be doing more to address the problem. Nate Landry, whose daughter attends Edna Brewer Middle School, said installing additional Flowater bottle-filling systems is a good start but not enough.\u003c/p>\n\u003cp>[aside postID=news_12005223 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/230802-OAKLAND-CITY-HALL-MHN-02_qed-1020x680.jpg']\u003c/p>\n\u003cp>“We think that’s sort of somewhere between a Band-Aid and a suture. It’s not really the solution that we’re looking for,” Landry told KQED. They led a community rally outside the meeting to call on the district to meet a list of demands, including stricter parts-per-billion lead standards and better communication.\u003c/p>\n\u003cp>“What we’re looking for is not only accountability for why there was this complete sort of failure in communication, but also we’re looking for a comprehensive analysis of where the contamination points are at any given school site and how those will be addressed,” Landry said.\u003c/p>\n\u003cp>In the longer term, the district plans to analyze how extensive the remediation will need to be, but how it will pay for the work it identifies is unclear. Thomas said further testing would help OUSD determine where repairing the fixtures got rid of lead or where larger systems, like the pipes, might be the root of the problem.\u003c/p>\n\u003cp>“We are ongoing in testing every day as we speak right now, and then we will circle back to those schools at the end of this school year to do a second round of testing,” he said.\u003c/p>\n\u003cp>So far, the district has installed 50 of 60 new FloWater bottle-filling systems, which routinely test extremely low for lead, Thomas said at the meeting. All of the fixtures where lead was initially detected have been repaired and are awaiting retesting.\u003c/p>\n\u003cp>OUSD also has plans to install 88 more FloWater stations by the end of the year, aiming to have one water fountain per every 200 students on a school site. Installing the additional Flowater systems will cost an estimated $1.5 million, plus more than half a million to maintain annually.\u003c/p>\n\u003cp>The larger cost of remediation comes as Oakland and its school district are both dealing with budget deficits. School board Vice President Mike Hutchinson said there isn’t much money left unaccounted for in the budget set aside for facilities through recent bond measures.\u003c/p>\n\u003cp>District leaders at Monday’s meeting asked about using funds from a settlement initiated in 2019 between 10 cities and counties in California, including Oakland, and companies whose lead paint “poisons tens of thousands of children across California each year,” according to a press release, but Selia Warren, a deputy attorney at the Oakland city attorney’s office, said that money is required to be used for remediation efforts related to lead paint.\u003c/p>\n\u003cp>Kalb suggested a city staffer help the district with outreach to state and local agencies and applications for grants that have funding available for lead-related remediation. But the true cost won’t be known until at least the end of the year.\u003c/p>\n\u003cp>“We greatly need help and support from everyone,” Hutchinson said. “Both to make sure this short-term solution of Flowater systems is accessible and workable, but especially for the medium and long-term fix, which probably is going to involve repairs at some of our school sites that could become more extensive. … We don’t know what the cost is, but we have to take care of this immediately.”\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "Oakland and its school district both face budget deficits, raising worry about the cost of a long-term fix after water at 22 OUSD schools tested above district limits for lead.",
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"title": "Lead Problems in Oakland Schools’ Drinking Water Could Cost Over $50 Million to Fix | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>As parents and educators call for stricter lead regulations in \u003ca href=\"https://www.kqed.org/news/12002387/oakland-schools-official-calls-for-state-federal-help-after-lead-contamination-findings\">Oakland schools\u003c/a>, district directors worry about the budget needed to remediate the issue — which could cost more than $50 million at the high end of estimates.\u003c/p>\n\u003cp>The costs were discussed at a Monday special meeting of the Oakland school board and the City Council’s Education Partnership Committee, where officials said the district was making progress in installing safe drinking sources and testing water fixtures after over 185 water sources across 22 Oakland schools tested above district limits for lead ahead of this school year.\u003c/p>\n\u003cp>Some of the tests were done as far back as April, but school communities did not find out that their \u003ca href=\"https://www.kqed.org/news/12000525/water-at-22-oakland-schools-tested-high-for-lead-its-no-surprise-parents-and-teachers-say\">water sources were contaminated\u003c/a> until Aug. 12 — the first week of the school year for the Oakland Unified School District.\u003c/p>\n\u003cp>Since then, the district has repaired the fixtures where lead was detected, started a \u003ca href=\"https://www.kqed.org/news/12002005/oakland-schools-vow-to-step-up-lead-testing-but-teachers-arent-convinced\">tiered system to test all schools’ fixtures\u003c/a> by the end of the year, and installed new water bottle filling stations. However, in the longer term, it will need to decide how often to test which fixtures and what additional repairs might be necessary.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The district is currently estimating that full remediation could cost between $16 million and $53 million, OUSD Chief Systems and Services Officer Preston Thomas said during the meeting.\u003c/p>\n\u003cp>“It’s kind of scary how much it costs,” Councilmember Dan Kalb said. “Thirty, $40, $50 million — that’s scary because people are drinking this water.”\u003c/p>\n\u003cp>Frustrated families think the district should be doing more to address the problem. Nate Landry, whose daughter attends Edna Brewer Middle School, said installing additional Flowater bottle-filling systems is a good start but not enough.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We think that’s sort of somewhere between a Band-Aid and a suture. It’s not really the solution that we’re looking for,” Landry told KQED. They led a community rally outside the meeting to call on the district to meet a list of demands, including stricter parts-per-billion lead standards and better communication.\u003c/p>\n\u003cp>“What we’re looking for is not only accountability for why there was this complete sort of failure in communication, but also we’re looking for a comprehensive analysis of where the contamination points are at any given school site and how those will be addressed,” Landry said.\u003c/p>\n\u003cp>In the longer term, the district plans to analyze how extensive the remediation will need to be, but how it will pay for the work it identifies is unclear. Thomas said further testing would help OUSD determine where repairing the fixtures got rid of lead or where larger systems, like the pipes, might be the root of the problem.\u003c/p>\n\u003cp>“We are ongoing in testing every day as we speak right now, and then we will circle back to those schools at the end of this school year to do a second round of testing,” he said.\u003c/p>\n\u003cp>So far, the district has installed 50 of 60 new FloWater bottle-filling systems, which routinely test extremely low for lead, Thomas said at the meeting. All of the fixtures where lead was initially detected have been repaired and are awaiting retesting.\u003c/p>\n\u003cp>OUSD also has plans to install 88 more FloWater stations by the end of the year, aiming to have one water fountain per every 200 students on a school site. Installing the additional Flowater systems will cost an estimated $1.5 million, plus more than half a million to maintain annually.\u003c/p>\n\u003cp>The larger cost of remediation comes as Oakland and its school district are both dealing with budget deficits. School board Vice President Mike Hutchinson said there isn’t much money left unaccounted for in the budget set aside for facilities through recent bond measures.\u003c/p>\n\u003cp>District leaders at Monday’s meeting asked about using funds from a settlement initiated in 2019 between 10 cities and counties in California, including Oakland, and companies whose lead paint “poisons tens of thousands of children across California each year,” according to a press release, but Selia Warren, a deputy attorney at the Oakland city attorney’s office, said that money is required to be used for remediation efforts related to lead paint.\u003c/p>\n\u003cp>Kalb suggested a city staffer help the district with outreach to state and local agencies and applications for grants that have funding available for lead-related remediation. But the true cost won’t be known until at least the end of the year.\u003c/p>\n\u003cp>“We greatly need help and support from everyone,” Hutchinson said. “Both to make sure this short-term solution of Flowater systems is accessible and workable, but especially for the medium and long-term fix, which probably is going to involve repairs at some of our school sites that could become more extensive. … We don’t know what the cost is, but we have to take care of this immediately.”\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "a-hot-mess-as-heat-rises-california-kids-are-sweltering-in-schools-without-air-conditioning",
"title": "'A Hot Mess': As Heat Rises, California Kids Are Sweltering in Schools Without Air Conditioning",
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"headTitle": "‘A Hot Mess’: As Heat Rises, California Kids Are Sweltering in Schools Without Air Conditioning | KQED",
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"content": "\u003cp>In her fifth grade class in a Los Angeles school, on a day when outdoor temperatures reached 116 degrees, the heat gave Lilian Chin\u003cem> \u003c/em>a headache. The air conditioner in her classroom was broken. Her fingers felt numb, and she vomited in class, according to her mother. The nurse wasn’t available, so she was sent back to her hot classroom.\u003c/p>\n\u003cp>By the time the school day was over and Lilian made it to her mother’s air-conditioned car, she was exhausted and red-faced. At home, she vomited again and got a leg cramp. Veronica Chin rushed her 11-year-old daughter to an emergency room, where she was diagnosed with heat exhaustion — a serious condition that leads to a life-threatening heat stroke if not treated promptly.\u003c/p>\n\u003cp>When Chin called the school, Haskell Elementary STEAM Magnet, to complain about the broken air conditioning, she received an email that a repair ticket had been created. The San Fernando Valley school, in the Los Angeles Unified School District, had marked the repair a “low priority.” (School officials did not respond to CalMatters’ questions when a reporter called and visited the campus.)\u003c/p>\n\u003cp>Chin was furious. “I’m trusting them with my children,” she said. “I’m thinking that my children are in a safe space when they’re not.”\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/environment/climate-change/2024/09/california-extreme-heat-population-growth-inland-communities/\">As climate change intensifies heat waves\u003c/a>, California schools are unprepared to protect their students from extreme heat. Some schools don’t have air conditioning at all because they were built before hotter climates made it a necessity. Others have old systems pushed to their limits, with school districts struggling to keep up with repairs or replacements with limited staff and funding.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For instance, in Long Beach — which reached a \u003ca href=\"https://lbpost.com/news/record-heat-long-beach-temperature-109-heat-wave/\">record high of 109 \u003c/a>degrees last month — all or most buildings in 13 public schools with about 14,000 students have no air conditioning systems. In Oakland, as many as 2,000 classrooms don’t have them. And in Fresno, officials have been overwhelmed with more than 5,000 calls for air conditioning repairs in the past 12 months.\u003c/p>\n\u003cp>Between 15% and 20% of California’s kindergarten through 12th-grade public schools “have \u003ca href=\"https://static1.squarespace.com/static/635dbc6808cab54e82a25127/t/640f57089a49a966b5803dcb/1678726934033/Climate-Resilient+California+Schools\">no functioning heating and air conditioning systems at all\u003c/a>, and as many as another 10% of schools need major repair or replacement for their systems to function adequately,” UC Berkeley and Stanford University researchers wrote in a report last year. Some advocates say that is likely an underestimate.\u003c/p>\n\u003cp>School officials say they would need tens of billions of dollars to install and repair air conditioning. Many of the worst problems are in hot, inland school districts that serve low-income communities of color, where there are fewer financial resources to replace or repair them.\u003c/p>\n\u003cp>“If it’s too hot, just like if you’re too hungry, it’s almost impossible to learn, so the impact on students and teachers is great,” said Paul Idsvoog, the Fresno Unified School District’s chief operations officer. “If you have multiple systems that are 20 years old, sooner or later, you’re not going to be able to keep up with the tide.”\u003c/p>\n\u003cp>Voters in November will be asked to approve a \u003ca href=\"https://calmatters.org/education/2024/06/school-bond-california/\">$10 billion school infrastructure bond\u003c/a> to fund repairs and upgrades of buildings at K–12 schools and community colleges, including air conditioning systems.\u003c/p>\n\u003cp>Gov. Gavin Newsom last month vetoed \u003ca href=\"https://digitaldemocracy.calmatters.org/bills/ca_202320240sb1182\">a bill that would have created a master plan\u003c/a> for climate-resilient schools, including an assessment of when air conditioning systems were last modernized. State officials currently do not collect data on air conditioning in schools.\u003c/p>\n\u003cfigure id=\"attachment_12007309\" class=\"wp-caption alignnone\" style=\"max-width: 1568px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_24.jpeg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007309\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_24.jpeg\" alt=\"A portable air conditioner in a classroom.\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_24.jpeg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_24-800x533.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_24-1020x680.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_24-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_24-1536x1024.jpeg 1536w\" sizes=\"(max-width: 1568px) 100vw, 1568px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A portable air conditioning unit is used in the library of the Melrose Leadership Academy in Oakland on a hot day in late September. \u003ccite>(Laure Andrillon/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nationally, \u003ca href=\"https://www.gao.gov/products/gao-20-494\">41% of school districts\u003c/a> need to update or replace their heating, air conditioning and ventilation systems in at least half of their schools, according to a federal study.\u003c/p>\n\u003cp>In California, the problems are common statewide, jeopardizing children and teachers in inland as well as coastal communities.\u003c/p>\n\u003cp>“It’s just a hot mess,” said Aaron Kahlenberg, a teacher at Los Angeles Unified’s John F. Kennedy High School in Granada Hills\u003cem>.\u003c/em> “When it was cool out, it worked, and when it got hot, it didn’t work. It got to be very frustrating.”\u003c/p>\n\u003ch2 id=\"h-absences-rise-and-learning-drops-on-hot-days\" class=\"wp-block-heading\">\u003cstrong>Absences rise and learning drops on hot days\u003c/strong>\u003c/h2>\n\u003cp>Hot classrooms lead to more student and teacher \u003ca href=\"https://calmatters.org/economy/2024/07/extreme-heat-report-insurance/\">illnesses \u003c/a>and absences, and studies show that they reduce children’s ability to learn.\u003c/p>\n\u003cp>On a recent day in Oakland, when outdoor temperatures reached 88 degrees, 8th-grader Juliette Sanchez felt sticky and hot in a stuffy room at Melrose Leadership Academy.\u003c/p>\n\u003cp>“For me, it’s a lot harder to focus on what I’m doing,” Sanchez said. “Like, right now, I’m sticking to the table. It’s uncomfortable to write. My arm is sticky, and I’m just hot.”\u003c/p>\n\u003cfigure id=\"attachment_12007306\" class=\"wp-caption alignnone\" style=\"max-width: 1600px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_18.jpeg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007306\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_18.jpeg\" alt=\"A young girl with sunglasses on her forehead sits in a classroom behind a tower of small colored blocks.\" width=\"1600\" height=\"2000\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_18.jpeg 1600w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_18-800x1000.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_18-1020x1275.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_18-160x200.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_18-1229x1536.jpeg 1229w\" sizes=\"(max-width: 1600px) 100vw, 1600px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Juliette Sanchez, 13, an eighth grader, said the heat is sometimes unbearable at the Melrose Leadership Academy in Oakland. She is a member of an environmental club that advocated for more efficient heat and air conditioning systems at her school. \u003ccite>(Laure Andrillon/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Student performance on exams declines by up to 14% on hot days, according to a 2018 \u003ca href=\"https://scholar.harvard.edu/files/jisungpark/files/paper_nyc_aejep.pdf\">Harvard study\u003c/a> in New York City. According to another study, an increase in the average temperature of 1 degree leads to \u003ca href=\"https://www.aeaweb.org/articles?id=10.1257/pol.20180612\">1% less learning\u003c/a>, measured by changes in test scores.\u003c/p>\n\u003cp>For Black and brown students, the learning losses are even greater, said V. Kelly Turner, a heat expert at UCLA’s Luskin School of Public Affairs who has researched hot schools.\u003c/p>\n\u003cp>“They’re already perhaps in schools that don’t have enough teachers or enough supplies and then put on top of that, they’re going to hot homes,” she said. “Maybe they don’t have any rights to install air conditioning systems. Maybe they live in mobile homes and have even fewer rights.”\u003c/p>\n\u003cp>A state program, \u003ca href=\"https://www.energy.ca.gov/programs-and-topics/programs/california-schools-healthy-air-plumbing-and-efficiency-program\">called CalSHAPE\u003c/a>, helps public schools improve air conditioning and water systems. Between 2021 and 2023, more than 3,800 schools were \u003ca href=\"https://efiling.energy.ca.gov/GetDocument.aspx?tn=254791&DocumentContentId=90470\">awarded\u003c/a> $421 million to assess their systems, with 11 undertaking major repairs or replacements.\u003c/p>\n\u003cp>However, in August, state legislators considered eliminating the program \u003ca href=\"https://calmatters.org/environment/2024/08/california-electric-bill-legislation/\">as part of a plan to give utility ratepayers small rebates\u003c/a>. Although the bill failed, the program has been closed to new applications since July. More than a dozen school districts have \u003ca href=\"https://efiling.energy.ca.gov/Lists/DocketLog.aspx?docketnumber=20-RENEW-01\">urged the state Energy Commission\u003c/a> to reopen applications.\u003c/p>\n\u003cp>The attempt to gut the program worries school and environmental advocates, who say the state is failing to prioritize schools as climate change raises temperatures.\u003c/p>\n\u003cp>“For many schools, cooling is no longer just a nicety, but a necessity,” Jonathan Klein, head of UndauntedK12, an organization that supports schools transitioning to zero emissions to reduce greenhouse gasses, said in a statement. “Students and staff deserve safe, healthy, resilient school campuses that support teaching and learning amidst extreme weather.”\u003c/p>\n\u003ch2 id=\"h-fixing-air-conditioners-9-billion-in-la-schools-alone\" class=\"wp-block-heading\">\u003cstrong>Fixing air conditioners: $9 billion in LA schools alone\u003c/strong>\u003c/h2>\n\u003cp>Most students return to school in mid-August or early September, when much of the state — particularly in the Los Angeles region — suffers its most intense heat waves. Some schools also operate year-round.\u003c/p>\n\u003cp>In the San Fernando Valley region of Los Angeles, classroom temperatures reached into the mid-90s during an early September heat wave.\u003c/p>\n\u003cp>Teachers at several schools there told CalMatters that their requests for air conditioning repairs went unanswered or were slow to come. Portable units installed in classrooms were insufficient to keep temperatures comfortable enough for students to learn. Students were visibly lethargic from the heat. Some parents opted to keep their children home.\u003c/p>\n\u003cp>Kahlenberg, who teaches high school architecture, said he had asked for the air conditioning in his classroom to be repaired for weeks. By the time a heat wave hit in early September, it still wasn’t fixed. His classroom temperature reached 95 degrees.\u003c/p>\n\u003cp>“Everybody was tired,” Kahlenberg said. “I told them if they needed to take a break, that if they didn’t want to work, it was totally acceptable. I would just extend the project. But it just shouldn’t have to be like that.”\u003c/p>\n\u003cp>Kahlenberg said teachers told him about 20 other classrooms at his school also didn’t have working air conditioning during that heat wave.\u003c/p>\n\u003cfigure id=\"attachment_12007308\" class=\"wp-caption alignnone\" style=\"max-width: 1568px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_20.jpeg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007308\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_20.jpeg\" alt=\"Students sit in the shade on a soccer field in a schoolyard, next to basketball courts.\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_20.jpeg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_20-800x533.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_20-1020x680.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_20-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_20-1536x1024.jpeg 1536w\" sizes=\"(max-width: 1568px) 100vw, 1568px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Students sit in the shade in the schoolyard of the Melrose Leadership Academy in Oakland on Sept. 23, 2024. \u003ccite>(Laure Andrillon/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A physical education teacher in another Los Angeles school said she spent weeks before the September heat wave trying to flag air conditioning problems in her office. (The teacher wished to remain anonymous out of fear she would be disciplined for discussing the issue with CalMatters.)\u003c/p>\n\u003cp>Then, when the extreme heat came and the gymnasium temperature was too hot for the students, she and others informed the school. She said the school responded on the last day of the heat wave that students could sit outside in shade if they needed to. The suggestion dumbfounded her: Why would she have her students sit outside, where it was even hotter than in the gym?\u003c/p>\n\u003cp>All schools in Los Angeles Unified have air conditioners. But Krisztina Tokes, the district’s chief facilities executive\u003cem>, \u003c/em>said 50,000 faulty or aged units and pieces of equipment need to be replaced in the district’s more than 1,000 schools.\u003c/p>\n\u003cp>LA Unified, the largest school district in the state, has invested $1 billion to upgrade heating, ventilation and cooling systems in the last two decades, including $287 million for 20 projects that are currently under construction or being designed.\u003c/p>\n\u003cp>Tokes said officials work to keep students safe by following protocols when air conditioning breaks down, such as installing portable units or moving students to spare air-conditioned spaces. Outside, schools place portable misting fans and commercial-grade pop-up tents for shade.\u003c/p>\n\u003cp>School days were cut short in schools where district officials felt they couldn’t provide a safe learning environment. Air conditioning systems are also checked at the start of summer and again just before classes start. Teachers and staff are trained to identify and respond to signs of heat related illness, a district spokesperson said.\u003c/p>\n\u003cp>“Under no circumstance should there be a child or parent thinking their health isn’t being addressed,” Tokes said. “There were conditions that were beyond the district’s control.”\u003c/p>\n\u003cp>Replacing all air conditioners in the district’s schools would cost at least $9 billion, according to Amanda Wherritt, Los Angeles Unified’s deputy chief of staff.\u003c/p>\n\u003cp>“It’s really about financial resources,” Tokes said. “We do not receive enough money from the state to either repair or replace our systems.”\u003c/p>\n\u003ch2 id=\"h-even-coastal-schools-are-sweltering-nbsp\" class=\"wp-block-heading\">\u003cstrong>Even coastal schools are sweltering \u003c/strong>\u003c/h2>\n\u003cp>While many classrooms throughout the state have air conditioning, those that don’t are often in coastal areas. Many of these schools were built in the 1950s or ’60s before the warming effects of climate change had worsened heat waves.\u003c/p>\n\u003cp>In Long Beach, less than a decade ago, 51 out of 84 schools didn’t have air conditioning in all classrooms. Since then, a \u003ca href=\"https://www.presstelegram.com/2016/10/22/long-beach-election-2016-school-district-asking-for-15-billion-bond/\">$1.5 billion local facilities bond \u003c/a>has helped the school district upgrade many of them.\u003c/p>\n\u003cp>But 13 schools, serving about a quarter of the district’s students, still \u003ca href=\"https://www.nbclosangeles.com/news/local/thirteen-long-beach-schools-braving-socal-heatwave-without-air-conditioning/3503162/\">won’t be fully air-conditioned \u003c/a>for at least another three years. One school, Polytechnic High School, which has about 4,000 students, will undergo major renovations, including adding air conditioning, that won’t be complete until 2028, said Alan Reising, Long Beach Unified School District’s facilities and operations assistant superintendent. In the meantime, officials installed portable air conditioners and outdoor shade structures in many of the schools, Reising said.\u003c/p>\n\u003cp>Some inland Long Beach neighborhoods experience five high-heat days a year when temperatures exceed 97 degrees.\u003c/p>\n\u003cp>“Arguably, we haven’t needed it,” Reising said. But now, he said, “with the obvious signs of climate change, we have more hot days we have to deal with every year. There’s no thought that it’s going to get better in the future, so the need for air conditioning now has become very obvious.”\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://calmatters-graphics-heat-housing.netlify.app/heat-days-lookup?initialWidth=780&childId=pym_0&parentTitle=As%20heat%20rises%2C%20kids%20are%20sweltering%20in%20CA%20schools%20with%20no%20AC%20-%20CalMatters&parentUrl=https%3A%2F%2Fcalmatters.org%2Fenvironment%2Fclimate-change%2F2024%2F10%2Fcalifornia-schools-air-conditioning-heatwave-climate%2F\" width=\"1000\" height=\"780\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>In the San Diego Unified School District, all 175 schools now have air conditioning. The district spent $460 million between 2013 and 2019 to install systems in the 118 schools that didn’t have them.\u003c/p>\n\u003cp>While many of the systems are newer as a result, they’re still \u003ca href=\"https://www.nbcsandiego.com/news/local/hoover-high-school-hot-classroom-air-conditioning/3598054/\">breaking down, \u003c/a>with students saying some classrooms reached around 100 degrees in September. Some San Diego neighborhoods have four high-heat days a year that exceed 91 degrees.\u003c/p>\n\u003cp>“We were definitely experiencing some air conditioning issues throughout the district. We are doing our best to respond to all repair requests as quickly as possible,” said Samer Naji, a district spokesperson.\u003c/p>\n\u003cp>In the Oakland Unified School District, about 2,000 classrooms in 77 schools have no air conditioners. In late September, outdoor temperatures reached 88 degrees; some Oakland neighborhoods have seven days a year that exceed 89 degrees.\u003c/p>\n\u003cp>Equipping those schools with air conditioning would be an expensive and complicated task that would cost at least $400 million, said Preston Thomas, Oakland Unified School District’s chief systems and services officer.\u003c/p>\n\u003cp>At Melrose Learning Academy in Oakland, students said the heat makes it hard to focus. Lyra Modersbach, an eighth grader who is a member of an environmental club at the school, said she has noticed temperatures getting hotter year after year. When she’s home, she can wear cool clothes and rest to beat the heat, but she can’t do that at school.\u003c/p>\n\u003cp>Modersbach said her school has a few portable air conditioners, but if too many are on at once, they shut off.\u003c/p>\n\u003cp>The heat “is very distracting,” she said. “I’ve noticed having a harder time getting my work done or feeling frustrated.”\u003c/p>\n\u003cp>As members of the Youth Versus Apocalypse environmental club, Modersbach and Juliette Sanchez\u003ca href=\"https://www.theguardian.com/environment/article/2024/jun/10/school-heat-pump-climate-emissions\"> advocated for their school to stop using a gas boiler\u003c/a> and invest in an energy-efficient heat pump that will provide air conditioning. The district will use funds from a 2020 $735 million bond measure to \u003ca href=\"https://oaklandside.org/2023/12/08/oakland-middle-school-students-win-heat-pump-climate-activism/\">install heat pumps\u003c/a> at their school next year.\u003c/p>\n\u003ch2 id=\"h-inland-schools-have-little-money-to-invest\" class=\"wp-block-heading\">Inland schools have little money to invest\u003c/h2>\n\u003cp>While many inland schools are fully air-conditioned, some don’t have air conditioning in their gymnasiums, cafeterias and multi-purpose rooms.\u003c/p>\n\u003cp>Many inland school districts, where 100-degree days are common, have far fewer financial resources than wealthier coastal districts, said Sara Hinkley, California program manager for UC Berkeley’s Center for Cities + Schools.\u003c/p>\n\u003cp>“Most of the spending on facility upgrades is based on local bond measures, which is based on your ability to levy property taxes,” she said. “So districts that have lower levels of property values per student are able to raise less money to upgrade their facilities.”\u003c/p>\n\u003cp>School districts in the Central Valley and the Inland Empire are among those that have invested less money because of lower property values and a smaller voter base to tap into, Hinkley said.\u003c/p>\n\u003cp>“There’s no environmental justice or climate equity imperative. That would take an active regulation to change how bond disbursements are made in the state,” UCLA’s Turner said. “The state could go a long way by investing in better technical assistance to communities to apply for these funds and focusing on priority schools.”\u003c/p>\n\u003cp>Fresno Unified School District, where 90% of students are on free or reduced lunch plans, recently invested $60 million in federal funds to replace or install air conditioning systems in some of its gyms, cafeterias and multi-purpose rooms, said Alex Belanger, chief executive over the district’s operations.\u003c/p>\n\u003cp>But the district needs about $500 million to improve its heating and ventilation systems, Belanger said.\u003c/p>\n\u003cp>Belanger said during heat waves, it’s\u003ca href=\"https://abc30.com/heat-wave-central-california-fresno-unified-ac-down-courthouse/12204755/\"> “all hands on deck” \u003c/a>to keep students cool. Staff work weekends and nights to repair air conditioning systems and the school provides temporary chillers and portable air conditioning if systems break down.\u003c/p>\n\u003cp>Idsvoog said the Fresno school district would like to invest in energy-efficient strategies such as building well-insulated schools with green space and oriented in a way that won’t absorb heat. But there’s simply no money to do so.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“The reality is it’s not going to get any cooler and resources will always be a challenge for any school district,” Idsvoog said. “Any assistance, grants or state funding that can support those efforts is more than welcome.”\u003c/p>\n\n",
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"excerpt": "Underfunded schools are struggling to keep classrooms cool amid more frequent heat waves. An estimated 1 in 5 schools has no air conditioning and another 10% need repair.",
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"title": "'A Hot Mess': As Heat Rises, California Kids Are Sweltering in Schools Without Air Conditioning | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In her fifth grade class in a Los Angeles school, on a day when outdoor temperatures reached 116 degrees, the heat gave Lilian Chin\u003cem> \u003c/em>a headache. The air conditioner in her classroom was broken. Her fingers felt numb, and she vomited in class, according to her mother. The nurse wasn’t available, so she was sent back to her hot classroom.\u003c/p>\n\u003cp>By the time the school day was over and Lilian made it to her mother’s air-conditioned car, she was exhausted and red-faced. At home, she vomited again and got a leg cramp. Veronica Chin rushed her 11-year-old daughter to an emergency room, where she was diagnosed with heat exhaustion — a serious condition that leads to a life-threatening heat stroke if not treated promptly.\u003c/p>\n\u003cp>When Chin called the school, Haskell Elementary STEAM Magnet, to complain about the broken air conditioning, she received an email that a repair ticket had been created. The San Fernando Valley school, in the Los Angeles Unified School District, had marked the repair a “low priority.” (School officials did not respond to CalMatters’ questions when a reporter called and visited the campus.)\u003c/p>\n\u003cp>Chin was furious. “I’m trusting them with my children,” she said. “I’m thinking that my children are in a safe space when they’re not.”\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/environment/climate-change/2024/09/california-extreme-heat-population-growth-inland-communities/\">As climate change intensifies heat waves\u003c/a>, California schools are unprepared to protect their students from extreme heat. Some schools don’t have air conditioning at all because they were built before hotter climates made it a necessity. Others have old systems pushed to their limits, with school districts struggling to keep up with repairs or replacements with limited staff and funding.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For instance, in Long Beach — which reached a \u003ca href=\"https://lbpost.com/news/record-heat-long-beach-temperature-109-heat-wave/\">record high of 109 \u003c/a>degrees last month — all or most buildings in 13 public schools with about 14,000 students have no air conditioning systems. In Oakland, as many as 2,000 classrooms don’t have them. And in Fresno, officials have been overwhelmed with more than 5,000 calls for air conditioning repairs in the past 12 months.\u003c/p>\n\u003cp>Between 15% and 20% of California’s kindergarten through 12th-grade public schools “have \u003ca href=\"https://static1.squarespace.com/static/635dbc6808cab54e82a25127/t/640f57089a49a966b5803dcb/1678726934033/Climate-Resilient+California+Schools\">no functioning heating and air conditioning systems at all\u003c/a>, and as many as another 10% of schools need major repair or replacement for their systems to function adequately,” UC Berkeley and Stanford University researchers wrote in a report last year. Some advocates say that is likely an underestimate.\u003c/p>\n\u003cp>School officials say they would need tens of billions of dollars to install and repair air conditioning. Many of the worst problems are in hot, inland school districts that serve low-income communities of color, where there are fewer financial resources to replace or repair them.\u003c/p>\n\u003cp>“If it’s too hot, just like if you’re too hungry, it’s almost impossible to learn, so the impact on students and teachers is great,” said Paul Idsvoog, the Fresno Unified School District’s chief operations officer. “If you have multiple systems that are 20 years old, sooner or later, you’re not going to be able to keep up with the tide.”\u003c/p>\n\u003cp>Voters in November will be asked to approve a \u003ca href=\"https://calmatters.org/education/2024/06/school-bond-california/\">$10 billion school infrastructure bond\u003c/a> to fund repairs and upgrades of buildings at K–12 schools and community colleges, including air conditioning systems.\u003c/p>\n\u003cp>Gov. Gavin Newsom last month vetoed \u003ca href=\"https://digitaldemocracy.calmatters.org/bills/ca_202320240sb1182\">a bill that would have created a master plan\u003c/a> for climate-resilient schools, including an assessment of when air conditioning systems were last modernized. State officials currently do not collect data on air conditioning in schools.\u003c/p>\n\u003cfigure id=\"attachment_12007309\" class=\"wp-caption alignnone\" style=\"max-width: 1568px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_24.jpeg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007309\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_24.jpeg\" alt=\"A portable air conditioner in a classroom.\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_24.jpeg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_24-800x533.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_24-1020x680.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_24-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_24-1536x1024.jpeg 1536w\" sizes=\"(max-width: 1568px) 100vw, 1568px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A portable air conditioning unit is used in the library of the Melrose Leadership Academy in Oakland on a hot day in late September. \u003ccite>(Laure Andrillon/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nationally, \u003ca href=\"https://www.gao.gov/products/gao-20-494\">41% of school districts\u003c/a> need to update or replace their heating, air conditioning and ventilation systems in at least half of their schools, according to a federal study.\u003c/p>\n\u003cp>In California, the problems are common statewide, jeopardizing children and teachers in inland as well as coastal communities.\u003c/p>\n\u003cp>“It’s just a hot mess,” said Aaron Kahlenberg, a teacher at Los Angeles Unified’s John F. Kennedy High School in Granada Hills\u003cem>.\u003c/em> “When it was cool out, it worked, and when it got hot, it didn’t work. It got to be very frustrating.”\u003c/p>\n\u003ch2 id=\"h-absences-rise-and-learning-drops-on-hot-days\" class=\"wp-block-heading\">\u003cstrong>Absences rise and learning drops on hot days\u003c/strong>\u003c/h2>\n\u003cp>Hot classrooms lead to more student and teacher \u003ca href=\"https://calmatters.org/economy/2024/07/extreme-heat-report-insurance/\">illnesses \u003c/a>and absences, and studies show that they reduce children’s ability to learn.\u003c/p>\n\u003cp>On a recent day in Oakland, when outdoor temperatures reached 88 degrees, 8th-grader Juliette Sanchez felt sticky and hot in a stuffy room at Melrose Leadership Academy.\u003c/p>\n\u003cp>“For me, it’s a lot harder to focus on what I’m doing,” Sanchez said. “Like, right now, I’m sticking to the table. It’s uncomfortable to write. My arm is sticky, and I’m just hot.”\u003c/p>\n\u003cfigure id=\"attachment_12007306\" class=\"wp-caption alignnone\" style=\"max-width: 1600px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_18.jpeg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007306\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_18.jpeg\" alt=\"A young girl with sunglasses on her forehead sits in a classroom behind a tower of small colored blocks.\" width=\"1600\" height=\"2000\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_18.jpeg 1600w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_18-800x1000.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_18-1020x1275.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_18-160x200.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_18-1229x1536.jpeg 1229w\" sizes=\"(max-width: 1600px) 100vw, 1600px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Juliette Sanchez, 13, an eighth grader, said the heat is sometimes unbearable at the Melrose Leadership Academy in Oakland. She is a member of an environmental club that advocated for more efficient heat and air conditioning systems at her school. \u003ccite>(Laure Andrillon/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Student performance on exams declines by up to 14% on hot days, according to a 2018 \u003ca href=\"https://scholar.harvard.edu/files/jisungpark/files/paper_nyc_aejep.pdf\">Harvard study\u003c/a> in New York City. According to another study, an increase in the average temperature of 1 degree leads to \u003ca href=\"https://www.aeaweb.org/articles?id=10.1257/pol.20180612\">1% less learning\u003c/a>, measured by changes in test scores.\u003c/p>\n\u003cp>For Black and brown students, the learning losses are even greater, said V. Kelly Turner, a heat expert at UCLA’s Luskin School of Public Affairs who has researched hot schools.\u003c/p>\n\u003cp>“They’re already perhaps in schools that don’t have enough teachers or enough supplies and then put on top of that, they’re going to hot homes,” she said. “Maybe they don’t have any rights to install air conditioning systems. Maybe they live in mobile homes and have even fewer rights.”\u003c/p>\n\u003cp>A state program, \u003ca href=\"https://www.energy.ca.gov/programs-and-topics/programs/california-schools-healthy-air-plumbing-and-efficiency-program\">called CalSHAPE\u003c/a>, helps public schools improve air conditioning and water systems. Between 2021 and 2023, more than 3,800 schools were \u003ca href=\"https://efiling.energy.ca.gov/GetDocument.aspx?tn=254791&DocumentContentId=90470\">awarded\u003c/a> $421 million to assess their systems, with 11 undertaking major repairs or replacements.\u003c/p>\n\u003cp>However, in August, state legislators considered eliminating the program \u003ca href=\"https://calmatters.org/environment/2024/08/california-electric-bill-legislation/\">as part of a plan to give utility ratepayers small rebates\u003c/a>. Although the bill failed, the program has been closed to new applications since July. More than a dozen school districts have \u003ca href=\"https://efiling.energy.ca.gov/Lists/DocketLog.aspx?docketnumber=20-RENEW-01\">urged the state Energy Commission\u003c/a> to reopen applications.\u003c/p>\n\u003cp>The attempt to gut the program worries school and environmental advocates, who say the state is failing to prioritize schools as climate change raises temperatures.\u003c/p>\n\u003cp>“For many schools, cooling is no longer just a nicety, but a necessity,” Jonathan Klein, head of UndauntedK12, an organization that supports schools transitioning to zero emissions to reduce greenhouse gasses, said in a statement. “Students and staff deserve safe, healthy, resilient school campuses that support teaching and learning amidst extreme weather.”\u003c/p>\n\u003ch2 id=\"h-fixing-air-conditioners-9-billion-in-la-schools-alone\" class=\"wp-block-heading\">\u003cstrong>Fixing air conditioners: $9 billion in LA schools alone\u003c/strong>\u003c/h2>\n\u003cp>Most students return to school in mid-August or early September, when much of the state — particularly in the Los Angeles region — suffers its most intense heat waves. Some schools also operate year-round.\u003c/p>\n\u003cp>In the San Fernando Valley region of Los Angeles, classroom temperatures reached into the mid-90s during an early September heat wave.\u003c/p>\n\u003cp>Teachers at several schools there told CalMatters that their requests for air conditioning repairs went unanswered or were slow to come. Portable units installed in classrooms were insufficient to keep temperatures comfortable enough for students to learn. Students were visibly lethargic from the heat. Some parents opted to keep their children home.\u003c/p>\n\u003cp>Kahlenberg, who teaches high school architecture, said he had asked for the air conditioning in his classroom to be repaired for weeks. By the time a heat wave hit in early September, it still wasn’t fixed. His classroom temperature reached 95 degrees.\u003c/p>\n\u003cp>“Everybody was tired,” Kahlenberg said. “I told them if they needed to take a break, that if they didn’t want to work, it was totally acceptable. I would just extend the project. But it just shouldn’t have to be like that.”\u003c/p>\n\u003cp>Kahlenberg said teachers told him about 20 other classrooms at his school also didn’t have working air conditioning during that heat wave.\u003c/p>\n\u003cfigure id=\"attachment_12007308\" class=\"wp-caption alignnone\" style=\"max-width: 1568px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_20.jpeg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007308\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_20.jpeg\" alt=\"Students sit in the shade on a soccer field in a schoolyard, next to basketball courts.\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_20.jpeg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_20-800x533.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_20-1020x680.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_20-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/092324_Oakland-Schools-AC_LA_CM_20-1536x1024.jpeg 1536w\" sizes=\"(max-width: 1568px) 100vw, 1568px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Students sit in the shade in the schoolyard of the Melrose Leadership Academy in Oakland on Sept. 23, 2024. \u003ccite>(Laure Andrillon/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A physical education teacher in another Los Angeles school said she spent weeks before the September heat wave trying to flag air conditioning problems in her office. (The teacher wished to remain anonymous out of fear she would be disciplined for discussing the issue with CalMatters.)\u003c/p>\n\u003cp>Then, when the extreme heat came and the gymnasium temperature was too hot for the students, she and others informed the school. She said the school responded on the last day of the heat wave that students could sit outside in shade if they needed to. The suggestion dumbfounded her: Why would she have her students sit outside, where it was even hotter than in the gym?\u003c/p>\n\u003cp>All schools in Los Angeles Unified have air conditioners. But Krisztina Tokes, the district’s chief facilities executive\u003cem>, \u003c/em>said 50,000 faulty or aged units and pieces of equipment need to be replaced in the district’s more than 1,000 schools.\u003c/p>\n\u003cp>LA Unified, the largest school district in the state, has invested $1 billion to upgrade heating, ventilation and cooling systems in the last two decades, including $287 million for 20 projects that are currently under construction or being designed.\u003c/p>\n\u003cp>Tokes said officials work to keep students safe by following protocols when air conditioning breaks down, such as installing portable units or moving students to spare air-conditioned spaces. Outside, schools place portable misting fans and commercial-grade pop-up tents for shade.\u003c/p>\n\u003cp>School days were cut short in schools where district officials felt they couldn’t provide a safe learning environment. Air conditioning systems are also checked at the start of summer and again just before classes start. Teachers and staff are trained to identify and respond to signs of heat related illness, a district spokesperson said.\u003c/p>\n\u003cp>“Under no circumstance should there be a child or parent thinking their health isn’t being addressed,” Tokes said. “There were conditions that were beyond the district’s control.”\u003c/p>\n\u003cp>Replacing all air conditioners in the district’s schools would cost at least $9 billion, according to Amanda Wherritt, Los Angeles Unified’s deputy chief of staff.\u003c/p>\n\u003cp>“It’s really about financial resources,” Tokes said. “We do not receive enough money from the state to either repair or replace our systems.”\u003c/p>\n\u003ch2 id=\"h-even-coastal-schools-are-sweltering-nbsp\" class=\"wp-block-heading\">\u003cstrong>Even coastal schools are sweltering \u003c/strong>\u003c/h2>\n\u003cp>While many classrooms throughout the state have air conditioning, those that don’t are often in coastal areas. Many of these schools were built in the 1950s or ’60s before the warming effects of climate change had worsened heat waves.\u003c/p>\n\u003cp>In Long Beach, less than a decade ago, 51 out of 84 schools didn’t have air conditioning in all classrooms. Since then, a \u003ca href=\"https://www.presstelegram.com/2016/10/22/long-beach-election-2016-school-district-asking-for-15-billion-bond/\">$1.5 billion local facilities bond \u003c/a>has helped the school district upgrade many of them.\u003c/p>\n\u003cp>But 13 schools, serving about a quarter of the district’s students, still \u003ca href=\"https://www.nbclosangeles.com/news/local/thirteen-long-beach-schools-braving-socal-heatwave-without-air-conditioning/3503162/\">won’t be fully air-conditioned \u003c/a>for at least another three years. One school, Polytechnic High School, which has about 4,000 students, will undergo major renovations, including adding air conditioning, that won’t be complete until 2028, said Alan Reising, Long Beach Unified School District’s facilities and operations assistant superintendent. In the meantime, officials installed portable air conditioners and outdoor shade structures in many of the schools, Reising said.\u003c/p>\n\u003cp>Some inland Long Beach neighborhoods experience five high-heat days a year when temperatures exceed 97 degrees.\u003c/p>\n\u003cp>“Arguably, we haven’t needed it,” Reising said. But now, he said, “with the obvious signs of climate change, we have more hot days we have to deal with every year. There’s no thought that it’s going to get better in the future, so the need for air conditioning now has become very obvious.”\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://calmatters-graphics-heat-housing.netlify.app/heat-days-lookup?initialWidth=780&childId=pym_0&parentTitle=As%20heat%20rises%2C%20kids%20are%20sweltering%20in%20CA%20schools%20with%20no%20AC%20-%20CalMatters&parentUrl=https%3A%2F%2Fcalmatters.org%2Fenvironment%2Fclimate-change%2F2024%2F10%2Fcalifornia-schools-air-conditioning-heatwave-climate%2F\" width=\"1000\" height=\"780\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>In the San Diego Unified School District, all 175 schools now have air conditioning. The district spent $460 million between 2013 and 2019 to install systems in the 118 schools that didn’t have them.\u003c/p>\n\u003cp>While many of the systems are newer as a result, they’re still \u003ca href=\"https://www.nbcsandiego.com/news/local/hoover-high-school-hot-classroom-air-conditioning/3598054/\">breaking down, \u003c/a>with students saying some classrooms reached around 100 degrees in September. Some San Diego neighborhoods have four high-heat days a year that exceed 91 degrees.\u003c/p>\n\u003cp>“We were definitely experiencing some air conditioning issues throughout the district. We are doing our best to respond to all repair requests as quickly as possible,” said Samer Naji, a district spokesperson.\u003c/p>\n\u003cp>In the Oakland Unified School District, about 2,000 classrooms in 77 schools have no air conditioners. In late September, outdoor temperatures reached 88 degrees; some Oakland neighborhoods have seven days a year that exceed 89 degrees.\u003c/p>\n\u003cp>Equipping those schools with air conditioning would be an expensive and complicated task that would cost at least $400 million, said Preston Thomas, Oakland Unified School District’s chief systems and services officer.\u003c/p>\n\u003cp>At Melrose Learning Academy in Oakland, students said the heat makes it hard to focus. Lyra Modersbach, an eighth grader who is a member of an environmental club at the school, said she has noticed temperatures getting hotter year after year. When she’s home, she can wear cool clothes and rest to beat the heat, but she can’t do that at school.\u003c/p>\n\u003cp>Modersbach said her school has a few portable air conditioners, but if too many are on at once, they shut off.\u003c/p>\n\u003cp>The heat “is very distracting,” she said. “I’ve noticed having a harder time getting my work done or feeling frustrated.”\u003c/p>\n\u003cp>As members of the Youth Versus Apocalypse environmental club, Modersbach and Juliette Sanchez\u003ca href=\"https://www.theguardian.com/environment/article/2024/jun/10/school-heat-pump-climate-emissions\"> advocated for their school to stop using a gas boiler\u003c/a> and invest in an energy-efficient heat pump that will provide air conditioning. The district will use funds from a 2020 $735 million bond measure to \u003ca href=\"https://oaklandside.org/2023/12/08/oakland-middle-school-students-win-heat-pump-climate-activism/\">install heat pumps\u003c/a> at their school next year.\u003c/p>\n\u003ch2 id=\"h-inland-schools-have-little-money-to-invest\" class=\"wp-block-heading\">Inland schools have little money to invest\u003c/h2>\n\u003cp>While many inland schools are fully air-conditioned, some don’t have air conditioning in their gymnasiums, cafeterias and multi-purpose rooms.\u003c/p>\n\u003cp>Many inland school districts, where 100-degree days are common, have far fewer financial resources than wealthier coastal districts, said Sara Hinkley, California program manager for UC Berkeley’s Center for Cities + Schools.\u003c/p>\n\u003cp>“Most of the spending on facility upgrades is based on local bond measures, which is based on your ability to levy property taxes,” she said. “So districts that have lower levels of property values per student are able to raise less money to upgrade their facilities.”\u003c/p>\n\u003cp>School districts in the Central Valley and the Inland Empire are among those that have invested less money because of lower property values and a smaller voter base to tap into, Hinkley said.\u003c/p>\n\u003cp>“There’s no environmental justice or climate equity imperative. That would take an active regulation to change how bond disbursements are made in the state,” UCLA’s Turner said. “The state could go a long way by investing in better technical assistance to communities to apply for these funds and focusing on priority schools.”\u003c/p>\n\u003cp>Fresno Unified School District, where 90% of students are on free or reduced lunch plans, recently invested $60 million in federal funds to replace or install air conditioning systems in some of its gyms, cafeterias and multi-purpose rooms, said Alex Belanger, chief executive over the district’s operations.\u003c/p>\n\u003cp>But the district needs about $500 million to improve its heating and ventilation systems, Belanger said.\u003c/p>\n\u003cp>Belanger said during heat waves, it’s\u003ca href=\"https://abc30.com/heat-wave-central-california-fresno-unified-ac-down-courthouse/12204755/\"> “all hands on deck” \u003c/a>to keep students cool. Staff work weekends and nights to repair air conditioning systems and the school provides temporary chillers and portable air conditioning if systems break down.\u003c/p>\n\u003cp>Idsvoog said the Fresno school district would like to invest in energy-efficient strategies such as building well-insulated schools with green space and oriented in a way that won’t absorb heat. But there’s simply no money to do so.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The reality is it’s not going to get any cooler and resources will always be a challenge for any school district,” Idsvoog said. “Any assistance, grants or state funding that can support those efforts is more than welcome.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "care-court-was-supposed-to-help-those-hardest-to-treat-heres-how-its-going",
"title": "CARE Court Was Supposed to Help Those Hardest to Treat. Here's How It's Going",
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"headTitle": "CARE Court Was Supposed to Help Those Hardest to Treat. Here’s How It’s Going | KQED",
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"content": "\u003cp>[dropcap]W[/dropcap]hen it rolled out last year in eight counties, CARE Court took aim at one of the state’s most vexing challenges: how to treat people whose illness often makes them believe they are not sick and who, if left untreated, can oscillate between jails, hospitals and homelessness.\u003c/p>\n\u003cp>Using the weight of a judge’s black robe to nudge county health departments’ doctors in white coats to provide an array of services, the program sought to reach the hardest-to-treat cases.\u003c/p>\n\u003cp>Now, a year after the program went live in seven counties — San Francisco, Glenn, Tuolumne, Stanislaus, Orange, Riverside, and San Diego — and ten months after it launched in Los Angeles County, petitions appear to be trickling in slower than expected and treatment plans are taking longer to put in place.\u003c/p>\n\u003cp>And, while Gov. Gavin Newsom, who first \u003ca href=\"https://www.gov.ca.gov/2022/03/03/governor-newsom-launches-new-plan-to-help-californians-struggling-with-mental-health-challenges-homelessness/\">introduced the initiative in March 2022\u003c/a>, initially said it would target those “living on our streets with severe mental health and substance use disorders,” the number of unhoused people going through the program varies widely from county to county.\u003c/p>\n\u003cfigure id=\"attachment_12005914\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12005914\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05.jpg\" alt=\"A white man wearing a suit stands at a podium with a microphone.\" width=\"2000\" height=\"1355\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05-800x542.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05-1020x691.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05-160x108.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05-1536x1041.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05-1920x1301.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">California State Senator Thomas Umberg speaks before the Senate Judiciary Committee about SB1338, the Community Assistance, Recovery, and Empowerment (CARE) Court Program, on April 26, 2022, in Sacramento. \u003ccite>(Fred Greaves/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>State Sen. Tom Umberg, who co-authored the \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB1338\">legislation\u003c/a> that implemented CARE Court, said the gradual rollout hasn’t come as a complete surprise.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We’re changing the culture here,” he said. “So, that takes a little time.”\u003c/p>\n\u003cp>As of mid-September, at least 692 petitions had been filed across seven of the counties in the first cohort, excluding San Francisco, according to data provided by superior court and county health officials. Of those petitions, a little more than a third, or 245, have been dismissed. And nearly one in five, or 121 petitions, have resulted in a CARE Agreement, an official document that details a voluntary treatment regime. There have been six court-ordered, or involuntary, CARE Plans issued.\u003c/p>\n\u003cp>San Francisco has so far received 42 petitions, said Melanie Kushnir, director of the Collaborative Justice Programs at the San Francisco Superior Courts. Of those, she said roughly half are active, meaning the participant is attending hearings and working toward or enrolled in a CARE Agreement. Citing privacy concerns, Kushnir declined to provide data on the exact number of dismissals or CARE Agreements reached but said there had been no CARE Plans issued.\u003c/p>\n\u003cp>The state had initially estimated that between 7,000 and 12,000 people would qualify for CARE Court each year once the program was fully implemented. But even accounting for the small number of counties that launched last year, court and public health officials agree the number of petitions is far fewer than expected — prompting opponents to argue the program is wasting taxpayers’ dollars.\u003c/p>\n\u003cp>According to the California Department of Finance, the state has already allocated $72 million to counties for start-up costs, along with $12 million for ongoing operations in fiscal year 2024–25, which will increase to $47 million in fiscal year 2026–27.\u003c/p>\n\u003cp>“We feel like the program has already failed,” said Samuel Jain, a senior mental health policy attorney at Disability Rights California, which is among the groups that advocated against CARE Court from the start. “The law doesn’t provide any new services and instead directs the limited resources we have to these expensive court processes.”\u003c/p>\n\u003cp>But supporters say it’s too early to pass judgment on a program that has yet to be fully implemented. The remaining 50 counties are due to open their own programs by Dec. 1.\u003c/p>\n\u003cp>“To really make some grand statement about its efficacy in the first 12 months of it rolling out, I think, is a leap for a state with 40 million people,” Dr. Mark Ghaly, the outgoing Secretary of California’s Health and Human Services Agency, told KQED. “But I do think that’s exactly the question that we have to keep in mind.”\u003c/p>\n\u003ch3>The number of petitions varies widely\u003c/h3>\n\u003cp>In Glenn County, with a population of \u003ca href=\"https://data.census.gov/profile/Glenn_County,_California?g=050XX00US06021\">around 29,000\u003c/a>, just one petition has been filed as of Sept. 12, and it was ultimately dismissed, said Chris Ruhl, executive officer of the Glenn County Superior Court. Ruhl expects one or two more may be submitted soon and that more will follow as word of the program spreads.\u003c/p>\n\u003cp>“We generally anticipate there will be an increase in the number of petitions and filings, but we don’t know that for sure,” he said. “We’ll be watching very closely.”\u003c/p>\n\u003cfigure id=\"attachment_12007228\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007228\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed.jpg\" alt=\"A white man wearing a blue dress suit leans against a wooden divider in a court room.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Judge Michael Begert, presiding over CARE Court, stands in the San Francisco Superior Court in San Francisco on Sept. 17, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At the other end of the spectrum is Los Angeles County, which, with a population of around \u003ca href=\"https://data.census.gov/profile/Los_Angeles_County,_California?g=050XX00US06037\">10 million\u003c/a>, has seen the most petitions: 268 as of Sept. 18. There, the number of petitions has been steadily increasing, Los Angeles Superior Court Judge Scott Herin said.\u003c/p>\n\u003cp>“I don’t think it started off like everybody expected, which was an overwhelming flood of cases,” Herin said, adding that the gradual ramp-up was perhaps “more healthy.”\u003c/p>\n\u003cp>That’s allowed some county behavioral health agencies to reappropriate staff assigned to CARE Court to other needs. In Stanislaus County, which has received 47 petitions, 19 of which have been dismissed, Behavioral Health & Recovery Services Director Tony Vartan said some of his CARE Court staff spent the first four to five months doing outreach with police and sheriff departments, hospital workers and others to build awareness.\u003c/p>\n\u003cp>“But as we saw that trend of those petitions, we pulled back some of our staff, and we assigned them to areas that needed more work,” he said. “Our staff emphasize where the cases are, regardless of what program we manage. That way, we make sure that the staff are working and they’ve got cases.”\u003c/p>\n\u003ch3>Cases dismissed\u003c/h3>\n\u003cp>Despite the lower-than-expected number of petitions, county behavioral health and court staff say they weren’t surprised to see that more than a third have been dismissed. Dismissal rates vary across the counties, from just over 90% in Tuolumne County, where 10 of 11 cases were dismissed, to a low of 26% in both Riverside and Los Angeles counties.\u003c/p>\n\u003cp>To be eligible, San Francisco Superior Court Judge Michael Begert said participants need to not only be diagnosed with schizophrenia or another psychotic disorder, but they also must be likely to benefit from services, can’t already be enrolled in services, and must be unlikely to survive without additional support.\u003c/p>\n\u003cp>“And that’s a small eye in a needle to thread,” Begert said.\u003c/p>\n\u003cp>Algenib Collin is trying to thread that needle as she looks for any program that might help for her daughter.\u003c/p>\n\u003cp>Collin applied for CARE Court the day it opened, she said, “I was so desperate.”\u003c/p>\n\u003cp>For roughly 18 months prior, she had seen her daughter, now 27, rapidly deteriorate on San Francisco’s streets. Collin said she would receive a call from the hospital nearly every other week, reporting her daughter had been placed on a 5150, or a temporary mental health hold, only to be rereleased back into homelessness and addiction.\u003c/p>\n\u003cfigure id=\"attachment_11955160\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11955160\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED.jpg\" alt=\"A large multi-story building and a driveway alongside it.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Orange County Superior Court will technically house the local CARE Court, though judges say they will more likely hold meetings with patients at a more neutral site, like a conference room at the county health office. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>High on fentanyl and possibly other drugs, Collin said her daughter would bang her head against the sidewalk or speak to herself in a language only she could understand.\u003c/p>\n\u003cp>“My daughter will die if she doesn’t get help,” Collin said. “Believe me.”\u003c/p>\n\u003cp>However, when it came to determining whether she qualified for CARE Court, the petition was rejected. Collin doesn’t know why, and she may never know. Privacy laws prohibit her from accessing her daughter’s medical records, so she isn’t sure whether her daughter has been formally diagnosed with a psychotic disorder.\u003c/p>\n\u003cp>The legislation doesn’t include any provision that gives petitioners the right to appeal a judge’s denial, though Ghaly said she could potentially refile the case.\u003c/p>\n\u003cp>“It’s frustrating,” Collin said. “I don’t want my daughter to die.”\u003c/p>\n\u003cp>Representatives from the San Francisco Public Health Department declined to be interviewed. Begert said he couldn’t comment on individual cases.\u003c/p>\n\u003cp>Ultimately, it’s up to the judge to hold public health departments accountable for providing appropriate care, Ghaly said, sharing an anecdote about how officials in San Diego frame the program: “They share with clients that CARE is an approach for the individual to … really get the black robe effect to hold the county accountable. And that’s exactly the way that we had hoped.”\u003c/p>\n\u003ch3>Breaking the pattern\u003c/h3>\n\u003cp>Collin’s experience, however, highlights a disconnect between the way the program was initially described — to, in Newsom’s words from 2022, “break the pattern that leaves people without hope and cycling repeatedly through homelessness and incarceration” — and what was actually written into legislation.\u003c/p>\n\u003cp>In the first year of the program’s rollout, success rates of getting people who are also experiencing homelessness into the program have varied. In Stanislaus County, for instance, Vartan said roughly 70% of the participants were unhoused before enrolling.\u003c/p>\n\u003cp>The opposite is true in Los Angeles and Riverside counties, where 30% and 20%–25% of enrollees are experiencing homelessness, respectively, health officials said. In Orange County, the figure is closer to 15%, according to Dr. Veronica Kelley, Director of the Orange County Health Care Agency.\u003c/p>\n\u003cfigure id=\"attachment_12007229\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007229\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398.jpg\" alt=\"A man sits next to three women at a table as he points to something.\" width=\"1024\" height=\"694\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398.jpg 1024w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398-800x542.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398-1020x691.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398-160x108.jpg 160w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Veronica Kelley, director of Behavioral Health Services for Orange County, right, listens as Orange County Superior Judge Ebrahim Baytieh speaks during a CARE court information session at Behavioral Health Training Center on Aug. 16, 2023, in Orange. The county’s behavioral health department and a representative from the public defender’s office is meeting with the public to explain what the CARE Act is. \u003ccite>(Gina Ferazzi / Los Angeles Times via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In the former two counties, the majority of petitions have come from family members, health officials said. In Orange County, Kelley said the figure is closer to 40%.\u003c/p>\n\u003cp>Rather than view this as a failure to reach people who are living outside, Ghaly said he’s actually pleased to see the higher levels of petitions coming from family members on behalf of people who have housing, emphasizing that the goal was not to solve homelessness but to solve the problem of untreated mental illness “upstream.”\u003c/p>\n\u003cp>“It means that we’re getting to meet them earlier,” he said. “Almost anyone with severe schizophrenia or a psychotic disorder may be at risk of homelessness.”\u003c/p>\n\u003cp>But, Ghaly acknowledged that because eligibility is narrowly tailored, it may also mean, “We might not see the kind of outcomes that we wanted to see.”\u003c/p>\n\u003cp>Under the legislation, people whose primary diagnosis is a psychotic disorder are eligible for CARE Court, but those whose psychosis is primarily the result of using drugs are not. Asked whether the state would consider expanding eligibility to include cases of drug-induced psychosis, Ghaly said the question is a “fraught” one.\u003c/p>\n\u003cp>“If you ask most psychiatrists who take care of patients with these diagnoses and in largely these social circumstances, it’s really hard to tell what came first,” he said. “Was it the substance-use disorder that drove the psychosis? Or, were there underlying psychotic features to some disorder — maybe diagnosed, maybe not — that then drove the substance-use disorder?”\u003c/p>\n\u003cp>He continued, “Where the state lands at the moment is, there may be a very important population of people who have significant substance-use disorders and these other mental health conditions, who could benefit from CARE. And as we engage with our county partners and the practitioners who are in CARE, we’re asking exactly this question.”\u003c/p>\n\u003cp>But, even if someone doesn’t end up in CARE Court, health officials say they’re often referred to other programs within the county. And in Orange County, Kelley said 41 out of 95 petitions were dismissed because the client was already receiving services.\u003c/p>\n\u003cp>“And it would be unethical to remove them from that treatment and stick them over here in court and hope that that works better,” she said.\u003c/p>\n\u003cp>Ultimately, Ghaly said, that is also part of the point.\u003c/p>\n\u003cp>“It really is a group of people who didn’t go all the way down the CARE path, but because the CARE pathway was a potential, they got served and supported,” he said.\u003c/p>\n\u003ch3>Building trust\u003c/h3>\n\u003cp>For those who do qualify for CARE Court, the process to reach a voluntary treatment plan or CARE Agreement can be challenging, judges and health officials said. Just building enough trust to get someone to come into court can itself sometimes take two months, Kelley said.\u003c/p>\n\u003cp>“None of us would be open to a stranger coming up to us and telling us, ‘Come with me to court. I can help you,’” she said. “So, to believe that someone who’s severely impacted by a mental illness would be open to that doesn’t make any sense.” [aside postID=\"news_11955211,news_11952228,news_11924117\" label=\"Related Stories\"]\u003c/p>\n\u003cp>Kaitlyn Willison, an attorney with Legal Assistance to the Elderly in San Francisco who represents CARE Court participants, said the first step might involve combing the streets to search for people, which takes time. Once the person is found, the next hurdle is building trust.\u003c/p>\n\u003cp>“That means I need to see them two, three, four times before they go to court,” Willison said. “And the timelines just aren’t set up in a way that allows us as respondents’ counsel enough time to build that really precious trust that we need to best advocate for our clients.”\u003c/p>\n\u003cp>Umberg said he’s looking into further legislation or possible rule changes within the court system to address the challenges Willison and others have experienced so far.\u003c/p>\n\u003cp>But Jain, with Disability Rights California, is skeptical. One of those challenges is baked into the nature of the program itself, he said: that it has the potential to veer away from voluntary agreements and into coerced care.\u003c/p>\n\u003cp>“The bottom line is that the court is a coercive program,” he said.\u003c/p>\n\u003cfigure id=\"attachment_12007227\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007227\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed.jpg\" alt=\"A white man wearing a blue dress suit rests his hand on his face with a calendar in the background.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Judge Michael Begert, presiding over CARE Court, sits in the San Francisco Superior Court in San Francisco on Sept. 17, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>For Judge Begert in San Francisco, coerced treatment is very much “what we’re trying to avoid.” But, he acknowledged that changing the cultures of both the court system and the mental health care system is no easy task.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“Getting people to change their mindset in a culture that’s very well-formed and static is a hard thing to do,” he said. “You bring the healthcare system into the criminal justice system — or the justice system in general — it starts to act like the justice system. So, that’s always a challenge.”\u003c/p>\n\n",
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"excerpt": "The California program is marking one year since it first rolled out in seven counties. It was billed as a way to get people with untreated schizophrenia and associated disorders — particularly those experiencing street homelessness — into services and housing.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">W\u003c/span>\u003c/p>\u003cp>hen it rolled out last year in eight counties, CARE Court took aim at one of the state’s most vexing challenges: how to treat people whose illness often makes them believe they are not sick and who, if left untreated, can oscillate between jails, hospitals and homelessness.\u003c/p>\n\u003cp>Using the weight of a judge’s black robe to nudge county health departments’ doctors in white coats to provide an array of services, the program sought to reach the hardest-to-treat cases.\u003c/p>\n\u003cp>Now, a year after the program went live in seven counties — San Francisco, Glenn, Tuolumne, Stanislaus, Orange, Riverside, and San Diego — and ten months after it launched in Los Angeles County, petitions appear to be trickling in slower than expected and treatment plans are taking longer to put in place.\u003c/p>\n\u003cp>And, while Gov. Gavin Newsom, who first \u003ca href=\"https://www.gov.ca.gov/2022/03/03/governor-newsom-launches-new-plan-to-help-californians-struggling-with-mental-health-challenges-homelessness/\">introduced the initiative in March 2022\u003c/a>, initially said it would target those “living on our streets with severe mental health and substance use disorders,” the number of unhoused people going through the program varies widely from county to county.\u003c/p>\n\u003cfigure id=\"attachment_12005914\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12005914\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05.jpg\" alt=\"A white man wearing a suit stands at a podium with a microphone.\" width=\"2000\" height=\"1355\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05-800x542.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05-1020x691.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05-160x108.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05-1536x1041.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/092024-Senate-Judiciary-FG-05-1920x1301.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">California State Senator Thomas Umberg speaks before the Senate Judiciary Committee about SB1338, the Community Assistance, Recovery, and Empowerment (CARE) Court Program, on April 26, 2022, in Sacramento. \u003ccite>(Fred Greaves/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>State Sen. Tom Umberg, who co-authored the \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB1338\">legislation\u003c/a> that implemented CARE Court, said the gradual rollout hasn’t come as a complete surprise.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We’re changing the culture here,” he said. “So, that takes a little time.”\u003c/p>\n\u003cp>As of mid-September, at least 692 petitions had been filed across seven of the counties in the first cohort, excluding San Francisco, according to data provided by superior court and county health officials. Of those petitions, a little more than a third, or 245, have been dismissed. And nearly one in five, or 121 petitions, have resulted in a CARE Agreement, an official document that details a voluntary treatment regime. There have been six court-ordered, or involuntary, CARE Plans issued.\u003c/p>\n\u003cp>San Francisco has so far received 42 petitions, said Melanie Kushnir, director of the Collaborative Justice Programs at the San Francisco Superior Courts. Of those, she said roughly half are active, meaning the participant is attending hearings and working toward or enrolled in a CARE Agreement. Citing privacy concerns, Kushnir declined to provide data on the exact number of dismissals or CARE Agreements reached but said there had been no CARE Plans issued.\u003c/p>\n\u003cp>The state had initially estimated that between 7,000 and 12,000 people would qualify for CARE Court each year once the program was fully implemented. But even accounting for the small number of counties that launched last year, court and public health officials agree the number of petitions is far fewer than expected — prompting opponents to argue the program is wasting taxpayers’ dollars.\u003c/p>\n\u003cp>According to the California Department of Finance, the state has already allocated $72 million to counties for start-up costs, along with $12 million for ongoing operations in fiscal year 2024–25, which will increase to $47 million in fiscal year 2026–27.\u003c/p>\n\u003cp>“We feel like the program has already failed,” said Samuel Jain, a senior mental health policy attorney at Disability Rights California, which is among the groups that advocated against CARE Court from the start. “The law doesn’t provide any new services and instead directs the limited resources we have to these expensive court processes.”\u003c/p>\n\u003cp>But supporters say it’s too early to pass judgment on a program that has yet to be fully implemented. The remaining 50 counties are due to open their own programs by Dec. 1.\u003c/p>\n\u003cp>“To really make some grand statement about its efficacy in the first 12 months of it rolling out, I think, is a leap for a state with 40 million people,” Dr. Mark Ghaly, the outgoing Secretary of California’s Health and Human Services Agency, told KQED. “But I do think that’s exactly the question that we have to keep in mind.”\u003c/p>\n\u003ch3>The number of petitions varies widely\u003c/h3>\n\u003cp>In Glenn County, with a population of \u003ca href=\"https://data.census.gov/profile/Glenn_County,_California?g=050XX00US06021\">around 29,000\u003c/a>, just one petition has been filed as of Sept. 12, and it was ultimately dismissed, said Chris Ruhl, executive officer of the Glenn County Superior Court. Ruhl expects one or two more may be submitted soon and that more will follow as word of the program spreads.\u003c/p>\n\u003cp>“We generally anticipate there will be an increase in the number of petitions and filings, but we don’t know that for sure,” he said. “We’ll be watching very closely.”\u003c/p>\n\u003cfigure id=\"attachment_12007228\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007228\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed.jpg\" alt=\"A white man wearing a blue dress suit leans against a wooden divider in a court room.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-12-BL_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Judge Michael Begert, presiding over CARE Court, stands in the San Francisco Superior Court in San Francisco on Sept. 17, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At the other end of the spectrum is Los Angeles County, which, with a population of around \u003ca href=\"https://data.census.gov/profile/Los_Angeles_County,_California?g=050XX00US06037\">10 million\u003c/a>, has seen the most petitions: 268 as of Sept. 18. There, the number of petitions has been steadily increasing, Los Angeles Superior Court Judge Scott Herin said.\u003c/p>\n\u003cp>“I don’t think it started off like everybody expected, which was an overwhelming flood of cases,” Herin said, adding that the gradual ramp-up was perhaps “more healthy.”\u003c/p>\n\u003cp>That’s allowed some county behavioral health agencies to reappropriate staff assigned to CARE Court to other needs. In Stanislaus County, which has received 47 petitions, 19 of which have been dismissed, Behavioral Health & Recovery Services Director Tony Vartan said some of his CARE Court staff spent the first four to five months doing outreach with police and sheriff departments, hospital workers and others to build awareness.\u003c/p>\n\u003cp>“But as we saw that trend of those petitions, we pulled back some of our staff, and we assigned them to areas that needed more work,” he said. “Our staff emphasize where the cases are, regardless of what program we manage. That way, we make sure that the staff are working and they’ve got cases.”\u003c/p>\n\u003ch3>Cases dismissed\u003c/h3>\n\u003cp>Despite the lower-than-expected number of petitions, county behavioral health and court staff say they weren’t surprised to see that more than a third have been dismissed. Dismissal rates vary across the counties, from just over 90% in Tuolumne County, where 10 of 11 cases were dismissed, to a low of 26% in both Riverside and Los Angeles counties.\u003c/p>\n\u003cp>To be eligible, San Francisco Superior Court Judge Michael Begert said participants need to not only be diagnosed with schizophrenia or another psychotic disorder, but they also must be likely to benefit from services, can’t already be enrolled in services, and must be unlikely to survive without additional support.\u003c/p>\n\u003cp>“And that’s a small eye in a needle to thread,” Begert said.\u003c/p>\n\u003cp>Algenib Collin is trying to thread that needle as she looks for any program that might help for her daughter.\u003c/p>\n\u003cp>Collin applied for CARE Court the day it opened, she said, “I was so desperate.”\u003c/p>\n\u003cp>For roughly 18 months prior, she had seen her daughter, now 27, rapidly deteriorate on San Francisco’s streets. Collin said she would receive a call from the hospital nearly every other week, reporting her daughter had been placed on a 5150, or a temporary mental health hold, only to be rereleased back into homelessness and addiction.\u003c/p>\n\u003cfigure id=\"attachment_11955160\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11955160\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED.jpg\" alt=\"A large multi-story building and a driveway alongside it.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Orange County Superior Court will technically house the local CARE Court, though judges say they will more likely hold meetings with patients at a more neutral site, like a conference room at the county health office. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>High on fentanyl and possibly other drugs, Collin said her daughter would bang her head against the sidewalk or speak to herself in a language only she could understand.\u003c/p>\n\u003cp>“My daughter will die if she doesn’t get help,” Collin said. “Believe me.”\u003c/p>\n\u003cp>However, when it came to determining whether she qualified for CARE Court, the petition was rejected. Collin doesn’t know why, and she may never know. Privacy laws prohibit her from accessing her daughter’s medical records, so she isn’t sure whether her daughter has been formally diagnosed with a psychotic disorder.\u003c/p>\n\u003cp>The legislation doesn’t include any provision that gives petitioners the right to appeal a judge’s denial, though Ghaly said she could potentially refile the case.\u003c/p>\n\u003cp>“It’s frustrating,” Collin said. “I don’t want my daughter to die.”\u003c/p>\n\u003cp>Representatives from the San Francisco Public Health Department declined to be interviewed. Begert said he couldn’t comment on individual cases.\u003c/p>\n\u003cp>Ultimately, it’s up to the judge to hold public health departments accountable for providing appropriate care, Ghaly said, sharing an anecdote about how officials in San Diego frame the program: “They share with clients that CARE is an approach for the individual to … really get the black robe effect to hold the county accountable. And that’s exactly the way that we had hoped.”\u003c/p>\n\u003ch3>Breaking the pattern\u003c/h3>\n\u003cp>Collin’s experience, however, highlights a disconnect between the way the program was initially described — to, in Newsom’s words from 2022, “break the pattern that leaves people without hope and cycling repeatedly through homelessness and incarceration” — and what was actually written into legislation.\u003c/p>\n\u003cp>In the first year of the program’s rollout, success rates of getting people who are also experiencing homelessness into the program have varied. In Stanislaus County, for instance, Vartan said roughly 70% of the participants were unhoused before enrolling.\u003c/p>\n\u003cp>The opposite is true in Los Angeles and Riverside counties, where 30% and 20%–25% of enrollees are experiencing homelessness, respectively, health officials said. In Orange County, the figure is closer to 15%, according to Dr. Veronica Kelley, Director of the Orange County Health Care Agency.\u003c/p>\n\u003cfigure id=\"attachment_12007229\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007229\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398.jpg\" alt=\"A man sits next to three women at a table as he points to something.\" width=\"1024\" height=\"694\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398.jpg 1024w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398-800x542.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398-1020x691.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1612098398-160x108.jpg 160w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Veronica Kelley, director of Behavioral Health Services for Orange County, right, listens as Orange County Superior Judge Ebrahim Baytieh speaks during a CARE court information session at Behavioral Health Training Center on Aug. 16, 2023, in Orange. The county’s behavioral health department and a representative from the public defender’s office is meeting with the public to explain what the CARE Act is. \u003ccite>(Gina Ferazzi / Los Angeles Times via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In the former two counties, the majority of petitions have come from family members, health officials said. In Orange County, Kelley said the figure is closer to 40%.\u003c/p>\n\u003cp>Rather than view this as a failure to reach people who are living outside, Ghaly said he’s actually pleased to see the higher levels of petitions coming from family members on behalf of people who have housing, emphasizing that the goal was not to solve homelessness but to solve the problem of untreated mental illness “upstream.”\u003c/p>\n\u003cp>“It means that we’re getting to meet them earlier,” he said. “Almost anyone with severe schizophrenia or a psychotic disorder may be at risk of homelessness.”\u003c/p>\n\u003cp>But, Ghaly acknowledged that because eligibility is narrowly tailored, it may also mean, “We might not see the kind of outcomes that we wanted to see.”\u003c/p>\n\u003cp>Under the legislation, people whose primary diagnosis is a psychotic disorder are eligible for CARE Court, but those whose psychosis is primarily the result of using drugs are not. Asked whether the state would consider expanding eligibility to include cases of drug-induced psychosis, Ghaly said the question is a “fraught” one.\u003c/p>\n\u003cp>“If you ask most psychiatrists who take care of patients with these diagnoses and in largely these social circumstances, it’s really hard to tell what came first,” he said. “Was it the substance-use disorder that drove the psychosis? Or, were there underlying psychotic features to some disorder — maybe diagnosed, maybe not — that then drove the substance-use disorder?”\u003c/p>\n\u003cp>He continued, “Where the state lands at the moment is, there may be a very important population of people who have significant substance-use disorders and these other mental health conditions, who could benefit from CARE. And as we engage with our county partners and the practitioners who are in CARE, we’re asking exactly this question.”\u003c/p>\n\u003cp>But, even if someone doesn’t end up in CARE Court, health officials say they’re often referred to other programs within the county. And in Orange County, Kelley said 41 out of 95 petitions were dismissed because the client was already receiving services.\u003c/p>\n\u003cp>“And it would be unethical to remove them from that treatment and stick them over here in court and hope that that works better,” she said.\u003c/p>\n\u003cp>Ultimately, Ghaly said, that is also part of the point.\u003c/p>\n\u003cp>“It really is a group of people who didn’t go all the way down the CARE path, but because the CARE pathway was a potential, they got served and supported,” he said.\u003c/p>\n\u003ch3>Building trust\u003c/h3>\n\u003cp>For those who do qualify for CARE Court, the process to reach a voluntary treatment plan or CARE Agreement can be challenging, judges and health officials said. Just building enough trust to get someone to come into court can itself sometimes take two months, Kelley said.\u003c/p>\n\u003cp>“None of us would be open to a stranger coming up to us and telling us, ‘Come with me to court. I can help you,’” she said. “So, to believe that someone who’s severely impacted by a mental illness would be open to that doesn’t make any sense.” \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Kaitlyn Willison, an attorney with Legal Assistance to the Elderly in San Francisco who represents CARE Court participants, said the first step might involve combing the streets to search for people, which takes time. Once the person is found, the next hurdle is building trust.\u003c/p>\n\u003cp>“That means I need to see them two, three, four times before they go to court,” Willison said. “And the timelines just aren’t set up in a way that allows us as respondents’ counsel enough time to build that really precious trust that we need to best advocate for our clients.”\u003c/p>\n\u003cp>Umberg said he’s looking into further legislation or possible rule changes within the court system to address the challenges Willison and others have experienced so far.\u003c/p>\n\u003cp>But Jain, with Disability Rights California, is skeptical. One of those challenges is baked into the nature of the program itself, he said: that it has the potential to veer away from voluntary agreements and into coerced care.\u003c/p>\n\u003cp>“The bottom line is that the court is a coercive program,” he said.\u003c/p>\n\u003cfigure id=\"attachment_12007227\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007227\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed.jpg\" alt=\"A white man wearing a blue dress suit rests his hand on his face with a calendar in the background.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/240917-CARECourt-04-BL_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Judge Michael Begert, presiding over CARE Court, sits in the San Francisco Superior Court in San Francisco on Sept. 17, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>For Judge Begert in San Francisco, coerced treatment is very much “what we’re trying to avoid.” But, he acknowledged that changing the cultures of both the court system and the mental health care system is no easy task.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Getting people to change their mindset in a culture that’s very well-formed and static is a hard thing to do,” he said. “You bring the healthcare system into the criminal justice system — or the justice system in general — it starts to act like the justice system. So, that’s always a challenge.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "california-sues-a-catholic-hospital-for-denying-patient-an-emergency-abortion",
"title": "California Sues a Catholic Hospital for Denying Patient an Emergency Abortion",
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"headTitle": "California Sues a Catholic Hospital for Denying Patient an Emergency Abortion | KQED",
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"content": "\u003cp>\u003cem>[Updated at 3:15 p.m. Sept. 30]\u003c/em>\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/california\">California\u003c/a> sued a Catholic hospital in Northern California for denying a pregnant patient emergency abortion care, Attorney General \u003ca href=\"https://www.kqed.org/news/tag/rob-bonta\">Rob Bonta\u003c/a> announced during a Monday press conference.\u003c/p>\n\u003cp>In the lawsuit, filed in Humboldt County Superior Court, Bonta alleges Providence St. Joseph Hospital in Eureka violated multiple laws, including the state’s Emergency Services Law, which mandates hospitals to provide care “necessary to relieve or eliminate the emergency medical condition.”\u003c/p>\n\u003cp>The case reveals the limits and challenges of abortion access in California despite the state having some of the nation’s strongest reproductive health protections.\u003c/p>\n\u003cp>In February, Eureka resident Dr. Anna Nusslock was 15 weeks pregnant when her water broke, she said at the press conference. Multiple doctors told her that the twins she was carrying would not survive, and if she didn’t receive an emergency abortion, neither would she. But Providence St. Joseph Hospital told Nusslock that it could not provide her with an abortion due to a hospital policy prohibiting medical intervention so long as “fetal heart tones” were present.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>While experiencing bleeding and “blinding pain,” Nusslock was rushed 12 miles to Mad River Community Hospital in Arcata, California, where she received a life-saving surgery.\u003c/p>\n\u003cp>“I am here today to tell my story for one simple reason, because I don’t want other people in my community to experience the same life-threatening trauma that I experienced,” Nusslock said.\u003c/p>\n\u003cp>Bonta said that it’s not unusual to hear tragic stories of women denied life-saving treatment coming out of the 22 states with full or partial abortion bans.\u003c/p>\n\u003cp>“But as Anna’s story illustrates, even here in California, we are not immune from this problem,” Bonta said.\u003c/p>\n\u003cp>Providence, which operates 51 hospitals and 1,000 clinics on the West Coast, a spokesperson said the hospital learned about the lawsuit Monday morning.\u003c/p>\n\u003cp>“We are currently reviewing the filings to understand what is being alleged,” Bryan Kawasaki wrote in a statement, which added that the hospital was “heartbroken” over Nusslock’s experience. “We review every event that may not have met our patient needs or expectations to understand what happened and take appropriate steps to meet those needs and expectations for every patient we encounter.\u003c/p>\n\u003cp>California’s suit also alleges that Providence’s policy discriminates against pregnant patients, providing different choices than they would for other patients.\u003c/p>\n\u003cp>[aside postID=news_12005009 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/iStock_000039661108_Large_qed-1020x678.jpg']\u003c/p>\n\u003cp>“The hospital ignores the medical advice of their physicians and the desires of their patients, subjecting them to intrusive hospital policies that are of no benefit to the patient’s health,” Bonta said.\u003c/p>\n\u003cp>Dr. Mary Ziegler, an abortion law expert at UC Davis, said that although the state has some of the strongest abortion rights in the country, there are “parts of California where those rights aren’t being realized.” That tends to be in disproportionately rural, conservative and smaller communities.\u003c/p>\n\u003cp>“We’ve also seen the influence of which kinds of hospitals operate in those communities,” Ziegler said. “Catholic and conservative hospitals tend to have different policies regarding access to these rights than others do.”\u003c/p>\n\u003cp>Widely seen as a potential candidate for governor in 2026, Bonta has used his enforcement powers to preserve and strengthen reproductive rights in the state.\u003c/p>\n\u003cp>Earlier this year, Bonta welcomed abortion care providers from states with restrictive laws like Arizona and Idaho, promising to protect them from anti-abortion laws. Last year, Bonta \u003ca href=\"https://www.kqed.org/news/11962088/california-sues-anti-abortion-counseling-centers-says-they-misled-women\">sued an anti-abortion group\u003c/a> and a chain of anti-abortion counseling centers, alleging the organizations misled women when they offered unproven treatments to reverse \u003ca href=\"https://www.kqed.org/news/11990192/what-the-supreme-court-ruling-on-the-abortion-pill-means-for-access-in-california\">medication abortions\u003c/a>.\u003c/p>\n\u003cp>Bonta said his attorneys believe there may be others who have endured experiences similar to Nusslock and urged others who may have been denied medical care to share their stories with the state Department of Justice.\u003c/p>\n\u003cp>“We don’t yet know the full scope of this problem or how many patients have suffered, but we do know that unless we act, this will happen again and again,” Bonta said.\u003c/p>\n\u003cp>Ziegler said the state government has made major financial and political commitments facilitating abortion access, positioning itself as an “\u003ca href=\"https://www.kqed.org/news/12002780/california-democrats-strike-back-against-local-conservative-rebellions-on-lgbtq-rights-abortion\">abortion sanctuary\u003c/a>” since the U.S. Supreme Court overturned the constitutional right to an abortion two years ago.\u003c/p>\n\u003cp>“The challenge now is to make those resources work in underprivileged parts of California,” Ziegler said.\u003c/p>\n\u003cp>“There may need to be more kind of targeted work done at the local level — as opposed to the state level — to make sure that the people we know are still not aware of or able to access those resources are able to do so,” she added.\u003c/p>\n\u003cp>\u003cem>KQED’s \u003ca href=\"https://www.kqed.org/author/carlysevern\">Carly Severn\u003c/a> contributed to this report. \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"headline": "California Sues a Catholic Hospital for Denying Patient an Emergency Abortion",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>[Updated at 3:15 p.m. Sept. 30]\u003c/em>\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/california\">California\u003c/a> sued a Catholic hospital in Northern California for denying a pregnant patient emergency abortion care, Attorney General \u003ca href=\"https://www.kqed.org/news/tag/rob-bonta\">Rob Bonta\u003c/a> announced during a Monday press conference.\u003c/p>\n\u003cp>In the lawsuit, filed in Humboldt County Superior Court, Bonta alleges Providence St. Joseph Hospital in Eureka violated multiple laws, including the state’s Emergency Services Law, which mandates hospitals to provide care “necessary to relieve or eliminate the emergency medical condition.”\u003c/p>\n\u003cp>The case reveals the limits and challenges of abortion access in California despite the state having some of the nation’s strongest reproductive health protections.\u003c/p>\n\u003cp>In February, Eureka resident Dr. Anna Nusslock was 15 weeks pregnant when her water broke, she said at the press conference. Multiple doctors told her that the twins she was carrying would not survive, and if she didn’t receive an emergency abortion, neither would she. But Providence St. Joseph Hospital told Nusslock that it could not provide her with an abortion due to a hospital policy prohibiting medical intervention so long as “fetal heart tones” were present.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>While experiencing bleeding and “blinding pain,” Nusslock was rushed 12 miles to Mad River Community Hospital in Arcata, California, where she received a life-saving surgery.\u003c/p>\n\u003cp>“I am here today to tell my story for one simple reason, because I don’t want other people in my community to experience the same life-threatening trauma that I experienced,” Nusslock said.\u003c/p>\n\u003cp>Bonta said that it’s not unusual to hear tragic stories of women denied life-saving treatment coming out of the 22 states with full or partial abortion bans.\u003c/p>\n\u003cp>“But as Anna’s story illustrates, even here in California, we are not immune from this problem,” Bonta said.\u003c/p>\n\u003cp>Providence, which operates 51 hospitals and 1,000 clinics on the West Coast, a spokesperson said the hospital learned about the lawsuit Monday morning.\u003c/p>\n\u003cp>“We are currently reviewing the filings to understand what is being alleged,” Bryan Kawasaki wrote in a statement, which added that the hospital was “heartbroken” over Nusslock’s experience. “We review every event that may not have met our patient needs or expectations to understand what happened and take appropriate steps to meet those needs and expectations for every patient we encounter.\u003c/p>\n\u003cp>California’s suit also alleges that Providence’s policy discriminates against pregnant patients, providing different choices than they would for other patients.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The hospital ignores the medical advice of their physicians and the desires of their patients, subjecting them to intrusive hospital policies that are of no benefit to the patient’s health,” Bonta said.\u003c/p>\n\u003cp>Dr. Mary Ziegler, an abortion law expert at UC Davis, said that although the state has some of the strongest abortion rights in the country, there are “parts of California where those rights aren’t being realized.” That tends to be in disproportionately rural, conservative and smaller communities.\u003c/p>\n\u003cp>“We’ve also seen the influence of which kinds of hospitals operate in those communities,” Ziegler said. “Catholic and conservative hospitals tend to have different policies regarding access to these rights than others do.”\u003c/p>\n\u003cp>Widely seen as a potential candidate for governor in 2026, Bonta has used his enforcement powers to preserve and strengthen reproductive rights in the state.\u003c/p>\n\u003cp>Earlier this year, Bonta welcomed abortion care providers from states with restrictive laws like Arizona and Idaho, promising to protect them from anti-abortion laws. Last year, Bonta \u003ca href=\"https://www.kqed.org/news/11962088/california-sues-anti-abortion-counseling-centers-says-they-misled-women\">sued an anti-abortion group\u003c/a> and a chain of anti-abortion counseling centers, alleging the organizations misled women when they offered unproven treatments to reverse \u003ca href=\"https://www.kqed.org/news/11990192/what-the-supreme-court-ruling-on-the-abortion-pill-means-for-access-in-california\">medication abortions\u003c/a>.\u003c/p>\n\u003cp>Bonta said his attorneys believe there may be others who have endured experiences similar to Nusslock and urged others who may have been denied medical care to share their stories with the state Department of Justice.\u003c/p>\n\u003cp>“We don’t yet know the full scope of this problem or how many patients have suffered, but we do know that unless we act, this will happen again and again,” Bonta said.\u003c/p>\n\u003cp>Ziegler said the state government has made major financial and political commitments facilitating abortion access, positioning itself as an “\u003ca href=\"https://www.kqed.org/news/12002780/california-democrats-strike-back-against-local-conservative-rebellions-on-lgbtq-rights-abortion\">abortion sanctuary\u003c/a>” since the U.S. Supreme Court overturned the constitutional right to an abortion two years ago.\u003c/p>\n\u003cp>“The challenge now is to make those resources work in underprivileged parts of California,” Ziegler said.\u003c/p>\n\u003cp>“There may need to be more kind of targeted work done at the local level — as opposed to the state level — to make sure that the people we know are still not aware of or able to access those resources are able to do so,” she added.\u003c/p>\n\u003cp>\u003cem>KQED’s \u003ca href=\"https://www.kqed.org/author/carlysevern\">Carly Severn\u003c/a> contributed to this report. \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Gov. Gavin Newsom vetoed a \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240AB3129\">bill\u003c/a> that would have given \u003ca href=\"https://www.kqed.org/news/tag/california\">California\u003c/a> the ability to block private equity acquisitions of health care facilities.\u003c/p>\n\u003cp>The proposed legislation would have empowered the state’s attorney general to review and veto deals garnered by private equity firms deemed bad for consumers and patients. It covered transactions involving public hospitals, health systems, physician groups and long-term care facilities operating in California.\u003c/p>\n\u003cp>A key provision aimed to prevent investors from meddling in health care decisions, ensuring that physicians and medical professionals retain autonomy over patient care.\u003c/p>\n\u003cp>Newsom said the bill was redundant because the \u003ca href=\"https://hcai.ca.gov/affordability/ohca/\">Office of Health Care Affordability\u003c/a> already has the authority to review and evaluate health care transactions in the state.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Private equity firms spend about \u003ca href=\"https://www.chcf.org/publication/private-equity-in-health-care-prevalence-impact-and-policy-options-for-california-and-the-u-s/#:~:text=View%20the%20Report&text=At%20its%20most%20recent%20peak,and%20%2420%20billion%20in%20California.\">$20 billion\u003c/a> a year on health care transactions in California alone and $83 billion nationally. Physician practices are particularly appealing targets, with the number of transactions increasing \u003ca href=\"https://www.antitrustinstitute.org/wp-content/uploads/2023/07/AAI-UCB-EG_Private-Equity-I-Physician-Practice-Report_FINAL.pdf\">sixfold over the past decade\u003c/a>. While financial firms promise operational efficiency and management expertise, critics said the need for rapid returns — typically within three to seven years — could lead to aggressive cost-cutting measures.\u003c/p>\n\u003cp>“Investors often decrease staffing ratios, increase prices and buy up multiple health care entities in the same region or specialty to use that market power to hike prices,” said Dr. Christopher Cai, a physician at Brigham and Women’s Hospital and a Harvard Medical School researcher specializing in pharmacoeconomics.\u003c/p>\n\u003cp>According to a 2021 \u003ca href=\"https://www.antitrustinstitute.org/wp-content/uploads/2023/07/AAI-UCB-EG_Private-Equity-I-Physician-Practice-Report_FINAL.pdf\">report\u003c/a> from UC Berkeley, the financial pressures created by private equity ownership can push physicians to meet patient quotas, prioritize more lucrative procedures or cut back on less profitable services. Over time, this can erode the quality of care patients receive.\u003c/p>\n\u003cp>[aside postID=science_1994424 hero='https://cdn.kqed.org/wp-content/uploads/sites/35/2024/09/240617-HealthcareMinWage-14-BL-1020x680.jpg']\u003c/p>\n\u003cp>Consumer advocates, labor unions and the California Medical Association called the measure crucial to patient care.\u003c/p>\n\u003cp>“Today is a sad day for health care consumers,” said Assemblymember Jim Wood (D-Healdsburg), the bill’s sponsor, in a statement. “When we look across the nation, we see private equity’s encroachment into health care growing by leaps and bounds — and I had hoped California would be the first state to provide a preventive and reasonable initial review to protect health care consumers from being the victims of profit-driven investors who are not interested in ensuring that Californians get quality care where they need it and at an affordable price.”\u003c/p>\n\u003cp>The bill faced fierce opposition from the California Hospital Association and industry groups such as the American Investment Council (AIC) that argued the extra regulation could discourage investment in health care and limit innovation and access to capital.\u003c/p>\n\u003cp>“The Governor’s well-reasoned decision will help patients and communities continue to have access to quality care,” said Drew Maloney, the Council’s CEO.\u003c/p>\n\u003cp>Newsom’s veto may negatively influence support for a \u003ca href=\"https://www.markey.senate.gov/HealthOverWealth\">similar proposal\u003c/a> at the national level, where it was introduced by Sen. Ed Markey (D-Massachusetts).\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Gov. Gavin Newsom vetoed a \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240AB3129\">bill\u003c/a> that would have given \u003ca href=\"https://www.kqed.org/news/tag/california\">California\u003c/a> the ability to block private equity acquisitions of health care facilities.\u003c/p>\n\u003cp>The proposed legislation would have empowered the state’s attorney general to review and veto deals garnered by private equity firms deemed bad for consumers and patients. It covered transactions involving public hospitals, health systems, physician groups and long-term care facilities operating in California.\u003c/p>\n\u003cp>A key provision aimed to prevent investors from meddling in health care decisions, ensuring that physicians and medical professionals retain autonomy over patient care.\u003c/p>\n\u003cp>Newsom said the bill was redundant because the \u003ca href=\"https://hcai.ca.gov/affordability/ohca/\">Office of Health Care Affordability\u003c/a> already has the authority to review and evaluate health care transactions in the state.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Private equity firms spend about \u003ca href=\"https://www.chcf.org/publication/private-equity-in-health-care-prevalence-impact-and-policy-options-for-california-and-the-u-s/#:~:text=View%20the%20Report&text=At%20its%20most%20recent%20peak,and%20%2420%20billion%20in%20California.\">$20 billion\u003c/a> a year on health care transactions in California alone and $83 billion nationally. Physician practices are particularly appealing targets, with the number of transactions increasing \u003ca href=\"https://www.antitrustinstitute.org/wp-content/uploads/2023/07/AAI-UCB-EG_Private-Equity-I-Physician-Practice-Report_FINAL.pdf\">sixfold over the past decade\u003c/a>. While financial firms promise operational efficiency and management expertise, critics said the need for rapid returns — typically within three to seven years — could lead to aggressive cost-cutting measures.\u003c/p>\n\u003cp>“Investors often decrease staffing ratios, increase prices and buy up multiple health care entities in the same region or specialty to use that market power to hike prices,” said Dr. Christopher Cai, a physician at Brigham and Women’s Hospital and a Harvard Medical School researcher specializing in pharmacoeconomics.\u003c/p>\n\u003cp>According to a 2021 \u003ca href=\"https://www.antitrustinstitute.org/wp-content/uploads/2023/07/AAI-UCB-EG_Private-Equity-I-Physician-Practice-Report_FINAL.pdf\">report\u003c/a> from UC Berkeley, the financial pressures created by private equity ownership can push physicians to meet patient quotas, prioritize more lucrative procedures or cut back on less profitable services. Over time, this can erode the quality of care patients receive.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Consumer advocates, labor unions and the California Medical Association called the measure crucial to patient care.\u003c/p>\n\u003cp>“Today is a sad day for health care consumers,” said Assemblymember Jim Wood (D-Healdsburg), the bill’s sponsor, in a statement. “When we look across the nation, we see private equity’s encroachment into health care growing by leaps and bounds — and I had hoped California would be the first state to provide a preventive and reasonable initial review to protect health care consumers from being the victims of profit-driven investors who are not interested in ensuring that Californians get quality care where they need it and at an affordable price.”\u003c/p>\n\u003cp>The bill faced fierce opposition from the California Hospital Association and industry groups such as the American Investment Council (AIC) that argued the extra regulation could discourage investment in health care and limit innovation and access to capital.\u003c/p>\n\u003cp>“The Governor’s well-reasoned decision will help patients and communities continue to have access to quality care,” said Drew Maloney, the Council’s CEO.\u003c/p>\n\u003cp>Newsom’s veto may negatively influence support for a \u003ca href=\"https://www.markey.senate.gov/HealthOverWealth\">similar proposal\u003c/a> at the national level, where it was introduced by Sen. Ed Markey (D-Massachusetts).\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "bay-areas-long-covid-community-celebrates-moonshot-bill-for-10-billion-in-funding",
"title": "Bay Area's Long COVID Community Celebrates Moonshot Bill for $10 Billion in Funding",
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"headTitle": "Bay Area’s Long COVID Community Celebrates Moonshot Bill for $10 Billion in Funding | KQED",
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"content": "\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/long-covid\">Long COVID\u003c/a> patients and advocates in the \u003ca href=\"https://www.kqed.org/news/tag/bay-area\">Bay Area\u003c/a> have spent years pushing for a concerted effort toward research, prevention and a cure.\u003c/p>\n\u003cp>They’re now hopeful that the increasingly widespread chronic condition that follows many COVID-19 infections will soon be better understood, thanks to legislation introduced Friday in the House of Representatives that would provide $10 billion in funding for long COVID research and education.\u003c/p>\n\u003cp>The Long COVID Research Moonshot Act, proposed by Rep. Ilhan Omar (D-Minn.) and co-sponsored by Rep.\u003ca href=\"https://www.kqed.org/news/11973684\"> Barbara Lee\u003c/a> (D-Oakland), is a companion bill to one that Sen. Bernie Sanders (I-Vt.) \u003ca href=\"https://www.congress.gov/bill/118th-congress/senate-bill/4964/cosponsors?s=2&r=2&q=%7B%22search%22%3A%22bernie+sanders%22%7D\">introduced\u003c/a> in the Senate in August.\u003c/p>\n\u003cp>“It’s huge for us,” said Lisa McCorkell, an Oakland resident who co-founded the Patient-Led Research Collaborative. The PLRC is a group of researchers living with long COVID and other related chronic conditions.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It really shows that this bill has broad support — as it should — because it’s aiming to address the crisis of long COVID in a way that puts the resources that are necessary behind it,” McCorkell said.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.kqed.org/news/11986724/after-months-long-coma-this-latino-immigrant-worker-is-still-fighting-mysterious-symptoms\">symptoms of long COVID\u003c/a> often include brain fog and fatigue. Many people found to have it have also been diagnosed with conditions like \u003ca href=\"https://solvecfs.org/me-cfs-long-covid/about-the-disease/\">myalgic encephalomyelitis/chronic fatigue syndrome\u003c/a> (ME/CF) and \u003ca href=\"https://www.hopkinsmedicine.org/health/conditions-and-diseases/postural-orthostatic-tachycardia-syndrome-pots\">postural orthostatic tachycardia syndrome\u003c/a> (POTS). These chronic, complex immune diseases can profoundly limit the wellness and productivity of patients and, like long COVID, are often triggered by an infection.\u003c/p>\n\u003cp>Studies have also found that COVID-19 can cause immune system \u003ca href=\"https://www.yalemedicine.org/news/the-long-covid-puzzle-autoimmunity-inflammation-and-other-possible-causes#:~:text=The%20theory%20is%20that%20COVID,in%20those%20with%20Long%20COVID.\">dysfunction\u003c/a>, allowing dormant infections, like the virus that causes Epstein-Barr disease or the bacteria that causes Lyme disease, to reemerge. And while vaccines have ensured bouts of COVID-19 are less likely to be deadly than they were at the pandemic’s start, every infection makes you more \u003ca href=\"https://www.unmc.edu/healthsecurity/transmission/2023/12/27/every-covid-infection-increases-your-risk-of-long-covid-study-warns/\">susceptible \u003c/a>to contracting long COVID.\u003c/p>\n\u003cp>[aside postID=news_12006600 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/GettyImages-1668874864-1020x646.jpg']\u003c/p>\n\u003cp>Dr. Linda Geng, co-director of the Stanford Post-Acute COVID-19 Syndrome Clinic, said long COVID has become a “huge public health problem,” affecting millions of people in the United States long term.\u003c/p>\n\u003cp>Though physicians have an FDA-approved therapeutic toolkit for COVID-19, they currently have “minimal to no evidence-based strategies” to help those who have long COVID or who may develop it in the future, Geng said.\u003c/p>\n\u003cp>The Long COVID Research Moonshot Act would create a new research center within the National Institutes of Health to study the condition and other related illnesses, like ME/CFS and POTS. The center would house a new database tracking long COVID cases, an advisory board, and new grant processes to accelerate clinical trials, according to a report by \u003ca href=\"https://www.motherjones.com/politics/2024/09/ilhan-omar-bernie-long-covid-house-bill/\">\u003cem>Mother Jones\u003c/em>\u003c/a>.\u003c/p>\n\u003cp>The legislation would also fund public health education and clinics dedicated to long COVID care, especially in underserved communities — and would require any new treatments developed through the act to be reasonably priced and accessible to more patients.\u003c/p>\n\u003cp>The Bay Area’s Umoja Health, which serves the COVID-19 and health needs of people of color, was an early sponsor of the Sanders bill. Co-founder Kim Rhoads described how long COVID can transform patients’ lives and contribute to long-term disability.\u003c/p>\n\u003cp>“We’ve heard stories of folks who now have a hospital bed in their house where the family member who was affected by long COVID lives,” Rhoads said. “Folks who do not like to get out of bed, have burning feet and difficulty walking or have exertional malaise, which is basically a fatigue that can come over people after just doing simple things like cooking a meal.\u003c/p>\n\u003cp>Rhoads said the disease has largely been ignored or treated like a seasonal virus, such as the flu. “There are political reasons to deny that there are any long-term effects of COVID,” Rhoads said, “to allow for us to ‘get back to normal.’”\u003c/p>\n\u003cp>In her work, Rhoads has seen firsthand how communities of color and disabled people have been disproportionately harmed by long COVID. Historically marginalized groups are also on the frontlines of infections and suffer from the highest mortality rates.\u003c/p>\n\u003cp>Disabled people \u003ca href=\"https://www.cidrap.umn.edu/covid-19/long-covid-rate-among-disabled-people-double-able-bodied\">are twice as likely\u003c/a> to contract long COVID as nondisabled people, said Sabrina Epstein, a policy analyst with Disability Rights California.\u003c/p>\n\u003cp>“This is deeply an equity and justice issue,” said Epstein, whose disability makes her at risk for long COVID. “The research proposed by this bill has the potential to benefit folks in the disability and chronic illness community.”\u003c/p>\n\u003cp>\u003cem>KQED’s \u003ca href=\"https://www.kqed.org/author/carlysevern\">Carly Severn\u003c/a> contributed to this report. \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "Legislation introduced in Congress could improve the lives of millions of patients, according to long COVID patients and advocates in the Bay Area.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/long-covid\">Long COVID\u003c/a> patients and advocates in the \u003ca href=\"https://www.kqed.org/news/tag/bay-area\">Bay Area\u003c/a> have spent years pushing for a concerted effort toward research, prevention and a cure.\u003c/p>\n\u003cp>They’re now hopeful that the increasingly widespread chronic condition that follows many COVID-19 infections will soon be better understood, thanks to legislation introduced Friday in the House of Representatives that would provide $10 billion in funding for long COVID research and education.\u003c/p>\n\u003cp>The Long COVID Research Moonshot Act, proposed by Rep. Ilhan Omar (D-Minn.) and co-sponsored by Rep.\u003ca href=\"https://www.kqed.org/news/11973684\"> Barbara Lee\u003c/a> (D-Oakland), is a companion bill to one that Sen. Bernie Sanders (I-Vt.) \u003ca href=\"https://www.congress.gov/bill/118th-congress/senate-bill/4964/cosponsors?s=2&r=2&q=%7B%22search%22%3A%22bernie+sanders%22%7D\">introduced\u003c/a> in the Senate in August.\u003c/p>\n\u003cp>“It’s huge for us,” said Lisa McCorkell, an Oakland resident who co-founded the Patient-Led Research Collaborative. The PLRC is a group of researchers living with long COVID and other related chronic conditions.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It really shows that this bill has broad support — as it should — because it’s aiming to address the crisis of long COVID in a way that puts the resources that are necessary behind it,” McCorkell said.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.kqed.org/news/11986724/after-months-long-coma-this-latino-immigrant-worker-is-still-fighting-mysterious-symptoms\">symptoms of long COVID\u003c/a> often include brain fog and fatigue. Many people found to have it have also been diagnosed with conditions like \u003ca href=\"https://solvecfs.org/me-cfs-long-covid/about-the-disease/\">myalgic encephalomyelitis/chronic fatigue syndrome\u003c/a> (ME/CF) and \u003ca href=\"https://www.hopkinsmedicine.org/health/conditions-and-diseases/postural-orthostatic-tachycardia-syndrome-pots\">postural orthostatic tachycardia syndrome\u003c/a> (POTS). These chronic, complex immune diseases can profoundly limit the wellness and productivity of patients and, like long COVID, are often triggered by an infection.\u003c/p>\n\u003cp>Studies have also found that COVID-19 can cause immune system \u003ca href=\"https://www.yalemedicine.org/news/the-long-covid-puzzle-autoimmunity-inflammation-and-other-possible-causes#:~:text=The%20theory%20is%20that%20COVID,in%20those%20with%20Long%20COVID.\">dysfunction\u003c/a>, allowing dormant infections, like the virus that causes Epstein-Barr disease or the bacteria that causes Lyme disease, to reemerge. And while vaccines have ensured bouts of COVID-19 are less likely to be deadly than they were at the pandemic’s start, every infection makes you more \u003ca href=\"https://www.unmc.edu/healthsecurity/transmission/2023/12/27/every-covid-infection-increases-your-risk-of-long-covid-study-warns/\">susceptible \u003c/a>to contracting long COVID.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Dr. Linda Geng, co-director of the Stanford Post-Acute COVID-19 Syndrome Clinic, said long COVID has become a “huge public health problem,” affecting millions of people in the United States long term.\u003c/p>\n\u003cp>Though physicians have an FDA-approved therapeutic toolkit for COVID-19, they currently have “minimal to no evidence-based strategies” to help those who have long COVID or who may develop it in the future, Geng said.\u003c/p>\n\u003cp>The Long COVID Research Moonshot Act would create a new research center within the National Institutes of Health to study the condition and other related illnesses, like ME/CFS and POTS. The center would house a new database tracking long COVID cases, an advisory board, and new grant processes to accelerate clinical trials, according to a report by \u003ca href=\"https://www.motherjones.com/politics/2024/09/ilhan-omar-bernie-long-covid-house-bill/\">\u003cem>Mother Jones\u003c/em>\u003c/a>.\u003c/p>\n\u003cp>The legislation would also fund public health education and clinics dedicated to long COVID care, especially in underserved communities — and would require any new treatments developed through the act to be reasonably priced and accessible to more patients.\u003c/p>\n\u003cp>The Bay Area’s Umoja Health, which serves the COVID-19 and health needs of people of color, was an early sponsor of the Sanders bill. Co-founder Kim Rhoads described how long COVID can transform patients’ lives and contribute to long-term disability.\u003c/p>\n\u003cp>“We’ve heard stories of folks who now have a hospital bed in their house where the family member who was affected by long COVID lives,” Rhoads said. “Folks who do not like to get out of bed, have burning feet and difficulty walking or have exertional malaise, which is basically a fatigue that can come over people after just doing simple things like cooking a meal.\u003c/p>\n\u003cp>Rhoads said the disease has largely been ignored or treated like a seasonal virus, such as the flu. “There are political reasons to deny that there are any long-term effects of COVID,” Rhoads said, “to allow for us to ‘get back to normal.’”\u003c/p>\n\u003cp>In her work, Rhoads has seen firsthand how communities of color and disabled people have been disproportionately harmed by long COVID. Historically marginalized groups are also on the frontlines of infections and suffer from the highest mortality rates.\u003c/p>\n\u003cp>Disabled people \u003ca href=\"https://www.cidrap.umn.edu/covid-19/long-covid-rate-among-disabled-people-double-able-bodied\">are twice as likely\u003c/a> to contract long COVID as nondisabled people, said Sabrina Epstein, a policy analyst with Disability Rights California.\u003c/p>\n\u003cp>“This is deeply an equity and justice issue,” said Epstein, whose disability makes her at risk for long COVID. “The research proposed by this bill has the potential to benefit folks in the disability and chronic illness community.”\u003c/p>\n\u003cp>\u003cem>KQED’s \u003ca href=\"https://www.kqed.org/author/carlysevern\">Carly Severn\u003c/a> contributed to this report. \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "bill-on-newsoms-desk-would-require-nonprofits-that-serve-californians-with-developmental-disabilities-to-fulfill-public-records-requests",
"title": "Bill Would Mandate Greater Transparency From Nonprofits Serving Californians With Developmental Disabilities",
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"headTitle": "Bill Would Mandate Greater Transparency From Nonprofits Serving Californians With Developmental Disabilities | KQED",
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"content": "\u003cp>A bill before Gov. Gavin Newsom would force the group of regional nonprofits that serve Californians with developmental disabilities to comply with the same transparency laws as state agencies, allowing \u003ca href=\"https://docs.google.com/spreadsheets/d/16S5-6nFOe4xMZ8wN0cVXhdZjGoy2PyJD/edit?usp=drive_link&ouid=109411565409580749553&rtpof=true&sd=true\">nearly 450,000 people\u003c/a> with disabilities to access certain records and information related to their care for the first time.\u003c/p>\n\u003cp>The bill, AB 1147, \u003ca href=\"https://digitaldemocracy.calmatters.org/bills/ca_202320240ab1147\">passed the state Assembly and Senate \u003c/a>without opposition at the end of August, \u003ca href=\"https://digitaldemocracy.calmatters.org/bills/ca_202320240ab1147\">after a 19-month fight\u003c/a> in which many of its accountability measures were stripped out. The most impactful remaining provision would make the 21 nonprofit organizations throughout the state, called “regional centers,” subject to the \u003ca href=\"https://www.thefirstamendment.org/media/publicrecordsact.pdf\">California Public Records Act (PRA)\u003c/a>, a law that requires the public disclosure of government records when requested.\u003c/p>\n\u003cp>Proponents of the bill argue the regional centers perform a public function and are entirely funded by state dollars and should, therefore, be subject to the PRA. However, the centers that oppose the bill say that complying with it would strain an already cash-strapped system and could lead to accidental disclosures of personal information.\u003c/p>\n\u003cp>California’s developmental disability system operates with a budget of more than $15 billion, serving Californians with a range of conditions, including autism, cerebral palsy, intellectual disability and epilepsy. All funding and services flow through the regional centers, which connect people with disabilities to various service providers.\u003c/p>\n\u003cp>The governor is expected to sign or veto the bill by Sept. 26.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>A quirk of California’s sweeping 1977 developmental disability law, known as the Lanterman Act, established the regional centers as private nonprofits rather than public agencies, keeping them exempt from the PRA. The intention was to create independent, board-operated organizations that could respond more nimbly than a single statewide agency to each community’s needs. However, critics say this design has led to a system with 21 different operational methods, and the policies of each center remain opaque.\u003c/p>\n\u003cp>“It just seems so wrong and so unfair that an entire sector of local entities could evade the Public Records Act through some wrinkle that they happened to have been established decades ago as nonprofits,” said Vivian Haun, a senior policy attorney at Disability Rights California, which has advocated for the bill.\u003c/p>\n\u003cp>Haun researched and wrote the original PRA policy proposal that ended up in AB 1147. She points to \u003ca href=\"https://www.cde.ca.gov/sp/ch/ec47604faq.asp#:~:text=All%20state%20and%20local%20agencies,are%20subject%20to%20the%20Public\">a law Newsom signed in 2019\u003c/a> making charter schools subject to the PRA and argues that should be the precedent for other nonprofits that serve a public function.\u003c/p>\n\u003cp>“They’re expected by the government to do all the same things that a traditional school district is supposed to do, which is to provide a public education to children using the same source of funds,” Haun said. “It just so happens that many of them are nonprofit in status.”\u003c/p>\n\u003cp>In a July 2023 \u003ca href=\"https://sjud.senate.ca.gov/sites/sjud.senate.ca.gov/files/ab_1147_sjud_analysis.pdf\">report\u003c/a>, the state Senate Judiciary Committee firmly underscored Haun’s argument, stating, “If anything, the regional centers land even more squarely in the public domain than charter schools: While charter schools are a quasi-private alternative to public schools, regional centers are the public option.”\u003c/p>\n\u003ch2>Calls for more transparency\u003c/h2>\n\u003cp>A slew of reports in recent years have called out California’s developmental disability system for a lack of transparency and accountability, among other issues. A 2022 \u003ca href=\"https://information.auditor.ca.gov/pdfs/reports/2021-107.pdf\">State Auditor’s Office report\u003c/a> found that \u003ca href=\"https://drive.google.com/file/d/1po5JtPCmC5pryZKHbylflJr4kNIxhTKn/view?usp=drive_link\">some regional centers \u003c/a>were not conducting regular quality assurance reviews of their vendors despite a 2016 report identifying the same issue.\u003c/p>\n\u003cp>Last year, \u003ca href=\"https://lhc.ca.gov/wp-content/uploads/Reports/273/Report273.pdf\">the Little Hoover Commission\u003c/a>, an independent state oversight agency, found that extreme racial disparities have persisted in the system for decades despite the state investing $66 million over recent years to address the issue. It also found that the quality of care disabled people and their families receive can differ wildly from one regional center to another.\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"disability-community\"]\u003c/p>\n\u003cp>Last year, \u003ca href=\"https://www.kqed.org/news/11969597/whistleblowers-call-out-california-group-home-for-abuse-against-disabled-residents\">KQED published an investigation \u003c/a>of abuse allegations at a disability group home in the Sacramento area that fell within the jurisdiction of Alta Regional Center. At the time, the information about the center’s investigations into the allegations were not publicly available.\u003c/p>\n\u003cp>The KQED analysis of data from the Department of Developmental Services (DDS) showed that reports of abuse in disability group homes are somewhat common. From 2012 to 2022, the agency recorded at least 1,900 incidents of suspected abuse and more than 500 incidents of suspected neglect.\u003c/p>\n\u003cp>Judy Mark, president of Disability Voices United, a sponsor of AB 1147, said the additional transparency the bill calls for would help watchdog groups investigate and understand why these cases keep happening. “If we had that information, we would be able to see, ‘Oh, there is a pattern of problems at this time at this agency.’ Or, ‘Everything looked fine; how did you not see that these abuses were happening or that things were dirty or that people were getting hurt?’” she said.\u003c/p>\n\u003cp>Besides cases of abuse, Mark said the opaqueness of regional centers makes it especially frustrating for disabled individuals when they attempt to understand why they were denied services.\u003c/p>\n\u003cp>“All we know as families is that if you are at one regional center, you can get a service, but if you’re at a different regional center, you don’t,” Mark said. “We would be asking, like, ‘What are the consistent policies that you are applying toward individuals so that we know why somebody got a yes and another person got a no?’”\u003c/p>\n\u003ch2>Centers push back\u003c/h2>\n\u003cp>Regional centers fervently oppose the PRA requirement in the bill, claiming that they don’t have the staffing or resources to comply with it — despite a recent \u003ca href=\"https://www.latimes.com/california/story/2024-08-20/unused-money-at-regional-centers#:~:text=Nearly%20%241%20billion%20allocated%20for,said%20they%20needed%20more%20help.\">Los Angeles Times report\u003c/a> that found regional centers left nearly $1 billion unspent in 2021–22. Doing so, the centers said, could also result in the release of private health information.\u003c/p>\n\u003cp>“Given the highly sensitive information maintained on each individual, and the potential for redaction errors, there is an inherent privacy risk every time a PRA is responded to,” said Amy Westling, executive director of the Association of Regional Center Agencies (ARCA), in an email. “This is particularly true when new staff without prior experience with the PRA would be responding to requests.”\u003c/p>\n\u003cp>Westling also pointed to the litany of disclosures that regional centers are already required to make publicly available online, including “information about policies, spending patterns, and boards of directors for each regional center.” Each regional center also transmits information daily to the DDS, which is subject to the PRA, she said.\u003c/p>\n\u003cp>But Haun, of Disability Rights California, said the bigger issue is that regional centers should be held to the same accountability standards as other publicly funded entities.\u003c/p>\n\u003cp>“Why should they be exempt from the same transparency requirements and expectations that all other entities are expected to comply with when they are using taxpayer dollars to carry out governmental functions?” she said.\u003c/p>\n\u003ch2>Upcoming reform efforts\u003c/h2>\n\u003cp>Advocates say the timing of the bill is crucial. Earlier this year, the California Health and Human Services Agency began working on the \u003ca href=\"https://www.chhs.ca.gov/home/master-plan-for-developmental-services/#\">Master Plan for Developmental Services\u003c/a>, an expansive effort to significantly transform how the state’s developmental disability system operates. The agency is convening stakeholders from across the system to develop a framework “for providing equitable, high quality, and person-centered services to all Californians with intellectual and developmental disabilities.” The plan is expected to be completed by March 2025.\u003c/p>\n\u003cp>The transparency that the bill’s PRA requirement would provide is critical to the master plan’s success, advocates argued.\u003c/p>\n\u003cp>“We can’t possibly do what we need to do to get that master plan done if we don’t have access to the information we need from the regional centers,” Mark said. “And that’s why we hope that Gov. Newsom will see this as just one step towards complete transparency and accountability over a system that spends over $15 billion a year.”\u003c/p>\n\u003cp>But Westling, of ARCA, said the goals of the master plan can be met without subjecting regional centers to the PRA. “If gaps in available data and information are identified through the master plan or other processes, we are happy to help identify potential solutions,” she said.\u003c/p>\n\u003cp>Haun added that increasing transparency for regional centers would also open the doors to independent studies, research, and policy analyses that could help dramatically improve the system. “There’s almost nothing like that now,” she said. “It’s critical to be able to improve the system and help the state know how to better invest the funds.”\u003c/p>\n\u003cp>She also believes that the bill goes beyond policy implications; a longer-term effect will be an increased sense of empowerment for people with developmental disabilities.\u003c/p>\n\u003cp>“When policies, rules, and information about how decisions are made that affect your everyday life are held from you, it is so disempowering,” Haun said. “Even if you wanted to engage or try to speak up or change things for the better, you don’t know how, and you can’t even begin to identify where or what’s even happening to you.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ci>This story was made possible in part with funding and support from the USC Center for Health Journalism’s Data Fellowship.\u003c/i>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A bill before Gov. Gavin Newsom would force the group of regional nonprofits that serve Californians with developmental disabilities to comply with the same transparency laws as state agencies, allowing \u003ca href=\"https://docs.google.com/spreadsheets/d/16S5-6nFOe4xMZ8wN0cVXhdZjGoy2PyJD/edit?usp=drive_link&ouid=109411565409580749553&rtpof=true&sd=true\">nearly 450,000 people\u003c/a> with disabilities to access certain records and information related to their care for the first time.\u003c/p>\n\u003cp>The bill, AB 1147, \u003ca href=\"https://digitaldemocracy.calmatters.org/bills/ca_202320240ab1147\">passed the state Assembly and Senate \u003c/a>without opposition at the end of August, \u003ca href=\"https://digitaldemocracy.calmatters.org/bills/ca_202320240ab1147\">after a 19-month fight\u003c/a> in which many of its accountability measures were stripped out. The most impactful remaining provision would make the 21 nonprofit organizations throughout the state, called “regional centers,” subject to the \u003ca href=\"https://www.thefirstamendment.org/media/publicrecordsact.pdf\">California Public Records Act (PRA)\u003c/a>, a law that requires the public disclosure of government records when requested.\u003c/p>\n\u003cp>Proponents of the bill argue the regional centers perform a public function and are entirely funded by state dollars and should, therefore, be subject to the PRA. However, the centers that oppose the bill say that complying with it would strain an already cash-strapped system and could lead to accidental disclosures of personal information.\u003c/p>\n\u003cp>California’s developmental disability system operates with a budget of more than $15 billion, serving Californians with a range of conditions, including autism, cerebral palsy, intellectual disability and epilepsy. All funding and services flow through the regional centers, which connect people with disabilities to various service providers.\u003c/p>\n\u003cp>The governor is expected to sign or veto the bill by Sept. 26.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>A quirk of California’s sweeping 1977 developmental disability law, known as the Lanterman Act, established the regional centers as private nonprofits rather than public agencies, keeping them exempt from the PRA. The intention was to create independent, board-operated organizations that could respond more nimbly than a single statewide agency to each community’s needs. However, critics say this design has led to a system with 21 different operational methods, and the policies of each center remain opaque.\u003c/p>\n\u003cp>“It just seems so wrong and so unfair that an entire sector of local entities could evade the Public Records Act through some wrinkle that they happened to have been established decades ago as nonprofits,” said Vivian Haun, a senior policy attorney at Disability Rights California, which has advocated for the bill.\u003c/p>\n\u003cp>Haun researched and wrote the original PRA policy proposal that ended up in AB 1147. She points to \u003ca href=\"https://www.cde.ca.gov/sp/ch/ec47604faq.asp#:~:text=All%20state%20and%20local%20agencies,are%20subject%20to%20the%20Public\">a law Newsom signed in 2019\u003c/a> making charter schools subject to the PRA and argues that should be the precedent for other nonprofits that serve a public function.\u003c/p>\n\u003cp>“They’re expected by the government to do all the same things that a traditional school district is supposed to do, which is to provide a public education to children using the same source of funds,” Haun said. “It just so happens that many of them are nonprofit in status.”\u003c/p>\n\u003cp>In a July 2023 \u003ca href=\"https://sjud.senate.ca.gov/sites/sjud.senate.ca.gov/files/ab_1147_sjud_analysis.pdf\">report\u003c/a>, the state Senate Judiciary Committee firmly underscored Haun’s argument, stating, “If anything, the regional centers land even more squarely in the public domain than charter schools: While charter schools are a quasi-private alternative to public schools, regional centers are the public option.”\u003c/p>\n\u003ch2>Calls for more transparency\u003c/h2>\n\u003cp>A slew of reports in recent years have called out California’s developmental disability system for a lack of transparency and accountability, among other issues. A 2022 \u003ca href=\"https://information.auditor.ca.gov/pdfs/reports/2021-107.pdf\">State Auditor’s Office report\u003c/a> found that \u003ca href=\"https://drive.google.com/file/d/1po5JtPCmC5pryZKHbylflJr4kNIxhTKn/view?usp=drive_link\">some regional centers \u003c/a>were not conducting regular quality assurance reviews of their vendors despite a 2016 report identifying the same issue.\u003c/p>\n\u003cp>Last year, \u003ca href=\"https://lhc.ca.gov/wp-content/uploads/Reports/273/Report273.pdf\">the Little Hoover Commission\u003c/a>, an independent state oversight agency, found that extreme racial disparities have persisted in the system for decades despite the state investing $66 million over recent years to address the issue. It also found that the quality of care disabled people and their families receive can differ wildly from one regional center to another.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Last year, \u003ca href=\"https://www.kqed.org/news/11969597/whistleblowers-call-out-california-group-home-for-abuse-against-disabled-residents\">KQED published an investigation \u003c/a>of abuse allegations at a disability group home in the Sacramento area that fell within the jurisdiction of Alta Regional Center. At the time, the information about the center’s investigations into the allegations were not publicly available.\u003c/p>\n\u003cp>The KQED analysis of data from the Department of Developmental Services (DDS) showed that reports of abuse in disability group homes are somewhat common. From 2012 to 2022, the agency recorded at least 1,900 incidents of suspected abuse and more than 500 incidents of suspected neglect.\u003c/p>\n\u003cp>Judy Mark, president of Disability Voices United, a sponsor of AB 1147, said the additional transparency the bill calls for would help watchdog groups investigate and understand why these cases keep happening. “If we had that information, we would be able to see, ‘Oh, there is a pattern of problems at this time at this agency.’ Or, ‘Everything looked fine; how did you not see that these abuses were happening or that things were dirty or that people were getting hurt?’” she said.\u003c/p>\n\u003cp>Besides cases of abuse, Mark said the opaqueness of regional centers makes it especially frustrating for disabled individuals when they attempt to understand why they were denied services.\u003c/p>\n\u003cp>“All we know as families is that if you are at one regional center, you can get a service, but if you’re at a different regional center, you don’t,” Mark said. “We would be asking, like, ‘What are the consistent policies that you are applying toward individuals so that we know why somebody got a yes and another person got a no?’”\u003c/p>\n\u003ch2>Centers push back\u003c/h2>\n\u003cp>Regional centers fervently oppose the PRA requirement in the bill, claiming that they don’t have the staffing or resources to comply with it — despite a recent \u003ca href=\"https://www.latimes.com/california/story/2024-08-20/unused-money-at-regional-centers#:~:text=Nearly%20%241%20billion%20allocated%20for,said%20they%20needed%20more%20help.\">Los Angeles Times report\u003c/a> that found regional centers left nearly $1 billion unspent in 2021–22. Doing so, the centers said, could also result in the release of private health information.\u003c/p>\n\u003cp>“Given the highly sensitive information maintained on each individual, and the potential for redaction errors, there is an inherent privacy risk every time a PRA is responded to,” said Amy Westling, executive director of the Association of Regional Center Agencies (ARCA), in an email. “This is particularly true when new staff without prior experience with the PRA would be responding to requests.”\u003c/p>\n\u003cp>Westling also pointed to the litany of disclosures that regional centers are already required to make publicly available online, including “information about policies, spending patterns, and boards of directors for each regional center.” Each regional center also transmits information daily to the DDS, which is subject to the PRA, she said.\u003c/p>\n\u003cp>But Haun, of Disability Rights California, said the bigger issue is that regional centers should be held to the same accountability standards as other publicly funded entities.\u003c/p>\n\u003cp>“Why should they be exempt from the same transparency requirements and expectations that all other entities are expected to comply with when they are using taxpayer dollars to carry out governmental functions?” she said.\u003c/p>\n\u003ch2>Upcoming reform efforts\u003c/h2>\n\u003cp>Advocates say the timing of the bill is crucial. Earlier this year, the California Health and Human Services Agency began working on the \u003ca href=\"https://www.chhs.ca.gov/home/master-plan-for-developmental-services/#\">Master Plan for Developmental Services\u003c/a>, an expansive effort to significantly transform how the state’s developmental disability system operates. The agency is convening stakeholders from across the system to develop a framework “for providing equitable, high quality, and person-centered services to all Californians with intellectual and developmental disabilities.” The plan is expected to be completed by March 2025.\u003c/p>\n\u003cp>The transparency that the bill’s PRA requirement would provide is critical to the master plan’s success, advocates argued.\u003c/p>\n\u003cp>“We can’t possibly do what we need to do to get that master plan done if we don’t have access to the information we need from the regional centers,” Mark said. “And that’s why we hope that Gov. Newsom will see this as just one step towards complete transparency and accountability over a system that spends over $15 billion a year.”\u003c/p>\n\u003cp>But Westling, of ARCA, said the goals of the master plan can be met without subjecting regional centers to the PRA. “If gaps in available data and information are identified through the master plan or other processes, we are happy to help identify potential solutions,” she said.\u003c/p>\n\u003cp>Haun added that increasing transparency for regional centers would also open the doors to independent studies, research, and policy analyses that could help dramatically improve the system. “There’s almost nothing like that now,” she said. “It’s critical to be able to improve the system and help the state know how to better invest the funds.”\u003c/p>\n\u003cp>She also believes that the bill goes beyond policy implications; a longer-term effect will be an increased sense of empowerment for people with developmental disabilities.\u003c/p>\n\u003cp>“When policies, rules, and information about how decisions are made that affect your everyday life are held from you, it is so disempowering,” Haun said. “Even if you wanted to engage or try to speak up or change things for the better, you don’t know how, and you can’t even begin to identify where or what’s even happening to you.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ci>This story was made possible in part with funding and support from the USC Center for Health Journalism’s Data Fellowship.\u003c/i>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"mindshift": {
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 12
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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},
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"pri-the-world": {
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"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
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