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"content": "\u003cp>If you haven’t yet sought out your updated COVID-19 vaccine — or your flu shot — now might be a good time.\u003c/p>\n\u003cp>That’s because, after a lengthy COVID-19 surge this summer that lasted twice as long as 2023’s summer swell, the Bay Area is now about to enter the winter respiratory virus season.\u003c/p>\n\u003cp>In August, \u003ca href=\"https://www.kqed.org/news/12001396/where-can-i-get-new-covid-vaccine-near-me-2024\">the updated 2024 COVID-19 vaccine was made available to everyone age 6 months and over\u003c/a>, with shots from manufacturers Pfizer, Moderna and most recently, Novavax. These COVID-19 vaccines are now provided as annual fall vaccines, alongside the yearly flu shot, updated to target the latest strains and timed in order to offer maximum protection against the predicted winter surge of these viruses.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>All of which means if you haven’t gotten either your COVID-19 or flu shot yet at this stage in the fall, seeking them out in the next few weeks is a good idea. Keep reading for what you need to know about fall vaccines, including the best time to get them, what to do if you got COVID-19 this summer and more.\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Jump straight to: \u003ca href=\"#covidbayarea\">If I got COVID this summer, when should I get my vaccine?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003ch2>When is the best time to get my COVID and flu shot?\u003c/h2>\n\u003cp>The recommendations medical professionals make about when to get a COVID-19 or flu shot are based on:\u003c/p>\n\u003cul>\n\u003cli>The fact that it takes about two weeks after you get vaccinated for antibodies to develop and provide protection against the virus\u003c/li>\n\u003cli>When levels of the virus are predicted to rise that year\u003c/li>\n\u003c/ul>\n\u003cp>\u003cstrong>Getting your COVID shot\u003c/strong>\u003c/p>\n\u003cp>Last year, the Bay Area’s fall and winter COVID-19 surge began in late October, according to Stanford University’s WastewaterSCAN team, which monitors levels of the virus in local sewage. And when it comes to the timing of your COVID-19 shot, you want to aim for what UCSF infectious disease expert Dr. Peter Chin-Hong called “the Goldilocks moment.”\u003c/p>\n\u003cp>“You don’t want to get it too soon because your antibodies might wane just when you need it the most,” Chin-Hong said. “And you don’t want to get it too late because you want to prevent infection. So generally, by Halloween or mid to late October is when most people say the right time is.”\u003c/p>\n\u003cp>[aside postID=news_12001396]\u003c/p>\n\u003cp>The reason for this, explained Chin-Hong, is to ensure you get your full immunity ahead of the busy holiday season, from trick-or-treating at Halloween to holiday travel, Thanksgiving and beyond.\u003c/p>\n\u003cp>With your vaccine, “you not only get protection against serious disease, hospitalization and death, but you get a little bit of a buffer against infection itself,” Chin-Hong said. “So that if you want to have peace of mind while doing all of these things, it’s probably a good idea to peak your antibodies just when people are getting together again.”\u003c/p>\n\u003cp>\u003cstrong>Getting your flu shot\u003c/strong>\u003c/p>\n\u003cp>The Centers for Disease Control and Prevention estimates that last year’s flu season caused between 17,000 and 100,000 deaths and up to 900,000 hospitalizations. Typically, flu season starts in November and peaks around January or February, Chin-Hong said.\u003c/p>\n\u003cp>The CDC recommends that \u003ca href=\"https://www.cdc.gov/flu/prevention/index.html\">everyone 6 months and older get an annual flu vaccine “ideally by the end of October.”\u003c/a> Chin-Hong told KQED that his “optimal sweet point” for getting this shot is “sometime before Halloween” — but that if you see flu cases start to rise earlier, you should hustle to seek out your flu shot even sooner.\u003c/p>\n\u003ch2>Can I get my COVID and my flu shot at the same time?\u003c/h2>\n\u003cp>Yes — it’s totally fine and safe to get your flu shot at the same time as your new COVID-19 vaccine, and you’ll find many pharmacies offer appointments where you can get multiple vaccines at the same time.\u003c/p>\n\u003cp>A caveat: if you’re trying to schedule vaccinations for a child, the CDC advised in 2023 that you first talk to your pediatrician about the best schedule for the COVID-19 and flu vaccines (and now the RSV — respiratory syncytial virus — preventive treatment, too).\u003c/p>\n\u003ch2>\u003ca id=\"covidbayarea\">\u003c/a>I got COVID over the summer. Do I still need a COVID shot?\u003c/h2>\n\u003cp>Yes, Chin-Hong said — although make sure you’re not getting a shot too soon after having COVID-19.\u003c/p>\n\u003cp>That’s because “after getting infected with COVID, in general, you have a force field for around three months,” Chin-Hong said, meaning your infection will give you a good level of immunity against getting COVID-19 again during that period.\u003c/p>\n\u003cp>That said, this immunity will wane, Chin-Hong said, so having “a little bit of a buffer” is something to consider. This means getting your COVID-19 shot even after two months “won’t be a bad idea if it coincides with the time when we expect COVID to come back.”\u003c/p>\n\u003ch2>Where can I get my COVID and flu shot?\u003c/h2>\n\u003cp>For full information on \u003ca href=\"https://www.kqed.org/news/12001396/where-can-i-get-new-covid-vaccine-near-me-2024\">how to find an updated 2024 COVID-19 shot, read our guide\u003c/a>. If you have health insurance, the cost of your COVID-19 vaccine should be fully covered.\u003c/p>\n\u003cp>[aside postID=news_12006600]\u003c/p>\n\u003cp>To learn more about where to find a flu shot with or without insurance, \u003ca href=\"https://www.kqed.org/news/11961649/when-should-i-get-2023-flu-shot-safe-with-new-covid-vaccine-rsv#flushotnearme\">read our 2023 guide to locations offering flu vaccination around the Bay Area\u003c/a>.\u003c/p>\n\u003cp>Remember that many locations — including pharmacies — will offer appointments where you can get both vaccines at the same time.\u003c/p>\n\u003ch2>What about RSV? Should I get a vaccine for that?\u003c/h2>\n\u003cp>The CDC said that while RSV “does not usually cause severe illness in healthy adults and children,” older adults and infants younger than six months of age are especially at risk of becoming “very sick and may need to be hospitalized.”\u003c/p>\n\u003cp>The \u003ca href=\"https://www.cdc.gov/vaccines/vpd/rsv/index.html\">vaccine against RSV is accordingly recommended by the CDC for infants, young children and adults ages 60 and older\u003c/a>, as well as for pregnant people.\u003c/p>\n\u003cp>The virus spreads in the fall and winter like other respiratory viruses and “usually peaks in December and January,” according to the agency, which recommends that \u003ca href=\"https://www.cdc.gov/rsv/hcp/vaccine-clinical-guidance/older-adults.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fvaccines%2Fvpd%2Frsv%2Fhcp%2Folder-adults-faqs.html\">vaccination against RSV “will have the most benefit if administered in late summer or early fall\u003c/a> [August through October], just before the RSV season.”\u003c/p>\n\u003cp>Speak to your health care provider about getting the RSV vaccine, when might be the best time for you and whether to get it alongside other vaccines. 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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The reason for this, explained Chin-Hong, is to ensure you get your full immunity ahead of the busy holiday season, from trick-or-treating at Halloween to holiday travel, Thanksgiving and beyond.\u003c/p>\n\u003cp>With your vaccine, “you not only get protection against serious disease, hospitalization and death, but you get a little bit of a buffer against infection itself,” Chin-Hong said. “So that if you want to have peace of mind while doing all of these things, it’s probably a good idea to peak your antibodies just when people are getting together again.”\u003c/p>\n\u003cp>\u003cstrong>Getting your flu shot\u003c/strong>\u003c/p>\n\u003cp>The Centers for Disease Control and Prevention estimates that last year’s flu season caused between 17,000 and 100,000 deaths and up to 900,000 hospitalizations. Typically, flu season starts in November and peaks around January or February, Chin-Hong said.\u003c/p>\n\u003cp>The CDC recommends that \u003ca href=\"https://www.cdc.gov/flu/prevention/index.html\">everyone 6 months and older get an annual flu vaccine “ideally by the end of October.”\u003c/a> Chin-Hong told KQED that his “optimal sweet point” for getting this shot is “sometime before Halloween” — but that if you see flu cases start to rise earlier, you should hustle to seek out your flu shot even sooner.\u003c/p>\n\u003ch2>Can I get my COVID and my flu shot at the same time?\u003c/h2>\n\u003cp>Yes — it’s totally fine and safe to get your flu shot at the same time as your new COVID-19 vaccine, and you’ll find many pharmacies offer appointments where you can get multiple vaccines at the same time.\u003c/p>\n\u003cp>A caveat: if you’re trying to schedule vaccinations for a child, the CDC advised in 2023 that you first talk to your pediatrician about the best schedule for the COVID-19 and flu vaccines (and now the RSV — respiratory syncytial virus — preventive treatment, too).\u003c/p>\n\u003ch2>\u003ca id=\"covidbayarea\">\u003c/a>I got COVID over the summer. Do I still need a COVID shot?\u003c/h2>\n\u003cp>Yes, Chin-Hong said — although make sure you’re not getting a shot too soon after having COVID-19.\u003c/p>\n\u003cp>That’s because “after getting infected with COVID, in general, you have a force field for around three months,” Chin-Hong said, meaning your infection will give you a good level of immunity against getting COVID-19 again during that period.\u003c/p>\n\u003cp>That said, this immunity will wane, Chin-Hong said, so having “a little bit of a buffer” is something to consider. This means getting your COVID-19 shot even after two months “won’t be a bad idea if it coincides with the time when we expect COVID to come back.”\u003c/p>\n\u003ch2>Where can I get my COVID and flu shot?\u003c/h2>\n\u003cp>For full information on \u003ca href=\"https://www.kqed.org/news/12001396/where-can-i-get-new-covid-vaccine-near-me-2024\">how to find an updated 2024 COVID-19 shot, read our guide\u003c/a>. If you have health insurance, the cost of your COVID-19 vaccine should be fully covered.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>To learn more about where to find a flu shot with or without insurance, \u003ca href=\"https://www.kqed.org/news/11961649/when-should-i-get-2023-flu-shot-safe-with-new-covid-vaccine-rsv#flushotnearme\">read our 2023 guide to locations offering flu vaccination around the Bay Area\u003c/a>.\u003c/p>\n\u003cp>Remember that many locations — including pharmacies — will offer appointments where you can get both vaccines at the same time.\u003c/p>\n\u003ch2>What about RSV? Should I get a vaccine for that?\u003c/h2>\n\u003cp>The CDC said that while RSV “does not usually cause severe illness in healthy adults and children,” older adults and infants younger than six months of age are especially at risk of becoming “very sick and may need to be hospitalized.”\u003c/p>\n\u003cp>The \u003ca href=\"https://www.cdc.gov/vaccines/vpd/rsv/index.html\">vaccine against RSV is accordingly recommended by the CDC for infants, young children and adults ages 60 and older\u003c/a>, as well as for pregnant people.\u003c/p>\n\u003cp>The virus spreads in the fall and winter like other respiratory viruses and “usually peaks in December and January,” according to the agency, which recommends that \u003ca href=\"https://www.cdc.gov/rsv/hcp/vaccine-clinical-guidance/older-adults.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fvaccines%2Fvpd%2Frsv%2Fhcp%2Folder-adults-faqs.html\">vaccination against RSV “will have the most benefit if administered in late summer or early fall\u003c/a> [August through October], just before the RSV season.”\u003c/p>\n\u003cp>Speak to your health care provider about getting the RSV vaccine, when might be the best time for you and whether to get it alongside other vaccines. And as ever, if you’re trying to schedule your kid’s vaccinations, \u003ca href=\"https://www.npr.org/sections/health-shots/2023/09/13/1198803134/covid-boosters-updated-vaccines-fda-cdc\">the CDC advises that you first talk to your pediatrician\u003c/a> about the best schedule for the COVID-19, flu and RSV vaccines.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Cristina Cortez keeps two fuzzy blankets and pillows in her car to nap during lunch breaks in the parking lot of the hospital where she works. On a recent afternoon, she opened her trunk to reveal instant ramen packages, a gym bag with clean clothes and soft plush toys her kids gave her so she wouldn’t feel alone.\u003c/p>\n\u003cp>The mother of three doesn’t have enough time to sleep, see her family or cook meals because she commutes, often seven days a week, between two demanding \u003ca href=\"https://www.kqed.org/news/tag/health-care\">health care\u003c/a> jobs to make ends meet.\u003c/p>\n\u003cp>“What hurts me the most, is being away from my family, having to do that with the cost of everything. It’s just so expensive,” said Cortez, 44, a Los Banos resident who starts work as a dialysis technician at 4:30 a.m. in Gilroy, 30 miles south of San José.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>She picks shifts up as a medical assistant at a hospital emergency room in the afternoons or overnight in nearby Hollister, where she was raised. She’s trying to make enough money to afford to move her family back there.\u003c/p>\n\u003cp>“It’s just been really, really hard,” she said.\u003c/p>\n\u003cfigure id=\"attachment_12009757\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12009757\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Cristina Cortez, a dialysis technician, organizes items in her trunk outside Satellite Healthcare in Gilroy on Oct. 16, 2024. Due to working double shifts and having a long commute, Cortez carries a blanket and pillow to nap in her car, noodles for when she doesn’t have time for lunch, and two stuffed animals given to her by her children that remind her of them. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Cortez is one of hundreds of thousands of health care workers expected to see paycheck raises thanks to a California law that went into effect Wednesday. After months of delays, the mandated minimum wage increase, the first in the United States to target the health care industry, aims to alleviate workforce shortages and improve patient care. The raises could help health employers recruit and retain workers in often tough, frontline jobs.\u003c/p>\n\u003cp>The \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240SB525\">law\u003c/a> requires most health care employers to gradually boost their lowest wage to reach $25 an hour in the coming years. According to the \u003ca href=\"https://www.dir.ca.gov/dlse/Health-Care-Worker-Minimum-Wage-FAQ.htm\">phased-in schedule\u003c/a>, large health systems must pay at least $25 an hour by mid-2026. Smaller ones will have more time to increase the pay of nursing assistants, pharmacy technicians, janitors, receptionists and other positions.\u003c/p>\n\u003cp>“This is a well-deserved increase,” said Tia Orr, executive director of the Service Employees International Union California, which sponsored SB 525. “This is going to prove to be more beneficial for patients, more beneficial for California, and hugely beneficial to the workers who sacrifice their lives literally every single day to provide us the health care that we all need.”\u003c/p>\n\u003cp>About 350,000 health care employees, most of them people of color and women, are projected to see an annual average increase of $6,400 in the first year of the policy, according to an \u003ca href=\"https://laborcenter.berkeley.edu/wp-content/uploads/2024/02/california-health-care-minimum-wage-new-estimates-february-2024.pdf\">analysis\u003c/a> by the UC Berkeley Labor Center. In earlier estimates, the labor center calculated up to 426,000 people would be impacted, but that figure included workers at skilled nursing facilities who are currently not covered by the law, according to Laurel Lucia, who directs the center’s health care program.\u003c/p>\n\u003cp>California already \u003ca href=\"https://www.kqed.org/news/12007150/californias-20-fast-food-minimum-wage-sees-no-job-loss-slight-price-hikes\">mandates most fast-food employers\u003c/a> pay at least $20 an hour. Fast food, as well as the retail industry, often compete with health care for workers, said Bianca Frogner, who directs the Center for Health Workforce Studies at the University of Washington School of Medicine.\u003c/p>\n\u003cp>“It gives health care maybe a fighting chance against other industries that might be raising wages and are competing for workers,” Frogner, a health economist, said.\u003c/p>\n\u003cfigure id=\"attachment_12009760\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12009760\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Cristina Cortez, a dialysis technician, displays a Dialysis Workers United sticker on her shirt of Satellite Healthcare in Gilroy on Oct. 16, 2024, where she and fellow health care workers were protesting unfair labor practices. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Gov. Gavin Newsom signed SB 525 last fall, with an original implementation date of June 1. However, Newsom and lawmakers agreed to \u003ca href=\"https://www.kqed.org/news/11992165/why-the-budget-deal-delaying-the-health-care-minimum-wage-hike-is-not-as-big-as-you-might-think\">defer the measure twice\u003c/a> due to concerns that costs would exacerbate a state budget deficit.\u003c/p>\n\u003cp>Cortez said she was crushed by the delays and kept checking social media for updates from the governor on whether the Oct. 16 implementation date would stick. Earning more at her dialysis job, she said, will allow her to spend time with her children. She said she might cry when she finally sees a paycheck from her employer, Satellite Healthcare, reflecting the raise.\u003c/p>\n\u003cp>“Going from $20 to $23 from one month to the next is, like, to me winning a lotto because, yeah, it’s $3, but that’s going to make a big difference for me and my family,” Cortez said.\u003c/p>\n\u003cfigure id=\"attachment_12009759\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12009759\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Cristina Cortez, a dialysis technician, speaks with a colleague outside of Satellite Healthcare in Gilroy on Oct. 16, 2024, where she and fellow health care workers were protesting unfair labor practices. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A long list of health care employers initially opposed the measure because they worried about how to pay for it. Some said that raising their wage floor could lead to cuts in jobs or services. But many ended up supporting the bill — or withdrew their opposition — after weighing in on amendments that gave them additional time to adjust to a more expensive payroll.\u003c/p>\n\u003cp>Most research on minimum wage increases shows they do not lead to big job losses, as opponents often argue. Some health care employers may initially reduce hours or lay off employees, but those measures will likely be temporary, according to Frogner.\u003c/p>\n\u003cp>“I’m hoping that in the long run, as they see the phased-in approach of wages, that they can build that into their plan, into the future,” she said. “So it might be a very short-term challenge for a long-term gain.”\u003c/p>\n\u003cp>The law has already had a big impact on some workplaces.\u003c/p>\n\u003cfigure id=\"attachment_12009756\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12009756\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Cristina Cortez, a dialysis technician, organizes the extra uniform in her trunk outside Satellite Healthcare in Gilroy on Oct. 16, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Scripps Health, which provides a significant amount of free or discounted medical care at its four hospitals and dozens of outpatient centers in San Diego, adjusted pay for more than half of its nearly \u003ca href=\"https://www.scripps.org/about-us/who-we-are\">17,000 employees\u003c/a>, spokesperson Steve Carpowich said.\u003c/p>\n\u003cp>Only about 700 of those workers earned below the now required $23 an hour for large health employers, but Scripps also raised wages for others to “ensure fair pay and equity.” The move will cost Scripps about $20 million in the first year of the law’s implementation, Carpowich said.\u003c/p>\n\u003cp>“Scripps having to absorb the cost of this unfunded mandate comes against a backdrop of serious financial challenges for health systems,” he said in a statement. “These include government and commercial insurance payers whose reimbursements often don’t cover the cost of the care we provide; increased costs for supplies, pharmaceuticals and energy; and other unfunded government mandates, like SB 1953, the Seismic Safety Act.”\u003c/p>\n\u003cp>[aside postID=news_12007779 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-04-KQED-1020x680.jpg']\u003c/p>\n\u003cp>Large medical systems that serve more patients with private health insurance might have an easier time negotiating for higher rates to cover costs, according to Frogner and other health workforce experts. Community health centers, by comparison, rely heavily on more fixed reimbursements from Medi-Cal, the state’s public health insurance program.\u003c/p>\n\u003cp>Under the law, community and rural health clinics may apply to delay having to raise their wage floor. The Department of Industrial Relations, which issues the waivers, did not immediately respond to questions about how many clinics have applied for or received them.\u003c/p>\n\u003cp>The Newsom administration is considering changes to Medi-Cal rates as part of the budget process, but updates won’t be known until January, said H.D. Palmer, a spokesperson with the Department of Finance.\u003c/p>\n\u003cp>In its latest estimate, the department calculated the law would cost the state $1.4 billion in its first year and more later on, including higher Medi-Cal reimbursements for providers and wage hikes for about 26,000 state employees.\u003c/p>\n\u003cp>Katie Thompson, chief human resources officer at Clinica Sierra Vista, said the organization is dedicated to providing affordable health care to its primarily low-income patients in Fresno and Kern counties. To stay afloat, the community clinic, which started paying hundreds of its employees at least $21 per hour in May, hopes the state will increase Medi-Cal service rates.\u003c/p>\n\u003cp>“We’re not able to increase prices, nor do we want to,” Thompson said. “We do expect payments eventually to match the financial pressures that we are seeing. However, immediate state financial support is crucial.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Cristina Cortez keeps two fuzzy blankets and pillows in her car to nap during lunch breaks in the parking lot of the hospital where she works. On a recent afternoon, she opened her trunk to reveal instant ramen packages, a gym bag with clean clothes and soft plush toys her kids gave her so she wouldn’t feel alone.\u003c/p>\n\u003cp>The mother of three doesn’t have enough time to sleep, see her family or cook meals because she commutes, often seven days a week, between two demanding \u003ca href=\"https://www.kqed.org/news/tag/health-care\">health care\u003c/a> jobs to make ends meet.\u003c/p>\n\u003cp>“What hurts me the most, is being away from my family, having to do that with the cost of everything. It’s just so expensive,” said Cortez, 44, a Los Banos resident who starts work as a dialysis technician at 4:30 a.m. in Gilroy, 30 miles south of San José.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>She picks shifts up as a medical assistant at a hospital emergency room in the afternoons or overnight in nearby Hollister, where she was raised. She’s trying to make enough money to afford to move her family back there.\u003c/p>\n\u003cp>“It’s just been really, really hard,” she said.\u003c/p>\n\u003cfigure id=\"attachment_12009757\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12009757\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-09-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Cristina Cortez, a dialysis technician, organizes items in her trunk outside Satellite Healthcare in Gilroy on Oct. 16, 2024. Due to working double shifts and having a long commute, Cortez carries a blanket and pillow to nap in her car, noodles for when she doesn’t have time for lunch, and two stuffed animals given to her by her children that remind her of them. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Cortez is one of hundreds of thousands of health care workers expected to see paycheck raises thanks to a California law that went into effect Wednesday. After months of delays, the mandated minimum wage increase, the first in the United States to target the health care industry, aims to alleviate workforce shortages and improve patient care. The raises could help health employers recruit and retain workers in often tough, frontline jobs.\u003c/p>\n\u003cp>The \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240SB525\">law\u003c/a> requires most health care employers to gradually boost their lowest wage to reach $25 an hour in the coming years. According to the \u003ca href=\"https://www.dir.ca.gov/dlse/Health-Care-Worker-Minimum-Wage-FAQ.htm\">phased-in schedule\u003c/a>, large health systems must pay at least $25 an hour by mid-2026. Smaller ones will have more time to increase the pay of nursing assistants, pharmacy technicians, janitors, receptionists and other positions.\u003c/p>\n\u003cp>“This is a well-deserved increase,” said Tia Orr, executive director of the Service Employees International Union California, which sponsored SB 525. “This is going to prove to be more beneficial for patients, more beneficial for California, and hugely beneficial to the workers who sacrifice their lives literally every single day to provide us the health care that we all need.”\u003c/p>\n\u003cp>About 350,000 health care employees, most of them people of color and women, are projected to see an annual average increase of $6,400 in the first year of the policy, according to an \u003ca href=\"https://laborcenter.berkeley.edu/wp-content/uploads/2024/02/california-health-care-minimum-wage-new-estimates-february-2024.pdf\">analysis\u003c/a> by the UC Berkeley Labor Center. In earlier estimates, the labor center calculated up to 426,000 people would be impacted, but that figure included workers at skilled nursing facilities who are currently not covered by the law, according to Laurel Lucia, who directs the center’s health care program.\u003c/p>\n\u003cp>California already \u003ca href=\"https://www.kqed.org/news/12007150/californias-20-fast-food-minimum-wage-sees-no-job-loss-slight-price-hikes\">mandates most fast-food employers\u003c/a> pay at least $20 an hour. Fast food, as well as the retail industry, often compete with health care for workers, said Bianca Frogner, who directs the Center for Health Workforce Studies at the University of Washington School of Medicine.\u003c/p>\n\u003cp>“It gives health care maybe a fighting chance against other industries that might be raising wages and are competing for workers,” Frogner, a health economist, said.\u003c/p>\n\u003cfigure id=\"attachment_12009760\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12009760\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-28-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Cristina Cortez, a dialysis technician, displays a Dialysis Workers United sticker on her shirt of Satellite Healthcare in Gilroy on Oct. 16, 2024, where she and fellow health care workers were protesting unfair labor practices. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Gov. Gavin Newsom signed SB 525 last fall, with an original implementation date of June 1. However, Newsom and lawmakers agreed to \u003ca href=\"https://www.kqed.org/news/11992165/why-the-budget-deal-delaying-the-health-care-minimum-wage-hike-is-not-as-big-as-you-might-think\">defer the measure twice\u003c/a> due to concerns that costs would exacerbate a state budget deficit.\u003c/p>\n\u003cp>Cortez said she was crushed by the delays and kept checking social media for updates from the governor on whether the Oct. 16 implementation date would stick. Earning more at her dialysis job, she said, will allow her to spend time with her children. She said she might cry when she finally sees a paycheck from her employer, Satellite Healthcare, reflecting the raise.\u003c/p>\n\u003cp>“Going from $20 to $23 from one month to the next is, like, to me winning a lotto because, yeah, it’s $3, but that’s going to make a big difference for me and my family,” Cortez said.\u003c/p>\n\u003cfigure id=\"attachment_12009759\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12009759\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-25-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Cristina Cortez, a dialysis technician, speaks with a colleague outside of Satellite Healthcare in Gilroy on Oct. 16, 2024, where she and fellow health care workers were protesting unfair labor practices. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A long list of health care employers initially opposed the measure because they worried about how to pay for it. Some said that raising their wage floor could lead to cuts in jobs or services. But many ended up supporting the bill — or withdrew their opposition — after weighing in on amendments that gave them additional time to adjust to a more expensive payroll.\u003c/p>\n\u003cp>Most research on minimum wage increases shows they do not lead to big job losses, as opponents often argue. Some health care employers may initially reduce hours or lay off employees, but those measures will likely be temporary, according to Frogner.\u003c/p>\n\u003cp>“I’m hoping that in the long run, as they see the phased-in approach of wages, that they can build that into their plan, into the future,” she said. “So it might be a very short-term challenge for a long-term gain.”\u003c/p>\n\u003cp>The law has already had a big impact on some workplaces.\u003c/p>\n\u003cfigure id=\"attachment_12009756\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12009756\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241016-HEALTHCAREMINWAGERAISE-04-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Cristina Cortez, a dialysis technician, organizes the extra uniform in her trunk outside Satellite Healthcare in Gilroy on Oct. 16, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Scripps Health, which provides a significant amount of free or discounted medical care at its four hospitals and dozens of outpatient centers in San Diego, adjusted pay for more than half of its nearly \u003ca href=\"https://www.scripps.org/about-us/who-we-are\">17,000 employees\u003c/a>, spokesperson Steve Carpowich said.\u003c/p>\n\u003cp>Only about 700 of those workers earned below the now required $23 an hour for large health employers, but Scripps also raised wages for others to “ensure fair pay and equity.” The move will cost Scripps about $20 million in the first year of the law’s implementation, Carpowich said.\u003c/p>\n\u003cp>“Scripps having to absorb the cost of this unfunded mandate comes against a backdrop of serious financial challenges for health systems,” he said in a statement. “These include government and commercial insurance payers whose reimbursements often don’t cover the cost of the care we provide; increased costs for supplies, pharmaceuticals and energy; and other unfunded government mandates, like SB 1953, the Seismic Safety Act.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Large medical systems that serve more patients with private health insurance might have an easier time negotiating for higher rates to cover costs, according to Frogner and other health workforce experts. Community health centers, by comparison, rely heavily on more fixed reimbursements from Medi-Cal, the state’s public health insurance program.\u003c/p>\n\u003cp>Under the law, community and rural health clinics may apply to delay having to raise their wage floor. The Department of Industrial Relations, which issues the waivers, did not immediately respond to questions about how many clinics have applied for or received them.\u003c/p>\n\u003cp>The Newsom administration is considering changes to Medi-Cal rates as part of the budget process, but updates won’t be known until January, said H.D. Palmer, a spokesperson with the Department of Finance.\u003c/p>\n\u003cp>In its latest estimate, the department calculated the law would cost the state $1.4 billion in its first year and more later on, including higher Medi-Cal reimbursements for providers and wage hikes for about 26,000 state employees.\u003c/p>\n\u003cp>Katie Thompson, chief human resources officer at Clinica Sierra Vista, said the organization is dedicated to providing affordable health care to its primarily low-income patients in Fresno and Kern counties. To stay afloat, the community clinic, which started paying hundreds of its employees at least $21 per hour in May, hopes the state will increase Medi-Cal service rates.\u003c/p>\n\u003cp>“We’re not able to increase prices, nor do we want to,” Thompson said. “We do expect payments eventually to match the financial pressures that we are seeing. However, immediate state financial support is crucial.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "forced-sterilization-survivors-undertake-own-healing-after-feeling-silenced-again-by-state",
"title": "Forced Sterilization Survivors Undertake Own Healing After Feeling 'Silenced Again' by State",
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"headTitle": "Forced Sterilization Survivors Undertake Own Healing After Feeling ‘Silenced Again’ by State | KQED",
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"content": "\u003cp>\u003cem>This story was originally published in April 2024. The audio was first broadcast Oct. 11, 2024. Since the story first published, the compensation board has now approved a total of 118 applicants. It has denied 432 – or roughly 75% – of applicants. State agencies have now spent roughly $180,000 on memorials to survivors of state-sponsored sterilization. Dr. James Heinrich passed away in January 2024.Gov. Gavin Newsom \u003ca href=\"https://www.kqed.org/news/12008246/i-would-have-been-a-great-mom-california-finally-pays-reparations-to-woman-it-sterilized\">signed a bill on Sept. 30 \u003c/a>that gives more time to survivors of state-sponsored sterilization to appeal their case if they were denied reparations. They have until Jan. 1, 2025 to file an appeal.\u003c/em>\u003c/p>\n\u003cp>\u003cem>Listen to this and more in-depth storytelling by subscribing to \u003ca href=\"https://www.kqed.org/californiareportmagazine\">The California Report Magazine podcast\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>[dropcap]O[/dropcap]ne morning last spring, Moonlight Pulido called on rituals drawn from her Native American spirituality to confront a painful experience.\u003c/p>\n\u003cp>She stepped outside of her home in Carson, California, and lit a bundle of white sage that she keeps in an abalone shell by the back door. Pulido, who is Apache, fanned the smoke around her with a feather.\u003c/p>\n\u003cp>She was preparing to make quilt squares for a project to honor people who were \u003ca href=\"https://www.kqed.org/news/11965926/survivors-of-californias-forced-sterilization-denied-reparations\">forcibly sterilized at state prisons in California\u003c/a>. A survivor herself, she said she was searching for a way to release the hurt and heartache.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In 2005, while she was incarcerated at Valley State Prison in California’s Central Valley, a doctor ordered a hysterectomy without her consent.\u003c/p>\n\u003cp>“This guy really thought that he could play God and decide who was worthy and who wasn’t,” Pulido said.\u003c/p>\n\u003cp>Pulido, 59, was released in 2022. She spends her days caring for her mother, who has dementia. She also works in her stepfather’s appliance repair shop and volunteers with advocacy organizations.\u003c/p>\n\u003cp>In February 2023, she learned that one of the organizations she volunteers for, the California Coalition for Women Prisoners, or CCWP, was organizing a memorial quilt for prison sterilization survivors. She said it was an opportunity to let go of her animosity.\u003c/p>\n\u003cp>“Even though he took something that I can never get back, my spirit still felt free to heal and move on,” Pulido said.\u003c/p>\n\u003cp>Advocates and survivors say the quilt is a response to widespread disappointment over California’s implementation of a 2021 reparations law intended to make amends for a shameful chapter of the state’s history. The historic legislation allocated $4.5 million in reparative compensation to survivors who were forcibly sterilized in state prisons, state-run hospitals, homes and institutions.\u003c/p>\n\u003cp>Pulido is one of 573 people who applied. Her application was approved, and she received $35,000. However, as of March 5, just 115 applicants had been approved. The two-year program has been criticized by dozens of advocates, including CCWP and even those who drafted the bill, because of the interpretation of the reparations law. Roughly 70% of applicants were rejected.\u003c/p>\n\u003cp>[aside label=\"more reparations stories\" postID=\"news_12008246,news_11965926\"]The law also distributed $1 million between three state agencies to commission memorials that mark the harm caused by forced or involuntary sterilizations. The process required consultation with survivors and advocates. However, a review of the state’s memorialization efforts by UC Berkeley’s Investigative Reporting Program and KQED revealed that after making minimal progress in its first year the state rewrote its contracts to eliminate community engagement requirements that it had apparently failed to meet.\u003c/p>\n\u003cp>This story’s reporting is based on multiple public records requests, more than 600 pages of documents, and interviews with lawmakers, public officials and prison representatives. In interviews, advocates and survivors told KQED they feel excluded and disrespected.\u003c/p>\n\u003cp>“[The memorialization process] echoes what we saw across the whole program, which was a following of the letter of the law and not the spirit of the law,” said Jennifer James, an associate professor of sociology at UCSF and member of CCWP.\u003c/p>\n\u003ch2>‘Revictimized and silenced again’\u003c/h2>\n\u003cp>The memorial funding went to the three state agencies that allowed the forced sterilizations to occur: the California Department of Corrections and Rehabilitation, the California Department of State Hospitals and the California Department of Developmental Services. The agencies were charged with leading a collaborative memorialization process that would “acknowledge the wrongful sterilization of thousands of vulnerable people,” according to the legislation.\u003c/p>\n\u003cp>In their 2022 contracts with the California Victim Compensation Board, which oversees the reparations program, the state agencies were required to hold regular meetings, submit quarterly progress reports and create project teams that included survivors and advocates. Roughly one year later, the agencies had not fulfilled any of those requirements.\u003c/p>\n\u003cp>Instead of being held accountable by the compensation board, the agency’s contracts with the compensation board were rewritten.\u003c/p>\n\u003cp>The revised contracts reduced opportunities for community participation and transparency, according to KQED’s analysis of the original and revised contracts. For example, the requirement for agencies, survivors and advocates to meet “weekly or monthly to discuss and finalize the design, location and language that will appear on the markers or plaques” was deleted, as was the stipulation for agencies to provide quarterly reports.\u003c/p>\n\u003cp>When asked about the changes to the memorialization contracts, the compensation board said in a statement that “the contracts were amended to better reflect the roles and responsibilities of each department as described in state law. CalVCB’s statutory role is strictly fiduciary.”\u003c/p>\n\u003cp>Additionally, the funds originally earmarked for memorials have been almost cut in half to $550,000. It’s unclear how any unspent money will be used.\u003c/p>\n\u003cp>The state allocated $7.5 million to the two-year program, with $4.5 million earmarked for compensation, $1 million for memorialization and $2 million for program administration and outreach. Each individual whose application is approved receives $15,000. A second and final payment of $20,000, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240SB143\">signed into law by Gov. Gavin Newsom\u003c/a> in September 2023, will be processed by October. Up to $1 million of any remaining compensation funds could be extended for survivors if legislation is passed in the next few years.\u003c/p>\n\u003cp>When reparations advocates passed the legislation, they envisioned a collaborative and reparative process with the state where survivors, activists and community members could shape a memorial using the artists and materials they selected. Now advocates and survivors like Kelli Dillon, an advisor of the reparations bill, say they feel cheated.\u003c/p>\n\u003cp>“We thought we were going to be in partnership [with these agencies], and we were totally revictimized and silenced again,” said Dillon, who was coercively sterilized in 2001 at Central California Women’s Facility and was approved for reparations.\u003c/p>\n\u003cfigure id=\"attachment_11976953\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11976953\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">After feeling dismissed by the state, forced sterilization survivors and advocates created their own memorialization project: a quilt centered around a theme of healing and growth. \u003ccite>(Kathryn Styer Martínez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Records show that CDCR contracted Boules Consulting in July 2022 at $100 an hour to facilitate 30 hours of meetings between the agencies and the community, but only one meeting was held. Three days before it took place, the compensation board invited the eight survivors whose applications had been approved.\u003c/p>\n\u003cp>The meeting was a critical turning point. There was a tense back and forth between agency representatives and advocates, who shut down the meeting because only two survivors could attend on such short notice. A survivor-centered memorialization process, advocates argued, was contingent on meaningful outreach, opportunities for participation, inclusivity and accessibility.\u003c/p>\n\u003cp>Agency representatives postponed the meeting so more survivors could attend. Instead, according to records obtained through a public records request, CDCR’s Chief of Legislative Affairs, Sydney Tanimoto, emailed Boules Consulting to say there had been a “change of plans.” CDCR would move to a survey format instead of virtual meetings.\u003c/p>\n\u003cp>“The Administration pivoted to a survey model to address accessibility concerns raised by stakeholders as part of the initial stakeholder meeting,” Terri Hardy, a CDCR press secretary, said in a statement to KQED.\u003c/p>\n\u003cp>Survivors and advocates were deeply troubled by the decision.\u003c/p>\n\u003cp>“It could have been a historic moment where people who were greatly harmed could have gained a form of reparation through the process and that was lost,” said Cynthia Chandler, an attorney in Alameda County District Attorney Pamela Price’s office who helped draft the reparations law. “That can’t possibly happen through a survey.”\u003c/p>\n\u003cp>A short questionnaire was sent to a dozen advocates and survivors to assess their visual, auditory and language needs to participate in the survey process. Advocates with expertise in disability rights who had attended the meeting were not consulted, according to Silvia Yee, public policy director at Disability Rights Education and Defense Fund.\u003c/p>\n\u003cp>The first survey related to the design, location and language of the memorials was sent to 24 survivors whose applications had been approved. Based on six responses, the consultant wrote a final recommendation report suggesting the memorial be placed in front of the state capital and CDCR headquarters. A second survey, related to the language for the memorials was sent nearly five months later to 94 survivors. About a third responded.\u003c/p>\n\u003cp>Now, agencies say that they plan to install plaques, benches and gazebos at nine facilities where the sterilizations took place. As of March 26, the agencies had spent roughly $170,000. By the end of its contract, Boules Consulting had charged CDCR $9,900 for the work.\u003c/p>\n\u003cp>In response to KQED’s findings, the four state agencies sent a joint statement, saying that they “have worked together in partnership to meet and surpass the requirements established in the legislation.”\u003c/p>\n\u003cp>“All four departments recognized stakeholder input was a critical part of the process,” the statement continued. “Each department worked with CalVCB to actively engage in outreach efforts by using information collected and conducting targeted searches in hopes of reaching more survivors.”\u003c/p>\n\u003cp>Pulido said she never received a survey.\u003c/p>\n\u003cp>“It feels cold,” she said. “We should have been asked what kind of memorial we wanted.”\u003c/p>\n\u003cp>She said that if she had been asked, she would have replied that she’d like the memorial plaque to carry her name.\u003c/p>\n\u003cp>“I want them to know that I was victimized,” she said. “Remember me. Remember my fight and what I went through.”\u003c/p>\n\u003cp>Survivors of prison sterilization aren’t the only ones frustrated by the state’s memorialization efforts. Between 1909 and 1979, at least 20,000 Californians — disproportionately women and racial minorities — were forcibly sterilized while at state-run homes and hospitals.\u003c/p>\n\u003cp>The state’s memorialization plans don’t include any markers at Pacific Colony, a former state hospital. This upsets Stacy Cordova, whose great-aunt, Mary Franco, was sterilized when she was 13 at Pacific Colony in 1934. Franco had been institutionalized after being molested by a neighbor. She was labeled a “sex delinquent” and “low moron,” according to facility records reviewed by KQED.\u003c/p>\n\u003cp>Cordova said she never received a survey. “Why have I never been contacted?” she said. “It really makes me sad that this promise has gone unfulfilled.”\u003c/p>\n\u003cfigure id=\"attachment_11981912\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11981912\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Stacy Cordova, at her home in Azusa on Feb. 11, 2024, looks through records from Pacific Colony, where her great-aunt was forcibly sterilized in 1934 when she was 13. \u003ccite>(Cayla Mihalovich for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Cordova, a special education teacher who lives in Azusa, made her own memorial. She created a historical radio project titled “\u003ca href=\"http://www.americanhistoryeugenix.com/\">American History EugeniX\u003c/a>” to be used as a curriculum in high school and college classes. She will share the histories of people who were sterilized in the 1920s and 1930s based on eugenics records she found in the California State Archives. She hopes to launch the project this month.\u003c/p>\n\u003ch2>‘You have to gather stories’\u003c/h2>\n\u003cp>After the reparations law was passed, advocates and researchers tried to guard against the exclusion many now feel. They prepared a guidance document for the state agencies to follow as memorials were created, noting that including community input, specifically from survivors and their descendants, was crucial to the process.\u003c/p>\n\u003cp>An omission of survivor input, the document stated, “conveys not only an ugly message about state power, but ultimately will constitute a failure of contemporary agencies to properly acknowledge their role in past wrongs and harms.”\u003c/p>\n\u003cp>The document provided examples of memorialization projects from around the world, which are seen as successful because survivors were “active partners in the conceptualization and placement.” Advocates pointed to Los Angeles General Medical Center’s “Sobrevivir,” which recognizes hundreds of survivors who were forcibly sterilized at the hospital during the 1960s and 1970s.\u003c/p>\n\u003cp>Artist Phung Huynh made “Sobrevivir,” a monument with roses and praying hands etched into steel, with a budget of roughly $100,000. The flat disk is in the medical center’s courtyard. Huynh said she spent a year gathering input on what her piece should look like through open forums and correspondence with descendants of survivors and activists.\u003c/p>\n\u003cp>“You have to gather stories, be sensitive and thoughtful because it’s going to live in the community that it’s serving,” Huynh said of public art. “They have to feel like it represents who they are and the specific history that we’re trying to remember.”\u003c/p>\n\u003cp>[aside label='More Reparations Stories' postID='news_11981271,news_11975584,news_11961026']Alexandra Minna Stern, a UCLA humanities professor and the founder of the Sterilization and Social Justice Lab, helped draft the guidance document. She said the state has failed to engage survivors. Her lab has consulted on numerous memorialization efforts for survivors of eugenics-era sterilizations, including in Indiana and North Carolina.\u003c/p>\n\u003cp>“It’s frustrating to me that the state has taken over the memorialization efforts and turned it into plaques that will be [inscribed] with language they wrote and the coalition responded to,” Stern said. “Memorialization should be more than just plaques.”\u003c/p>\n\u003cp>After feeling dismissed by the state, survivors and advocates with CCWP met in January 2023 to discuss ideas for creating their own memorialization project. They landed on a memorial quilt centered around a theme of healing and growth.\u003c/p>\n\u003cp>“We are upset and angry,” said Diana Block, an advocate at CCWP. “But we chose to put our energy into developing something positive.”\u003c/p>\n\u003cp>They spent a year collecting handmade quilt squares from over 100 survivors and their supporters. Some advocates hosted quilt-making parties. Others who are currently incarcerated crocheted squares of their own.\u003c/p>\n\u003cp>Pulido sent her squares to Linda Evans, a formerly incarcerated quiltmaker and CCWP member, who assembled the 5-foot-long, 20-block quilt. It is bordered by red fabric and features images such as a lopsided heart, a peace sign and butterflies that envelop words like “hope” and “lies.”\u003c/p>\n\u003cp>The remaining squares will be assembled into an afghan by Chyrl Lamar, a formerly incarcerated CCWP member.\u003c/p>\n\u003cp>This spring, survivors and advocates of CCWP hope to bring the completed memorial quilt, called “Together We Rise, Together We Heal,” to the Central California Women’s Facility in Chowchilla, California, where many of the illegal sterilizations occurred. From there, the community-led memorial will travel around the country to libraries, prisons, museums and state capitals to serve as a centerpiece for education and conversation.\u003c/p>\n\u003cp>“History disappears,” Evans said. “If we don’t capture it and keep it in the present, we have a real danger of repeating terrible things that happened in the past.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Cayla Mihalovich is a reporter with the Investigative Reporting Program at the UC Berkeley Graduate School of Journalism.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>This story was originally published in April 2024. The audio was first broadcast Oct. 11, 2024. Since the story first published, the compensation board has now approved a total of 118 applicants. It has denied 432 – or roughly 75% – of applicants. State agencies have now spent roughly $180,000 on memorials to survivors of state-sponsored sterilization. Dr. James Heinrich passed away in January 2024.Gov. Gavin Newsom \u003ca href=\"https://www.kqed.org/news/12008246/i-would-have-been-a-great-mom-california-finally-pays-reparations-to-woman-it-sterilized\">signed a bill on Sept. 30 \u003c/a>that gives more time to survivors of state-sponsored sterilization to appeal their case if they were denied reparations. They have until Jan. 1, 2025 to file an appeal.\u003c/em>\u003c/p>\n\u003cp>\u003cem>Listen to this and more in-depth storytelling by subscribing to \u003ca href=\"https://www.kqed.org/californiareportmagazine\">The California Report Magazine podcast\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">O\u003c/span>\u003c/p>\u003cp>ne morning last spring, Moonlight Pulido called on rituals drawn from her Native American spirituality to confront a painful experience.\u003c/p>\n\u003cp>She stepped outside of her home in Carson, California, and lit a bundle of white sage that she keeps in an abalone shell by the back door. Pulido, who is Apache, fanned the smoke around her with a feather.\u003c/p>\n\u003cp>She was preparing to make quilt squares for a project to honor people who were \u003ca href=\"https://www.kqed.org/news/11965926/survivors-of-californias-forced-sterilization-denied-reparations\">forcibly sterilized at state prisons in California\u003c/a>. A survivor herself, she said she was searching for a way to release the hurt and heartache.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In 2005, while she was incarcerated at Valley State Prison in California’s Central Valley, a doctor ordered a hysterectomy without her consent.\u003c/p>\n\u003cp>“This guy really thought that he could play God and decide who was worthy and who wasn’t,” Pulido said.\u003c/p>\n\u003cp>Pulido, 59, was released in 2022. She spends her days caring for her mother, who has dementia. She also works in her stepfather’s appliance repair shop and volunteers with advocacy organizations.\u003c/p>\n\u003cp>In February 2023, she learned that one of the organizations she volunteers for, the California Coalition for Women Prisoners, or CCWP, was organizing a memorial quilt for prison sterilization survivors. She said it was an opportunity to let go of her animosity.\u003c/p>\n\u003cp>“Even though he took something that I can never get back, my spirit still felt free to heal and move on,” Pulido said.\u003c/p>\n\u003cp>Advocates and survivors say the quilt is a response to widespread disappointment over California’s implementation of a 2021 reparations law intended to make amends for a shameful chapter of the state’s history. The historic legislation allocated $4.5 million in reparative compensation to survivors who were forcibly sterilized in state prisons, state-run hospitals, homes and institutions.\u003c/p>\n\u003cp>Pulido is one of 573 people who applied. Her application was approved, and she received $35,000. However, as of March 5, just 115 applicants had been approved. The two-year program has been criticized by dozens of advocates, including CCWP and even those who drafted the bill, because of the interpretation of the reparations law. Roughly 70% of applicants were rejected.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The law also distributed $1 million between three state agencies to commission memorials that mark the harm caused by forced or involuntary sterilizations. The process required consultation with survivors and advocates. However, a review of the state’s memorialization efforts by UC Berkeley’s Investigative Reporting Program and KQED revealed that after making minimal progress in its first year the state rewrote its contracts to eliminate community engagement requirements that it had apparently failed to meet.\u003c/p>\n\u003cp>This story’s reporting is based on multiple public records requests, more than 600 pages of documents, and interviews with lawmakers, public officials and prison representatives. In interviews, advocates and survivors told KQED they feel excluded and disrespected.\u003c/p>\n\u003cp>“[The memorialization process] echoes what we saw across the whole program, which was a following of the letter of the law and not the spirit of the law,” said Jennifer James, an associate professor of sociology at UCSF and member of CCWP.\u003c/p>\n\u003ch2>‘Revictimized and silenced again’\u003c/h2>\n\u003cp>The memorial funding went to the three state agencies that allowed the forced sterilizations to occur: the California Department of Corrections and Rehabilitation, the California Department of State Hospitals and the California Department of Developmental Services. The agencies were charged with leading a collaborative memorialization process that would “acknowledge the wrongful sterilization of thousands of vulnerable people,” according to the legislation.\u003c/p>\n\u003cp>In their 2022 contracts with the California Victim Compensation Board, which oversees the reparations program, the state agencies were required to hold regular meetings, submit quarterly progress reports and create project teams that included survivors and advocates. Roughly one year later, the agencies had not fulfilled any of those requirements.\u003c/p>\n\u003cp>Instead of being held accountable by the compensation board, the agency’s contracts with the compensation board were rewritten.\u003c/p>\n\u003cp>The revised contracts reduced opportunities for community participation and transparency, according to KQED’s analysis of the original and revised contracts. For example, the requirement for agencies, survivors and advocates to meet “weekly or monthly to discuss and finalize the design, location and language that will appear on the markers or plaques” was deleted, as was the stipulation for agencies to provide quarterly reports.\u003c/p>\n\u003cp>When asked about the changes to the memorialization contracts, the compensation board said in a statement that “the contracts were amended to better reflect the roles and responsibilities of each department as described in state law. CalVCB’s statutory role is strictly fiduciary.”\u003c/p>\n\u003cp>Additionally, the funds originally earmarked for memorials have been almost cut in half to $550,000. It’s unclear how any unspent money will be used.\u003c/p>\n\u003cp>The state allocated $7.5 million to the two-year program, with $4.5 million earmarked for compensation, $1 million for memorialization and $2 million for program administration and outreach. Each individual whose application is approved receives $15,000. A second and final payment of $20,000, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240SB143\">signed into law by Gov. Gavin Newsom\u003c/a> in September 2023, will be processed by October. Up to $1 million of any remaining compensation funds could be extended for survivors if legislation is passed in the next few years.\u003c/p>\n\u003cp>When reparations advocates passed the legislation, they envisioned a collaborative and reparative process with the state where survivors, activists and community members could shape a memorial using the artists and materials they selected. Now advocates and survivors like Kelli Dillon, an advisor of the reparations bill, say they feel cheated.\u003c/p>\n\u003cp>“We thought we were going to be in partnership [with these agencies], and we were totally revictimized and silenced again,” said Dillon, who was coercively sterilized in 2001 at Central California Women’s Facility and was approved for reparations.\u003c/p>\n\u003cfigure id=\"attachment_11976953\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11976953\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240222-REPARATIONS-QUILT-KSM-07-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">After feeling dismissed by the state, forced sterilization survivors and advocates created their own memorialization project: a quilt centered around a theme of healing and growth. \u003ccite>(Kathryn Styer Martínez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Records show that CDCR contracted Boules Consulting in July 2022 at $100 an hour to facilitate 30 hours of meetings between the agencies and the community, but only one meeting was held. Three days before it took place, the compensation board invited the eight survivors whose applications had been approved.\u003c/p>\n\u003cp>The meeting was a critical turning point. There was a tense back and forth between agency representatives and advocates, who shut down the meeting because only two survivors could attend on such short notice. A survivor-centered memorialization process, advocates argued, was contingent on meaningful outreach, opportunities for participation, inclusivity and accessibility.\u003c/p>\n\u003cp>Agency representatives postponed the meeting so more survivors could attend. Instead, according to records obtained through a public records request, CDCR’s Chief of Legislative Affairs, Sydney Tanimoto, emailed Boules Consulting to say there had been a “change of plans.” CDCR would move to a survey format instead of virtual meetings.\u003c/p>\n\u003cp>“The Administration pivoted to a survey model to address accessibility concerns raised by stakeholders as part of the initial stakeholder meeting,” Terri Hardy, a CDCR press secretary, said in a statement to KQED.\u003c/p>\n\u003cp>Survivors and advocates were deeply troubled by the decision.\u003c/p>\n\u003cp>“It could have been a historic moment where people who were greatly harmed could have gained a form of reparation through the process and that was lost,” said Cynthia Chandler, an attorney in Alameda County District Attorney Pamela Price’s office who helped draft the reparations law. “That can’t possibly happen through a survey.”\u003c/p>\n\u003cp>A short questionnaire was sent to a dozen advocates and survivors to assess their visual, auditory and language needs to participate in the survey process. Advocates with expertise in disability rights who had attended the meeting were not consulted, according to Silvia Yee, public policy director at Disability Rights Education and Defense Fund.\u003c/p>\n\u003cp>The first survey related to the design, location and language of the memorials was sent to 24 survivors whose applications had been approved. Based on six responses, the consultant wrote a final recommendation report suggesting the memorial be placed in front of the state capital and CDCR headquarters. A second survey, related to the language for the memorials was sent nearly five months later to 94 survivors. About a third responded.\u003c/p>\n\u003cp>Now, agencies say that they plan to install plaques, benches and gazebos at nine facilities where the sterilizations took place. As of March 26, the agencies had spent roughly $170,000. By the end of its contract, Boules Consulting had charged CDCR $9,900 for the work.\u003c/p>\n\u003cp>In response to KQED’s findings, the four state agencies sent a joint statement, saying that they “have worked together in partnership to meet and surpass the requirements established in the legislation.”\u003c/p>\n\u003cp>“All four departments recognized stakeholder input was a critical part of the process,” the statement continued. “Each department worked with CalVCB to actively engage in outreach efforts by using information collected and conducting targeted searches in hopes of reaching more survivors.”\u003c/p>\n\u003cp>Pulido said she never received a survey.\u003c/p>\n\u003cp>“It feels cold,” she said. “We should have been asked what kind of memorial we wanted.”\u003c/p>\n\u003cp>She said that if she had been asked, she would have replied that she’d like the memorial plaque to carry her name.\u003c/p>\n\u003cp>“I want them to know that I was victimized,” she said. “Remember me. Remember my fight and what I went through.”\u003c/p>\n\u003cp>Survivors of prison sterilization aren’t the only ones frustrated by the state’s memorialization efforts. Between 1909 and 1979, at least 20,000 Californians — disproportionately women and racial minorities — were forcibly sterilized while at state-run homes and hospitals.\u003c/p>\n\u003cp>The state’s memorialization plans don’t include any markers at Pacific Colony, a former state hospital. This upsets Stacy Cordova, whose great-aunt, Mary Franco, was sterilized when she was 13 at Pacific Colony in 1934. Franco had been institutionalized after being molested by a neighbor. She was labeled a “sex delinquent” and “low moron,” according to facility records reviewed by KQED.\u003c/p>\n\u003cp>Cordova said she never received a survey. “Why have I never been contacted?” she said. “It really makes me sad that this promise has gone unfulfilled.”\u003c/p>\n\u003cfigure id=\"attachment_11981912\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11981912\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240404-FORCED-STERILIZATION-STACY_04-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Stacy Cordova, at her home in Azusa on Feb. 11, 2024, looks through records from Pacific Colony, where her great-aunt was forcibly sterilized in 1934 when she was 13. \u003ccite>(Cayla Mihalovich for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Cordova, a special education teacher who lives in Azusa, made her own memorial. She created a historical radio project titled “\u003ca href=\"http://www.americanhistoryeugenix.com/\">American History EugeniX\u003c/a>” to be used as a curriculum in high school and college classes. She will share the histories of people who were sterilized in the 1920s and 1930s based on eugenics records she found in the California State Archives. She hopes to launch the project this month.\u003c/p>\n\u003ch2>‘You have to gather stories’\u003c/h2>\n\u003cp>After the reparations law was passed, advocates and researchers tried to guard against the exclusion many now feel. They prepared a guidance document for the state agencies to follow as memorials were created, noting that including community input, specifically from survivors and their descendants, was crucial to the process.\u003c/p>\n\u003cp>An omission of survivor input, the document stated, “conveys not only an ugly message about state power, but ultimately will constitute a failure of contemporary agencies to properly acknowledge their role in past wrongs and harms.”\u003c/p>\n\u003cp>The document provided examples of memorialization projects from around the world, which are seen as successful because survivors were “active partners in the conceptualization and placement.” Advocates pointed to Los Angeles General Medical Center’s “Sobrevivir,” which recognizes hundreds of survivors who were forcibly sterilized at the hospital during the 1960s and 1970s.\u003c/p>\n\u003cp>Artist Phung Huynh made “Sobrevivir,” a monument with roses and praying hands etched into steel, with a budget of roughly $100,000. The flat disk is in the medical center’s courtyard. Huynh said she spent a year gathering input on what her piece should look like through open forums and correspondence with descendants of survivors and activists.\u003c/p>\n\u003cp>“You have to gather stories, be sensitive and thoughtful because it’s going to live in the community that it’s serving,” Huynh said of public art. “They have to feel like it represents who they are and the specific history that we’re trying to remember.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Alexandra Minna Stern, a UCLA humanities professor and the founder of the Sterilization and Social Justice Lab, helped draft the guidance document. She said the state has failed to engage survivors. Her lab has consulted on numerous memorialization efforts for survivors of eugenics-era sterilizations, including in Indiana and North Carolina.\u003c/p>\n\u003cp>“It’s frustrating to me that the state has taken over the memorialization efforts and turned it into plaques that will be [inscribed] with language they wrote and the coalition responded to,” Stern said. “Memorialization should be more than just plaques.”\u003c/p>\n\u003cp>After feeling dismissed by the state, survivors and advocates with CCWP met in January 2023 to discuss ideas for creating their own memorialization project. They landed on a memorial quilt centered around a theme of healing and growth.\u003c/p>\n\u003cp>“We are upset and angry,” said Diana Block, an advocate at CCWP. “But we chose to put our energy into developing something positive.”\u003c/p>\n\u003cp>They spent a year collecting handmade quilt squares from over 100 survivors and their supporters. Some advocates hosted quilt-making parties. Others who are currently incarcerated crocheted squares of their own.\u003c/p>\n\u003cp>Pulido sent her squares to Linda Evans, a formerly incarcerated quiltmaker and CCWP member, who assembled the 5-foot-long, 20-block quilt. It is bordered by red fabric and features images such as a lopsided heart, a peace sign and butterflies that envelop words like “hope” and “lies.”\u003c/p>\n\u003cp>The remaining squares will be assembled into an afghan by Chyrl Lamar, a formerly incarcerated CCWP member.\u003c/p>\n\u003cp>This spring, survivors and advocates of CCWP hope to bring the completed memorial quilt, called “Together We Rise, Together We Heal,” to the Central California Women’s Facility in Chowchilla, California, where many of the illegal sterilizations occurred. From there, the community-led memorial will travel around the country to libraries, prisons, museums and state capitals to serve as a centerpiece for education and conversation.\u003c/p>\n\u003cp>“History disappears,” Evans said. “If we don’t capture it and keep it in the present, we have a real danger of repeating terrible things that happened in the past.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Cayla Mihalovich is a reporter with the Investigative Reporting Program at the UC Berkeley Graduate School of Journalism.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "OUSD to Consider Using Entirety of Measure Y Funds to Address Campus Lead Crisis",
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"content": "\u003cp>The Oakland Unified Board of Education is reviewing a new proposal that would divert millions of dollars in unused funds from an infrastructure bond to address the lead \u003ca href=\"https://www.kqed.org/news/12002387/oakland-schools-official-calls-for-state-federal-help-after-lead-contamination-findings\">contamination\u003c/a> issue plaguing many of its schools.\u003c/p>\n\u003cp>Introduced to the board on Wednesday, the resolution proposes redirecting funding from Measure Y, a $35 million facilities bond passed by the city’s voters in 2020, to help address the problem.\u003c/p>\n\u003cp>It comes several months after district officials announced that elevated lead levels, well above the threshold set by the district, had \u003ca href=\"https://www.kqed.org/news/12002387/oakland-schools-official-calls-for-state-federal-help-after-lead-contamination-findings\">been detected in water sources\u003c/a> on the campuses of nearly two dozen schools.\u003c/p>\n\u003cp>On Sept. 30, a community coalition of students, teachers and parents rallied outside Oakland City Hall to protest what they called an unacceptable response from the district, which they said had taken far too long to notify families and was failing to address the issue with the urgency it deserved.\u003c/p>\n\u003cp>“Is this what our students deserve? Is that what should be allowed to happen? Does that show care for our students? No, it does not,” said Stuart Loebl, a teacher at Frick United Academy of Language — the campus with the highest lead levels — who urged the district to reprioritize the available funds.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Demonstrators also emphasized the potentially devastating health effects that can come from consuming elevated amounts of lead — such as brain and kidney damage, myalgia and other severe consequences.\u003c/p>\n\u003cp>Measure Y was initially intended for construction, demolition and renovation projects within the district, including major renovations to Skyline High School and Elmhurst Middle School and the demolition of the district’s abandoned headquarters near Lake Merritt. But none of those projects have started yet.\u003c/p>\n\u003cp>Board members Mike Hutchinson and Jorge Lerma, who authored the resolution, are proposing that the board amend the measure’s original spending plan, scrapping those projects and using the funding entirely for lead remediation.\u003c/p>\n\u003cp>[aside label=\"more on OUSD's lead crisis\" tag=\"ousd\"]The board is expected to vote on the resolution in the next two weeks.\u003c/p>\n\u003cp>“I am excited about the prospect of utilizing Measure Y funds for lead,” Loebl, the teacher, told KQED, emphasizing that this should be the district’s top infrastructure improvement priority. “This is a needed first step to address the crisis that is causing our students to be poisoned by lead in the water.”\u003c/p>\n\u003cp>But even if the board approves using the measure’s funds for lead treatment, it may not be enough to address the full scale of the problem — in a previous meeting, the district \u003ca href=\"https://www.kqed.org/news/12007326/lead-problems-in-oakland-schools-drinking-water-could-cost-over-50-million-to-fix\">estimated\u003c/a> that a complete remediation could cost as much as $53 million.\u003c/p>\n\u003cp>The board’s consideration of the proposal aligns with a landmark \u003ca href=\"https://www.nytimes.com/2024/10/08/climate/biden-epa-lead-pipes.html\">Biden administration announcement\u003c/a> on Tuesday, requiring virtually every water utility in the nation to install new pipes within the next 10 years.\u003c/p>\n\u003cp>Nate Landry, an OUSD parent and community organizer, says that if the board passes the resolution, he hopes the district will collaborate with his coalition in addressing the issue.\u003c/p>\n\u003cp>\u003cb>“\u003c/b>The question of what the actual remediation plan this measure pays for is something that I hope can be developed in partnership with the community,” he said. “That’s been a major focus of the demands that we released.”\u003c/p>\n\u003cp>Those demands include free blood testing for all OUSD students and employees, comprehensive testing of the soil and grass in playgrounds and other outdoor school areas, and an overhaul of water fixtures at all district schools. Coalition members have also urged the district to lower its threshold for shutting down a water source from 5 parts per billion to 0 parts.\u003c/p>\n\u003cp>Loebl, who attended Wednesday’s board meeting, has reservations about how the funds will be used, even if the proposal is approved.\u003c/p>\n\u003cp>“We shouldn’t be seeing this bond money being spent on filters,” Loebl said. “It should be spent on pipe repairs, on fixture replacements.”\u003c/p>\n\u003cp>Loebl and Landry also both expressed concerns that the district would not include the coalition in decisions about the use of the funds.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“It’s a true coalition in the sense that students are involved, teachers are involved, parents are involved. We have representatives from every union at OUSD who are involved,” Loebl said. “The idea that they might even consider doing any kind of lead legislation without consulting us would be a really big mistake.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Oakland Unified Board of Education is reviewing a new proposal that would divert millions of dollars in unused funds from an infrastructure bond to address the lead \u003ca href=\"https://www.kqed.org/news/12002387/oakland-schools-official-calls-for-state-federal-help-after-lead-contamination-findings\">contamination\u003c/a> issue plaguing many of its schools.\u003c/p>\n\u003cp>Introduced to the board on Wednesday, the resolution proposes redirecting funding from Measure Y, a $35 million facilities bond passed by the city’s voters in 2020, to help address the problem.\u003c/p>\n\u003cp>It comes several months after district officials announced that elevated lead levels, well above the threshold set by the district, had \u003ca href=\"https://www.kqed.org/news/12002387/oakland-schools-official-calls-for-state-federal-help-after-lead-contamination-findings\">been detected in water sources\u003c/a> on the campuses of nearly two dozen schools.\u003c/p>\n\u003cp>On Sept. 30, a community coalition of students, teachers and parents rallied outside Oakland City Hall to protest what they called an unacceptable response from the district, which they said had taken far too long to notify families and was failing to address the issue with the urgency it deserved.\u003c/p>\n\u003cp>“Is this what our students deserve? Is that what should be allowed to happen? Does that show care for our students? No, it does not,” said Stuart Loebl, a teacher at Frick United Academy of Language — the campus with the highest lead levels — who urged the district to reprioritize the available funds.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Demonstrators also emphasized the potentially devastating health effects that can come from consuming elevated amounts of lead — such as brain and kidney damage, myalgia and other severe consequences.\u003c/p>\n\u003cp>Measure Y was initially intended for construction, demolition and renovation projects within the district, including major renovations to Skyline High School and Elmhurst Middle School and the demolition of the district’s abandoned headquarters near Lake Merritt. But none of those projects have started yet.\u003c/p>\n\u003cp>Board members Mike Hutchinson and Jorge Lerma, who authored the resolution, are proposing that the board amend the measure’s original spending plan, scrapping those projects and using the funding entirely for lead remediation.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The board is expected to vote on the resolution in the next two weeks.\u003c/p>\n\u003cp>“I am excited about the prospect of utilizing Measure Y funds for lead,” Loebl, the teacher, told KQED, emphasizing that this should be the district’s top infrastructure improvement priority. “This is a needed first step to address the crisis that is causing our students to be poisoned by lead in the water.”\u003c/p>\n\u003cp>But even if the board approves using the measure’s funds for lead treatment, it may not be enough to address the full scale of the problem — in a previous meeting, the district \u003ca href=\"https://www.kqed.org/news/12007326/lead-problems-in-oakland-schools-drinking-water-could-cost-over-50-million-to-fix\">estimated\u003c/a> that a complete remediation could cost as much as $53 million.\u003c/p>\n\u003cp>The board’s consideration of the proposal aligns with a landmark \u003ca href=\"https://www.nytimes.com/2024/10/08/climate/biden-epa-lead-pipes.html\">Biden administration announcement\u003c/a> on Tuesday, requiring virtually every water utility in the nation to install new pipes within the next 10 years.\u003c/p>\n\u003cp>Nate Landry, an OUSD parent and community organizer, says that if the board passes the resolution, he hopes the district will collaborate with his coalition in addressing the issue.\u003c/p>\n\u003cp>\u003cb>“\u003c/b>The question of what the actual remediation plan this measure pays for is something that I hope can be developed in partnership with the community,” he said. “That’s been a major focus of the demands that we released.”\u003c/p>\n\u003cp>Those demands include free blood testing for all OUSD students and employees, comprehensive testing of the soil and grass in playgrounds and other outdoor school areas, and an overhaul of water fixtures at all district schools. Coalition members have also urged the district to lower its threshold for shutting down a water source from 5 parts per billion to 0 parts.\u003c/p>\n\u003cp>Loebl, who attended Wednesday’s board meeting, has reservations about how the funds will be used, even if the proposal is approved.\u003c/p>\n\u003cp>“We shouldn’t be seeing this bond money being spent on filters,” Loebl said. “It should be spent on pipe repairs, on fixture replacements.”\u003c/p>\n\u003cp>Loebl and Landry also both expressed concerns that the district would not include the coalition in decisions about the use of the funds.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“It’s a true coalition in the sense that students are involved, teachers are involved, parents are involved. We have representatives from every union at OUSD who are involved,” Loebl said. “The idea that they might even consider doing any kind of lead legislation without consulting us would be a really big mistake.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Proposition 35 Aims to Improve Health Care for Low-Income Californians. Critics Warn it Could Backfire",
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"content": "\u003cp>Among the blitz of election ads flooding TV, social media and street corners, you won’t see any opposition to a \u003ca href=\"https://calmatters.org/politics/elections/2024/10/california-propositions-november-election/\" target=\"_blank\" rel=\"noreferrer noopener\">ballot measure\u003c/a> proposing to lock in billions of dollars to pay doctors more for treating low-income patients.\u003c/p>\n\u003cp>However, opponents of \u003ca href=\"https://calmatters.org/california-voter-guide-2024/propositions/prop-35-health-care-tax/\" target=\"_blank\" rel=\"noreferrer noopener\">Proposition 35\u003c/a> have a warning, even if they don’t have the money to pay for ads: The measure could backfire and cause the state to lose billions in federal funding.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/health/2024/07/medi-cal-mco-tax-initiative/\" target=\"_blank\" rel=\"noreferrer noopener\">Proposition 35 would take an existing tax on health insurance plans\u003c/a> and use the money to increase payment to doctors and other providers who see Medi-Cal patients. Its supporters have \u003ca href=\"https://powersearch.sos.ca.gov/advanced.php\" target=\"_blank\" rel=\"noreferrer noopener\">raised $50 million\u003c/a>, drawing from groups representing hospitals, doctors and insurers.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/tag/medi-cal/\" target=\"_blank\" rel=\"noreferrer noopener\">Medi-Cal\u003c/a>, the subsidized insurance plan serving some 14 million Californians, has ballooned in size over the past decade with increased eligibility and benefits. But those changes haven’t come with a commensurate increase in payment to doctors.\u003c/p>\n\u003cp>As a result, health care providers and advocates say too few doctors accept Medi-Cal, leaving patients with nowhere to turn.\u003c/p>\n\u003cp>According to the \u003ca href=\"https://www.ppic.org/publication/ppic-statewide-survey-californians-and-their-government-september-2024/\" target=\"_blank\" rel=\"noreferrer noopener\">Public Policy Institute of California\u003c/a>, the measure is leading and likely to pass.\u003c/p>\n\u003cp>However, opponents, represented by a small coalition of community health advocates, seniors and activists for good governance, say the details of the proposition put the state at risk of losing billions in federal funding.\u003c/p>\n\u003cp>That’s because the federal government, under both the Biden and Trump administrations, has warned California that its tax on health plans to fund Medi-Cal services takes unfair advantage of a loophole in federal regulations. The federal Centers for Medicare and Medicaid Services intends to close that loophole, \u003ca href=\"https://www.dhcs.ca.gov/Documents/CA-MCO-Tax-Waiver.pdf\">regulators wrote in a letter\u003c/a> to California officials late last year.\u003c/p>\n\u003cp>“This is the fatal flaw of this initiative,” said Kiran Savage-Sangwan, executive director of the California Pan-Ethnic Health Coalition, which is leading the opposition. “We can all have opinions on how to spend the money, but we have to raise the funds first.”\u003c/p>\n\u003cp>The problem, opponents say, lies in how California taxes health plans and how Proposition 35 limits changes in the future.\u003c/p>\n\u003cp>Right now, the Managed Care Organization Tax, also known as the MCO Tax, generates revenue for Medi-Cal by taxing health insurers that serve both Medi-Cal and commercially insured patients. The federal government gives California a dollar-for-dollar match to whatever the tax raises funds. For Proposition 35, that’s an estimated $7 billion to $8 billion annually through 2027.\u003c/p>\n\u003cp>However, California has historically placed the majority of the tax burden on Medi-Cal insurers and not commercial insurers. In its letter to state officials, federal regulators said Medi-Cal plans represent 50% of all insured people but bear “99% of the total tax burden.” That is at odds with the spirit of the law, which is meant to redistribute revenue from commercial insurers to Medi-Cal plans, regulators wrote.\u003c/p>\n\u003cp>Proposition 35 would cap the tax on commercial insurers at a minimal rate. Any attempts to modify the tax would have to go back to the ballot box or be approved by three-fourths of the Legislature. Opponents say that means federal rule changes requiring the commercial tax to be more equal to the Medi-Cal tax will force the state to reduce taxes on the Medi-Cal plans.\u003c/p>\n\u003cp>“The end result of that is when the federal government makes good on their promise to change the rules on this tax, the revenue we raise from this tax will be dramatically reduced, and we would leave billions of dollars on the table,” Savage-Sangwan said.\u003c/p>\n\u003cp>Proponents of the measure said this argument is false but did not provide details. They say Proposition 35 will make the Medi-Cal program more stable and higher rates will encourage more providers to see low-income patients.\u003c/p>\n\u003cp>California’s Medi-Cal reimbursement rates fall in the bottom third compared to all other states, according to the \u003ca href=\"https://www.kff.org/medicaid/state-indicator/medicaid-to-medicare-fee-index/?currentTimeframe=0&sortModel=%7B%22colId%22:%22All%20Services%22,%22sort%22:%22desc%22%7D\" target=\"_blank\" rel=\"noreferrer noopener\">Kaiser Family Foundation\u003c/a>, and \u003ca href=\"https://calmatters.org/health/2024/02/midwife-medi-cal/?series=no-deliveries-maternity-care\" target=\"_blank\" rel=\"noreferrer noopener\">rates for specific services like obstetrics\u003c/a> are among the lowest in the country.[aside label=\"2024 California Voter Guide\" link1='https://www.kqed.org/voterguide,Learn everything you need to cast an informed ballot for the 2024 general election' hero=https://cdn.kqed.org/wp-content/uploads/sites/80/2024/09/Aside-California-Voter-Guide-2024-General-Election-1200x1200-1.png]\u003c/p>\n\u003cp>“Prop. 35 is a critically needed investment to protect and expand access to care for Medi-Cal patients and all Californians,” said Molly Weedn, spokesperson for the Yes on Prop. 35 campaign, in a statement. “The principal purpose behind Prop. 35 is to provide stability and predictability… to address the significant shortfall of providers who can see Medi-Cal patients.”\u003c/p>\n\u003cp>The California Association of Health Plans said that it did not ask for the commercial tax cap in the proposition and that it has historically supported this tax structure to pay for Medi-Cal. A higher tax on commercial plans could increase premiums.\u003c/p>\n\u003ch2>Where is Gov. Newsom on Proposition 35?\u003c/h2>\n\u003cp>The largest donors to the yes campaign are the California Hospital Association, Global Medical Response, and the California Medical Association, which collectively donated $38 million. Opponents have raised no money, according to \u003ca href=\"https://powersearch.sos.ca.gov/advanced.php\" target=\"_blank\" rel=\"noreferrer noopener\">state campaign finance records\u003c/a>.\u003c/p>\n\u003cp>Gov. Gavin Newsom has not taken a formal stance on the measure, although he said at a press conference in July that he’s concerned about how it would lock in tax revenue for a single purpose. The state budget he signed that month shifted most of the tax revenue from the tax on health insurers into the general fund to pay for the Medi-Cal program.[aside label=\"From the 2024 Voter Guide\" link1='https://www.kqed.org/voterguide/california,Learn about the California Propositions' hero=https://cdn.kqed.org/wp-content/uploads/sites/80/2024/09/Aside-California-Propositions-2024-General-Election-1200x1200-1.png]\u003c/p>\n\u003cp>If voters approve Proposition 35, the state would face a $2.6 billion deficit in the current budget, which relies on the tax to fill in gaps. That deficit would increase to $11.9 billion over the next three budget cycles, according to an analysis from the Department of Finance.\u003c/p>\n\u003cp>“This initiative hamstrings our ability to have the kind of flexibility that’s required at the moment we’re living in. I haven’t come out publicly against it. But I’m implying a point of view. Perhaps you can read between those many, many lines,” \u003ca href=\"https://calmatters.org/newsletter/newsom-ballot-measures/\" target=\"_blank\" rel=\"noreferrer noopener\">Newsom said at the press conference\u003c/a>.\u003c/p>\n\u003cp>Newsom’s office did not respond to multiple requests on whether he would formally oppose the measure.\u003c/p>\n\u003cp>Savage-Sangwan said the opposition had not solicited any money for their campaign.\u003c/p>\n\u003cp>“We are using the very small megaphone that we do have to just get the facts out,” she said.\u003c/p>\n\u003ch2>Trade-offs in 2024 health care ballot measure\u003c/h2>\n\u003cp>The political split over Proposition 35 is unusual. The measure’s opponents are often on the same side as its supporters when it comes to health policy issues in the Capitol. But community health advocates say they’re speaking up because the future ramifications of the initiative are too risky.\u003c/p>\n\u003cp>“We want to make clear that the goals of the prop are goals we agree with. We recognize our providers in Medi-Cal are paid far too little, and that disproportionately impacts people of color, children of color especially,” said Mayra Alvarez, president of The Children’s Partnership, another opposing group.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Some lawmakers agree. During multiple budget hearings, Sen. Caroline Menjivar, a Democrat from Van Nuys, came to oppose the proposition in part because the industry organizations that negotiated who would get money from the tax left out “community providers” and those “who don’t have high-paid lobbyists.”\u003c/p>\n\u003cp>“By listening to those with boots on the ground, the legislature developed a plan to equitably address many Medi-Cal concerns over the next few years,” Menjivar said in a statement from the opposition campaign.\u003c/p>\n\u003cp>The tax is expected to generate more than $30 billion over the next four years. The budget Newsom signed puts most of the money in the state’s general spending account but sets aside roughly $2 billion to increase rates for services, including community health workers, private duty nursing, adult and children’s day centers and children at risk of \u003ca href=\"https://calmatters.org/health/2023/07/medi-cal-eligibility-california-review/\" target=\"_blank\" rel=\"noreferrer noopener\">automatic Medi-Cal disenrollment\u003c/a>. If Proposition 35 passes, different groups will get rate increases.\u003c/p>\n\u003cp>Weedn with the Yes on Prop. 35 campaign said the initiative won’t automatically cause cuts if it passes. It would be up to the Legislature to decide how to pay for the programs opponents are worried about, she said, and that the initiative provides about $2 billion of flexible dollars annually for legislative priorities.\u003c/p>\n\u003cp>\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15%E2%80%AFAM.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-12008728\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15%E2%80%AFAM.png\" alt='A screenshot of a graph that reads \"Which California health providers get rate increases under the MCO tax?\"' width=\"1258\" height=\"1346\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15 AM.png 1258w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15 AM-800x856.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15 AM-1020x1091.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15 AM-160x171.png 160w\" sizes=\"auto, (max-width: 1258px) 100vw, 1258px\">\u003c/a>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Proposition 35 would take an existing tax on health insurance plans and use the money to increase payment to doctors who see Medi-Cal patients. Critics say it could backfire and cause the state to lose billions in federal funding.",
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"title": "Proposition 35 Aims to Improve Health Care for Low-Income Californians. Critics Warn it Could Backfire | KQED",
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"headline": "Proposition 35 Aims to Improve Health Care for Low-Income Californians. Critics Warn it Could Backfire",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Among the blitz of election ads flooding TV, social media and street corners, you won’t see any opposition to a \u003ca href=\"https://calmatters.org/politics/elections/2024/10/california-propositions-november-election/\" target=\"_blank\" rel=\"noreferrer noopener\">ballot measure\u003c/a> proposing to lock in billions of dollars to pay doctors more for treating low-income patients.\u003c/p>\n\u003cp>However, opponents of \u003ca href=\"https://calmatters.org/california-voter-guide-2024/propositions/prop-35-health-care-tax/\" target=\"_blank\" rel=\"noreferrer noopener\">Proposition 35\u003c/a> have a warning, even if they don’t have the money to pay for ads: The measure could backfire and cause the state to lose billions in federal funding.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/health/2024/07/medi-cal-mco-tax-initiative/\" target=\"_blank\" rel=\"noreferrer noopener\">Proposition 35 would take an existing tax on health insurance plans\u003c/a> and use the money to increase payment to doctors and other providers who see Medi-Cal patients. Its supporters have \u003ca href=\"https://powersearch.sos.ca.gov/advanced.php\" target=\"_blank\" rel=\"noreferrer noopener\">raised $50 million\u003c/a>, drawing from groups representing hospitals, doctors and insurers.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/tag/medi-cal/\" target=\"_blank\" rel=\"noreferrer noopener\">Medi-Cal\u003c/a>, the subsidized insurance plan serving some 14 million Californians, has ballooned in size over the past decade with increased eligibility and benefits. But those changes haven’t come with a commensurate increase in payment to doctors.\u003c/p>\n\u003cp>As a result, health care providers and advocates say too few doctors accept Medi-Cal, leaving patients with nowhere to turn.\u003c/p>\n\u003cp>According to the \u003ca href=\"https://www.ppic.org/publication/ppic-statewide-survey-californians-and-their-government-september-2024/\" target=\"_blank\" rel=\"noreferrer noopener\">Public Policy Institute of California\u003c/a>, the measure is leading and likely to pass.\u003c/p>\n\u003cp>However, opponents, represented by a small coalition of community health advocates, seniors and activists for good governance, say the details of the proposition put the state at risk of losing billions in federal funding.\u003c/p>\n\u003cp>That’s because the federal government, under both the Biden and Trump administrations, has warned California that its tax on health plans to fund Medi-Cal services takes unfair advantage of a loophole in federal regulations. The federal Centers for Medicare and Medicaid Services intends to close that loophole, \u003ca href=\"https://www.dhcs.ca.gov/Documents/CA-MCO-Tax-Waiver.pdf\">regulators wrote in a letter\u003c/a> to California officials late last year.\u003c/p>\n\u003cp>“This is the fatal flaw of this initiative,” said Kiran Savage-Sangwan, executive director of the California Pan-Ethnic Health Coalition, which is leading the opposition. “We can all have opinions on how to spend the money, but we have to raise the funds first.”\u003c/p>\n\u003cp>The problem, opponents say, lies in how California taxes health plans and how Proposition 35 limits changes in the future.\u003c/p>\n\u003cp>Right now, the Managed Care Organization Tax, also known as the MCO Tax, generates revenue for Medi-Cal by taxing health insurers that serve both Medi-Cal and commercially insured patients. The federal government gives California a dollar-for-dollar match to whatever the tax raises funds. For Proposition 35, that’s an estimated $7 billion to $8 billion annually through 2027.\u003c/p>\n\u003cp>However, California has historically placed the majority of the tax burden on Medi-Cal insurers and not commercial insurers. In its letter to state officials, federal regulators said Medi-Cal plans represent 50% of all insured people but bear “99% of the total tax burden.” That is at odds with the spirit of the law, which is meant to redistribute revenue from commercial insurers to Medi-Cal plans, regulators wrote.\u003c/p>\n\u003cp>Proposition 35 would cap the tax on commercial insurers at a minimal rate. Any attempts to modify the tax would have to go back to the ballot box or be approved by three-fourths of the Legislature. Opponents say that means federal rule changes requiring the commercial tax to be more equal to the Medi-Cal tax will force the state to reduce taxes on the Medi-Cal plans.\u003c/p>\n\u003cp>“The end result of that is when the federal government makes good on their promise to change the rules on this tax, the revenue we raise from this tax will be dramatically reduced, and we would leave billions of dollars on the table,” Savage-Sangwan said.\u003c/p>\n\u003cp>Proponents of the measure said this argument is false but did not provide details. They say Proposition 35 will make the Medi-Cal program more stable and higher rates will encourage more providers to see low-income patients.\u003c/p>\n\u003cp>California’s Medi-Cal reimbursement rates fall in the bottom third compared to all other states, according to the \u003ca href=\"https://www.kff.org/medicaid/state-indicator/medicaid-to-medicare-fee-index/?currentTimeframe=0&sortModel=%7B%22colId%22:%22All%20Services%22,%22sort%22:%22desc%22%7D\" target=\"_blank\" rel=\"noreferrer noopener\">Kaiser Family Foundation\u003c/a>, and \u003ca href=\"https://calmatters.org/health/2024/02/midwife-medi-cal/?series=no-deliveries-maternity-care\" target=\"_blank\" rel=\"noreferrer noopener\">rates for specific services like obstetrics\u003c/a> are among the lowest in the country.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Prop. 35 is a critically needed investment to protect and expand access to care for Medi-Cal patients and all Californians,” said Molly Weedn, spokesperson for the Yes on Prop. 35 campaign, in a statement. “The principal purpose behind Prop. 35 is to provide stability and predictability… to address the significant shortfall of providers who can see Medi-Cal patients.”\u003c/p>\n\u003cp>The California Association of Health Plans said that it did not ask for the commercial tax cap in the proposition and that it has historically supported this tax structure to pay for Medi-Cal. A higher tax on commercial plans could increase premiums.\u003c/p>\n\u003ch2>Where is Gov. Newsom on Proposition 35?\u003c/h2>\n\u003cp>The largest donors to the yes campaign are the California Hospital Association, Global Medical Response, and the California Medical Association, which collectively donated $38 million. Opponents have raised no money, according to \u003ca href=\"https://powersearch.sos.ca.gov/advanced.php\" target=\"_blank\" rel=\"noreferrer noopener\">state campaign finance records\u003c/a>.\u003c/p>\n\u003cp>Gov. Gavin Newsom has not taken a formal stance on the measure, although he said at a press conference in July that he’s concerned about how it would lock in tax revenue for a single purpose. The state budget he signed that month shifted most of the tax revenue from the tax on health insurers into the general fund to pay for the Medi-Cal program.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>If voters approve Proposition 35, the state would face a $2.6 billion deficit in the current budget, which relies on the tax to fill in gaps. That deficit would increase to $11.9 billion over the next three budget cycles, according to an analysis from the Department of Finance.\u003c/p>\n\u003cp>“This initiative hamstrings our ability to have the kind of flexibility that’s required at the moment we’re living in. I haven’t come out publicly against it. But I’m implying a point of view. Perhaps you can read between those many, many lines,” \u003ca href=\"https://calmatters.org/newsletter/newsom-ballot-measures/\" target=\"_blank\" rel=\"noreferrer noopener\">Newsom said at the press conference\u003c/a>.\u003c/p>\n\u003cp>Newsom’s office did not respond to multiple requests on whether he would formally oppose the measure.\u003c/p>\n\u003cp>Savage-Sangwan said the opposition had not solicited any money for their campaign.\u003c/p>\n\u003cp>“We are using the very small megaphone that we do have to just get the facts out,” she said.\u003c/p>\n\u003ch2>Trade-offs in 2024 health care ballot measure\u003c/h2>\n\u003cp>The political split over Proposition 35 is unusual. The measure’s opponents are often on the same side as its supporters when it comes to health policy issues in the Capitol. But community health advocates say they’re speaking up because the future ramifications of the initiative are too risky.\u003c/p>\n\u003cp>“We want to make clear that the goals of the prop are goals we agree with. We recognize our providers in Medi-Cal are paid far too little, and that disproportionately impacts people of color, children of color especially,” said Mayra Alvarez, president of The Children’s Partnership, another opposing group.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Some lawmakers agree. During multiple budget hearings, Sen. Caroline Menjivar, a Democrat from Van Nuys, came to oppose the proposition in part because the industry organizations that negotiated who would get money from the tax left out “community providers” and those “who don’t have high-paid lobbyists.”\u003c/p>\n\u003cp>“By listening to those with boots on the ground, the legislature developed a plan to equitably address many Medi-Cal concerns over the next few years,” Menjivar said in a statement from the opposition campaign.\u003c/p>\n\u003cp>The tax is expected to generate more than $30 billion over the next four years. The budget Newsom signed puts most of the money in the state’s general spending account but sets aside roughly $2 billion to increase rates for services, including community health workers, private duty nursing, adult and children’s day centers and children at risk of \u003ca href=\"https://calmatters.org/health/2023/07/medi-cal-eligibility-california-review/\" target=\"_blank\" rel=\"noreferrer noopener\">automatic Medi-Cal disenrollment\u003c/a>. If Proposition 35 passes, different groups will get rate increases.\u003c/p>\n\u003cp>Weedn with the Yes on Prop. 35 campaign said the initiative won’t automatically cause cuts if it passes. It would be up to the Legislature to decide how to pay for the programs opponents are worried about, she said, and that the initiative provides about $2 billion of flexible dollars annually for legislative priorities.\u003c/p>\n\u003cp>\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15%E2%80%AFAM.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-12008728\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15%E2%80%AFAM.png\" alt='A screenshot of a graph that reads \"Which California health providers get rate increases under the MCO tax?\"' width=\"1258\" height=\"1346\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15 AM.png 1258w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15 AM-800x856.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15 AM-1020x1091.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/Screenshot-2024-10-09-at-10.11.15 AM-160x171.png 160w\" sizes=\"auto, (max-width: 1258px) 100vw, 1258px\">\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/california\">California\u003c/a> and New York are leading the charge of more than a dozen states suing\u003ca href=\"https://www.kqed.org/news/tag/tiktok\"> TikTok\u003c/a>, accusing the social media giant of designing addictive features to keep kids hooked on the platform.\u003c/p>\n\u003cp>The 81-page, heavily redacted complaint filed by California Attorney General Rob Bonta in Santa Clara County on Tuesday alleges that TikTok violated California’s Unfair Competition Law and False Advertising Law by collecting the personal information of young users. It also claims that the company’s scheme of purported safety features and tools misled the public about the app’s dangers and instead promoted harmful content to children.\u003c/p>\n\u003cp>Bonta and New York Attorney General Letitia Brown co-led the coalition of attorneys general from 13 states and the District of Columbia, with each filing its own lawsuit alleging that TikTok violated consumer laws and damaged the mental health of children.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Bonta’s office started investigating TikTok’s potential harms in 2022. California filed a similar lawsuit against Facebook’s parent company, Meta, last year.\u003c/p>\n\u003cp>In a Tuesday press conference at the San Francisco Public Library, Bonta called youth addiction “a key and central pillar to TikTok’s business model.”\u003c/p>\n\u003cp>“They specifically prey on young people’s vulnerabilities and their developing brains,” Bonta said. “They have an algorithm that’s designed to suck our kids in and keep them on.”\u003c/p>\n\u003cfigure id=\"attachment_12008466\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12008466\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty.jpg\" alt=\"\" width=\"2000\" height=\"1498\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty-800x599.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty-1020x764.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty-1536x1150.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty-1920x1438.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">California Attorney General Rob Bonta is leading a multi-state lawsuit against TikTok, accusing the company of exploiting and harming young users. Bonta filed the suit in Santa Clara County Superior Court and announced the action at San Francisco’s main library on Tuesday. \u003ccite>(Dan Kitwood/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Bonta outlined several features of the app that state regulators say harm the mental health of young people — especially girls — including beauty filters, infinite scrolling, push notifications and likes.\u003c/p>\n\u003cp>“The use of these features, which are manipulative and harmful, is intentional,” Bonta said.\u003c/p>\n\u003cp>TikTok spokesperson Jason Grosse told KQED the company strongly disagrees with the claims made by Bonta, which he called “inaccurate and misleading.”\u003c/p>\n\u003cp>“We’re proud of and remain deeply committed to the work we’ve done to protect teens, and we will continue to update and improve our product,” he said.\u003c/p>\n\u003cp>Grosse noted that the lawsuit followed more than two years of negotiations with the 12 states.\u003c/p>\n\u003cp>“It is incredibly disappointing they have taken this step rather than work with us on constructive solutions to industry-wide challenges,” he said.\u003c/p>\n\u003cp>[aside postID=news_11999273 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/TikTokGetty-1020x706.jpg']\u003c/p>\n\u003cp>TikTok faced Congressional scrutiny last year when CEO Shou Zi Chew was grilled by lawmakers about the safety and security of the immensely popular app. Chew testified that while the vast majority of TikTok users are over 18, the company has invested in measures to protect young people who use the app.\u003c/p>\n\u003cp>TikTok also faces legal threats at the federal level. In April, President Joe Biden signed into law legislation to ban or force a sale of TikTok by ByteDance, the app’s parent company. TikTok has 16 million users in California and an outsized influence in Silicon Valley, where it expanded its offices in San Jose earlier this year. According to California’s complaint, San Jose and neighboring Mountain View are “the hub” for the app’s Trust and Safety Team, which protects user data and is intended to specialize in youth safety.\u003c/p>\n\u003cp>A 2022 Pew Research Center \u003ca href=\"https://www.pewresearch.org/internet/2022/08/10/teens-social-media-and-technology-2022/\">report\u003c/a> found that 67% of U.S. teens ages 13-17 use TikTok, and 16% of all teens said they use the app almost constantly.\u003c/p>\n\u003cp>A \u003ca href=\"https://www.ucsf.edu/news/2024/10/428581/preteens-more-screen-time-tied-depression-anxiety-later\">UCSF study\u003c/a> published Monday found that for preteens, longer screen time increases the likelihood that nine- and 10-year-olds will develop symptoms of mental illness. The lead author, Dr. Jason Nagata, an associate professor of pediatrics at UCSF, pointed out that even though the minimum age requirement for social media use, including TikTok, is 13, the study found that two-thirds of the students had social media accounts.\u003c/p>\n\u003cp>“Robust age verification is not currently present, and many kids are able to lie about their age and get TikTok accounts,” Nagata said.\u003c/p>\n\u003cp>The UCSF study also found that the impact on mental health also varied by race, with Black and Asian youth reporting weaker associations between screen time use and mental health than their white peers.\u003c/p>\n\u003cp>“I think it is also possible that through social media, minority groups — whether it’s racial or ethnic minorities or even LGBT youth — may be able to connect with others on social media, even if they don’t have that community in their immediate in-person environment,” Nagata said.\u003c/p>\n\u003cp>\u003cem>KQED’s \u003ca href=\"https://www.kqed.org/author/lesleymcclurg\">Leslie McClurg\u003c/a> contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Bonta’s office started investigating TikTok’s potential harms in 2022. California filed a similar lawsuit against Facebook’s parent company, Meta, last year.\u003c/p>\n\u003cp>In a Tuesday press conference at the San Francisco Public Library, Bonta called youth addiction “a key and central pillar to TikTok’s business model.”\u003c/p>\n\u003cp>“They specifically prey on young people’s vulnerabilities and their developing brains,” Bonta said. “They have an algorithm that’s designed to suck our kids in and keep them on.”\u003c/p>\n\u003cfigure id=\"attachment_12008466\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12008466\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty.jpg\" alt=\"\" width=\"2000\" height=\"1498\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty-800x599.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty-1020x764.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty-1536x1150.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/TikTokGetty-1920x1438.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">California Attorney General Rob Bonta is leading a multi-state lawsuit against TikTok, accusing the company of exploiting and harming young users. Bonta filed the suit in Santa Clara County Superior Court and announced the action at San Francisco’s main library on Tuesday. \u003ccite>(Dan Kitwood/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Bonta outlined several features of the app that state regulators say harm the mental health of young people — especially girls — including beauty filters, infinite scrolling, push notifications and likes.\u003c/p>\n\u003cp>“The use of these features, which are manipulative and harmful, is intentional,” Bonta said.\u003c/p>\n\u003cp>TikTok spokesperson Jason Grosse told KQED the company strongly disagrees with the claims made by Bonta, which he called “inaccurate and misleading.”\u003c/p>\n\u003cp>“We’re proud of and remain deeply committed to the work we’ve done to protect teens, and we will continue to update and improve our product,” he said.\u003c/p>\n\u003cp>Grosse noted that the lawsuit followed more than two years of negotiations with the 12 states.\u003c/p>\n\u003cp>“It is incredibly disappointing they have taken this step rather than work with us on constructive solutions to industry-wide challenges,” he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>TikTok faced Congressional scrutiny last year when CEO Shou Zi Chew was grilled by lawmakers about the safety and security of the immensely popular app. Chew testified that while the vast majority of TikTok users are over 18, the company has invested in measures to protect young people who use the app.\u003c/p>\n\u003cp>TikTok also faces legal threats at the federal level. In April, President Joe Biden signed into law legislation to ban or force a sale of TikTok by ByteDance, the app’s parent company. TikTok has 16 million users in California and an outsized influence in Silicon Valley, where it expanded its offices in San Jose earlier this year. According to California’s complaint, San Jose and neighboring Mountain View are “the hub” for the app’s Trust and Safety Team, which protects user data and is intended to specialize in youth safety.\u003c/p>\n\u003cp>A 2022 Pew Research Center \u003ca href=\"https://www.pewresearch.org/internet/2022/08/10/teens-social-media-and-technology-2022/\">report\u003c/a> found that 67% of U.S. teens ages 13-17 use TikTok, and 16% of all teens said they use the app almost constantly.\u003c/p>\n\u003cp>A \u003ca href=\"https://www.ucsf.edu/news/2024/10/428581/preteens-more-screen-time-tied-depression-anxiety-later\">UCSF study\u003c/a> published Monday found that for preteens, longer screen time increases the likelihood that nine- and 10-year-olds will develop symptoms of mental illness. The lead author, Dr. Jason Nagata, an associate professor of pediatrics at UCSF, pointed out that even though the minimum age requirement for social media use, including TikTok, is 13, the study found that two-thirds of the students had social media accounts.\u003c/p>\n\u003cp>“Robust age verification is not currently present, and many kids are able to lie about their age and get TikTok accounts,” Nagata said.\u003c/p>\n\u003cp>The UCSF study also found that the impact on mental health also varied by race, with Black and Asian youth reporting weaker associations between screen time use and mental health than their white peers.\u003c/p>\n\u003cp>“I think it is also possible that through social media, minority groups — whether it’s racial or ethnic minorities or even LGBT youth — may be able to connect with others on social media, even if they don’t have that community in their immediate in-person environment,” Nagata said.\u003c/p>\n\u003cp>\u003cem>KQED’s \u003ca href=\"https://www.kqed.org/author/lesleymcclurg\">Leslie McClurg\u003c/a> contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "sf-frontline-workers-who-help-people-on-streets-in-shelters-call-for-fair-pay",
"title": "SF Frontline Workers Who Help People on Streets, In Shelters Call for Fair Pay",
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"content": "\u003cp>\u003cem>[\u003cstrong>Editor’s Note:\u003c/strong> This story was updated at 10:30 a.m. to clarify UCSF’s response to a KQED reporter’s questions about pay parity.]\u003c/em>\u003c/p>\n\u003cp>Brenna Alexander fills her backpack before her shift with granola bars, taxi vouchers and \u003ca href=\"https://www.kqed.org/news/tag/narcan\">Narcan\u003c/a>, the opioid overdose reversal medication.\u003c/p>\n\u003cp>The\u003ca href=\"https://www.kqed.org/news/tag/uc-san-francisco\"> UC San Francisco\u003c/a> clinical social worker then goes to single-room occupancy hotels in the city, knocking on doors and slowly gaining the trust of residents, many with mental health conditions, so she can help them stay housed.\u003c/p>\n\u003cp>Safety is always a concern.\u003c/p>\n\u003cp>Her colleagues on the roving teams in the Tenderloin and the Mission have witnessed stabbings and have been robbed, she said. They endure verbal abuse almost daily.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>UCSF “campus” social workers like Alexander earn about one-third less than employees with similar qualifications at the university’s large medical centers, according to the union that represents the employees. Many campus social workers, who treat non-hospitalized people in streets, shelters and outpatient clinics, say they feel discouraged and undervalued.\u003c/p>\n\u003cp>“We cannot show up for clients like we need to when we are burnt out and left to feel like the last priority,” said Alexander, 32. “This cannot be the way forward. Campus social workers deserve equitable compensation.”\u003c/p>\n\u003cfigure id=\"attachment_12007899\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007899\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Brenna Alexander speaks at a UPTE-CWA union meeting at UCSF on Oct. 3, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The pay disparity contributes to understaffing and burnout for a workforce that is critical to San Francisco’s response to substance abuse, homelessness and mental health crises, University Professional and Technical Employees members and officials said. As campus social workers quit their jobs for higher-paying positions at UCSF medical centers or elsewhere, disadvantaged patients are left languishing on growing waitlists.\u003c/p>\n\u003cp>At a town hall organized by UPTE on Oct. 3, dozens of clinical social workers booed loudly when speakers said colleagues at UCSF’s Parnassus, Mission Bay and other medical centers made 31% more on average per year.\u003c/p>\n\u003cp>The problem stems from UCSF hiring campus social workers at lower-paid job classifications, making it more difficult for these employees to move up, even when they have the same licensure and experience as higher-paid colleagues at medical centers and hospitals, according to salary data the union obtained from the public university.\u003c/p>\n\u003cfigure id=\"attachment_12007902\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007902\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">San Francisco Board of Supervisors President Aaron Peskin speaks at a UPTE-CWA union meeting at UCSF on Oct. 3, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>UCSF, the city’s second-largest employer, reported \u003ca href=\"https://www.ucsf.edu/about/ucsf-budget#:~:text=The%20second%2Dlargest%20employer%20in,the%20National%20Institutes%20of%20Health.\">$10.2 billion in revenue\u003c/a> in fiscal year 2022-2023. San Francisco has approved 13 contracts worth roughly $300 million with UCSF since 2017 for public health and homelessness services, according to a union analysis of records from the Controller’s Office. But that’s not a comprehensive list, so total city and county payments to the university could be higher.\u003c/p>\n\u003cp>Board of Supervisors President Aaron Peskin, who attended the town hall, said San Francisco must use its economic power to push for equitable pay at UCSF.\u003c/p>\n\u003cp>“If these people leave these jobs, it is just going to exacerbate the spiraling problem that we have on our streets,” said Peskin, a mayoral candidate who was one of seven supervisors to approve a \u003ca href=\"https://sfgov.legistar.com/LegislationDetail.aspx?ID=6869100&GUID=EF2B0D58-6D96-4440-A921-F95965BE1816\">resolution\u003c/a> last month urging the university to address the wage and advancement inequities.\u003c/p>\n\u003cp>“There’s rightfully a cry to address the abject misery we see on our streets,” he said. “We have to have these workers devote their lives and their professional training to making a difference, and it starts with making sure that they’re compensated appropriately.”\u003c/p>\n\u003cfigure id=\"attachment_12007898\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007898\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The audience applauds the speakers at a UPTE-CWA union meeting at UCSF on Oct. 3, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>UCSF failed to deliver services to help transition people into housing in at least one contract staffed by campus social workers, according to the San Francisco Department of Homelessness and Supportive Housing. In a \u003ca href=\"https://www.documentcloud.org/documents/25194948-department-of-homelessness-and-supportive-housing-letter-050224\">letter\u003c/a> sent to the Homelessness Oversight Commission in May, department staffers noted that the university had spent just 45% of a $1.5 million budget over two years of the contract.\u003c/p>\n\u003cp>“The underspending of funds can be attributed primarily to challenges in staff hiring, turnover and retention. Moreover, the constant flux in personnel led to noncompliance in service delivery,” Marion Sanders, the department’s chief deputy director, wrote.\u003c/p>\n\u003cp>[aside postID=news_12007119 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230828-ROB-BONTA-AP-MJS-KQED-1020x680.jpg']\u003c/p>\n\u003cp>Union officials said they are pushing for UCSF to offer fair pay and career progression, including by reclassifying employees into job titles that accurately reflect their credentials and work. UC and the union have been negotiating a new contract covering more than 18,000 employees since June.\u003c/p>\n\u003cp>The university’s most \u003ca href=\"https://www.universityofcalifornia.edu/press-room/uc-offers-historic-wage-increases-upte-represented-employees\">recent offer\u003c/a> includes raises of 5% starting in mid-2025, 3% in 2026 and up to 3% in 2027. The union \u003ca href=\"https://upte.org/updates/bargaining-update-5-uc-finally-makes-a-compensation-proposal-and-it-leaves-a-lot-to-be-desired\">countered\u003c/a> that the proposal doesn’t make up for inflation costs and shrinks some existing benefits.\u003c/p>\n\u003cp>UCSF forwarded KQED’s questions to the UC Office of the President, which declined to comment on specific questions about pay parity.\u003c/p>\n\u003cp>“UC is optimistic we’ll reach an agreement soon,” Heather Hansen, a spokesperson with the Office of the President, said in a statement. “As part of our negotiations, we have representatives from each of our campuses and health centers to collaborate to address union concerns and put forth meaningful proposals so that UPTE-represented members are recognized for their contributions.”\u003c/p>\n\u003cp>Differences in the daily tasks of campus and medical center social workers, as well as the sources of funding for each group, could impact their salaries, according to experts at the National Association of Social Workers and the Clinical Social Work Association.\u003c/p>\n\u003cp>Campus professionals often provide one-on-one psychotherapy services, while clinical social workers at hospitals coordinate the care of patients who are discharged, for instance. Medi-Cal, California’s public health insurance program, is an important source of funding for campus social work. Private insurance pays for a larger share of services at medical centers.\u003c/p>\n\u003cfigure id=\"attachment_12007895\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007895\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Matias Campos at a UPTE-CWA union meeting at UCSF on Oct. 3, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Matias Campos, UPTE’s statewide executive vice president, said that regardless of how UCSF crafts its budget, it can easily stop underpaying campus social workers in San Francisco. He pointed to UCSF’s construction of new hospitals in San Francisco and Oakland and the big raise in its chancellor’s pay to nearly \u003ca href=\"https://www.latimes.com/california/story/2024-09-20/uc-chancellors-get-big-raises\">$1.2 million\u003c/a> per year, which was approved last month.\u003c/p>\n\u003cp>“Why are these the priorities of a university and not fixing the inequities that they already have? The funds are there,” said Campos, a UCSF pharmacist who is part of the union’s bargaining team.\u003c/p>\n\u003cp>Another large health care employer, Kaiser Permanente, does not have significant compensation disparities among behavioral and social services employees with similar licensure requirements, according to the workers’ union, Service Employees International Union-United Healthcare Workers.\u003c/p>\n\u003cp>“Part of our contract negotiations with the Coalition of Kaiser Permanente Unions last year was to ensure wage parity amongst workers in various locations and settings,” said Renée Saldaña, a SEIU-UHW spokeswoman.\u003c/p>\n\u003cp>Juliette Suarez, a campus clinical social worker at UCSF for four years, said she was deeply bothered that choosing to provide therapy and other services at a small clinic in the Mission for people with severe trauma meant taking a pay cut.\u003c/p>\n\u003cp>The 31-year-old San Francisco native, who grew up in the Mission neighborhood, said she was priced out of the city. She would like to live closer to the community that she serves, but she can’t afford it.\u003c/p>\n\u003cp>“I’m in the red. I can’t afford a medical emergency as a health care provider,” said Suarez, who works at the UCSF Trauma Recovery Center. “I’ve seen colleagues that are struggling with the physical and emotional impacts of the stress and also the inability to fully afford taking care of themselves while they do this work.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "UCSF campus social workers who serve non-hospitalized individuals in streets, shelters, and outpatient clinics earn approximately one-third less than their counterparts at the university's large medical centers. This pay disparity has left many feeling discouraged and undervalued.",
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"title": "SF Frontline Workers Who Help People on Streets, In Shelters Call for Fair Pay | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>[\u003cstrong>Editor’s Note:\u003c/strong> This story was updated at 10:30 a.m. to clarify UCSF’s response to a KQED reporter’s questions about pay parity.]\u003c/em>\u003c/p>\n\u003cp>Brenna Alexander fills her backpack before her shift with granola bars, taxi vouchers and \u003ca href=\"https://www.kqed.org/news/tag/narcan\">Narcan\u003c/a>, the opioid overdose reversal medication.\u003c/p>\n\u003cp>The\u003ca href=\"https://www.kqed.org/news/tag/uc-san-francisco\"> UC San Francisco\u003c/a> clinical social worker then goes to single-room occupancy hotels in the city, knocking on doors and slowly gaining the trust of residents, many with mental health conditions, so she can help them stay housed.\u003c/p>\n\u003cp>Safety is always a concern.\u003c/p>\n\u003cp>Her colleagues on the roving teams in the Tenderloin and the Mission have witnessed stabbings and have been robbed, she said. They endure verbal abuse almost daily.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>UCSF “campus” social workers like Alexander earn about one-third less than employees with similar qualifications at the university’s large medical centers, according to the union that represents the employees. Many campus social workers, who treat non-hospitalized people in streets, shelters and outpatient clinics, say they feel discouraged and undervalued.\u003c/p>\n\u003cp>“We cannot show up for clients like we need to when we are burnt out and left to feel like the last priority,” said Alexander, 32. “This cannot be the way forward. Campus social workers deserve equitable compensation.”\u003c/p>\n\u003cfigure id=\"attachment_12007899\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007899\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-09-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Brenna Alexander speaks at a UPTE-CWA union meeting at UCSF on Oct. 3, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The pay disparity contributes to understaffing and burnout for a workforce that is critical to San Francisco’s response to substance abuse, homelessness and mental health crises, University Professional and Technical Employees members and officials said. As campus social workers quit their jobs for higher-paying positions at UCSF medical centers or elsewhere, disadvantaged patients are left languishing on growing waitlists.\u003c/p>\n\u003cp>At a town hall organized by UPTE on Oct. 3, dozens of clinical social workers booed loudly when speakers said colleagues at UCSF’s Parnassus, Mission Bay and other medical centers made 31% more on average per year.\u003c/p>\n\u003cp>The problem stems from UCSF hiring campus social workers at lower-paid job classifications, making it more difficult for these employees to move up, even when they have the same licensure and experience as higher-paid colleagues at medical centers and hospitals, according to salary data the union obtained from the public university.\u003c/p>\n\u003cfigure id=\"attachment_12007902\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007902\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-19-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">San Francisco Board of Supervisors President Aaron Peskin speaks at a UPTE-CWA union meeting at UCSF on Oct. 3, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>UCSF, the city’s second-largest employer, reported \u003ca href=\"https://www.ucsf.edu/about/ucsf-budget#:~:text=The%20second%2Dlargest%20employer%20in,the%20National%20Institutes%20of%20Health.\">$10.2 billion in revenue\u003c/a> in fiscal year 2022-2023. San Francisco has approved 13 contracts worth roughly $300 million with UCSF since 2017 for public health and homelessness services, according to a union analysis of records from the Controller’s Office. But that’s not a comprehensive list, so total city and county payments to the university could be higher.\u003c/p>\n\u003cp>Board of Supervisors President Aaron Peskin, who attended the town hall, said San Francisco must use its economic power to push for equitable pay at UCSF.\u003c/p>\n\u003cp>“If these people leave these jobs, it is just going to exacerbate the spiraling problem that we have on our streets,” said Peskin, a mayoral candidate who was one of seven supervisors to approve a \u003ca href=\"https://sfgov.legistar.com/LegislationDetail.aspx?ID=6869100&GUID=EF2B0D58-6D96-4440-A921-F95965BE1816\">resolution\u003c/a> last month urging the university to address the wage and advancement inequities.\u003c/p>\n\u003cp>“There’s rightfully a cry to address the abject misery we see on our streets,” he said. “We have to have these workers devote their lives and their professional training to making a difference, and it starts with making sure that they’re compensated appropriately.”\u003c/p>\n\u003cfigure id=\"attachment_12007898\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007898\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-06-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The audience applauds the speakers at a UPTE-CWA union meeting at UCSF on Oct. 3, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>UCSF failed to deliver services to help transition people into housing in at least one contract staffed by campus social workers, according to the San Francisco Department of Homelessness and Supportive Housing. In a \u003ca href=\"https://www.documentcloud.org/documents/25194948-department-of-homelessness-and-supportive-housing-letter-050224\">letter\u003c/a> sent to the Homelessness Oversight Commission in May, department staffers noted that the university had spent just 45% of a $1.5 million budget over two years of the contract.\u003c/p>\n\u003cp>“The underspending of funds can be attributed primarily to challenges in staff hiring, turnover and retention. Moreover, the constant flux in personnel led to noncompliance in service delivery,” Marion Sanders, the department’s chief deputy director, wrote.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Union officials said they are pushing for UCSF to offer fair pay and career progression, including by reclassifying employees into job titles that accurately reflect their credentials and work. UC and the union have been negotiating a new contract covering more than 18,000 employees since June.\u003c/p>\n\u003cp>The university’s most \u003ca href=\"https://www.universityofcalifornia.edu/press-room/uc-offers-historic-wage-increases-upte-represented-employees\">recent offer\u003c/a> includes raises of 5% starting in mid-2025, 3% in 2026 and up to 3% in 2027. The union \u003ca href=\"https://upte.org/updates/bargaining-update-5-uc-finally-makes-a-compensation-proposal-and-it-leaves-a-lot-to-be-desired\">countered\u003c/a> that the proposal doesn’t make up for inflation costs and shrinks some existing benefits.\u003c/p>\n\u003cp>UCSF forwarded KQED’s questions to the UC Office of the President, which declined to comment on specific questions about pay parity.\u003c/p>\n\u003cp>“UC is optimistic we’ll reach an agreement soon,” Heather Hansen, a spokesperson with the Office of the President, said in a statement. “As part of our negotiations, we have representatives from each of our campuses and health centers to collaborate to address union concerns and put forth meaningful proposals so that UPTE-represented members are recognized for their contributions.”\u003c/p>\n\u003cp>Differences in the daily tasks of campus and medical center social workers, as well as the sources of funding for each group, could impact their salaries, according to experts at the National Association of Social Workers and the Clinical Social Work Association.\u003c/p>\n\u003cp>Campus professionals often provide one-on-one psychotherapy services, while clinical social workers at hospitals coordinate the care of patients who are discharged, for instance. Medi-Cal, California’s public health insurance program, is an important source of funding for campus social work. Private insurance pays for a larger share of services at medical centers.\u003c/p>\n\u003cfigure id=\"attachment_12007895\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007895\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/241003-UCSF-CLINICAL-SOCIAL-WORKERS-MD-01-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Matias Campos at a UPTE-CWA union meeting at UCSF on Oct. 3, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Matias Campos, UPTE’s statewide executive vice president, said that regardless of how UCSF crafts its budget, it can easily stop underpaying campus social workers in San Francisco. He pointed to UCSF’s construction of new hospitals in San Francisco and Oakland and the big raise in its chancellor’s pay to nearly \u003ca href=\"https://www.latimes.com/california/story/2024-09-20/uc-chancellors-get-big-raises\">$1.2 million\u003c/a> per year, which was approved last month.\u003c/p>\n\u003cp>“Why are these the priorities of a university and not fixing the inequities that they already have? The funds are there,” said Campos, a UCSF pharmacist who is part of the union’s bargaining team.\u003c/p>\n\u003cp>Another large health care employer, Kaiser Permanente, does not have significant compensation disparities among behavioral and social services employees with similar licensure requirements, according to the workers’ union, Service Employees International Union-United Healthcare Workers.\u003c/p>\n\u003cp>“Part of our contract negotiations with the Coalition of Kaiser Permanente Unions last year was to ensure wage parity amongst workers in various locations and settings,” said Renée Saldaña, a SEIU-UHW spokeswoman.\u003c/p>\n\u003cp>Juliette Suarez, a campus clinical social worker at UCSF for four years, said she was deeply bothered that choosing to provide therapy and other services at a small clinic in the Mission for people with severe trauma meant taking a pay cut.\u003c/p>\n\u003cp>The 31-year-old San Francisco native, who grew up in the Mission neighborhood, said she was priced out of the city. She would like to live closer to the community that she serves, but she can’t afford it.\u003c/p>\n\u003cp>“I’m in the red. I can’t afford a medical emergency as a health care provider,” said Suarez, who works at the UCSF Trauma Recovery Center. “I’ve seen colleagues that are struggling with the physical and emotional impacts of the stress and also the inability to fully afford taking care of themselves while they do this work.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "How a Court Ruling Affects California Stem Cell Clinics That Use Unproven Therapies",
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"content": "\u003cp>Stem cell clinics have popped up throughout California, promising cures and relief for arthritis, Alzheimer’s and other conditions through cutting-edge technologies. Some, however, are offering services that have not been approved by federal health regulators.\u003c/p>\n\u003cp>The U.S. Food and Drug Administration last week gained a significant court win against stem cell clinics that promote and administer unproven therapies.\u003c/p>\n\u003cp>A three-judge panel on \u003ca href=\"https://cdn.ca9.uscourts.gov/datastore/opinions/2024/09/27/22-56014.pdf\">the 9th U.S. Circuit Court of Appeals ruled (PDF)\u003c/a> that the FDA can regulate two affiliated Southern California stem cell clinics and their treatments after a lower court had exempted them from regulation.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The decision, experts say, reasserts the FDA’s authority over regenerative medicine at a time when clinics advertising these types of stem cell products are booming. Unproven therapies have led to \u003ca href=\"https://www.pewtrusts.org/en/research-and-analysis/issue-briefs/2021/06/harms-linked-to-unapproved-stem-cell-interventions-highlight-need-for-greater-fda-enforcement\">infections, disabilities and even death\u003c/a>, according to adverse reaction reports.\u003c/p>\n\u003cp>The case dates to 2018, when the FDA sued the California Stem Cell Treatment Center Inc., which has clinics in Rancho Mirage and Beverly Hills, for “improperly manufacturing and labeling” an unapproved product.\u003c/p>\n\u003cp>The FDA sought to stop the clinics from administering a so-called therapy that takes fat tissue from a patient to create a mixture of cells known as stromal vascular fraction. This is then injected back into the patient to treat a problem area, such as the knee for osteoarthritis.\u003c/p>\n\u003cp>“In recent years, clinics offering similar stem cell mixtures have proliferated despite concerns over whether such treatments are safe and effective,” one of the 9th Circuit judges wrote.\u003c/p>\n\u003cp>As stated in the appeals court ruling, the clinics advertised technology that could alleviate dozens of medical conditions, including arthritis, multiple sclerosis, Parkinson’s and heart problems, among others.\u003c/p>\n\u003cp>Because these treatments are not covered by insurance, people seeking these products pay tens of thousands of dollars out of pocket. A 12-treatment option could cost $41,500, the decision documents show.\u003c/p>\n\u003cp>The stem cell clinics countered that the treatment should be exempt from FDA oversight because it was more like a surgery than a new drug. \u003ca href=\"https://www.latimes.com/business/story/2022-08-31/federal-judge-tosses-lawsuit-targeting-stem-cell-clinic\">In 2022, a federal judge ruled in favor of the clinics\u003c/a> and the FDA appealed.\u003c/p>\n\u003cp>Experts say this most recent ruling strengthens the FDA’s authority over stem cell therapies and will help keep patients safe. It also \u003ca href=\"https://www.nbcnews.com/health/health-news/fda-wins-case-against-florida-stem-cell-clinic-harmed-three-n1013641\">matches the outcome of an earlier case\u003c/a> where the \u003ca href=\"https://www.justice.gov/opa/pr/florida-company-barred-using-experimental-stem-cell-drugs-patients\">FDA sued a Florida stem cell clinic\u003c/a> for administering a similar product and won, barring the clinic from selling such treatment.\u003c/p>\n\u003cp>“Now there is a coherent federal legal picture that this product can be regulated by the FDA as a drug. As a result, these cells cannot legally be used on patients by stem cell clinics without working with the agency first,” Paul Knoepfler, a professor of cell biology and human anatomy at the University of California, Davis, said via email. “Hundreds of clinics had been marketing them around the U.S. without FDA permission.”\u003c/p>\n\u003cp>An FDA spokesperson declined to comment on the ruling, saying the agency does not comment on ongoing litigation. Attorneys for the clinics did not return requests for comment.\u003c/p>\n\u003ch2>The landscape of stem cell therapies\u003c/h2>\n\u003cp>The FDA has issued multiple public warnings about stem cell treatments because of their popularity. In its notices, the FDA writes that \u003ca href=\"https://www.fda.gov/vaccines-blood-biologics/consumers-biologics/consumer-alert-regenerative-medicine-products-including-stem-cells-and-exosomes\">the only treatments approved for consumers\u003c/a> consist of blood-forming stem cells, which are used to fight certain cancers or blood disorders. The list of therapies ready for commercial use is short, experts say. Other types of stem cell treatments have been approved for clinical trials only.[aside label=\"Related Stories\" postID=\"news_12001344,news_12003006,news_12007157\"]Every drug and therapy approved in the U.S. has to first go through a rigorous and lengthy process that includes a clinical trial to prove it is both safe and effective.\u003c/p>\n\u003cp>“Please know that if you are being charged for these products or offered these products outside of a clinical trial, you are likely being deceived and offered a product illegally,” \u003ca href=\"https://www.fda.gov/vaccines-blood-biologics/consumers-biologics/important-patient-and-consumer-information-about-regenerative-medicine-therapies\">the FDA wrote in a warning\u003c/a> to consumers in 2021.\u003c/p>\n\u003cp>Unapproved stem cell products are not only illegal but also dangerous. In a high profile case, three elderly women went blind after receiving an unproven fat tissue-based stem cell treatment for macular degeneration at a Florida clinic, the same one that was later sued by the FDA. \u003ca href=\"https://www.statnews.com/2017/03/15/stem-cell-patients-blind-macular-degeneration/\">According to news reports\u003c/a> from when the case was first made public, the women sought treatments because they had difficulty reading fine print. After the procedures, the women suffered detached retinas, vision loss and bleeding inside the eye.\u003c/p>\n\u003ch2>‘You see them on billboards’\u003c/h2>\n\u003cp>The California Institute for Regenerative Medicine, the multibillion-dollar agency voters authorized in 2004 to fund stem cell research, also \u003ca href=\"https://www.cirm.ca.gov/participating-clinical-trial/\">warns on its website\u003c/a> against companies that promote “bogus therapies.”\u003c/p>\n\u003cp>“The general public knows that stem cells are a very important field that continues to develop, and they believe, as we certainly do, that they’re going to be the source of therapies and cures. The problem is these companies make it sound like we’re there already, and that’s just not the case,” said \u003ca href=\"https://www.cirm.ca.gov/about-cirm/cirm-leadership/\">Jonathan Thomas\u003c/a>, president of the agency.\u003c/p>\n\u003cp>Thomas said last week’s ruling is important because not only does it send a message to clinics that they can’t provide treatments without regulation, but it also gives a nod to researchers who are doing legitimate stem cell work and following the rules.\u003c/p>\n\u003cp>It’s also a warning for consumers, he said.\u003c/p>\n\u003cp>It is difficult to track these clinics advertising unapproved cures, so it is unclear how many are operating today. “We just know that they are proliferating because you see signs for them … you see them on billboards, you see ads, you see all sorts of things,” Thomas told CalMatters.\u003c/p>\n\u003cp>People who are considering a stem cell treatment should ask if the therapy has been approved by the FDA. Thomas said the public should be wary if a stem cell clinic says they are exempt from federal regulation. “Anytime you hear anything like that, I would say that’s a huge red flag,” he said.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Stem cell clinics have popped up throughout California, promising cures and relief for arthritis, Alzheimer’s and other conditions through cutting-edge technologies. Some, however, are offering services that have not been approved by federal health regulators.\u003c/p>\n\u003cp>The U.S. Food and Drug Administration last week gained a significant court win against stem cell clinics that promote and administer unproven therapies.\u003c/p>\n\u003cp>A three-judge panel on \u003ca href=\"https://cdn.ca9.uscourts.gov/datastore/opinions/2024/09/27/22-56014.pdf\">the 9th U.S. Circuit Court of Appeals ruled (PDF)\u003c/a> that the FDA can regulate two affiliated Southern California stem cell clinics and their treatments after a lower court had exempted them from regulation.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The decision, experts say, reasserts the FDA’s authority over regenerative medicine at a time when clinics advertising these types of stem cell products are booming. Unproven therapies have led to \u003ca href=\"https://www.pewtrusts.org/en/research-and-analysis/issue-briefs/2021/06/harms-linked-to-unapproved-stem-cell-interventions-highlight-need-for-greater-fda-enforcement\">infections, disabilities and even death\u003c/a>, according to adverse reaction reports.\u003c/p>\n\u003cp>The case dates to 2018, when the FDA sued the California Stem Cell Treatment Center Inc., which has clinics in Rancho Mirage and Beverly Hills, for “improperly manufacturing and labeling” an unapproved product.\u003c/p>\n\u003cp>The FDA sought to stop the clinics from administering a so-called therapy that takes fat tissue from a patient to create a mixture of cells known as stromal vascular fraction. This is then injected back into the patient to treat a problem area, such as the knee for osteoarthritis.\u003c/p>\n\u003cp>“In recent years, clinics offering similar stem cell mixtures have proliferated despite concerns over whether such treatments are safe and effective,” one of the 9th Circuit judges wrote.\u003c/p>\n\u003cp>As stated in the appeals court ruling, the clinics advertised technology that could alleviate dozens of medical conditions, including arthritis, multiple sclerosis, Parkinson’s and heart problems, among others.\u003c/p>\n\u003cp>Because these treatments are not covered by insurance, people seeking these products pay tens of thousands of dollars out of pocket. A 12-treatment option could cost $41,500, the decision documents show.\u003c/p>\n\u003cp>The stem cell clinics countered that the treatment should be exempt from FDA oversight because it was more like a surgery than a new drug. \u003ca href=\"https://www.latimes.com/business/story/2022-08-31/federal-judge-tosses-lawsuit-targeting-stem-cell-clinic\">In 2022, a federal judge ruled in favor of the clinics\u003c/a> and the FDA appealed.\u003c/p>\n\u003cp>Experts say this most recent ruling strengthens the FDA’s authority over stem cell therapies and will help keep patients safe. It also \u003ca href=\"https://www.nbcnews.com/health/health-news/fda-wins-case-against-florida-stem-cell-clinic-harmed-three-n1013641\">matches the outcome of an earlier case\u003c/a> where the \u003ca href=\"https://www.justice.gov/opa/pr/florida-company-barred-using-experimental-stem-cell-drugs-patients\">FDA sued a Florida stem cell clinic\u003c/a> for administering a similar product and won, barring the clinic from selling such treatment.\u003c/p>\n\u003cp>“Now there is a coherent federal legal picture that this product can be regulated by the FDA as a drug. As a result, these cells cannot legally be used on patients by stem cell clinics without working with the agency first,” Paul Knoepfler, a professor of cell biology and human anatomy at the University of California, Davis, said via email. “Hundreds of clinics had been marketing them around the U.S. without FDA permission.”\u003c/p>\n\u003cp>An FDA spokesperson declined to comment on the ruling, saying the agency does not comment on ongoing litigation. Attorneys for the clinics did not return requests for comment.\u003c/p>\n\u003ch2>The landscape of stem cell therapies\u003c/h2>\n\u003cp>The FDA has issued multiple public warnings about stem cell treatments because of their popularity. In its notices, the FDA writes that \u003ca href=\"https://www.fda.gov/vaccines-blood-biologics/consumers-biologics/consumer-alert-regenerative-medicine-products-including-stem-cells-and-exosomes\">the only treatments approved for consumers\u003c/a> consist of blood-forming stem cells, which are used to fight certain cancers or blood disorders. The list of therapies ready for commercial use is short, experts say. Other types of stem cell treatments have been approved for clinical trials only.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Every drug and therapy approved in the U.S. has to first go through a rigorous and lengthy process that includes a clinical trial to prove it is both safe and effective.\u003c/p>\n\u003cp>“Please know that if you are being charged for these products or offered these products outside of a clinical trial, you are likely being deceived and offered a product illegally,” \u003ca href=\"https://www.fda.gov/vaccines-blood-biologics/consumers-biologics/important-patient-and-consumer-information-about-regenerative-medicine-therapies\">the FDA wrote in a warning\u003c/a> to consumers in 2021.\u003c/p>\n\u003cp>Unapproved stem cell products are not only illegal but also dangerous. In a high profile case, three elderly women went blind after receiving an unproven fat tissue-based stem cell treatment for macular degeneration at a Florida clinic, the same one that was later sued by the FDA. \u003ca href=\"https://www.statnews.com/2017/03/15/stem-cell-patients-blind-macular-degeneration/\">According to news reports\u003c/a> from when the case was first made public, the women sought treatments because they had difficulty reading fine print. After the procedures, the women suffered detached retinas, vision loss and bleeding inside the eye.\u003c/p>\n\u003ch2>‘You see them on billboards’\u003c/h2>\n\u003cp>The California Institute for Regenerative Medicine, the multibillion-dollar agency voters authorized in 2004 to fund stem cell research, also \u003ca href=\"https://www.cirm.ca.gov/participating-clinical-trial/\">warns on its website\u003c/a> against companies that promote “bogus therapies.”\u003c/p>\n\u003cp>“The general public knows that stem cells are a very important field that continues to develop, and they believe, as we certainly do, that they’re going to be the source of therapies and cures. The problem is these companies make it sound like we’re there already, and that’s just not the case,” said \u003ca href=\"https://www.cirm.ca.gov/about-cirm/cirm-leadership/\">Jonathan Thomas\u003c/a>, president of the agency.\u003c/p>\n\u003cp>Thomas said last week’s ruling is important because not only does it send a message to clinics that they can’t provide treatments without regulation, but it also gives a nod to researchers who are doing legitimate stem cell work and following the rules.\u003c/p>\n\u003cp>It’s also a warning for consumers, he said.\u003c/p>\n\u003cp>It is difficult to track these clinics advertising unapproved cures, so it is unclear how many are operating today. “We just know that they are proliferating because you see signs for them … you see them on billboards, you see ads, you see all sorts of things,” Thomas told CalMatters.\u003c/p>\n\u003cp>People who are considering a stem cell treatment should ask if the therapy has been approved by the FDA. Thomas said the public should be wary if a stem cell clinic says they are exempt from federal regulation. “Anytime you hear anything like that, I would say that’s a huge red flag,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>When we think about air pollution, most of us focus on its effects on our lungs and maybe our hearts. But new \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S1878929324000975?via%3Dihub\">research\u003c/a> reveals something more troubling: the air we breathe may affect \u003ca href=\"https://www.kqed.org/news/tag/children\">children’s\u003c/a> brains.\u003c/p>\n\u003cp>A team of \u003ca href=\"https://www.kqed.org/news/tag/uc-davis\">UC Davis\u003c/a> scientists systematically reviewed 40 different studies looking at how outdoor air pollution impacts the development of children’s brains. The research linked exposure to pollutants to changes in the brain. This includes differences in white matter, crucial for things like memory and learning, and even early signs of neurodegenerative diseases like Alzheimer’s.\u003c/p>\n\u003cp>“We’re seeing notable differences in brain outcomes between kids exposed to higher pollution levels and those with lower exposure,” said Camelia Hostinar, associate professor of psychology at UC Davis and the study’s corresponding author.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Children are especially vulnerable to air pollution for a few reasons. Their bodies and brains are still developing, and they breathe faster than adults, meaning they take in more air (and more pollutants) relative to their body size. And they spend a lot of time outside — whether that’s playing in the yard, walking to school, or just hanging out with friends. That outdoor time increases their exposure, particularly in cities or near freeways where pollution levels can spike.\u003c/p>\n\u003cp>“What should concern us in these studies and what they show is that fossil fuel pollution is literally damaging, not only things like the vasculature of infants and children’s brains but also what we call the cortical thickness, which is associated with cognitive capacities or cognitive deficits,” said Dr. Lisa Patel, a pediatrician for Stanford Children’s Health, who was not involved in the study.\u003c/p>\n\u003ch2>The impact of pollution on young brains\u003c/h2>\n\u003cp>Pollutants like fine particulate matter, what researchers refer to as PM2.5, and nitrogen dioxide from car exhaust, power plants and wildfires can penetrate deep into the lungs and bloodstream. From there, they can travel to the brain, where they can trigger inflammation, which contributes to cell loss within the central nervous system. This process may trigger \u003ca href=\"https://www.researchgate.net/publication/299999970_How_Air_Pollution_Alters_Brain_Development_The_Role_of_Neuroinflammation\">cognitive decline, an increased risk for dementia\u003c/a>, \u003ca href=\"https://www.sciencedirect.com/science/article/abs/pii/S0197018619305078\">autism\u003c/a> and \u003ca href=\"https://www.sciencedirect.com/science/article/abs/pii/S0013935119307273\">attention deficit hyperactivity disorder\u003c/a>.\u003c/p>\n\u003cp>The UC Davis research team examined studies primarily from the U.S., Mexico and Europe, with one each from Asia and Australia. Some used advanced imaging techniques like MRI scans, while others tested chemical compounds or even looked for signs of brain tumors.\u003c/p>\n\u003cp>[aside postID=news_12000147 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/iStock-515594796_qed-1020x680.jpg']\u003c/p>\n\u003cp>“These are observational studies, so we can’t definitively say air pollution causes these brain changes,” said Dr. John Balmes, a physician-scientist at UCSF and UC Berkeley, whose \u003ca href=\"https://ehp.niehs.nih.gov/doi/10.1289/EHP10812\">research\u003c/a> has shown links between early-life pollution exposure and reduced IQ by age 10. He was not involved in the UC Davis study. “But when so many studies show consistent results, the association becomes strong — strong enough to move toward causality.”\u003c/p>\n\u003cp>Researchers also looked at animal models to explore potential causal links. In these models, exposure to pollution led to brain changes similar to what’s observed in human children.\u003c/p>\n\u003cp>“Between what the animal models show, what these pathology results show, and what we know from the adult literature, connecting what we know from animal studies to humans is a reasonable assertion,” Patel said.\u003c/p>\n\u003ch2>Reducing the risks\u003c/h2>\n\u003cp>On days like Wednesday and Thursday, when the air district issues a Spare the Air Alert for the Bay Area due to unhealthy smog levels, health officials urge people, especially children and sensitive groups, to limit outdoor activities.\u003c/p>\n\u003cp>“Kids should probably not be exercising vigorously outside if they don’t have to,” Balmes said.\u003c/p>\n\u003cp>Patel suggested several other steps to reduce exposure to air pollution, particularly for children. Installing portable air purifiers in homes and schools can significantly improve indoor air quality, especially near high-traffic areas. If you’re looking for a new home, try to avoid areas near major roads or industrial zones. For those already living near pollution sources, weatherizing your home by sealing cracks and gaps to prevent dirty air from sneaking in.\u003c/p>\n\u003cp>The UC Davis researchers also encouraged other scientists to include air pollution data in studies related to brain health.\u003c/p>\n\u003cp>“Anyone researching brain development or health outcomes should be asking about air pollution exposure,” said Sally Hang, a Ph.D. student at UC Davis and the study’s first co-author. “It’s a simple yet critical factor that could deepen our understanding of how to protect future generations.”\u003c/p>\n\u003cp>As research mounts on connecting air pollution to poorer neurodevelopment, policymakers may need to rethink what they consider safe levels of pollution, particularly when it comes to the most vulnerable among us — our children.\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "Pollutants from cars and power plants can travel to children's brains, causing inflammation and potential long-term neurodevelopmental damage.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When we think about air pollution, most of us focus on its effects on our lungs and maybe our hearts. But new \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S1878929324000975?via%3Dihub\">research\u003c/a> reveals something more troubling: the air we breathe may affect \u003ca href=\"https://www.kqed.org/news/tag/children\">children’s\u003c/a> brains.\u003c/p>\n\u003cp>A team of \u003ca href=\"https://www.kqed.org/news/tag/uc-davis\">UC Davis\u003c/a> scientists systematically reviewed 40 different studies looking at how outdoor air pollution impacts the development of children’s brains. The research linked exposure to pollutants to changes in the brain. This includes differences in white matter, crucial for things like memory and learning, and even early signs of neurodegenerative diseases like Alzheimer’s.\u003c/p>\n\u003cp>“We’re seeing notable differences in brain outcomes between kids exposed to higher pollution levels and those with lower exposure,” said Camelia Hostinar, associate professor of psychology at UC Davis and the study’s corresponding author.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Children are especially vulnerable to air pollution for a few reasons. Their bodies and brains are still developing, and they breathe faster than adults, meaning they take in more air (and more pollutants) relative to their body size. And they spend a lot of time outside — whether that’s playing in the yard, walking to school, or just hanging out with friends. That outdoor time increases their exposure, particularly in cities or near freeways where pollution levels can spike.\u003c/p>\n\u003cp>“What should concern us in these studies and what they show is that fossil fuel pollution is literally damaging, not only things like the vasculature of infants and children’s brains but also what we call the cortical thickness, which is associated with cognitive capacities or cognitive deficits,” said Dr. Lisa Patel, a pediatrician for Stanford Children’s Health, who was not involved in the study.\u003c/p>\n\u003ch2>The impact of pollution on young brains\u003c/h2>\n\u003cp>Pollutants like fine particulate matter, what researchers refer to as PM2.5, and nitrogen dioxide from car exhaust, power plants and wildfires can penetrate deep into the lungs and bloodstream. From there, they can travel to the brain, where they can trigger inflammation, which contributes to cell loss within the central nervous system. This process may trigger \u003ca href=\"https://www.researchgate.net/publication/299999970_How_Air_Pollution_Alters_Brain_Development_The_Role_of_Neuroinflammation\">cognitive decline, an increased risk for dementia\u003c/a>, \u003ca href=\"https://www.sciencedirect.com/science/article/abs/pii/S0197018619305078\">autism\u003c/a> and \u003ca href=\"https://www.sciencedirect.com/science/article/abs/pii/S0013935119307273\">attention deficit hyperactivity disorder\u003c/a>.\u003c/p>\n\u003cp>The UC Davis research team examined studies primarily from the U.S., Mexico and Europe, with one each from Asia and Australia. Some used advanced imaging techniques like MRI scans, while others tested chemical compounds or even looked for signs of brain tumors.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“These are observational studies, so we can’t definitively say air pollution causes these brain changes,” said Dr. John Balmes, a physician-scientist at UCSF and UC Berkeley, whose \u003ca href=\"https://ehp.niehs.nih.gov/doi/10.1289/EHP10812\">research\u003c/a> has shown links between early-life pollution exposure and reduced IQ by age 10. He was not involved in the UC Davis study. “But when so many studies show consistent results, the association becomes strong — strong enough to move toward causality.”\u003c/p>\n\u003cp>Researchers also looked at animal models to explore potential causal links. In these models, exposure to pollution led to brain changes similar to what’s observed in human children.\u003c/p>\n\u003cp>“Between what the animal models show, what these pathology results show, and what we know from the adult literature, connecting what we know from animal studies to humans is a reasonable assertion,” Patel said.\u003c/p>\n\u003ch2>Reducing the risks\u003c/h2>\n\u003cp>On days like Wednesday and Thursday, when the air district issues a Spare the Air Alert for the Bay Area due to unhealthy smog levels, health officials urge people, especially children and sensitive groups, to limit outdoor activities.\u003c/p>\n\u003cp>“Kids should probably not be exercising vigorously outside if they don’t have to,” Balmes said.\u003c/p>\n\u003cp>Patel suggested several other steps to reduce exposure to air pollution, particularly for children. Installing portable air purifiers in homes and schools can significantly improve indoor air quality, especially near high-traffic areas. If you’re looking for a new home, try to avoid areas near major roads or industrial zones. For those already living near pollution sources, weatherizing your home by sealing cracks and gaps to prevent dirty air from sneaking in.\u003c/p>\n\u003cp>The UC Davis researchers also encouraged other scientists to include air pollution data in studies related to brain health.\u003c/p>\n\u003cp>“Anyone researching brain development or health outcomes should be asking about air pollution exposure,” said Sally Hang, a Ph.D. student at UC Davis and the study’s first co-author. “It’s a simple yet critical factor that could deepen our understanding of how to protect future generations.”\u003c/p>\n\u003cp>As research mounts on connecting air pollution to poorer neurodevelopment, policymakers may need to rethink what they consider safe levels of pollution, particularly when it comes to the most vulnerable among us — our children.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "more-california-immigrants-are-eligible-for-medi-cal-but-some-are-hesitant-to-enroll",
"title": "More California Immigrants Are Eligible For Medi-Cal, but Some Are Hesitant to Enroll",
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"headTitle": "More California Immigrants Are Eligible For Medi-Cal, but Some Are Hesitant to Enroll | KQED",
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"content": "\u003cp>\u003ci data-stringify-type=\"italic\">This story was produced by \u003ca href=\"https://www.eltimpano.org\">El Tímpano\u003c/a>\u003c/i>\u003ci data-stringify-type=\"italic\">, a bilingual nonprofit news outlet that amplifies the voices of Latino and Mayan immigrants in Oakland and the wider Bay Area. The original version of the story can be found \u003ca href=\"https://www.eltimpano.org/health/lingering-fears-over-past-immigration-policies-are-fueling-a-reluctance-to-enroll-in-medi-cal\">here\u003c/a>\u003c/i>\u003ci data-stringify-type=\"italic\">.\u003c/i>\u003c/p>\n\u003cp>[dropcap]O[/dropcap]n a bright and early morning in Pittsburg, two women position themselves tactically outside the La Superior Mercados between the extra-large charcoal grill for roasting chicken and the rows of yellow-trimmed grocery carts. The supermarket is frequented by the area’s Latino community and anyone trying to get in or out this morning must pass the women first and hear their sales pitch. Their product should be easy to sell: free to low-cost health insurance for people with low incomes. But often, a surprising answer to their question, “Can we sign you up for Medi-Cal?” is “no.”\u003c/p>\n\u003cp>The list of benefits a patient can receive with full-scope Medi-Cal for free or at low cost includes emergency services, maternity care, mental health and substance use disorder services, pediatric care, and more, the women explain to passers-by. Their enrollment services are offered for free through Monument Impact, a nonprofit organization in Contra Costa County that helps connect low-income immigrants to resources, they remind folks. Still, several of the shoppers, mostly Spanish-speaking Latinos, look at the women with skepticism as they make their pitch.\u003c/p>\n\u003cp>Medi-Cal expanded to include all qualifying adults regardless of immigration status in January 2024. This year’s expansion was the final phase of an eight-year effort to extend Medi-Cal to undocumented immigrants, first to children and pregnant women, then to children under 19, to young adults under 26, and to older adults over 50, as part of the state’s initiative to expand health care access to all Californians. The UC Berkeley Labor Center \u003ca href=\"https://laborcenter.berkeley.edu/californias-uninsured-in-2024/\">estimates\u003c/a> that close to one million undocumented Californians will have gained access to Medi-Cal through this expansion.\u003c/p>\n\u003cp>Judith Peralta and Mireya Robles said that at the start of the year, it was no problem engaging folks and encouraging them to sign up for the program. As \u003cem>promotoras de salud\u003c/em>, health promoters, Peralta and Robles serve as trusted messengers to connect their community to limited health insurance options available to low-income immigrants.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The first few months of the year, the women saw a rush to apply for Medi-Cal—hundreds of people in the community were ready to enroll. But in recent months, they’ve found convincing people to sign up more challenging. Many of the people they encounter either already have Medi-Cal, know they don’t meet the income requirements to qualify for the program, or, in many cases, brush them off with a kind but adamant “no.” They’re afraid of Medi-Cal, the women say.\u003c/p>\n\u003cp>“It’s often men who have more fear, they’ll tell us ‘no, no,’” Peralta said in Spanish. “Like they’ll say it has something to do with immigration or it has to do with the government. Like they don’t want to give their name.”\u003c/p>\n\u003cp>Distrust of government has long run deep in Latino immigrant communities but reached a low point in 2019. That’s when the Trump administration announced that using certain government benefits could prevent undocumented immigrants from ever qualifying for legal status. The Trump administration leaned on a category known as a “\u003ca href=\"https://www.uscis.gov/green-card/green-card-processes-and-procedures/public-charge/public-charge-resources\">public charge\u003c/a>” to institute these changes. A public charge is an unauthorized immigrant who is likely to become dependent on government benefits. A designation of public charge jeopardizes an immigrant’s chances of securing legal status in the U.S. Before 2019, only using cash assistance for income like Temporary Assistance for Needy Families or needing long-term institutionalized care paid for by the government meant risking a designation of public charge from an immigration official.\u003c/p>\n\u003cp>The Trump administration expanded public charge to include Medicaid, the Supplemental Nutrition Assistance Program, housing assistance, energy assistance, child-care subsidies, and other benefits, according to the Migration Policy Institute, a nonpartisan research organization. Overnight, what was once an obscure set of bureaucratic rules became a household concern.\u003c/p>\n\u003cfigure id=\"attachment_12007441\" class=\"wp-caption aligncenter\" style=\"max-width: 2560px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007441\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-scaled.jpg\" alt=\"Three women sit at a table together in a building with a man sitting in a chair across from them.\" width=\"2560\" height=\"1703\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-800x532.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-1536x1022.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-2048x1363.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-1920x1277.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Azucena Espinoza, a senior promotora at Monument Impact, registered walk-ins looking for help with their Medi-Cal application at Monument Impact’s offices in Antioch on Thursday, Sept. 5, 2024. \u003ccite>(Hiram Alejandro Durán for El Tímpano/CatchLight Local/Report for America corps member)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Before 2019, “I actually had no clue of even the words ‘public charge,’” said Janet Anwar, registration services manager at Tiburcio Vasquez Health Center, a nonprofit East Bay health clinic. “It wasn’t a common word in our community, not until then. It brought a lot of concerns to our patients because there was a lot of miscommunication as to what was public charge, how it impacts immigration cases.”\u003c/p>\n\u003cp>Though the Trump public charge rules were only in effect for a short period and were reversed officially at the start of the Biden administration, researchers and immigrant advocates said the changes caused a long-lasting “chilling effect.” Experts say the Trump 2024 campaign has so far not mentioned public charge in its immigration agenda, but undocumented immigrants in California remain afraid, and that fear is preventing people from applying for the newly expanded Medi-Cal benefits.\u003c/p>\n\u003cp>This better-safe-than-sorry mindset means that undocumented immigrants may go years without seeing a medical professional or end up with high out-of-pocket expenses when they do seek medical care. Without insurance, immigrants will \u003ca href=\"https://www.kff.org/racial-equity-and-health-policy/fact-sheet/key-facts-on-health-coverage-of-immigrants/\">delay care\u003c/a> until their health condition is no longer tolerable or go without care entirely.\u003c/p>\n\u003cp>“We saw it all,” Anwar said, describing the years that followed Trump’s changes to public charge. “We saw patients not wanting to come in, not even for their appointments, thinking that just getting the services for their health care was going to affect them.”\u003c/p>\n\u003cp>People were also afraid to apply for benefits for their U.S.-born children, she added. “They even thought that that was going to affect them in some sort of way.”\u003c/p>\n\u003cp>In an election year, with former President Donald Trump again on the ballot, many undocumented immigrants are expressing concern about a return of the expanded public charge rules and how the government might use their information should they apply for Medi-Cal without legal status.\u003c/p>\n\u003cp>“They are afraid no matter what,” Azucena Espinoza, a senior \u003cem>promotora\u003c/em> with Monument Impact, explained in Spanish. “They say, ‘For what reason do they want all this information about us? So that tomorrow or the day after, they can use it [against us]?’ And they are right to feel that way because we know it could be Donald Trump. We don’t know what will happen, right?”\u003c/p>\n\u003cfigure id=\"attachment_12007440\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007440\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-scaled.jpg\" alt=\"A headshot of a woman wearing earrings and a drew with flower designs.\" width=\"1920\" height=\"2560\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-scaled.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-800x1067.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-1020x1360.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-160x213.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-1152x1536.jpg 1152w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-1536x2048.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Azucena Espinoza, a senior promotora at Monument Impact, registered walk-ins looking for help with their Medi-Cal application at Monument Impact’s offices in Antioch on Thursday, Sept. 5, 2024. \u003ccite>(Hiram Alejandro Durán for El Tímpano/CatchLight Local/Report for America corps member)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>The ‘chilling effect’\u003c/h2>\n\u003cp>The concept of public charge has existed in U.S. immigration policy for \u003ca href=\"https://www.kff.org/racial-equity-and-health-policy/issue-brief/2022-changes-to-the-public-charge-inadmissibility-rule-and-the-implications-for-health-care/\">more than a century\u003c/a>. From 1999 to 2019, the share of undocumented immigrants who could be considered a public charge was 3%, according to the \u003ca href=\"https://latino.ucla.edu/research/lessons-2022-adult-medical-expansion/\">UCLA Latino Policy and Politics Institute\u003c/a> (LPPI), because the number of social programs an unauthorized immigrant would need to use in order to be deemed a public charge was limited. When the Trump administration expanded that list to include more social programs, the share of undocumented immigrants who could be considered a public charge rose to 47%.\u003c/p>\n\u003cp>Applications for Medicaid immediately declined following the Trump administration’s changes to public charge, according to the UCLA researchers. They found that 17% of undocumented immigrants avoided any public benefits enrollment in 2019. Mixed-status households also avoided applying for public benefits for fear of jeopardizing their undocumented loved ones, or immigrant parents of U.S.-born children avoided signing their children up for health benefits for fear it would negatively impact the family’s position in the country.\u003c/p>\n\u003cp>Though the Trump administration’s changes were challenged in court and ultimately were reversed in 2021, UCLA researchers have found evidence that the “chilling effect” lingers years later. When, in 2023, the UCLA researchers began studying California’s expansion of Medi-Cal to undocumented immigrants, fear of public charge came up again.\u003c/p>\n\u003cp>“Immigration status continues to be a barrier for folks to enroll in Medi-Cal,” said Lucía Félix Beltrán, senior research fellow at LPPI. “There is still a fair amount of work to be done around public charge. That’s where partnering with community organizations comes in. But even then it’s like, these decisions are made at the household level. It doesn’t matter how many organizations get involved or how many flyers you give out or how many briefs you publish. These decisions are made within households and that’s where it gets kind of tricky.”\u003c/p>\n\u003cp>In a statement to El Tímpano, a California Department of Health Care Services spokesperson said the agency is “unable to speculate about the potential impact of future public charge rule changes.” They added, however, that “California law strictly protects personal information, including immigration status, ensuring confidentiality for all applicants. If an individual does not have satisfactory immigration status and applies for Medi-Cal, California does not share their immigration status with the federal government, and the federal government does not have access to state-owned data.”\u003c/p>\n\u003ch2>Changing minds\u003c/h2>\n\u003cp>Changing minds when the perceived risk is so high is a challenge for the nonprofits tasked with informing community members about Medi-Cal and public charge.\u003c/p>\n\u003cp>The DHCS website includes \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/SPAN-Medi-Cal-Expansion-FAQ.pdf\">information in Spanish\u003c/a> that reminds interested Medi-Cal applicants that their information will not be shared with federal immigration enforcement agencies. All dollars spent on the expansion of Medi-Cal to undocumented people come from state funding. Regardless, other than long-term institutionalized care paid for by the government—nursing home or mental health institution care are examples, according to \u003ca href=\"https://www.uscis.gov/green-card/green-card-processes-and-procedures/public-charge/public-charge-resources\">U.S. Citizenship and Immigration Services\u003c/a>—Medi-Cal is exempt from the public charge rule. (According to DHCS, short-term institutional care like rehabilitation, respite care or treatment for behavioral or substance use disorder issues are not considered subject to public charge review).\u003c/p>\n\u003cp>However, for advice on navigating public charge and Medi-Cal, DHCS said to speak to certified nonprofit organizations—the agency cannot directly answer questions on this topic. Among those certified nonprofits is the Multicultural Institute, which provides immigrant families with health, immigration and labor resources at their three locations across the Bay Area.\u003c/p>\n\u003cp>The blocks surrounding the Multicultural Institute in Berkeley are lined with day laborers, immigrant men looking for whatever work they can find in construction or other household jobs. Outreach workers from the organization spend mornings canvassing the blocks to talk to the men and see what they might need, whether it’s food from their pantry or Medi-Cal coverage.\u003c/p>\n\u003cp>“We don’t have any lawyers here, but we do our best” to address public charge questions, said Daniela Gonzalez-Perez, Health and Engagement Manager at the Multicultural Institute, who added that they do still often hear concerns, the aftermath of what life was like during the Trump administration.\u003c/p>\n\u003cfigure id=\"attachment_12007438\" class=\"wp-caption aligncenter\" style=\"max-width: 2560px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007438\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-scaled.jpg\" alt=\"A woman with glasses and a white flowery shirt stands outside near plants.\" width=\"2560\" height=\"1703\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-800x532.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-1536x1022.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-2048x1363.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-1920x1277.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Daniela Gonzalez-Perez, Health and Engagement Manager at the Multicultural Institute says the community of immigrant families and individuals they serve worry about another Trump Administration, photographed on Thursday, Aug. 15, 2024. \u003ccite>(Hiram Alejandro Durán for El Tímpano/CatchLight Local/Report for America corps member)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>There was “a lot of fear of deportation, you know, just a fear of the reality that we were living in under Trump’s America and his hate or disdain for the immigrant community,” she said. “There’s a lot of uncertainty still of what would actually happen if they apply for benefits…If they are super, super concerned then we would refer them out to a partner organization that handles immigration cases.”\u003c/p>\n\u003cp>What many health and immigrant advocates hear frequently, according to interviews with El Tímpano, is that undocumented immigrants will avoid public benefits and delay seeing a doctor or medical professional for years, until their needs are dire and have to go to an emergency room.[aside postID=\"news_11998034,news_11991442\" label=\"Related Stories\"]\u003c/p>\n\u003cp>“There are people out there who said…that immigrants use way too much public benefits and it’s just not true based on the numbers,” said Valerie Lacarte, a senior policy analyst with the Migration Policy Institute who studied immigrant participation in government programs like Medicaid. When comparing low-income U.S. citizens with low-income non-citizens, usage of public benefits dips. In the vast majority of the U.S., most undocumented immigrants do not qualify for Medicaid—California is an exception. However, when comparing the U.S.-born low-income population and immigrants who are federally eligible for Medicaid, participation in the program was at 76% for citizens and 66% for non-citizens, \u003ca href=\"https://www.migrationpolicy.org/sites/default/files/publications/mpi-hsi_medicaid-brief_final.pdf\">according to MPI\u003c/a>. Fears of participating in government programs may depress participation, the researchers found.\u003c/p>\n\u003cp>Helping undocumented immigrants in California overcome that fear can be an uphill battle for the \u003cem>promotoras\u003c/em> tasked with connecting their community with Medi-Cal.\u003c/p>\n\u003cp>“There was a man who we were trying to get to sign up for Medi-Cal, and he said no because Trump will just take it away,” Robles said in Spanish, laughing about it with Peralta in front of the La Superior grocery store in Pittsburgh.\u003c/p>\n\u003cp>“Little by little, people start trusting us since they’ll see us so often,” she added. “At first it was like no one wanted to [enroll], like they didn’t trust us much. But now, since we’re out here so often…people will recognize us, and they’ll say, ‘Oh, you are the women from Medi-Cal’—they’ll recognize us and start sharing their problems.”\u003c/p>\n\u003cfigure id=\"attachment_12007442\" class=\"wp-caption aligncenter\" style=\"max-width: 2560px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007442\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-scaled.jpg\" alt=\"Two women wearing black t-shirts and hats talk to two men outside a building as another man walks past pushing a shopping cart.\" width=\"2560\" height=\"1703\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-800x532.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-1536x1022.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-2048x1363.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-1920x1277.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Mireya Robles and her colleague Judith Peralta distribute information to Spanish-speaking Latinos outside of La Superior Mercados in Pittsburg on Thursday, Sept. 5, 2024. Robles and her colleague listened to stories of personal health concerns, employment and income to help people determine what the best possible route to attaining health care coverage looks like in their individual situation. \u003ccite>(Hiram Alejandro Durán for El Tímpano/CatchLight Local/Report for America corps member)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Robles, herself undocumented, recently obtained Medi-Cal this year through the latest expansion of the program. She’ll often share her own experience with people who express fear over public charge.\u003c/p>\n\u003cp>“We’re here to convince them,” she said. “Look, this is very important for you, for your health…This doesn’t hurt, on the contrary, it helps.”\u003c/p>\n\u003cp>In many cases, their efforts are successful. A few miles away at the Monument Impact office in Antioch, Espinoza, the senior \u003cem>promotora\u003c/em> for the organization, helps to organize the day’s appointments for immigrants to sit with a member of the team and work on their Medi-Cal application together. Some of the people in the waiting room are walk-ins.\u003c/p>\n\u003cp>“There are some people who cannot be convinced,” Espinoza said, “but others can be.”\u003c/p>\n\u003cp>By the end of the day, 13 new people were enrolled in Medi-Cal.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Jasmine Aguilera is participating in the Journalism & Women Symposium’s Health Journalism Fellowship, supported by The Commonwealth Fund.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Though the restrictive Trump-era public charge rule is no longer in place, it’s left people wary of signing up for newly expanded health benefits.",
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"title": "More California Immigrants Are Eligible For Medi-Cal, but Some Are Hesitant to Enroll | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ci data-stringify-type=\"italic\">This story was produced by \u003ca href=\"https://www.eltimpano.org\">El Tímpano\u003c/a>\u003c/i>\u003ci data-stringify-type=\"italic\">, a bilingual nonprofit news outlet that amplifies the voices of Latino and Mayan immigrants in Oakland and the wider Bay Area. The original version of the story can be found \u003ca href=\"https://www.eltimpano.org/health/lingering-fears-over-past-immigration-policies-are-fueling-a-reluctance-to-enroll-in-medi-cal\">here\u003c/a>\u003c/i>\u003ci data-stringify-type=\"italic\">.\u003c/i>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">O\u003c/span>\u003c/p>\u003cp>n a bright and early morning in Pittsburg, two women position themselves tactically outside the La Superior Mercados between the extra-large charcoal grill for roasting chicken and the rows of yellow-trimmed grocery carts. The supermarket is frequented by the area’s Latino community and anyone trying to get in or out this morning must pass the women first and hear their sales pitch. Their product should be easy to sell: free to low-cost health insurance for people with low incomes. But often, a surprising answer to their question, “Can we sign you up for Medi-Cal?” is “no.”\u003c/p>\n\u003cp>The list of benefits a patient can receive with full-scope Medi-Cal for free or at low cost includes emergency services, maternity care, mental health and substance use disorder services, pediatric care, and more, the women explain to passers-by. Their enrollment services are offered for free through Monument Impact, a nonprofit organization in Contra Costa County that helps connect low-income immigrants to resources, they remind folks. Still, several of the shoppers, mostly Spanish-speaking Latinos, look at the women with skepticism as they make their pitch.\u003c/p>\n\u003cp>Medi-Cal expanded to include all qualifying adults regardless of immigration status in January 2024. This year’s expansion was the final phase of an eight-year effort to extend Medi-Cal to undocumented immigrants, first to children and pregnant women, then to children under 19, to young adults under 26, and to older adults over 50, as part of the state’s initiative to expand health care access to all Californians. The UC Berkeley Labor Center \u003ca href=\"https://laborcenter.berkeley.edu/californias-uninsured-in-2024/\">estimates\u003c/a> that close to one million undocumented Californians will have gained access to Medi-Cal through this expansion.\u003c/p>\n\u003cp>Judith Peralta and Mireya Robles said that at the start of the year, it was no problem engaging folks and encouraging them to sign up for the program. As \u003cem>promotoras de salud\u003c/em>, health promoters, Peralta and Robles serve as trusted messengers to connect their community to limited health insurance options available to low-income immigrants.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The first few months of the year, the women saw a rush to apply for Medi-Cal—hundreds of people in the community were ready to enroll. But in recent months, they’ve found convincing people to sign up more challenging. Many of the people they encounter either already have Medi-Cal, know they don’t meet the income requirements to qualify for the program, or, in many cases, brush them off with a kind but adamant “no.” They’re afraid of Medi-Cal, the women say.\u003c/p>\n\u003cp>“It’s often men who have more fear, they’ll tell us ‘no, no,’” Peralta said in Spanish. “Like they’ll say it has something to do with immigration or it has to do with the government. Like they don’t want to give their name.”\u003c/p>\n\u003cp>Distrust of government has long run deep in Latino immigrant communities but reached a low point in 2019. That’s when the Trump administration announced that using certain government benefits could prevent undocumented immigrants from ever qualifying for legal status. The Trump administration leaned on a category known as a “\u003ca href=\"https://www.uscis.gov/green-card/green-card-processes-and-procedures/public-charge/public-charge-resources\">public charge\u003c/a>” to institute these changes. A public charge is an unauthorized immigrant who is likely to become dependent on government benefits. A designation of public charge jeopardizes an immigrant’s chances of securing legal status in the U.S. Before 2019, only using cash assistance for income like Temporary Assistance for Needy Families or needing long-term institutionalized care paid for by the government meant risking a designation of public charge from an immigration official.\u003c/p>\n\u003cp>The Trump administration expanded public charge to include Medicaid, the Supplemental Nutrition Assistance Program, housing assistance, energy assistance, child-care subsidies, and other benefits, according to the Migration Policy Institute, a nonpartisan research organization. Overnight, what was once an obscure set of bureaucratic rules became a household concern.\u003c/p>\n\u003cfigure id=\"attachment_12007441\" class=\"wp-caption aligncenter\" style=\"max-width: 2560px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007441\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-scaled.jpg\" alt=\"Three women sit at a table together in a building with a man sitting in a chair across from them.\" width=\"2560\" height=\"1703\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-800x532.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-1536x1022.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-2048x1363.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990928363_dcca480217_3k-1920x1277.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Azucena Espinoza, a senior promotora at Monument Impact, registered walk-ins looking for help with their Medi-Cal application at Monument Impact’s offices in Antioch on Thursday, Sept. 5, 2024. \u003ccite>(Hiram Alejandro Durán for El Tímpano/CatchLight Local/Report for America corps member)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Before 2019, “I actually had no clue of even the words ‘public charge,’” said Janet Anwar, registration services manager at Tiburcio Vasquez Health Center, a nonprofit East Bay health clinic. “It wasn’t a common word in our community, not until then. It brought a lot of concerns to our patients because there was a lot of miscommunication as to what was public charge, how it impacts immigration cases.”\u003c/p>\n\u003cp>Though the Trump public charge rules were only in effect for a short period and were reversed officially at the start of the Biden administration, researchers and immigrant advocates said the changes caused a long-lasting “chilling effect.” Experts say the Trump 2024 campaign has so far not mentioned public charge in its immigration agenda, but undocumented immigrants in California remain afraid, and that fear is preventing people from applying for the newly expanded Medi-Cal benefits.\u003c/p>\n\u003cp>This better-safe-than-sorry mindset means that undocumented immigrants may go years without seeing a medical professional or end up with high out-of-pocket expenses when they do seek medical care. Without insurance, immigrants will \u003ca href=\"https://www.kff.org/racial-equity-and-health-policy/fact-sheet/key-facts-on-health-coverage-of-immigrants/\">delay care\u003c/a> until their health condition is no longer tolerable or go without care entirely.\u003c/p>\n\u003cp>“We saw it all,” Anwar said, describing the years that followed Trump’s changes to public charge. “We saw patients not wanting to come in, not even for their appointments, thinking that just getting the services for their health care was going to affect them.”\u003c/p>\n\u003cp>People were also afraid to apply for benefits for their U.S.-born children, she added. “They even thought that that was going to affect them in some sort of way.”\u003c/p>\n\u003cp>In an election year, with former President Donald Trump again on the ballot, many undocumented immigrants are expressing concern about a return of the expanded public charge rules and how the government might use their information should they apply for Medi-Cal without legal status.\u003c/p>\n\u003cp>“They are afraid no matter what,” Azucena Espinoza, a senior \u003cem>promotora\u003c/em> with Monument Impact, explained in Spanish. “They say, ‘For what reason do they want all this information about us? So that tomorrow or the day after, they can use it [against us]?’ And they are right to feel that way because we know it could be Donald Trump. We don’t know what will happen, right?”\u003c/p>\n\u003cfigure id=\"attachment_12007440\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007440\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-scaled.jpg\" alt=\"A headshot of a woman wearing earrings and a drew with flower designs.\" width=\"1920\" height=\"2560\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-scaled.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-800x1067.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-1020x1360.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-160x213.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-1152x1536.jpg 1152w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53990695216_ea9e0d141e_o-1536x2048.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Azucena Espinoza, a senior promotora at Monument Impact, registered walk-ins looking for help with their Medi-Cal application at Monument Impact’s offices in Antioch on Thursday, Sept. 5, 2024. \u003ccite>(Hiram Alejandro Durán for El Tímpano/CatchLight Local/Report for America corps member)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>The ‘chilling effect’\u003c/h2>\n\u003cp>The concept of public charge has existed in U.S. immigration policy for \u003ca href=\"https://www.kff.org/racial-equity-and-health-policy/issue-brief/2022-changes-to-the-public-charge-inadmissibility-rule-and-the-implications-for-health-care/\">more than a century\u003c/a>. From 1999 to 2019, the share of undocumented immigrants who could be considered a public charge was 3%, according to the \u003ca href=\"https://latino.ucla.edu/research/lessons-2022-adult-medical-expansion/\">UCLA Latino Policy and Politics Institute\u003c/a> (LPPI), because the number of social programs an unauthorized immigrant would need to use in order to be deemed a public charge was limited. When the Trump administration expanded that list to include more social programs, the share of undocumented immigrants who could be considered a public charge rose to 47%.\u003c/p>\n\u003cp>Applications for Medicaid immediately declined following the Trump administration’s changes to public charge, according to the UCLA researchers. They found that 17% of undocumented immigrants avoided any public benefits enrollment in 2019. Mixed-status households also avoided applying for public benefits for fear of jeopardizing their undocumented loved ones, or immigrant parents of U.S.-born children avoided signing their children up for health benefits for fear it would negatively impact the family’s position in the country.\u003c/p>\n\u003cp>Though the Trump administration’s changes were challenged in court and ultimately were reversed in 2021, UCLA researchers have found evidence that the “chilling effect” lingers years later. When, in 2023, the UCLA researchers began studying California’s expansion of Medi-Cal to undocumented immigrants, fear of public charge came up again.\u003c/p>\n\u003cp>“Immigration status continues to be a barrier for folks to enroll in Medi-Cal,” said Lucía Félix Beltrán, senior research fellow at LPPI. “There is still a fair amount of work to be done around public charge. That’s where partnering with community organizations comes in. But even then it’s like, these decisions are made at the household level. It doesn’t matter how many organizations get involved or how many flyers you give out or how many briefs you publish. These decisions are made within households and that’s where it gets kind of tricky.”\u003c/p>\n\u003cp>In a statement to El Tímpano, a California Department of Health Care Services spokesperson said the agency is “unable to speculate about the potential impact of future public charge rule changes.” They added, however, that “California law strictly protects personal information, including immigration status, ensuring confidentiality for all applicants. If an individual does not have satisfactory immigration status and applies for Medi-Cal, California does not share their immigration status with the federal government, and the federal government does not have access to state-owned data.”\u003c/p>\n\u003ch2>Changing minds\u003c/h2>\n\u003cp>Changing minds when the perceived risk is so high is a challenge for the nonprofits tasked with informing community members about Medi-Cal and public charge.\u003c/p>\n\u003cp>The DHCS website includes \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/SPAN-Medi-Cal-Expansion-FAQ.pdf\">information in Spanish\u003c/a> that reminds interested Medi-Cal applicants that their information will not be shared with federal immigration enforcement agencies. All dollars spent on the expansion of Medi-Cal to undocumented people come from state funding. Regardless, other than long-term institutionalized care paid for by the government—nursing home or mental health institution care are examples, according to \u003ca href=\"https://www.uscis.gov/green-card/green-card-processes-and-procedures/public-charge/public-charge-resources\">U.S. Citizenship and Immigration Services\u003c/a>—Medi-Cal is exempt from the public charge rule. (According to DHCS, short-term institutional care like rehabilitation, respite care or treatment for behavioral or substance use disorder issues are not considered subject to public charge review).\u003c/p>\n\u003cp>However, for advice on navigating public charge and Medi-Cal, DHCS said to speak to certified nonprofit organizations—the agency cannot directly answer questions on this topic. Among those certified nonprofits is the Multicultural Institute, which provides immigrant families with health, immigration and labor resources at their three locations across the Bay Area.\u003c/p>\n\u003cp>The blocks surrounding the Multicultural Institute in Berkeley are lined with day laborers, immigrant men looking for whatever work they can find in construction or other household jobs. Outreach workers from the organization spend mornings canvassing the blocks to talk to the men and see what they might need, whether it’s food from their pantry or Medi-Cal coverage.\u003c/p>\n\u003cp>“We don’t have any lawyers here, but we do our best” to address public charge questions, said Daniela Gonzalez-Perez, Health and Engagement Manager at the Multicultural Institute, who added that they do still often hear concerns, the aftermath of what life was like during the Trump administration.\u003c/p>\n\u003cfigure id=\"attachment_12007438\" class=\"wp-caption aligncenter\" style=\"max-width: 2560px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007438\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-scaled.jpg\" alt=\"A woman with glasses and a white flowery shirt stands outside near plants.\" width=\"2560\" height=\"1703\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-800x532.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-1536x1022.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-2048x1363.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53955177560_6ab629b4a7_3k-1920x1277.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Daniela Gonzalez-Perez, Health and Engagement Manager at the Multicultural Institute says the community of immigrant families and individuals they serve worry about another Trump Administration, photographed on Thursday, Aug. 15, 2024. \u003ccite>(Hiram Alejandro Durán for El Tímpano/CatchLight Local/Report for America corps member)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>There was “a lot of fear of deportation, you know, just a fear of the reality that we were living in under Trump’s America and his hate or disdain for the immigrant community,” she said. “There’s a lot of uncertainty still of what would actually happen if they apply for benefits…If they are super, super concerned then we would refer them out to a partner organization that handles immigration cases.”\u003c/p>\n\u003cp>What many health and immigrant advocates hear frequently, according to interviews with El Tímpano, is that undocumented immigrants will avoid public benefits and delay seeing a doctor or medical professional for years, until their needs are dire and have to go to an emergency room.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“There are people out there who said…that immigrants use way too much public benefits and it’s just not true based on the numbers,” said Valerie Lacarte, a senior policy analyst with the Migration Policy Institute who studied immigrant participation in government programs like Medicaid. When comparing low-income U.S. citizens with low-income non-citizens, usage of public benefits dips. In the vast majority of the U.S., most undocumented immigrants do not qualify for Medicaid—California is an exception. However, when comparing the U.S.-born low-income population and immigrants who are federally eligible for Medicaid, participation in the program was at 76% for citizens and 66% for non-citizens, \u003ca href=\"https://www.migrationpolicy.org/sites/default/files/publications/mpi-hsi_medicaid-brief_final.pdf\">according to MPI\u003c/a>. Fears of participating in government programs may depress participation, the researchers found.\u003c/p>\n\u003cp>Helping undocumented immigrants in California overcome that fear can be an uphill battle for the \u003cem>promotoras\u003c/em> tasked with connecting their community with Medi-Cal.\u003c/p>\n\u003cp>“There was a man who we were trying to get to sign up for Medi-Cal, and he said no because Trump will just take it away,” Robles said in Spanish, laughing about it with Peralta in front of the La Superior grocery store in Pittsburgh.\u003c/p>\n\u003cp>“Little by little, people start trusting us since they’ll see us so often,” she added. “At first it was like no one wanted to [enroll], like they didn’t trust us much. But now, since we’re out here so often…people will recognize us, and they’ll say, ‘Oh, you are the women from Medi-Cal’—they’ll recognize us and start sharing their problems.”\u003c/p>\n\u003cfigure id=\"attachment_12007442\" class=\"wp-caption aligncenter\" style=\"max-width: 2560px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12007442\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-scaled.jpg\" alt=\"Two women wearing black t-shirts and hats talk to two men outside a building as another man walks past pushing a shopping cart.\" width=\"2560\" height=\"1703\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-800x532.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-1536x1022.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-2048x1363.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/53991008254_4b67325eb8_o-1920x1277.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Mireya Robles and her colleague Judith Peralta distribute information to Spanish-speaking Latinos outside of La Superior Mercados in Pittsburg on Thursday, Sept. 5, 2024. Robles and her colleague listened to stories of personal health concerns, employment and income to help people determine what the best possible route to attaining health care coverage looks like in their individual situation. \u003ccite>(Hiram Alejandro Durán for El Tímpano/CatchLight Local/Report for America corps member)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Robles, herself undocumented, recently obtained Medi-Cal this year through the latest expansion of the program. She’ll often share her own experience with people who express fear over public charge.\u003c/p>\n\u003cp>“We’re here to convince them,” she said. “Look, this is very important for you, for your health…This doesn’t hurt, on the contrary, it helps.”\u003c/p>\n\u003cp>In many cases, their efforts are successful. A few miles away at the Monument Impact office in Antioch, Espinoza, the senior \u003cem>promotora\u003c/em> for the organization, helps to organize the day’s appointments for immigrants to sit with a member of the team and work on their Medi-Cal application together. Some of the people in the waiting room are walk-ins.\u003c/p>\n\u003cp>“There are some people who cannot be convinced,” Espinoza said, “but others can be.”\u003c/p>\n\u003cp>By the end of the day, 13 new people were enrolled in Medi-Cal.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Jasmine Aguilera is participating in the Journalism & Women Symposium’s Health Journalism Fellowship, supported by The Commonwealth Fund.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "california-open-to-resolving-suit-against-catholic-hospital-over-emergency-abortion-care",
"title": "California Open to Resolving Suit Against Catholic Hospital Over Emergency Abortion Care",
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"content": "\u003cp>The state’s Department of Justice on Wednesday appeared to suggest it was open to settling its lawsuit against a Catholic hospital in \u003ca href=\"https://www.kqed.org/news/tag/northern-california\">Northern California\u003c/a> accused of denying a pregnant woman emergency abortion care.\u003c/p>\n\u003cp>Attorney General Rob Bonta announced the \u003ca href=\"https://www.kqed.org/news/12007119/california-sues-a-catholic-hospital-for-denying-patient-an-emergency-abortion\">lawsuit\u003c/a> on Monday, alleging that policy at Providence St. Joseph Hospital in Eureka prevented doctors from performing a potentially life-saving emergency abortion on Dr. Anna Nusslock, who was 15 weeks pregnant with twins when her water broke, so long as “fetal heart tones” were present.\u003c/p>\n\u003cp>Garry Olney, chief executive for Providence’s Northern California service area, apologized in a statement to employees, saying Nusslock’s treatment did not meet Providence’s “high standards for safe, quality, compassionate care.” A spokesperson pointed to the Catholic Church’s U.S. health care directives that allow for “operations, treatments, and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman” that cannot be safely postponed until the child is viable, “even if they will result in the death of the unborn child.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We are immediately revisiting our training, education and escalation processes in emergency medical situations to ensure that this does not happen again and to ensure that our care teams have the training and support they need to deliver the best possible care for each patient we serve,” Olney’s message reads.\u003c/p>\n\u003cp>The hospital did not clarify whether it has a policy that bans medical intervention when a fetal heartbeat can be detected unless the patient’s life is sufficiently at risk. According to the lawsuit, a doctor at Providence St. Joseph told Nusslock that she could not perform an in-clinic abortion procedure known as dilation and evacuation unless Nusslock’s life was at risk, nor could she induce contractions with misoprostol while the fetuses still had a heartbeat.\u003c/p>\n\u003cp>“If Providence is committed to changing its policies to comply with the law and ensuring this never happens again, our office is prepared to work constructively with them to resolve this litigation and to protect patients,” a spokesperson for the California Department of Justice said.\u003c/p>\n\u003cp>According to the lawsuit, Nusslock was experiencing contractions and bleeding and was told that her twins would not survive — and that her health would also be at risk if she did not receive an emergency abortion. But a Providence St. Joseph doctor, the suit alleges, told Nusslock the only care she could provide was expectant management or closely monitoring her symptoms for changes that would allow intervention. She suggested that Nusslock travel to another hospital to receive care.\u003c/p>\n\u003cp>[aside postID=news_12007157 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/GavinNewsomAP2-1020x680.jpg']\u003c/p>\n\u003cp>Nusslock ultimately drove — with towels and buckets, “in case something happen[ed] in the car” — to Mad River Community Hospital 12 miles away in Arcata, where a doctor performed an emergency abortion. They said Nusslock was “actively hemorrhaging” on the operating table.\u003c/p>\n\u003cp>The suit claims that though Providence “will ostensibly intervene” if a pregnant patient is “on the verge of death,” California law requires that, as a licensed facility, it must act in the event of serious injury or illness as well. It also alleges that Providence discriminates against pregnant patients by not giving them comprehensive emergency care as it would others.\u003c/p>\n\u003cp>The attorney general’s office said it believes that others might have had experiences similar to Nusslock, and is asking that they share their experiences with the Department of Justice.\u003c/p>\n\u003cp>“We don’t yet know the full scope of this problem or how many patients have suffered, but we do know that unless we act, this will happen again and again,” Bonta said.\u003c/p>\n\u003cp>He asked the court to issue an injunction prohibiting the hospital and its affiliates from violating the state laws it says required them to provide Nusslock with care, along with requiring them to pay monetary damages.\u003c/p>\n\u003cp>“Even in California, a champion for reproductive freedom, we are not immune from practices like the one we’re seeing today, and we will not stand by as it occurs,” Bonta said during a press conference on Monday. “We will take action as we’re doing today and move to end it immediately.”\u003c/p>\n\u003cp>\u003cem>KQED’s \u003ca href=\"https://www.kqed.org/author/carlysevern\">Carly Severn\u003c/a> contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The state’s Department of Justice on Wednesday appeared to suggest it was open to settling its lawsuit against a Catholic hospital in \u003ca href=\"https://www.kqed.org/news/tag/northern-california\">Northern California\u003c/a> accused of denying a pregnant woman emergency abortion care.\u003c/p>\n\u003cp>Attorney General Rob Bonta announced the \u003ca href=\"https://www.kqed.org/news/12007119/california-sues-a-catholic-hospital-for-denying-patient-an-emergency-abortion\">lawsuit\u003c/a> on Monday, alleging that policy at Providence St. Joseph Hospital in Eureka prevented doctors from performing a potentially life-saving emergency abortion on Dr. Anna Nusslock, who was 15 weeks pregnant with twins when her water broke, so long as “fetal heart tones” were present.\u003c/p>\n\u003cp>Garry Olney, chief executive for Providence’s Northern California service area, apologized in a statement to employees, saying Nusslock’s treatment did not meet Providence’s “high standards for safe, quality, compassionate care.” A spokesperson pointed to the Catholic Church’s U.S. health care directives that allow for “operations, treatments, and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman” that cannot be safely postponed until the child is viable, “even if they will result in the death of the unborn child.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We are immediately revisiting our training, education and escalation processes in emergency medical situations to ensure that this does not happen again and to ensure that our care teams have the training and support they need to deliver the best possible care for each patient we serve,” Olney’s message reads.\u003c/p>\n\u003cp>The hospital did not clarify whether it has a policy that bans medical intervention when a fetal heartbeat can be detected unless the patient’s life is sufficiently at risk. According to the lawsuit, a doctor at Providence St. Joseph told Nusslock that she could not perform an in-clinic abortion procedure known as dilation and evacuation unless Nusslock’s life was at risk, nor could she induce contractions with misoprostol while the fetuses still had a heartbeat.\u003c/p>\n\u003cp>“If Providence is committed to changing its policies to comply with the law and ensuring this never happens again, our office is prepared to work constructively with them to resolve this litigation and to protect patients,” a spokesperson for the California Department of Justice said.\u003c/p>\n\u003cp>According to the lawsuit, Nusslock was experiencing contractions and bleeding and was told that her twins would not survive — and that her health would also be at risk if she did not receive an emergency abortion. But a Providence St. Joseph doctor, the suit alleges, told Nusslock the only care she could provide was expectant management or closely monitoring her symptoms for changes that would allow intervention. She suggested that Nusslock travel to another hospital to receive care.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Nusslock ultimately drove — with towels and buckets, “in case something happen[ed] in the car” — to Mad River Community Hospital 12 miles away in Arcata, where a doctor performed an emergency abortion. They said Nusslock was “actively hemorrhaging” on the operating table.\u003c/p>\n\u003cp>The suit claims that though Providence “will ostensibly intervene” if a pregnant patient is “on the verge of death,” California law requires that, as a licensed facility, it must act in the event of serious injury or illness as well. It also alleges that Providence discriminates against pregnant patients by not giving them comprehensive emergency care as it would others.\u003c/p>\n\u003cp>The attorney general’s office said it believes that others might have had experiences similar to Nusslock, and is asking that they share their experiences with the Department of Justice.\u003c/p>\n\u003cp>“We don’t yet know the full scope of this problem or how many patients have suffered, but we do know that unless we act, this will happen again and again,” Bonta said.\u003c/p>\n\u003cp>He asked the court to issue an injunction prohibiting the hospital and its affiliates from violating the state laws it says required them to provide Nusslock with care, along with requiring them to pay monetary damages.\u003c/p>\n\u003cp>“Even in California, a champion for reproductive freedom, we are not immune from practices like the one we’re seeing today, and we will not stand by as it occurs,” Bonta said during a press conference on Monday. “We will take action as we’re doing today and move to end it immediately.”\u003c/p>\n\u003cp>\u003cem>KQED’s \u003ca href=\"https://www.kqed.org/author/carlysevern\">Carly Severn\u003c/a> contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"title": "California’s Bold Moves to Curb Fentanyl Deaths Leave Experts Urging for More",
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"content": "\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/california\">California\u003c/a> is forging ahead with a series of new laws aimed at reducing overdose deaths, even as opioid overdose rates have started to decline slightly. The new measures signed by Gov. \u003ca href=\"https://www.kqed.org/news/tag/gavin-newsom\">Gavin Newsom\u003c/a> this week include expanded access to addiction treatment, life-saving overdose reversal medications, and more.\u003c/p>\n\u003cp>“California legislators have shown a serious commitment to addressing the fentanyl crisis,” said Dr. Keith Humphreys, a professor of psychiatry and behavioral sciences at Stanford University. While deaths remain higher than pre-pandemic levels, \u003ca href=\"https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm\">the Centers for Disease Control and Prevention\u003c/a> reports that fatal overdoses across the country have dropped to their lowest numbers in three years. California is just beginning to see a \u003ca href=\"https://skylab.cdph.ca.gov/ODdash/?tab=CA\">downward trend\u003c/a>.\u003c/p>\n\u003cp>The reasons for this shift remain unclear. “Why? The best answer is, ‘We don’t know,'” said Dr. Dan Ciccarone, a professor of addiction medicine at UCSF. “People will point to different interventions, whether it’s restoring public order, increasing access to naloxone, or expanding treatment options, but none of these happened swiftly or broadly enough to fully explain the drop.”\u003c/p>\n\u003cp>Fentanyl, the inexpensive opioid that’s 20–40 times stronger than heroin, has \u003ca href=\"https://www.kqed.org/news/11972898/2023-was-san-franciscos-deadliest-year-for-drug-overdoses-new-data-confirms\">flooded the drug market in San Francisco\u003c/a> and other cities in recent years, leading to record deaths.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It’s not just about one law — it’s a coordinated suite of policies focused on prevention, treatment, and harm reduction. As both an addiction researcher and a resident, I feel California is moving in the right direction,” Humphreys said.\u003c/p>\n\u003cp>Among the newly signed bills is \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240AB1842\">AB 1842\u003c/a>, which eliminates the need for insurers to require prior authorization before treating patients with opioid use disorder. Ciccarone called it a critical move, describing prior authorization as “a clinical barrier that frustrates both doctors and patients and ultimately stifles care.”\u003c/p>\n\u003cfigure id=\"attachment_11998108\" class=\"wp-caption aligncenter\" style=\"max-width: 1999px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11998108\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed.jpg\" alt=\"\" width=\"1999\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed.jpg 1999w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 1999px) 100vw, 1999px\">\u003cfigcaption class=\"wp-caption-text\">Contents of a harm reduction kit on June 17, 2024. The kit includes new syringes, fentanyl test strips and Narcan. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Another key piece of legislation, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB1976\">AB 1976\u003c/a>, will require businesses to stock naloxone, a medication that can instantly reverse opioid overdoses, in their first-aid kits by 2027. Meanwhile, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB1841\">AB 1841\u003c/a> will provide two doses of naloxone to resident advisors at public colleges in California.\u003c/p>\n\u003cp>Access to methadone, a medication used to treat opioid addiction, will also be broadened under \u003ca href=\"https://www.kqed.org/science/1992298/a-bay-area-lawmaker-pushes-to-expand-access-to-methadone\">AB 2115\u003c/a>, which allows patients to take home more doses and increases the number of practitioners permitted to prescribe it. Current regulations require most patients to visit clinics daily to receive a single dose.\u003c/p>\n\u003cp>“I support most of these bills and believe each will contribute in small but meaningful ways,” Ciccarone said. He singled out the elimination of prior authorization requirements as particularly impactful and praised the expansion of naloxone access into schools and workplaces as “a great package of ideas.”\u003c/p>\n\u003cp>Yet, Ciccarone noted the absence of a more controversial measure: supervised drug consumption sites, where individuals can use illicit drugs under the supervision of trained staff. \u003ca href=\"https://www.kqed.org/science/1979220/debate-heats-up-over-effort-to-pilot-safe-injection-sites-in-california\">Research\u003c/a> shows that such sites reduce hospitalizations, lower public costs, and save lives. Gov. Newsom vetoed a bill in 2022 that would have allowed a limited number of California cities to pilot these facilities.\u003c/p>\n\u003cp>[aside postID=news_12006134 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/RS57150_037_KQED_DABrookeJenkins_07072022-qut-1020x680.jpg']\u003c/p>\n\u003cp>“The most effective solutions are often the ones people fear the most,” Ciccarone said. “What we need now is the courage and political will to take bolder steps.”\u003c/p>\n\u003cp>Another critical policy gap, according to Humphreys, is the failure to pass a \u003ca href=\"https://legiscan.com/CA/text/AB3073/id/2966699\">bill\u003c/a> that would have mandated wastewater testing for illicit drugs. This measure died in committee earlier this year.\u003c/p>\n\u003cp>“Wastewater testing reveals where drugs are being used and what’s circulating in the community,” Humphreys said. “It’s an early warning system for dangerous substances, and it also shows whether investments in treatment, prevention, and law enforcement are actually making a difference.”\u003c/p>\n\u003cp>Last year, 7,748 Californians died from fentanyl overdoses, more than double the number just five years ago, according to the CDC. While the new laws represent significant progress, addiction experts caution that the road to reversing the opioid crisis remains long.\u003c/p>\n\u003cp>Several additional bills signed by Newsom are aimed at curbing fentanyl use and saving lives:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>AB 2429\u003c/strong>: Expands high school health education to include lessons on the dangers of fentanyl use.\u003c/li>\n\u003cli>\u003cstrong>AB 2136\u003c/strong>: Prevents law enforcement from arresting individuals who allow harm reduction service providers to test their drugs.\u003c/li>\n\u003cli>\u003cstrong>SB 997\u003c/strong>: Authorizes middle and high school students to carry naloxone and requires schools to stock and distribute fentanyl test strips.\u003c/li>\n\u003cli>\u003cstrong>SB 908\u003c/strong>: Directs the state’s health department to investigate fentanyl-related deaths among children ages 0 to 5.\u003c/li>\n\u003cli>\u003cstrong>SB 1468\u003c/strong>: Encourages providers to prescribe a three-day supply of narcotic medication to begin detoxification or maintenance treatment for people using opioids.\u003c/li>\n\u003cli>\u003cstrong>SB 910\u003c/strong>: Enhances programming, drug testing, and medication-assisted treatment for individuals in the criminal justice system.\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/california\">California\u003c/a> is forging ahead with a series of new laws aimed at reducing overdose deaths, even as opioid overdose rates have started to decline slightly. The new measures signed by Gov. \u003ca href=\"https://www.kqed.org/news/tag/gavin-newsom\">Gavin Newsom\u003c/a> this week include expanded access to addiction treatment, life-saving overdose reversal medications, and more.\u003c/p>\n\u003cp>“California legislators have shown a serious commitment to addressing the fentanyl crisis,” said Dr. Keith Humphreys, a professor of psychiatry and behavioral sciences at Stanford University. While deaths remain higher than pre-pandemic levels, \u003ca href=\"https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm\">the Centers for Disease Control and Prevention\u003c/a> reports that fatal overdoses across the country have dropped to their lowest numbers in three years. California is just beginning to see a \u003ca href=\"https://skylab.cdph.ca.gov/ODdash/?tab=CA\">downward trend\u003c/a>.\u003c/p>\n\u003cp>The reasons for this shift remain unclear. “Why? The best answer is, ‘We don’t know,'” said Dr. Dan Ciccarone, a professor of addiction medicine at UCSF. “People will point to different interventions, whether it’s restoring public order, increasing access to naloxone, or expanding treatment options, but none of these happened swiftly or broadly enough to fully explain the drop.”\u003c/p>\n\u003cp>Fentanyl, the inexpensive opioid that’s 20–40 times stronger than heroin, has \u003ca href=\"https://www.kqed.org/news/11972898/2023-was-san-franciscos-deadliest-year-for-drug-overdoses-new-data-confirms\">flooded the drug market in San Francisco\u003c/a> and other cities in recent years, leading to record deaths.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It’s not just about one law — it’s a coordinated suite of policies focused on prevention, treatment, and harm reduction. As both an addiction researcher and a resident, I feel California is moving in the right direction,” Humphreys said.\u003c/p>\n\u003cp>Among the newly signed bills is \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240AB1842\">AB 1842\u003c/a>, which eliminates the need for insurers to require prior authorization before treating patients with opioid use disorder. Ciccarone called it a critical move, describing prior authorization as “a clinical barrier that frustrates both doctors and patients and ultimately stifles care.”\u003c/p>\n\u003cfigure id=\"attachment_11998108\" class=\"wp-caption aligncenter\" style=\"max-width: 1999px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11998108\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed.jpg\" alt=\"\" width=\"1999\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed.jpg 1999w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 1999px) 100vw, 1999px\">\u003cfigcaption class=\"wp-caption-text\">Contents of a harm reduction kit on June 17, 2024. The kit includes new syringes, fentanyl test strips and Narcan. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Another key piece of legislation, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB1976\">AB 1976\u003c/a>, will require businesses to stock naloxone, a medication that can instantly reverse opioid overdoses, in their first-aid kits by 2027. Meanwhile, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB1841\">AB 1841\u003c/a> will provide two doses of naloxone to resident advisors at public colleges in California.\u003c/p>\n\u003cp>Access to methadone, a medication used to treat opioid addiction, will also be broadened under \u003ca href=\"https://www.kqed.org/science/1992298/a-bay-area-lawmaker-pushes-to-expand-access-to-methadone\">AB 2115\u003c/a>, which allows patients to take home more doses and increases the number of practitioners permitted to prescribe it. Current regulations require most patients to visit clinics daily to receive a single dose.\u003c/p>\n\u003cp>“I support most of these bills and believe each will contribute in small but meaningful ways,” Ciccarone said. He singled out the elimination of prior authorization requirements as particularly impactful and praised the expansion of naloxone access into schools and workplaces as “a great package of ideas.”\u003c/p>\n\u003cp>Yet, Ciccarone noted the absence of a more controversial measure: supervised drug consumption sites, where individuals can use illicit drugs under the supervision of trained staff. \u003ca href=\"https://www.kqed.org/science/1979220/debate-heats-up-over-effort-to-pilot-safe-injection-sites-in-california\">Research\u003c/a> shows that such sites reduce hospitalizations, lower public costs, and save lives. Gov. Newsom vetoed a bill in 2022 that would have allowed a limited number of California cities to pilot these facilities.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The most effective solutions are often the ones people fear the most,” Ciccarone said. “What we need now is the courage and political will to take bolder steps.”\u003c/p>\n\u003cp>Another critical policy gap, according to Humphreys, is the failure to pass a \u003ca href=\"https://legiscan.com/CA/text/AB3073/id/2966699\">bill\u003c/a> that would have mandated wastewater testing for illicit drugs. This measure died in committee earlier this year.\u003c/p>\n\u003cp>“Wastewater testing reveals where drugs are being used and what’s circulating in the community,” Humphreys said. “It’s an early warning system for dangerous substances, and it also shows whether investments in treatment, prevention, and law enforcement are actually making a difference.”\u003c/p>\n\u003cp>Last year, 7,748 Californians died from fentanyl overdoses, more than double the number just five years ago, according to the CDC. While the new laws represent significant progress, addiction experts caution that the road to reversing the opioid crisis remains long.\u003c/p>\n\u003cp>Several additional bills signed by Newsom are aimed at curbing fentanyl use and saving lives:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>AB 2429\u003c/strong>: Expands high school health education to include lessons on the dangers of fentanyl use.\u003c/li>\n\u003cli>\u003cstrong>AB 2136\u003c/strong>: Prevents law enforcement from arresting individuals who allow harm reduction service providers to test their drugs.\u003c/li>\n\u003cli>\u003cstrong>SB 997\u003c/strong>: Authorizes middle and high school students to carry naloxone and requires schools to stock and distribute fentanyl test strips.\u003c/li>\n\u003cli>\u003cstrong>SB 908\u003c/strong>: Directs the state’s health department to investigate fentanyl-related deaths among children ages 0 to 5.\u003c/li>\n\u003cli>\u003cstrong>SB 1468\u003c/strong>: Encourages providers to prescribe a three-day supply of narcotic medication to begin detoxification or maintenance treatment for people using opioids.\u003c/li>\n\u003cli>\u003cstrong>SB 910\u003c/strong>: Enhances programming, drug testing, and medication-assisted treatment for individuals in the criminal justice system.\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"id": "american-suburb-podcast",
"title": "American Suburb: The Podcast",
"tagline": "The flip side of gentrification, told through one town",
"info": "Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?",
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},
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},
"baycurious": {
"id": "baycurious",
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"tagline": "Exploring the Bay Area, one question at a time",
"info": "KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.",
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},
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},
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},
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},
"californiareport": {
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"tagline": "California, day by day",
"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
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"officialWebsiteLink": "/californiareport",
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"order": 8
},
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}
},
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"tagline": "Your state, your stories",
"info": "Every week, The California Report Magazine takes you on a road trip for the ears: to visit the places and meet the people who make California unique. The in-depth storytelling podcast from the California Report.",
"airtime": "FRI 4:30pm-5pm, 6:30pm-7pm, 11pm-11:30pm",
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"order": 10
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM3NjkwNjk1OTAz",
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"info": "A one-hour radio program to hear celebrated writers, artists and thinkers address contemporary ideas and values, often discussing the creative process. Please note: tapes or transcripts are not available",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/cityartsandlecture-300x300.jpg",
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"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
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"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
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"order": 1
},
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"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"meta": {
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
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"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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}
},
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"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"source": "kqed",
"order": 9
},
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"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
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"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
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"id": "fresh-air",
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"officialWebsiteLink": "https://www.npr.org/series/423302056/hidden-brain",
"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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"how-i-built-this": {
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"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
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"airtime": "SUN 7:30pm-8pm",
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"link": "/radio/program/how-i-built-this",
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"hyphenacion": {
"id": "hyphenacion",
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"tagline": "Where conversation and cultura meet",
"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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"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"order": 18
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},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
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"source": "npr"
},
"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"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.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
}
},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Masters-of-Scale-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
"site": "radio",
"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
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"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"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>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
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