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"content": "\u003cp>When you stroll down the cold and flu aisle in a drugstore it’s easy to get lost in the dizzying array of products promising to clear sinus pressure, dry up sniffles and stop plaguing coughs. Some concoctions even offer it all in one magical pill. However, a government panel has found the evidence behind some of these claims is lackluster — and doctors say that could extend all the way down the aisle.\u003c/p>\n\u003cp>“There’s just not much that’s very effective for treating the common cold,” said Dr. Lauren Eggert, clinical assistant professor in the Pulmonary Allergy and Critical Care Division at Stanford University. “Most of the things out there — antihistamines, decongestants, cough medicines — none of them have a lot of evidence that they’re super effective at improving cough or common cold symptoms.”\u003c/p>\n\u003cp>[aside postID=science_1936021 hero='https://cdn.kqed.org/wp-content/uploads/sites/35/2018/12/iStock-912854994-1180x787.jpg']This week the Food and Drug administration determined the country’s leading decongestant is really no better than a sugar pill. \u003ca href=\"https://www.fda.gov/drugs/drug-safety-and-availability/fda-clarifies-results-recent-advisory-committee-meeting-oral-phenylephrine\">In a unanimous vote Tuesday\u003c/a>, advisers to the agency said the key drug, phenylephrine, found in Sudafed P.E., Mucinex Sinus Max, Dayquil and other oral medications is simply not effective. The review was prompted by \u003ca href=\"https://www.usatoday.com/story/money/business/2014/02/21/fda-overhauling-over-the-counter-regulations/5704165/\">inquiries dating back nearly a decade\u003c/a>. And experts warn the ineffectiveness is not limited to just that one drug. More reviews of over-the-counter drugs are expected.\u003c/p>\n\u003cp>Eggert pointed to the database \u003ca href=\"https://www.wolterskluwer.com/en/solutions/uptodate\">UpToDate\u003c/a>. Physicians use the resource when they want to see the summary of evidence for a group of medications. The conclusions for cold and flu remedies are disconcerting:\u003c/p>\n\u003cul>\n\u003cli>Antihistamines, vitamins and herbal remedies are deemed \u003cem>ineffective\u003c/em>.\u003c/li>\n\u003cli>Cough syrups, decongestants, expectorants, and zinc may have \u003cem>minimal or uncertain benefits\u003c/em>.\u003c/li>\n\u003cli>Nasal sprays and analgesics like Tylenol and ibuprofen \u003cem>may be effective\u003c/em>.\u003c/li>\n\u003c/ul>\n\u003cp>So, why are there so many cold and flu products on store shelves making big promises with little evidence to back them up?\u003c/p>\n\u003cp>The FDA’s \u003ca href=\"https://www.fda.gov/drugs/otc-drug-review-process-otc-drug-monographs#:~:text=An%20OTC%20drug%20monograph%20establishes,GRASE)%20for%20its%20intended%20use.\">over-the-counter drug list\u003c/a> has not been updated since 1995. And many of the drugs sold today were grandfathered during the ’60s and ’70s when scientific studies were much less rigorous.[pullquote align=\"right\" size=\"medium\" citation=\"Dr. Shalini Lynch, health sciences clinical professor, UCSF School of Pharmacy\"]‘You want to feel better instantly. But the reality is most cough and cold, viral types of upper respiratory infections, they just take time to go away.’[/pullquote]“Back in those days, statistics were not very developed,” said \u003ca href=\"https://pharmacy.ufl.edu/profile/hendeles-leslie/\">Dr. Leslie Hendeles\u003c/a>, PharmD, professor emeritus at the University of Florida in Gainesville, who was one of the petitioners who prompted this week’s FDA review. “The whole concept of clinical trials and study design was in its infancy.”\u003c/p>\n\u003cp>And since then the system for updating the drug list has traditionally taken many years or even decades, requiring multiple rounds of review and public comments.\u003c/p>\n\u003cp>The passage of \u003ca href=\"https://www.fda.gov/news-events/fda-voices/exciting-new-chapter-otc-drug-history-otc-monograph-reform-cares-act#:~:text=The%20beginning%20of%20an%20exciting,regulated%20in%20the%20United%20States.\">the 2020 CARES Act\u003c/a> should improve what’s available by streamlining the laborious process that may have allowed unchecked medications on the market. This week’s vote on phenylephrine, which was based on the latest scientific evidence, is the first test case for the law. But the FDA has not yet issued a final decision on whether the product will be removed from store shelves.\u003c/p>\n\u003cp>“The message here is that there are a lot of products on the market that fall into the same category as phenylephrine,” said Hendeles. “They’re not for diseases where people die or have to go to an emergency room. So they have not gotten the attention — even from the FDA — until now.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Hendeles believes regulators are likely to ultimately find that many other over-the-counter drugs are futile, too. “I know for sure that the cough suppressants and the expectorants are next in line.”\u003c/p>\n\u003cp>He points to a compilation of data he presented in \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/29669663/\">a 2018 paper\u003c/a> published in the journal Allergy and Asthma Proceedings, where he concluded the marketing claims on products designed for respiratory symptoms are overblown. And the evidence for decongestants, expectorants and cough suppressants does not “justify their use.”\u003c/p>\n\u003cp>Industry groups like the Consumer Healthcare Products Association maintain that phenylephrine has provided the public with clear health benefits for years. They asked the FDA not to remove it from a list of safe and effective over-the-counter drugs, arguing it provides the public with accessible treatment.\u003c/p>\n\u003cp>“Simply put, the burdens created from decreased choice and availability of these products would be placed directly onto consumers and an already-strained U.S. healthcare system, which is why CHPA encourages the panel to consider the real-world experience and needs of consumers when making decisions that will have such broad implications,” said Marcia Howard, the association’s vice president of regulatory and scientific affairs, \u003ca href=\"https://www.chpa.org/news/2023/09/statement-sept-11-12-2023-meeting-fda-ndac-evaluate-efficacy-oral-pe\">in a statement\u003c/a>.\u003c/p>\n\u003ch2>So, what can help your runny nose?\u003c/h2>\n\u003cp>Hendeles recommends steroidal nasal sprays for people suffering from allergies. Look for fluticasone (Flonase) or triamcinolone (Nascort). One squirt in each nostril. Evidence suggests Oxymetazoline Hydrochloride (Afrin or Sinex) is the best nasal spray for people who are sick with a respiratory illness.\u003c/p>\n\u003ch2>What about the rest of the meds lining your medicine cabinet?\u003c/h2>\n\u003cp>“If you’ve used something and you felt like it was helpful, I don’t think there’s a problem with that,” said Eggbert. “There’s little harm for people who are looking for relief. And I do believe in the placebo effect.”\u003c/p>\n\u003cp>But don’t look for a magical concoction. Single-ingredient products will help lower the possibility for side effects, according to Dr. Shalini Lynch, PharmD, health sciences clinical professor at UCSF’s School of Pharmacy. She says it should be obvious in a day or two if the product is relieving a desired symptom.\u003c/p>\n\u003cp>Science also supports some natural remedies. Saline nasal rinses may help clear your sinuses and \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/22869830/\">honey can quell your cough\u003c/a>. Additionally, it may be worth standing in a steamy shower or filling your humidifier to open your nasal passages. However, Lynch’s best advice is simply to lay low and hydrate.\u003c/p>\n\u003cp>“The common cold is something that pretty much needs to run its course,” she said. “You want to feel better instantly. But the reality is most cough and cold, viral types of upper respiratory infections, they just take time to go away.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When you stroll down the cold and flu aisle in a drugstore it’s easy to get lost in the dizzying array of products promising to clear sinus pressure, dry up sniffles and stop plaguing coughs. Some concoctions even offer it all in one magical pill. However, a government panel has found the evidence behind some of these claims is lackluster — and doctors say that could extend all the way down the aisle.\u003c/p>\n\u003cp>“There’s just not much that’s very effective for treating the common cold,” said Dr. Lauren Eggert, clinical assistant professor in the Pulmonary Allergy and Critical Care Division at Stanford University. “Most of the things out there — antihistamines, decongestants, cough medicines — none of them have a lot of evidence that they’re super effective at improving cough or common cold symptoms.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>This week the Food and Drug administration determined the country’s leading decongestant is really no better than a sugar pill. \u003ca href=\"https://www.fda.gov/drugs/drug-safety-and-availability/fda-clarifies-results-recent-advisory-committee-meeting-oral-phenylephrine\">In a unanimous vote Tuesday\u003c/a>, advisers to the agency said the key drug, phenylephrine, found in Sudafed P.E., Mucinex Sinus Max, Dayquil and other oral medications is simply not effective. The review was prompted by \u003ca href=\"https://www.usatoday.com/story/money/business/2014/02/21/fda-overhauling-over-the-counter-regulations/5704165/\">inquiries dating back nearly a decade\u003c/a>. And experts warn the ineffectiveness is not limited to just that one drug. More reviews of over-the-counter drugs are expected.\u003c/p>\n\u003cp>Eggert pointed to the database \u003ca href=\"https://www.wolterskluwer.com/en/solutions/uptodate\">UpToDate\u003c/a>. Physicians use the resource when they want to see the summary of evidence for a group of medications. The conclusions for cold and flu remedies are disconcerting:\u003c/p>\n\u003cul>\n\u003cli>Antihistamines, vitamins and herbal remedies are deemed \u003cem>ineffective\u003c/em>.\u003c/li>\n\u003cli>Cough syrups, decongestants, expectorants, and zinc may have \u003cem>minimal or uncertain benefits\u003c/em>.\u003c/li>\n\u003cli>Nasal sprays and analgesics like Tylenol and ibuprofen \u003cem>may be effective\u003c/em>.\u003c/li>\n\u003c/ul>\n\u003cp>So, why are there so many cold and flu products on store shelves making big promises with little evidence to back them up?\u003c/p>\n\u003cp>The FDA’s \u003ca href=\"https://www.fda.gov/drugs/otc-drug-review-process-otc-drug-monographs#:~:text=An%20OTC%20drug%20monograph%20establishes,GRASE)%20for%20its%20intended%20use.\">over-the-counter drug list\u003c/a> has not been updated since 1995. And many of the drugs sold today were grandfathered during the ’60s and ’70s when scientific studies were much less rigorous.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“Back in those days, statistics were not very developed,” said \u003ca href=\"https://pharmacy.ufl.edu/profile/hendeles-leslie/\">Dr. Leslie Hendeles\u003c/a>, PharmD, professor emeritus at the University of Florida in Gainesville, who was one of the petitioners who prompted this week’s FDA review. “The whole concept of clinical trials and study design was in its infancy.”\u003c/p>\n\u003cp>And since then the system for updating the drug list has traditionally taken many years or even decades, requiring multiple rounds of review and public comments.\u003c/p>\n\u003cp>The passage of \u003ca href=\"https://www.fda.gov/news-events/fda-voices/exciting-new-chapter-otc-drug-history-otc-monograph-reform-cares-act#:~:text=The%20beginning%20of%20an%20exciting,regulated%20in%20the%20United%20States.\">the 2020 CARES Act\u003c/a> should improve what’s available by streamlining the laborious process that may have allowed unchecked medications on the market. This week’s vote on phenylephrine, which was based on the latest scientific evidence, is the first test case for the law. But the FDA has not yet issued a final decision on whether the product will be removed from store shelves.\u003c/p>\n\u003cp>“The message here is that there are a lot of products on the market that fall into the same category as phenylephrine,” said Hendeles. “They’re not for diseases where people die or have to go to an emergency room. So they have not gotten the attention — even from the FDA — until now.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Hendeles believes regulators are likely to ultimately find that many other over-the-counter drugs are futile, too. “I know for sure that the cough suppressants and the expectorants are next in line.”\u003c/p>\n\u003cp>He points to a compilation of data he presented in \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/29669663/\">a 2018 paper\u003c/a> published in the journal Allergy and Asthma Proceedings, where he concluded the marketing claims on products designed for respiratory symptoms are overblown. And the evidence for decongestants, expectorants and cough suppressants does not “justify their use.”\u003c/p>\n\u003cp>Industry groups like the Consumer Healthcare Products Association maintain that phenylephrine has provided the public with clear health benefits for years. They asked the FDA not to remove it from a list of safe and effective over-the-counter drugs, arguing it provides the public with accessible treatment.\u003c/p>\n\u003cp>“Simply put, the burdens created from decreased choice and availability of these products would be placed directly onto consumers and an already-strained U.S. healthcare system, which is why CHPA encourages the panel to consider the real-world experience and needs of consumers when making decisions that will have such broad implications,” said Marcia Howard, the association’s vice president of regulatory and scientific affairs, \u003ca href=\"https://www.chpa.org/news/2023/09/statement-sept-11-12-2023-meeting-fda-ndac-evaluate-efficacy-oral-pe\">in a statement\u003c/a>.\u003c/p>\n\u003ch2>So, what can help your runny nose?\u003c/h2>\n\u003cp>Hendeles recommends steroidal nasal sprays for people suffering from allergies. Look for fluticasone (Flonase) or triamcinolone (Nascort). One squirt in each nostril. Evidence suggests Oxymetazoline Hydrochloride (Afrin or Sinex) is the best nasal spray for people who are sick with a respiratory illness.\u003c/p>\n\u003ch2>What about the rest of the meds lining your medicine cabinet?\u003c/h2>\n\u003cp>“If you’ve used something and you felt like it was helpful, I don’t think there’s a problem with that,” said Eggbert. “There’s little harm for people who are looking for relief. And I do believe in the placebo effect.”\u003c/p>\n\u003cp>But don’t look for a magical concoction. Single-ingredient products will help lower the possibility for side effects, according to Dr. Shalini Lynch, PharmD, health sciences clinical professor at UCSF’s School of Pharmacy. She says it should be obvious in a day or two if the product is relieving a desired symptom.\u003c/p>\n\u003cp>Science also supports some natural remedies. Saline nasal rinses may help clear your sinuses and \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/22869830/\">honey can quell your cough\u003c/a>. Additionally, it may be worth standing in a steamy shower or filling your humidifier to open your nasal passages. However, Lynch’s best advice is simply to lay low and hydrate.\u003c/p>\n\u003cp>“The common cold is something that pretty much needs to run its course,” she said. “You want to feel better instantly. But the reality is most cough and cold, viral types of upper respiratory infections, they just take time to go away.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "california-kaiser-workers-authorize-strike-as-contract-negotiations-continue",
"title": "California Kaiser Workers Authorize Strike as Contract Negotiations Continue",
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"content": "\u003cp>Nearly 60,000 Kaiser Permanente workers, mostly based in California, voted overwhelming in favor of going on strike if a fair contract agreement is not reached by the end of September, setting the stage for what could be the largest health care industry walkout in U.S. history.\u003c/p>\n\u003cp>The strike authorization was supported by 98% of Kaiser workers — ranging from lab technicians to respiratory therapists to cooking staff — who are represented by SEIU-United Healthcare Workers West, the union announced Thursday. It comes amid ongoing worker demands for significant pay raises and more robust staffing, as Kaiser and other large health care providers continue to struggle with severe understaffing and strained caseloads.\u003c/p>\n\u003cp>“Being understaffed and being not appropriately compensated for the amount of work that they put on our plate, we had no choice but to collectively agree to authorize a strike,” said Rashaad Pritchett, who works as housekeeping aide at a Kaiser facility in Richmond, where he cleans and sanitizes operating rooms and other sensitive health space.\u003c/p>\n\u003cp>[aside postID=news_11957005,news_11947640 label='The Healthcare Staffing Crisis']Born and raised in Richmond, Pritchett says his wages have failed to keep pace with inflation and the rising cost of living.\u003c/p>\n\u003cp>“Over the next four years, we want to make sure that we will have livable wages. At the end of our career we want to make sure that we will be taken care of,” said Pritchett. “We are all fighting for what we believe is right. It’s not a vindictive approach, but it’s like, ‘OK, you have forced our collective bargaining hand.’”\u003c/p>\n\u003cp>Workers argue that staffing levels have sunk dangerously low as many practitioners have left the field because of burnout. Kaiser workers are calling on their employer to increase staffing levels in order to reduce workloads.\u003c/p>\n\u003cp>The workers — some of whom are based in Oregon and Washington — are pushing for a 7% wage increase in the first two years of this next contract, and a 6.25% increase the following two years.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In its proposal, Kaiser offered across-the-board wage increases of between 10–14% over four years, as well as a minimum performance bonus aimed to prevent any employees from receiving no payout. Kaiser also offered a blanket $21 per hour minimum wage.\u003c/p>\n\u003cp>But union leaders last week rejected the company’s most recent offer. They said the new minimum would limit performance bonuses for frontline workers, arguing that will only result in increased turnover, further straining the workforce and diminishing the quality of care.\u003c/p>\n\u003cp>The union is also seeking a $25 per hour minimum wage for employees.\u003c/p>\n\u003cp>That pay bump would align with \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202320240SB525\">a California bill\u003c/a> currently making its way through the Legislature that would increase all California health care workers’ minimum wage to $25 per hour.\u003c/p>\n\u003cp>The Legislature also recently approved a bill that would provide unemployment insurance benefits to workers on strike.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Nahid Bokaee, a Kaiser pharmacist\"]‘Our patients expect more from a health care system that reported $3 billion in profits in the first half of this year alone, and so do we.’[/pullquote]“Every one of these proposals from Kaiser will make staffing problems worse and continue to delay care to patients,” Dave Regan, president of SEIU-UHW, said in a press release announcing the vote. “Kaiser has failed to bargain in good faith with the caregivers, who are doing everything they can to protect patient safety.”\u003c/p>\n\u003cp>Kaiser insists that it has continued to bargain in good faith. In an email, Kaiser refuted many of the claims the union made about their proposal. The company also pointed to rising costs for drugs, supplies and labor due to inflation, which has been “driving up the cost of health care as well.”\u003c/p>\n\u003cp>Despite the impasse, representatives for the Oakland-based health care giant said they are “confident” a deal can be reached by Sept. 30.\u003c/p>\n\u003cp>“We have two more bargaining sessions scheduled for next week. Our priority is to reach an agreement that ensures we can continue to provide market-competitive pay and outstanding benefits,” a spokesperson for Kaiser said in an email to KQED. “We are confident we’ll reach an agreement before the national agreement expires on Sept. 30 that strengthens our position as a best place to work and ensures that the high-quality care our members expect from us remains affordable and easy to access.”\u003c/p>\n\u003cp>In a recent \u003ca href=\"https://www.unioncoalition.org/wp-content/uploads/2023/04/2022-04_Report_Staffing-Survey-10.1_DIGITAL.pdf?emci=11db37e0-b5df-ed11-8e8b-00224832eb73&emdi=ea000000-0000-0000-0000-000000000001&ceid=%7B%7BContactsEmailID%7D%7D\">union-led survey (PDF)\u003c/a> of about 33,000 Kaiser workers, more than 80% of respondents said they were in understaffed departments, and 65% said they had seen care delayed or denied to patients due to those staffing challenges. Nearly half said they regularly have to skip meals or breaks to keep up with their workloads.\u003c/p>\n\u003cp>“Our patients expect more from a health care system that reported $3 billion in profits in the first half of this year alone, and so do we,” Nahid Bokaee, a Kaiser pharmacist in Sterling, Virginia, said in a recent press release about the looming strike vote. “Kaiser can afford to end this dangerous understaffing, but they choose not to.”\u003c/p>\n\u003cp>The company claims it has filled 8,700 of the 10,000 positions it has committed to fill by the end of 2023.[aside postID=news_11960517 hero='https://ww2.kqed.org/app/uploads/sites/10/2023/09/GettyImages-1668439446-1020x683.jpg']The union representing Kaiser employees in California is part of the broader Coalition of Kaiser Permanente Unions, which represents about 88,000 employees in seven states, including Colorado, Oregon and Washington, \u003ca href=\"https://www.koin.com/news/union-announces-overwhelming-support-for-kaiser-permanente-strike-authorization/\">where local unions have also recently approved going on strike\u003c/a>.\u003c/p>\n\u003cp>The latest strike authorization vote comes amid an uptick in labor actions across the country, particularly within the health care industry.\u003c/p>\n\u003cp>Nearly \u003ca href=\"https://www.kqed.org/news/11929713/kaiser-mental-health-workers-appove-new-contract-ending-10-week-strike\">2,000 Kaiser mental health care workers in Northern California went on strike last year for 10 weeks\u003c/a> over many of the same staffing and pay issues that workers today are protesting. Earlier this month, \u003ca href=\"https://ktla.com/news/california/23-health-care-workers-arrested-after-protesting-outside-kaiser-permanente-in-hollywood/\">23 health care workers were arrested\u003c/a> while protesting outside a Kaiser hospital in Hollywood. Nurses in Minnesota \u003ca href=\"https://www.cbsnews.com/news/minnesota-nurses-strike-vote-2nd-time-2022-minnesota-nurses-association/\">voted twice\u003c/a> but ultimately avoided a strike in 2022, citing low pay and rapid turnover.\u003c/p>\n\u003cp>\u003cem>KQED reporter Farida Jhabvala Romero contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Nearly 60,000 Kaiser Permanente workers, mostly based in California, voted overwhelming in favor of going on strike if a fair contract agreement is not reached by the end of September, setting the stage for what could be the largest health care industry walkout in U.S. history.\u003c/p>\n\u003cp>The strike authorization was supported by 98% of Kaiser workers — ranging from lab technicians to respiratory therapists to cooking staff — who are represented by SEIU-United Healthcare Workers West, the union announced Thursday. It comes amid ongoing worker demands for significant pay raises and more robust staffing, as Kaiser and other large health care providers continue to struggle with severe understaffing and strained caseloads.\u003c/p>\n\u003cp>“Being understaffed and being not appropriately compensated for the amount of work that they put on our plate, we had no choice but to collectively agree to authorize a strike,” said Rashaad Pritchett, who works as housekeeping aide at a Kaiser facility in Richmond, where he cleans and sanitizes operating rooms and other sensitive health space.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Born and raised in Richmond, Pritchett says his wages have failed to keep pace with inflation and the rising cost of living.\u003c/p>\n\u003cp>“Over the next four years, we want to make sure that we will have livable wages. At the end of our career we want to make sure that we will be taken care of,” said Pritchett. “We are all fighting for what we believe is right. It’s not a vindictive approach, but it’s like, ‘OK, you have forced our collective bargaining hand.’”\u003c/p>\n\u003cp>Workers argue that staffing levels have sunk dangerously low as many practitioners have left the field because of burnout. Kaiser workers are calling on their employer to increase staffing levels in order to reduce workloads.\u003c/p>\n\u003cp>The workers — some of whom are based in Oregon and Washington — are pushing for a 7% wage increase in the first two years of this next contract, and a 6.25% increase the following two years.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In its proposal, Kaiser offered across-the-board wage increases of between 10–14% over four years, as well as a minimum performance bonus aimed to prevent any employees from receiving no payout. Kaiser also offered a blanket $21 per hour minimum wage.\u003c/p>\n\u003cp>But union leaders last week rejected the company’s most recent offer. They said the new minimum would limit performance bonuses for frontline workers, arguing that will only result in increased turnover, further straining the workforce and diminishing the quality of care.\u003c/p>\n\u003cp>The union is also seeking a $25 per hour minimum wage for employees.\u003c/p>\n\u003cp>That pay bump would align with \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202320240SB525\">a California bill\u003c/a> currently making its way through the Legislature that would increase all California health care workers’ minimum wage to $25 per hour.\u003c/p>\n\u003cp>The Legislature also recently approved a bill that would provide unemployment insurance benefits to workers on strike.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“Every one of these proposals from Kaiser will make staffing problems worse and continue to delay care to patients,” Dave Regan, president of SEIU-UHW, said in a press release announcing the vote. “Kaiser has failed to bargain in good faith with the caregivers, who are doing everything they can to protect patient safety.”\u003c/p>\n\u003cp>Kaiser insists that it has continued to bargain in good faith. In an email, Kaiser refuted many of the claims the union made about their proposal. The company also pointed to rising costs for drugs, supplies and labor due to inflation, which has been “driving up the cost of health care as well.”\u003c/p>\n\u003cp>Despite the impasse, representatives for the Oakland-based health care giant said they are “confident” a deal can be reached by Sept. 30.\u003c/p>\n\u003cp>“We have two more bargaining sessions scheduled for next week. Our priority is to reach an agreement that ensures we can continue to provide market-competitive pay and outstanding benefits,” a spokesperson for Kaiser said in an email to KQED. “We are confident we’ll reach an agreement before the national agreement expires on Sept. 30 that strengthens our position as a best place to work and ensures that the high-quality care our members expect from us remains affordable and easy to access.”\u003c/p>\n\u003cp>In a recent \u003ca href=\"https://www.unioncoalition.org/wp-content/uploads/2023/04/2022-04_Report_Staffing-Survey-10.1_DIGITAL.pdf?emci=11db37e0-b5df-ed11-8e8b-00224832eb73&emdi=ea000000-0000-0000-0000-000000000001&ceid=%7B%7BContactsEmailID%7D%7D\">union-led survey (PDF)\u003c/a> of about 33,000 Kaiser workers, more than 80% of respondents said they were in understaffed departments, and 65% said they had seen care delayed or denied to patients due to those staffing challenges. Nearly half said they regularly have to skip meals or breaks to keep up with their workloads.\u003c/p>\n\u003cp>“Our patients expect more from a health care system that reported $3 billion in profits in the first half of this year alone, and so do we,” Nahid Bokaee, a Kaiser pharmacist in Sterling, Virginia, said in a recent press release about the looming strike vote. “Kaiser can afford to end this dangerous understaffing, but they choose not to.”\u003c/p>\n\u003cp>The company claims it has filled 8,700 of the 10,000 positions it has committed to fill by the end of 2023.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The union representing Kaiser employees in California is part of the broader Coalition of Kaiser Permanente Unions, which represents about 88,000 employees in seven states, including Colorado, Oregon and Washington, \u003ca href=\"https://www.koin.com/news/union-announces-overwhelming-support-for-kaiser-permanente-strike-authorization/\">where local unions have also recently approved going on strike\u003c/a>.\u003c/p>\n\u003cp>The latest strike authorization vote comes amid an uptick in labor actions across the country, particularly within the health care industry.\u003c/p>\n\u003cp>Nearly \u003ca href=\"https://www.kqed.org/news/11929713/kaiser-mental-health-workers-appove-new-contract-ending-10-week-strike\">2,000 Kaiser mental health care workers in Northern California went on strike last year for 10 weeks\u003c/a> over many of the same staffing and pay issues that workers today are protesting. Earlier this month, \u003ca href=\"https://ktla.com/news/california/23-health-care-workers-arrested-after-protesting-outside-kaiser-permanente-in-hollywood/\">23 health care workers were arrested\u003c/a> while protesting outside a Kaiser hospital in Hollywood. Nurses in Minnesota \u003ca href=\"https://www.cbsnews.com/news/minnesota-nurses-strike-vote-2nd-time-2022-minnesota-nurses-association/\">voted twice\u003c/a> but ultimately avoided a strike in 2022, citing low pay and rapid turnover.\u003c/p>\n\u003cp>\u003cem>KQED reporter Farida Jhabvala Romero contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "oil-industry-sets-back-efforts-to-increase-fines-against-polluting-california-refineries-yet-again",
"title": "Oil Industry Blocks Effort to Increase Fines Against Polluting California Refineries … Again",
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"content": "\u003cp>California’s oil industry has once again quashed an attempt in the state Capitol to increase penalties on refineries that violate air quality laws.\u003c/p>\n\u003cp>It’s the fourth time in a decade that the industry has successfully killed or delayed such an endeavor.\u003c/p>\n\u003cp>The latest proposal was put on hold last week, just days before the Legislature finishes its work for the year on Sept. 14. Assemblymember Buffy Wicks (D-Oakland), who authored the \u003ca href=\"https://legiscan.com/CA/bill/AB1465/2023\">bill\u003c/a>, said the move was prompted by concerns some lawmakers would vote against it because it wasn’t weakened enough to satisfy California’s main oil industry group, the Western States Petroleum Association (WSPA).\u003c/p>\n\u003cp>“It became apparent that we were going to need more time to work on AB 1465 with our sponsor, the Bay Area Air Quality Management District, and with opposition groups who engaged us on the possibility of additional amendments,” Wicks said in an email on Friday.\u003c/p>\n\u003cp>WSPA represents the oil companies that own all of the Bay Area’s petroleum refineries. The region’s Chevron, Valero, PBF, Marathon and Phillips 66 plants have for decades produced gasoline and jet fuels that have powered major components of the region’s transportation sector. But they have also received \u003ca href=\"https://www.baaqmd.gov/rules-and-compliance/compliance-assistance/notices-of-violations/novs-issued\">hundreds of notices of violations\u003c/a> from local air regulators in recent years, stemming from minor flaring incidents to severe accidents that forced nearby residents to stay indoors.\u003c/p>\n\u003cp>Those incidents prompted Wicks to propose tripling the maximum penalty amounts oil companies would pay when their refineries violate air quality regulations.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Asm. Buffy Wicks at a July 11 hearing\"]‘This morning in Martinez, which I drive through on my way here, there was a toxic dust release. This is happening in our communities all the time.’[/pullquote]There are a variety of fine amounts refineries can face, but the general limit on those fines is currently $10,000. Environmentalists and some Bay Area elected leaders have described those penalties as part of the mere cost of doing business for companies like \u003ca href=\"https://chevroncorp.gcs-web.com/static-files/359d5f9b-5519-476e-976c-8ace50143c49\">Chevron, which earned $6 billion in the second quarter of this year\u003c/a>.\u003c/p>\n\u003cp>Wicks’ bill would increase the ceiling on fines to $30,000 per violation.\u003c/p>\n\u003cp>But WSPA has opposed any attempts to crack down on air quality violations.\u003c/p>\n\u003cp>And even before Wicks sidelined the bill last week, the industry group had already convinced legislators to significantly change the proposal several months ago by expanding its scope. Under the changes, the fines would also apply to dozens of industrial facilities that release chemicals into the air, including refineries, that are covered by Title V of the federal Clean Air Act. In the Bay Area there are \u003ca href=\"https://www.baaqmd.gov/permits/major-facility-review-title-v/title-v-permits\">dozens of such sites\u003c/a>.\u003c/p>\n\u003cp>“There is no public policy rationale for singling out refineries,” wrote Shant Apekian, vice president of California policy and strategic affairs at WSPA, in a letter to Wicks in April.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>While that complaint arose this spring, lawmakers did not amend the bill until June — and not everyone was happy with the change. Several industry and public agency associations, including the California Association of Sanitation Agencies, urged legislators to vote “no” on the bill.\u003c/p>\n\u003cp>“Unlike refineries, which are privately held for-profit corporations, public wastewater agencies provide an essential public service and all costs to the agency, including penalties, are borne by the rate-paying public,” the group wrote to legislators.\u003c/p>\n\u003cp>But even though lawmakers in the Senate approved the change, WSPA continued to fight against the bill. It’s a debate that has taken place behind closed doors — not in public committees.\u003c/p>\n\u003cp>In fact, the bill has \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billVotesClient.xhtml?bill_id=202320240AB1465\">sailed through all of its legislative votes\u003c/a> and was headed for a full vote in the state Senate when, last week, Wicks abruptly asked that the proposal be moved to the “inactive file,” essentially scuttling any debate or votes until next year.\u003c/p>\n\u003cp>Those involved in conversations with Wicks and WSPA say that decision was driven by a push by the petroleum association to make the proposal effective only in rare cases — in WSPA’s words, only when “discharge results in a significant increase in hospitalizations, residential displacement, shelter in place, evacuation or destruction of property.”\u003c/p>\n\u003cp>But air district officials say that definition is too narrow, because refineries often violate air regulations in less extreme incidents that are still dangerous to human health. They argue the standard the industry is arguing for won’t actually provide a deterrent or change how refineries do business.\u003c/p>\n\u003cp>[aside label='Related Stories' tag='refineries']For example, last November the PBF refinery in Martinez \u003ca href=\"https://www.kqed.org/news/11952517/martinez-refinery-chemical-release-poses-no-long-term-hazard-tests-find\">released nearly 50,000 pounds of powdered, industrial chemicals, much of it landing on residential neighborhoods\u003c/a>. The accident led to investigations by the EPA, FBI, Contra Costa County regulators and the air district.\u003c/p>\n\u003cp>Under the changes the oil industry wants to make, that release would not be covered by the proposed fine increases, local air regulators said.\u003c/p>\n\u003cp>“In our view, the purpose of the bill is to strengthen penalties for those types of events, not to protect them,” said air district spokeswoman Kristine Roselius, adding that the changes proposed by WSPA “would have provided an economic incentive to large facilities such as refineries, to downplay events as they were happening if they felt they could avoid higher penalties.”\u003c/p>\n\u003cp>If this kind of successful pushback sounds similar, that’s because it has happened every time a refinery fine increase proposal has emerged in Sacramento over the last decade.\u003c/p>\n\u003cp>Last year, just as another Wicks bill to do something similar was about to get a vote in the state Senate, \u003ca href=\"https://www.kqed.org/news/11923242/watered-down-state-bill-to-punish-refinery-pollution-gets-scrapped-after-oil-industry-pushback\">she killed it because it was watered down so much\u003c/a> that even the industry dropped its opposition.\u003c/p>\n\u003cp>In 2018, Sen. Bill Dodd (D-Napa) proposed tripling some of the most serious penalties for refineries. Amid opposition from the oil industry — and, on the other side, pushback from environmentalists and the mayors of Richmond and Benicia, who said the proposal wasn’t strong enough — \u003ca href=\"https://www.kqed.org/news/11660005/facing-widespread-opposition-lawmaker-ends-effort-to-increase-refinery-penalties\">that bill never even got a hearing\u003c/a>.\u003c/p>\n\u003cp>In 2013, then state Sen. Loni Hancock (D-Berkeley) introduced legislation to raise such penalties on the heels of a major fire at Richmond’s Chevron refinery, the worst refinery accident in the Bay Area in the last few decades. That bill died on the Assembly floor, also after opposition from oil companies.\u003c/p>\n\u003cp>But even as the debate rages on in Sacramento, the problem for communities around these refineries persists. The day Wicks presented this year’s bill — at its final hearing before a Senate committee — the Contra Costa County refinery owned by PBF Energy released petroleum coke dust. Some residents described the dust as a “flaky ash.” The pollution came eight months after a \u003ca href=\"https://www.kqed.org/news/11952517/martinez-refinery-chemical-release-poses-no-long-term-hazard-tests-find\">much more severe chemical release from the same facility\u003c/a>.\u003c/p>\n\u003cp>“This morning in Martinez, which I drive through on my way here, there was a toxic dust release,” Wicks said at the July 11 hearing. “This is happening in our communities all the time.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California’s oil industry has once again quashed an attempt in the state Capitol to increase penalties on refineries that violate air quality laws.\u003c/p>\n\u003cp>It’s the fourth time in a decade that the industry has successfully killed or delayed such an endeavor.\u003c/p>\n\u003cp>The latest proposal was put on hold last week, just days before the Legislature finishes its work for the year on Sept. 14. Assemblymember Buffy Wicks (D-Oakland), who authored the \u003ca href=\"https://legiscan.com/CA/bill/AB1465/2023\">bill\u003c/a>, said the move was prompted by concerns some lawmakers would vote against it because it wasn’t weakened enough to satisfy California’s main oil industry group, the Western States Petroleum Association (WSPA).\u003c/p>\n\u003cp>“It became apparent that we were going to need more time to work on AB 1465 with our sponsor, the Bay Area Air Quality Management District, and with opposition groups who engaged us on the possibility of additional amendments,” Wicks said in an email on Friday.\u003c/p>\n\u003cp>WSPA represents the oil companies that own all of the Bay Area’s petroleum refineries. The region’s Chevron, Valero, PBF, Marathon and Phillips 66 plants have for decades produced gasoline and jet fuels that have powered major components of the region’s transportation sector. But they have also received \u003ca href=\"https://www.baaqmd.gov/rules-and-compliance/compliance-assistance/notices-of-violations/novs-issued\">hundreds of notices of violations\u003c/a> from local air regulators in recent years, stemming from minor flaring incidents to severe accidents that forced nearby residents to stay indoors.\u003c/p>\n\u003cp>Those incidents prompted Wicks to propose tripling the maximum penalty amounts oil companies would pay when their refineries violate air quality regulations.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘This morning in Martinez, which I drive through on my way here, there was a toxic dust release. This is happening in our communities all the time.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>There are a variety of fine amounts refineries can face, but the general limit on those fines is currently $10,000. Environmentalists and some Bay Area elected leaders have described those penalties as part of the mere cost of doing business for companies like \u003ca href=\"https://chevroncorp.gcs-web.com/static-files/359d5f9b-5519-476e-976c-8ace50143c49\">Chevron, which earned $6 billion in the second quarter of this year\u003c/a>.\u003c/p>\n\u003cp>Wicks’ bill would increase the ceiling on fines to $30,000 per violation.\u003c/p>\n\u003cp>But WSPA has opposed any attempts to crack down on air quality violations.\u003c/p>\n\u003cp>And even before Wicks sidelined the bill last week, the industry group had already convinced legislators to significantly change the proposal several months ago by expanding its scope. Under the changes, the fines would also apply to dozens of industrial facilities that release chemicals into the air, including refineries, that are covered by Title V of the federal Clean Air Act. In the Bay Area there are \u003ca href=\"https://www.baaqmd.gov/permits/major-facility-review-title-v/title-v-permits\">dozens of such sites\u003c/a>.\u003c/p>\n\u003cp>“There is no public policy rationale for singling out refineries,” wrote Shant Apekian, vice president of California policy and strategic affairs at WSPA, in a letter to Wicks in April.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>While that complaint arose this spring, lawmakers did not amend the bill until June — and not everyone was happy with the change. Several industry and public agency associations, including the California Association of Sanitation Agencies, urged legislators to vote “no” on the bill.\u003c/p>\n\u003cp>“Unlike refineries, which are privately held for-profit corporations, public wastewater agencies provide an essential public service and all costs to the agency, including penalties, are borne by the rate-paying public,” the group wrote to legislators.\u003c/p>\n\u003cp>But even though lawmakers in the Senate approved the change, WSPA continued to fight against the bill. It’s a debate that has taken place behind closed doors — not in public committees.\u003c/p>\n\u003cp>In fact, the bill has \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billVotesClient.xhtml?bill_id=202320240AB1465\">sailed through all of its legislative votes\u003c/a> and was headed for a full vote in the state Senate when, last week, Wicks abruptly asked that the proposal be moved to the “inactive file,” essentially scuttling any debate or votes until next year.\u003c/p>\n\u003cp>Those involved in conversations with Wicks and WSPA say that decision was driven by a push by the petroleum association to make the proposal effective only in rare cases — in WSPA’s words, only when “discharge results in a significant increase in hospitalizations, residential displacement, shelter in place, evacuation or destruction of property.”\u003c/p>\n\u003cp>But air district officials say that definition is too narrow, because refineries often violate air regulations in less extreme incidents that are still dangerous to human health. They argue the standard the industry is arguing for won’t actually provide a deterrent or change how refineries do business.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>For example, last November the PBF refinery in Martinez \u003ca href=\"https://www.kqed.org/news/11952517/martinez-refinery-chemical-release-poses-no-long-term-hazard-tests-find\">released nearly 50,000 pounds of powdered, industrial chemicals, much of it landing on residential neighborhoods\u003c/a>. The accident led to investigations by the EPA, FBI, Contra Costa County regulators and the air district.\u003c/p>\n\u003cp>Under the changes the oil industry wants to make, that release would not be covered by the proposed fine increases, local air regulators said.\u003c/p>\n\u003cp>“In our view, the purpose of the bill is to strengthen penalties for those types of events, not to protect them,” said air district spokeswoman Kristine Roselius, adding that the changes proposed by WSPA “would have provided an economic incentive to large facilities such as refineries, to downplay events as they were happening if they felt they could avoid higher penalties.”\u003c/p>\n\u003cp>If this kind of successful pushback sounds similar, that’s because it has happened every time a refinery fine increase proposal has emerged in Sacramento over the last decade.\u003c/p>\n\u003cp>Last year, just as another Wicks bill to do something similar was about to get a vote in the state Senate, \u003ca href=\"https://www.kqed.org/news/11923242/watered-down-state-bill-to-punish-refinery-pollution-gets-scrapped-after-oil-industry-pushback\">she killed it because it was watered down so much\u003c/a> that even the industry dropped its opposition.\u003c/p>\n\u003cp>In 2018, Sen. Bill Dodd (D-Napa) proposed tripling some of the most serious penalties for refineries. Amid opposition from the oil industry — and, on the other side, pushback from environmentalists and the mayors of Richmond and Benicia, who said the proposal wasn’t strong enough — \u003ca href=\"https://www.kqed.org/news/11660005/facing-widespread-opposition-lawmaker-ends-effort-to-increase-refinery-penalties\">that bill never even got a hearing\u003c/a>.\u003c/p>\n\u003cp>In 2013, then state Sen. Loni Hancock (D-Berkeley) introduced legislation to raise such penalties on the heels of a major fire at Richmond’s Chevron refinery, the worst refinery accident in the Bay Area in the last few decades. That bill died on the Assembly floor, also after opposition from oil companies.\u003c/p>\n\u003cp>But even as the debate rages on in Sacramento, the problem for communities around these refineries persists. The day Wicks presented this year’s bill — at its final hearing before a Senate committee — the Contra Costa County refinery owned by PBF Energy released petroleum coke dust. Some residents described the dust as a “flaky ash.” The pollution came eight months after a \u003ca href=\"https://www.kqed.org/news/11952517/martinez-refinery-chemical-release-poses-no-long-term-hazard-tests-find\">much more severe chemical release from the same facility\u003c/a>.\u003c/p>\n\u003cp>“This morning in Martinez, which I drive through on my way here, there was a toxic dust release,” Wicks said at the July 11 hearing. “This is happening in our communities all the time.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Kaiser Permanente has agreed to pay $49 million as part of a settlement with California prosecutors who say the health care giant illegally disposed of thousands of private medical records, hazardous materials and medical waste, including blood and body parts, in dumpsters headed to local landfills, authorities said Friday\u003c/p>\n\u003cp>Prosecutors started an investigation in 2015 after undercover trash inspectors found pharmaceutical drugs, and syringes, vials, canisters and other medical devices filled with human blood and other bodily fluids, and body parts removed during surgery inside bins handled by municipal waste haulers. They also found batteries, electronic devices and other hazardous waste in trash cans and bins at 16 Kaiser medical facilities throughout the state, Attorney General Rob Bonta said.\u003c/p>\n\u003cp>“The items found pose a serious risk to anyone who might come into contact with them from health care providers and patients in the same room as the trash cans to custodians and sanitation workers who directly handle the waste to workers at the landfill,” Bonta said.\u003c/p>\n\u003cp>Kaiser is California’s largest health care provider and has more than 700 health care facilities that treat about 8.8 million patients in the state, Bonta said.[pullquote align=\"right\" size=\"medium\" citation=\"California Attorney General Rob Bonta\"]‘As a major health care provider Kaiser has a clear responsibility to know and follow specific laws when it comes to properly disposing of waste and safeguarding patient’s medical information. Their failure to do so is unacceptable, it cannot happen again.’[/pullquote]He said the undercover inspectors also found over 10,000 paper records containing the information of over 7,700 patients, which led to an investigation by prosecutors in San Francisco, Alameda, San Bernardino, San Joaquin, San Mateo, and Yolo counties. County officials later sought the intervention of this office, Bonta said.\u003c/p>\n\u003cp>“As a major health care provider Kaiser has a clear responsibility to know and follow specific laws when it comes to properly disposing of waste and safeguarding patient’s medical information. Their failure to do so is unacceptable, it cannot happen again,” Bonta said.\u003c/p>\n\u003cp>Kaiser Permanente, based in Oakland, California, said in a statement it takes the matter extremely seriously. It said it has taken full responsibility and is cooperating with the California Attorney General and county district attorneys to correct the way some of its facilities were disposing of hazardous and medical waste.\u003c/p>\n\u003cp>“About six years ago we became aware of occasions when, contrary to our rigorous policies and procedures, some facilities’ landfill-bound dumpsters included items that should have been disposed of differently,” the company said. “Upon learning of this issue, we immediately completed an extensive auditing effort of the waste stream at our facilities and established mandatory and ongoing training to address the findings.”\u003c/p>\n\u003cp>Kaiser said it was not aware of any body part being found at any time during this investigation.\u003c/p>\n\u003cp>As part of the settlement, the health care provider must also retain for five years an independent third-party auditor approved by the Attorney General’s Office and the district attorneys involved in the complaint. The auditor will check Kaiser’s compliance with California’s laws related to the handling of hazardous and medical waste, and the protection of patients’ health information.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“As a major corporation in Alameda County, Kaiser Permanente has a special obligation to treat its communities with the same bedside manner as its patients,” said Alameda County District Attorney Pamela Price. “Dumping medical waste and private information are wrong, which they have acknowledged. This action will hold them accountable in such a way that we hope means it doesn’t happen again.”\u003c/p>\n\u003cp>In 2021, \u003ca href=\"https://apnews.com/article/business-health-medicare-566111a018e5e8f3d0224180050cbf0a\">the federal government sued Kaiser Permanente\u003c/a>, alleging the health care giant committed Medicare fraud and pressured doctors to list incorrect diagnoses on medical records in order to receive higher reimbursements.\u003c/p>\n\u003cp>The California Department of Justice sued the company in 2014 after it delayed notifying its employees about an unencrypted USB drive that contained the records of over 20,000 Kaiser workers. The USB drive was discovered at a Santa Cruz thrift store.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>He said the undercover inspectors also found over 10,000 paper records containing the information of over 7,700 patients, which led to an investigation by prosecutors in San Francisco, Alameda, San Bernardino, San Joaquin, San Mateo, and Yolo counties. County officials later sought the intervention of this office, Bonta said.\u003c/p>\n\u003cp>“As a major health care provider Kaiser has a clear responsibility to know and follow specific laws when it comes to properly disposing of waste and safeguarding patient’s medical information. Their failure to do so is unacceptable, it cannot happen again,” Bonta said.\u003c/p>\n\u003cp>Kaiser Permanente, based in Oakland, California, said in a statement it takes the matter extremely seriously. It said it has taken full responsibility and is cooperating with the California Attorney General and county district attorneys to correct the way some of its facilities were disposing of hazardous and medical waste.\u003c/p>\n\u003cp>“About six years ago we became aware of occasions when, contrary to our rigorous policies and procedures, some facilities’ landfill-bound dumpsters included items that should have been disposed of differently,” the company said. “Upon learning of this issue, we immediately completed an extensive auditing effort of the waste stream at our facilities and established mandatory and ongoing training to address the findings.”\u003c/p>\n\u003cp>Kaiser said it was not aware of any body part being found at any time during this investigation.\u003c/p>\n\u003cp>As part of the settlement, the health care provider must also retain for five years an independent third-party auditor approved by the Attorney General’s Office and the district attorneys involved in the complaint. The auditor will check Kaiser’s compliance with California’s laws related to the handling of hazardous and medical waste, and the protection of patients’ health information.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Scientists have produced the first data indicating that a variant that has raised alarm is unlikely to pose a big new COVID-19 threat.\u003c/p>\n\u003cp>Four preliminary laboratory studies released over the weekend found that antibodies from previous infections and vaccinations appear capable of neutralizing the variant, known as BA.2.86.\u003c/p>\n\u003cp>“It is reassuring,” says Dr. Dan Barouch, who conducted \u003ca href=\"https://twitter.com/BarouchLab/status/1698850719959544271?s=20\">one of the studies \u003c/a>at the Beth Israel Deaconess Medical Center in Boston.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>When it was first spotted, BA.2.86 set off alarm bells. It contains more than 30 mutations on the spike protein the virus uses to infect cells. That’s a level of mutation on par with the original Omicron variant, which caused a massive surge.\u003c/p>\n\u003cp>The concern was that BA.2.86, while still rare, could sneak around the immunity people had built up and cause another huge, deadly wave.\u003c/p>\n\u003cp>“When something heavily mutated comes out of nowhere … there’s this risk that it’s dramatically different and that it changes the nature of the pandemic,” says Benjamin Murrell, who conducted \u003ca href=\"https://www.biorxiv.org/content/10.1101/2023.09.02.556033v1\">one of the other studies \u003c/a>at the Karolinska Institute in Sweden.[pullquote size=\"medium\" align=\"right\" citation=\"Benjamin Murrell, researcher, Karolinska Institute\"]‘When something heavily mutated comes out of nowhere … there’s this risk that it’s dramatically different and that it changes the nature of the pandemic.’[/pullquote]But Murrell and Barouch’s experiments, along with \u003ca href=\"https://twitter.com/yunlong_cao\">similar studies\u003c/a> conducted by Yunlong Richard Cao at Peking University in China and by Dr. \u003ca href=\"https://microbiology.columbia.edu/faculty-david-ho\">David Ho \u003c/a>at Columbia University in New York, indicate that BA.2.86, is unlikely to be another game-changer.\u003c/p>\n\u003cp>“For BA.2.86 the initial antibody neutralization results suggest that history is not repeating itself here,” Murrell says. “Its degree of antibody evasion is quite similar to recently circulating variants. It seems unlikely that this will be a seismic shift for the pandemic.”\u003c/p>\n\u003cp>The studies indicate that BA.2.86 doesn’t look like it’s any better than any of the other variants at evading the immune system. It appears to be even less adept at escaping from antibodies than other variants. And may also be less efficient at infecting cells.[aside label='More on COVID Variants' tag='covid']“BA.2.86 actually poses either similar or less of an immune escape risk compared with currently circulating variants, not more,” Barouch says. “So that is good news. It does bode well for the vaccine.”\u003c/p>\n\u003cp>The Food and Drug Administration is expected to approve new vaccines soon that target a more recent omicron subvariant than the original shots. The Centers for Disease Control and Prevention would then recommend who should get them.\u003c/p>\n\u003cp>While that subvariant, XBB.1.5, has already been replaced by others, it’s a close enough match for the new shots to protect people, scientists say.\u003c/p>\n\u003cp>“I wish the booster was already out,” says Dr. \u003ca href=\"https://www.bcm.edu/people-search/peter-hotez-23229\">Peter Hotez \u003c/a>of the Baylor College of Medicine, noting that \u003ca href=\"https://covid.cdc.gov/covid-data-tracker/#datatracker-home\">yet another wave \u003c/a>of infections has already begun increasing the number of people catching the virus and getting so sick that they’re ending up in the hospital and dying. “We need it now.”\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Scientists have produced the first data indicating that a variant that has raised alarm is unlikely to pose a big new COVID-19 threat.\u003c/p>\n\u003cp>Four preliminary laboratory studies released over the weekend found that antibodies from previous infections and vaccinations appear capable of neutralizing the variant, known as BA.2.86.\u003c/p>\n\u003cp>“It is reassuring,” says Dr. Dan Barouch, who conducted \u003ca href=\"https://twitter.com/BarouchLab/status/1698850719959544271?s=20\">one of the studies \u003c/a>at the Beth Israel Deaconess Medical Center in Boston.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>When it was first spotted, BA.2.86 set off alarm bells. It contains more than 30 mutations on the spike protein the virus uses to infect cells. That’s a level of mutation on par with the original Omicron variant, which caused a massive surge.\u003c/p>\n\u003cp>The concern was that BA.2.86, while still rare, could sneak around the immunity people had built up and cause another huge, deadly wave.\u003c/p>\n\u003cp>“When something heavily mutated comes out of nowhere … there’s this risk that it’s dramatically different and that it changes the nature of the pandemic,” says Benjamin Murrell, who conducted \u003ca href=\"https://www.biorxiv.org/content/10.1101/2023.09.02.556033v1\">one of the other studies \u003c/a>at the Karolinska Institute in Sweden.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>But Murrell and Barouch’s experiments, along with \u003ca href=\"https://twitter.com/yunlong_cao\">similar studies\u003c/a> conducted by Yunlong Richard Cao at Peking University in China and by Dr. \u003ca href=\"https://microbiology.columbia.edu/faculty-david-ho\">David Ho \u003c/a>at Columbia University in New York, indicate that BA.2.86, is unlikely to be another game-changer.\u003c/p>\n\u003cp>“For BA.2.86 the initial antibody neutralization results suggest that history is not repeating itself here,” Murrell says. “Its degree of antibody evasion is quite similar to recently circulating variants. It seems unlikely that this will be a seismic shift for the pandemic.”\u003c/p>\n\u003cp>The studies indicate that BA.2.86 doesn’t look like it’s any better than any of the other variants at evading the immune system. It appears to be even less adept at escaping from antibodies than other variants. And may also be less efficient at infecting cells.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“BA.2.86 actually poses either similar or less of an immune escape risk compared with currently circulating variants, not more,” Barouch says. “So that is good news. It does bode well for the vaccine.”\u003c/p>\n\u003cp>The Food and Drug Administration is expected to approve new vaccines soon that target a more recent omicron subvariant than the original shots. The Centers for Disease Control and Prevention would then recommend who should get them.\u003c/p>\n\u003cp>While that subvariant, XBB.1.5, has already been replaced by others, it’s a close enough match for the new shots to protect people, scientists say.\u003c/p>\n\u003cp>“I wish the booster was already out,” says Dr. \u003ca href=\"https://www.bcm.edu/people-search/peter-hotez-23229\">Peter Hotez \u003c/a>of the Baylor College of Medicine, noting that \u003ca href=\"https://covid.cdc.gov/covid-data-tracker/#datatracker-home\">yet another wave \u003c/a>of infections has already begun increasing the number of people catching the virus and getting so sick that they’re ending up in the hospital and dying. “We need it now.”\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "in-act-of-civil-disobedience-activists-set-up-safe-drug-consumption-site-in-san-francisco",
"title": "In Act of Civil Disobedience, Activists Set Up Safe Drug Consumption Site in San Francisco",
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"headTitle": "In Act of Civil Disobedience, Activists Set Up Safe Drug Consumption Site in San Francisco | KQED",
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"content": "\u003cp>At least two lives were saved on Thursday at \u003ca href=\"https://www.kqed.org/news/11923303/sf-health-groups-determined-to-forge-ahead-with-safe-consumption-site-despite-newsoms-veto\">a supervised consumption site in San Francisco\u003c/a>, also known as an overdose prevention site, where residents can consume drugs in a safe environment and trained staff are able to prevent overdoses. With the city on track this year to record the highest number of overdose deaths yet, the site was organized by public health advocates as a way to put pressure on leaders to open such a facility permanently.\u003c/p>\n\u003cp>“This is a public response to the fact that there are nearly three people a day dying of overdose in San Francisco. While we continue to talk about how to best prevent loss of life, people continue to die,” said Lydia Bransten, who was volunteering at the event. “So today is a day of action, where we are saying ‘Look how easy this is.’ It’s a very simple response to a complicated issue.”\u003c/p>\n\u003cfigure id=\"attachment_11959779\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://ww2.kqed.org/news/230831-safe-use-pop-up-md-03-kqed/\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959779\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED.jpg\" alt=\"A person with blue-rimmed glasses stands beside some tents outdoors.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lydia Bransten, a member of Concerned Public Response, volunteered at the safe consumption site. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The set-up was simple: Two E-Z UP tents were stationed in an alleyway between Polk and Van Ness on Willow Street, and underneath, people could smoke or inject their pre-obtained drugs in a safer and more private setting than on the sidewalk or elsewhere out in the public. Trained staff were present to supervise and provide water and snacks, or to administer Narcan and respirators in the event of an overdose.\u003c/p>\n\u003cp>Organizers set up the site after long delays by city leaders in opening planned “wellness hubs” with these safe consumption services. The city has already allocated $18.9 million to open the wellness hubs, which would include a variety of health and hygiene services for people experiencing homelessness or substance use disorder. Private funding would then be used to support safe consumption services, which research shows help reduce overdose deaths and operate in nearly 200 places around the globe.\u003c/p>\n\u003cp>Supporters like Bransten said that the sites are meant to be one part of a broader coordinated response to overdoses and substance use disorder, alongside expanded treatment options, mental health care and housing opportunities.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The pop-up event, held on International Overdose Awareness Day (Aug. 31), comes as \u003ca href=\"https://sf.gov/resource/2020/ocme-accidental-overdose-reports\">San Francisco is currently on pace to have its highest year for overdose deaths\u003c/a>, exceeding the record set in 2020 when 725 people lost their lives to drug overdose. In the first half of this year, 473 people died from accidental drug overdose in San Francisco, according to the medical examiner’s office.\u003c/p>\n\u003cp>The majority (80%) of those deaths involved fentanyl, an opioid 50 times stronger than heroin.\u003c/p>\n\u003cp>In addition to the safe consumption site, volunteers spoke with people in the area about safer ways to consume drugs, treatment options, and handed out donuts and water to anyone who was simply hungry.\u003c/p>\n\u003cfigure id=\"attachment_11959780\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://ww2.kqed.org/news/230831-safe-use-pop-up-md-04-kqed/\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959780\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED.jpg\" alt=\"A group of people congregate around a table in an outdoor setting.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Michael Scarce (second from left) greets a community member visiting the safe drug consumption site created by volunteers with Concerned Public Response. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The site was not only a demonstration of civil disobedience — \u003ca href=\"https://www.kqed.org/science/1980034/california-allows-supervised-illicit-drug-use-to-prevent-overdoses\">Gov. Gavin Newsom vetoed a bill in 2022 that would have allowed San Francisco to pilot the sites\u003c/a> — but also a functional facility. At least two overdoses were reversed at the site on Thursday.\u003c/p>\n\u003cp>“This is exactly what we are here to do. If we can prevent even a fraction of the overdose deaths, that’s important,” said Eli Smith, an EMT who helped reverse an overdose at the site on Thursday. “It was really great to be able to help out.”\u003c/p>\n\u003cp>J.M., who did not use a full name to protect his privacy, was staying in the alley where the demonstration took place, and noticed his friend stopped breathing after consuming fentanyl. So he hurried down to the other side of the alley, where the site was set up, and grabbed Narcan. Smith, the EMT, grabbed his medical kit and ran to follow J.M. to the friend, who was lying unresponsive on the sidewalk behind a concrete divider.\u003c/p>\n\u003cp>J.M. administered two rounds of Narcan, a nasal spray that can reverse an opioid overdose, and Smith followed with a respirator pump to provide oxygen. Soon, J.M.’s friend was breathing and slowly back on his feet, and paramedics arrived on scene to follow up. The friend chose not to leave with the paramedics, and walked away on foot.[aside label=\"Related Stories\" postID=\"news_11959733,news_11923303,news_11943309\"]“You saved his life,” Supervisor Hillary Ronen, who was at the safe consumption site on Thursday supporting the volunteers, told J.M.\u003c/p>\n\u003cp>Volunteers at the demonstration also handed out clean needles, which can prevent transmission of HIV and Hepatitis C between drug users, as well as other supplies to cut down on the physical harms associated with drug use, like alcohol wipes, fentanyl test strips and clean smoking supplies.\u003c/p>\n\u003cdiv class=\"mceTemp\">\u003c/div>\n\u003cp>Tom, Rich and Henry, who didn’t share their last names due to privacy concerns, heard about the site after organizers reached out to people living on the streets nearby. They walked over to pick up Narcan, wipes and clean needles, and they used the supervised consumption area.\u003c/p>\n\u003cp>“It’s pretty incredible how accessible this is,” said Tom. “We come across people that really do need this. We need way more [sites like this].”\u003c/p>\n\u003cp>The three men have all lost friends to overdose. Narcan, they said, has been an incredible tool to keep each other alive, but said it can be scary to use without a medical professional present. The trained staff on site gave them more reassurance that they would be okay, Tom said.\u003c/p>\n\u003cp>“People are going to use drugs no matter what, you know? Why not have a safe place where you can make sure people don’t die and there aren’t predators hanging around when you’re using,” Tom said.\u003c/p>\n\u003cfigure id=\"attachment_11959782\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959782\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED.jpg\" alt=\"A sidewalk covered with people's names and drawing of hearts.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A memorial to deceased loved ones at the safe consumption site. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Safe consumption sites can also provide other essential services like showers and laundry, free meals, and sign-ups to housing or drug treatment.\u003c/p>\n\u003cp>Sky and Q, who declined to share their last names, are currently living on the street near where the site was set up. They picked up some donuts, water and a glass pipe from the booth, and even ran into some friends.\u003c/p>\n\u003cp>“I try to use all the drop-in resources like this, this stuff is really helpful. I always keep Narcan on me in case someone needs one,” said Sky, 20. “I think people would see a lot less of what they don’t like seeing, like shoplifting and stuff, if we had more of this. It helps provide things people can’t get for themselves.”\u003c/p>\n\u003cp>More than 200 safe consumption sites operate globally, including in countries with multiple sites like France, Germany and Norway. Zero overdose deaths have been recorded in these facilities.\u003c/p>\n\u003cp>But San Francisco and California government leaders have long delayed opening safe consumption sites, which are also known as overdose prevention centers.\u003c/p>\n\u003cp>The Tenderloin Center, in United Nations Plaza, offered safe consumption services while it was open for 11 months in 2022, before city officials closed it down.\u003c/p>\n\u003cp>But local businesses complained that the facility drew crowds of people waiting for services just outside the Civic Center BART station, and \u003ca href=\"https://www.kqed.org/news/11923129/sf-political-leaders-speak-at-rally-opposing-safe-injection-sites-even-as-many-privately-say-they-support-them\">other residents and political leaders criticized\u003c/a> the model for failing to connect many people to longer-term drug treatment.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11915870/inside-san-franciscos-tenderloin-center-that-serves-hundreds-every-day\">Inside the Tenderloin Center\u003c/a>, however, hundreds of people arrived daily to get their basic needs met. In total, 333 overdoses were reversed by trained staff there and no one died on the premises, research on the facility shows.\u003c/p>\n\u003cp>Smith, the EMT who helped reverse overdoses at the demonstration on Thursday, witnessed hundreds of overdoses reversed at the Tenderloin Center while he was working there.\u003c/p>\n\u003cp>One woman at the pop-up site on Thursday said she would visit the Tenderloin Center “everyday” back when it was still open for a hot meal, showers and a safe place away from the sidewalk to smoke.\u003c/p>\n\u003cfigure id=\"attachment_11959777\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959777\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED.jpg\" alt=\"Two tents set up on a sidewalk on a city block.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Concerned Public Response safe drug consumption site on Aug. 31, 2023. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Mayor London Breed, whose sister died of a drug overdose, supports supervised consumption services. But opening one in San Francisco has been a slow battle. Gavin Newsom vetoed legislation that would have allowed the city to pilot the services. Meanwhile, Rhode Island and New York City have moved ahead with plans and programs despite legal uncertainties.\u003c/p>\n\u003cp>“The mayor continues to support safe consumption sites. These are complicated legal issues that we continue to navigate with our nonprofit partners,” a spokesperson from the mayor’s office said in an email to KQED.\u003c/p>\n\u003cp>After Newsom’s veto, San Francisco leaders funded so-called “wellness hubs” instead, to serve as low-barrier drop-in health facilities that could offer similar services as the Tenderloin Center, with \u003ca href=\"https://www.kqed.org/news/11943309/sf-supervisors-carve-path-for-privately-run-safe-consumption-sites-but-can-nonprofits-fund-them-alone&sa=D&source=docs&ust=1693523375935961&usg=AOvVaw3NGVB6_gFojpUoI4tJe-un\">a private nonprofit funding and running the safe consumption sites at these hubs\u003c/a>, similar to the model used in New York City.\u003c/p>\n\u003cp>Supervisor Ronen stressed that opening up wellness hubs with safe consumption sites is a priority in her remaining time in office.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“Overdose prevention sites, they are not a nefarious, scary thing. Take a look at one in public. We are offering a space where we can watch people to make sure they don’t die. That’s it, it’s that simple,” said Ronen. “We want to provide love, tell people we care about them, and want to support them to eventually get into treatment and get well. But in the meantime, we need to keep them alive to get there.”\u003c/p>\n\n",
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"excerpt": "A group of health practitioners and activists protested delays by city leaders to address the overdose crisis — and saved lives in the process.",
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"title": "In Act of Civil Disobedience, Activists Set Up Safe Drug Consumption Site in San Francisco | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>At least two lives were saved on Thursday at \u003ca href=\"https://www.kqed.org/news/11923303/sf-health-groups-determined-to-forge-ahead-with-safe-consumption-site-despite-newsoms-veto\">a supervised consumption site in San Francisco\u003c/a>, also known as an overdose prevention site, where residents can consume drugs in a safe environment and trained staff are able to prevent overdoses. With the city on track this year to record the highest number of overdose deaths yet, the site was organized by public health advocates as a way to put pressure on leaders to open such a facility permanently.\u003c/p>\n\u003cp>“This is a public response to the fact that there are nearly three people a day dying of overdose in San Francisco. While we continue to talk about how to best prevent loss of life, people continue to die,” said Lydia Bransten, who was volunteering at the event. “So today is a day of action, where we are saying ‘Look how easy this is.’ It’s a very simple response to a complicated issue.”\u003c/p>\n\u003cfigure id=\"attachment_11959779\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://ww2.kqed.org/news/230831-safe-use-pop-up-md-03-kqed/\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959779\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED.jpg\" alt=\"A person with blue-rimmed glasses stands beside some tents outdoors.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lydia Bransten, a member of Concerned Public Response, volunteered at the safe consumption site. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The set-up was simple: Two E-Z UP tents were stationed in an alleyway between Polk and Van Ness on Willow Street, and underneath, people could smoke or inject their pre-obtained drugs in a safer and more private setting than on the sidewalk or elsewhere out in the public. Trained staff were present to supervise and provide water and snacks, or to administer Narcan and respirators in the event of an overdose.\u003c/p>\n\u003cp>Organizers set up the site after long delays by city leaders in opening planned “wellness hubs” with these safe consumption services. The city has already allocated $18.9 million to open the wellness hubs, which would include a variety of health and hygiene services for people experiencing homelessness or substance use disorder. Private funding would then be used to support safe consumption services, which research shows help reduce overdose deaths and operate in nearly 200 places around the globe.\u003c/p>\n\u003cp>Supporters like Bransten said that the sites are meant to be one part of a broader coordinated response to overdoses and substance use disorder, alongside expanded treatment options, mental health care and housing opportunities.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The pop-up event, held on International Overdose Awareness Day (Aug. 31), comes as \u003ca href=\"https://sf.gov/resource/2020/ocme-accidental-overdose-reports\">San Francisco is currently on pace to have its highest year for overdose deaths\u003c/a>, exceeding the record set in 2020 when 725 people lost their lives to drug overdose. In the first half of this year, 473 people died from accidental drug overdose in San Francisco, according to the medical examiner’s office.\u003c/p>\n\u003cp>The majority (80%) of those deaths involved fentanyl, an opioid 50 times stronger than heroin.\u003c/p>\n\u003cp>In addition to the safe consumption site, volunteers spoke with people in the area about safer ways to consume drugs, treatment options, and handed out donuts and water to anyone who was simply hungry.\u003c/p>\n\u003cfigure id=\"attachment_11959780\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://ww2.kqed.org/news/230831-safe-use-pop-up-md-04-kqed/\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959780\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED.jpg\" alt=\"A group of people congregate around a table in an outdoor setting.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Michael Scarce (second from left) greets a community member visiting the safe drug consumption site created by volunteers with Concerned Public Response. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The site was not only a demonstration of civil disobedience — \u003ca href=\"https://www.kqed.org/science/1980034/california-allows-supervised-illicit-drug-use-to-prevent-overdoses\">Gov. Gavin Newsom vetoed a bill in 2022 that would have allowed San Francisco to pilot the sites\u003c/a> — but also a functional facility. At least two overdoses were reversed at the site on Thursday.\u003c/p>\n\u003cp>“This is exactly what we are here to do. If we can prevent even a fraction of the overdose deaths, that’s important,” said Eli Smith, an EMT who helped reverse an overdose at the site on Thursday. “It was really great to be able to help out.”\u003c/p>\n\u003cp>J.M., who did not use a full name to protect his privacy, was staying in the alley where the demonstration took place, and noticed his friend stopped breathing after consuming fentanyl. So he hurried down to the other side of the alley, where the site was set up, and grabbed Narcan. Smith, the EMT, grabbed his medical kit and ran to follow J.M. to the friend, who was lying unresponsive on the sidewalk behind a concrete divider.\u003c/p>\n\u003cp>J.M. administered two rounds of Narcan, a nasal spray that can reverse an opioid overdose, and Smith followed with a respirator pump to provide oxygen. Soon, J.M.’s friend was breathing and slowly back on his feet, and paramedics arrived on scene to follow up. The friend chose not to leave with the paramedics, and walked away on foot.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“You saved his life,” Supervisor Hillary Ronen, who was at the safe consumption site on Thursday supporting the volunteers, told J.M.\u003c/p>\n\u003cp>Volunteers at the demonstration also handed out clean needles, which can prevent transmission of HIV and Hepatitis C between drug users, as well as other supplies to cut down on the physical harms associated with drug use, like alcohol wipes, fentanyl test strips and clean smoking supplies.\u003c/p>\n\u003cdiv class=\"mceTemp\">\u003c/div>\n\u003cp>Tom, Rich and Henry, who didn’t share their last names due to privacy concerns, heard about the site after organizers reached out to people living on the streets nearby. They walked over to pick up Narcan, wipes and clean needles, and they used the supervised consumption area.\u003c/p>\n\u003cp>“It’s pretty incredible how accessible this is,” said Tom. “We come across people that really do need this. We need way more [sites like this].”\u003c/p>\n\u003cp>The three men have all lost friends to overdose. Narcan, they said, has been an incredible tool to keep each other alive, but said it can be scary to use without a medical professional present. The trained staff on site gave them more reassurance that they would be okay, Tom said.\u003c/p>\n\u003cp>“People are going to use drugs no matter what, you know? Why not have a safe place where you can make sure people don’t die and there aren’t predators hanging around when you’re using,” Tom said.\u003c/p>\n\u003cfigure id=\"attachment_11959782\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959782\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED.jpg\" alt=\"A sidewalk covered with people's names and drawing of hearts.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A memorial to deceased loved ones at the safe consumption site. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Safe consumption sites can also provide other essential services like showers and laundry, free meals, and sign-ups to housing or drug treatment.\u003c/p>\n\u003cp>Sky and Q, who declined to share their last names, are currently living on the street near where the site was set up. They picked up some donuts, water and a glass pipe from the booth, and even ran into some friends.\u003c/p>\n\u003cp>“I try to use all the drop-in resources like this, this stuff is really helpful. I always keep Narcan on me in case someone needs one,” said Sky, 20. “I think people would see a lot less of what they don’t like seeing, like shoplifting and stuff, if we had more of this. It helps provide things people can’t get for themselves.”\u003c/p>\n\u003cp>More than 200 safe consumption sites operate globally, including in countries with multiple sites like France, Germany and Norway. Zero overdose deaths have been recorded in these facilities.\u003c/p>\n\u003cp>But San Francisco and California government leaders have long delayed opening safe consumption sites, which are also known as overdose prevention centers.\u003c/p>\n\u003cp>The Tenderloin Center, in United Nations Plaza, offered safe consumption services while it was open for 11 months in 2022, before city officials closed it down.\u003c/p>\n\u003cp>But local businesses complained that the facility drew crowds of people waiting for services just outside the Civic Center BART station, and \u003ca href=\"https://www.kqed.org/news/11923129/sf-political-leaders-speak-at-rally-opposing-safe-injection-sites-even-as-many-privately-say-they-support-them\">other residents and political leaders criticized\u003c/a> the model for failing to connect many people to longer-term drug treatment.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11915870/inside-san-franciscos-tenderloin-center-that-serves-hundreds-every-day\">Inside the Tenderloin Center\u003c/a>, however, hundreds of people arrived daily to get their basic needs met. In total, 333 overdoses were reversed by trained staff there and no one died on the premises, research on the facility shows.\u003c/p>\n\u003cp>Smith, the EMT who helped reverse overdoses at the demonstration on Thursday, witnessed hundreds of overdoses reversed at the Tenderloin Center while he was working there.\u003c/p>\n\u003cp>One woman at the pop-up site on Thursday said she would visit the Tenderloin Center “everyday” back when it was still open for a hot meal, showers and a safe place away from the sidewalk to smoke.\u003c/p>\n\u003cfigure id=\"attachment_11959777\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959777\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED.jpg\" alt=\"Two tents set up on a sidewalk on a city block.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Concerned Public Response safe drug consumption site on Aug. 31, 2023. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Mayor London Breed, whose sister died of a drug overdose, supports supervised consumption services. But opening one in San Francisco has been a slow battle. Gavin Newsom vetoed legislation that would have allowed the city to pilot the services. Meanwhile, Rhode Island and New York City have moved ahead with plans and programs despite legal uncertainties.\u003c/p>\n\u003cp>“The mayor continues to support safe consumption sites. These are complicated legal issues that we continue to navigate with our nonprofit partners,” a spokesperson from the mayor’s office said in an email to KQED.\u003c/p>\n\u003cp>After Newsom’s veto, San Francisco leaders funded so-called “wellness hubs” instead, to serve as low-barrier drop-in health facilities that could offer similar services as the Tenderloin Center, with \u003ca href=\"https://www.kqed.org/news/11943309/sf-supervisors-carve-path-for-privately-run-safe-consumption-sites-but-can-nonprofits-fund-them-alone&sa=D&source=docs&ust=1693523375935961&usg=AOvVaw3NGVB6_gFojpUoI4tJe-un\">a private nonprofit funding and running the safe consumption sites at these hubs\u003c/a>, similar to the model used in New York City.\u003c/p>\n\u003cp>Supervisor Ronen stressed that opening up wellness hubs with safe consumption sites is a priority in her remaining time in office.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Overdose prevention sites, they are not a nefarious, scary thing. Take a look at one in public. We are offering a space where we can watch people to make sure they don’t die. That’s it, it’s that simple,” said Ronen. “We want to provide love, tell people we care about them, and want to support them to eventually get into treatment and get well. But in the meantime, we need to keep them alive to get there.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "These San Franciscans Say Recovery From Drug Addiction Is Possible",
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"content": "\u003cp>In the first half of 2023, 473 people — at least — died from accidental drug overdose in San Francisco, according to the medical examiner’s office.\u003c/p>\n\u003cp>The majority (80%) of those deaths involved\u003ca href=\"https://www.kqed.org/news/tag/fentanyl\"> fentanyl\u003c/a>, an opioid 50 times stronger than heroin. This year, the overdose rate is currently on pace to be the highest for overdose deaths in the city’s history, exceeding the record set in 2020 when 725 people died due to drug overdose.\u003c/p>\n\u003cp>The overdose epidemic in San Francisco has continued to escalate despite attempts from city leaders to expand access to treatment and \u003ca href=\"https://www.kqed.org/news/11948062/newsom-taps-chp-national-guard-to-fight-san-franciscos-fentanyl-crisis\">tap the National Guard\u003c/a> to throttle drug supply trafficking.\u003c/p>\n\u003cp>The situation is bleak, but it’s not without hope. Recovery is possible.\u003c/p>\n\u003cp>What follows is the story of three San Francisco residents, who share their journey through recovery and life beyond drug addiction.\u003c/p>\n\u003cp>KQED is publishing these stories on Aug. 31, International Overdose Awareness Day, and the week the Biden administration has designated to “honor and remember those who have lost their lives to the drug overdose epidemic.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003ch2>Jean\u003c/h2>\n\u003cp>San Francisco has long been a city where people come to reinvent themselves. Sometimes, it just takes a little while.\u003c/p>\n\u003cp>Take Jean, now 60, a mother and longtime San Francisco resident.\u003c/p>\n\u003cp>Jean, who is not using her last name to protect her privacy, grew up in Berkeley and faced numerous traumatizing experiences, including abuse at a young age. She started consuming drugs at just 9 years old to cope with feelings and cover up shame. Over the years, Jean developed addictions to cocaine, alcohol and heroin.[pullquote size=\"medium\" align=\"right\" citation=\"Jean, San Francisco resident in recovery\"]‘I sought help because I knew that I couldn’t get out of my drug addiction by myself. … It can be a new beginning, and the energy you put into that, you’re going to get back.’[/pullquote]“I basically did a lot of things in order to support a heroin habit and a cocaine habit and alcohol. And it just got progressively worse,” Jean told KQED of her experience with addiction.\u003c/p>\n\u003cp>When she was diagnosed with cancer later on in her life, she thought she might not make it.\u003c/p>\n\u003cp>But Jean defied the odds she gave herself and beat cancer. Armed with a new perspective, she decided it was time to fight her addiction, too.\u003c/p>\n\u003cp>She started by going to Zuckerberg San Francisco General Hospital and asking for help. There, she got connected to an \u003ca href=\"https://dsaam.org/otop/\">outpatient treatment program\u003c/a>.\u003c/p>\n\u003cp>“I sought help because I knew that I couldn’t get out of my drug addiction by myself,” she said. “I got help and throughout that process. I learned about addiction. I learned that it’s a disease, it’s something that you can work through and that doesn’t have to take all your life away. It can be a new beginning, and the energy you put into that, you’re going to get back.”\u003c/p>\n\u003cp>Through her treatment, Jean was connected to substance-use counselors like Louie Ramos and had access to medications that helped ease cravings and withdrawal. She also participated in a detox program at \u003ca href=\"https://www.healthright360.org/\">HealthRight360\u003c/a>, a nonprofit that provides mental health therapy and substance-use treatment for extremely low-income residents in San Francisco and other parts of California.\u003c/p>\n\u003cp>Today, Jean is living a life she once couldn’t imagine: sober and living on her own in an apartment near the Giants’ baseball stadium. She’s established a new community of friends who support her changes and understand the challenges she faces.\u003c/p>\n\u003cp>She wants other people in similar positions to know they can do the same.\u003c/p>\n\u003cfigure id=\"attachment_11959603\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959603\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED.jpg\" alt='Two people walk down a hallway beneath a banner that reads \"Welcome to OTOP.\"' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jean, 60, walks with counselor Louie Ramos, UCSF/OTOP clinical supervisor, through the Opiate Treatment Outpatient Program (OTOP) at Zuckerberg San Francisco General Hospital in San Francisco on Aug. 29, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“There is a way out. There is freedom from addiction. It’s possible to come out from under fentanyl. You really just have to keep putting your best foot forward,” Jean said.\u003c/p>\n\u003cp>While Jean walked into San Francisco General on her own, San Francisco has a handful of teams that respond to overdoses and drug-related medical problems on the street. They include the \u003ca href=\"https://sf.gov/street-overdose-response-team\">Street Overdose Response Team\u003c/a>, Post Overdose Engagement Team, and the Bridge and Engagement Services Team Neighborhoods program, which aims to identify individuals who may be in crisis and connect them to long-term behavioral health services.\u003c/p>\n\u003cp>Getting connected to methadone, a medication that can help relieve addiction cravings and withdrawal symptoms, was a crucial stepping stone in recovering from addiction, Jean said.[pullquote size=\"medium\" align=\"right\" citation=\"Louie Ramos, substance-use counselor, Zuckerberg San Francisco General Hospital\"]‘I’ve been doing this job for many years, and I just want people to know that recovery is very possible. Treatment is accessible.’[/pullquote]San Francisco has been simultaneously working to expand ways people can get connected to methadone and other medication-assisted treatments for drug addiction, through \u003ca href=\"https://www.kqed.org/news/11941618/sfs-mobile-clinics-made-opioid-treatment-more-accessible-during-the-pandemic-but-will-they-stay\">mobile clinics\u003c/a>, longer open hours at brick-and-mortar clinics in the city and even \u003ca href=\"https://www.kqed.org/news/11945418/san-francisco-has-doubled-participants-of-this-opioid-treatment-heres-why\">delivery services in supportive housing buildings\u003c/a>.\u003c/p>\n\u003cp>“I’ve been doing this job for many years, and I just want people to know that recovery is very possible. Treatment is accessible,” said Ramos, who is a clinical site supervisor for one of San Francisco General’s mobile methadone clinics in the Bayview. “A lot of people are reluctant to seek services, and you don’t want to force or impose. It takes a while to build trust and not everybody is able to do everything at once. You have to walk with them continuously, through the ups and downs, [and] let them know they are not being judged.”\u003c/p>\n\u003cp>It wasn’t a linear path to where she is today. At several points since deciding she wanted to quit using, Jean relapsed. One time, it happened after someone she knew sexually assaulted her.\u003c/p>\n\u003cp>“I went towards street drugs to ease my pain instead of reaching out to the recovery community, so it led me down a path that took a long time to come out of,” Jean said, after an appointment with her counselor on a recent Wednesday afternoon. “But I did.”\u003c/p>\n\u003ch2>Juliana and Michael\u003c/h2>\n\u003cp>Juliana, 29, and her partner Michael, 31, fell in love dancing at raves and music festivals in their early 20s. Michael worked up the courage to talk to her at a show in Las Vegas, and the two kept in touch at various music events. The two made their relationship official after attending the Coachella Valley Music and Arts Festival in Indio, California.\u003c/p>\n\u003cp>“She was super beautiful, and I just knew that she was really cool. She liked the same things as me,” Michael said. “After Coachella, I was like, I got to make her my girlfriend.”[pullquote size=\"medium\" align=\"right\" citation=\"Juliana, San Francisco resident in recovery\"]‘The three things we always made sure we had were a car, a hotel and drugs, always.’[/pullquote]The duo had fun getting lost in the music together. But drugs were common in the festival scene, and Michael already struggled with an addiction to smoking oxycontin when they met.\u003c/p>\n\u003cp>Juliana eventually consumed harder drugs with Michael, including heroin and fentanyl, and the two spent several years drifting between family members’ houses in San José and Santa Rosa, and many nights in and out of jail for drug use and shoplifting. They talked about getting help and quitting drugs, but it still felt too far off, and too expensive, so they delayed.\u003c/p>\n\u003cp>“The three things we always made sure we had were a car, a hotel and drugs, always,” Juliana said.\u003c/p>\n\u003cp>During the pandemic, they stayed in hotels in San Francisco. But their lives suddenly changed one day in 2021.\u003c/p>\n\u003cp>Juliana felt an extremely sharp pain in her abdomen and checked into the hospital. There, she discovered that she not only was pregnant, but was in labor and about to give birth.\u003c/p>\n\u003cp>“She wasn’t active in my stomach, and I didn’t have morning sickness. I didn’t really have the regular pregnancy signs,” said Juliana, referring to her baby girl.\u003c/p>\n\u003cp>Michael was equally shocked.\u003c/p>\n\u003cfigure id=\"attachment_11959601\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959601\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED.jpg\" alt=\"Two adults and one infant sit on the floor and play together with blocks.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Juliana and Michael play blocks with their daughter Paloma at their home in San Francisco on Aug. 29, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“If we had known that we were having a baby, I would have been too scared to be a father. I wasn’t ready. But it just happened all of the sudden. They let me in and said, congratulations, you have a daughter. I felt a connection immediately, her smile, I was like, ‘Oh my God, I have a daughter.’”\u003c/p>\n\u003cp>Child protective services and Family Treatment Court quickly approached them, helping create a plan for how they would re-establish their lives together and welcome home their baby.\u003c/p>\n\u003cp>Juliana and Michael entered treatment and joined groups to help them in their recovery. That included living at \u003ca href=\"https://www.hamiltonfamilies.org/\">Hamilton Families\u003c/a>, a transitional housing program where they stayed while starting their recovery journey.[pullquote size=\"medium\" align=\"right\" citation=\"Michael, San Francisco resident in recovery\"]‘We basically had to learn how to be a couple again, without the drugs, because that was part of our relationship for so long. We had to relearn how to be a normal couple, and not only that, but parents.’[/pullquote]Meanwhile, Juliana worked with \u003ca href=\"https://obgyn.ucsf.edu/san-francisco-general-hospital/team-lily\">Team Lily, a group at San Francisco General Hospital\u003c/a> that supports pregnant people and new parents who are experiencing homelessness, substance-use disorders, incarceration and other challenges.\u003c/p>\n\u003cp>Just like Jean, Michael and Juliana relapsed during their effort to stay sober. They separated for a short period of time during their treatment programs and used again after reuniting.\u003c/p>\n\u003cp>“It was a problem of not being able to set boundaries with each other,” Juliana said.\u003c/p>\n\u003cp>Michael agrees.\u003c/p>\n\u003cp>“We basically had to learn how to be a couple again, without the drugs, because that was part of our relationship for so long,” he said. “We had to relearn how to be a normal couple, and not only that, but parents.”\u003c/p>\n\u003cfigure id=\"attachment_11959600\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959600\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED.jpg\" alt=\"A framed photo of a group of people in an official looking setting.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A photo sits on a shelf from a graduation ceremony for the San Francisco Family Treatment Court at the home of Juliana and Michael in San Francisco on Aug. 29, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>With help from their case manager, the two were able to get back on track and hold on to the progress they made, including their housing and future as a family together.\u003c/p>\n\u003cp>Juliana added that the city’s prenatal program for those experiencing homelessness “connected us with a bunch of things that helped us get back on our feet, like health insurance, and just showed us a lot of options that were available to us that we didn’t know about.”\u003c/p>\n\u003cp>Methadone has been a big part of their recovery. Each month, Juliana will visit an outpatient treatment program to refill her prescription of opioid addiction medication and take a drug test before meeting with a counselor.[aside postID=news_11954871 hero='https://ww2.kqed.org/app/uploads/sites/10/2023/07/RS66620_20230623-SFAIDSFoundation-004-BL-KQED-1020x680.jpg']“Some people look at methadone in a bad light. But honestly, it’s the only thing that helps me stop smoking. My life is so much better and I’m happy and able to have a family and be a father. All this just wouldn’t be possible without it,” Michael said.\u003c/p>\n\u003cp>Today, the couple is raising their baby, Paloma, in a bright apartment in the Richmond District, while continuing to meet with recovery groups and other programs that have supported their journey.\u003c/p>\n\u003cp>Michael is leading a group for fathers within the prenatal program that helped his family. He’s also taking a course on mental health and substance abuse to further his training in counseling facilitation. Juliana has plans to someday return to hairstyling and has maintained a cosmetology license.\u003c/p>\n\u003cp>It’s not always an easy journey, but it’s given the two more faith in what they can overcome.\u003c/p>\n\u003cp>“If you can find an addiction together,” Michael said, “you can find recovery together.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In the first half of 2023, 473 people — at least — died from accidental drug overdose in San Francisco, according to the medical examiner’s office.\u003c/p>\n\u003cp>The majority (80%) of those deaths involved\u003ca href=\"https://www.kqed.org/news/tag/fentanyl\"> fentanyl\u003c/a>, an opioid 50 times stronger than heroin. This year, the overdose rate is currently on pace to be the highest for overdose deaths in the city’s history, exceeding the record set in 2020 when 725 people died due to drug overdose.\u003c/p>\n\u003cp>The overdose epidemic in San Francisco has continued to escalate despite attempts from city leaders to expand access to treatment and \u003ca href=\"https://www.kqed.org/news/11948062/newsom-taps-chp-national-guard-to-fight-san-franciscos-fentanyl-crisis\">tap the National Guard\u003c/a> to throttle drug supply trafficking.\u003c/p>\n\u003cp>The situation is bleak, but it’s not without hope. Recovery is possible.\u003c/p>\n\u003cp>What follows is the story of three San Francisco residents, who share their journey through recovery and life beyond drug addiction.\u003c/p>\n\u003cp>KQED is publishing these stories on Aug. 31, International Overdose Awareness Day, and the week the Biden administration has designated to “honor and remember those who have lost their lives to the drug overdose epidemic.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch2>Jean\u003c/h2>\n\u003cp>San Francisco has long been a city where people come to reinvent themselves. Sometimes, it just takes a little while.\u003c/p>\n\u003cp>Take Jean, now 60, a mother and longtime San Francisco resident.\u003c/p>\n\u003cp>Jean, who is not using her last name to protect her privacy, grew up in Berkeley and faced numerous traumatizing experiences, including abuse at a young age. She started consuming drugs at just 9 years old to cope with feelings and cover up shame. Over the years, Jean developed addictions to cocaine, alcohol and heroin.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“I basically did a lot of things in order to support a heroin habit and a cocaine habit and alcohol. And it just got progressively worse,” Jean told KQED of her experience with addiction.\u003c/p>\n\u003cp>When she was diagnosed with cancer later on in her life, she thought she might not make it.\u003c/p>\n\u003cp>But Jean defied the odds she gave herself and beat cancer. Armed with a new perspective, she decided it was time to fight her addiction, too.\u003c/p>\n\u003cp>She started by going to Zuckerberg San Francisco General Hospital and asking for help. There, she got connected to an \u003ca href=\"https://dsaam.org/otop/\">outpatient treatment program\u003c/a>.\u003c/p>\n\u003cp>“I sought help because I knew that I couldn’t get out of my drug addiction by myself,” she said. “I got help and throughout that process. I learned about addiction. I learned that it’s a disease, it’s something that you can work through and that doesn’t have to take all your life away. It can be a new beginning, and the energy you put into that, you’re going to get back.”\u003c/p>\n\u003cp>Through her treatment, Jean was connected to substance-use counselors like Louie Ramos and had access to medications that helped ease cravings and withdrawal. She also participated in a detox program at \u003ca href=\"https://www.healthright360.org/\">HealthRight360\u003c/a>, a nonprofit that provides mental health therapy and substance-use treatment for extremely low-income residents in San Francisco and other parts of California.\u003c/p>\n\u003cp>Today, Jean is living a life she once couldn’t imagine: sober and living on her own in an apartment near the Giants’ baseball stadium. She’s established a new community of friends who support her changes and understand the challenges she faces.\u003c/p>\n\u003cp>She wants other people in similar positions to know they can do the same.\u003c/p>\n\u003cfigure id=\"attachment_11959603\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959603\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED.jpg\" alt='Two people walk down a hallway beneath a banner that reads \"Welcome to OTOP.\"' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jean, 60, walks with counselor Louie Ramos, UCSF/OTOP clinical supervisor, through the Opiate Treatment Outpatient Program (OTOP) at Zuckerberg San Francisco General Hospital in San Francisco on Aug. 29, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“There is a way out. There is freedom from addiction. It’s possible to come out from under fentanyl. You really just have to keep putting your best foot forward,” Jean said.\u003c/p>\n\u003cp>While Jean walked into San Francisco General on her own, San Francisco has a handful of teams that respond to overdoses and drug-related medical problems on the street. They include the \u003ca href=\"https://sf.gov/street-overdose-response-team\">Street Overdose Response Team\u003c/a>, Post Overdose Engagement Team, and the Bridge and Engagement Services Team Neighborhoods program, which aims to identify individuals who may be in crisis and connect them to long-term behavioral health services.\u003c/p>\n\u003cp>Getting connected to methadone, a medication that can help relieve addiction cravings and withdrawal symptoms, was a crucial stepping stone in recovering from addiction, Jean said.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>San Francisco has been simultaneously working to expand ways people can get connected to methadone and other medication-assisted treatments for drug addiction, through \u003ca href=\"https://www.kqed.org/news/11941618/sfs-mobile-clinics-made-opioid-treatment-more-accessible-during-the-pandemic-but-will-they-stay\">mobile clinics\u003c/a>, longer open hours at brick-and-mortar clinics in the city and even \u003ca href=\"https://www.kqed.org/news/11945418/san-francisco-has-doubled-participants-of-this-opioid-treatment-heres-why\">delivery services in supportive housing buildings\u003c/a>.\u003c/p>\n\u003cp>“I’ve been doing this job for many years, and I just want people to know that recovery is very possible. Treatment is accessible,” said Ramos, who is a clinical site supervisor for one of San Francisco General’s mobile methadone clinics in the Bayview. “A lot of people are reluctant to seek services, and you don’t want to force or impose. It takes a while to build trust and not everybody is able to do everything at once. You have to walk with them continuously, through the ups and downs, [and] let them know they are not being judged.”\u003c/p>\n\u003cp>It wasn’t a linear path to where she is today. At several points since deciding she wanted to quit using, Jean relapsed. One time, it happened after someone she knew sexually assaulted her.\u003c/p>\n\u003cp>“I went towards street drugs to ease my pain instead of reaching out to the recovery community, so it led me down a path that took a long time to come out of,” Jean said, after an appointment with her counselor on a recent Wednesday afternoon. “But I did.”\u003c/p>\n\u003ch2>Juliana and Michael\u003c/h2>\n\u003cp>Juliana, 29, and her partner Michael, 31, fell in love dancing at raves and music festivals in their early 20s. Michael worked up the courage to talk to her at a show in Las Vegas, and the two kept in touch at various music events. The two made their relationship official after attending the Coachella Valley Music and Arts Festival in Indio, California.\u003c/p>\n\u003cp>“She was super beautiful, and I just knew that she was really cool. She liked the same things as me,” Michael said. “After Coachella, I was like, I got to make her my girlfriend.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The duo had fun getting lost in the music together. But drugs were common in the festival scene, and Michael already struggled with an addiction to smoking oxycontin when they met.\u003c/p>\n\u003cp>Juliana eventually consumed harder drugs with Michael, including heroin and fentanyl, and the two spent several years drifting between family members’ houses in San José and Santa Rosa, and many nights in and out of jail for drug use and shoplifting. They talked about getting help and quitting drugs, but it still felt too far off, and too expensive, so they delayed.\u003c/p>\n\u003cp>“The three things we always made sure we had were a car, a hotel and drugs, always,” Juliana said.\u003c/p>\n\u003cp>During the pandemic, they stayed in hotels in San Francisco. But their lives suddenly changed one day in 2021.\u003c/p>\n\u003cp>Juliana felt an extremely sharp pain in her abdomen and checked into the hospital. There, she discovered that she not only was pregnant, but was in labor and about to give birth.\u003c/p>\n\u003cp>“She wasn’t active in my stomach, and I didn’t have morning sickness. I didn’t really have the regular pregnancy signs,” said Juliana, referring to her baby girl.\u003c/p>\n\u003cp>Michael was equally shocked.\u003c/p>\n\u003cfigure id=\"attachment_11959601\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959601\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED.jpg\" alt=\"Two adults and one infant sit on the floor and play together with blocks.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Juliana and Michael play blocks with their daughter Paloma at their home in San Francisco on Aug. 29, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“If we had known that we were having a baby, I would have been too scared to be a father. I wasn’t ready. But it just happened all of the sudden. They let me in and said, congratulations, you have a daughter. I felt a connection immediately, her smile, I was like, ‘Oh my God, I have a daughter.’”\u003c/p>\n\u003cp>Child protective services and Family Treatment Court quickly approached them, helping create a plan for how they would re-establish their lives together and welcome home their baby.\u003c/p>\n\u003cp>Juliana and Michael entered treatment and joined groups to help them in their recovery. That included living at \u003ca href=\"https://www.hamiltonfamilies.org/\">Hamilton Families\u003c/a>, a transitional housing program where they stayed while starting their recovery journey.\u003c/p>\u003c/div>",
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"content": "‘We basically had to learn how to be a couple again, without the drugs, because that was part of our relationship for so long. We had to relearn how to be a normal couple, and not only that, but parents.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Meanwhile, Juliana worked with \u003ca href=\"https://obgyn.ucsf.edu/san-francisco-general-hospital/team-lily\">Team Lily, a group at San Francisco General Hospital\u003c/a> that supports pregnant people and new parents who are experiencing homelessness, substance-use disorders, incarceration and other challenges.\u003c/p>\n\u003cp>Just like Jean, Michael and Juliana relapsed during their effort to stay sober. They separated for a short period of time during their treatment programs and used again after reuniting.\u003c/p>\n\u003cp>“It was a problem of not being able to set boundaries with each other,” Juliana said.\u003c/p>\n\u003cp>Michael agrees.\u003c/p>\n\u003cp>“We basically had to learn how to be a couple again, without the drugs, because that was part of our relationship for so long,” he said. “We had to relearn how to be a normal couple, and not only that, but parents.”\u003c/p>\n\u003cfigure id=\"attachment_11959600\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959600\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED.jpg\" alt=\"A framed photo of a group of people in an official looking setting.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A photo sits on a shelf from a graduation ceremony for the San Francisco Family Treatment Court at the home of Juliana and Michael in San Francisco on Aug. 29, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>With help from their case manager, the two were able to get back on track and hold on to the progress they made, including their housing and future as a family together.\u003c/p>\n\u003cp>Juliana added that the city’s prenatal program for those experiencing homelessness “connected us with a bunch of things that helped us get back on our feet, like health insurance, and just showed us a lot of options that were available to us that we didn’t know about.”\u003c/p>\n\u003cp>Methadone has been a big part of their recovery. Each month, Juliana will visit an outpatient treatment program to refill her prescription of opioid addiction medication and take a drug test before meeting with a counselor.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“Some people look at methadone in a bad light. But honestly, it’s the only thing that helps me stop smoking. My life is so much better and I’m happy and able to have a family and be a father. All this just wouldn’t be possible without it,” Michael said.\u003c/p>\n\u003cp>Today, the couple is raising their baby, Paloma, in a bright apartment in the Richmond District, while continuing to meet with recovery groups and other programs that have supported their journey.\u003c/p>\n\u003cp>Michael is leading a group for fathers within the prenatal program that helped his family. He’s also taking a course on mental health and substance abuse to further his training in counseling facilitation. Juliana has plans to someday return to hairstyling and has maintained a cosmetology license.\u003c/p>\n\u003cp>It’s not always an easy journey, but it’s given the two more faith in what they can overcome.\u003c/p>\n\u003cp>“If you can find an addiction together,” Michael said, “you can find recovery together.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "California Advocates Push to Decriminalize Psychedelics With Therapeutic Benefits",
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"content": "\u003cp>Psychedelics are having a moment. A nationwide push to bring magic mushrooms and other psychedelics into the mainstream is gaining traction, and some Californians want in.\u003c/p>\n\u003cp>While hallucinogens are often associated with the drug culture of the 1960s, today’s movement on psychedelics is largely about using them to help treat the nation’s ballooning mental health crisis. Growing research portrays the drugs as a promising tool in helping people heal from various mental illnesses, including depression and post-traumatic stress disorder.[pullquote size=\"medium\" align=\"right\" citation=\"Jennifer Mitchell, neurology professor, UC San Francisco\"]‘[Psychedelics] are actually exceedingly safe physiologically; psychologically is where we get into trouble.’[/pullquote]Now several proposals floating around in California seek to make psychedelics more accessible for therapeutic and personal use. These include one legislative proposal that would decriminalize use of certain natural hallucinogens and two pending initiatives for next year’s ballot — one that would legalize the use and sale of psilocybin mushrooms, and a second that would fund a $5 billion agency to research and develop psychedelic therapies.\u003c/p>\n\u003cp>One recent \u003ca href=\"https://psychedelics.berkeley.edu/bcsp-first-study-results/\">UC Berkeley survey\u003c/a> offers a glimpse of where the public currently stands on these types of reforms. For example, more than 60% of those surveyed supported psychedelics for therapeutic use. Also, 78% supported making it easier for researchers to further study psychedelics. Meanwhile, 49% said they supported removing criminal penalties for personal use.\u003c/p>\n\u003cp>Some researchers, doctors and parents urge caution around personal use because psychedelics aren’t for everyone and potential risks are still not all that well understood. Use of these substances should be done with safeguards in place, they say.\u003c/p>\n\u003cp>The bill to decriminalize plant-based psychedelics faces a key test this week at a hearing that could determine whether it moves forward this year. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240SB58\">Senate Bill 58\u003c/a>, by state Sen. Scott Wiener, a San Francisco Democrat, would ensure that people do not get arrested for possessing and ingesting specified quantities of psilocybin and psilocin, the psychoactive ingredient in hallucinogenic mushrooms; mescaline; ibogaine; and dimethyltryptamine, or DMT.\u003c/p>\n\u003cp>The bill does not, however, legalize the sale of any of these substances.\u003c/p>\n\u003cp>“A huge number of people right now in California are using psychedelics, despite the fact that it is banned,” Wiener said during an Assembly Health Committee hearing last month.[aside postID=\"science_1982857,forum_2010101883458,news_11873841\" label=\"Related Stories\"]Decriminalizing these substances, he argued, promotes responsible use. “If you think you’re doing something wrong, you’re less likely to seek information or talk to someone about how to be safe,” he said.\u003c/p>\n\u003cp>His bill would also order the state’s health agency to form a workgroup that would make recommendations regarding supervised medical use of these psychedelics — although any psychedelic-assisted therapies first need approval from the U.S. Food and Drug Administration.\u003c/p>\n\u003cp>This is the second time Wiener has tried to decriminalize psychedelics; the first failed last year. This time around, his bill is more narrow in that it excludes synthetic psychedelics, such as LSD.\u003c/p>\n\u003cp>If Wiener’s bill makes it through the Legislature and across the governor’s desk, California would follow Oregon and Colorado, where voters have already decriminalized psychedelics. Some cities in the Golden State are a step ahead — \u003ca href=\"https://www.sfchronicle.com/bayarea/article/Oakland-expected-to-vote-tonight-on-whether-to-13937792.php\">Oakland\u003c/a>, \u003ca href=\"https://sfstandard.com/2022/11/01/san-francisco-has-effectively-decriminalized-mushrooms-now-what/\">San Francisco\u003c/a>, \u003ca href=\"https://www.santacruzsentinel.com/2020/01/29/santa-cruz-decriminalizes-natural-psychedelics/\">Santa Cruz\u003c/a> and most recently \u003ca href=\"https://www.berkeleyside.org/2023/07/12/berkeley-psychedelics-decriminalization\">Berkeley\u003c/a>, have already passed measures that order law enforcement to back off arresting people for using plant-based psychedelics.\u003c/p>\n\u003ch2>Benefits and risks of psychedelics\u003c/h2>\n\u003cp>Supporters of decriminalization point to \u003ca href=\"https://maps.org/mdma/ptsd/\">promising data about some psychedelic-assisted therapies\u003c/a> now in \u003ca href=\"https://clinicaltrials.gov/study/NCT03537014\">end stages of clinical trials\u003c/a>, such as the use of MDMA (commonly known as “ecstasy”) to treat symptoms in patients with post-traumatic stress disorder.\u003c/p>\n\u003cp>Additionally, psilocybin, found in hallucinogenic mushrooms, is being studied for treating depression. For example, early data from The Johns Hopkins Center for Psychedelic and Consciousness Research, has shown that \u003ca href=\"https://journals.sagepub.com/doi/10.1177/02698811211073759\">psilocybin therapy can reduce major depressive disorder symptoms\u003c/a> for up to a year.\u003c/p>\n\u003cp>Wiener has taken combat veterans and retired first responders to testify before the Legislature about their “transformational” experiences using psychedelics to help relieve suicidal thoughts and PTSD symptoms.\u003c/p>\n\u003cp>According to the U.S. Veterans Affairs Department, \u003ca href=\"https://www.ptsd.va.gov/understand/common/common_adults.asp\">about 6% of the U.S. population\u003c/a> will have PTSD at some point in their lives. About \u003ca href=\"https://www.nimh.nih.gov/health/statistics/mental-illness#:~:text=Mental%20illnesses%20are%20common%20in,(57.8%20million%20in%202021).\">one in five adults live with a mental illness\u003c/a>, according to some national estimates.\u003c/p>\n\u003cp>Researchers believe public attention on the worsening mental health crisis during the COVID-19 pandemic may also play a role in this renewed interest in psychedelics.\u003c/p>\n\u003cp>“Suddenly you’ve got this discussion about mental health issues in a way that, at least in American culture, we really hadn’t been discussing,” said Jennifer Mitchell, a neurology professor at the University of California, San Francisco who has been working on the development of psychedelic therapies and collecting safety data.\u003c/p>\n\u003cp>Mitchell opposes Wiener’s decriminalization bill because she believes access to psychedelics for therapeutic use should come before personal use.\u003c/p>\n\u003cp>Currently, psychedelics are only allowed for clinical research. If and once therapies are approved by the FDA, those lessons, she argues, could then help inform safety guidelines for personal access.\u003c/p>\n\u003cp>“[Psychedelics] are actually exceedingly safe physiologically; psychologically is where we get into trouble,” Mitchell said. “Because if you take a drug and think you can fly, you’re capable of self-harm. If you take a drug and think you can breathe underwater, you are capable of self-harm. And those are the types of reasons why when you take a psychedelic, we want you to be in a facilitated environment where you’re being watched and well maintained.”\u003c/p>\n\u003ch2>A California mother’s campaign\u003c/h2>\n\u003cp>One powerful voice opposing Wiener’s bill is \u003ca href=\"https://www.sfgate.com/politics/article/moms-not-cops-biggest-roadblock-calif-drug-reform-18200005.php\">a coalition led by mothers\u003c/a> who have lost a child to an adverse reaction after ingesting psychedelics. Kristin Nash, for one, has widely shared the story of her son who died 21 months before his college graduation. In \u003ca href=\"https://themicrodose.substack.com/p/5-questions-for-kristin-nash\">blogs and Op-Eds\u003c/a>, Nash has shared that in 2020, Will took two grams of psilocybin mushrooms and in his altered state mistook a jar of protein powder for a water jug and suffocated.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Nash now \u003ca href=\"https://www.williamgnash.org/\">runs a foundation named after her son\u003c/a>, William, through which she works to raise awareness and advocates for harm-reduction efforts, such as better tracking of adverse reactions and training for college campus responders. Nash said she is not against allowing veterans and others to use these substances for treatment, but she’d like to see Wiener’s bill amended so it includes safety measures for personal use.\u003c/p>\n\u003cp>Nash, who also has a background in public health and most recently worked at an AIDS nonprofit, is a participating author in a Stanford-led study (yet to be peer reviewed), that showed \u003ca href=\"https://www.medrxiv.org/content/10.1101/2023.08.18.23294275v1\">emergency room visits in California linked to hallucinogens\u003c/a> jumped 84% from 2,260 in 2016 to 4,161 in 2021. But that data includes a spectrum of substances, from plant-based psychedelics to MDMA and ketamine. Authors note that currently data is collected in a way that makes it difficult to comb for specific substances.\u003c/p>\n\u003cp>“I don’t believe people should be arrested for possessing and using mushrooms,” Nash told CalMatters. “These are being used whether we legalize them or not. And so I would argue that we need these safeguards. When we make this policy shift, we know that use will increase further, that adverse events will increase further, and so I feel like we don’t have to choose between social justice, equitable access and safety, we can do all of those things.”\u003c/p>\n\u003ch2>Mushrooms on the ballot\u003c/h2>\n\u003cp>California voters may hear more about psychedelics next year even if Wiener’s bill fails as advocacy groups attempt to qualify ballot initiatives for the November 2024 election.\u003c/p>\n\u003cp>One group, \u003ca href=\"https://decrimca.org/\">Decriminalize California\u003c/a>, is looking to legalize hallucinogenic mushrooms. Its proposal goes further than Wiener’s bill by legalizing not only possession, but also the sale and commercialization of these substances. If approved by voters, the measure would go into effect in January 2025.\u003c/p>\n\u003cp>“Originally we wanted to go for all psychedelics, but the problem was there wasn’t enough public comprehension about what else was out there,” said Ryan Munevar, campaign director at Decriminalize California. Noting that voters are a lot more familiar and likely more comfortable with magic mushrooms than any other psychedelic drug.\u003c/p>\n\u003cp>A separate measure would ask voters to approve $5 billion in bonds to create a government agency that would focus on psychedelic research with the goal of developing therapeutics. The idea, according to proponents, is to dedicate more resources to research that shows promise but has for long been underfunded.\u003c/p>\n\u003cp>Dr. Jeannie Fontana, the chief executive officer of \u003ca href=\"https://www.treatcalifornia.org/\">TREAT California\u003c/a>, who is spearheading this initiative, said California’s lead on innovation makes it the ideal location for this type of research. TREAT stands for Treatments, Research, Education, Access and Therapies.\u003c/p>\n\u003cp>“The federal government is not there yet. They recognize the problem, but they just don’t know how to deal with this psychedelic hangover from the ’60s and ’70s,” Fontana said. “California is a progressive citizenry. We are innovators and leaders in many things.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Psychedelics are having a moment. A nationwide push to bring magic mushrooms and other psychedelics into the mainstream is gaining traction, and some Californians want in.\u003c/p>\n\u003cp>While hallucinogens are often associated with the drug culture of the 1960s, today’s movement on psychedelics is largely about using them to help treat the nation’s ballooning mental health crisis. Growing research portrays the drugs as a promising tool in helping people heal from various mental illnesses, including depression and post-traumatic stress disorder.\u003c/p>\u003c/div>",
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"content": "‘[Psychedelics] are actually exceedingly safe physiologically; psychologically is where we get into trouble.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Now several proposals floating around in California seek to make psychedelics more accessible for therapeutic and personal use. These include one legislative proposal that would decriminalize use of certain natural hallucinogens and two pending initiatives for next year’s ballot — one that would legalize the use and sale of psilocybin mushrooms, and a second that would fund a $5 billion agency to research and develop psychedelic therapies.\u003c/p>\n\u003cp>One recent \u003ca href=\"https://psychedelics.berkeley.edu/bcsp-first-study-results/\">UC Berkeley survey\u003c/a> offers a glimpse of where the public currently stands on these types of reforms. For example, more than 60% of those surveyed supported psychedelics for therapeutic use. Also, 78% supported making it easier for researchers to further study psychedelics. Meanwhile, 49% said they supported removing criminal penalties for personal use.\u003c/p>\n\u003cp>Some researchers, doctors and parents urge caution around personal use because psychedelics aren’t for everyone and potential risks are still not all that well understood. Use of these substances should be done with safeguards in place, they say.\u003c/p>\n\u003cp>The bill to decriminalize plant-based psychedelics faces a key test this week at a hearing that could determine whether it moves forward this year. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240SB58\">Senate Bill 58\u003c/a>, by state Sen. Scott Wiener, a San Francisco Democrat, would ensure that people do not get arrested for possessing and ingesting specified quantities of psilocybin and psilocin, the psychoactive ingredient in hallucinogenic mushrooms; mescaline; ibogaine; and dimethyltryptamine, or DMT.\u003c/p>\n\u003cp>The bill does not, however, legalize the sale of any of these substances.\u003c/p>\n\u003cp>“A huge number of people right now in California are using psychedelics, despite the fact that it is banned,” Wiener said during an Assembly Health Committee hearing last month.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Decriminalizing these substances, he argued, promotes responsible use. “If you think you’re doing something wrong, you’re less likely to seek information or talk to someone about how to be safe,” he said.\u003c/p>\n\u003cp>His bill would also order the state’s health agency to form a workgroup that would make recommendations regarding supervised medical use of these psychedelics — although any psychedelic-assisted therapies first need approval from the U.S. Food and Drug Administration.\u003c/p>\n\u003cp>This is the second time Wiener has tried to decriminalize psychedelics; the first failed last year. This time around, his bill is more narrow in that it excludes synthetic psychedelics, such as LSD.\u003c/p>\n\u003cp>If Wiener’s bill makes it through the Legislature and across the governor’s desk, California would follow Oregon and Colorado, where voters have already decriminalized psychedelics. Some cities in the Golden State are a step ahead — \u003ca href=\"https://www.sfchronicle.com/bayarea/article/Oakland-expected-to-vote-tonight-on-whether-to-13937792.php\">Oakland\u003c/a>, \u003ca href=\"https://sfstandard.com/2022/11/01/san-francisco-has-effectively-decriminalized-mushrooms-now-what/\">San Francisco\u003c/a>, \u003ca href=\"https://www.santacruzsentinel.com/2020/01/29/santa-cruz-decriminalizes-natural-psychedelics/\">Santa Cruz\u003c/a> and most recently \u003ca href=\"https://www.berkeleyside.org/2023/07/12/berkeley-psychedelics-decriminalization\">Berkeley\u003c/a>, have already passed measures that order law enforcement to back off arresting people for using plant-based psychedelics.\u003c/p>\n\u003ch2>Benefits and risks of psychedelics\u003c/h2>\n\u003cp>Supporters of decriminalization point to \u003ca href=\"https://maps.org/mdma/ptsd/\">promising data about some psychedelic-assisted therapies\u003c/a> now in \u003ca href=\"https://clinicaltrials.gov/study/NCT03537014\">end stages of clinical trials\u003c/a>, such as the use of MDMA (commonly known as “ecstasy”) to treat symptoms in patients with post-traumatic stress disorder.\u003c/p>\n\u003cp>Additionally, psilocybin, found in hallucinogenic mushrooms, is being studied for treating depression. For example, early data from The Johns Hopkins Center for Psychedelic and Consciousness Research, has shown that \u003ca href=\"https://journals.sagepub.com/doi/10.1177/02698811211073759\">psilocybin therapy can reduce major depressive disorder symptoms\u003c/a> for up to a year.\u003c/p>\n\u003cp>Wiener has taken combat veterans and retired first responders to testify before the Legislature about their “transformational” experiences using psychedelics to help relieve suicidal thoughts and PTSD symptoms.\u003c/p>\n\u003cp>According to the U.S. Veterans Affairs Department, \u003ca href=\"https://www.ptsd.va.gov/understand/common/common_adults.asp\">about 6% of the U.S. population\u003c/a> will have PTSD at some point in their lives. About \u003ca href=\"https://www.nimh.nih.gov/health/statistics/mental-illness#:~:text=Mental%20illnesses%20are%20common%20in,(57.8%20million%20in%202021).\">one in five adults live with a mental illness\u003c/a>, according to some national estimates.\u003c/p>\n\u003cp>Researchers believe public attention on the worsening mental health crisis during the COVID-19 pandemic may also play a role in this renewed interest in psychedelics.\u003c/p>\n\u003cp>“Suddenly you’ve got this discussion about mental health issues in a way that, at least in American culture, we really hadn’t been discussing,” said Jennifer Mitchell, a neurology professor at the University of California, San Francisco who has been working on the development of psychedelic therapies and collecting safety data.\u003c/p>\n\u003cp>Mitchell opposes Wiener’s decriminalization bill because she believes access to psychedelics for therapeutic use should come before personal use.\u003c/p>\n\u003cp>Currently, psychedelics are only allowed for clinical research. If and once therapies are approved by the FDA, those lessons, she argues, could then help inform safety guidelines for personal access.\u003c/p>\n\u003cp>“[Psychedelics] are actually exceedingly safe physiologically; psychologically is where we get into trouble,” Mitchell said. “Because if you take a drug and think you can fly, you’re capable of self-harm. If you take a drug and think you can breathe underwater, you are capable of self-harm. And those are the types of reasons why when you take a psychedelic, we want you to be in a facilitated environment where you’re being watched and well maintained.”\u003c/p>\n\u003ch2>A California mother’s campaign\u003c/h2>\n\u003cp>One powerful voice opposing Wiener’s bill is \u003ca href=\"https://www.sfgate.com/politics/article/moms-not-cops-biggest-roadblock-calif-drug-reform-18200005.php\">a coalition led by mothers\u003c/a> who have lost a child to an adverse reaction after ingesting psychedelics. Kristin Nash, for one, has widely shared the story of her son who died 21 months before his college graduation. In \u003ca href=\"https://themicrodose.substack.com/p/5-questions-for-kristin-nash\">blogs and Op-Eds\u003c/a>, Nash has shared that in 2020, Will took two grams of psilocybin mushrooms and in his altered state mistook a jar of protein powder for a water jug and suffocated.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Nash now \u003ca href=\"https://www.williamgnash.org/\">runs a foundation named after her son\u003c/a>, William, through which she works to raise awareness and advocates for harm-reduction efforts, such as better tracking of adverse reactions and training for college campus responders. Nash said she is not against allowing veterans and others to use these substances for treatment, but she’d like to see Wiener’s bill amended so it includes safety measures for personal use.\u003c/p>\n\u003cp>Nash, who also has a background in public health and most recently worked at an AIDS nonprofit, is a participating author in a Stanford-led study (yet to be peer reviewed), that showed \u003ca href=\"https://www.medrxiv.org/content/10.1101/2023.08.18.23294275v1\">emergency room visits in California linked to hallucinogens\u003c/a> jumped 84% from 2,260 in 2016 to 4,161 in 2021. But that data includes a spectrum of substances, from plant-based psychedelics to MDMA and ketamine. Authors note that currently data is collected in a way that makes it difficult to comb for specific substances.\u003c/p>\n\u003cp>“I don’t believe people should be arrested for possessing and using mushrooms,” Nash told CalMatters. “These are being used whether we legalize them or not. And so I would argue that we need these safeguards. When we make this policy shift, we know that use will increase further, that adverse events will increase further, and so I feel like we don’t have to choose between social justice, equitable access and safety, we can do all of those things.”\u003c/p>\n\u003ch2>Mushrooms on the ballot\u003c/h2>\n\u003cp>California voters may hear more about psychedelics next year even if Wiener’s bill fails as advocacy groups attempt to qualify ballot initiatives for the November 2024 election.\u003c/p>\n\u003cp>One group, \u003ca href=\"https://decrimca.org/\">Decriminalize California\u003c/a>, is looking to legalize hallucinogenic mushrooms. Its proposal goes further than Wiener’s bill by legalizing not only possession, but also the sale and commercialization of these substances. If approved by voters, the measure would go into effect in January 2025.\u003c/p>\n\u003cp>“Originally we wanted to go for all psychedelics, but the problem was there wasn’t enough public comprehension about what else was out there,” said Ryan Munevar, campaign director at Decriminalize California. Noting that voters are a lot more familiar and likely more comfortable with magic mushrooms than any other psychedelic drug.\u003c/p>\n\u003cp>A separate measure would ask voters to approve $5 billion in bonds to create a government agency that would focus on psychedelic research with the goal of developing therapeutics. The idea, according to proponents, is to dedicate more resources to research that shows promise but has for long been underfunded.\u003c/p>\n\u003cp>Dr. Jeannie Fontana, the chief executive officer of \u003ca href=\"https://www.treatcalifornia.org/\">TREAT California\u003c/a>, who is spearheading this initiative, said California’s lead on innovation makes it the ideal location for this type of research. TREAT stands for Treatments, Research, Education, Access and Therapies.\u003c/p>\n\u003cp>“The federal government is not there yet. They recognize the problem, but they just don’t know how to deal with this psychedelic hangover from the ’60s and ’70s,” Fontana said. “California is a progressive citizenry. We are innovators and leaders in many things.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "California Families Can Expect Eligibility Limits in CARE Courts Rollout",
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"headTitle": "California Families Can Expect Eligibility Limits in CARE Courts Rollout | KQED",
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"content": "\u003cp>Under the low hum of cold fluorescent lights in a nondescript office park in Orange County, dozens of Californians gathered to find out if they could get help for their loved ones under the state’s new \u003ca href=\"https://www.kqed.org/news/tag/care-court\">CARE Court\u003c/a> system.\u003c/p>\n\u003cp>Unless that loved one has a medical diagnosis specific to schizophrenia or some other psychotic disorders, the answer is probably not.\u003c/p>\n\u003cp>The mid-August meeting was a series held by a mental health advocacy group in Orange County with the officials in charge of implementing CARE Court, which starts in October, about what the new system can and cannot do.\u003c/p>\n\u003cp>“What we’re here to do is share the facts to help manage expectations,” said Veronica Kelley, Orange County’s chief of mental health and recovery services.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Community Assistance, Recovery, and Empowerment (CARE) Court was Gov. Gavin Newsom’s \u003ca href=\"https://calmatters.org/housing/2022/09/california-lawmakers-approved-care-court-what-comes-next/\">biggest legislative priority\u003c/a> last year — what state lawmakers and local politicians hoped would be one answer to California’s dual, overlapping homelessness and mental health crises.\u003c/p>\n\u003cp>The new program allows family members and others to petition someone with untreated mental illness into civil courts, where a judge would order a treatment plan and require county mental health departments to provide it.\u003c/p>\n\u003cp>Backed by millions in new state funds, it’s a mandate for those departments at a time when Californians have become increasingly frustrated with one of the most visible consequences of the state’s trenchant homelessness crisis — people with the most severe mental illnesses languishing on the streets. [pullquote size=\"medium\" align=\"right\" citation=\"Luke Bergmann, director, San Diego County Behavioral Health Services\"]‘[CARE Court’s] not going to be this thing that dramatically changes homelessness.’[/pullquote] Counties will be judged on how well they’re able to get people, who may be resistant to help, inside and into treatment, even though CARE Court is not exclusively a program targeting homelessness. Local mental health officials are warning it won’t be a panacea.\u003c/p>\n\u003cp>“There’s been a presumption — and this is, to be clear, driven by how the administration talked about CARE Court at the outset — a broad presumption that CARE Court is going to fix homelessness or have a broad impact on the nexus of homelessness and behavioral health,” said Luke Bergmann, director of the San Diego County Behavioral Health Services department.\u003c/p>\n\u003cp>In reality, he said, it’s “actually going to be a pretty small program. It’s not going to be this thing that dramatically changes homelessness.”\u003c/p>\n\u003cp>The program aims to walk the line between forced treatment and completely voluntary treatment for those with the gravest needs. Disability rights groups decry it as a violation of a person’s civil liberties, and a potential path \u003ca href=\"https://calmatters.org/justice/2021/07/britney-spears-conservatorship/\">toward conservatorship\u003c/a> and the loss of legal rights for those who repeatedly decline care.\u003c/p>\n\u003cfigure id=\"attachment_11959338\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959338\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts02.jpg\" alt='An office full of people sit at tables looking toward a woman with a purple blouse who speaks from a microphone and holding index cards in her other hand. A flat-screen television hangs above her head displaying \"What is in a CARE Agreement Plan?\"' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Annette Mugrditchian, deputy director, speaks to community members about CARE Court at the Behavioral Health Training Center in Orange County. \u003ccite>(Lauren Justice/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>CARE Court \u003ca href=\"https://www.latimes.com/california/story/2023-01-26/disability-advocates-lawsuit-care-court-newsom-mental-illness-addiction-homeless\">survived a legal challenge\u003c/a> from Disability Rights California and other civil rights groups earlier this year. The group sat on a state working group for the program’s implementation and will monitor its rollout.\u003c/p>\n\u003cp>The program was welcomed by some family members of those with severe mental illness, who have complained that the state’s privacy and patients’ rights laws only allow their loved ones to \u003ca href=\"https://calmatters.org/projects/mentally-ill-forced-treatment-conservatorship-california-debate/\">be compelled into treatment \u003c/a>when in crisis, trapping them in a revolving door of short-term hospital stays and homelessness.\u003c/p>\n\u003cp>The first courts will open across the state in about a month. Seven counties, urban and rural, have been deep in preparation to be the first to roll out the program in October.\u003c/p>\n\u003cp>Los Angeles County, whose roughly 75,000-person unhoused population is the state’s largest, will start the program in December; the rest of the state will follow next year.\u003c/p>\n\u003cp>Those in the first group — San Francisco, Orange, San Diego, Riverside, Stanislaus, Glenn and Tuolumne counties — have had numerous questions to address, such as:\u003c/p>\n\u003cul>\n\u003cli>Who will find and serve respondents with their CARE Court petition if the respondent is unhoused?\u003c/li>\n\u003cli>How can county courts make the paperwork-heavy petition process easy for family members?\u003c/li>\n\u003cli>How many mental health treatment beds will counties need to add?\u003c/li>\n\u003cli>Where will people live after completing the court-ordered plans?\u003c/li>\n\u003c/ul>\n\u003cp>The state estimates between 7,000 and 12,000 people will qualify. They needn’t be homeless to receive the services, though many who qualify are likely to be unhoused. The state’s homeless population on any given night last year topped 171,000. [aside postID=news_11955211 hero='https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-1020x680.jpg'] A UC San Francisco \u003ca href=\"https://homelessness.ucsf.edu/sites/default/files/2023-06/CASPEH_Report_62023.pdf\">study of homelessness statewide (PDF)\u003c/a> this year found that more than a quarter of unhoused people had been hospitalized at some point in their lives for a mental health problem; the homeless services authority in Los Angeles \u003ca href=\"https://www.lahsa.org/documents?id=3422-2019-greater-los-angeles-homeless-count-los-angeles-continuum-of-care.pdf\">has estimated (PDF)\u003c/a> a quarter of the city’s homeless adults has a severe mental illness. But CARE Court is targeted at an even narrower set of diagnoses and circumstances.\u003c/p>\n\u003cp>So counties are also playing a careful game of “level-setting,” Bergman said, “about what this thing will actually be.”\u003c/p>\n\u003cp>Still, local officials see the program as an opportunity to get more people into mental health care who haven’t been treated, before their condition deteriorates to the point of being put in conservatorships.\u003c/p>\n\u003cp>And the state’s Department of Health Care Services says it will be looking out for whether the program reduces emergency room visits, police encounters, short-term hospital stays and involuntary psychiatric holds — and whether it helps people find stable housing.\u003c/p>\n\u003ch2>Managing expectations\u003c/h2>\n\u003cp>One major uncertainty counties face, officials say, is even knowing how many cases they’ll get.\u003c/p>\n\u003cp>That’s in part because the law allows a wide range of people to petition for someone to be in CARE Court, including family members, roommates, health care providers, paramedics, hospital officials or homeless outreach workers.\u003c/p>\n\u003cp>But the list of actual conditions the program targets is narrow. It’s limited to schizophrenia and related illnesses. [pullquote size=\"medium\" align=\"right\" citation=\"Michelle Doty Cabrera, director, County Behavioral Health Directors Association\"]‘What the public thinks CARE Court is and what it is are definitely two very different things.’[/pullquote] That could disappoint those whose loved ones have other diagnoses — and create an unknown amount of work for counties if a flood of those family members file petitions. Behavioral health departments must evaluate each person if it’s not clear whether they qualify for the program.\u003c/p>\n\u003cp>San Diego County estimates it will get 1,000 petitions in the first year and establish court-ordered treatment plans for 250 people; the remainder likely will either not qualify or will agree to services voluntarily, Bergmann said. Orange County expects about 1,400 petitions and anywhere from 400 to 600 treatment plans.\u003c/p>\n\u003cp>Officials in Riverside County don’t even have an estimate, citing varying data there on the prevalence of schizophrenia in the unhoused population.\u003c/p>\n\u003cp>“We really think it’s unknowable,” said Marcus Cannon, the county’s deputy behavioral health director.\u003c/p>\n\u003cp>Counties want the state to help them manage public expectations. Both Kelley and Cannon said they’ve heard from local leaders who have floated having city workers file petitions for a wide swath of unhoused residents, to get them indoors.\u003c/p>\n\u003cp>“What the public thinks CARE Court is and what it is are definitely two very different things,” said Michelle Doty Cabrera, director of \u003ca href=\"https://www.cbhda.org/\">the County Behavioral Health Directors Association\u003c/a>.\u003c/p>\n\u003cp>In an emailed statement, state Department of Health Care Services spokesperson Sami Gallegos said that counties “are managing public relations among local elected officials and others” to spread the message about who the program is and isn’t for.\u003c/p>\n\u003cp>After learning of the narrow eligibility criteria at a community meeting in August, Nancy Beltran considered her options.\u003c/p>\n\u003cp>Beltran, of Anaheim, said she lives with a family member whose psychotic condition caused him to hit another relative in 2020, landing him in the hospital against his will. She said he’s refused treatment and doesn’t believe he’s sick. Another psychotic episode earlier this year didn’t qualify him for hospitalization, she said, because the symptoms weren’t as severe.\u003c/p>\n\u003cp>“I didn’t want it to get to that point,” she said. “I don’t want him to be incarcerated. I want it to be the least restrictive, least traumatic experience.”\u003c/p>\n\u003cp>She’s still not sure whether the program is for her family member, because they haven’t gotten a clear diagnosis, she said.\u003c/p>\n\u003cp>Beltran said she also wishes the program could help a friend, who is already enrolled in therapy sessions for diagnosed schizophrenia, find a place to live. Her friend’s condition, she said, deteriorates because he is unhoused, but he remains on waiting lists for housing. But CARE Court, she was disappointed to learn at the meetings, is only for those with untreated schizophrenia.\u003c/p>\n\u003ch2>Threading a needle\u003c/h2>\n\u003cp>Everyone involved in CARE Court in Orange County — from the judge who would ultimately order treatment to the public defender who will represent respondents to the behavioral health officials responsible for finding, diagnosing and treating them — had the same message for the public: The program will be voluntary.\u003c/p>\n\u003cp>Critics, however,\u003cstrong> \u003c/strong>contend that there’s no way a court process can be voluntary, since at some point there is a judge’s order. By law, counties must try at least twice to persuade a respondent to accept treatment before a judge orders it. Even then, the treatment plan, which can include therapy, medication and housing, doesn’t come with much enforcement. Medication can be ordered, but not forcibly administered.\u003c/p>\n\u003cfigure id=\"attachment_11959344\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959344\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts03.jpg\" alt=\"A bald man in a business suit speaks to a crowd as he sits at a table holding a microphone in his hand.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Judge Ebrahim Baytieh speaks to community members about CARE Court, a new program that will be implemented in the fall. \u003ccite>(Lauren Justice/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Over the course of a year, respondents will attend court hearings to see whether they’re adhering to the treatment and whether the county is providing it. Counties can be fined as much as $1,000 a day for not providing the care; if the person fails to complete treatment they could be considered for conservatorship.\u003c/p>\n\u003cp>But county officials stressed that’s not the goal.\u003c/p>\n\u003cp>“We have tried for 40 years in this wonderful country of ours to force people with mental illness” to be treated, Orange County Superior Court Judge Ebrahim Baytieh told family members at another community meeting, in a church in Cypress. “Study after study has found it doesn’t work. We all know there’s no magical answer. But we will be patient, and we will be persistent.”\u003c/p>\n\u003cp>Kelley’s department is training its workers and peer supporters — people who also have mental illness or have recovered who can help guide a respondent through CARE Court — in a well-regarded communication method \u003ca href=\"https://leapinstitute.org/about/#:~:text=LEAP%20(Listen%2DEmpathize%2DAgree,and%20the%20treatment%20they%20need.\">called LEAP\u003c/a> to persuade respondents to accept care. It will offer services to those in CARE Court under a “whatever it takes” approach, whether it’s a ride to the doctor’s office, help to enroll in food stamps, addiction treatment, or temporary housing.\u003c/p>\n\u003cp>The task will take time.\u003c/p>\n\u003cp>At the community meetings, Kelley and her colleagues repeatedly described a pilot program she ran as behavioral health director in San Bernardino County. The program took referrals from family, police or other community members who wanted to prod those who were resistant to mental health treatment. [pullquote size=\"medium\" align=\"right\" citation=\"Orange County Superior Court Judge Ebrahim Baytieh\"]‘We have tried for 40 years in this wonderful country of ours to force people with mental illness” [to be treated]. … We all know there’s no magical answer. But we will be patient, and we will be persistent.’[/pullquote] The time it took for county workers using the LEAP method to persuade respondents to enter treatment varied, Kelley said. But on average, she said it took 20 visits if a respondent was housed — and 40 visits if they were unhoused. Visit times varied, from a few minutes to a whole day so that the whole process could take weeks or months, Kelley said.\u003c/p>\n\u003cp>The timetables set by law for CARE Court are much tighter.\u003c/p>\n\u003cp>If counties initially determine a client won’t agree to treatment, they get 14 days to try again before the next court hearing. Kelley said the judges in her county are sympathetic toward those concerns, but not all counties will get such flexibility.\u003c/p>\n\u003cp>“I can’t do 40 face-to-face visits in 14 days,” she said.\u003c/p>\n\u003cp>Civil rights advocates balked at the counties’ suggestion that any program involving the pressure of the judicial system, even a non-criminal court, could be voluntary.\u003c/p>\n\u003cp>“If you’re trying to engage somebody, and there’s a petition that involves a court,” there’s less hope of building genuine trust, said Keris Myrick, a mental health advocate who lives with schizophrenia and a board member of Disability Rights California.\u003c/p>\n\u003cp>The group is particularly concerned the court process could be ineffective or harmful among Black residents, who are overrepresented both in California’s homeless population and among people diagnosed with schizophrenia.\u003c/p>\n\u003cp>Myrick, who is Black, said she has been subject to involuntary treatment and described harrowing experiences during which she was handcuffed in the back of a police car or strapped down to a gurney for hours before a doctor visited. She said one thing that actually helped her recover was having a peer supporter who was also African American and related to her experiences, eventually persuading her to get treatment on her own terms.\u003c/p>\n\u003cp>She later ran a peer support program in Los Angeles County and trained workers in the county mental health department. Myrick says the state needs to expand those services, as well as housing and social supports to help people live stable lives, without the threat of a judicial order.\u003c/p>\n\u003cp>Alex Barnard, a sociologist at New York University who has studied involuntary mental health treatment in California, is skeptical about whether the state can appease both civil libertarians and those who want more aggressive treatment. But he said the program’s mandate of a year of persistent engagement is promising.\u003c/p>\n\u003cp>“If CARE Courts work, it will probably be because of that,” he said. “It creates some accountability on the provider to keep trying to work with somebody who might be very challenging, and elsewhere in the system would just have their file closed out.”\u003c/p>\n\u003ch2>Long-term resources\u003c/h2>\n\u003cp>Those implementation questions are among a list of other practical hurdles counties face for the program to be successful.\u003c/p>\n\u003cp>There’s long-term funding. The first seven counties were given $26 million in one-time state grants to start the programs; some have estimated annual costs of the services themselves will \u003ca href=\"https://sfstandard.com/2023/04/20/newsoms-care-court-faces-50-million-hurdle-in-san-francisco-as-key-deadline-approaches/\">far exceed\u003c/a> those allotments.\u003c/p>\n\u003cp>The state says most services will be covered by Medi-Cal or private insurance, and expects counties to submit reimbursement requests, including the costs of going to court or finding respondents.\u003c/p>\n\u003cp>But the \u003ca href=\"https://www.kqed.org/news/11923034/were-drowning-why-kaiser-mental-health-workers-are-striking#:~:text=Kaiser%20administrators%20point%20to%20what,15%20statement.\">nationwide shortage of behavioral health workers\u003c/a> has made it a challenge for some departments to hire. In San Diego County, Bergmann’s department plans to add 55 new staff, including 10 clinicians, for CARE Court. Only 35% have been hired so far, a spokesperson said. [aside label='More on Public Health' tag='public-health'] And there’s housing and beds, which all agree are crucial to making treatment a success.\u003c/p>\n\u003cp>Health officials believe most people who qualify for CARE Court will need a more intensive treatment placement in the beginning, while some may be able to be placed in residential facilities or their own apartments after being stabilized.\u003c/p>\n\u003cp>But there are shortages across that spectrum. A \u003ca href=\"https://www.rand.org/pubs/research_reports/RRA1824-1-v2.html\">2021 Rand analysis\u003c/a> found the state is short more than 4,700 psychiatric inpatient treatment beds and nearly 3,000 residential facility beds such as \u003ca href=\"https://calmatters.org/projects/board-and-care-homes-closing-in-california-mental-health-crisis/\">board-and-cares\u003c/a>—long-term housing for people with severe mental illness and one option for respondents to live after they complete CARE Court.\u003c/p>\n\u003cp>Included in last year’s state budget was \u003ca href=\"https://bridgehousing.buildingcalhhs.com/county-behavioral-health-agencies/\">nearly $1 billion\u003c/a> in new funding for counties to expand temporary housing placements for those with mental illness, with priority given to people in CARE Court.\u003c/p>\n\u003cp>Orange County and some others are using the grants to open new treatment beds. In San Diego, Bergmann’s department will use the money to pay for board-and-care placements. Significant new infrastructure, however, will take years to complete. Over the past five years, Bergmann said, the county has lost a fifth of those residential facilities.\u003c/p>\n\u003cp>“In the near term, those funds will help us help people with the fewest resources to compete more” for placements, he said. “It’s not going to all of a sudden create a net increase in infrastructure.”\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://calmatters.org/author/marisa-kendall/\">Marisa Kendall\u003c/a> contributed to this reporting.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Gov. Gavin Newsom’s plan to encourage people with mental illnesses to accept treatment starts this fall. Counties responsible say it may be more modest than advertised.",
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"title": "California Families Can Expect Eligibility Limits in CARE Courts Rollout | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Under the low hum of cold fluorescent lights in a nondescript office park in Orange County, dozens of Californians gathered to find out if they could get help for their loved ones under the state’s new \u003ca href=\"https://www.kqed.org/news/tag/care-court\">CARE Court\u003c/a> system.\u003c/p>\n\u003cp>Unless that loved one has a medical diagnosis specific to schizophrenia or some other psychotic disorders, the answer is probably not.\u003c/p>\n\u003cp>The mid-August meeting was a series held by a mental health advocacy group in Orange County with the officials in charge of implementing CARE Court, which starts in October, about what the new system can and cannot do.\u003c/p>\n\u003cp>“What we’re here to do is share the facts to help manage expectations,” said Veronica Kelley, Orange County’s chief of mental health and recovery services.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Community Assistance, Recovery, and Empowerment (CARE) Court was Gov. Gavin Newsom’s \u003ca href=\"https://calmatters.org/housing/2022/09/california-lawmakers-approved-care-court-what-comes-next/\">biggest legislative priority\u003c/a> last year — what state lawmakers and local politicians hoped would be one answer to California’s dual, overlapping homelessness and mental health crises.\u003c/p>\n\u003cp>The new program allows family members and others to petition someone with untreated mental illness into civil courts, where a judge would order a treatment plan and require county mental health departments to provide it.\u003c/p>\n\u003cp>Backed by millions in new state funds, it’s a mandate for those departments at a time when Californians have become increasingly frustrated with one of the most visible consequences of the state’s trenchant homelessness crisis — people with the most severe mental illnesses languishing on the streets. \u003c/p>\u003c/div>",
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"content": "‘[CARE Court’s] not going to be this thing that dramatically changes homelessness.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp> Counties will be judged on how well they’re able to get people, who may be resistant to help, inside and into treatment, even though CARE Court is not exclusively a program targeting homelessness. Local mental health officials are warning it won’t be a panacea.\u003c/p>\n\u003cp>“There’s been a presumption — and this is, to be clear, driven by how the administration talked about CARE Court at the outset — a broad presumption that CARE Court is going to fix homelessness or have a broad impact on the nexus of homelessness and behavioral health,” said Luke Bergmann, director of the San Diego County Behavioral Health Services department.\u003c/p>\n\u003cp>In reality, he said, it’s “actually going to be a pretty small program. It’s not going to be this thing that dramatically changes homelessness.”\u003c/p>\n\u003cp>The program aims to walk the line between forced treatment and completely voluntary treatment for those with the gravest needs. Disability rights groups decry it as a violation of a person’s civil liberties, and a potential path \u003ca href=\"https://calmatters.org/justice/2021/07/britney-spears-conservatorship/\">toward conservatorship\u003c/a> and the loss of legal rights for those who repeatedly decline care.\u003c/p>\n\u003cfigure id=\"attachment_11959338\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959338\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts02.jpg\" alt='An office full of people sit at tables looking toward a woman with a purple blouse who speaks from a microphone and holding index cards in her other hand. A flat-screen television hangs above her head displaying \"What is in a CARE Agreement Plan?\"' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Annette Mugrditchian, deputy director, speaks to community members about CARE Court at the Behavioral Health Training Center in Orange County. \u003ccite>(Lauren Justice/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>CARE Court \u003ca href=\"https://www.latimes.com/california/story/2023-01-26/disability-advocates-lawsuit-care-court-newsom-mental-illness-addiction-homeless\">survived a legal challenge\u003c/a> from Disability Rights California and other civil rights groups earlier this year. The group sat on a state working group for the program’s implementation and will monitor its rollout.\u003c/p>\n\u003cp>The program was welcomed by some family members of those with severe mental illness, who have complained that the state’s privacy and patients’ rights laws only allow their loved ones to \u003ca href=\"https://calmatters.org/projects/mentally-ill-forced-treatment-conservatorship-california-debate/\">be compelled into treatment \u003c/a>when in crisis, trapping them in a revolving door of short-term hospital stays and homelessness.\u003c/p>\n\u003cp>The first courts will open across the state in about a month. Seven counties, urban and rural, have been deep in preparation to be the first to roll out the program in October.\u003c/p>\n\u003cp>Los Angeles County, whose roughly 75,000-person unhoused population is the state’s largest, will start the program in December; the rest of the state will follow next year.\u003c/p>\n\u003cp>Those in the first group — San Francisco, Orange, San Diego, Riverside, Stanislaus, Glenn and Tuolumne counties — have had numerous questions to address, such as:\u003c/p>\n\u003cul>\n\u003cli>Who will find and serve respondents with their CARE Court petition if the respondent is unhoused?\u003c/li>\n\u003cli>How can county courts make the paperwork-heavy petition process easy for family members?\u003c/li>\n\u003cli>How many mental health treatment beds will counties need to add?\u003c/li>\n\u003cli>Where will people live after completing the court-ordered plans?\u003c/li>\n\u003c/ul>\n\u003cp>The state estimates between 7,000 and 12,000 people will qualify. They needn’t be homeless to receive the services, though many who qualify are likely to be unhoused. The state’s homeless population on any given night last year topped 171,000. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp> A UC San Francisco \u003ca href=\"https://homelessness.ucsf.edu/sites/default/files/2023-06/CASPEH_Report_62023.pdf\">study of homelessness statewide (PDF)\u003c/a> this year found that more than a quarter of unhoused people had been hospitalized at some point in their lives for a mental health problem; the homeless services authority in Los Angeles \u003ca href=\"https://www.lahsa.org/documents?id=3422-2019-greater-los-angeles-homeless-count-los-angeles-continuum-of-care.pdf\">has estimated (PDF)\u003c/a> a quarter of the city’s homeless adults has a severe mental illness. But CARE Court is targeted at an even narrower set of diagnoses and circumstances.\u003c/p>\n\u003cp>So counties are also playing a careful game of “level-setting,” Bergman said, “about what this thing will actually be.”\u003c/p>\n\u003cp>Still, local officials see the program as an opportunity to get more people into mental health care who haven’t been treated, before their condition deteriorates to the point of being put in conservatorships.\u003c/p>\n\u003cp>And the state’s Department of Health Care Services says it will be looking out for whether the program reduces emergency room visits, police encounters, short-term hospital stays and involuntary psychiatric holds — and whether it helps people find stable housing.\u003c/p>\n\u003ch2>Managing expectations\u003c/h2>\n\u003cp>One major uncertainty counties face, officials say, is even knowing how many cases they’ll get.\u003c/p>\n\u003cp>That’s in part because the law allows a wide range of people to petition for someone to be in CARE Court, including family members, roommates, health care providers, paramedics, hospital officials or homeless outreach workers.\u003c/p>\n\u003cp>But the list of actual conditions the program targets is narrow. It’s limited to schizophrenia and related illnesses. \u003c/p>\u003c/div>",
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"content": "‘What the public thinks CARE Court is and what it is are definitely two very different things.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp> That could disappoint those whose loved ones have other diagnoses — and create an unknown amount of work for counties if a flood of those family members file petitions. Behavioral health departments must evaluate each person if it’s not clear whether they qualify for the program.\u003c/p>\n\u003cp>San Diego County estimates it will get 1,000 petitions in the first year and establish court-ordered treatment plans for 250 people; the remainder likely will either not qualify or will agree to services voluntarily, Bergmann said. Orange County expects about 1,400 petitions and anywhere from 400 to 600 treatment plans.\u003c/p>\n\u003cp>Officials in Riverside County don’t even have an estimate, citing varying data there on the prevalence of schizophrenia in the unhoused population.\u003c/p>\n\u003cp>“We really think it’s unknowable,” said Marcus Cannon, the county’s deputy behavioral health director.\u003c/p>\n\u003cp>Counties want the state to help them manage public expectations. Both Kelley and Cannon said they’ve heard from local leaders who have floated having city workers file petitions for a wide swath of unhoused residents, to get them indoors.\u003c/p>\n\u003cp>“What the public thinks CARE Court is and what it is are definitely two very different things,” said Michelle Doty Cabrera, director of \u003ca href=\"https://www.cbhda.org/\">the County Behavioral Health Directors Association\u003c/a>.\u003c/p>\n\u003cp>In an emailed statement, state Department of Health Care Services spokesperson Sami Gallegos said that counties “are managing public relations among local elected officials and others” to spread the message about who the program is and isn’t for.\u003c/p>\n\u003cp>After learning of the narrow eligibility criteria at a community meeting in August, Nancy Beltran considered her options.\u003c/p>\n\u003cp>Beltran, of Anaheim, said she lives with a family member whose psychotic condition caused him to hit another relative in 2020, landing him in the hospital against his will. She said he’s refused treatment and doesn’t believe he’s sick. Another psychotic episode earlier this year didn’t qualify him for hospitalization, she said, because the symptoms weren’t as severe.\u003c/p>\n\u003cp>“I didn’t want it to get to that point,” she said. “I don’t want him to be incarcerated. I want it to be the least restrictive, least traumatic experience.”\u003c/p>\n\u003cp>She’s still not sure whether the program is for her family member, because they haven’t gotten a clear diagnosis, she said.\u003c/p>\n\u003cp>Beltran said she also wishes the program could help a friend, who is already enrolled in therapy sessions for diagnosed schizophrenia, find a place to live. Her friend’s condition, she said, deteriorates because he is unhoused, but he remains on waiting lists for housing. But CARE Court, she was disappointed to learn at the meetings, is only for those with untreated schizophrenia.\u003c/p>\n\u003ch2>Threading a needle\u003c/h2>\n\u003cp>Everyone involved in CARE Court in Orange County — from the judge who would ultimately order treatment to the public defender who will represent respondents to the behavioral health officials responsible for finding, diagnosing and treating them — had the same message for the public: The program will be voluntary.\u003c/p>\n\u003cp>Critics, however,\u003cstrong> \u003c/strong>contend that there’s no way a court process can be voluntary, since at some point there is a judge’s order. By law, counties must try at least twice to persuade a respondent to accept treatment before a judge orders it. Even then, the treatment plan, which can include therapy, medication and housing, doesn’t come with much enforcement. Medication can be ordered, but not forcibly administered.\u003c/p>\n\u003cfigure id=\"attachment_11959344\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959344\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts03.jpg\" alt=\"A bald man in a business suit speaks to a crowd as he sits at a table holding a microphone in his hand.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Judge Ebrahim Baytieh speaks to community members about CARE Court, a new program that will be implemented in the fall. \u003ccite>(Lauren Justice/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Over the course of a year, respondents will attend court hearings to see whether they’re adhering to the treatment and whether the county is providing it. Counties can be fined as much as $1,000 a day for not providing the care; if the person fails to complete treatment they could be considered for conservatorship.\u003c/p>\n\u003cp>But county officials stressed that’s not the goal.\u003c/p>\n\u003cp>“We have tried for 40 years in this wonderful country of ours to force people with mental illness” to be treated, Orange County Superior Court Judge Ebrahim Baytieh told family members at another community meeting, in a church in Cypress. “Study after study has found it doesn’t work. We all know there’s no magical answer. But we will be patient, and we will be persistent.”\u003c/p>\n\u003cp>Kelley’s department is training its workers and peer supporters — people who also have mental illness or have recovered who can help guide a respondent through CARE Court — in a well-regarded communication method \u003ca href=\"https://leapinstitute.org/about/#:~:text=LEAP%20(Listen%2DEmpathize%2DAgree,and%20the%20treatment%20they%20need.\">called LEAP\u003c/a> to persuade respondents to accept care. It will offer services to those in CARE Court under a “whatever it takes” approach, whether it’s a ride to the doctor’s office, help to enroll in food stamps, addiction treatment, or temporary housing.\u003c/p>\n\u003cp>The task will take time.\u003c/p>\n\u003cp>At the community meetings, Kelley and her colleagues repeatedly described a pilot program she ran as behavioral health director in San Bernardino County. The program took referrals from family, police or other community members who wanted to prod those who were resistant to mental health treatment. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp> The time it took for county workers using the LEAP method to persuade respondents to enter treatment varied, Kelley said. But on average, she said it took 20 visits if a respondent was housed — and 40 visits if they were unhoused. Visit times varied, from a few minutes to a whole day so that the whole process could take weeks or months, Kelley said.\u003c/p>\n\u003cp>The timetables set by law for CARE Court are much tighter.\u003c/p>\n\u003cp>If counties initially determine a client won’t agree to treatment, they get 14 days to try again before the next court hearing. Kelley said the judges in her county are sympathetic toward those concerns, but not all counties will get such flexibility.\u003c/p>\n\u003cp>“I can’t do 40 face-to-face visits in 14 days,” she said.\u003c/p>\n\u003cp>Civil rights advocates balked at the counties’ suggestion that any program involving the pressure of the judicial system, even a non-criminal court, could be voluntary.\u003c/p>\n\u003cp>“If you’re trying to engage somebody, and there’s a petition that involves a court,” there’s less hope of building genuine trust, said Keris Myrick, a mental health advocate who lives with schizophrenia and a board member of Disability Rights California.\u003c/p>\n\u003cp>The group is particularly concerned the court process could be ineffective or harmful among Black residents, who are overrepresented both in California’s homeless population and among people diagnosed with schizophrenia.\u003c/p>\n\u003cp>Myrick, who is Black, said she has been subject to involuntary treatment and described harrowing experiences during which she was handcuffed in the back of a police car or strapped down to a gurney for hours before a doctor visited. She said one thing that actually helped her recover was having a peer supporter who was also African American and related to her experiences, eventually persuading her to get treatment on her own terms.\u003c/p>\n\u003cp>She later ran a peer support program in Los Angeles County and trained workers in the county mental health department. Myrick says the state needs to expand those services, as well as housing and social supports to help people live stable lives, without the threat of a judicial order.\u003c/p>\n\u003cp>Alex Barnard, a sociologist at New York University who has studied involuntary mental health treatment in California, is skeptical about whether the state can appease both civil libertarians and those who want more aggressive treatment. But he said the program’s mandate of a year of persistent engagement is promising.\u003c/p>\n\u003cp>“If CARE Courts work, it will probably be because of that,” he said. “It creates some accountability on the provider to keep trying to work with somebody who might be very challenging, and elsewhere in the system would just have their file closed out.”\u003c/p>\n\u003ch2>Long-term resources\u003c/h2>\n\u003cp>Those implementation questions are among a list of other practical hurdles counties face for the program to be successful.\u003c/p>\n\u003cp>There’s long-term funding. The first seven counties were given $26 million in one-time state grants to start the programs; some have estimated annual costs of the services themselves will \u003ca href=\"https://sfstandard.com/2023/04/20/newsoms-care-court-faces-50-million-hurdle-in-san-francisco-as-key-deadline-approaches/\">far exceed\u003c/a> those allotments.\u003c/p>\n\u003cp>The state says most services will be covered by Medi-Cal or private insurance, and expects counties to submit reimbursement requests, including the costs of going to court or finding respondents.\u003c/p>\n\u003cp>But the \u003ca href=\"https://www.kqed.org/news/11923034/were-drowning-why-kaiser-mental-health-workers-are-striking#:~:text=Kaiser%20administrators%20point%20to%20what,15%20statement.\">nationwide shortage of behavioral health workers\u003c/a> has made it a challenge for some departments to hire. In San Diego County, Bergmann’s department plans to add 55 new staff, including 10 clinicians, for CARE Court. Only 35% have been hired so far, a spokesperson said. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp> And there’s housing and beds, which all agree are crucial to making treatment a success.\u003c/p>\n\u003cp>Health officials believe most people who qualify for CARE Court will need a more intensive treatment placement in the beginning, while some may be able to be placed in residential facilities or their own apartments after being stabilized.\u003c/p>\n\u003cp>But there are shortages across that spectrum. A \u003ca href=\"https://www.rand.org/pubs/research_reports/RRA1824-1-v2.html\">2021 Rand analysis\u003c/a> found the state is short more than 4,700 psychiatric inpatient treatment beds and nearly 3,000 residential facility beds such as \u003ca href=\"https://calmatters.org/projects/board-and-care-homes-closing-in-california-mental-health-crisis/\">board-and-cares\u003c/a>—long-term housing for people with severe mental illness and one option for respondents to live after they complete CARE Court.\u003c/p>\n\u003cp>Included in last year’s state budget was \u003ca href=\"https://bridgehousing.buildingcalhhs.com/county-behavioral-health-agencies/\">nearly $1 billion\u003c/a> in new funding for counties to expand temporary housing placements for those with mental illness, with priority given to people in CARE Court.\u003c/p>\n\u003cp>Orange County and some others are using the grants to open new treatment beds. In San Diego, Bergmann’s department will use the money to pay for board-and-care placements. Significant new infrastructure, however, will take years to complete. Over the past five years, Bergmann said, the county has lost a fifth of those residential facilities.\u003c/p>\n\u003cp>“In the near term, those funds will help us help people with the fewest resources to compete more” for placements, he said. “It’s not going to all of a sudden create a net increase in infrastructure.”\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://calmatters.org/author/marisa-kendall/\">Marisa Kendall\u003c/a> contributed to this reporting.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Seventeen \u003ca href=\"https://hcai.ca.gov/california-announces-300-million-in-financial-support-for-community-hospitals-across-the-state/\">financially distressed California hospitals\u003c/a> — including three that filed for bankruptcy earlier this year — will receive close to $300 million in interest-free loans, state officials announced Thursday.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/health/2023/01/hospital-closure/\">Madera Community Hospital\u003c/a>, which closed its doors in January, stands to receive the biggest chunk, $52 million. The money comes from the Distressed Hospital Loan Program, which the Legislature created to support rural and independent hospitals that faced financial challenges coming out of the COVID-19 pandemic.\u003c/p>\n\u003cp>The Madera hospital had requested $80 million, but the money it received is expected to be enough to fund a reopening for the rural hospital about 25 miles north of Fresno.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Adventist Health, which operates hospitals in four West Coast states, last month announced a proposal to take over Madera’s operations through a management agreement, contingent on it receiving the state funds. In a letter outlining its terms, Adventist \u003ca href=\"https://calmatters.org/wp-content/uploads/2023/08/Madera-LOI-20230727-final.pdf\">projected needing $55 million to reopen (PDF)\u003c/a> and another $30 million to sustain operations in the second year.[aside postID=news_11958245 hero='https://ww2.kqed.org/app/uploads/sites/10/2023/08/033023_Hollister_Hospital_LV_CM_01-1020x680.jpg']Madera will initially receive $2 million to cover immediate operating costs. Officials at Adventist Health and Madera Community will have to submit a “comprehensive hospital turnaround plan” and, if approved, will then become eligible to receive the remaining $50 million.\u003c/p>\n\u003cp>“This financial assistance is an important step in the right direction to help Madera Community Hospital reopen its doors to the community. We have more work to do, but I’m proud to have led this effort,” said Assemblymember Esmeralda Soria, a Fresno Democrat whose district includes Madera and who authored legislation that led to the loan program.\u003c/p>\n\u003cp>Adventist Health in a written statement said it is working with “community partners and stakeholders in developing a thoughtful, comprehensive hospital turnaround plan.”\u003c/p>\n\u003cp>Beverly Hospital, located east of Los Angeles, will receive $5 million to cover operations while it is in bankruptcy. The hospital applied for $35 million, but it is now set to be bought by Adventist Health White Memorial. A bankruptcy judge last week approved \u003ca href=\"https://oag.ca.gov/system/files/media/bh-638.pdf\">Adventist’s $39 million purchase of Beverly (PDF)\u003c/a>.[pullquote size=\"medium\" align=\"right\" citation=\"State Treasurer Fiona Ma\"]‘The hospitals approved for this program have shown a detailed plan for financial recovery and these funds will help them keep the doors open so they can keep serving their communities.’[/pullquote]Another bankrupt hospital, Hazel Hawkins Memorial, will receive the $10 million it requested. It’s the only source of emergency care in San Benito County, a rural community east of Monterey.\u003c/p>\n\u003cp>“The hospitals approved for this program have shown a detailed plan for financial recovery and these funds will help them keep the doors open so they can keep serving their communities,” said State Treasurer Fiona Ma, whose office is helping administer the funds. Ma said her team has already begun providing instructions and assistance to the awarded hospitals.\u003c/p>\n\u003ch2>Biggest loans to distressed hospitals\u003c/h2>\n\u003cp>The Department of Health Care Access and Information reviewed applications and selected hospitals for the program. Thirty hospitals applied for loans.\u003c/p>\n\u003cp>Other hospitals that will receive significant funding include the following:\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://www.tricitymed.org/wp-content/uploads/2023/07/agenda-packet.Special-Meeting-7.27.23.pdf\">Tri-City Medical Center (PDF)\u003c/a> in San Diego will receive $33.2 million. The hospital recently announced plans to suspend its labor and delivery services amid “financial losses.”\u003c/li>\n\u003cli>\u003ca href=\"https://calmatters.org/health/2023/01/hospital-closure/\">Kaweah Delta Health Care District\u003c/a> in Visalia will get a $20.8 million loan. This hospital laid off 130 employees late last year.\u003c/li>\n\u003cli>\u003ca href=\"https://inewsource.org/2023/02/07/el-centro-hospital-financial-problems/\">El Centro Regional Medical Center\u003c/a> in Imperial County, which in January closed its maternity ward, will receive $28 million.\u003c/li>\n\u003cli>\u003ca href=\"https://pmhd.org/\">Pioneers Memorial Healthcare District\u003c/a>, Imperial County’s only other hospital, also is set to receive $28 million.\u003c/li>\n\u003cli>\u003ca href=\"https://www.dameronhospital.org/\">Dameron Hospital\u003c/a> in Stockton, now also being managed by Adventist Health, will be loaned $29 million.\u003c/li>\n\u003c/ul>\n\u003ch2>Vulnerable California hospitals\u003c/h2>\n\u003cp>Most California hospitals are part of large networks that can navigate turbulent financial periods. A number of community and independent hospitals have struggled for years, especially after the peak of the pandemic. Some recently reduced services or laid off staff.[aside label='More on Health Care' tag='health-care']Hospitals have pointed to a number of factors for their distressed state — increased labor costs, and inadequate reimbursement from public insurance programs, Medicare and Medi-Cal, and in \u003ca href=\"https://fresnoland.org/2023/03/01/reimbursements-rates-madera-hospital-closure/\">some cases private insurance.\u003c/a>\u003c/p>\n\u003cp>Some hospitals began to ask the state for help late last year, but the closure of Madera Community Hospital prompted more urgency from lawmakers. It shut its doors after Trinity Health, a large Catholic health system, pulled out of negotiations to purchase the hospital.\u003c/p>\n\u003cp>Madera Community Hospital in the San Joaquin Valley was the only general acute care hospital in the county of about 160,000 people. The closest emergency rooms are about \u003ca href=\"https://www.fresnobee.com/news/local/article272712840.html\">30 and 40 minutes drive away in Fresno and Merced\u003c/a>.\u003c/p>\n\u003cp>The Distressed Hospital Loan Program closes at the end of 2031. Hospitals will get an 18-month grace period and then will have to repay loans over a six-year period.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Seventeen \u003ca href=\"https://hcai.ca.gov/california-announces-300-million-in-financial-support-for-community-hospitals-across-the-state/\">financially distressed California hospitals\u003c/a> — including three that filed for bankruptcy earlier this year — will receive close to $300 million in interest-free loans, state officials announced Thursday.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/health/2023/01/hospital-closure/\">Madera Community Hospital\u003c/a>, which closed its doors in January, stands to receive the biggest chunk, $52 million. The money comes from the Distressed Hospital Loan Program, which the Legislature created to support rural and independent hospitals that faced financial challenges coming out of the COVID-19 pandemic.\u003c/p>\n\u003cp>The Madera hospital had requested $80 million, but the money it received is expected to be enough to fund a reopening for the rural hospital about 25 miles north of Fresno.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Adventist Health, which operates hospitals in four West Coast states, last month announced a proposal to take over Madera’s operations through a management agreement, contingent on it receiving the state funds. In a letter outlining its terms, Adventist \u003ca href=\"https://calmatters.org/wp-content/uploads/2023/08/Madera-LOI-20230727-final.pdf\">projected needing $55 million to reopen (PDF)\u003c/a> and another $30 million to sustain operations in the second year.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Madera will initially receive $2 million to cover immediate operating costs. Officials at Adventist Health and Madera Community will have to submit a “comprehensive hospital turnaround plan” and, if approved, will then become eligible to receive the remaining $50 million.\u003c/p>\n\u003cp>“This financial assistance is an important step in the right direction to help Madera Community Hospital reopen its doors to the community. We have more work to do, but I’m proud to have led this effort,” said Assemblymember Esmeralda Soria, a Fresno Democrat whose district includes Madera and who authored legislation that led to the loan program.\u003c/p>\n\u003cp>Adventist Health in a written statement said it is working with “community partners and stakeholders in developing a thoughtful, comprehensive hospital turnaround plan.”\u003c/p>\n\u003cp>Beverly Hospital, located east of Los Angeles, will receive $5 million to cover operations while it is in bankruptcy. The hospital applied for $35 million, but it is now set to be bought by Adventist Health White Memorial. A bankruptcy judge last week approved \u003ca href=\"https://oag.ca.gov/system/files/media/bh-638.pdf\">Adventist’s $39 million purchase of Beverly (PDF)\u003c/a>.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Another bankrupt hospital, Hazel Hawkins Memorial, will receive the $10 million it requested. It’s the only source of emergency care in San Benito County, a rural community east of Monterey.\u003c/p>\n\u003cp>“The hospitals approved for this program have shown a detailed plan for financial recovery and these funds will help them keep the doors open so they can keep serving their communities,” said State Treasurer Fiona Ma, whose office is helping administer the funds. Ma said her team has already begun providing instructions and assistance to the awarded hospitals.\u003c/p>\n\u003ch2>Biggest loans to distressed hospitals\u003c/h2>\n\u003cp>The Department of Health Care Access and Information reviewed applications and selected hospitals for the program. Thirty hospitals applied for loans.\u003c/p>\n\u003cp>Other hospitals that will receive significant funding include the following:\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://www.tricitymed.org/wp-content/uploads/2023/07/agenda-packet.Special-Meeting-7.27.23.pdf\">Tri-City Medical Center (PDF)\u003c/a> in San Diego will receive $33.2 million. The hospital recently announced plans to suspend its labor and delivery services amid “financial losses.”\u003c/li>\n\u003cli>\u003ca href=\"https://calmatters.org/health/2023/01/hospital-closure/\">Kaweah Delta Health Care District\u003c/a> in Visalia will get a $20.8 million loan. This hospital laid off 130 employees late last year.\u003c/li>\n\u003cli>\u003ca href=\"https://inewsource.org/2023/02/07/el-centro-hospital-financial-problems/\">El Centro Regional Medical Center\u003c/a> in Imperial County, which in January closed its maternity ward, will receive $28 million.\u003c/li>\n\u003cli>\u003ca href=\"https://pmhd.org/\">Pioneers Memorial Healthcare District\u003c/a>, Imperial County’s only other hospital, also is set to receive $28 million.\u003c/li>\n\u003cli>\u003ca href=\"https://www.dameronhospital.org/\">Dameron Hospital\u003c/a> in Stockton, now also being managed by Adventist Health, will be loaned $29 million.\u003c/li>\n\u003c/ul>\n\u003ch2>Vulnerable California hospitals\u003c/h2>\n\u003cp>Most California hospitals are part of large networks that can navigate turbulent financial periods. A number of community and independent hospitals have struggled for years, especially after the peak of the pandemic. Some recently reduced services or laid off staff.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Hospitals have pointed to a number of factors for their distressed state — increased labor costs, and inadequate reimbursement from public insurance programs, Medicare and Medi-Cal, and in \u003ca href=\"https://fresnoland.org/2023/03/01/reimbursements-rates-madera-hospital-closure/\">some cases private insurance.\u003c/a>\u003c/p>\n\u003cp>Some hospitals began to ask the state for help late last year, but the closure of Madera Community Hospital prompted more urgency from lawmakers. It shut its doors after Trinity Health, a large Catholic health system, pulled out of negotiations to purchase the hospital.\u003c/p>\n\u003cp>Madera Community Hospital in the San Joaquin Valley was the only general acute care hospital in the county of about 160,000 people. The closest emergency rooms are about \u003ca href=\"https://www.fresnobee.com/news/local/article272712840.html\">30 and 40 minutes drive away in Fresno and Merced\u003c/a>.\u003c/p>\n\u003cp>The Distressed Hospital Loan Program closes at the end of 2031. Hospitals will get an 18-month grace period and then will have to repay loans over a six-year period.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Alvin Vallejo, a public health nurse in San Francisco, steps inside a dilapidated apartment building in the Tenderloin neighborhood.\u003c/p>\n\u003cp>He climbs a narrow staircase to visit a client on the third floor recovering from a high-risk pregnancy and a difficult birth. Vallejo turns down the hall, passes a communal bathroom, and knocks on a door.\u003c/p>\n\u003cp>Dayanis, a 35-year-old mother cradling a newborn dressed in a turquoise onesie, answers the door. (Only her first name is used to protect her medical privacy.)\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Last year, she and her husband immigrated from Cuba, determined for a better life. They left two adolescent daughters behind with relatives. Their newest child, Abraham José, was unplanned.\u003c/p>\n\u003cp>Maternal mortality is at its \u003ca href=\"https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2021/maternal-mortality-rates-2021.htm\">highest level\u003c/a> since 1965. But a new state bill, \u003ca href=\"https://legiscan.com/CA/text/AB1057/id/2701737\">AB 1057\u003c/a>, aims to improve conditions by helping more at-risk families like Dayanis’ receive \u003ca href=\"https://www.cdph.ca.gov/Programs/CFH/DMCAH/CHVP/Pages/default.aspx\">medical care at home in the early postpartum period\u003c/a> to ensure she and the baby thrive.[pullquote size=\"medium\" align=\"right\" citation=\"Michelle Gibbons, executive director, County Health Executives Association of California\"]‘How awesome is it to have a nurse come into your home and just be there to support you? … This offers quality care in an intimate setting and engagement with a nurse.’[/pullquote]Dayanis ushers Vallejo inside the orderly but tiny, tightly packed room. A makeshift kitchen lines one wall with a single burner and a tiny fridge. Dayanis sits on a twin bed before covering her baby’s ears as the wails from a nearby police siren fill the space.\u003c/p>\n\u003cp>Vallejo pulls up a metal chair and opens his clipboard before asking questions about medications, vitamins, unusual symptoms and eating habits. Dayanis says she’s recuperating well.\u003c/p>\n\u003cp>Vallejo routinely measures her blood pressure. Dayanis’s pulse is a touch high, but he assures her it’s nothing to worry about. He then asks about the baby.\u003c/p>\n\u003cp>During Vallejo’s visit, Dayanis rocks her son gently as he closes his eyes. She assures Vallejo that her baby, Abraham, is well, but he doesn’t like drinking from a bottle.[aside label='More Stories on Health Care' tag='health-care']So Vallejo offers to order a new one to help. After about an hour and a half, the appointment concludes and Vallejo schedules a time to return the following week.\u003c/p>\n\u003cp>“Wow. How awesome is it to have a nurse come into your home and just be there to support you?” asks Michelle Gibbons, executive director of the County Health Executives Association of California. “Everybody wants to do what’s best for your kid, and yet, not knowing if you’re actually doing what’s best for your kid. This offers quality care in an intimate setting and engagement with a nurse.”\u003c/p>\n\u003cp>She says public health nurses provide education on child development, nutrition, housing, and safety and also offer mental health screenings. \u003ca href=\"https://www.cdph.ca.gov/Programs/CFH/DMCAH/CHVP/CDPH%20Document%20Library/CHVP-AnnualFederalReportSummary-2020.pdf\">Research (PDF)\u003c/a> suggests that home-visiting programs increase breastfeeding rates and lead to lower cases of child abuse and substance abuse.\u003c/p>\n\u003cp>“It’s just one strategy to be able to address some of the disparities that we see in getting these kids off to a really good start in life,” Gibbons said.[pullquote size=\"medium\" align=\"right\" citation=\"Dayanis, mother\"]‘I have been well taken care of. I am very grateful.’[/pullquote]She added that she would love to see the program address more people, including options for the unhoused and families with more than one child. It’s why, she says, her group is backing AB 1057. The bill would expand the number of evidenced-based, home-visiting models that can be implemented. The legislation was unanimously passed in the state Assembly. Now, the proposal is before the Senate.\u003c/p>\n\u003cp>Back inside Dayanis’ studio, she says home health visits have improved her mental health and connected her to useful services like housing. Soon, her family plans to move into a city-supported unit nearby with two bedrooms and a private bathroom.\u003c/p>\n\u003cp>“I have been well taken care of,” Dayanis said in Spanish. “I am very grateful.”\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cp>When Dr. Yohualli Anaya first noticed a lack of representation of Latina physicians in the U.S., she hoped to discover a different outcome when she embarked on a similar study — this time looking at California demographics. Latinos make up nearly 40% of the state’s population.[pullquote size=\"medium\" align=\"right\" citation=\"Dr. Yohualli Anaya, associate professor, University of Wisconsin-Madison\"]‘It’s something that I encounter on a day-to-day basis. It’s constantly being reminded of the lack of representation of Latina physicians.’[/pullquote]Anaya, the lead author of a new report published this month by UCLA’s Latino Policy and Politics Institute, found “disappointing” results when further examining nationwide trends.\u003c/p>\n\u003cp>“A reminder of the work that still needs to be done,” said Anaya, an associate professor of family medicine and community health at the University of Wisconsin-Madison. “There are so few of us that are in the clinic exam rooms with our patients, in the medical schools teaching our medical students. It’s something that I encounter on a day-to-day basis. It’s constantly being reminded of the lack of representation of Latina physicians.”\u003c/p>\n\u003cp>The study, which draws on census data from 2014–18, finds Latinas accounted for nearly 3% of California doctors. That’s slightly higher than the nationwide number at 2%.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Another detail that stood out to Anaya is that Latina physicians were almost 36 times more likely to speak Spanish at home compared to non-Hispanic white physicians.\u003c/p>\n\u003cp>“This is about ensuring equitable health care delivery for all populations. And Latino populations certainly deserve to have equitable health care delivery,” she said.\u003c/p>\n\u003cp>Anaya spoke more about the study’s results and what can be done to improve the shortage with KQED’s Alexander Gonzalez. Their conversation was edited for brevity and clarity.\u003c/p>\n\u003cp>\u003cstrong>Alexander Gonzalez: Why are we seeing these numbers? What’s driving this?\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Dr. Yohualli Anaya:\u003c/strong> It’s a multitude of things that are leading to this lack of representation. In the report, I highlight the different stages of the educational pathway where we can do some interventions to improve these numbers. We really need an approach that is addressing each of these levels because doing one or the other is going to be insufficient. We have been making some efforts and yet our efforts have been insufficient thus far.\u003c/p>\n\u003cp>\u003cstrong>It sounds like this is a really systemic issue and it’s going to take looking at people’s education as young as high school. Is that fair to say?\u003c/strong>\u003c/p>\n\u003cp>I would say even earlier, from an early age. So, if we invest in the quality of the education that our students are receiving, then we’re going to have students that are even more qualified and better prepared to enter college, succeed in college [and] enter medical school.\u003c/p>\n\u003cp>\u003cstrong>The tuition for medical education is typically steep. How much of the issue is related to costs based on the numbers reported in this study?\u003c/strong>\u003c/p>\n\u003cp>It is definitely a contributor. And if we are thinking about being inclusive in our recruitment rates, we want students and physicians who represent the full scope of the patients we’re taking care of. And that not only includes diversity in race and ethnicity, that also includes diversity in socioeconomic status.[aside label='More on Health Care' tag='health-care']Let’s say we want more students who are of immigrant background, who are first generation; these students are likely to be affected by socioeconomic disadvantage. They’re likely to be underrepresented in medicine. They’ve also been shown in research to practice in underserved communities. So supporting students in community college, supporting students who are underrepresented minorities with scholarships, with programs for extended research opportunities, and ensuring their success through their undergraduate career is going to then funnel additional students into medical school.\u003c/p>\n\u003cp>\u003cstrong>What’s another recommendation for helping improve the shortage?\u003c/strong>\u003c/p>\n\u003cp>We are at risk of losing a number of both students and existing health care workers in the workforce if we lose the ability for students to have \u003ca href=\"https://www.uscis.gov/DACA\">DACA\u003c/a> (Deferred Action for Childhood Arrivals) and maintain work authorization and stay in the educational pathway. Protecting the ability of undocumented students to pursue and study and practice medicine in the United States is going to ensure that we continue to build our numbers and that we don’t lose numbers when we already don’t have numbers to lose\u003cem>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Another detail that stood out to Anaya is that Latina physicians were almost 36 times more likely to speak Spanish at home compared to non-Hispanic white physicians.\u003c/p>\n\u003cp>“This is about ensuring equitable health care delivery for all populations. And Latino populations certainly deserve to have equitable health care delivery,” she said.\u003c/p>\n\u003cp>Anaya spoke more about the study’s results and what can be done to improve the shortage with KQED’s Alexander Gonzalez. Their conversation was edited for brevity and clarity.\u003c/p>\n\u003cp>\u003cstrong>Alexander Gonzalez: Why are we seeing these numbers? What’s driving this?\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Dr. Yohualli Anaya:\u003c/strong> It’s a multitude of things that are leading to this lack of representation. In the report, I highlight the different stages of the educational pathway where we can do some interventions to improve these numbers. We really need an approach that is addressing each of these levels because doing one or the other is going to be insufficient. We have been making some efforts and yet our efforts have been insufficient thus far.\u003c/p>\n\u003cp>\u003cstrong>It sounds like this is a really systemic issue and it’s going to take looking at people’s education as young as high school. Is that fair to say?\u003c/strong>\u003c/p>\n\u003cp>I would say even earlier, from an early age. So, if we invest in the quality of the education that our students are receiving, then we’re going to have students that are even more qualified and better prepared to enter college, succeed in college [and] enter medical school.\u003c/p>\n\u003cp>\u003cstrong>The tuition for medical education is typically steep. How much of the issue is related to costs based on the numbers reported in this study?\u003c/strong>\u003c/p>\n\u003cp>It is definitely a contributor. And if we are thinking about being inclusive in our recruitment rates, we want students and physicians who represent the full scope of the patients we’re taking care of. And that not only includes diversity in race and ethnicity, that also includes diversity in socioeconomic status.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Let’s say we want more students who are of immigrant background, who are first generation; these students are likely to be affected by socioeconomic disadvantage. They’re likely to be underrepresented in medicine. They’ve also been shown in research to practice in underserved communities. So supporting students in community college, supporting students who are underrepresented minorities with scholarships, with programs for extended research opportunities, and ensuring their success through their undergraduate career is going to then funnel additional students into medical school.\u003c/p>\n\u003cp>\u003cstrong>What’s another recommendation for helping improve the shortage?\u003c/strong>\u003c/p>\n\u003cp>We are at risk of losing a number of both students and existing health care workers in the workforce if we lose the ability for students to have \u003ca href=\"https://www.uscis.gov/DACA\">DACA\u003c/a> (Deferred Action for Childhood Arrivals) and maintain work authorization and stay in the educational pathway. Protecting the ability of undocumented students to pursue and study and practice medicine in the United States is going to ensure that we continue to build our numbers and that we don’t lose numbers when we already don’t have numbers to lose\u003cem>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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