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"content": "\u003cp>Medical debt weighs heavily on the lives of millions of Californians. It can ding their credit scores and hurt their chances of landing a rental or securing a home mortgage.\u003c/p>\n\u003cp>Earlier this year, the Biden administration announced a proposal to stop medical debt from showing up on credit reports. That \u003ca href=\"https://www.federalregister.gov/documents/2024/06/18/2024-13208/prohibition-on-creditors-and-consumer-reporting-agencies-concerning-medical-information-regulation-v\" target=\"_blank\" rel=\"noreferrer noopener\">proposed rule is under consideration\u003c/a> with an uncertain timeline.\u003c/p>\n\u003cp>California lawmakers are moving faster with a similar measure that would take effect as soon as January if it becomes law.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"https://digitaldemocracy.calmatters.org/legislators/monique-limon-13069\" target=\"_blank\" rel=\"noreferrer noopener\">Sen. Monique Limón\u003c/a>, a Santa Barbara Democrat, is carrying \u003ca href=\"https://digitaldemocracy.calmatters.org/bills/ca_202320240sb1061\" target=\"_blank\" rel=\"noreferrer noopener\">Senate Bill 1061\u003c/a>, which would remove medical debt from credit reports and prohibit debt collectors from reporting patients’ medical debt information to credit agencies. It would pertain specifically to debt owed to a medical provider, such as a hospital or a doctor’s office.\u003c/p>\n\u003cp>It passed the Assembly on Monday and is heading to the Senate for a final vote. Until recently, the bill would have also included debt charged to medical credit cards and specialty loans, but changes in the Assembly Appropriations Committee redefined “medical debt” to exclude these.\u003c/p>\n\u003cp>Limón was surprised by the changes. The amendments were a win for a\u003ca href=\"https://ct3.blob.core.windows.net/23blobs/e48c3e46-b46e-4876-a636-22a46392b276\" target=\"_blank\" rel=\"noreferrer noopener\"> coalition of bankers and lenders\u003c/a> that had been requesting that change for months. Following the amendments, the coalition removed its opposition to the proposal.\u003c/p>\n\u003cp>“This legislation passed through three Assembly policy committees without the most recent amendments by Assembly Appropriations, which substantially weaken the bill,” Limon told CalMatters in an emailed statement. “It is clear that … influential entities opposed to the measure prevailed.\u003c/p>\n\u003cp>“In spite of this disappointing setback, I plan to continue pushing for the passage of SB 1061 in the hope that we can provide partial relief to consumers.”\u003c/p>\n\u003cp>Representatives for Assembly Speaker Robert Rivas would not comment on the bill and Assembly Appropriations Committee Chairperson Buffy Wicks did not reply to messages and emails asking why the changes were made. Those lawmakers can change bills in the Appropriations Committee.\u003c/p>\n\u003cp>Supporters of Limon’s bill say even though the feds are moving in a similar direction, California’s bill still has merit.\u003c/p>\n\u003cp>“The (federal) rulemaking right now, it’s just a proposal. It could get watered down; they take a long time. And then, of course, depending on what happens with the election, there’s a big question mark of what happens to any of our federal rules,” said Jenn Engstrom, state director with the California Interest Research Group, a co-sponsor of the bill. “So rather than leaving it up to the uncertainty of the federal government, we think it’s really important that California has a strong role here.”\u003c/p>\n\u003cp>\u003ca href=\"https://oag.ca.gov/news/press-releases/attorney-general-bonta-continues-fight-against-medical-debt-reporting\">Attorney General Rob Bonta\u003c/a> and the California Nurses Association, among other health advocates, back the bill. Proponents argue that people acquire medical debt through no fault of their own. After all, going into debt because you need surgery is not the same as going into debt for a luxury vacation. Experts and advocates say medical debt is also more prone to inaccuracies because of mistakes in billing or disputes with insurers.\u003c/p>\n\u003cp>The bill “does not forgive debt, but it does ensure that when it’s not reported, we don’t negatively impact credit scores for a lifetime for people,” Limón said.\u003c/p>\n\u003cp>If the bill makes it to the governor’s desk and he signs it, California would join states such as Colorado and New York in prohibiting medical debt from damaging credit scores.\u003c/p>\n\u003ch2 id=\"h-the-burden-of-medical-debt\" class=\"wp-block-heading\">The burden of medical debt\u003c/h2>\n\u003cp>About \u003ca href=\"https://www.chcf.org/blog/top-takeaways-california-health-policy-poll/#:~:text=Meanwhile%2C%20close%20to%204%20in,racial%20equity%20in%20health%20care.\" target=\"_blank\" rel=\"noreferrer noopener\">4 in 10 Californians\u003c/a> report carrying some type of medical debt, according to the California Health Care Foundation. Nationally, \u003ca href=\"https://www.consumerfinance.gov/about-us/newsroom/cfpb-finds-15-million-americans-have-medical-bills-on-their-credit-reports/\" target=\"_blank\" rel=\"noreferrer noopener\">the average medical balance\u003c/a> on credit reports is around $3,100.\u003c/p>\n\u003cp>“The impact of this debt is so well-known that many people take it into consideration when deciding whether to seek care when they need it, and many opt not to, deciding to steer clear of the (medical) bill, which puts their health at risk,” said Katie Van Deynze, a policy and legislative advocate with the consumer advocacy group Health Access California.\u003c/p>\n\u003cp>[aside label=\"Related Stories\" postID=\"news_11996598,news_11984163,news_12000706\"]\u003c/p>\n\u003cp>In June, \u003ca href=\"https://www.whitehouse.gov/briefing-room/statements-releases/2024/06/11/fact-sheet-vice-president-harris-announces-proposal-to-prohibit-medical-bills-from-being-included-on-credit-reports-and-calls-on-states-and-localities-to-take-further-actions-to-reduce-medical-debt/\" target=\"_blank\" rel=\"noreferrer noopener\">the Biden administration announced\u003c/a> a proposal to bar medical debt from appearing on credit reports. It’s expected to help raise the credit scores of approximately 15 million Americans by an average of 20 points, according to the administration’s announcement. The administration estimates that would translate to the approval of about 22,000 additional mortgages every year.\u003c/p>\n\u003cp>The federal proposal also leaves out medical credit cards, a gap Limón hoped to close.\u003c/p>\n\u003cp>Medical providers may offer \u003ca href=\"https://www.forbes.com/advisor/credit-cards/medical-credit-cards-should-you-apply/\">medical credit cards\u003c/a> as an option to cover the cost of a procedure. They can be enticing, offering people the option of no payment upfront and a promotional period of deferred interest. However, if interest does kick in, it can be higher than that of a regular credit card.\u003c/p>\n\u003cp>Groups such as the California Bankers Association argued that the definition of “medical debt” in Limón’s bill was too broad. The only debt that should be included in this legislation, they said, is the kind that is directly owed to a medical facility or provider. In hearings and \u003ca href=\"https://ct3.blob.core.windows.net/23blobs/e48c3e46-b46e-4876-a636-22a46392b276\" target=\"_blank\" rel=\"noreferrer noopener\">letters to the Legislature\u003c/a>, lobbyists for these groups argued that medical credit cards could also be used for elective procedures, fitness programs and veterinary services, among other expenses. That type of debt, they argued, should not be hidden from creditors.\u003c/p>\n\u003ch2 id=\"h-medical-debt-forgiveness\" class=\"wp-block-heading\">Medical debt forgiveness\u003c/h2>\n\u003cp>The topic of medical debt resonates so much with the public that some local governments and states are going one step further and pushing for debt relief programs.\u003c/p>\n\u003cp>This summer, the Los Angeles County Board of Supervisors announced a \u003ca href=\"https://www.latimes.com/california/story/2024-06-25/medical-debt\">pilot program to buy off\u003c/a> millions worth of its residents’ medical debt through a partnership with the national nonprofit Undue Medical Debt. Hospitals and other providers can sell unpaid debt to companies that would profit from collecting that money. Undue Medical Debt leverages this arrangement and purchases debt for cents on the dollar, but instead of collecting the debt, it cancels it.\u003c/p>\n\u003cp>Through this model, county supervisors estimate \u003ca href=\"https://hahn.lacounty.gov/la-county-will-launch-pilot-program-to-eliminate-low-income-residents-medical-debt/\" target=\"_blank\" rel=\"noreferrer noopener\">they can spend $5 million\u003c/a> to cancel $500 million worth of debt for 150,000 lower-income residents. Medical debt in Los Angeles County \u003ca href=\"https://www.google.com/search?client=firefox-b-1-d&q=synoynm+for+system\" target=\"_blank\" rel=\"noreferrer noopener\">surpasses $2.9 billion\u003c/a>, according to an analysis by the county’s public health department.\u003c/p>\n\u003cp>New York City and \u003ca href=\"https://azgovernor.gov/office-arizona-governor/medical-debt-relief-faq\">Arizona\u003c/a> have done similar deals with the same nonprofit. And just last week, New Jersey Democratic Gov. Phil Murphy announced that the state would use leftover pandemic relief dollars to eliminate \u003ca href=\"https://www.nj.gov/governor/news/news/562024/approved/20240820a.shtml\" target=\"_blank\" rel=\"noreferrer noopener\">$100 million worth of medical debt\u003c/a> for 50,000 residents.\u003c/p>\n\u003cp>Democratic presidential nominee Kamala Harris has pledged to build on the current administration’s efforts to wipe medical debt from credit reports by incorporating debt forgiveness. Among her campaign promises: “Work with states to cancel medical debt for millions of Americans.”\u003c/p>\n\u003cp>Last month, \u003ca href=\"https://www.washingtonpost.com/health/2024/07/26/vice-president-kamala-harris-medical-debt/\" target=\"_blank\" rel=\"noreferrer noopener\">the \u003cem>Washington Post\u003c/em> reported\u003c/a> that Harris had been working with North Carolina to incentivize hospitals there to forgive patients’ medical debt in exchange for additional Medicaid dollars. In mid-August, North Carolina Democratic \u003ca href=\"https://governor.nc.gov/news/press-releases/2024/08/12/north-carolina-hospitals-sign-relieve-medical-debt\" target=\"_blank\" rel=\"noreferrer noopener\">Gov. Roy Cooper announced\u003c/a> that all of the state’s 99 hospitals agreed to participate in this program. About 2 million lower- and middle-income North Carolina residents will benefit starting next summer.\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://digitaldemocracy.calmatters.org/legislators/monique-limon-13069\" target=\"_blank\" rel=\"noreferrer noopener\">Sen. Monique Limón\u003c/a>, a Santa Barbara Democrat, is carrying \u003ca href=\"https://digitaldemocracy.calmatters.org/bills/ca_202320240sb1061\" target=\"_blank\" rel=\"noreferrer noopener\">Senate Bill 1061\u003c/a>, which would remove medical debt from credit reports and prohibit debt collectors from reporting patients’ medical debt information to credit agencies. It would pertain specifically to debt owed to a medical provider, such as a hospital or a doctor’s office.\u003c/p>\n\u003cp>It passed the Assembly on Monday and is heading to the Senate for a final vote. Until recently, the bill would have also included debt charged to medical credit cards and specialty loans, but changes in the Assembly Appropriations Committee redefined “medical debt” to exclude these.\u003c/p>\n\u003cp>Limón was surprised by the changes. The amendments were a win for a\u003ca href=\"https://ct3.blob.core.windows.net/23blobs/e48c3e46-b46e-4876-a636-22a46392b276\" target=\"_blank\" rel=\"noreferrer noopener\"> coalition of bankers and lenders\u003c/a> that had been requesting that change for months. Following the amendments, the coalition removed its opposition to the proposal.\u003c/p>\n\u003cp>“This legislation passed through three Assembly policy committees without the most recent amendments by Assembly Appropriations, which substantially weaken the bill,” Limon told CalMatters in an emailed statement. “It is clear that … influential entities opposed to the measure prevailed.\u003c/p>\n\u003cp>“In spite of this disappointing setback, I plan to continue pushing for the passage of SB 1061 in the hope that we can provide partial relief to consumers.”\u003c/p>\n\u003cp>Representatives for Assembly Speaker Robert Rivas would not comment on the bill and Assembly Appropriations Committee Chairperson Buffy Wicks did not reply to messages and emails asking why the changes were made. Those lawmakers can change bills in the Appropriations Committee.\u003c/p>\n\u003cp>Supporters of Limon’s bill say even though the feds are moving in a similar direction, California’s bill still has merit.\u003c/p>\n\u003cp>“The (federal) rulemaking right now, it’s just a proposal. It could get watered down; they take a long time. And then, of course, depending on what happens with the election, there’s a big question mark of what happens to any of our federal rules,” said Jenn Engstrom, state director with the California Interest Research Group, a co-sponsor of the bill. “So rather than leaving it up to the uncertainty of the federal government, we think it’s really important that California has a strong role here.”\u003c/p>\n\u003cp>\u003ca href=\"https://oag.ca.gov/news/press-releases/attorney-general-bonta-continues-fight-against-medical-debt-reporting\">Attorney General Rob Bonta\u003c/a> and the California Nurses Association, among other health advocates, back the bill. Proponents argue that people acquire medical debt through no fault of their own. After all, going into debt because you need surgery is not the same as going into debt for a luxury vacation. Experts and advocates say medical debt is also more prone to inaccuracies because of mistakes in billing or disputes with insurers.\u003c/p>\n\u003cp>The bill “does not forgive debt, but it does ensure that when it’s not reported, we don’t negatively impact credit scores for a lifetime for people,” Limón said.\u003c/p>\n\u003cp>If the bill makes it to the governor’s desk and he signs it, California would join states such as Colorado and New York in prohibiting medical debt from damaging credit scores.\u003c/p>\n\u003ch2 id=\"h-the-burden-of-medical-debt\" class=\"wp-block-heading\">The burden of medical debt\u003c/h2>\n\u003cp>About \u003ca href=\"https://www.chcf.org/blog/top-takeaways-california-health-policy-poll/#:~:text=Meanwhile%2C%20close%20to%204%20in,racial%20equity%20in%20health%20care.\" target=\"_blank\" rel=\"noreferrer noopener\">4 in 10 Californians\u003c/a> report carrying some type of medical debt, according to the California Health Care Foundation. Nationally, \u003ca href=\"https://www.consumerfinance.gov/about-us/newsroom/cfpb-finds-15-million-americans-have-medical-bills-on-their-credit-reports/\" target=\"_blank\" rel=\"noreferrer noopener\">the average medical balance\u003c/a> on credit reports is around $3,100.\u003c/p>\n\u003cp>“The impact of this debt is so well-known that many people take it into consideration when deciding whether to seek care when they need it, and many opt not to, deciding to steer clear of the (medical) bill, which puts their health at risk,” said Katie Van Deynze, a policy and legislative advocate with the consumer advocacy group Health Access California.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In June, \u003ca href=\"https://www.whitehouse.gov/briefing-room/statements-releases/2024/06/11/fact-sheet-vice-president-harris-announces-proposal-to-prohibit-medical-bills-from-being-included-on-credit-reports-and-calls-on-states-and-localities-to-take-further-actions-to-reduce-medical-debt/\" target=\"_blank\" rel=\"noreferrer noopener\">the Biden administration announced\u003c/a> a proposal to bar medical debt from appearing on credit reports. It’s expected to help raise the credit scores of approximately 15 million Americans by an average of 20 points, according to the administration’s announcement. The administration estimates that would translate to the approval of about 22,000 additional mortgages every year.\u003c/p>\n\u003cp>The federal proposal also leaves out medical credit cards, a gap Limón hoped to close.\u003c/p>\n\u003cp>Medical providers may offer \u003ca href=\"https://www.forbes.com/advisor/credit-cards/medical-credit-cards-should-you-apply/\">medical credit cards\u003c/a> as an option to cover the cost of a procedure. They can be enticing, offering people the option of no payment upfront and a promotional period of deferred interest. However, if interest does kick in, it can be higher than that of a regular credit card.\u003c/p>\n\u003cp>Groups such as the California Bankers Association argued that the definition of “medical debt” in Limón’s bill was too broad. The only debt that should be included in this legislation, they said, is the kind that is directly owed to a medical facility or provider. In hearings and \u003ca href=\"https://ct3.blob.core.windows.net/23blobs/e48c3e46-b46e-4876-a636-22a46392b276\" target=\"_blank\" rel=\"noreferrer noopener\">letters to the Legislature\u003c/a>, lobbyists for these groups argued that medical credit cards could also be used for elective procedures, fitness programs and veterinary services, among other expenses. That type of debt, they argued, should not be hidden from creditors.\u003c/p>\n\u003ch2 id=\"h-medical-debt-forgiveness\" class=\"wp-block-heading\">Medical debt forgiveness\u003c/h2>\n\u003cp>The topic of medical debt resonates so much with the public that some local governments and states are going one step further and pushing for debt relief programs.\u003c/p>\n\u003cp>This summer, the Los Angeles County Board of Supervisors announced a \u003ca href=\"https://www.latimes.com/california/story/2024-06-25/medical-debt\">pilot program to buy off\u003c/a> millions worth of its residents’ medical debt through a partnership with the national nonprofit Undue Medical Debt. Hospitals and other providers can sell unpaid debt to companies that would profit from collecting that money. Undue Medical Debt leverages this arrangement and purchases debt for cents on the dollar, but instead of collecting the debt, it cancels it.\u003c/p>\n\u003cp>Through this model, county supervisors estimate \u003ca href=\"https://hahn.lacounty.gov/la-county-will-launch-pilot-program-to-eliminate-low-income-residents-medical-debt/\" target=\"_blank\" rel=\"noreferrer noopener\">they can spend $5 million\u003c/a> to cancel $500 million worth of debt for 150,000 lower-income residents. Medical debt in Los Angeles County \u003ca href=\"https://www.google.com/search?client=firefox-b-1-d&q=synoynm+for+system\" target=\"_blank\" rel=\"noreferrer noopener\">surpasses $2.9 billion\u003c/a>, according to an analysis by the county’s public health department.\u003c/p>\n\u003cp>New York City and \u003ca href=\"https://azgovernor.gov/office-arizona-governor/medical-debt-relief-faq\">Arizona\u003c/a> have done similar deals with the same nonprofit. And just last week, New Jersey Democratic Gov. Phil Murphy announced that the state would use leftover pandemic relief dollars to eliminate \u003ca href=\"https://www.nj.gov/governor/news/news/562024/approved/20240820a.shtml\" target=\"_blank\" rel=\"noreferrer noopener\">$100 million worth of medical debt\u003c/a> for 50,000 residents.\u003c/p>\n\u003cp>Democratic presidential nominee Kamala Harris has pledged to build on the current administration’s efforts to wipe medical debt from credit reports by incorporating debt forgiveness. Among her campaign promises: “Work with states to cancel medical debt for millions of Americans.”\u003c/p>\n\u003cp>Last month, \u003ca href=\"https://www.washingtonpost.com/health/2024/07/26/vice-president-kamala-harris-medical-debt/\" target=\"_blank\" rel=\"noreferrer noopener\">the \u003cem>Washington Post\u003c/em> reported\u003c/a> that Harris had been working with North Carolina to incentivize hospitals there to forgive patients’ medical debt in exchange for additional Medicaid dollars. In mid-August, North Carolina Democratic \u003ca href=\"https://governor.nc.gov/news/press-releases/2024/08/12/north-carolina-hospitals-sign-relieve-medical-debt\" target=\"_blank\" rel=\"noreferrer noopener\">Gov. Roy Cooper announced\u003c/a> that all of the state’s 99 hospitals agreed to participate in this program. About 2 million lower- and middle-income North Carolina residents will benefit starting next summer.\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "oakland-schools-vow-to-step-up-lead-testing-but-teachers-arent-convinced",
"title": "Oakland Schools Vow to Step Up Lead Testing, But Teachers Aren’t Convinced",
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"content": "\u003cp>After high lead levels were found in water sources \u003ca href=\"https://www.kqed.org/news/12000525/water-at-22-oakland-schools-tested-high-for-lead-its-no-surprise-parents-and-teachers-say\">at nearly two dozen Oakland public schools\u003c/a>, the district plans to roll out more robust testing on a routine schedule and share the data in a public dashboard.\u003c/p>\n\u003cp>The plans are set to be presented by Superintendent Kyla Johnson-Trammell at Wednesday’s school board meeting as the district seeks to quell concerns over the safety of drinking water at its campuses. Still, teachers say the situation has affected their classrooms and aren’t convinced that the district’s plans go far enough to ensure water on campus is safe in the future.\u003c/p>\n\u003cp>During the first week of school, OUSD sent emails notifying families of 22 schools that at least one water source on their campus had heightened lead levels in routine testing over the spring and summer. In one case, the concentration was as high as 900 parts per billion. The Oakland school board’s maximum allowable level is 5 parts per billion, while the state and federal standard is 15 parts per billion.\u003c/p>\n\u003cp>The testing took place at 49 sites and found a total of 186 needed repairs, according to Johnson-Trammell’s presentation.\u003c/p>\n\u003cp>As of Aug. 16, 66 have been addressed and are waiting for retesting. The district plans to complete the remediation process within three weeks.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Some teachers and parents criticized what they called a lag in communication after tests were completed, as early as April at certain schools. Stuart Loebl, a sixth-grade teacher at Frick United Academy of Language, where the highest detected lead level was 51 parts per billion, said he doesn’t feel the district’s response has been adequate.\u003c/p>\n\u003cp>“They let students continue to drink from that fountain for months, both during the rest of the school year and [when] we had 80 students at our site during summer school. To call the problem an issue of communication is very damaging to the trust that I can put in the districts to solve this issue,” Loebl said. “I haven’t seen any kind of explanation as to why that failure happened, in which all these water fountains were not immediately shut down.”\u003c/p>\n\u003cp>OUSD officials did not respond to a request for comment on Tuesday, but spokesperson John Sasaki told KQED earlier this month that district officials were “aggressive about the testing but were not as efficient at communicating in the ways we should have been. That’s something we are working on as an organization.”\u003c/p>\n\u003cp>Frick staff found out on Aug. 12, the first day of school, that six fixtures on campus tested over the district limit in April.\u003c/p>\n\u003cp>Loebl said that made for a hectic start to the school year as everybody was directed to use only the campus’ single FloWater filtered water bottle filling station.\u003c/p>\n\u003cp>“When 400 people, 370 students plus staff, are trying to use that one FloWater station, it very quickly started to break down and go out of service because the way that these work is they need a certain amount of time for them to filter the water,” he said.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">[aside postID=news_12000525 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/016_KQEDScience_IntCommunitySchoolOakland_10202022_qed-1020x680.jpg']\u003c/span>\u003c/p>\n\u003cp>The administration added a second FloWater station last week and brought in Gatorade jugs to supplement the amount of water available. But Loebl teaches on the second floor of the two-story campus, while the FloWater stations are located on the first floor and in the cafeteria — “It’s, the way that students walk, a five to 10-minute round trip to get water,” he said.\u003c/p>\n\u003cp>Cassandra Lizardi Morales, who teaches sixth grade English at Frick, said it’s been “hit and miss” trying to meet the demand for water in her classroom, especially on hot days.\u003c/p>\n\u003cp>The district began expedited testing of all campuses more than 50 years old that were not tested earlier this year on Aug. 17. Reports from that testing showed that more than 95% of the fixtures were below OUSD’s permissible lead level and six fixtures were identified for repair, according to the superintendent’s presentation.\u003c/p>\n\u003cp>Throughout the fall, OUSD plans to conduct testing at its other sites, working from the oldest campuses to the newest and prioritizing early education centers that were not tested recently.\u003c/p>\n\u003cp>A comprehensive testing schedule will also be announced within 30 days, the presentation says, and OUSD will ask the facilities committee to install more water bottle filling stations on campuses. By January, the district plans to launch a testing dashboard on its website.\u003c/p>\n\u003cp>But teachers say that the efforts to test and repair fixtures where lead is found might just be “kicking the can down the road.”\u003c/p>\n\u003cp>“There’s soldering in the lead pipes, and you can do short-term filters, but if you’re not regularly maintaining the filters, the lead will come back into the water,” Loebl said. “There needs to be a long-term plan to replace the pipes so that there is no longer lead seeping into our water.”\u003c/p>\n\u003cp>Lizardi Morales added that she feels the district will need to rebuild trust in schools’ water sources after their retesting is complete. She said she wouldn’t feel comfortable drinking the water unless lead was not detectable at all.\u003c/p>\n\u003cp>“They are serving a community of children who are already exposed to lead in the paint of their old homes and soil; they shouldn’t be exasperating the lead poisoning of our children,” Lizardi Morales said. “I’m not even comfortable with the 5 parts per billion… no amount of lead is safe.”\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>After high lead levels were found in water sources \u003ca href=\"https://www.kqed.org/news/12000525/water-at-22-oakland-schools-tested-high-for-lead-its-no-surprise-parents-and-teachers-say\">at nearly two dozen Oakland public schools\u003c/a>, the district plans to roll out more robust testing on a routine schedule and share the data in a public dashboard.\u003c/p>\n\u003cp>The plans are set to be presented by Superintendent Kyla Johnson-Trammell at Wednesday’s school board meeting as the district seeks to quell concerns over the safety of drinking water at its campuses. Still, teachers say the situation has affected their classrooms and aren’t convinced that the district’s plans go far enough to ensure water on campus is safe in the future.\u003c/p>\n\u003cp>During the first week of school, OUSD sent emails notifying families of 22 schools that at least one water source on their campus had heightened lead levels in routine testing over the spring and summer. In one case, the concentration was as high as 900 parts per billion. The Oakland school board’s maximum allowable level is 5 parts per billion, while the state and federal standard is 15 parts per billion.\u003c/p>\n\u003cp>The testing took place at 49 sites and found a total of 186 needed repairs, according to Johnson-Trammell’s presentation.\u003c/p>\n\u003cp>As of Aug. 16, 66 have been addressed and are waiting for retesting. The district plans to complete the remediation process within three weeks.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Some teachers and parents criticized what they called a lag in communication after tests were completed, as early as April at certain schools. Stuart Loebl, a sixth-grade teacher at Frick United Academy of Language, where the highest detected lead level was 51 parts per billion, said he doesn’t feel the district’s response has been adequate.\u003c/p>\n\u003cp>“They let students continue to drink from that fountain for months, both during the rest of the school year and [when] we had 80 students at our site during summer school. To call the problem an issue of communication is very damaging to the trust that I can put in the districts to solve this issue,” Loebl said. “I haven’t seen any kind of explanation as to why that failure happened, in which all these water fountains were not immediately shut down.”\u003c/p>\n\u003cp>OUSD officials did not respond to a request for comment on Tuesday, but spokesperson John Sasaki told KQED earlier this month that district officials were “aggressive about the testing but were not as efficient at communicating in the ways we should have been. That’s something we are working on as an organization.”\u003c/p>\n\u003cp>Frick staff found out on Aug. 12, the first day of school, that six fixtures on campus tested over the district limit in April.\u003c/p>\n\u003cp>Loebl said that made for a hectic start to the school year as everybody was directed to use only the campus’ single FloWater filtered water bottle filling station.\u003c/p>\n\u003cp>“When 400 people, 370 students plus staff, are trying to use that one FloWater station, it very quickly started to break down and go out of service because the way that these work is they need a certain amount of time for them to filter the water,” he said.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>\u003c/p>\n\u003cp>The administration added a second FloWater station last week and brought in Gatorade jugs to supplement the amount of water available. But Loebl teaches on the second floor of the two-story campus, while the FloWater stations are located on the first floor and in the cafeteria — “It’s, the way that students walk, a five to 10-minute round trip to get water,” he said.\u003c/p>\n\u003cp>Cassandra Lizardi Morales, who teaches sixth grade English at Frick, said it’s been “hit and miss” trying to meet the demand for water in her classroom, especially on hot days.\u003c/p>\n\u003cp>The district began expedited testing of all campuses more than 50 years old that were not tested earlier this year on Aug. 17. Reports from that testing showed that more than 95% of the fixtures were below OUSD’s permissible lead level and six fixtures were identified for repair, according to the superintendent’s presentation.\u003c/p>\n\u003cp>Throughout the fall, OUSD plans to conduct testing at its other sites, working from the oldest campuses to the newest and prioritizing early education centers that were not tested recently.\u003c/p>\n\u003cp>A comprehensive testing schedule will also be announced within 30 days, the presentation says, and OUSD will ask the facilities committee to install more water bottle filling stations on campuses. By January, the district plans to launch a testing dashboard on its website.\u003c/p>\n\u003cp>But teachers say that the efforts to test and repair fixtures where lead is found might just be “kicking the can down the road.”\u003c/p>\n\u003cp>“There’s soldering in the lead pipes, and you can do short-term filters, but if you’re not regularly maintaining the filters, the lead will come back into the water,” Loebl said. “There needs to be a long-term plan to replace the pipes so that there is no longer lead seeping into our water.”\u003c/p>\n\u003cp>Lizardi Morales added that she feels the district will need to rebuild trust in schools’ water sources after their retesting is complete. She said she wouldn’t feel comfortable drinking the water unless lead was not detectable at all.\u003c/p>\n\u003cp>“They are serving a community of children who are already exposed to lead in the paint of their old homes and soil; they shouldn’t be exasperating the lead poisoning of our children,” Lizardi Morales said. “I’m not even comfortable with the 5 parts per billion… no amount of lead is safe.”\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "lawmakers-say-newsom-staff-inflated-cost-of-failed-health-care-bills",
"title": "Lawmakers Say Newsom Staff ‘Inflated’ Cost of Failed Health Care Bills",
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"headTitle": "Lawmakers Say Newsom Staff ‘Inflated’ Cost of Failed Health Care Bills | KQED",
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"content": "\u003cp>Lawmakers and advocates say Gov. Gavin Newsom’s administration is making inflated estimates about the cost of legislation, with some suggesting his subordinates have been trying to kill the bills without making the governor politically accountable for the outcome.\u003c/p>\n\u003cp>“While people are dying on the streets from a lack of access to behavioral health care treatment, state agencies continue to fabricate exorbitant cost estimates,” Sen. \u003ca href=\"https://digitaldemocracy.calmatters.org/legislators/dave-cortese-164699\">Dave Cortese\u003c/a>, a Democrat from Campbell, told CalMatters after one of his mental health proposals died recently in the Assembly Appropriations Committee.\u003c/p>\n\u003cp>Sen. \u003ca href=\"https://digitaldemocracy.calmatters.org/legislators/scott-wiener-100936\">Scott Wiener\u003c/a>, a Democrat from San Francisco who authored another mental health bill that died recently, \u003ca href=\"https://digitaldemocracy.calmatters.org/hearings/258192?t=295&f=a2f15a64e9e6ef40221b60296d414495\">said in a public hearing last month\u003c/a> that the administration’s cost estimate of his bill was “extreme and outrageous.”\u003c/p>\n\u003cp>The pointed accusations from Democratic lawmakers and health care advocates who tend to be friendly with the Democratic governor are extraordinary because such criticism is rarely made in public. The examples also stand out because they challenge the administration’s response to one of the governor’s top priorities, \u003ca href=\"https://calmatters.org/tag/mental-health/\">mental health\u003c/a>.\u003c/p>\n\u003cp>The administration did not accept an interview request with CalMatters and would not provide more detail — to CalMatters or to lawmakers — to explain the cost estimates. By email, however, a spokesperson insisted the costs were accurate and rejected the idea that they were intentionally inflated.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It’s outrageous and inaccurate for anyone to suggest these numbers are fabricated or artificially inflated,” Rodger Butler, a spokesperson for Newsom’s Health and Human Services Agency, said in an email. “Legislative fiscal analyses from state government departments are informed by real-world, on-the-ground experience implementing legislative mandates.”\u003c/p>\n\u003cp>Whatever the motivations, four health care bills with controversial cost estimates died quietly earlier this month in the Senate and Assembly Appropriations committees even after each had advanced without a single “no” vote from a Democratic legislator.\u003c/p>\n\u003cfigure id=\"attachment_12002025\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/081524-Suspense-File-FG-CM-04.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12002025\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/081524-Suspense-File-FG-CM-04.jpg\" alt=\"Three women dressed in orange, pink and green jackets and a man wearing a dark business suit sit in green chairs with the United States and California flags behind them.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/081524-Suspense-File-FG-CM-04.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/081524-Suspense-File-FG-CM-04-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/081524-Suspense-File-FG-CM-04-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/081524-Suspense-File-FG-CM-04-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/081524-Suspense-File-FG-CM-04-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/081524-Suspense-File-FG-CM-04-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Assembly lawmakers meet during a Suspense File hearing at the Capitol Annex Swing Space on O Street in Sacramento on Aug. 15, 2024. \u003ccite>(Fred Greaves / CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Appropriations Committees are focused on the cost of legislation, especially in a year when the state is struggling with a \u003ca href=\"https://calmatters.org/tag/california-budget/\">budget deficit\u003c/a>. The four bills were moved to the committees’ “suspense files,” \u003ca href=\"https://calmatters.org/politics/capitol/2024/08/california-laws-legislature-suspense-file/\">along with 263 other controversial or costly bills\u003c/a>. Each committee then killed the bills in their respective suspense file with a single vote.\u003c/p>\n\u003cp>Mike Gatto, a former Democratic lawmaker from Los Angeles who chaired the Assembly Appropriations Committee, said inflated cost estimates from a governor’s administration are nothing new.\u003c/p>\n\u003cp>When an executive branch agency provides “a significantly exaggerated cost” on a piece of legislation, “it’s generally a big flashing light that the administration dislikes the bill and that the governor would likely veto it,” he said.\u003c/p>\n\u003cp>It can be advantageous for the governor when legislators quietly kill those bills, he said.\u003c/p>\n\u003cp>“Having the appropriations committee there to kill it and to take the arrows (of criticism), that is a tremendous benefit politically for any governor,” Gatto said.\u003c/p>\n\u003cp>Gatto has a hand-written note framed on his wall that former Gov. Jerry Brown gave him expressing Brown’s appreciation for keeping bills from reaching the governor’s desk.\u003c/p>\n\u003cp>In a corner of the note are two words: “Keep holding.”\u003c/p>\n\u003cp>But Thad Kousser, a former legislative staffer who’s now a professor of political science at UC San Diego, said the integrity of the legislative process is jeopardized if cost estimates are not accurate.\u003c/p>\n\u003cp>“You’ve got to have reasonable and realistic estimates that are not part of a political strategy in order for everyone to make informed decisions,” he said.\u003c/p>\n\u003cp>This year alone, \u003ca href=\"https://digitaldemocracy.calmatters.org/\">according to the Digital Democracy database\u003c/a>, lawmakers considered 2,522 bills, many of them with large potential costs to taxpayers.\u003c/p>\n\u003ch2>Democrat calls costs ‘extreme and outrageous’\u003c/h2>\n\u003cp>Sen. Wiener’s legislation, \u003ca href=\"https://digitaldemocracy.calmatters.org/bills/ca_202320240sb294?slug=CA_202320240SB294\">Senate Bill 294\u003c/a>, would have required an automatic review of cases in which commercial health plans denied children and young people mental health treatment.\u003c/p>\n\u003cp>Wiener, the chair of the Senate’s mental health caucus, said in the public hearing last month that the measure “does nothing more than require health plans to provide the coverage that they’re required to provide and stop denying covered behavioral health care treatment to children.”\u003c/p>\n\u003cp>So he said it was “outrageous” when the \u003ca href=\"https://s3.documentcloud.org/documents/25074843/sb-294-2024.pdf\">Department of Managed Health Care estimated\u003c/a> that the bill would cost $87.6 million per year by 2028 and would require 340 new employees. That’s a 55% increase over the\u003ca href=\"https://ebudget.ca.gov/reference/2024-PositionVacancyReport.pdf\"> 610 positions in the department’s budget for the 2022–23 fiscal year.\u003c/a> A separate state office, the Department of Insurance, also said the bill would require it to hire an additional five positions by 2026 for $1.2 million. There is no description in the cost estimate about how the departments arrived at the estimate or what jobs the new positions would perform.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/FM6KA/9/\" width=\"800\" height=\"500\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>The estimate also was a surprise to supporters of Wiener’s bill. In June, they sent a three-page memo to the chair of the Assembly Appropriations Committee, Democrat \u003ca href=\"https://digitaldemocracy.calmatters.org/legislators/buffy-wicks-165044\">Buffy Wicks\u003c/a> from Oakland, saying that a similar bill that failed last year had a significantly lower cost estimate. They also noted that the pending bill was more narrow in scope.\u003c/p>\n\u003cp>Lishaun Francis, director of behavioral health for the advocacy group Children Now, told CalMatters the Department of Managed Health Care, which is intended to protect consumers, inflated the cost of Wiener’s bill, presumably to try to kill it.\u003c/p>\n\u003cp>“This is not an analysis in good faith,” she said. “The unfortunate thing here is that DMHC has fallen into a trap where they are trying to be here for consumers while also inflating costs to make sure bills don’t get to the governor when there is a tight budget year.”\u003c/p>\n\u003cp>Before the bill died, it passed the Senate and an Assembly committee without any Democrats voting against it, according to the Digital Democracy database.\u003c/p>\n\u003ch2>Are there ‘multiple layers of fiscal review?’\u003c/h2>\n\u003cp>The Department of Managed Health Care, which issued the cost estimates, is part of the state’s \u003ca href=\"https://www.chhs.ca.gov/wp-content/uploads/2024/08/CalHHS-Organizational-Chart_AUG24.pdf\">Health and Human Services Agency\u003c/a>. Secretary Dr. Mark Ghaly, a Newsom appointee, oversees the agency.\u003c/p>\n\u003cp>CalMatters requested an interview with Ghaly or another top official to talk about the cost estimates, but the administration would not talk beyond providing the emailed statement from Butler at the Health and Human Services Agency.\u003c/p>\n\u003cp>“It’s important to note there are multiple layers of fiscal review throughout the process,” he said, citing the policy and appropriations committees in the Legislature and the governor’s Department of Finance.\u003c/p>\n\u003cp>However, Department of Finance spokesman H.D. Palmer told CalMatters, “We rely principally on (agencies and departments) to provide us with the personnel and fiscal estimates.”\u003c/p>\n\u003cfigure id=\"attachment_12002024\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/051024_Newsom-Budget_FG_CM_33.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12002024\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/051024_Newsom-Budget_FG_CM_33.jpg\" alt=\"Two men wearing dark business suits stand behind two flags. The man on the left stands in front of a podium with a microphone and gestures with his right hand.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/051024_Newsom-Budget_FG_CM_33.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/051024_Newsom-Budget_FG_CM_33-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/051024_Newsom-Budget_FG_CM_33-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/051024_Newsom-Budget_FG_CM_33-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/051024_Newsom-Budget_FG_CM_33-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/051024_Newsom-Budget_FG_CM_33-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Gov. Gavin Newsom, left, listens as Joe Stephenshaw, director of the Department of Finance, speaks during a press conference unveiling Newsom’s revised 2024–25 budget proposal at the Capitol Annex Swing Space in Sacramento on May 10, 2024. \u003ccite>(Fred Greaves / CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Policy committees, meanwhile, don’t evaluate the costs of bills.\u003c/p>\n\u003cp>“To say that policy committees vetted the finances of a bill is almost uniformly incorrect,” said Gatto, the former Assembly Appropriations chair. “Policy committees don’t do that.”\u003c/p>\n\u003cp>That independent fiscal review is supposed to happen at the Assembly and Senate Appropriations Committees, whose staffers are widely regarded as some of the smartest people in the Capitol. Their job is to independently vet the administration estimate and provide their own cost estimates for bills, Kousser and Gatto said.\u003c/p>\n\u003cp>“These people are professionals,” Kousser said. “They’re trying to get it right.”\u003c/p>\n\u003cp>Yet when it came to these four disputed bills, the analysis written by the staffs of the Appropriations Committees described the administration cost estimates and nothing more. Each of the four analysis included \u003ca href=\"https://digitaldemocracy.calmatters.org/bills/ca_202320240sb999?slug=CA_202320240SB999\">language similar to SB 999\u003c/a>, which said only: “The Department of Managed Health Care (DMHC) reports the total costs of this bill as follows:”\u003c/p>\n\u003cp>Luis Quinonez, chief of staff for Sen. \u003ca href=\"https://digitaldemocracy.calmatters.org/legislators/anna-caballero-101330\">Anna Caballero\u003c/a> of Merced, who chairs the Senate’s Appropriations Committee, declined to discuss specific bills other than to say the committee’s consultants perform their own analyses.\u003c/p>\n\u003cp>Representatives for Assemblymember Wicks, who chairs the Assembly Appropriations Committee, did not return messages.\u003c/p>\n\u003ch2>Another Democrat calls costs ‘exorbitant’\u003c/h2>\n\u003cp>Regarding his mental health bill, Sen. Cortese said in an email he has “serious concerns about how the health care agencies are coming up with these cost projections.” \u003ca href=\"https://digitaldemocracy.calmatters.org/bills/ca_202320240sb999?slug=CA_202320240SB999\">Senate Bill 999 \u003c/a>would have required health insurers to make sure they have mental health and addiction experts review claims for treatment, something advocates say is already required under state law.\u003c/p>\n\u003cp>This was the second time Cortese introduced the bill. A previous version made it through the Legislature in 2022 before Newsom \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2022/09/SB-999-VETO.pdf\">vetoed it\u003c/a>, saying the issue could be addressed by new regulations that would be issued soon.\u003c/p>\n\u003cp>After he felt draft regulations last year were inadequate, Cortese introduced a pared-down version of the 2022 bill. \u003cspan style=\"margin: 0px;padding: 0px\">However, advocates were surprised to see the \u003ca href=\"https://s3.documentcloud.org/documents/25074841/sb-999-2024-analysis.pdf\" target=\"_blank\" rel=\"noopener\">department’s cost estimate \u003c/a>increase significantly to $18 million over five years and about $4 million annually after 2028 to pay for 13 permanent positions.\u003c/span> The estimate does not explain how the department determined the number of positions needed or what jobs they would perform.\u003c/p>\n\u003cp>\u003cspan style=\"margin: 0px;padding: 0px\">Advocacy groups supporting the bill noted that, in recent years, budget allocations, the Department of Managed Health Care already received \u003ca href=\"https://bcp.dof.ca.gov/2122/FY2122_ORG4150_BCP4308.pdf\" target=\"_blank\" rel=\"noopener\">millions of\u003c/a> \u003ca href=\"https://bcp.dof.ca.gov/2223/FY2223_ORG4150_BCP5107.pdf\" target=\"_blank\" rel=\"noopener\">dollars \u003c/a>to cover some of the costs of implementing the proposed rules, so it didn’t make sense that the costs would be so high.\u003c/span>\u003c/p>\n\u003cp>“It’s sad to see some of these good faith efforts by advocates to try to bring accountability to the system kind of fall under the weight of a cost estimate that we don’t have a lot of insight into from the department,” said Lauren Finke, policy director for The Kennedy Forum, one of the bill’s sponsors.\u003c/p>\n\u003cfigure id=\"attachment_12002026\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/01192023_Assembly-Chamber_RL_CM_03.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12002026\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/01192023_Assembly-Chamber_RL_CM_03.jpg\" alt=\"A white woman wearing a black jacket and grey shirt looks at a woman wearing a red jacket that has her back turned to the camera.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/01192023_Assembly-Chamber_RL_CM_03.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/01192023_Assembly-Chamber_RL_CM_03-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/01192023_Assembly-Chamber_RL_CM_03-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/01192023_Assembly-Chamber_RL_CM_03-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/01192023_Assembly-Chamber_RL_CM_03-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/01192023_Assembly-Chamber_RL_CM_03-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Assemblymember Gail Pellerin, a Santa Cruz Democrat, convenes with legislators during a session at the state Capitol in Sacramento on Jan. 19, 2023. \u003ccite>(Rahul Lal / CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Santa Cruz Democratic Assemblymember \u003ca href=\"https://digitaldemocracy.calmatters.org/legislators/gail-pellerin-149519\">Gail Pellerin\u003c/a> similarly couldn’t understand why there was such a high cost associated with her \u003ca href=\"https://digitaldemocracy.calmatters.org/bills/ca_202320240ab3260?slug=CA_202320240AB3260\">Assembly Bill 3260\u003c/a>, which would have required health insurers to expedite reviews of mental health claims that doctors deem urgent.\u003c/p>\n\u003cp>The \u003ca href=\"https://s3.documentcloud.org/documents/25074842/ab-3260-analysis.pdf\">Department of Managed Health Care estimated\u003c/a> the bill would cost nearly $140 million in the first five years and $32 million annually after 2029 to pay 144 new positions — a 23% increase in staff size, Pellerin said in an interview. The estimate, which also includes an additional $238,000 annually for the Department of Insurance, does not provide any further description of the need for the positions.\u003c/p>\n\u003cp>Sal Rosselli, president emeritus of the National Union of Healthcare Workers, which supported the bill, said in an email that his organization reached out to agency officials to ask for an explanation of the cost analysis, “but they declined to engage with us.”\u003c/p>\n\u003cp>Eleven other states, plus Washington, D.C., have already adopted similar laws, he said, with no evidence that those laws resulted in a major increase in workload.\u003c/p>\n\u003cp>Pellerin said she and her staff also couldn’t get an answer from the department about how it came up with what she called “inflated” numbers.\u003c/p>\n\u003cp>“Is this taxpayer-funded state department doing the job it is required to do?” she asked.\u003c/p>\n\u003cp>For Pellerin, the issue is personal. She knows firsthand how an urgent mental health crisis can spiral out of control. Her husband died by suicide in 2018.\u003c/p>\n\u003cp>“My family, we’ve experienced this kind of situation,” she told CalMatters.\u003c/p>\n\u003ch2>Are agencies not showing their work?\u003c/h2>\n\u003cp>Advocates for Health Access California also were frustrated by the cost estimates associated with \u003ca href=\"https://digitaldemocracy.calmatters.org/bills/ca_202320240ab236?_gl=1*ip5o3s*_gcl_au*MTQyNDUxODAyMS4xNzIzNTY4MzM1*_ga*OTk2OTcyMDkyLjE2OTk5MTE3MzA.*_ga_5TKXNLE5NK*MTcyNDM2MDMwNi43MjEuMS4xNzI0MzYwNDYwLjU3LjAuMA..*_ga_DX0K9PCWYH*MTcyNDM2MDMwNi4xNjUuMS4xNzI0MzYwNDU3LjAuMC4w*_ga_GNY4L81DZE*MTcyNDM2MDQ1Ny41OTguMC4xNzI0MzYwNDU3LjAuMC4w\">Assembly Bill 236\u003c/a> by Pasadena Democratic Assemblymember \u003ca href=\"https://digitaldemocracy.calmatters.org/legislators/chris-holden-78\">Chris Holden\u003c/a>. The bill \u003ca href=\"https://calmatters.org/health/2024/07/ghost-network-doctor-referrals/\">would have given state regulators\u003c/a> the authority to fine health insurers if their publicly available lists of in-network doctors and specialists aren’t accurate.\u003c/p>\n\u003cp>In testimony supporting the bill’s promises to crack down on so-called “ghost networks,” \u003ca href=\"https://digitaldemocracy.calmatters.org/hearings/258106?t=469&f=723bb83d8559a8dceb9316c055b8b3b2&_gl=1*6kjdh0*_gcl_au*MTQyNDUxODAyMS4xNzIzNTY4MzM1*_ga*OTk2OTcyMDkyLjE2OTk5MTE3MzA.*_ga_5TKXNLE5NK*MTcyNDM1NTkxNS43MjAuMS4xNzI0MzU2NDQ2LjU5LjAuMA..*_ga_DX0K9PCWYH*MTcyNDM1NTkxNS4xNjQuMS4xNzI0MzU2NDQ1LjAuMC4w*_ga_GNY4L81DZE*MTcyNDM1NjQ0NS41OTcuMC4xNzI0MzU2NDQ1LjAuMC4w\">a therapist described\u003c/a> having a patient end up in the emergency room from a suicide attempt after she called through a list of 50 mental health providers and couldn’t find one who’d see her.\u003c/p>\n\u003cp>The bill would have added teeth to a law that insurers and doctors are already supposed to follow and that state regulators are supposed to monitor.[aside postID=\"news_11981977,news_11999996,news_12000706\" label=\"Related Stories\"]\u003c/p>\n\u003cp>The Department of Managed Health Care \u003ca href=\"https://s3.documentcloud.org/documents/25074840/ab-236-2024.pdf\">estimated its cost\u003c/a> to be $3.5 million annually after 2029 for 14 new positions. In its one-sentence description, the Department of Health Care Services said its cost for the bill would be “approximately” $24 million. In an email, the department told CalMatters the bill would lead to “increased costs in the Medi-Cal managed care and behavioral health delivery systems and staffing requirements.”\u003c/p>\n\u003cp>“This $24 million is just mind-blowing,” said Rachel Linn Gish, a spokesperson for Health Access. “We do not understand how they came up with this number.”\u003c/p>\n\u003cp>Michael Genest spent four years as Gov. Arnold Schwarzenegger’s director of the Department of Finance. At CalMatters’ request, he reviewed the cost estimates of the four bills.\u003c/p>\n\u003cp>He said he could expect high costs for Wiener’s and Pellerin’s bills, but he said it wasn’t possible for him to independently evaluate the figures without more detail.\u003c/p>\n\u003cp>However, he said the other two estimates definitely seemed out of line based on the information the administration and the committees provided.\u003c/p>\n\u003cp>He said it wouldn’t surprise him if the agencies were inflating the projected costs of the bills to try to get more money to backfill their budgets — or if top officials in Newsom’s administration had told departments to oppose bills that weren’t the governor’s priorities.\u003c/p>\n\u003cp>Either way, he said the agencies should do a better job of explaining their cost projections.\u003c/p>\n\u003cp>“It’s poor practice,” he said. “It’s not a good thing that they’re not showing the detail.”\u003c/p>\n\u003cp>Genest worked in the Capitol when Willie Brown was Assembly speaker and when John Burton was president of the Senate. He said those leaders, known for their aggressive leadership styles, would never let the governor’s administration get away with blowing off lawmakers’ concerns. Back then, he said, lawmakers would have threatened to cut the departments’ budgets if they felt they were getting the runaround.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“If a member was disrespected to that extent by a member of the bureaucracy,” he said, “there would be consequences.”\u003c/p>\n\n",
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"excerpt": "A trio of California Democratic lawmakers says they’re frustrated by high-cost estimates that helped kill their health care legislation. Did the Newsom administration inflate the numbers to quietly kill the bills?",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Lawmakers and advocates say Gov. Gavin Newsom’s administration is making inflated estimates about the cost of legislation, with some suggesting his subordinates have been trying to kill the bills without making the governor politically accountable for the outcome.\u003c/p>\n\u003cp>“While people are dying on the streets from a lack of access to behavioral health care treatment, state agencies continue to fabricate exorbitant cost estimates,” Sen. \u003ca href=\"https://digitaldemocracy.calmatters.org/legislators/dave-cortese-164699\">Dave Cortese\u003c/a>, a Democrat from Campbell, told CalMatters after one of his mental health proposals died recently in the Assembly Appropriations Committee.\u003c/p>\n\u003cp>Sen. \u003ca href=\"https://digitaldemocracy.calmatters.org/legislators/scott-wiener-100936\">Scott Wiener\u003c/a>, a Democrat from San Francisco who authored another mental health bill that died recently, \u003ca href=\"https://digitaldemocracy.calmatters.org/hearings/258192?t=295&f=a2f15a64e9e6ef40221b60296d414495\">said in a public hearing last month\u003c/a> that the administration’s cost estimate of his bill was “extreme and outrageous.”\u003c/p>\n\u003cp>The pointed accusations from Democratic lawmakers and health care advocates who tend to be friendly with the Democratic governor are extraordinary because such criticism is rarely made in public. The examples also stand out because they challenge the administration’s response to one of the governor’s top priorities, \u003ca href=\"https://calmatters.org/tag/mental-health/\">mental health\u003c/a>.\u003c/p>\n\u003cp>The administration did not accept an interview request with CalMatters and would not provide more detail — to CalMatters or to lawmakers — to explain the cost estimates. By email, however, a spokesperson insisted the costs were accurate and rejected the idea that they were intentionally inflated.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It’s outrageous and inaccurate for anyone to suggest these numbers are fabricated or artificially inflated,” Rodger Butler, a spokesperson for Newsom’s Health and Human Services Agency, said in an email. “Legislative fiscal analyses from state government departments are informed by real-world, on-the-ground experience implementing legislative mandates.”\u003c/p>\n\u003cp>Whatever the motivations, four health care bills with controversial cost estimates died quietly earlier this month in the Senate and Assembly Appropriations committees even after each had advanced without a single “no” vote from a Democratic legislator.\u003c/p>\n\u003cfigure id=\"attachment_12002025\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/081524-Suspense-File-FG-CM-04.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12002025\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/081524-Suspense-File-FG-CM-04.jpg\" alt=\"Three women dressed in orange, pink and green jackets and a man wearing a dark business suit sit in green chairs with the United States and California flags behind them.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/081524-Suspense-File-FG-CM-04.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/081524-Suspense-File-FG-CM-04-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/081524-Suspense-File-FG-CM-04-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/081524-Suspense-File-FG-CM-04-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/081524-Suspense-File-FG-CM-04-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/081524-Suspense-File-FG-CM-04-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Assembly lawmakers meet during a Suspense File hearing at the Capitol Annex Swing Space on O Street in Sacramento on Aug. 15, 2024. \u003ccite>(Fred Greaves / CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Appropriations Committees are focused on the cost of legislation, especially in a year when the state is struggling with a \u003ca href=\"https://calmatters.org/tag/california-budget/\">budget deficit\u003c/a>. The four bills were moved to the committees’ “suspense files,” \u003ca href=\"https://calmatters.org/politics/capitol/2024/08/california-laws-legislature-suspense-file/\">along with 263 other controversial or costly bills\u003c/a>. Each committee then killed the bills in their respective suspense file with a single vote.\u003c/p>\n\u003cp>Mike Gatto, a former Democratic lawmaker from Los Angeles who chaired the Assembly Appropriations Committee, said inflated cost estimates from a governor’s administration are nothing new.\u003c/p>\n\u003cp>When an executive branch agency provides “a significantly exaggerated cost” on a piece of legislation, “it’s generally a big flashing light that the administration dislikes the bill and that the governor would likely veto it,” he said.\u003c/p>\n\u003cp>It can be advantageous for the governor when legislators quietly kill those bills, he said.\u003c/p>\n\u003cp>“Having the appropriations committee there to kill it and to take the arrows (of criticism), that is a tremendous benefit politically for any governor,” Gatto said.\u003c/p>\n\u003cp>Gatto has a hand-written note framed on his wall that former Gov. Jerry Brown gave him expressing Brown’s appreciation for keeping bills from reaching the governor’s desk.\u003c/p>\n\u003cp>In a corner of the note are two words: “Keep holding.”\u003c/p>\n\u003cp>But Thad Kousser, a former legislative staffer who’s now a professor of political science at UC San Diego, said the integrity of the legislative process is jeopardized if cost estimates are not accurate.\u003c/p>\n\u003cp>“You’ve got to have reasonable and realistic estimates that are not part of a political strategy in order for everyone to make informed decisions,” he said.\u003c/p>\n\u003cp>This year alone, \u003ca href=\"https://digitaldemocracy.calmatters.org/\">according to the Digital Democracy database\u003c/a>, lawmakers considered 2,522 bills, many of them with large potential costs to taxpayers.\u003c/p>\n\u003ch2>Democrat calls costs ‘extreme and outrageous’\u003c/h2>\n\u003cp>Sen. Wiener’s legislation, \u003ca href=\"https://digitaldemocracy.calmatters.org/bills/ca_202320240sb294?slug=CA_202320240SB294\">Senate Bill 294\u003c/a>, would have required an automatic review of cases in which commercial health plans denied children and young people mental health treatment.\u003c/p>\n\u003cp>Wiener, the chair of the Senate’s mental health caucus, said in the public hearing last month that the measure “does nothing more than require health plans to provide the coverage that they’re required to provide and stop denying covered behavioral health care treatment to children.”\u003c/p>\n\u003cp>So he said it was “outrageous” when the \u003ca href=\"https://s3.documentcloud.org/documents/25074843/sb-294-2024.pdf\">Department of Managed Health Care estimated\u003c/a> that the bill would cost $87.6 million per year by 2028 and would require 340 new employees. That’s a 55% increase over the\u003ca href=\"https://ebudget.ca.gov/reference/2024-PositionVacancyReport.pdf\"> 610 positions in the department’s budget for the 2022–23 fiscal year.\u003c/a> A separate state office, the Department of Insurance, also said the bill would require it to hire an additional five positions by 2026 for $1.2 million. There is no description in the cost estimate about how the departments arrived at the estimate or what jobs the new positions would perform.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/FM6KA/9/\" width=\"800\" height=\"500\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>The estimate also was a surprise to supporters of Wiener’s bill. In June, they sent a three-page memo to the chair of the Assembly Appropriations Committee, Democrat \u003ca href=\"https://digitaldemocracy.calmatters.org/legislators/buffy-wicks-165044\">Buffy Wicks\u003c/a> from Oakland, saying that a similar bill that failed last year had a significantly lower cost estimate. They also noted that the pending bill was more narrow in scope.\u003c/p>\n\u003cp>Lishaun Francis, director of behavioral health for the advocacy group Children Now, told CalMatters the Department of Managed Health Care, which is intended to protect consumers, inflated the cost of Wiener’s bill, presumably to try to kill it.\u003c/p>\n\u003cp>“This is not an analysis in good faith,” she said. “The unfortunate thing here is that DMHC has fallen into a trap where they are trying to be here for consumers while also inflating costs to make sure bills don’t get to the governor when there is a tight budget year.”\u003c/p>\n\u003cp>Before the bill died, it passed the Senate and an Assembly committee without any Democrats voting against it, according to the Digital Democracy database.\u003c/p>\n\u003ch2>Are there ‘multiple layers of fiscal review?’\u003c/h2>\n\u003cp>The Department of Managed Health Care, which issued the cost estimates, is part of the state’s \u003ca href=\"https://www.chhs.ca.gov/wp-content/uploads/2024/08/CalHHS-Organizational-Chart_AUG24.pdf\">Health and Human Services Agency\u003c/a>. Secretary Dr. Mark Ghaly, a Newsom appointee, oversees the agency.\u003c/p>\n\u003cp>CalMatters requested an interview with Ghaly or another top official to talk about the cost estimates, but the administration would not talk beyond providing the emailed statement from Butler at the Health and Human Services Agency.\u003c/p>\n\u003cp>“It’s important to note there are multiple layers of fiscal review throughout the process,” he said, citing the policy and appropriations committees in the Legislature and the governor’s Department of Finance.\u003c/p>\n\u003cp>However, Department of Finance spokesman H.D. Palmer told CalMatters, “We rely principally on (agencies and departments) to provide us with the personnel and fiscal estimates.”\u003c/p>\n\u003cfigure id=\"attachment_12002024\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/051024_Newsom-Budget_FG_CM_33.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12002024\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/051024_Newsom-Budget_FG_CM_33.jpg\" alt=\"Two men wearing dark business suits stand behind two flags. The man on the left stands in front of a podium with a microphone and gestures with his right hand.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/051024_Newsom-Budget_FG_CM_33.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/051024_Newsom-Budget_FG_CM_33-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/051024_Newsom-Budget_FG_CM_33-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/051024_Newsom-Budget_FG_CM_33-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/051024_Newsom-Budget_FG_CM_33-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/051024_Newsom-Budget_FG_CM_33-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Gov. Gavin Newsom, left, listens as Joe Stephenshaw, director of the Department of Finance, speaks during a press conference unveiling Newsom’s revised 2024–25 budget proposal at the Capitol Annex Swing Space in Sacramento on May 10, 2024. \u003ccite>(Fred Greaves / CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Policy committees, meanwhile, don’t evaluate the costs of bills.\u003c/p>\n\u003cp>“To say that policy committees vetted the finances of a bill is almost uniformly incorrect,” said Gatto, the former Assembly Appropriations chair. “Policy committees don’t do that.”\u003c/p>\n\u003cp>That independent fiscal review is supposed to happen at the Assembly and Senate Appropriations Committees, whose staffers are widely regarded as some of the smartest people in the Capitol. Their job is to independently vet the administration estimate and provide their own cost estimates for bills, Kousser and Gatto said.\u003c/p>\n\u003cp>“These people are professionals,” Kousser said. “They’re trying to get it right.”\u003c/p>\n\u003cp>Yet when it came to these four disputed bills, the analysis written by the staffs of the Appropriations Committees described the administration cost estimates and nothing more. Each of the four analysis included \u003ca href=\"https://digitaldemocracy.calmatters.org/bills/ca_202320240sb999?slug=CA_202320240SB999\">language similar to SB 999\u003c/a>, which said only: “The Department of Managed Health Care (DMHC) reports the total costs of this bill as follows:”\u003c/p>\n\u003cp>Luis Quinonez, chief of staff for Sen. \u003ca href=\"https://digitaldemocracy.calmatters.org/legislators/anna-caballero-101330\">Anna Caballero\u003c/a> of Merced, who chairs the Senate’s Appropriations Committee, declined to discuss specific bills other than to say the committee’s consultants perform their own analyses.\u003c/p>\n\u003cp>Representatives for Assemblymember Wicks, who chairs the Assembly Appropriations Committee, did not return messages.\u003c/p>\n\u003ch2>Another Democrat calls costs ‘exorbitant’\u003c/h2>\n\u003cp>Regarding his mental health bill, Sen. Cortese said in an email he has “serious concerns about how the health care agencies are coming up with these cost projections.” \u003ca href=\"https://digitaldemocracy.calmatters.org/bills/ca_202320240sb999?slug=CA_202320240SB999\">Senate Bill 999 \u003c/a>would have required health insurers to make sure they have mental health and addiction experts review claims for treatment, something advocates say is already required under state law.\u003c/p>\n\u003cp>This was the second time Cortese introduced the bill. A previous version made it through the Legislature in 2022 before Newsom \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2022/09/SB-999-VETO.pdf\">vetoed it\u003c/a>, saying the issue could be addressed by new regulations that would be issued soon.\u003c/p>\n\u003cp>After he felt draft regulations last year were inadequate, Cortese introduced a pared-down version of the 2022 bill. \u003cspan style=\"margin: 0px;padding: 0px\">However, advocates were surprised to see the \u003ca href=\"https://s3.documentcloud.org/documents/25074841/sb-999-2024-analysis.pdf\" target=\"_blank\" rel=\"noopener\">department’s cost estimate \u003c/a>increase significantly to $18 million over five years and about $4 million annually after 2028 to pay for 13 permanent positions.\u003c/span> The estimate does not explain how the department determined the number of positions needed or what jobs they would perform.\u003c/p>\n\u003cp>\u003cspan style=\"margin: 0px;padding: 0px\">Advocacy groups supporting the bill noted that, in recent years, budget allocations, the Department of Managed Health Care already received \u003ca href=\"https://bcp.dof.ca.gov/2122/FY2122_ORG4150_BCP4308.pdf\" target=\"_blank\" rel=\"noopener\">millions of\u003c/a> \u003ca href=\"https://bcp.dof.ca.gov/2223/FY2223_ORG4150_BCP5107.pdf\" target=\"_blank\" rel=\"noopener\">dollars \u003c/a>to cover some of the costs of implementing the proposed rules, so it didn’t make sense that the costs would be so high.\u003c/span>\u003c/p>\n\u003cp>“It’s sad to see some of these good faith efforts by advocates to try to bring accountability to the system kind of fall under the weight of a cost estimate that we don’t have a lot of insight into from the department,” said Lauren Finke, policy director for The Kennedy Forum, one of the bill’s sponsors.\u003c/p>\n\u003cfigure id=\"attachment_12002026\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/01192023_Assembly-Chamber_RL_CM_03.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12002026\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/01192023_Assembly-Chamber_RL_CM_03.jpg\" alt=\"A white woman wearing a black jacket and grey shirt looks at a woman wearing a red jacket that has her back turned to the camera.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/01192023_Assembly-Chamber_RL_CM_03.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/01192023_Assembly-Chamber_RL_CM_03-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/01192023_Assembly-Chamber_RL_CM_03-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/01192023_Assembly-Chamber_RL_CM_03-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/01192023_Assembly-Chamber_RL_CM_03-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/01192023_Assembly-Chamber_RL_CM_03-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Assemblymember Gail Pellerin, a Santa Cruz Democrat, convenes with legislators during a session at the state Capitol in Sacramento on Jan. 19, 2023. \u003ccite>(Rahul Lal / CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Santa Cruz Democratic Assemblymember \u003ca href=\"https://digitaldemocracy.calmatters.org/legislators/gail-pellerin-149519\">Gail Pellerin\u003c/a> similarly couldn’t understand why there was such a high cost associated with her \u003ca href=\"https://digitaldemocracy.calmatters.org/bills/ca_202320240ab3260?slug=CA_202320240AB3260\">Assembly Bill 3260\u003c/a>, which would have required health insurers to expedite reviews of mental health claims that doctors deem urgent.\u003c/p>\n\u003cp>The \u003ca href=\"https://s3.documentcloud.org/documents/25074842/ab-3260-analysis.pdf\">Department of Managed Health Care estimated\u003c/a> the bill would cost nearly $140 million in the first five years and $32 million annually after 2029 to pay 144 new positions — a 23% increase in staff size, Pellerin said in an interview. The estimate, which also includes an additional $238,000 annually for the Department of Insurance, does not provide any further description of the need for the positions.\u003c/p>\n\u003cp>Sal Rosselli, president emeritus of the National Union of Healthcare Workers, which supported the bill, said in an email that his organization reached out to agency officials to ask for an explanation of the cost analysis, “but they declined to engage with us.”\u003c/p>\n\u003cp>Eleven other states, plus Washington, D.C., have already adopted similar laws, he said, with no evidence that those laws resulted in a major increase in workload.\u003c/p>\n\u003cp>Pellerin said she and her staff also couldn’t get an answer from the department about how it came up with what she called “inflated” numbers.\u003c/p>\n\u003cp>“Is this taxpayer-funded state department doing the job it is required to do?” she asked.\u003c/p>\n\u003cp>For Pellerin, the issue is personal. She knows firsthand how an urgent mental health crisis can spiral out of control. Her husband died by suicide in 2018.\u003c/p>\n\u003cp>“My family, we’ve experienced this kind of situation,” she told CalMatters.\u003c/p>\n\u003ch2>Are agencies not showing their work?\u003c/h2>\n\u003cp>Advocates for Health Access California also were frustrated by the cost estimates associated with \u003ca href=\"https://digitaldemocracy.calmatters.org/bills/ca_202320240ab236?_gl=1*ip5o3s*_gcl_au*MTQyNDUxODAyMS4xNzIzNTY4MzM1*_ga*OTk2OTcyMDkyLjE2OTk5MTE3MzA.*_ga_5TKXNLE5NK*MTcyNDM2MDMwNi43MjEuMS4xNzI0MzYwNDYwLjU3LjAuMA..*_ga_DX0K9PCWYH*MTcyNDM2MDMwNi4xNjUuMS4xNzI0MzYwNDU3LjAuMC4w*_ga_GNY4L81DZE*MTcyNDM2MDQ1Ny41OTguMC4xNzI0MzYwNDU3LjAuMC4w\">Assembly Bill 236\u003c/a> by Pasadena Democratic Assemblymember \u003ca href=\"https://digitaldemocracy.calmatters.org/legislators/chris-holden-78\">Chris Holden\u003c/a>. The bill \u003ca href=\"https://calmatters.org/health/2024/07/ghost-network-doctor-referrals/\">would have given state regulators\u003c/a> the authority to fine health insurers if their publicly available lists of in-network doctors and specialists aren’t accurate.\u003c/p>\n\u003cp>In testimony supporting the bill’s promises to crack down on so-called “ghost networks,” \u003ca href=\"https://digitaldemocracy.calmatters.org/hearings/258106?t=469&f=723bb83d8559a8dceb9316c055b8b3b2&_gl=1*6kjdh0*_gcl_au*MTQyNDUxODAyMS4xNzIzNTY4MzM1*_ga*OTk2OTcyMDkyLjE2OTk5MTE3MzA.*_ga_5TKXNLE5NK*MTcyNDM1NTkxNS43MjAuMS4xNzI0MzU2NDQ2LjU5LjAuMA..*_ga_DX0K9PCWYH*MTcyNDM1NTkxNS4xNjQuMS4xNzI0MzU2NDQ1LjAuMC4w*_ga_GNY4L81DZE*MTcyNDM1NjQ0NS41OTcuMC4xNzI0MzU2NDQ1LjAuMC4w\">a therapist described\u003c/a> having a patient end up in the emergency room from a suicide attempt after she called through a list of 50 mental health providers and couldn’t find one who’d see her.\u003c/p>\n\u003cp>The bill would have added teeth to a law that insurers and doctors are already supposed to follow and that state regulators are supposed to monitor.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The Department of Managed Health Care \u003ca href=\"https://s3.documentcloud.org/documents/25074840/ab-236-2024.pdf\">estimated its cost\u003c/a> to be $3.5 million annually after 2029 for 14 new positions. In its one-sentence description, the Department of Health Care Services said its cost for the bill would be “approximately” $24 million. In an email, the department told CalMatters the bill would lead to “increased costs in the Medi-Cal managed care and behavioral health delivery systems and staffing requirements.”\u003c/p>\n\u003cp>“This $24 million is just mind-blowing,” said Rachel Linn Gish, a spokesperson for Health Access. “We do not understand how they came up with this number.”\u003c/p>\n\u003cp>Michael Genest spent four years as Gov. Arnold Schwarzenegger’s director of the Department of Finance. At CalMatters’ request, he reviewed the cost estimates of the four bills.\u003c/p>\n\u003cp>He said he could expect high costs for Wiener’s and Pellerin’s bills, but he said it wasn’t possible for him to independently evaluate the figures without more detail.\u003c/p>\n\u003cp>However, he said the other two estimates definitely seemed out of line based on the information the administration and the committees provided.\u003c/p>\n\u003cp>He said it wouldn’t surprise him if the agencies were inflating the projected costs of the bills to try to get more money to backfill their budgets — or if top officials in Newsom’s administration had told departments to oppose bills that weren’t the governor’s priorities.\u003c/p>\n\u003cp>Either way, he said the agencies should do a better job of explaining their cost projections.\u003c/p>\n\u003cp>“It’s poor practice,” he said. “It’s not a good thing that they’re not showing the detail.”\u003c/p>\n\u003cp>Genest worked in the Capitol when Willie Brown was Assembly speaker and when John Burton was president of the Senate. He said those leaders, known for their aggressive leadership styles, would never let the governor’s administration get away with blowing off lawmakers’ concerns. Back then, he said, lawmakers would have threatened to cut the departments’ budgets if they felt they were getting the runaround.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“If a member was disrespected to that extent by a member of the bureaucracy,” he said, “there would be consequences.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "they-delivered-5600-babies-they-blame-california-rules-for-putting-them-out-of-business",
"title": "They Delivered 5,600 Babies. They Blame California Rules for Putting Them Out of Business",
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"headTitle": "They Delivered 5,600 Babies. They Blame California Rules for Putting Them Out of Business | KQED",
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"content": "\u003cp>\u003cem>This story, produced by CalMatters, is published jointly with San Diego Magazine.\u003c/em>\u003c/p>\n\u003cp>Colorful collages line the hallways of Best Start Birth Center in San Diego, the squishy faces of hundreds of newborns carefully cut out and framed. A picture of executive director Karen Roslie’s son, born in 2003, hangs among the smiling, crying and squinting babies.\u003c/p>\n\u003cp>Thirty years ago, Roslie’s mother, Roberta Frank, opened Best Start after training to become a certified nurse midwife. Since that time, state agencies and national organizations have recognized the birth center as a model for alternative birth practices. The Canadian health ministry even visited in the 1990s as it developed plans to fund midwifery services, Roslie said.\u003c/p>\n\u003cp>But in March, Best Start closed its doors, unable to keep up with escalating costs. TRICARE, a major military insurer and Best Start’s biggest contractor, wouldn’t pay for licensed midwives — only nurses, who can make much more money in a hospital. In a community where the Navy is a major employer, it was a debilitating blow to the birth center. The photos Roslie meticulously framed over the years will most likely have to be destroyed to avoid any medical privacy violations — evidence of more than 5,600 births shredded.\u003c/p>\n\u003cp>“It feels like I’m mourning a death,” Roslie said, gazing at the pictures.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Best Start was the first licensed and accredited birth center in California, and even those credentials couldn’t save it. In fact, they may have hindered the birth center’s survival, requiring expensive renovations that many midwives say aren’t relevant to the care they provide or the safety of their practice. Its closure was one of at least 19 birth center shutdowns and service reductions in the past four years, according to the California chapter of the American Association of Birth Centers.\u003c/p>\n\u003cp>Those closures deepen a crisis of declining women’s health services across California. \u003ca href=\"https://calmatters.org/series/no-deliveries-maternity-care/\">More than 50 California hospital labor and delivery wards have closed\u003c/a> in the past decade, creating maternity care deserts in rural communities and overburdening the remaining labor wards in cities and suburbs.\u003c/p>\n\u003cp>Health experts have pointed to birth centers as a way to expand capacity in communities where hospitals no longer deliver babies. The midwife-run clinics handle low-risk births and direct higher-risk pregnancies to hospitals.\u003c/p>\n\u003cfigure id=\"attachment_12001858\" class=\"wp-caption alignright\" style=\"max-width: 280px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-12001858\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/02_032024_Best-Start-Birthing_AD_CM_01-800x1000.jpg\" alt=\"Two women wearing. One sitting, one standing. \" width=\"280\" height=\"350\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/02_032024_Best-Start-Birthing_AD_CM_01-800x1000.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/02_032024_Best-Start-Birthing_AD_CM_01-1020x1275.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/02_032024_Best-Start-Birthing_AD_CM_01-160x200.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/02_032024_Best-Start-Birthing_AD_CM_01-1229x1536.jpg 1229w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/02_032024_Best-Start-Birthing_AD_CM_01.jpg 1600w\" sizes=\"auto, (max-width: 280px) 100vw, 280px\">\u003cfigcaption class=\"wp-caption-text\">Left to right, Founder Roberta Frank and Executive Director Karen Rosalie at the Best Start Birthing Center in San Diego on March 20, 2024. \u003ccite>(Ariana Drehsler/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>However, California has some of the toughest licensing requirements in the country, according to the American Association of Birth Centers, and facilities such as Best Start have long argued that California’s onerous regulations and an uncooperative Public Health Department prevent them from succeeding.\u003c/p>\n\u003cp>Only six operating birth centers are licensed in California. Another 26 are unlicensed. Licensure isn’t required, but it helps enable a practice to work with insurance plans and serve lower-income families who can’t pay birthing costs out of pocket.\u003c/p>\n\u003cp>Increasingly, only wealthy families who pay cash can afford a midwife.\u003c/p>\n\u003cp>“The system is just a mess. It’s flawed. It’s set up to prevent providers that can provide really good care from even getting started,” Frank, the founder of Best Start, said.\u003c/p>\n\u003cp>While most California births happen in hospitals, birth centers serve a small but growing number of families. Planned out-of-hospital births attended by midwives have doubled over the past decade even as birth rates overall declined, according to \u003ca href=\"https://www.mbc.ca.gov/Resources/Publications/Licensed-Midwife-Annual-Report.aspx\">data from the Medical Board of California\u003c/a>. And a statewide survey conducted in 2018 by the California Health Care Foundation indicated that more than one-third of pregnant people would be\u003ca href=\"https://www.chcf.org/wp-content/uploads/2018/09/ListeningMothersCAFullSurveyReport2018.pdf\"> interested in having a midwife for a future birth (PDF)\u003c/a>.\u003c/p>\n\u003cp>Frequently, those who seek the services of midwives and birth centers cite the desire for more personalized care or poor experiences with previous hospital births. Studies show that for low-risk pregnancies, \u003ca href=\"https://www.ncbi.nlm.nih.gov/books/NBK555483/\">midwife-led deliveries at birth centers\u003c/a> are safe and lead to fewer interventions such as cesarean sections.\u003c/p>\n\u003cp>“Women deserve this,” Frank said. “Every human deserves to find their own strength, find their place, exercise their initiative, and I wanted to share it.”\u003c/p>\n\u003cp>But even as demand for out-of-hospital births increases, birth centers across the state are shutting their doors, unable to withstand the joint battering ram of financial and regulatory challenges.\u003c/p>\n\u003cp>Last year, the \u003ca href=\"https://www.pressdemocrat.com/article/news/if-you-dont-want-to-give-birth-in-a-hospital-your-options-are-few-in-sono/\">Santa Rosa Birth Center stopped delivering babies\u003c/a>, reducing options in a Wine Country community that recently lost a hospital maternity ward and another birth center.\u003c/p>\n\u003cp>A \u003ca href=\"https://calmatters.org/health/2024/02/midwife-medi-cal/\">Sacramento midwife closed her birth center\u003c/a> in February and left the country because she said California’s health system was too unfriendly to make ends meet. Another Sacramento birth center is also on the verge of closure because it cannot get a state license.\u003c/p>\n\u003cfigure id=\"attachment_12001860\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-12001860\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/sidebyside_graphic-800x450.jpg\" alt=\"Collage of two images: On the left a pregnant belly being measured and on the right a woman with a face mask.\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/sidebyside_graphic-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/sidebyside_graphic-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/sidebyside_graphic-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/sidebyside_graphic-1536x864.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/sidebyside_graphic.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Midwife Madeleine Wisner measures and checks Chloé Mick’s belly during a maternity care consultation at Mick’s home in Sacramento on Feb. 6, 2024. \u003ccite>(Miguel Gutierrez Jr./CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In September, Monterey Birth and Wellness Center will close, citing high costs and poor insurance reimbursement.\u003c/p>\n\u003cp>The California Public Health Department refused multiple requests for an interview about licensing, responding only to emailed questions. Licensing requires facilities to meet “minimum standards” for patient care, which include regulations about proper equipment and staff competency, the department said in an unsigned statement.\u003c/p>\n\u003cp>“We cannot speculate or comment on any reason why providers chose to close these facilities, aren’t seeking licensure for new (birth centers), or what could be done to improve the process,” the department statement said.\u003c/p>\n\u003ch3>Years-long wait for a health department license\u003c/h3>\n\u003cp>Nancy Myrick, a co-founder of the San Francisco Birth Center, said it took four-and-a-half years of back-and-forth with the state health department to obtain a license. In one instance, Myrick said, she asked for a list of items an inspector would check and the health department referred her to regulations that had not yet been written.\u003c/p>\n\u003cp>“In the process of opening, the state bureaucracy was like the Great Wall of China. It was such a horrible barrier,” Myrick said.\u003c/p>\n\u003cp>It wasn’t until Myrick called her state assemblymember’s office to complain about the inability to get licensed and see Medi-Cal patients that the application was approved, she said. The birth center was licensed in 2020.\u003c/p>\n\u003cp>“It literally took calling in the political dogs to get it done,” Myrick said.\u003c/p>\n\u003cp>Many providers noticed that getting a license became much more difficult after the state centralized the process under the public health department in 2018. Since then, nearly all birth center applications —11 out of 13 — have been rejected, according to department-provided data.\u003c/p>\n\u003cp>The department said in a statement the change was necessary to improve “standardization and consistency” in licensing multiple kinds of facilities. Previously, the department’s 14 regional offices processed applications and approved 11 out of 12 applications.\u003c/p>\n\u003cp>Yet midwives and advocates say obstacles continue to plague the process. It’s slow, often taking years; it’s expensive, costing tens of thousands of dollars to retrofit buildings and maintain a license; and the standards are frequently at odds with midwives’ scope of practice. What results is a “de facto ban” on birth center licensure in California, said Sandra Poole, a lobbyist with the Western Center on Law and Poverty.\u003c/p>\n\u003cp>Without licensing reform, more birth centers will close, said Bethany Sasaki, president of the state chapter of the American Association of Birth Centers.\u003c/p>\n\u003cfigure id=\"attachment_12001867\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12001867\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/05_032024_Best-Start-Birthing_AD_CM_18.jpg\" alt=\"Pregnant woman sits in a room with a monitor, clock and greyish walls.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/05_032024_Best-Start-Birthing_AD_CM_18.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/05_032024_Best-Start-Birthing_AD_CM_18-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/05_032024_Best-Start-Birthing_AD_CM_18-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/05_032024_Best-Start-Birthing_AD_CM_18-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/05_032024_Best-Start-Birthing_AD_CM_18-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/05_032024_Best-Start-Birthing_AD_CM_18-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Sally K., right, 38-weeks pregnant, talks to midwife Andrea Bergleen, left, during a check-up at the Best Start Birthing Center in San Diego on March 20, 2024. \u003ccite>(Ariana Drehsler/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A key problem, Sasaki said, is that birth centers are expected to comply with \u003ca href=\"https://hcai.ca.gov/wp-content/uploads/2023/10/2022_1226.6-Primary-Care-Clinic_Checklist_102023.pdf\">building standards designed for hospitals (PDF)\u003c/a>. For example, the standards include negative pressure rooms for infection control and cast iron plumbing for water supply and drainage.\u003c/p>\n\u003cp>Many midwives argue the standards don’t make sense because their patients are legally required to be healthy with low-risk pregnancies. Any condition that would require the additional medical intervention the standards are meant to accommodate, such as surgery, would force the patient to be transferred to a doctor or hospital, Sasaki said.\u003c/p>\n\u003cp>“There’s no reason to hold a birth center to the same standards as a hospital because it’s not a hospital, and that’s the whole point, Sasaki said.\u003c/p>\n\u003cp>According to the state Department of Health Care Access and Information, which sets building codes for health facilities, it would take legislative changes to make exceptions for birth centers. Poole and a number of groups representing midwives and Black maternal health advocates tried to introduce a bill earlier this year that would ease licensing requirements but could not find a legislator to carry it.\u003c/p>\n\u003cp>The state denied Sasaki’s licensure application for Midtown Nurse Midwives in Sacramento in 2020. The holdup is the building’s ventilation system, which doesn’t meet hospital building code.\u003c/p>\n\u003cp>In March, Sasaki requested an appeal and emergency license after TRICARE, the same insurer that Best Start relied on, stopped contracting with unlicensed facilities. As of mid-July, she has not received a response from the state, though the department told CalMatters the appeal deadline for Sasaki’s application had passed.\u003c/p>\n\u003cp>Without the TRICARE contract, which made up about 30% of her clients, Sasaki said the birth center will close by November.\u003c/p>\n\u003cp>“We’ve had to turn away so many people that we stopped answering our phone because I don’t want to listen to another person cry,” Sasaki said.\u003c/p>\n\u003ch3>Birth centers must get licensed for Medi-Cal\u003c/h3>\n\u003cp>Why is licensure such a stumbling block for birth centers? Medi-Cal, the state’s public insurance program for low-income families, pays for half of all births in the state, requiring birth centers to be licensed.\u003c/p>\n\u003cp>“The single biggest thing that will help with sustainability is if birth centers can take Medi-Cal and if Medi-Cal can actually reimburse appropriately,” Sasaki said.\u003c/p>\n\u003cp>The majority of Medi-Cal births — more than 80% — are babies of color. A statewide survey also indicates that people of color, particularly Black women, \u003ca href=\"https://www.chcf.org/wp-content/uploads/2018/09/ListeningMothersCAFullSurveyReport2018.pdf\">want alternative birth support, such as midwives and doulas, more than any other demographic group (PDF)\u003c/a>. White women and those with private insurance were the highest users of midwives, the survey shows. While those who wanted a midwife but didn’t use one most commonly cited lack of insurance coverage as a barrier.\u003c/p>\n\u003cfigure id=\"attachment_12001870\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12001870 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/2-e1724696255489.jpg\" alt=\"Image collage with two rooms, one with a small blue pool and one with a white bathtub.\" width=\"1920\" height=\"646\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/2-e1724696255489.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/2-e1724696255489-800x269.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/2-e1724696255489-1020x343.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/2-e1724696255489-160x54.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/2-e1724696255489-1536x517.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Birthing rooms at the Best Start Birthing Center in San Diego on March 20, 2024. \u003ccite>(Ariana Drehsler/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Caroline Cusenza, a midwife and owner of the Monterey Birth and Wellness Center, said taking insurance allowed her to serve a more diverse population in the working-class Latino enclave where the birth center is located. She wanted to take Medi-Cal patients but couldn’t. Cusenza applied for licensure twice but was also rejected because the building didn’t meet ventilation standards.\u003c/p>\n\u003cp>The birth center will close in September after seven years.\u003c/p>\n\u003cp>“It was a hard decision to walk away, but we really just could see no path forward,” Cusenza said.\u003c/p>\n\u003cp>The Western Center for Law and Poverty has pointed to accreditation as a possible alternative to licensure. The Commission for the Accreditation of Birth Centers is the national organization that sets standards for birth center quality and safety. California regulators have used accreditation to help license \u003ca href=\"https://www.cdph.ca.gov/Programs/OSPHLD/LFS/CDPH%20Document%20Library/ACLL--16-01.pdf\">other kinds of health facilities (PDF)\u003c/a>, but health department officials see no need to provide birth centers with alternate options. They argue, in an email to CalMatters, that very few have tried to get a license in the first place. Only 23 birth centers have applied in the past decade.\u003c/p>\n\u003cp>Holly Smith, a certified nurse midwife and co-lead of Midwifery Access California, contends the low number of applicants reflects the difficulty of the process. Midwives know licensure is nearly impossible, so they don’t bother applying, Smith said.\u003c/p>\n\u003cp>“If (the Public Health Department) can be much more involved in figuring out solutions to help birth centers exist and be licensed should they want to be, then we would see a greater proliferation of it,” Smith said.\u003c/p>\n\u003cp>Midwifery Access California is working with another state agency to improve access for low-income patients, Smith said. The advocates hope to convince the Department of Health Care Services to increase Medi-Cal payments to midwives. Right now, a licensed birth center gets about $1,300 per birth, while the midwife gets $400.\u003c/p>\n\u003cp>At those rates, some birth centers say even Medi-Cal wouldn’t be enough to save them.\u003c/p>\n\u003cp>“If our birth center were to accept Medi-Cal, we would go bankrupt,” said Trisha Wimbs, owner of the California Birth Center in Rocklin.\u003c/p>\n\u003cp>Wimbs’ facility was one of only three birth centers to get licensed since the public health department took over and tightened building codes. It was licensed in 2023. Wimbs said it cost $1 million to build the “hospital grade facility” to code, including $80,000 to move a fire hydrant two feet closer to the building. The birth center does not take Medi-Cal because it pays too little to recoup expenses. Instead, the birth center caters to cash pay and commercially insured clients in the affluent suburb of Sacramento. Licensure was essential to securing commercial insurance contracts, Wimbs said.\u003c/p>\n\u003cp>To sustain birth centers, Medi-Cal needs to pay around $8,000 per birth, Smith said. At that price point, delivering at a birth center would cost \u003ca href=\"https://healthcostinstitute.org/hcci-originals-dropdown/all-hcci-reports/the-price-of-childbirth-in-the-u-s-tops-13-000-in-2020\">less than half as much as a hospital delivery\u003c/a>.\u003c/p>\n\u003ch3>Saying goodbye to Best Start\u003c/h3>\n\u003cp>Eighteen years ago, Ellary Alonso was born at Best Start Birth Center when her mom, a former labor and delivery nurse, sought a more personalized birth experience. Alonso, who was 21 weeks along in March, wanted to deliver her son in the same place, surrounded by midwives she knew, maybe even in a bath. She wanted the emotional support of the team, she said, because her husband is a Marine, and there’s no guarantee he’ll be able to make it to the birth.\u003c/p>\n\u003cp>But a week before her first prenatal appointment at Best Start, Alonso got a call that the center was closing permanently. No other birth centers in Southern California take her insurance.\u003c/p>\n\u003cp>“In this time when everything is about choice, you can choose not to have a baby, but you can’t choose how to have your baby,” Alonso said. “Hospitals are the only option.”\u003c/p>\n\u003cfigure id=\"attachment_12001873\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12001873\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/032024_Best-Start-Birthing_AD_CM_26.jpg\" alt=\"Two women, one sitting and one standing pose for the camera.\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/032024_Best-Start-Birthing_AD_CM_26.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/032024_Best-Start-Birthing_AD_CM_26-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/032024_Best-Start-Birthing_AD_CM_26-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/032024_Best-Start-Birthing_AD_CM_26-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/032024_Best-Start-Birthing_AD_CM_26-1536x1025.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/032024_Best-Start-Birthing_AD_CM_26-1920x1281.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Ellary Alonso, right, 18 years old and 21-weeks pregnant, with her mom Hannah Fraley, left, at the Best Start Birthing Center in San Diego on March 20, 2024. Fraley had two of her kids at the center. \u003ccite>(Ariana Drehsler/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Compared to a hospital room, Best Start offers a homey atmosphere and promises that the midwife attending each birth will be familiar to the laboring client. The birthing rooms come with queen-sized beds, floral duvets, and white porcelain tubs for water births. A marble-topped “crash cart” sits in each room. With the doors closed, the cart looks just like an end table that matches the decor. Inside, it’s filled with medical supplies for emergency resuscitations or to stitch up lacerations. The rooms are homey but bear the hallmarks of a by-the-book clinic. Boxes of nitrile gloves are in each room; hazardous waste bins are mounted discreetly to the wall. Best Start was the only birth center in the state to have a licensed clinical laboratory to confirm water breakage. [aside tag=\"health\" label=\"More Related Stories\"]\u003c/p>\n\u003cp>It has never lost a mother or baby, Roslie said. Its transfer rate for cesarean sections was less than half the statewide target set for low-risk births. In the past five years, no episiotomies have been performed. And 96% of newborns are exclusively breastfed before leaving Best Start compared to the statewide hospital rate of 69%.\u003c/p>\n\u003cp>Despite the center’s recognized success, keeping it running has always been a labor of love, Roslie said.\u003c/p>\n\u003cp>“It’s never been a thriving business,” Roslie said. “Roberta’s gone without pay. I’ve gone with reduced pay. That’s what it takes to run a birth center.”\u003c/p>\n\u003cp>When Roberta Frank, Roslie’s mother, graduated from UC San Diego with her nursing midwifery degree in 1981, she was told, “San Diego will never accept midwives.”\u003c/p>\n\u003cp>Sometimes — in the face of Best Start’s closure — it still feels that way.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Birth centers are popular options for families who want to deliver a baby outside of a hospital. Nineteen of them closed in California in the past decade, deepening the state’s maternity care crisis.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>This story, produced by CalMatters, is published jointly with San Diego Magazine.\u003c/em>\u003c/p>\n\u003cp>Colorful collages line the hallways of Best Start Birth Center in San Diego, the squishy faces of hundreds of newborns carefully cut out and framed. A picture of executive director Karen Roslie’s son, born in 2003, hangs among the smiling, crying and squinting babies.\u003c/p>\n\u003cp>Thirty years ago, Roslie’s mother, Roberta Frank, opened Best Start after training to become a certified nurse midwife. Since that time, state agencies and national organizations have recognized the birth center as a model for alternative birth practices. The Canadian health ministry even visited in the 1990s as it developed plans to fund midwifery services, Roslie said.\u003c/p>\n\u003cp>But in March, Best Start closed its doors, unable to keep up with escalating costs. TRICARE, a major military insurer and Best Start’s biggest contractor, wouldn’t pay for licensed midwives — only nurses, who can make much more money in a hospital. In a community where the Navy is a major employer, it was a debilitating blow to the birth center. The photos Roslie meticulously framed over the years will most likely have to be destroyed to avoid any medical privacy violations — evidence of more than 5,600 births shredded.\u003c/p>\n\u003cp>“It feels like I’m mourning a death,” Roslie said, gazing at the pictures.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Best Start was the first licensed and accredited birth center in California, and even those credentials couldn’t save it. In fact, they may have hindered the birth center’s survival, requiring expensive renovations that many midwives say aren’t relevant to the care they provide or the safety of their practice. Its closure was one of at least 19 birth center shutdowns and service reductions in the past four years, according to the California chapter of the American Association of Birth Centers.\u003c/p>\n\u003cp>Those closures deepen a crisis of declining women’s health services across California. \u003ca href=\"https://calmatters.org/series/no-deliveries-maternity-care/\">More than 50 California hospital labor and delivery wards have closed\u003c/a> in the past decade, creating maternity care deserts in rural communities and overburdening the remaining labor wards in cities and suburbs.\u003c/p>\n\u003cp>Health experts have pointed to birth centers as a way to expand capacity in communities where hospitals no longer deliver babies. The midwife-run clinics handle low-risk births and direct higher-risk pregnancies to hospitals.\u003c/p>\n\u003cfigure id=\"attachment_12001858\" class=\"wp-caption alignright\" style=\"max-width: 280px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-12001858\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/02_032024_Best-Start-Birthing_AD_CM_01-800x1000.jpg\" alt=\"Two women wearing. One sitting, one standing. \" width=\"280\" height=\"350\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/02_032024_Best-Start-Birthing_AD_CM_01-800x1000.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/02_032024_Best-Start-Birthing_AD_CM_01-1020x1275.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/02_032024_Best-Start-Birthing_AD_CM_01-160x200.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/02_032024_Best-Start-Birthing_AD_CM_01-1229x1536.jpg 1229w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/02_032024_Best-Start-Birthing_AD_CM_01.jpg 1600w\" sizes=\"auto, (max-width: 280px) 100vw, 280px\">\u003cfigcaption class=\"wp-caption-text\">Left to right, Founder Roberta Frank and Executive Director Karen Rosalie at the Best Start Birthing Center in San Diego on March 20, 2024. \u003ccite>(Ariana Drehsler/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>However, California has some of the toughest licensing requirements in the country, according to the American Association of Birth Centers, and facilities such as Best Start have long argued that California’s onerous regulations and an uncooperative Public Health Department prevent them from succeeding.\u003c/p>\n\u003cp>Only six operating birth centers are licensed in California. Another 26 are unlicensed. Licensure isn’t required, but it helps enable a practice to work with insurance plans and serve lower-income families who can’t pay birthing costs out of pocket.\u003c/p>\n\u003cp>Increasingly, only wealthy families who pay cash can afford a midwife.\u003c/p>\n\u003cp>“The system is just a mess. It’s flawed. It’s set up to prevent providers that can provide really good care from even getting started,” Frank, the founder of Best Start, said.\u003c/p>\n\u003cp>While most California births happen in hospitals, birth centers serve a small but growing number of families. Planned out-of-hospital births attended by midwives have doubled over the past decade even as birth rates overall declined, according to \u003ca href=\"https://www.mbc.ca.gov/Resources/Publications/Licensed-Midwife-Annual-Report.aspx\">data from the Medical Board of California\u003c/a>. And a statewide survey conducted in 2018 by the California Health Care Foundation indicated that more than one-third of pregnant people would be\u003ca href=\"https://www.chcf.org/wp-content/uploads/2018/09/ListeningMothersCAFullSurveyReport2018.pdf\"> interested in having a midwife for a future birth (PDF)\u003c/a>.\u003c/p>\n\u003cp>Frequently, those who seek the services of midwives and birth centers cite the desire for more personalized care or poor experiences with previous hospital births. Studies show that for low-risk pregnancies, \u003ca href=\"https://www.ncbi.nlm.nih.gov/books/NBK555483/\">midwife-led deliveries at birth centers\u003c/a> are safe and lead to fewer interventions such as cesarean sections.\u003c/p>\n\u003cp>“Women deserve this,” Frank said. “Every human deserves to find their own strength, find their place, exercise their initiative, and I wanted to share it.”\u003c/p>\n\u003cp>But even as demand for out-of-hospital births increases, birth centers across the state are shutting their doors, unable to withstand the joint battering ram of financial and regulatory challenges.\u003c/p>\n\u003cp>Last year, the \u003ca href=\"https://www.pressdemocrat.com/article/news/if-you-dont-want-to-give-birth-in-a-hospital-your-options-are-few-in-sono/\">Santa Rosa Birth Center stopped delivering babies\u003c/a>, reducing options in a Wine Country community that recently lost a hospital maternity ward and another birth center.\u003c/p>\n\u003cp>A \u003ca href=\"https://calmatters.org/health/2024/02/midwife-medi-cal/\">Sacramento midwife closed her birth center\u003c/a> in February and left the country because she said California’s health system was too unfriendly to make ends meet. Another Sacramento birth center is also on the verge of closure because it cannot get a state license.\u003c/p>\n\u003cfigure id=\"attachment_12001860\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-12001860\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/sidebyside_graphic-800x450.jpg\" alt=\"Collage of two images: On the left a pregnant belly being measured and on the right a woman with a face mask.\" width=\"800\" height=\"450\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/sidebyside_graphic-800x450.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/sidebyside_graphic-1020x574.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/sidebyside_graphic-160x90.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/sidebyside_graphic-1536x864.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/sidebyside_graphic.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Midwife Madeleine Wisner measures and checks Chloé Mick’s belly during a maternity care consultation at Mick’s home in Sacramento on Feb. 6, 2024. \u003ccite>(Miguel Gutierrez Jr./CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In September, Monterey Birth and Wellness Center will close, citing high costs and poor insurance reimbursement.\u003c/p>\n\u003cp>The California Public Health Department refused multiple requests for an interview about licensing, responding only to emailed questions. Licensing requires facilities to meet “minimum standards” for patient care, which include regulations about proper equipment and staff competency, the department said in an unsigned statement.\u003c/p>\n\u003cp>“We cannot speculate or comment on any reason why providers chose to close these facilities, aren’t seeking licensure for new (birth centers), or what could be done to improve the process,” the department statement said.\u003c/p>\n\u003ch3>Years-long wait for a health department license\u003c/h3>\n\u003cp>Nancy Myrick, a co-founder of the San Francisco Birth Center, said it took four-and-a-half years of back-and-forth with the state health department to obtain a license. In one instance, Myrick said, she asked for a list of items an inspector would check and the health department referred her to regulations that had not yet been written.\u003c/p>\n\u003cp>“In the process of opening, the state bureaucracy was like the Great Wall of China. It was such a horrible barrier,” Myrick said.\u003c/p>\n\u003cp>It wasn’t until Myrick called her state assemblymember’s office to complain about the inability to get licensed and see Medi-Cal patients that the application was approved, she said. The birth center was licensed in 2020.\u003c/p>\n\u003cp>“It literally took calling in the political dogs to get it done,” Myrick said.\u003c/p>\n\u003cp>Many providers noticed that getting a license became much more difficult after the state centralized the process under the public health department in 2018. Since then, nearly all birth center applications —11 out of 13 — have been rejected, according to department-provided data.\u003c/p>\n\u003cp>The department said in a statement the change was necessary to improve “standardization and consistency” in licensing multiple kinds of facilities. Previously, the department’s 14 regional offices processed applications and approved 11 out of 12 applications.\u003c/p>\n\u003cp>Yet midwives and advocates say obstacles continue to plague the process. It’s slow, often taking years; it’s expensive, costing tens of thousands of dollars to retrofit buildings and maintain a license; and the standards are frequently at odds with midwives’ scope of practice. What results is a “de facto ban” on birth center licensure in California, said Sandra Poole, a lobbyist with the Western Center on Law and Poverty.\u003c/p>\n\u003cp>Without licensing reform, more birth centers will close, said Bethany Sasaki, president of the state chapter of the American Association of Birth Centers.\u003c/p>\n\u003cfigure id=\"attachment_12001867\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12001867\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/05_032024_Best-Start-Birthing_AD_CM_18.jpg\" alt=\"Pregnant woman sits in a room with a monitor, clock and greyish walls.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/05_032024_Best-Start-Birthing_AD_CM_18.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/05_032024_Best-Start-Birthing_AD_CM_18-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/05_032024_Best-Start-Birthing_AD_CM_18-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/05_032024_Best-Start-Birthing_AD_CM_18-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/05_032024_Best-Start-Birthing_AD_CM_18-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/05_032024_Best-Start-Birthing_AD_CM_18-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Sally K., right, 38-weeks pregnant, talks to midwife Andrea Bergleen, left, during a check-up at the Best Start Birthing Center in San Diego on March 20, 2024. \u003ccite>(Ariana Drehsler/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A key problem, Sasaki said, is that birth centers are expected to comply with \u003ca href=\"https://hcai.ca.gov/wp-content/uploads/2023/10/2022_1226.6-Primary-Care-Clinic_Checklist_102023.pdf\">building standards designed for hospitals (PDF)\u003c/a>. For example, the standards include negative pressure rooms for infection control and cast iron plumbing for water supply and drainage.\u003c/p>\n\u003cp>Many midwives argue the standards don’t make sense because their patients are legally required to be healthy with low-risk pregnancies. Any condition that would require the additional medical intervention the standards are meant to accommodate, such as surgery, would force the patient to be transferred to a doctor or hospital, Sasaki said.\u003c/p>\n\u003cp>“There’s no reason to hold a birth center to the same standards as a hospital because it’s not a hospital, and that’s the whole point, Sasaki said.\u003c/p>\n\u003cp>According to the state Department of Health Care Access and Information, which sets building codes for health facilities, it would take legislative changes to make exceptions for birth centers. Poole and a number of groups representing midwives and Black maternal health advocates tried to introduce a bill earlier this year that would ease licensing requirements but could not find a legislator to carry it.\u003c/p>\n\u003cp>The state denied Sasaki’s licensure application for Midtown Nurse Midwives in Sacramento in 2020. The holdup is the building’s ventilation system, which doesn’t meet hospital building code.\u003c/p>\n\u003cp>In March, Sasaki requested an appeal and emergency license after TRICARE, the same insurer that Best Start relied on, stopped contracting with unlicensed facilities. As of mid-July, she has not received a response from the state, though the department told CalMatters the appeal deadline for Sasaki’s application had passed.\u003c/p>\n\u003cp>Without the TRICARE contract, which made up about 30% of her clients, Sasaki said the birth center will close by November.\u003c/p>\n\u003cp>“We’ve had to turn away so many people that we stopped answering our phone because I don’t want to listen to another person cry,” Sasaki said.\u003c/p>\n\u003ch3>Birth centers must get licensed for Medi-Cal\u003c/h3>\n\u003cp>Why is licensure such a stumbling block for birth centers? Medi-Cal, the state’s public insurance program for low-income families, pays for half of all births in the state, requiring birth centers to be licensed.\u003c/p>\n\u003cp>“The single biggest thing that will help with sustainability is if birth centers can take Medi-Cal and if Medi-Cal can actually reimburse appropriately,” Sasaki said.\u003c/p>\n\u003cp>The majority of Medi-Cal births — more than 80% — are babies of color. A statewide survey also indicates that people of color, particularly Black women, \u003ca href=\"https://www.chcf.org/wp-content/uploads/2018/09/ListeningMothersCAFullSurveyReport2018.pdf\">want alternative birth support, such as midwives and doulas, more than any other demographic group (PDF)\u003c/a>. White women and those with private insurance were the highest users of midwives, the survey shows. While those who wanted a midwife but didn’t use one most commonly cited lack of insurance coverage as a barrier.\u003c/p>\n\u003cfigure id=\"attachment_12001870\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12001870 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/2-e1724696255489.jpg\" alt=\"Image collage with two rooms, one with a small blue pool and one with a white bathtub.\" width=\"1920\" height=\"646\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/2-e1724696255489.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/2-e1724696255489-800x269.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/2-e1724696255489-1020x343.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/2-e1724696255489-160x54.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/2-e1724696255489-1536x517.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Birthing rooms at the Best Start Birthing Center in San Diego on March 20, 2024. \u003ccite>(Ariana Drehsler/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Caroline Cusenza, a midwife and owner of the Monterey Birth and Wellness Center, said taking insurance allowed her to serve a more diverse population in the working-class Latino enclave where the birth center is located. She wanted to take Medi-Cal patients but couldn’t. Cusenza applied for licensure twice but was also rejected because the building didn’t meet ventilation standards.\u003c/p>\n\u003cp>The birth center will close in September after seven years.\u003c/p>\n\u003cp>“It was a hard decision to walk away, but we really just could see no path forward,” Cusenza said.\u003c/p>\n\u003cp>The Western Center for Law and Poverty has pointed to accreditation as a possible alternative to licensure. The Commission for the Accreditation of Birth Centers is the national organization that sets standards for birth center quality and safety. California regulators have used accreditation to help license \u003ca href=\"https://www.cdph.ca.gov/Programs/OSPHLD/LFS/CDPH%20Document%20Library/ACLL--16-01.pdf\">other kinds of health facilities (PDF)\u003c/a>, but health department officials see no need to provide birth centers with alternate options. They argue, in an email to CalMatters, that very few have tried to get a license in the first place. Only 23 birth centers have applied in the past decade.\u003c/p>\n\u003cp>Holly Smith, a certified nurse midwife and co-lead of Midwifery Access California, contends the low number of applicants reflects the difficulty of the process. Midwives know licensure is nearly impossible, so they don’t bother applying, Smith said.\u003c/p>\n\u003cp>“If (the Public Health Department) can be much more involved in figuring out solutions to help birth centers exist and be licensed should they want to be, then we would see a greater proliferation of it,” Smith said.\u003c/p>\n\u003cp>Midwifery Access California is working with another state agency to improve access for low-income patients, Smith said. The advocates hope to convince the Department of Health Care Services to increase Medi-Cal payments to midwives. Right now, a licensed birth center gets about $1,300 per birth, while the midwife gets $400.\u003c/p>\n\u003cp>At those rates, some birth centers say even Medi-Cal wouldn’t be enough to save them.\u003c/p>\n\u003cp>“If our birth center were to accept Medi-Cal, we would go bankrupt,” said Trisha Wimbs, owner of the California Birth Center in Rocklin.\u003c/p>\n\u003cp>Wimbs’ facility was one of only three birth centers to get licensed since the public health department took over and tightened building codes. It was licensed in 2023. Wimbs said it cost $1 million to build the “hospital grade facility” to code, including $80,000 to move a fire hydrant two feet closer to the building. The birth center does not take Medi-Cal because it pays too little to recoup expenses. Instead, the birth center caters to cash pay and commercially insured clients in the affluent suburb of Sacramento. Licensure was essential to securing commercial insurance contracts, Wimbs said.\u003c/p>\n\u003cp>To sustain birth centers, Medi-Cal needs to pay around $8,000 per birth, Smith said. At that price point, delivering at a birth center would cost \u003ca href=\"https://healthcostinstitute.org/hcci-originals-dropdown/all-hcci-reports/the-price-of-childbirth-in-the-u-s-tops-13-000-in-2020\">less than half as much as a hospital delivery\u003c/a>.\u003c/p>\n\u003ch3>Saying goodbye to Best Start\u003c/h3>\n\u003cp>Eighteen years ago, Ellary Alonso was born at Best Start Birth Center when her mom, a former labor and delivery nurse, sought a more personalized birth experience. Alonso, who was 21 weeks along in March, wanted to deliver her son in the same place, surrounded by midwives she knew, maybe even in a bath. She wanted the emotional support of the team, she said, because her husband is a Marine, and there’s no guarantee he’ll be able to make it to the birth.\u003c/p>\n\u003cp>But a week before her first prenatal appointment at Best Start, Alonso got a call that the center was closing permanently. No other birth centers in Southern California take her insurance.\u003c/p>\n\u003cp>“In this time when everything is about choice, you can choose not to have a baby, but you can’t choose how to have your baby,” Alonso said. “Hospitals are the only option.”\u003c/p>\n\u003cfigure id=\"attachment_12001873\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12001873\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/032024_Best-Start-Birthing_AD_CM_26.jpg\" alt=\"Two women, one sitting and one standing pose for the camera.\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/032024_Best-Start-Birthing_AD_CM_26.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/032024_Best-Start-Birthing_AD_CM_26-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/032024_Best-Start-Birthing_AD_CM_26-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/032024_Best-Start-Birthing_AD_CM_26-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/032024_Best-Start-Birthing_AD_CM_26-1536x1025.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/032024_Best-Start-Birthing_AD_CM_26-1920x1281.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Ellary Alonso, right, 18 years old and 21-weeks pregnant, with her mom Hannah Fraley, left, at the Best Start Birthing Center in San Diego on March 20, 2024. Fraley had two of her kids at the center. \u003ccite>(Ariana Drehsler/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Compared to a hospital room, Best Start offers a homey atmosphere and promises that the midwife attending each birth will be familiar to the laboring client. The birthing rooms come with queen-sized beds, floral duvets, and white porcelain tubs for water births. A marble-topped “crash cart” sits in each room. With the doors closed, the cart looks just like an end table that matches the decor. Inside, it’s filled with medical supplies for emergency resuscitations or to stitch up lacerations. The rooms are homey but bear the hallmarks of a by-the-book clinic. Boxes of nitrile gloves are in each room; hazardous waste bins are mounted discreetly to the wall. Best Start was the only birth center in the state to have a licensed clinical laboratory to confirm water breakage. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It has never lost a mother or baby, Roslie said. Its transfer rate for cesarean sections was less than half the statewide target set for low-risk births. In the past five years, no episiotomies have been performed. And 96% of newborns are exclusively breastfed before leaving Best Start compared to the statewide hospital rate of 69%.\u003c/p>\n\u003cp>Despite the center’s recognized success, keeping it running has always been a labor of love, Roslie said.\u003c/p>\n\u003cp>“It’s never been a thriving business,” Roslie said. “Roberta’s gone without pay. I’ve gone with reduced pay. That’s what it takes to run a birth center.”\u003c/p>\n\u003cp>When Roberta Frank, Roslie’s mother, graduated from UC San Diego with her nursing midwifery degree in 1981, she was told, “San Diego will never accept midwives.”\u003c/p>\n\u003cp>Sometimes — in the face of Best Start’s closure — it still feels that way.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Attendees at this month’s foggy, mild Outside Lands might find it hard to believe that climate change could be affecting concerts, but an early summer music festival in Bakersfield resulted in a handful of cases of an illness that experts believe is spreading more due to the state’s changing weather patterns.\u003c/p>\n\u003cp>Valley fever is a respiratory disease caused by coccidioides or “cocci,” a soil-dwelling fungus found in California and the southwestern U.S. When contaminated soil is disturbed, infectious spores are released into the air and can be inhaled by people and animals. Once inhaled, cocci can infect the lungs, leading to symptoms such as cough, fever, chest pain and fatigue, according to the California Department of Public Health.\u003c/p>\n\u003cp>While valley fever has been present in the western United States for years, its incidence rate is increasing. The number of cases has tripled between 2014 and 2018 and again between 2018 and 2022, according to new research funded by the National Institutes of Health. In the past 20 years, the rate of infection has increased by 800%.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>By June 2024, more than 5,300 people in California have contracted the disease this year, including five who experienced symptoms after attending Bakersfield’s Lightning in a Bottle festival in May. The California Department of Public Health warned that these cases “occurred among people who traveled through Kern County, California, to attend the outdoor music festival.”\u003c/p>\n\u003cp>Climate and health experts believe that changing climate conditions contribute to the increase.\u003c/p>\n\u003cp>“We’ve had really the perfect conditions for the spread of coccidioides,” said Dr. George Thompson, a professor of medicine at UC Davis Medical Center in Sacramento. “The sort of cycle of precipitation and drought we’ve had really has favored the growth of coccidioides in the soil and then spread during and following periods of drought.”\u003c/p>\n\u003cfigure id=\"attachment_12001283\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/Valley-fever.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12001283\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/Valley-fever.png\" alt=\"Two bar charts shoring valley fever rise in California and the Bay Area since 2022.\" width=\"1920\" height=\"1079\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/Valley-fever.png 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/Valley-fever-800x450.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/Valley-fever-1020x573.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/Valley-fever-160x90.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/Valley-fever-1536x863.png 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">State health officials say California is on track to have more valley fever cases this year than ever before – including a notable uptick in the Bay Area – likely resulting in part from climate change. Source: \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/CocciinCAProvisionalMonthlyReport.pdf\">California Department of Public Health\u003c/a> \u003ccite>(Chart by Kara Newhouse/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The idea that drought could increase the number of valley fever cases is somewhat counterintuitive since it seems to dampen infection peaks in the short term.\u003c/p>\n\u003cp>However, Alexandra Heaney, an assistant professor of public health at UC San Diego and an author of the recent study, emphasized that her research indicated that drought increases the total number of cases in the long term.\u003c/p>\n\u003cp>“We think that there’s this sort of primary driver, which is wet conditions, followed by dry conditions, [that] leads to an increase in cases,” she said.\u003c/p>\n\u003cp>She and her co-authors hypothesize that wet, rainy periods promote extensive fungus growth, followed by dry spells that allow the fungus to form and release infectious spores into the air. Cocci can also withstand dryer, harsher conditions — allowing it to outlast much of its competition during droughts.\u003c/p>\n\u003cp>Another potential link between drought and valley fever is its impact on rodent populations, which serve as a nutrient source for the fungus. According to a release, Heaney and the team’s research suggests that during droughts, declining rodent populations lead to a “corresponding increase in rodent decomposition” and “may supply the necessary nutrients and moisture for the fungus to survive and spread in drought conditions.”\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">[aside postID=news_11998703 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/GettyImages-1771553132-1020x682.jpg']\u003c/span>\u003c/p>\n\u003cp>Drought also heightens the risk of wildfires, which can carry and spread infectious spores through smoke.\u003c/p>\n\u003cp>“Fire is going to follow droughts, just like valley fever follows droughts,” Thompson said. He explained that fires can create wind and updrafts that pull soil and particulate matter from the soil up into the air.\u003c/p>\n\u003cp>While the risk of infection remains low for most people, and valley fever is not transmitted from person to person, Heaney said that as climate change continues to alter California’s weather patterns, it could further accelerate the spread of the disease.\u003c/p>\n\u003cp>“Our evidence shows that these severe swings between really wet and really dry conditions tend to actually promote risk for the disease,” Heaney said. “And if this is going to continue to become more common due to climate change, it’s something that might be contributing to the increases we’ve seen and may actually promote increases in the future as well.”\u003c/p>\n\u003cp>\u003cem>KQED’s \u003c/em>\u003ca href=\"https://www.kqed.org/author/rcooke\">\u003cem>Riley Cooke\u003c/em>\u003c/a>\u003cem> contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"title": "Valley Fever Rises After California Music Festival, Experts Warn of Climate Change Link | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Attendees at this month’s foggy, mild Outside Lands might find it hard to believe that climate change could be affecting concerts, but an early summer music festival in Bakersfield resulted in a handful of cases of an illness that experts believe is spreading more due to the state’s changing weather patterns.\u003c/p>\n\u003cp>Valley fever is a respiratory disease caused by coccidioides or “cocci,” a soil-dwelling fungus found in California and the southwestern U.S. When contaminated soil is disturbed, infectious spores are released into the air and can be inhaled by people and animals. Once inhaled, cocci can infect the lungs, leading to symptoms such as cough, fever, chest pain and fatigue, according to the California Department of Public Health.\u003c/p>\n\u003cp>While valley fever has been present in the western United States for years, its incidence rate is increasing. The number of cases has tripled between 2014 and 2018 and again between 2018 and 2022, according to new research funded by the National Institutes of Health. In the past 20 years, the rate of infection has increased by 800%.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>By June 2024, more than 5,300 people in California have contracted the disease this year, including five who experienced symptoms after attending Bakersfield’s Lightning in a Bottle festival in May. The California Department of Public Health warned that these cases “occurred among people who traveled through Kern County, California, to attend the outdoor music festival.”\u003c/p>\n\u003cp>Climate and health experts believe that changing climate conditions contribute to the increase.\u003c/p>\n\u003cp>“We’ve had really the perfect conditions for the spread of coccidioides,” said Dr. George Thompson, a professor of medicine at UC Davis Medical Center in Sacramento. “The sort of cycle of precipitation and drought we’ve had really has favored the growth of coccidioides in the soil and then spread during and following periods of drought.”\u003c/p>\n\u003cfigure id=\"attachment_12001283\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/Valley-fever.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12001283\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/Valley-fever.png\" alt=\"Two bar charts shoring valley fever rise in California and the Bay Area since 2022.\" width=\"1920\" height=\"1079\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/Valley-fever.png 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/Valley-fever-800x450.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/Valley-fever-1020x573.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/Valley-fever-160x90.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/Valley-fever-1536x863.png 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">State health officials say California is on track to have more valley fever cases this year than ever before – including a notable uptick in the Bay Area – likely resulting in part from climate change. Source: \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/CocciinCAProvisionalMonthlyReport.pdf\">California Department of Public Health\u003c/a> \u003ccite>(Chart by Kara Newhouse/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The idea that drought could increase the number of valley fever cases is somewhat counterintuitive since it seems to dampen infection peaks in the short term.\u003c/p>\n\u003cp>However, Alexandra Heaney, an assistant professor of public health at UC San Diego and an author of the recent study, emphasized that her research indicated that drought increases the total number of cases in the long term.\u003c/p>\n\u003cp>“We think that there’s this sort of primary driver, which is wet conditions, followed by dry conditions, [that] leads to an increase in cases,” she said.\u003c/p>\n\u003cp>She and her co-authors hypothesize that wet, rainy periods promote extensive fungus growth, followed by dry spells that allow the fungus to form and release infectious spores into the air. Cocci can also withstand dryer, harsher conditions — allowing it to outlast much of its competition during droughts.\u003c/p>\n\u003cp>Another potential link between drought and valley fever is its impact on rodent populations, which serve as a nutrient source for the fungus. According to a release, Heaney and the team’s research suggests that during droughts, declining rodent populations lead to a “corresponding increase in rodent decomposition” and “may supply the necessary nutrients and moisture for the fungus to survive and spread in drought conditions.”\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>\u003c/p>\n\u003cp>Drought also heightens the risk of wildfires, which can carry and spread infectious spores through smoke.\u003c/p>\n\u003cp>“Fire is going to follow droughts, just like valley fever follows droughts,” Thompson said. He explained that fires can create wind and updrafts that pull soil and particulate matter from the soil up into the air.\u003c/p>\n\u003cp>While the risk of infection remains low for most people, and valley fever is not transmitted from person to person, Heaney said that as climate change continues to alter California’s weather patterns, it could further accelerate the spread of the disease.\u003c/p>\n\u003cp>“Our evidence shows that these severe swings between really wet and really dry conditions tend to actually promote risk for the disease,” Heaney said. “And if this is going to continue to become more common due to climate change, it’s something that might be contributing to the increases we’ve seen and may actually promote increases in the future as well.”\u003c/p>\n\u003cp>\u003cem>KQED’s \u003c/em>\u003ca href=\"https://www.kqed.org/author/rcooke\">\u003cem>Riley Cooke\u003c/em>\u003c/a>\u003cem> contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "santa-clara-county-plans-to-buy-east-san-jose-hospital-to-reverse-cuts-to-care",
"title": "Santa Clara County Plans to Buy East San José Hospital to Reverse Cuts to Care",
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"headTitle": "Santa Clara County Plans to Buy East San José Hospital to Reverse Cuts to Care | KQED",
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"content": "\u003cp>In a major move to preserve critical health care support for tens of thousands of residents, Santa Clara County plans to purchase Regional Medical Center, a privately owned hospital in East San José.\u003c/p>\n\u003cp>County officials on Wednesday announced a tentative agreement to pursue buying the facility for $175 million from its ownership, HCA Healthcare, the largest hospital corporation in the country. The agreement follows months of \u003ca href=\"https://www.kqed.org/news/11999936/cuts-at-east-san-jose-hospital-will-harm-vulnerable-residents-advocates-say\">protests against the company\u003c/a> for cutting trauma center, stroke and heart attack services at the hospital to save costs.\u003c/p>\n\u003cp>The deal would bring the hospital under the wing of Santa Clara Valley Healthcare, the public health system run by the county that already includes three hospitals and a series of clinics and health centers across the county.\u003c/p>\n\u003cp>“Making Regional Medical Center part of Santa Clara Valley Healthcare’s network of hospitals and clinics will ensure that East San José and the surrounding community continue to have access to top-notch Level II trauma, comprehensive stroke, specialized heart attack, and ultimately, labor and delivery care,” County Executive James Williams said in a statement.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The county said due diligence and a formal purchase agreement need to be hammered out, with HCA and the county hoping to complete the transaction in the first quarter of 2025.\u003c/p>\n\u003cp>The announcement by the county comes a little more than five years after the county completed its takeover of O’Connor Hospital in San José, St. Louise Regional Hospital in Gilroy, and the De Paul medical facility in Morgan Hill, now called VHC Morgan Hill, from the struggling Verity Health Systems in 2019.\u003c/p>\n\u003cp>It will also bring Regional Medical Center back into the realm of a public benefit facility. The hospital was previously run by a not-for-profit organization, Alexian Brothers when it was purchased by HCA Healthcare more than 20 years ago.\u003c/p>\n\u003cp>[aside label='More South Bay Coverage' tag='south-bay']\u003c/p>\n\u003cp>In February, Nashville-based HCA Healthcare announced it planned to close Regional Medical Center’s trauma center, completely eliminate its severe heart attack services and reduce stroke services on Aug. 12.\u003c/p>\n\u003cp>The company \u003ca href=\"https://www.kqed.org/news/11996422/hospital-operator-backs-off-closure-of-east-san-jose-trauma-center-after-public-outcry\">backed off those plans in mid-July\u003c/a> after a coalition of medical workers, including some doctors and nurses from the hospital, as well as community members, patient advocates and elected officials, \u003ca href=\"https://www.kqed.org/news/11990284/doctors-community-leaders-ramp-up-efforts-to-halt-closure-of-east-san-jose-trauma-center\">raised alarms in a series of rallies and demonstrations\u003c/a> at HCA hospitals.\u003c/p>\n\u003cp>Instead, the hospital downgraded its trauma center from a Level II to a Level III — something advocates said was a threat to patient safety because it offers lower levels of care, doesn’t require specialists to be on-site around the clock, and leans more on transferring patients with serious needs to other facilities after stabilizing them.\u003c/p>\n\u003cp>Instead of eliminating its ST-elevation myocardial infarction (STEMI) program, which handles severe heart attacks, it trimmed those services. One of the cuts targeted the hospital’s catheterization laboratory, where cardiologists insert catheters to help diagnose heart issues. On Aug. 12, it went from being an around-the-clock lab to daytime only.\u003c/p>\n\u003cp>Stroke services were set to be reduced from “comprehensive” to just above “primary” levels, though the company said the facility would still be able to serve 97% of patients.\u003c/p>\n\u003cfigure id=\"attachment_12001277\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12001277\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-1-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-1-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-1-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-1-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-1-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-1-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-1-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Santa Clara County CEO James Williams (at podium) is surrounded by county officials and medical professionals during a press conference about the county’s plan to purchase Regional Medical Center on Aug. 21. \u003ccite>(Joseph Geha/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A county report in April said Regional Medical Center was the only trauma center and only comprehensive stroke center on the county’s east side and that the reduction of services could have a “cascading effect” on the entire county health care system, as other facilities would have to pick up the slack.\u003c/p>\n\u003cp>The delayed access to care could potentially increase deaths and other poor health outcomes and could have a “disproportionate impact on communities of color and lower-income communities in East San José.”\u003c/p>\n\u003cp>Williams said that in addition to eventually restoring the services that were cut earlier this month, the county intends to also bring back labor and delivery services, which HCA cut from Regional in 2020. However, the lower level of services put in place on Aug. 12 will remain in the interim, a hospital official said.\u003c/p>\n\u003cp>“We have served this community for over 25 years. We’ve invested over $500 million in capital improvements at Regional Medical Center, and we believe this is the best path forward for our organization,” HCA Healthcare Far West Division President Jackie Van Blaricum said.\u003c/p>\n\u003ch2>Reduction in services pushed county action\u003c/h2>\n\u003cp>The cuts at Regional Medical Center were far from HCA Healthcare’s first foray into reducing services in the city.\u003c/p>\n\u003cp>In 2004, shortly after purchasing the downtown San José Medical Center, the company shuttered that hospital, which included a trauma center, and consolidated services into Regional Medical Center.\u003c/p>\n\u003cp>Santa Clara County Board of Supervisors President Susan Ellenberg said the county wasn’t looking to expand its hospital system, but alarms were raised after HCA cut labor and delivery services during the pandemic.\u003c/p>\n\u003cp>“When Regional Medical Center started and then continued to decrease critical services for our East San José residents, ultimately we got to the point where it felt irresponsible to allow them to continue to deplete care in this very high-need population without stepping in,” Ellenberg said.\u003c/p>\n\u003cp>“It reminded us of a similar pattern with San José Medical Center, where HCA discontinued one practice after another that they felt was not sufficiently profitable and ultimately closed down that entire center. We didn’t want to see that happen again,” she said.\u003c/p>\n\u003cp>Because the hospital was previously a not-for-profit facility, coalition members, including high-ranking local and state-level politicians, \u003ca href=\"https://www.kqed.org/news/11987665/advocates-urge-state-to-intervene-in-closure-of-san-jose-trauma-center\">called on Attorney General Rob Bonta and Gov. Gavin Newsom to intervene\u003c/a> in the planned closures and cuts, though none of those efforts had yet panned out.\u003c/p>\n\u003cp>Critics of the company say that HCA prioritizes profits over people and has taken issue with a planned major expansion of HCA’s Good Samaritan Hospital on the west side of San José near Los Gatos.\u003c/p>\n\u003cfigure id=\"attachment_12000977\" class=\"wp-caption aligncenter\" style=\"max-width: 1200px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12000977\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240524-REGIONALMEDICAL-JG-6_scr-1.jpg\" alt=\"\" width=\"1200\" height=\"800\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240524-REGIONALMEDICAL-JG-6_scr-1.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240524-REGIONALMEDICAL-JG-6_scr-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240524-REGIONALMEDICAL-JG-6_scr-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240524-REGIONALMEDICAL-JG-6_scr-1-160x107.jpg 160w\" sizes=\"(max-width: 1200px) 100vw, 1200px\">\u003cfigcaption class=\"wp-caption-text\">Santa Clara County Supervisor Cindy Chavez speaks during a rally outside of Regional Medical Center in East San José on May 24. \u003ccite>(Joseph Geha/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>One of the elected officials leading the charge against HCA’s cuts was Supervisor Cindy Chavez.\u003c/p>\n\u003cp>“I am really hopeful that this means that the services that our entire community, and specifically the East Side, need so desperately, will be protected into the future,” Chavez told KQED. “I am really grateful that the community raised their voices and really were heard. I really can’t express enough how life-saving this step is for our entire community.”\u003c/p>\n\u003cp>Supervisor Sylvia Arenas, who grew up in East San José, said the working-class East Side community deserves equitable health care access.\u003c/p>\n\u003cp>“These are our folks who are working maybe two jobs, children who are maybe living in poverty,” Arenas said. “When emergencies surge, you really need to have the highest level of care available to you, the closest available to you. And that’s what the county is hoping to do with this agreement.”\u003c/p>\n\u003cfigure id=\"attachment_12001279\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12001279\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-4-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-4-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-4-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-4-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-4-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-4-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-4-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Santa Clara County Supervisor Sylvia Arenas speaks at a press conference about the county’s plan to purchase Regional Medical Center, a privately owned hospital in East San José, in San José on Aug. 21. \u003ccite>(Joseph Geha/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Williams, the county CEO, acknowledged that the county just earlier this year closed a $250 million budget deficit.\u003c/p>\n\u003cp>He said the county will be able to cover the cost of the purchase of Regional with a “significant” reimbursement the county recently received from the Federal Emergency Management Agency for its pandemic-related expenditures, though he didn’t offer details. The county could also issue lease revenue bonds using Regional as collateral to help fund the purchase, he said.\u003c/p>\n\u003cp>\u003cem>This story has been updated.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Regional Medical Center's corporate owner recently enacted cuts to its trauma center, stroke and heart attack services. Santa Clara County is stepping in to try and preserve critical health care for tens of thousands of residents.",
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"title": "Santa Clara County Plans to Buy East San José Hospital to Reverse Cuts to Care | KQED",
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"headline": "Santa Clara County Plans to Buy East San José Hospital to Reverse Cuts to Care",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In a major move to preserve critical health care support for tens of thousands of residents, Santa Clara County plans to purchase Regional Medical Center, a privately owned hospital in East San José.\u003c/p>\n\u003cp>County officials on Wednesday announced a tentative agreement to pursue buying the facility for $175 million from its ownership, HCA Healthcare, the largest hospital corporation in the country. The agreement follows months of \u003ca href=\"https://www.kqed.org/news/11999936/cuts-at-east-san-jose-hospital-will-harm-vulnerable-residents-advocates-say\">protests against the company\u003c/a> for cutting trauma center, stroke and heart attack services at the hospital to save costs.\u003c/p>\n\u003cp>The deal would bring the hospital under the wing of Santa Clara Valley Healthcare, the public health system run by the county that already includes three hospitals and a series of clinics and health centers across the county.\u003c/p>\n\u003cp>“Making Regional Medical Center part of Santa Clara Valley Healthcare’s network of hospitals and clinics will ensure that East San José and the surrounding community continue to have access to top-notch Level II trauma, comprehensive stroke, specialized heart attack, and ultimately, labor and delivery care,” County Executive James Williams said in a statement.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The county said due diligence and a formal purchase agreement need to be hammered out, with HCA and the county hoping to complete the transaction in the first quarter of 2025.\u003c/p>\n\u003cp>The announcement by the county comes a little more than five years after the county completed its takeover of O’Connor Hospital in San José, St. Louise Regional Hospital in Gilroy, and the De Paul medical facility in Morgan Hill, now called VHC Morgan Hill, from the struggling Verity Health Systems in 2019.\u003c/p>\n\u003cp>It will also bring Regional Medical Center back into the realm of a public benefit facility. The hospital was previously run by a not-for-profit organization, Alexian Brothers when it was purchased by HCA Healthcare more than 20 years ago.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In February, Nashville-based HCA Healthcare announced it planned to close Regional Medical Center’s trauma center, completely eliminate its severe heart attack services and reduce stroke services on Aug. 12.\u003c/p>\n\u003cp>The company \u003ca href=\"https://www.kqed.org/news/11996422/hospital-operator-backs-off-closure-of-east-san-jose-trauma-center-after-public-outcry\">backed off those plans in mid-July\u003c/a> after a coalition of medical workers, including some doctors and nurses from the hospital, as well as community members, patient advocates and elected officials, \u003ca href=\"https://www.kqed.org/news/11990284/doctors-community-leaders-ramp-up-efforts-to-halt-closure-of-east-san-jose-trauma-center\">raised alarms in a series of rallies and demonstrations\u003c/a> at HCA hospitals.\u003c/p>\n\u003cp>Instead, the hospital downgraded its trauma center from a Level II to a Level III — something advocates said was a threat to patient safety because it offers lower levels of care, doesn’t require specialists to be on-site around the clock, and leans more on transferring patients with serious needs to other facilities after stabilizing them.\u003c/p>\n\u003cp>Instead of eliminating its ST-elevation myocardial infarction (STEMI) program, which handles severe heart attacks, it trimmed those services. One of the cuts targeted the hospital’s catheterization laboratory, where cardiologists insert catheters to help diagnose heart issues. On Aug. 12, it went from being an around-the-clock lab to daytime only.\u003c/p>\n\u003cp>Stroke services were set to be reduced from “comprehensive” to just above “primary” levels, though the company said the facility would still be able to serve 97% of patients.\u003c/p>\n\u003cfigure id=\"attachment_12001277\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12001277\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-1-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-1-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-1-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-1-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-1-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-1-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-1-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Santa Clara County CEO James Williams (at podium) is surrounded by county officials and medical professionals during a press conference about the county’s plan to purchase Regional Medical Center on Aug. 21. \u003ccite>(Joseph Geha/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A county report in April said Regional Medical Center was the only trauma center and only comprehensive stroke center on the county’s east side and that the reduction of services could have a “cascading effect” on the entire county health care system, as other facilities would have to pick up the slack.\u003c/p>\n\u003cp>The delayed access to care could potentially increase deaths and other poor health outcomes and could have a “disproportionate impact on communities of color and lower-income communities in East San José.”\u003c/p>\n\u003cp>Williams said that in addition to eventually restoring the services that were cut earlier this month, the county intends to also bring back labor and delivery services, which HCA cut from Regional in 2020. However, the lower level of services put in place on Aug. 12 will remain in the interim, a hospital official said.\u003c/p>\n\u003cp>“We have served this community for over 25 years. We’ve invested over $500 million in capital improvements at Regional Medical Center, and we believe this is the best path forward for our organization,” HCA Healthcare Far West Division President Jackie Van Blaricum said.\u003c/p>\n\u003ch2>Reduction in services pushed county action\u003c/h2>\n\u003cp>The cuts at Regional Medical Center were far from HCA Healthcare’s first foray into reducing services in the city.\u003c/p>\n\u003cp>In 2004, shortly after purchasing the downtown San José Medical Center, the company shuttered that hospital, which included a trauma center, and consolidated services into Regional Medical Center.\u003c/p>\n\u003cp>Santa Clara County Board of Supervisors President Susan Ellenberg said the county wasn’t looking to expand its hospital system, but alarms were raised after HCA cut labor and delivery services during the pandemic.\u003c/p>\n\u003cp>“When Regional Medical Center started and then continued to decrease critical services for our East San José residents, ultimately we got to the point where it felt irresponsible to allow them to continue to deplete care in this very high-need population without stepping in,” Ellenberg said.\u003c/p>\n\u003cp>“It reminded us of a similar pattern with San José Medical Center, where HCA discontinued one practice after another that they felt was not sufficiently profitable and ultimately closed down that entire center. We didn’t want to see that happen again,” she said.\u003c/p>\n\u003cp>Because the hospital was previously a not-for-profit facility, coalition members, including high-ranking local and state-level politicians, \u003ca href=\"https://www.kqed.org/news/11987665/advocates-urge-state-to-intervene-in-closure-of-san-jose-trauma-center\">called on Attorney General Rob Bonta and Gov. Gavin Newsom to intervene\u003c/a> in the planned closures and cuts, though none of those efforts had yet panned out.\u003c/p>\n\u003cp>Critics of the company say that HCA prioritizes profits over people and has taken issue with a planned major expansion of HCA’s Good Samaritan Hospital on the west side of San José near Los Gatos.\u003c/p>\n\u003cfigure id=\"attachment_12000977\" class=\"wp-caption aligncenter\" style=\"max-width: 1200px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12000977\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240524-REGIONALMEDICAL-JG-6_scr-1.jpg\" alt=\"\" width=\"1200\" height=\"800\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240524-REGIONALMEDICAL-JG-6_scr-1.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240524-REGIONALMEDICAL-JG-6_scr-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240524-REGIONALMEDICAL-JG-6_scr-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240524-REGIONALMEDICAL-JG-6_scr-1-160x107.jpg 160w\" sizes=\"(max-width: 1200px) 100vw, 1200px\">\u003cfigcaption class=\"wp-caption-text\">Santa Clara County Supervisor Cindy Chavez speaks during a rally outside of Regional Medical Center in East San José on May 24. \u003ccite>(Joseph Geha/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>One of the elected officials leading the charge against HCA’s cuts was Supervisor Cindy Chavez.\u003c/p>\n\u003cp>“I am really hopeful that this means that the services that our entire community, and specifically the East Side, need so desperately, will be protected into the future,” Chavez told KQED. “I am really grateful that the community raised their voices and really were heard. I really can’t express enough how life-saving this step is for our entire community.”\u003c/p>\n\u003cp>Supervisor Sylvia Arenas, who grew up in East San José, said the working-class East Side community deserves equitable health care access.\u003c/p>\n\u003cp>“These are our folks who are working maybe two jobs, children who are maybe living in poverty,” Arenas said. “When emergencies surge, you really need to have the highest level of care available to you, the closest available to you. And that’s what the county is hoping to do with this agreement.”\u003c/p>\n\u003cfigure id=\"attachment_12001279\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12001279\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-4-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-4-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-4-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-4-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-4-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-4-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240821-RMCPURCHASE-JG-4-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Santa Clara County Supervisor Sylvia Arenas speaks at a press conference about the county’s plan to purchase Regional Medical Center, a privately owned hospital in East San José, in San José on Aug. 21. \u003ccite>(Joseph Geha/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Williams, the county CEO, acknowledged that the county just earlier this year closed a $250 million budget deficit.\u003c/p>\n\u003cp>He said the county will be able to cover the cost of the purchase of Regional with a “significant” reimbursement the county recently received from the Federal Emergency Management Agency for its pandemic-related expenditures, though he didn’t offer details. The county could also issue lease revenue bonds using Regional as collateral to help fund the purchase, he said.\u003c/p>\n\u003cp>\u003cem>This story has been updated.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "newsom-rejects-air-quality-monitoring-expansion-for-california-refineries",
"title": "Newsom Rejects Air-Quality Monitoring Expansion for California Refineries",
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"headTitle": "Newsom Rejects Air-Quality Monitoring Expansion for California Refineries | KQED",
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"content": "\u003cp>A bill that would have expanded California’s air-quality monitoring system to include more refineries was vetoed by Gov. \u003ca href=\"https://www.kqed.org/news/tag/gavin-newsom\">Gavin Newsom\u003c/a>, who cited concerns on Monday about local control and high implementation costs in the decision. Groups supporting the bill, however, say these reasons “aren’t supported by the facts.”\u003c/p>\n\u003cp>SB 674, introduced by state Sen. Lena Gonzalez (D-Long Beach), would have expanded the statewide requirement for real-time air monitoring along the fencelines of petroleum refineries to sites producing biofuel and other pollutants. It also would have required that communities near refineries, including at the Chevron Refinery in Richmond, \u003ca href=\"https://www.kqed.org/news/11975650/bay-air-district-hails-decisive-victory-in-battle-to-cut-refinery-pollution\">where air quality has been notoriously poor\u003c/a>, receive a notification when pollutants were above specified thresholds and required efforts to remedy poor conditions.\u003c/p>\n\u003cp>Newsom told state representatives in a letter on Monday that he could not sign the bill, writing that there was no state funding available for reimbursements to the refineries implementing the systems in the event that it might be needed. The program put the cost burden on refineries, who would have paid through a series of fees over multiple years.\u003c/p>\n\u003cp>Two of three air quality districts where the refineries are located, the Bay Area and South Coast Air Quality Management District, which represents Southern California, supported the bill, according to Oscar Espino-Padron, a senior attorney at Earthjustice. He said the entities would have remained “empowered to implement [its] measures and to exercise their discretion to tailor this monitoring program based on when it’s appropriate in their jurisdictions.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It’s really a setback, not only for air quality but also for community safety,” Espino-Padron told KQED.\u003c/p>\n\u003cp>“These are inherently dangerous operations that are prone to explosions and fires. Communities are being deprived of real-time data about issues that are occurring at refineries and giving them an opportunity to protect their families and take proper precautions.”\u003c/p>\n\u003cp>There are 19 refineries in California, all of which are located in counties that received failing grades for particulate matter pollution on the American Lung Association’s State of the Air Report Card in 2022, according to a Senate floor analysis of the now-killed bill.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">[aside postID=news_11996994 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/012_KQED_SchnitzerSteelPortofOakland_03082022_qed-1020x679.jpg']\u003c/span>\u003c/p>\n\u003cp>This pollution, which consists of fine particles (PM2.5) and larger ones (PM10), is \u003ca href=\"https://www.kqed.org/news/11975650/bay-air-district-hails-decisive-victory-in-battle-to-cut-refinery-pollution\">associated with a wide range\u003c/a> of lung, heart and other chronic health problems.\u003c/p>\n\u003cp>Communities of color disproportionately live in the areas around the state’s refineries. The Senate floor analysis also stated that, on average, over 70% of people living within 5 miles of the sites are people of color.\u003c/p>\n\u003cp>Around Richmond’s refinery, that percentage is more than 80%.\u003c/p>\n\u003cp>The veto comes a week after the Richmond City Council \u003ca href=\"https://www.kqed.org/news/12000170/richmond-drops-bid-for-chevron-refinery-tax-in-550-million-deal-with-company\">killed a bill for the November ballot\u003c/a> that would have proposed a tax on the Chevron refinery. Instead, city officials reached a more than $500 million settlement agreement with the company. Richmond officials said the agreement was a win in the long-standing fight to get compensation from Chevron for the effects that pollution has on the city’s residents.\u003c/p>\n\u003cp>While Newsom’s decision ended a two-year community effort to increase refineries’ monitoring and reporting requirements, Espino-Padron said Earthjustice would “continue to work on holding this industry accountable and ensuring that communities are protected.”\u003c/p>\n\u003cp>\u003cem>KQED’s \u003ca href=\"https://www.kqed.org/author/shossaini\">Sara Hossaini\u003c/a> contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "SB 674 would have expanded the statewide requirement for real-time air monitoring along the fence lines of petroleum refineries to sites producing biofuel and other pollutants.",
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"title": "Newsom Rejects Air-Quality Monitoring Expansion for California Refineries | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A bill that would have expanded California’s air-quality monitoring system to include more refineries was vetoed by Gov. \u003ca href=\"https://www.kqed.org/news/tag/gavin-newsom\">Gavin Newsom\u003c/a>, who cited concerns on Monday about local control and high implementation costs in the decision. Groups supporting the bill, however, say these reasons “aren’t supported by the facts.”\u003c/p>\n\u003cp>SB 674, introduced by state Sen. Lena Gonzalez (D-Long Beach), would have expanded the statewide requirement for real-time air monitoring along the fencelines of petroleum refineries to sites producing biofuel and other pollutants. It also would have required that communities near refineries, including at the Chevron Refinery in Richmond, \u003ca href=\"https://www.kqed.org/news/11975650/bay-air-district-hails-decisive-victory-in-battle-to-cut-refinery-pollution\">where air quality has been notoriously poor\u003c/a>, receive a notification when pollutants were above specified thresholds and required efforts to remedy poor conditions.\u003c/p>\n\u003cp>Newsom told state representatives in a letter on Monday that he could not sign the bill, writing that there was no state funding available for reimbursements to the refineries implementing the systems in the event that it might be needed. The program put the cost burden on refineries, who would have paid through a series of fees over multiple years.\u003c/p>\n\u003cp>Two of three air quality districts where the refineries are located, the Bay Area and South Coast Air Quality Management District, which represents Southern California, supported the bill, according to Oscar Espino-Padron, a senior attorney at Earthjustice. He said the entities would have remained “empowered to implement [its] measures and to exercise their discretion to tailor this monitoring program based on when it’s appropriate in their jurisdictions.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It’s really a setback, not only for air quality but also for community safety,” Espino-Padron told KQED.\u003c/p>\n\u003cp>“These are inherently dangerous operations that are prone to explosions and fires. Communities are being deprived of real-time data about issues that are occurring at refineries and giving them an opportunity to protect their families and take proper precautions.”\u003c/p>\n\u003cp>There are 19 refineries in California, all of which are located in counties that received failing grades for particulate matter pollution on the American Lung Association’s State of the Air Report Card in 2022, according to a Senate floor analysis of the now-killed bill.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>\u003c/p>\n\u003cp>This pollution, which consists of fine particles (PM2.5) and larger ones (PM10), is \u003ca href=\"https://www.kqed.org/news/11975650/bay-air-district-hails-decisive-victory-in-battle-to-cut-refinery-pollution\">associated with a wide range\u003c/a> of lung, heart and other chronic health problems.\u003c/p>\n\u003cp>Communities of color disproportionately live in the areas around the state’s refineries. The Senate floor analysis also stated that, on average, over 70% of people living within 5 miles of the sites are people of color.\u003c/p>\n\u003cp>Around Richmond’s refinery, that percentage is more than 80%.\u003c/p>\n\u003cp>The veto comes a week after the Richmond City Council \u003ca href=\"https://www.kqed.org/news/12000170/richmond-drops-bid-for-chevron-refinery-tax-in-550-million-deal-with-company\">killed a bill for the November ballot\u003c/a> that would have proposed a tax on the Chevron refinery. Instead, city officials reached a more than $500 million settlement agreement with the company. Richmond officials said the agreement was a win in the long-standing fight to get compensation from Chevron for the effects that pollution has on the city’s residents.\u003c/p>\n\u003cp>While Newsom’s decision ended a two-year community effort to increase refineries’ monitoring and reporting requirements, Espino-Padron said Earthjustice would “continue to work on holding this industry accountable and ensuring that communities are protected.”\u003c/p>\n\u003cp>\u003cem>KQED’s \u003ca href=\"https://www.kqed.org/author/shossaini\">Sara Hossaini\u003c/a> contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"title": "Water at 22 Oakland Schools Tested High for Lead. It’s No Surprise, Parents and Teachers Say",
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"content": "\u003cp>As staff welcomed students back to Frick United Academy of Language in \u003ca href=\"https://www.kqed.org/news/tag/oakland\">Oakland\u003c/a> on Monday, they received concerning information — five water sources at their school contained unsafe levels of lead.\u003c/p>\n\u003cp>Ella Every-Wortman, who teaches eighth-grade English at Frick, said they were confused and frustrated.\u003c/p>\n\u003cp>Their two immediate concerns were “first, our safety, and second, how this lapse in communication and complete systems failure had happened,” Every-Wortman said. “The testing was done in April. The information was released in April. So why, as a school site, were we not receiving this information until August?”\u003c/p>\n\u003cp>Twenty-two campuses in the Oakland Unified School District were contacted this week regarding elevated lead levels, according to district spokesperson John Sasaki.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The district has been “aggressive” in testing water since 2017, he said, but “in this case, we were aggressive about the testing but were not as efficient at communicating in the ways we should have been,” referring to the tests done in April. “That’s something we are working on as an organization.”\u003c/p>\n\u003cp>On Tuesday morning, parents and community members at the schools received messages from the district, multiple of which have been viewed by KQED, notifying them of the testing and ensuring that the affected water sources were not accessible. Forty schools’ water has been tested, and Sasaki said the number with elevated lead in at least one source could be higher than 22.\u003c/p>\n\u003cp>Every-Wortman brought their concerns to a school board meeting on Wednesday, where they said the lead levels in one of the tested water sources at Frick was 51 parts per billion. Sasaki could not confirm any levels but said that the testing data would be made publicly available.\u003c/p>\n\u003cp>The Oakland school board’s maximum allowable level is 5 parts per billion, while the state and federal standard is 15 parts per billion.\u003c/p>\n\u003cp>The affected campuses had water sources that tested above the board’s maximum allowable level during routine testing over recent months.\u003c/p>\n\u003cp>In its letter to parents and community members, the district said its buildings and grounds team was installing new filters on every fixture that showed elevated levels of lead or replacing the fixtures and some of the attached piping.\u003c/p>\n\u003cp>Nate Landry, whose daughter began at Edna Brewer Middle School this week, said that when they got the notice, their reaction “unfortunately was not one of surprise.” Other parents gathered at a parent-teacher-student association coffee meeting on Friday shared similar sentiments.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">[aside postID=news_11999998 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/20240604_FloodedSchool-17_qed-1020x680.jpg']\u003c/span>\u003c/p>\n\u003cp>Multiple pointed to the lead previously identified in water sources at McClymonds High School, where elevated levels were reported in 2016. Over the next few years, 22 more schools were found to have at least one tap with lead levels above 15 parts per billion, according to \u003ca href=\"https://www.ktvu.com/news/lead-found-under-blacktop-at-two-oakland-schools\">KTVU\u003c/a>. In 2019, lead was also found under the blacktop at two schools in the district.\u003c/p>\n\u003cp>“This was a predictable problem,” Every-Wortman said. “We have many facilities in this district that were built prior to 1980. They have a high likelihood of containing lead.”\u003c/p>\n\u003cp>Brewer was built in \u003ca href=\"https://www.oaklandedfund.org/wp-content/uploads/2021/07/Edna-Brewer.pdf\">1913\u003c/a>, and a building at Frick was constructed in \u003ca href=\"https://abitofhistory.site/2019/10/08/oakland-schools-then-and-now-part-1/\">1927\u003c/a>.\u003c/p>\n\u003cp>Oakland Superintendent Kyla Johnson-Trammell is expected to give an update on the district’s progress in addressing the affected water fixtures at the next school board meeting on Aug. 28.\u003c/p>\n\u003cp>“Each fixture will be tested again after our staff installs the new filters to ensure they comply with our safety standards. We expect the work to be completed over the next several weeks,” the letter sent to Frick parents reads.\u003c/p>\n\u003cp>One Brewer mom said her kids only use the school’s filtered “FloWater” stations, which the district’s letter said are safe to drink and located on each campus. Most parents KQED spoke with said they were having their children bring water from home — and don’t really worry about them using the water on campus.\u003c/p>\n\u003cp>One parent lovingly said their daughter “isn’t the queen of hydration.”\u003c/p>\n\u003cp>With a laugh, Brewer mom, Stefanie Moser, said, “I can’t get [my son] to refill his water bottle during the day.”\u003c/p>\n\u003cp>“We want the kids to be safe, and we want them to be healthy, and we obviously want the staff to be safe and healthy too because they are drinking the same water out of the pipes,” she continued. “I’m glad that they’ve got a mitigation plan in place and that they’re going to work on it and get it fixed.”\u003c/p>\n\u003cp>Staff and parents said they hope the district will make it a priority to ensure that the water on campus does not contain lead, but Brewer employee Dinah Despenza said there was “nothing” the district could do that would make her feel comfortable drinking the school’s water.\u003c/p>\n\u003cp>“I just wash my hands in it, that’s all.”\u003c/p>\n\u003cp>\u003cem>KQED’s \u003ca href=\"https://www.kqed.org/author/afinney\">Annelise Finney\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>As staff welcomed students back to Frick United Academy of Language in \u003ca href=\"https://www.kqed.org/news/tag/oakland\">Oakland\u003c/a> on Monday, they received concerning information — five water sources at their school contained unsafe levels of lead.\u003c/p>\n\u003cp>Ella Every-Wortman, who teaches eighth-grade English at Frick, said they were confused and frustrated.\u003c/p>\n\u003cp>Their two immediate concerns were “first, our safety, and second, how this lapse in communication and complete systems failure had happened,” Every-Wortman said. “The testing was done in April. The information was released in April. So why, as a school site, were we not receiving this information until August?”\u003c/p>\n\u003cp>Twenty-two campuses in the Oakland Unified School District were contacted this week regarding elevated lead levels, according to district spokesperson John Sasaki.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The district has been “aggressive” in testing water since 2017, he said, but “in this case, we were aggressive about the testing but were not as efficient at communicating in the ways we should have been,” referring to the tests done in April. “That’s something we are working on as an organization.”\u003c/p>\n\u003cp>On Tuesday morning, parents and community members at the schools received messages from the district, multiple of which have been viewed by KQED, notifying them of the testing and ensuring that the affected water sources were not accessible. Forty schools’ water has been tested, and Sasaki said the number with elevated lead in at least one source could be higher than 22.\u003c/p>\n\u003cp>Every-Wortman brought their concerns to a school board meeting on Wednesday, where they said the lead levels in one of the tested water sources at Frick was 51 parts per billion. Sasaki could not confirm any levels but said that the testing data would be made publicly available.\u003c/p>\n\u003cp>The Oakland school board’s maximum allowable level is 5 parts per billion, while the state and federal standard is 15 parts per billion.\u003c/p>\n\u003cp>The affected campuses had water sources that tested above the board’s maximum allowable level during routine testing over recent months.\u003c/p>\n\u003cp>In its letter to parents and community members, the district said its buildings and grounds team was installing new filters on every fixture that showed elevated levels of lead or replacing the fixtures and some of the attached piping.\u003c/p>\n\u003cp>Nate Landry, whose daughter began at Edna Brewer Middle School this week, said that when they got the notice, their reaction “unfortunately was not one of surprise.” Other parents gathered at a parent-teacher-student association coffee meeting on Friday shared similar sentiments.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>\u003c/p>\n\u003cp>Multiple pointed to the lead previously identified in water sources at McClymonds High School, where elevated levels were reported in 2016. Over the next few years, 22 more schools were found to have at least one tap with lead levels above 15 parts per billion, according to \u003ca href=\"https://www.ktvu.com/news/lead-found-under-blacktop-at-two-oakland-schools\">KTVU\u003c/a>. In 2019, lead was also found under the blacktop at two schools in the district.\u003c/p>\n\u003cp>“This was a predictable problem,” Every-Wortman said. “We have many facilities in this district that were built prior to 1980. They have a high likelihood of containing lead.”\u003c/p>\n\u003cp>Brewer was built in \u003ca href=\"https://www.oaklandedfund.org/wp-content/uploads/2021/07/Edna-Brewer.pdf\">1913\u003c/a>, and a building at Frick was constructed in \u003ca href=\"https://abitofhistory.site/2019/10/08/oakland-schools-then-and-now-part-1/\">1927\u003c/a>.\u003c/p>\n\u003cp>Oakland Superintendent Kyla Johnson-Trammell is expected to give an update on the district’s progress in addressing the affected water fixtures at the next school board meeting on Aug. 28.\u003c/p>\n\u003cp>“Each fixture will be tested again after our staff installs the new filters to ensure they comply with our safety standards. We expect the work to be completed over the next several weeks,” the letter sent to Frick parents reads.\u003c/p>\n\u003cp>One Brewer mom said her kids only use the school’s filtered “FloWater” stations, which the district’s letter said are safe to drink and located on each campus. Most parents KQED spoke with said they were having their children bring water from home — and don’t really worry about them using the water on campus.\u003c/p>\n\u003cp>One parent lovingly said their daughter “isn’t the queen of hydration.”\u003c/p>\n\u003cp>With a laugh, Brewer mom, Stefanie Moser, said, “I can’t get [my son] to refill his water bottle during the day.”\u003c/p>\n\u003cp>“We want the kids to be safe, and we want them to be healthy, and we obviously want the staff to be safe and healthy too because they are drinking the same water out of the pipes,” she continued. “I’m glad that they’ve got a mitigation plan in place and that they’re going to work on it and get it fixed.”\u003c/p>\n\u003cp>Staff and parents said they hope the district will make it a priority to ensure that the water on campus does not contain lead, but Brewer employee Dinah Despenza said there was “nothing” the district could do that would make her feel comfortable drinking the school’s water.\u003c/p>\n\u003cp>“I just wash my hands in it, that’s all.”\u003c/p>\n\u003cp>\u003cem>KQED’s \u003ca href=\"https://www.kqed.org/author/afinney\">Annelise Finney\u003c/a> contributed to this report. \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "uninsured-experts-explain-how-to-get-your-free-covid-shot-before-the-money-runs-out",
"title": "Uninsured? Experts Explain How to Get Your Free COVID Shot Before the Money Runs Out",
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"content": "\u003cp>The federal program that funds free COVID-19 vaccines for people without health insurance is ending several months earlier than expected — and uninsured people are now being told it could be their last chance to seek out a free shot before the money runs out for good.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdc.gov/media/releases/2023/p0914-uninsured-vaccination.html\">The Bridge Access Program was launched\u003c/a> by the Centers for Disease Control and Prevention (CDC) in September 2023 to provide free COVID-19 vaccinations to the estimated 25 million to 30 million adults in the U.S. without health insurance. The funds were previously forecast to last until December and would have made COVID-19 vaccines accessible to uninsured people through the brunt of another winter respiratory virus season.\u003c/p>\n\u003cp>However, after March \u003ca href=\"https://www.pbs.org/newshour/health/this-covid-vaccine-program-offered-a-bridge-to-uninsured-adults-and-then-the-funding-crumbled\">negotiations in Congress resulted in $4.3 billion being withdrawn from the Department of Health and Human Services’ COVID-19 fund\u003c/a>, the program is instead ending this month, months ahead of schedule.\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#location\">Jump to: Where can I still find a free COVID vaccine if I’m uninsured?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>The CDC has not given a firm deadline for the end of the program beyond “August 2024” and has yet to respond to KQED’s request for more specific details.\u003c/p>\n\u003cp>However, in a statement, the California Department of Public Health said that the program is \u003ca href=\"https://www.fda.gov/vaccines-blood-biologics/updated-covid-19-vaccines-use-united-states-beginning-fall-2024\">“scheduled to end when the new 2024–25 COVID-19 vaccines are approved by the federal government.\u003c/a>” According to drug manufacturers Pfizer and Moderna, these updated fall COVID-19 vaccines, which will be targeted to the latest variants, \u003ca href=\"https://www.forbes.com/sites/ariannajohnson/2024/08/05/updated-covid-vaccines-are-coming-effectiveness-whos-eligible-and-more/\">could be ready as early as this month\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Finding locations that offer free COVID-19 shots has also become more difficult for those without insurance, even though the Bridge Access Program funding is technically still in place. The CDC’s online vaccine locator tool, which previously offered people a way to search for nearby vaccination sites and filter by whether they were participating in the program, has now been removed from \u003ca href=\"http://vaccines.gov\">vaccines.gov\u003c/a>.\u003c/p>\n\u003cp>A message on that site now states that the vaccine locator will be replaced with a pharmacy lookup tool that “will be added once 2024–25 flu and COVID-19 vaccines become widely available.” However, the site does not currently appear to offer any way to find free vaccination locations.\u003c/p>\n\u003cp>Keep reading for what to know about COVID-19 shots for uninsured people, or\u003cstrong>\u003ca href=\"#location\"> jump straight to how to find a free vaccine if you don’t have health insurance.\u003c/a>\u003c/strong>\u003c/p>\n\u003ch2>\u003cstrong>As funding dries up, clinics are left scrambling \u003c/strong>\u003c/h2>\n\u003cp>“We didn’t get any specific advance notice of exactly when it was going to be happening,” said Dr. Michael Stacey, chief medical officer at LifeLong Medical Care — one of the community clinics that’s been offering free COVID-19 shots to uninsured people through the Bridge Access Program. “Our notification came along with the rest of the rest of the world.”\u003c/p>\n\u003cp>The federal program launched when the commercial health care market began taking over COVID-19 vaccine distribution from the federal government, which had until then made the vaccines free to everyone, regardless of insurance. This means that, like the flu shot, a person’s COVID-19 vaccine is now either paid for under their health insurance plan if they have one or through a sizable out-of-pocket payment. At CVS, for instance, \u003ca href=\"https://www.cvs.com/immunizations/covid-19-vaccine\">a COVID-19 vaccine costs $190.99 if you don’t have any insurance\u003c/a>.\u003c/p>\n\u003cp>The Bridge Access Program was one of the few remaining sources of pandemic-era funding to offer COVID-19 care to “the most vulnerable in the community,” said Stacey, who noted that the timing is particularly unfortunate due to \u003ca href=\"https://www.kqed.org/news/11987343/covid-bay-area-wastewater-variant-symptoms-isolation-guidance\">the ongoing nationwide summer surge in infections\u003c/a>.\u003c/p>\n\u003cp>Uninsured children, ages 18 and under, can still get free COVID-19 vaccines and other free immunizations as part of \u003ca href=\"https://www.cdc.gov/vaccines-for-children/about/index.html\">the Vaccines for Children Program\u003c/a>.\u003c/p>\n\u003cp>During a visit this week to the Petaluma Health Center — one of the clinics still offering free COVID-19 shots for uninsured people — U.S. Secretary of Health and Human Services Xavier Becerra said he “believe[d] the clinics, the community health centers will continue to have shots” after the program’s funding ends. However, he did not offer any specifics on how the clinics could continue to offer them.\u003c/p>\n\u003cp>Locations like the Petaluma Health Center say they are now seeking grants, along with county and state funding, to make sure they can keep offering free vaccines.\u003c/p>\n\u003ch2>\u003cstrong>Should uninsured people seek a free shot ASAP before the funding runs out?\u003c/strong>\u003c/h2>\n\u003cp>For Stacey, of Lifelong Medical Care, the answer is simple: Yes. “For those that don’t have insurance, try to get the vaccine now before the [Bridge Access] program ends,” he said.\u003c/p>\n\u003cp>“We’re plugging ahead in these last days that we have to be able to vaccinate the uninsured as much as we can before the program actually shuts off,” Stacey said.\u003c/p>\n\u003cp>Dr. Peter Chin-Hong, an infectious disease expert at UCSF, echoed that, telling KQED by email that it’s “100% true that uninsured people should try to get the vaccine now, given the uncertainty of what will happen in the fall” regarding the program’s funding.\u003c/p>\n\u003cp>[aside label=\"More on covid treatment\" postID=\"news_11973108,news_11987343,news_11968709\"]\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11960630/free-new-covid-vaccine-near-me-2023\">The COVID-19 vaccine that’s currently available\u003c/a> has been around since September 2023 (and this spring, \u003ca href=\"https://www.kqed.org/news/11977786/a-new-covid-vaccine-dose-is-now-available-for-people-age-65-and-older-where-can-you-find-a-shot-near-you\">an extra shot of the vaccine formulation\u003c/a> was recommended for people age 65 and older.) The \u003ca href=\"https://www.fda.gov/vaccines-blood-biologics/updated-covid-19-vaccines-use-united-states-beginning-fall-2024\">new, updated COVID-19 vaccine targeted to the latest variants\u003c/a> is scheduled for release this fall, with \u003ca href=\"https://www.forbes.com/sites/ariannajohnson/2024/08/05/updated-covid-vaccines-are-coming-effectiveness-whos-eligible-and-more/\">Pfizer and Moderna both saying their vaccines could be ready as early as this month\u003c/a>.\u003c/p>\n\u003cp>But Chin-Hong said that just because a new vaccine is expected soon, uninsured people shouldn’t be dissuaded from getting the current vaccine for free now — not just because the money for free shots is about to run out, but also because it’s not necessarily the best idea to get the new shot the minute it’s released anyway.\u003c/p>\n\u003cp>Even though the CDC recommends waiting two months between COVID-19 shots, “you won’t want to get the vaccine when it comes out immediately anyway as it is meant for the expected onslaught of cases in the winter,” Chin-Hong said. “Get it too soon, and your maximal antibodies will peak before you need it.”\u003c/p>\n\u003cp>And amid current high infection rates, there’s data to indicate that the available COVID-19 vaccine still offers good protection against the latest variants causing this surge, even though it was originally targeted to older variants, Chin-Hong said.\u003c/p>\n\u003cp>“The superpower of the vaccine is to protect against serious disease, hospitalization and death,” he said. “And for that, even the [current] XBB.1.5 booster will perform spectacularly well.”\u003c/p>\n\u003cp>Getting the current COVID-19 vaccine now for free might also buy uninsured people some time — and extra immunity — as public health agencies work out how to continue extending access to them, Chin-Hong said.\u003c/p>\n\u003cp>“Uninsured people who get the vaccine now can rest assured that the vaccine will likely protect against serious disease for at least a year,” he said. “So even if there are problems with getting the new vaccine in the fall, I feel comfortable that many of those can take this immune system reminder to carry them through the winter reasonably well.”\u003c/p>\n\u003ch2>\u003cstrong>\u003ca id=\"location\">\u003c/a>How can I find a free COVID shot ASAP if I’m uninsured?\u003c/strong>\u003c/h2>\n\u003cp>Like many aspects of finding COVID-19 care at this stage of the pandemic, even finding a location that offers free COVID-19 vaccines to uninsured people through the Bridge Access Program has become more difficult — especially since the CDC removed its online vaccine locator tool, which showed all Bridge Access Program sites from \u003ca href=\"http://vaccines.gov\">vaccines.gov\u003c/a>.\u003c/p>\n\u003cp>So, if you’re uninsured and want to find a free COVID-19 shot as soon as possible before the program funding runs out, here’s a selection of options. Unfortunately, a number of them now require proactive research and action.\u003c/p>\n\u003cp>\u003cstrong>Use the state’s My Turn Vaccine Locator\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"https://myturn.ca.gov/vaccinelocator.html\">This online tool from the California Department of Public Health\u003c/a> allows you to filter by vaccine type and insurance status. However, this tool does not show every single vaccination site that may offer free shots through the Bridge Access Program for those without insurance. For example, it only returns two clinics that offer COVID-19 shots to uninsured people within 50 miles of San Francisco (in Napa and San Jose).\u003c/p>\n\u003cp>\u003cstrong>Find a community health center through the U.S. Department of Health and Human Services (HHS)\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"https://findahealthcenter.hrsa.gov/\">HHS has a map tool showing community health centers \u003c/a>that \u003cem>may \u003c/em>offer free COVID-19 shots for uninsured people. After you search for a nearby location, contact that center directly to ask if it’s offering no-insurance COVID-19 shots for free through the Bridge Access Program.\u003c/p>\n\u003cp>The San Francisco Department of Public Health (SFDPH) also said that\u003ca href=\"https://www.sf.gov/get-vaccinated-against-covid-19-flu-and-rsv\"> its AITC Immunization and Travel Clinic provides the COVID-19 vaccine to uninsured people\u003c/a>, although the agency notes that “people outside of San Francisco are encouraged to contact their local health department to find a vaccine near them.” The clinic is located at 101 Grove Street, Room 102, and appointments are required: call 415-554-2625 for hours and availability.\u003c/p>\n\u003cp>SFDPH also recommends that \u003ca href=\"https://www.sf.gov/get-vaccinated-against-covid-19-flu-and-rsv\">uninsured people visit the appointment-only San Francisco Free Clinic \u003c/a>(4900 California St.; call 415-750-9894 for hours and availability). But when you call, check if you need to be an SF resident to receive a free COVID-19 vaccine.\u003c/p>\n\u003cp>\u003cstrong>Reach out to your local pharmacy\u003c/strong>\u003c/p>\n\u003cp>Both the California Department of Public Health and SFDPH recommend you directly contact pharmacies near you to ask if they have COVID-19 vaccines in stock and whether they’re offering those shots for free through the Bridge Access Program.\u003c/p>\n\u003cp>Remember to be \u003cem>really \u003c/em>careful and confirm repeatedly that any shot will actually be free, as the \u003ca href=\"https://www.cvs.com/immunizations/covid-19-vaccine\">out-of-pocket cost can be steep. \u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Reach out to your local health department\u003c/strong>\u003c/p>\n\u003cp>Contact your city or county’s public health department to ask if they’re still offering free COVID-19 vaccines to people without insurance through the Bridge Access Program or otherwise. The following links may also provide information on community clinics offering vaccines — just be sure to stress you don’t have insurance and are looking for free shots.\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://covid-19.acgov.org/vaccines\">Alameda County COVID-19 vaccination \u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.cityofberkeley.info/covid19-vaccine/\">City of Berkeley COVID-19 vaccination \u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.cchealth.org/health-and-safety-information/communicable-disease-program/covid-19/covid-vaccine\">Contra Costa COVID-19 vaccination\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://coronavirus.marinhhs.org/vaccinefinder\">Marin County COVID-19 vaccination\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.countyofnapa.org/3096/Vaccination\">Napa County COVID-19 vaccination\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://sf.gov/get-vaccinated-against-covid-19-flu-and-rsv\">San Francisco COVID-19 vaccination\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.smchealth.org/coronavirus\">San Mateo County COVID-19 vaccination\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://publichealth.santaclaracounty.gov/programs-and-services/pharmacy-and-vaccination-services/covid-testing-vaccines-and-treatment\">Santa Clara County COVID-19 vaccination\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://solanocounty.com/depts/ph/default.asp\">Solano County COVID-19 vaccination\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://sonomacounty.ca.gov/health-and-human-services/health-services/divisions/public-health/disease-control/covid-19/vaccines\">Sonoma County COVID-19 vaccination\u003c/a>\u003c/li>\n\u003c/ul>\n\u003ch2>What will happen with free COVID vaccinations for uninsured people in the long run?\u003c/h2>\n\u003cp>It’s still unclear.\u003c/p>\n\u003cp>In a recent statement, the California Department of Public Health said they are “exploring options to continue to support COVID-19 vaccine access after the end of the BAP program for uninsured and underinsured adults, including limited federal and state funding sources,” and that vaccine manufacturers “may also develop patient assistance programs.”\u003c/p>\n\u003cp>The agency, it said, “remains committed to monitoring vaccine access options for vulnerable populations, including uninsured adults and will share relevant information as it becomes available.”\u003c/p>\n\u003cp>Stacey, of Lifelong Medical Care, said that in the absence of official guidance, clinics like his are “going to work on seeing what we can do to get funding and get resources to be able to continue, hopefully in the near future, to be able to provide the vaccines to the uninsured again.”\u003c/p>\n\u003cp>“We are trying to figure out how we can get funding or be able to purchase at least a limited supply of vaccines that we can use for those who are experiencing homelessness,” he said. “We don’t have a solution to that right now. Not only are the vaccines not being provided to us through this program, but the cost of the vaccines has also gone up.”\u003c/p>\n\u003cp>Chin-Hong, of UCSF, is optimistic that in the fall, Bay Area and statewide public health officials “will likely find a way to get the new COVID vaccine into uninsured arms” since he’s found those agencies “generally more forward-thinking” and willing to “provide more safety net programs than many other areas in the country.”\u003c/p>\n\u003cp>“However,” he said, “it will take some time for these programs to roll out smoothly.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story includes reporting from KQED’s Spencer Whitney and Danielle Venton. \u003c/em>\u003c/p>\n\n",
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"excerpt": "The federal program that funds free COVID-19 vaccines for those without health insurance is ending several months earlier than expected — and medical experts are advising uninsured people to get their shots before the money runs out for good.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The federal program that funds free COVID-19 vaccines for people without health insurance is ending several months earlier than expected — and uninsured people are now being told it could be their last chance to seek out a free shot before the money runs out for good.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdc.gov/media/releases/2023/p0914-uninsured-vaccination.html\">The Bridge Access Program was launched\u003c/a> by the Centers for Disease Control and Prevention (CDC) in September 2023 to provide free COVID-19 vaccinations to the estimated 25 million to 30 million adults in the U.S. without health insurance. The funds were previously forecast to last until December and would have made COVID-19 vaccines accessible to uninsured people through the brunt of another winter respiratory virus season.\u003c/p>\n\u003cp>However, after March \u003ca href=\"https://www.pbs.org/newshour/health/this-covid-vaccine-program-offered-a-bridge-to-uninsured-adults-and-then-the-funding-crumbled\">negotiations in Congress resulted in $4.3 billion being withdrawn from the Department of Health and Human Services’ COVID-19 fund\u003c/a>, the program is instead ending this month, months ahead of schedule.\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#location\">Jump to: Where can I still find a free COVID vaccine if I’m uninsured?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>The CDC has not given a firm deadline for the end of the program beyond “August 2024” and has yet to respond to KQED’s request for more specific details.\u003c/p>\n\u003cp>However, in a statement, the California Department of Public Health said that the program is \u003ca href=\"https://www.fda.gov/vaccines-blood-biologics/updated-covid-19-vaccines-use-united-states-beginning-fall-2024\">“scheduled to end when the new 2024–25 COVID-19 vaccines are approved by the federal government.\u003c/a>” According to drug manufacturers Pfizer and Moderna, these updated fall COVID-19 vaccines, which will be targeted to the latest variants, \u003ca href=\"https://www.forbes.com/sites/ariannajohnson/2024/08/05/updated-covid-vaccines-are-coming-effectiveness-whos-eligible-and-more/\">could be ready as early as this month\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Finding locations that offer free COVID-19 shots has also become more difficult for those without insurance, even though the Bridge Access Program funding is technically still in place. The CDC’s online vaccine locator tool, which previously offered people a way to search for nearby vaccination sites and filter by whether they were participating in the program, has now been removed from \u003ca href=\"http://vaccines.gov\">vaccines.gov\u003c/a>.\u003c/p>\n\u003cp>A message on that site now states that the vaccine locator will be replaced with a pharmacy lookup tool that “will be added once 2024–25 flu and COVID-19 vaccines become widely available.” However, the site does not currently appear to offer any way to find free vaccination locations.\u003c/p>\n\u003cp>Keep reading for what to know about COVID-19 shots for uninsured people, or\u003cstrong>\u003ca href=\"#location\"> jump straight to how to find a free vaccine if you don’t have health insurance.\u003c/a>\u003c/strong>\u003c/p>\n\u003ch2>\u003cstrong>As funding dries up, clinics are left scrambling \u003c/strong>\u003c/h2>\n\u003cp>“We didn’t get any specific advance notice of exactly when it was going to be happening,” said Dr. Michael Stacey, chief medical officer at LifeLong Medical Care — one of the community clinics that’s been offering free COVID-19 shots to uninsured people through the Bridge Access Program. “Our notification came along with the rest of the rest of the world.”\u003c/p>\n\u003cp>The federal program launched when the commercial health care market began taking over COVID-19 vaccine distribution from the federal government, which had until then made the vaccines free to everyone, regardless of insurance. This means that, like the flu shot, a person’s COVID-19 vaccine is now either paid for under their health insurance plan if they have one or through a sizable out-of-pocket payment. At CVS, for instance, \u003ca href=\"https://www.cvs.com/immunizations/covid-19-vaccine\">a COVID-19 vaccine costs $190.99 if you don’t have any insurance\u003c/a>.\u003c/p>\n\u003cp>The Bridge Access Program was one of the few remaining sources of pandemic-era funding to offer COVID-19 care to “the most vulnerable in the community,” said Stacey, who noted that the timing is particularly unfortunate due to \u003ca href=\"https://www.kqed.org/news/11987343/covid-bay-area-wastewater-variant-symptoms-isolation-guidance\">the ongoing nationwide summer surge in infections\u003c/a>.\u003c/p>\n\u003cp>Uninsured children, ages 18 and under, can still get free COVID-19 vaccines and other free immunizations as part of \u003ca href=\"https://www.cdc.gov/vaccines-for-children/about/index.html\">the Vaccines for Children Program\u003c/a>.\u003c/p>\n\u003cp>During a visit this week to the Petaluma Health Center — one of the clinics still offering free COVID-19 shots for uninsured people — U.S. Secretary of Health and Human Services Xavier Becerra said he “believe[d] the clinics, the community health centers will continue to have shots” after the program’s funding ends. However, he did not offer any specifics on how the clinics could continue to offer them.\u003c/p>\n\u003cp>Locations like the Petaluma Health Center say they are now seeking grants, along with county and state funding, to make sure they can keep offering free vaccines.\u003c/p>\n\u003ch2>\u003cstrong>Should uninsured people seek a free shot ASAP before the funding runs out?\u003c/strong>\u003c/h2>\n\u003cp>For Stacey, of Lifelong Medical Care, the answer is simple: Yes. “For those that don’t have insurance, try to get the vaccine now before the [Bridge Access] program ends,” he said.\u003c/p>\n\u003cp>“We’re plugging ahead in these last days that we have to be able to vaccinate the uninsured as much as we can before the program actually shuts off,” Stacey said.\u003c/p>\n\u003cp>Dr. Peter Chin-Hong, an infectious disease expert at UCSF, echoed that, telling KQED by email that it’s “100% true that uninsured people should try to get the vaccine now, given the uncertainty of what will happen in the fall” regarding the program’s funding.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11960630/free-new-covid-vaccine-near-me-2023\">The COVID-19 vaccine that’s currently available\u003c/a> has been around since September 2023 (and this spring, \u003ca href=\"https://www.kqed.org/news/11977786/a-new-covid-vaccine-dose-is-now-available-for-people-age-65-and-older-where-can-you-find-a-shot-near-you\">an extra shot of the vaccine formulation\u003c/a> was recommended for people age 65 and older.) The \u003ca href=\"https://www.fda.gov/vaccines-blood-biologics/updated-covid-19-vaccines-use-united-states-beginning-fall-2024\">new, updated COVID-19 vaccine targeted to the latest variants\u003c/a> is scheduled for release this fall, with \u003ca href=\"https://www.forbes.com/sites/ariannajohnson/2024/08/05/updated-covid-vaccines-are-coming-effectiveness-whos-eligible-and-more/\">Pfizer and Moderna both saying their vaccines could be ready as early as this month\u003c/a>.\u003c/p>\n\u003cp>But Chin-Hong said that just because a new vaccine is expected soon, uninsured people shouldn’t be dissuaded from getting the current vaccine for free now — not just because the money for free shots is about to run out, but also because it’s not necessarily the best idea to get the new shot the minute it’s released anyway.\u003c/p>\n\u003cp>Even though the CDC recommends waiting two months between COVID-19 shots, “you won’t want to get the vaccine when it comes out immediately anyway as it is meant for the expected onslaught of cases in the winter,” Chin-Hong said. “Get it too soon, and your maximal antibodies will peak before you need it.”\u003c/p>\n\u003cp>And amid current high infection rates, there’s data to indicate that the available COVID-19 vaccine still offers good protection against the latest variants causing this surge, even though it was originally targeted to older variants, Chin-Hong said.\u003c/p>\n\u003cp>“The superpower of the vaccine is to protect against serious disease, hospitalization and death,” he said. “And for that, even the [current] XBB.1.5 booster will perform spectacularly well.”\u003c/p>\n\u003cp>Getting the current COVID-19 vaccine now for free might also buy uninsured people some time — and extra immunity — as public health agencies work out how to continue extending access to them, Chin-Hong said.\u003c/p>\n\u003cp>“Uninsured people who get the vaccine now can rest assured that the vaccine will likely protect against serious disease for at least a year,” he said. “So even if there are problems with getting the new vaccine in the fall, I feel comfortable that many of those can take this immune system reminder to carry them through the winter reasonably well.”\u003c/p>\n\u003ch2>\u003cstrong>\u003ca id=\"location\">\u003c/a>How can I find a free COVID shot ASAP if I’m uninsured?\u003c/strong>\u003c/h2>\n\u003cp>Like many aspects of finding COVID-19 care at this stage of the pandemic, even finding a location that offers free COVID-19 vaccines to uninsured people through the Bridge Access Program has become more difficult — especially since the CDC removed its online vaccine locator tool, which showed all Bridge Access Program sites from \u003ca href=\"http://vaccines.gov\">vaccines.gov\u003c/a>.\u003c/p>\n\u003cp>So, if you’re uninsured and want to find a free COVID-19 shot as soon as possible before the program funding runs out, here’s a selection of options. Unfortunately, a number of them now require proactive research and action.\u003c/p>\n\u003cp>\u003cstrong>Use the state’s My Turn Vaccine Locator\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"https://myturn.ca.gov/vaccinelocator.html\">This online tool from the California Department of Public Health\u003c/a> allows you to filter by vaccine type and insurance status. However, this tool does not show every single vaccination site that may offer free shots through the Bridge Access Program for those without insurance. For example, it only returns two clinics that offer COVID-19 shots to uninsured people within 50 miles of San Francisco (in Napa and San Jose).\u003c/p>\n\u003cp>\u003cstrong>Find a community health center through the U.S. Department of Health and Human Services (HHS)\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"https://findahealthcenter.hrsa.gov/\">HHS has a map tool showing community health centers \u003c/a>that \u003cem>may \u003c/em>offer free COVID-19 shots for uninsured people. After you search for a nearby location, contact that center directly to ask if it’s offering no-insurance COVID-19 shots for free through the Bridge Access Program.\u003c/p>\n\u003cp>The San Francisco Department of Public Health (SFDPH) also said that\u003ca href=\"https://www.sf.gov/get-vaccinated-against-covid-19-flu-and-rsv\"> its AITC Immunization and Travel Clinic provides the COVID-19 vaccine to uninsured people\u003c/a>, although the agency notes that “people outside of San Francisco are encouraged to contact their local health department to find a vaccine near them.” The clinic is located at 101 Grove Street, Room 102, and appointments are required: call 415-554-2625 for hours and availability.\u003c/p>\n\u003cp>SFDPH also recommends that \u003ca href=\"https://www.sf.gov/get-vaccinated-against-covid-19-flu-and-rsv\">uninsured people visit the appointment-only San Francisco Free Clinic \u003c/a>(4900 California St.; call 415-750-9894 for hours and availability). But when you call, check if you need to be an SF resident to receive a free COVID-19 vaccine.\u003c/p>\n\u003cp>\u003cstrong>Reach out to your local pharmacy\u003c/strong>\u003c/p>\n\u003cp>Both the California Department of Public Health and SFDPH recommend you directly contact pharmacies near you to ask if they have COVID-19 vaccines in stock and whether they’re offering those shots for free through the Bridge Access Program.\u003c/p>\n\u003cp>Remember to be \u003cem>really \u003c/em>careful and confirm repeatedly that any shot will actually be free, as the \u003ca href=\"https://www.cvs.com/immunizations/covid-19-vaccine\">out-of-pocket cost can be steep. \u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Reach out to your local health department\u003c/strong>\u003c/p>\n\u003cp>Contact your city or county’s public health department to ask if they’re still offering free COVID-19 vaccines to people without insurance through the Bridge Access Program or otherwise. The following links may also provide information on community clinics offering vaccines — just be sure to stress you don’t have insurance and are looking for free shots.\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://covid-19.acgov.org/vaccines\">Alameda County COVID-19 vaccination \u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.cityofberkeley.info/covid19-vaccine/\">City of Berkeley COVID-19 vaccination \u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.cchealth.org/health-and-safety-information/communicable-disease-program/covid-19/covid-vaccine\">Contra Costa COVID-19 vaccination\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://coronavirus.marinhhs.org/vaccinefinder\">Marin County COVID-19 vaccination\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.countyofnapa.org/3096/Vaccination\">Napa County COVID-19 vaccination\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://sf.gov/get-vaccinated-against-covid-19-flu-and-rsv\">San Francisco COVID-19 vaccination\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.smchealth.org/coronavirus\">San Mateo County COVID-19 vaccination\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://publichealth.santaclaracounty.gov/programs-and-services/pharmacy-and-vaccination-services/covid-testing-vaccines-and-treatment\">Santa Clara County COVID-19 vaccination\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://solanocounty.com/depts/ph/default.asp\">Solano County COVID-19 vaccination\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://sonomacounty.ca.gov/health-and-human-services/health-services/divisions/public-health/disease-control/covid-19/vaccines\">Sonoma County COVID-19 vaccination\u003c/a>\u003c/li>\n\u003c/ul>\n\u003ch2>What will happen with free COVID vaccinations for uninsured people in the long run?\u003c/h2>\n\u003cp>It’s still unclear.\u003c/p>\n\u003cp>In a recent statement, the California Department of Public Health said they are “exploring options to continue to support COVID-19 vaccine access after the end of the BAP program for uninsured and underinsured adults, including limited federal and state funding sources,” and that vaccine manufacturers “may also develop patient assistance programs.”\u003c/p>\n\u003cp>The agency, it said, “remains committed to monitoring vaccine access options for vulnerable populations, including uninsured adults and will share relevant information as it becomes available.”\u003c/p>\n\u003cp>Stacey, of Lifelong Medical Care, said that in the absence of official guidance, clinics like his are “going to work on seeing what we can do to get funding and get resources to be able to continue, hopefully in the near future, to be able to provide the vaccines to the uninsured again.”\u003c/p>\n\u003cp>“We are trying to figure out how we can get funding or be able to purchase at least a limited supply of vaccines that we can use for those who are experiencing homelessness,” he said. “We don’t have a solution to that right now. Not only are the vaccines not being provided to us through this program, but the cost of the vaccines has also gone up.”\u003c/p>\n\u003cp>Chin-Hong, of UCSF, is optimistic that in the fall, Bay Area and statewide public health officials “will likely find a way to get the new COVID vaccine into uninsured arms” since he’s found those agencies “generally more forward-thinking” and willing to “provide more safety net programs than many other areas in the country.”\u003c/p>\n\u003cp>“However,” he said, “it will take some time for these programs to roll out smoothly.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story includes reporting from KQED’s Spencer Whitney and Danielle Venton. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "1 Dead in Santa Clara County’s 1st Human West Nile Cases of the Year",
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"content": "\u003cp>Santa Clara County reported its first \u003ca href=\"https://www.kqed.org/news/tag/west-nile-virus\">West Nile virus\u003c/a> death of the year on Wednesday, coming after mosquitos with the disease were found last month.\u003c/p>\n\u003cp>Two human cases of West Nile virus have been reported in the county so far in August, including one immunocompromised person who died at a hospital after experiencing symptoms. The other person is recovering at home after being hospitalized, according to a statement from the Department of Public Health.\u003c/p>\n\u003cp>“The risk of serious illness from West Nile virus is low for most people,” the statement reads. “However, people over 60 years of age and those with certain medical conditions have a higher chance of getting sick and are more likely to develop complications.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>There is no known connection between the two individuals, and the department said it is undetermined if the infections were contracted in the county.\u003c/p>\n\u003cp>The last West Nile virus death in Santa Clara County was in 2022, a county spokesperson told KQED.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">[aside postID=news_12000161 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/021_SanFrancisco_StFrancisER_08262021_qed-1020x680.jpg']\u003c/span>\u003c/p>\n\u003cp>Mosquitoes testing positive for West Nile were reported in parts of San José and unincorporated Santa Clara County on July 19. Since then, the county has found positive mosquitos in 13 zip codes, including in Milpitas.\u003c/p>\n\u003cp>Santa Clara has completed five treatments to reduce mosquito populations in these areas — most recently on Tuesday night, just hours before the announcement of the human cases. Its next treatment is scheduled for Thursday near the Plato Arroyo neighborhood in northeast San José.\u003c/p>\n\u003cp>In the East Bay, Contra Costa County reported its first case and death from the virus this year on July 16.\u003c/p>\n\u003cp>The mosquito-borne disease causes flu-like symptoms in about one in five people it infects. Most people who contract the virus have mild or no symptoms, including fever, headache and body aches, but severe cases can result in neurological effects and death.\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "Santa Clara County reported its first West Nile virus cases, including one death after another death in Contra Costa County.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Santa Clara County reported its first \u003ca href=\"https://www.kqed.org/news/tag/west-nile-virus\">West Nile virus\u003c/a> death of the year on Wednesday, coming after mosquitos with the disease were found last month.\u003c/p>\n\u003cp>Two human cases of West Nile virus have been reported in the county so far in August, including one immunocompromised person who died at a hospital after experiencing symptoms. The other person is recovering at home after being hospitalized, according to a statement from the Department of Public Health.\u003c/p>\n\u003cp>“The risk of serious illness from West Nile virus is low for most people,” the statement reads. “However, people over 60 years of age and those with certain medical conditions have a higher chance of getting sick and are more likely to develop complications.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>There is no known connection between the two individuals, and the department said it is undetermined if the infections were contracted in the county.\u003c/p>\n\u003cp>The last West Nile virus death in Santa Clara County was in 2022, a county spokesperson told KQED.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>\u003c/p>\n\u003cp>Mosquitoes testing positive for West Nile were reported in parts of San José and unincorporated Santa Clara County on July 19. Since then, the county has found positive mosquitos in 13 zip codes, including in Milpitas.\u003c/p>\n\u003cp>Santa Clara has completed five treatments to reduce mosquito populations in these areas — most recently on Tuesday night, just hours before the announcement of the human cases. Its next treatment is scheduled for Thursday near the Plato Arroyo neighborhood in northeast San José.\u003c/p>\n\u003cp>In the East Bay, Contra Costa County reported its first case and death from the virus this year on July 16.\u003c/p>\n\u003cp>The mosquito-borne disease causes flu-like symptoms in about one in five people it infects. Most people who contract the virus have mild or no symptoms, including fever, headache and body aches, but severe cases can result in neurological effects and death.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "san-francisco-overdose-deaths-fall-to-lowest-level-since-pre-pandemic",
"title": "San Francisco Overdose Deaths Fall to Lowest Level Since Pre-Pandemic",
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"content": "\u003cp>San Francisco’s \u003ca href=\"https://www.kqed.org/news/tag/overdose-deaths\">overdose deaths\u003c/a> last month reached a four-year low, falling to a level not seen since before the COVID-19 pandemic, according to preliminary data released Wednesday by the medical examiner’s office.\u003c/p>\n\u003cp>The city reported 39 deaths from accidental overdose in July, the first time the figure has dipped below 40 since January 2020. That represents a 50% year-over-year reduction from last July, when 79 overdoses were reported.\u003c/p>\n\u003cp>The decline continues a trend seen in the first half of the year, offering some hope after 2023 marked the \u003ca href=\"https://www.kqed.org/news/11972898/2023-was-san-franciscos-deadliest-year-for-drug-overdoses-new-data-confirms\">deadliest year on record for overdoses in San Francisco\u003c/a>, with 810. Through June, the city was still on track to get close to last year’s total, but after July, the annual figure is on pace to be 706 — lower than in 2023 and 2020, the year with the second-highest total.\u003c/p>\n\u003cp>July was the fourth consecutive month with a year-over-year decline in overdose deaths after June’s total marked the lowest monthly figure since 2022.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>This year to date, overdose deaths are 15% lower than they were during the same period last year.\u003c/p>\n\u003cp>Policy expert Keith Humphreys told KQED last month that the trend was\u003ca href=\"https://www.kqed.org/news/11995842/san-francisco-overdose-deaths-are-at-nearly-2-year-low-whats-behind-the-decline\"> likely due to factors reflected in the national decline\u003c/a> of overdose deaths — like fading heroin use and the waning COVID-19 pandemic, which he said likely accelerated some overdose deaths that otherwise could have occurred years later.\u003c/p>\n\u003cp>While health officials called the drop in deaths a “hopeful sign,” they said wider access to overdose-preventing medications is still needed.\u003c/p>\n\u003cfigure id=\"attachment_12000177\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12000177\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/230831-SAFE-USE-POP-UP-MD-05_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/230831-SAFE-USE-POP-UP-MD-05_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/230831-SAFE-USE-POP-UP-MD-05_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/230831-SAFE-USE-POP-UP-MD-05_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/230831-SAFE-USE-POP-UP-MD-05_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/230831-SAFE-USE-POP-UP-MD-05_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/230831-SAFE-USE-POP-UP-MD-05_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Boxes of Narcan, the overdose prevention drug, at a safe drug use pop-up site created by volunteers with Concerned Public Response in San Francisco on Aug. 31, 2023. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“California needs to make more regulatory changes around methadone access in order to make a greater impact locally,” Dr. Grant Colfax, the director of the San Francisco Department of Public Health, said during a press conference on Wednesday. “We must continue to break down the outdated and cumbersome and, frankly, sometimes ridiculous bureaucratic barriers that make treatment hard to access and to maintain.”\u003c/p>\n\u003cp>He said that methadone and buprenorphine, synthetic opioids used to treat opioid use disorder, reduce the risk of death by up to 50% in some cases and reduce cravings and withdrawal symptoms. Currently, more than 2,500 people are in methadone treatment through the Department of Public Health.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">[aside postID=news_11997957 hero='https://ww2.kqed.org/app/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED-1020x680.jpg']\u003c/span>\u003c/p>\n\u003cp>Dr. Hillary Kunins, the city’s director of behavioral health, said that methadone is the most regulated medication in the country.\u003c/p>\n\u003cp>“The stigma and barriers caused by this overregulation prevent people from entering and staying in treatment,” she said. “Can you imagine requiring a person who has heart disease to be physically present at a special cardiac clinic every day to take their medication? That’s what new methadone patients need to do to get their daily medication.”\u003c/p>\n\u003cp>In California, methadone can only be dispensed from a licensed opioid treatment program or methadone clinic.\u003c/p>\n\u003cp>New federal policy changes make the treatments more accessible. Patients can initiate methadone treatment via telehealth and receive up to three days’ worth of methadone from a hospital at a time. They can also be prescribed methadone by a nurse practitioner or physician’s assistant and get the treatments from a hospital or other health clinic.\u003c/p>\n\u003cp>Assembly Bill 2115, written by Assemblymember Matt Haney (D-San Francisco), would align California with the federal regulations.\u003c/p>\n\u003cp>“The state must adopt the federal rules before people wanting to start methadone treatment can benefit,” Kunins said. “We implore our California state legislators to pass AB 2115. Making methadone more accessible in California will save lives.”\u003c/p>\n\u003cp>\u003cem>KQED’s Gilare Zada contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "The city reported 39 deaths from accidental overdose in July, the first time the figure has dipped below 40 since January 2020, offering some hope amid the opioid crisis.",
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"title": "San Francisco Overdose Deaths Fall to Lowest Level Since Pre-Pandemic | KQED",
"description": "The city reported 39 deaths from accidental overdose in July, the first time the figure has dipped below 40 since January 2020, offering some hope amid the opioid crisis.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>San Francisco’s \u003ca href=\"https://www.kqed.org/news/tag/overdose-deaths\">overdose deaths\u003c/a> last month reached a four-year low, falling to a level not seen since before the COVID-19 pandemic, according to preliminary data released Wednesday by the medical examiner’s office.\u003c/p>\n\u003cp>The city reported 39 deaths from accidental overdose in July, the first time the figure has dipped below 40 since January 2020. That represents a 50% year-over-year reduction from last July, when 79 overdoses were reported.\u003c/p>\n\u003cp>The decline continues a trend seen in the first half of the year, offering some hope after 2023 marked the \u003ca href=\"https://www.kqed.org/news/11972898/2023-was-san-franciscos-deadliest-year-for-drug-overdoses-new-data-confirms\">deadliest year on record for overdoses in San Francisco\u003c/a>, with 810. Through June, the city was still on track to get close to last year’s total, but after July, the annual figure is on pace to be 706 — lower than in 2023 and 2020, the year with the second-highest total.\u003c/p>\n\u003cp>July was the fourth consecutive month with a year-over-year decline in overdose deaths after June’s total marked the lowest monthly figure since 2022.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>This year to date, overdose deaths are 15% lower than they were during the same period last year.\u003c/p>\n\u003cp>Policy expert Keith Humphreys told KQED last month that the trend was\u003ca href=\"https://www.kqed.org/news/11995842/san-francisco-overdose-deaths-are-at-nearly-2-year-low-whats-behind-the-decline\"> likely due to factors reflected in the national decline\u003c/a> of overdose deaths — like fading heroin use and the waning COVID-19 pandemic, which he said likely accelerated some overdose deaths that otherwise could have occurred years later.\u003c/p>\n\u003cp>While health officials called the drop in deaths a “hopeful sign,” they said wider access to overdose-preventing medications is still needed.\u003c/p>\n\u003cfigure id=\"attachment_12000177\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12000177\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/230831-SAFE-USE-POP-UP-MD-05_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/230831-SAFE-USE-POP-UP-MD-05_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/230831-SAFE-USE-POP-UP-MD-05_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/230831-SAFE-USE-POP-UP-MD-05_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/230831-SAFE-USE-POP-UP-MD-05_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/230831-SAFE-USE-POP-UP-MD-05_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/230831-SAFE-USE-POP-UP-MD-05_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Boxes of Narcan, the overdose prevention drug, at a safe drug use pop-up site created by volunteers with Concerned Public Response in San Francisco on Aug. 31, 2023. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“California needs to make more regulatory changes around methadone access in order to make a greater impact locally,” Dr. Grant Colfax, the director of the San Francisco Department of Public Health, said during a press conference on Wednesday. “We must continue to break down the outdated and cumbersome and, frankly, sometimes ridiculous bureaucratic barriers that make treatment hard to access and to maintain.”\u003c/p>\n\u003cp>He said that methadone and buprenorphine, synthetic opioids used to treat opioid use disorder, reduce the risk of death by up to 50% in some cases and reduce cravings and withdrawal symptoms. Currently, more than 2,500 people are in methadone treatment through the Department of Public Health.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>\u003c/p>\n\u003cp>Dr. Hillary Kunins, the city’s director of behavioral health, said that methadone is the most regulated medication in the country.\u003c/p>\n\u003cp>“The stigma and barriers caused by this overregulation prevent people from entering and staying in treatment,” she said. “Can you imagine requiring a person who has heart disease to be physically present at a special cardiac clinic every day to take their medication? That’s what new methadone patients need to do to get their daily medication.”\u003c/p>\n\u003cp>In California, methadone can only be dispensed from a licensed opioid treatment program or methadone clinic.\u003c/p>\n\u003cp>New federal policy changes make the treatments more accessible. Patients can initiate methadone treatment via telehealth and receive up to three days’ worth of methadone from a hospital at a time. They can also be prescribed methadone by a nurse practitioner or physician’s assistant and get the treatments from a hospital or other health clinic.\u003c/p>\n\u003cp>Assembly Bill 2115, written by Assemblymember Matt Haney (D-San Francisco), would align California with the federal regulations.\u003c/p>\n\u003cp>“The state must adopt the federal rules before people wanting to start methadone treatment can benefit,” Kunins said. “We implore our California state legislators to pass AB 2115. Making methadone more accessible in California will save lives.”\u003c/p>\n\u003cp>\u003cem>KQED’s Gilare Zada contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>A bill pending in California’s Legislature to ratchet up oversight of private equity investments in health care is receiving enthusiastic backing from consumer advocates, labor unions, and the California Medical Association but drawing heavy fire from hospitals concerned about losing a potential funding source.\u003c/p>\n\u003cp>The legislation, sponsored by Attorney General Rob Bonta, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billAnalysisClient.xhtml?bill_id=202320240AB3129\">would require\u003c/a> private equity groups and hedge funds to notify his office of planned purchases of many types of health care businesses and obtain its consent. It also reinforces state laws that bar nonphysicians from directly employing doctors or directing their activities, which is a primary reason for the doctor association’s support.\u003c/p>\n\u003cp>Private equity firms raise money from institutional investors such as pension funds and typically acquire companies they believe can be run more profitably. Then, they look to boost earnings and sell the assets for multiples of what they paid for them.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That can be good for future retirees and sometimes for mismanaged companies that need a capital infusion and a new direction. But critics say the profit-first approach isn’t good for health care. Private equity deals in the sector are coming under increased scrutiny around the country amid mounting evidence that they often lead to higher prices, lower-quality care, and reduced access to core health services.\u003c/p>\n\u003cp>Opponents of the bill, led by the state’s hospital association, the California Chamber of Commerce, and a national private equity advocacy group, say it would discourage much-needed investment. The hospital industry has already persuaded lawmakers to exempt sales of for-profit hospitals from the proposed law.\u003c/p>\n\u003cp>“We preferred not to make that amendment,” Bonta said in an interview. “But we still have a strong bill that provides very important protections.”\u003c/p>\n\u003cp>The legislation would still apply to a broad swath of medical businesses, including clinics, physician groups, nursing homes, testing labs, and outpatient facilities, among others. Nonprofit hospital deals are already subject to the attorney general’s review.\u003c/p>\n\u003cp>A final vote on the bill could come this month if a state Senate committee moves it forward.\u003c/p>\n\u003cp>Nationally, private equity investors \u003ca href=\"https://www.commonwealthfund.org/publications/explainer/2023/nov/private-equity-role-health-care\">have spent $1 trillion\u003c/a> on health care acquisitions in the past decade, according to a report by The Commonwealth Fund. Physician practices have been especially attractive to them, with transactions \u003ca href=\"https://www.antitrustinstitute.org/wp-content/uploads/2023/07/AAI-UCB-EG_Private-Equity-I-Physician-Practice-Report_FINAL.pdf\">growing sixfold (PDF)\u003c/a> in a decade and often leading to significant price increases. Other types of outpatient services, as well as clinics, have also been targets.\u003c/p>\n\u003cp>In California, the value of private equity health care deals \u003ca href=\"https://www.chcf.org/wp-content/uploads/2024/05/PrivateEquityPrevalenceImpactPolicy.pdf#page=9\">grew more than twentyfold (PDF)\u003c/a> from 2005 to 2021, from less than $1 billion to $20 billion, according to the California Health Care Foundation. Private equity firms are tracking the pending legislation closely but so far haven’t slowed investment in California, according to a \u003ca href=\"https://files.pitchbook.com/website/files/pdf/Q2_2024_Healthcare_Services_Report.pdf\">new report (PDF)\u003c/a> from the research firm PitchBook.\u003c/p>\n\u003cp>Multiple studies, as well as a \u003ca href=\"https://kffhealthnews.org/private-equity/\">series of reports by KFF Health News\u003c/a>, have documented some of the difficulties created by private equity in health care.\u003c/p>\n\u003cp>\u003ca href=\"https://jamanetwork.com/journals/jama/article-abstract/2813379\">Research published last December\u003c/a> in the Journal of the American Medical Association showed a larger likelihood of adverse events such as patient infections and falls at private equity hospitals compared with others. Analysts say more research is needed on how patient care is being affected but that the impact on cost is clear.\u003c/p>\n\u003cp>“We can be almost certain that after a private equity acquisition, we’re going to be paying more for the same thing or for something that’s gotten worse,” said Kristof Stremikis, the director of Market Analysis and Insight at the California Health Care Foundation.\u003c/p>\n\u003cp>Most private equity deals in health care are below the $119.5 million threshold that triggers a \u003ca href=\"https://www.ftc.gov/enforcement/competition-matters/2024/02/new-hsr-thresholds-filing-fees-2024\">requirement to notify\u003c/a> federal regulators, so they often slide under the government radar. The Federal Trade Commission is stepping up scrutiny, and \u003ca href=\"https://www.ftc.gov/news-events/news/press-releases/2023/09/ftc-challenges-private-equity-firms-scheme-suppress-competition-anesthesiology-practices-across\">last year, it sued\u003c/a> a private equity-backed anesthesia group for anti-competitive practices in Texas.\u003c/p>\n\u003cp>Lawmakers in several other states, including Connecticut, Minnesota, and Massachusetts, have proposed legislation that would subject private equity deals to greater transparency.\u003c/p>\n\u003cp>Not all private equity firms are bad operators, said Assemblymember Jim Wood, a Democrat from Healdsburg, but the review is essential: “If you are a good entity, you shouldn’t fear this.”\u003c/p>\n\u003cp>The bill would require the attorney general to examine proposed transactions to determine their impact on the quality and accessibility of care, as well as on regional competition and prices.\u003c/p>\n\u003cp>Critics note that private equity deals are often financed with debt that is then owed by the acquired company. In many cases, private equity groups \u003ca href=\"https://prospect.org/health/2023-05-23-quackonomics-medical-properties-trust/\">sell off real estate\u003c/a> to generate immediate returns for investors, and the new owners of the property then charge the acquired company rent.\u003c/p>\n\u003cp>[aside label=\"more health care stories\" postID=\"news_11990215,news_11986998,news_11986075\"]\u003c/p>\n\u003cp>That was a factor in the financial collapse of Steward Health Care, a multistate hospital system that was owned by the private equity firm Cerberus Capital Management from 2010 to 2020, \u003ca href=\"https://pestakeholder.org/reports/the-pillaging-of-steward-health-care/\">according to a report\u003c/a> by the Private Equity Stakeholder Project, a nonprofit that supports the California bill. Steward filed for Chapter 11 bankruptcy in May. “Almost all of the most distressed US healthcare companies are owned by private equity firms,” \u003ca href=\"https://pestakeholder.org/private-equity-healthcare-bankruptcies-are-on-the-rise/\">according to another study\u003c/a> by the group.\u003c/p>\n\u003cp>Opponents of the legislation argue it would dampen much-needed investment in an industry with soaring operating costs. “Our concern is that it will cut off funding that can improve health care,” said Ned Wigglesworth, a spokesperson for \u003ca href=\"https://protectcommunityhealthcare.org/\">Californians to Protect Community Health Care\u003c/a>, a coalition of groups fighting the legislation. The prospect of having to submit to a lengthy review by the attorney general, he said, would create “a chilling effect on private funders.”\u003c/p>\n\u003cp>Proponents of private equity investment point to what they say are notable successes in California health care.\u003c/p>\n\u003cp>Children’s Choice Dental Care, for example, said \u003ca href=\"https://kffhealthnews.org/wp-content/uploads/sites/2/2024/08/Childrens-Choice-Oppose-6.10.24.pdf\">in a letter (PDF)\u003c/a> to state senators that it logs over 227,000 dental visits annually, mostly with children on Medi-Cal, the health insurance program for low-income Californians. “We have been able to expand to 25 locations because we have been able to access capital from a private equity firm,” the group wrote.\u003c/p>\n\u003cp>Ivy Fertility, with clinics in California and eight other states, said \u003ca href=\"https://kffhealthnews.org/wp-content/uploads/sites/2/2024/08/Ivy-Fertility-Oppose.pdf\">in a letter (PDF)\u003c/a> to state senators that private investment has expanded its ability to provide fertility treatments at a time when demand for them is increasing.\u003c/p>\n\u003cp>Researchers note that private equity investors are hardly alone when it comes to health care profiteering, which extends even to nonprofits. \u003ca href=\"https://californiahealthline.org/news/surprise-settlement-in-sutter-health-antitrust-case/\">Sutter Health\u003c/a>, a major nonprofit hospital chain, for example, \u003ca href=\"https://oag.ca.gov/news/press-releases/attorney-general-bonta-announces-final-approval-575-million-settlement-sutter\">settled for $575 million\u003c/a> in a \u003ca href=\"https://oag.ca.gov/news/press-releases/attorney-general-becerra-sues-sutter-health-anti-competitive-practices-increase\">lawsuit brought\u003c/a> by then-Attorney General Xavier Becerra for unfair contracting and pricing.\u003c/p>\n\u003cp>“It’s helpful to look at ownership classes like private equity, but at the end of the day, we should look at behavior, and anyone can do the things that private equity firms do,” said Christopher Cai, a physician and health policy researcher at Harvard Medical School. He added, though, that private equity investors are “more likely to engage in financially risky or purely profit-driven behavior.”\u003c/p>\n\u003cp>\u003cem>This article was produced by \u003c/em>\u003ca href=\"https://kffhealthnews.org/about-us\" target=\"_blank\" rel=\"noreferrer noopener\">\u003cem>KFF Health News\u003c/em>\u003c/a>\u003cem>, which publishes \u003c/em>\u003ca href=\"http://www.californiahealthline.org/\" target=\"_blank\" rel=\"noreferrer noopener\">\u003cem>California Healthline\u003c/em>\u003c/a>\u003cem>, an editorially independent service of the \u003c/em>\u003ca href=\"http://www.chcf.org/\" target=\"_blank\" rel=\"noreferrer noopener\">\u003cem>California Health Care Foundation\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "The legislation, sponsored by Attorney General Rob Bonta, is being backed by labor unions, but hospitals are concerned about losing potential funding.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A bill pending in California’s Legislature to ratchet up oversight of private equity investments in health care is receiving enthusiastic backing from consumer advocates, labor unions, and the California Medical Association but drawing heavy fire from hospitals concerned about losing a potential funding source.\u003c/p>\n\u003cp>The legislation, sponsored by Attorney General Rob Bonta, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billAnalysisClient.xhtml?bill_id=202320240AB3129\">would require\u003c/a> private equity groups and hedge funds to notify his office of planned purchases of many types of health care businesses and obtain its consent. It also reinforces state laws that bar nonphysicians from directly employing doctors or directing their activities, which is a primary reason for the doctor association’s support.\u003c/p>\n\u003cp>Private equity firms raise money from institutional investors such as pension funds and typically acquire companies they believe can be run more profitably. Then, they look to boost earnings and sell the assets for multiples of what they paid for them.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That can be good for future retirees and sometimes for mismanaged companies that need a capital infusion and a new direction. But critics say the profit-first approach isn’t good for health care. Private equity deals in the sector are coming under increased scrutiny around the country amid mounting evidence that they often lead to higher prices, lower-quality care, and reduced access to core health services.\u003c/p>\n\u003cp>Opponents of the bill, led by the state’s hospital association, the California Chamber of Commerce, and a national private equity advocacy group, say it would discourage much-needed investment. The hospital industry has already persuaded lawmakers to exempt sales of for-profit hospitals from the proposed law.\u003c/p>\n\u003cp>“We preferred not to make that amendment,” Bonta said in an interview. “But we still have a strong bill that provides very important protections.”\u003c/p>\n\u003cp>The legislation would still apply to a broad swath of medical businesses, including clinics, physician groups, nursing homes, testing labs, and outpatient facilities, among others. Nonprofit hospital deals are already subject to the attorney general’s review.\u003c/p>\n\u003cp>A final vote on the bill could come this month if a state Senate committee moves it forward.\u003c/p>\n\u003cp>Nationally, private equity investors \u003ca href=\"https://www.commonwealthfund.org/publications/explainer/2023/nov/private-equity-role-health-care\">have spent $1 trillion\u003c/a> on health care acquisitions in the past decade, according to a report by The Commonwealth Fund. Physician practices have been especially attractive to them, with transactions \u003ca href=\"https://www.antitrustinstitute.org/wp-content/uploads/2023/07/AAI-UCB-EG_Private-Equity-I-Physician-Practice-Report_FINAL.pdf\">growing sixfold (PDF)\u003c/a> in a decade and often leading to significant price increases. Other types of outpatient services, as well as clinics, have also been targets.\u003c/p>\n\u003cp>In California, the value of private equity health care deals \u003ca href=\"https://www.chcf.org/wp-content/uploads/2024/05/PrivateEquityPrevalenceImpactPolicy.pdf#page=9\">grew more than twentyfold (PDF)\u003c/a> from 2005 to 2021, from less than $1 billion to $20 billion, according to the California Health Care Foundation. Private equity firms are tracking the pending legislation closely but so far haven’t slowed investment in California, according to a \u003ca href=\"https://files.pitchbook.com/website/files/pdf/Q2_2024_Healthcare_Services_Report.pdf\">new report (PDF)\u003c/a> from the research firm PitchBook.\u003c/p>\n\u003cp>Multiple studies, as well as a \u003ca href=\"https://kffhealthnews.org/private-equity/\">series of reports by KFF Health News\u003c/a>, have documented some of the difficulties created by private equity in health care.\u003c/p>\n\u003cp>\u003ca href=\"https://jamanetwork.com/journals/jama/article-abstract/2813379\">Research published last December\u003c/a> in the Journal of the American Medical Association showed a larger likelihood of adverse events such as patient infections and falls at private equity hospitals compared with others. Analysts say more research is needed on how patient care is being affected but that the impact on cost is clear.\u003c/p>\n\u003cp>“We can be almost certain that after a private equity acquisition, we’re going to be paying more for the same thing or for something that’s gotten worse,” said Kristof Stremikis, the director of Market Analysis and Insight at the California Health Care Foundation.\u003c/p>\n\u003cp>Most private equity deals in health care are below the $119.5 million threshold that triggers a \u003ca href=\"https://www.ftc.gov/enforcement/competition-matters/2024/02/new-hsr-thresholds-filing-fees-2024\">requirement to notify\u003c/a> federal regulators, so they often slide under the government radar. The Federal Trade Commission is stepping up scrutiny, and \u003ca href=\"https://www.ftc.gov/news-events/news/press-releases/2023/09/ftc-challenges-private-equity-firms-scheme-suppress-competition-anesthesiology-practices-across\">last year, it sued\u003c/a> a private equity-backed anesthesia group for anti-competitive practices in Texas.\u003c/p>\n\u003cp>Lawmakers in several other states, including Connecticut, Minnesota, and Massachusetts, have proposed legislation that would subject private equity deals to greater transparency.\u003c/p>\n\u003cp>Not all private equity firms are bad operators, said Assemblymember Jim Wood, a Democrat from Healdsburg, but the review is essential: “If you are a good entity, you shouldn’t fear this.”\u003c/p>\n\u003cp>The bill would require the attorney general to examine proposed transactions to determine their impact on the quality and accessibility of care, as well as on regional competition and prices.\u003c/p>\n\u003cp>Critics note that private equity deals are often financed with debt that is then owed by the acquired company. In many cases, private equity groups \u003ca href=\"https://prospect.org/health/2023-05-23-quackonomics-medical-properties-trust/\">sell off real estate\u003c/a> to generate immediate returns for investors, and the new owners of the property then charge the acquired company rent.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That was a factor in the financial collapse of Steward Health Care, a multistate hospital system that was owned by the private equity firm Cerberus Capital Management from 2010 to 2020, \u003ca href=\"https://pestakeholder.org/reports/the-pillaging-of-steward-health-care/\">according to a report\u003c/a> by the Private Equity Stakeholder Project, a nonprofit that supports the California bill. Steward filed for Chapter 11 bankruptcy in May. “Almost all of the most distressed US healthcare companies are owned by private equity firms,” \u003ca href=\"https://pestakeholder.org/private-equity-healthcare-bankruptcies-are-on-the-rise/\">according to another study\u003c/a> by the group.\u003c/p>\n\u003cp>Opponents of the legislation argue it would dampen much-needed investment in an industry with soaring operating costs. “Our concern is that it will cut off funding that can improve health care,” said Ned Wigglesworth, a spokesperson for \u003ca href=\"https://protectcommunityhealthcare.org/\">Californians to Protect Community Health Care\u003c/a>, a coalition of groups fighting the legislation. The prospect of having to submit to a lengthy review by the attorney general, he said, would create “a chilling effect on private funders.”\u003c/p>\n\u003cp>Proponents of private equity investment point to what they say are notable successes in California health care.\u003c/p>\n\u003cp>Children’s Choice Dental Care, for example, said \u003ca href=\"https://kffhealthnews.org/wp-content/uploads/sites/2/2024/08/Childrens-Choice-Oppose-6.10.24.pdf\">in a letter (PDF)\u003c/a> to state senators that it logs over 227,000 dental visits annually, mostly with children on Medi-Cal, the health insurance program for low-income Californians. “We have been able to expand to 25 locations because we have been able to access capital from a private equity firm,” the group wrote.\u003c/p>\n\u003cp>Ivy Fertility, with clinics in California and eight other states, said \u003ca href=\"https://kffhealthnews.org/wp-content/uploads/sites/2/2024/08/Ivy-Fertility-Oppose.pdf\">in a letter (PDF)\u003c/a> to state senators that private investment has expanded its ability to provide fertility treatments at a time when demand for them is increasing.\u003c/p>\n\u003cp>Researchers note that private equity investors are hardly alone when it comes to health care profiteering, which extends even to nonprofits. \u003ca href=\"https://californiahealthline.org/news/surprise-settlement-in-sutter-health-antitrust-case/\">Sutter Health\u003c/a>, a major nonprofit hospital chain, for example, \u003ca href=\"https://oag.ca.gov/news/press-releases/attorney-general-bonta-announces-final-approval-575-million-settlement-sutter\">settled for $575 million\u003c/a> in a \u003ca href=\"https://oag.ca.gov/news/press-releases/attorney-general-becerra-sues-sutter-health-anti-competitive-practices-increase\">lawsuit brought\u003c/a> by then-Attorney General Xavier Becerra for unfair contracting and pricing.\u003c/p>\n\u003cp>“It’s helpful to look at ownership classes like private equity, but at the end of the day, we should look at behavior, and anyone can do the things that private equity firms do,” said Christopher Cai, a physician and health policy researcher at Harvard Medical School. He added, though, that private equity investors are “more likely to engage in financially risky or purely profit-driven behavior.”\u003c/p>\n\u003cp>\u003cem>This article was produced by \u003c/em>\u003ca href=\"https://kffhealthnews.org/about-us\" target=\"_blank\" rel=\"noreferrer noopener\">\u003cem>KFF Health News\u003c/em>\u003c/a>\u003cem>, which publishes \u003c/em>\u003ca href=\"http://www.californiahealthline.org/\" target=\"_blank\" rel=\"noreferrer noopener\">\u003cem>California Healthline\u003c/em>\u003c/a>\u003cem>, an editorially independent service of the \u003c/em>\u003ca href=\"http://www.chcf.org/\" target=\"_blank\" rel=\"noreferrer noopener\">\u003cem>California Health Care Foundation\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"marketplace": {
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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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"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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"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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"politicalbreakdown": {
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"title": "Political Breakdown",
"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.",
"airtime": "THU 6:30pm-7pm",
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"possible": {
"id": "possible",
"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.",
"airtime": "SUN 2pm",
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"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"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.",
"airtime": "MON-FRI 2pm-3pm",
"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": {
"id": "reveal",
"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"order": 16
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},
"science-friday": {
"id": "science-friday",
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