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"content": "\u003cp>An agreement local air regulators made with Chevron earlier this year includes the settling of dozens of violations tied to some of the largest accidents at the company’s Richmond refinery over the last five years.\u003c/p>\n\u003cp>The Bay Area Air Quality Management District \u003ca href=\"https://www.kqed.org/news/11975650/bay-air-district-hails-decisive-victory-in-battle-to-cut-refinery-pollution\">announced in February that it had reached deals with Chevron and the Martinez Refining Company\u003c/a>, ending a legal war over a rule intended to reduce a harmful form of pollution emitted by the energy companies’ local refineries.\u003c/p>\n\u003cp>Under the agreement, Chevron is also paying $20 million to settle 678 separate violations related to its Richmond refinery. That marks the highest penalty agreement the energy giant has ever made with the air district, according to Philip Fine, the agency’s executive officer.\u003c/p>\n\u003cp>“This a new era of enforcement and holding facilities accountable,” Fine told the Richmond City Council on Feb. 27. “They need to feel these penalties in order to incentivize them to stay in compliance.”\u003c/p>\n\u003cp>The deal resolves all of the air district’s open enforcement actions with Chevron that took place between 2019 and June 30, 2023.\u003c/p>\n\u003cp>[aside postID=news_11975650]“We believe this resolution will allow us to turn our full focus on the future safe and reliable operation of our facility,” Chevron said in a statement sent by company spokesperson Caitlin Powell.\u003c/p>\n\u003cp>Air district officials told KQED 105 of the violations Chevron settled are tied to eight major incidents at the refinery over the last five years. They include several cases in which refinery components malfunctioned, leading to flaring.\u003c/p>\n\u003cp>\u003ca href=\"https://www.baaqmd.gov/plans-and-climate/emission-tracking-and-monitoring/flare-minimization-plans\">Flaring operations\u003c/a> take place when refineries send gasses to their flares to reduce pressure inside the facilities during malfunctions as well as start-up and shutdown operations. Oil industry officials have emphasized that the practice is a way to prevent more serious and possibly dangerous accidents.\u003c/p>\n\u003cp>Some of the flaring operations involved in the settlement released significant amounts of toxic gas into the air above the Richmond area. In several of these incidents, nearby residents could see black smoke and fire bursting into the sky, with some calling the air district to complain. Those cases garnered a significant amount of news coverage and social media posts.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Regulators say 71 of the violations are connected to \u003ca href=\"https://www.kqed.org/news/11894150/chevron-refinery-malfunction-during-storm-shut-down-processing-units-causing-fire-and-toxic-flaring\">several days of pollution releases from the Richmond refinery that began Oct. 24, 2021\u003c/a>, when one of the Bay Area’s strongest storms in recent years brought significant rain to the region. The refinery sustained a series of malfunctions that led to three days of flaring and significant concerns by Richmond area residents.\u003c/p>\n\u003cp>Two weeks after the releases started, the City Council asked Chevron executives to explain what happened in a public hearing. \u003ca href=\"https://www.kqed.org/news/11895438/richmond-to-chevron-listen-to-our-residents-concerns-about-your-problems\">Residents who showed up to the virtual meeting left upset\u003c/a>. They complained that company representatives did not have an explanation for what caused the major refinery malfunction. One of them, Randy Joseph, told the council and the company that he learned nothing from the hearing.\u003c/p>\n\u003cp>[aside postID=news_11895438]Reached two and a half years later, on the heels of the deal that essentially closes the book on that accident, Joseph said his dissatisfaction with Chevron has not subsided.\u003c/p>\n\u003cp>“Chevron always has the answers,” Joseph said in an interview. “They just refuse to share with us. They know they’re polluting. They also know they can come and say nothing and get away with it,” he said.\u003c/p>\n\u003cp>A few months after the October 2021 incident, \u003ca href=\"https://www.kqed.org/news/11901875/chevron-richmond-refinery-roof-leak-october-2021-flaring-incident\">KQED reported that problems started when an atmospheric river storm poured rain through a leaky roof into a key part of the refinery\u003c/a>, triggering significant power and steam loss. That, in turn, knocked half a dozen petroleum processing units offline, caused a small fire, and resulted in several days in which the refinery flared off toxic gases.\u003c/p>\n\u003cp>“They never came back to City Council. They never came back and explained. They never came back to apologize,” said Joseph, who is a community organizer with the group Reimagine Richmond and said he only learned of the cause of that accident from KQED’s reporting.\u003c/p>\n\u003cp>[aside label='Related Coverage' tag='chevron']Chevron says it informs the public and the air district about its releases. The company points out that residents can check real-time air quality data through \u003ca href=\"https://richmondairmonitoring.org/\">the refinery’s fenceline monitoring system\u003c/a>. The causes of many flaring events are posted several months later on \u003ca href=\"https://www.baaqmd.gov/about-air-quality/research-and-data/flare-data/flare-causal-reports\">the air district’s website\u003c/a>.\u003c/p>\n\u003cp>“Chevron Richmond also will be implementing various improvements to our flare monitoring and sampling systems and setting up ways to discuss flaring events and other air quality issues directly with our community,” the company said through its representative.\u003c/p>\n\u003cp>The 71 violations for the October 2021 incident involve times in which Chevron broke public nuisance, permit condition, visible emission and flare monitoring regulations, according to Kristine Roselius, an air district spokesperson. But the settlement essentially obscures the fine amount for each penalty.\u003c/p>\n\u003cp>“We accounted for the seriousness of these violations in determining an appropriate overall penalty amount for all the covered violations, but there is no allocation of specific dollar amounts to each individual violation, Roselius said in an email.\u003c/p>\n\u003cp>In the last decade, the oil industry \u003ca href=\"https://www.kqed.org/news/11960699/oil-industry-sets-back-efforts-to-increase-fines-against-polluting-california-refineries-yet-again\">has successfully killed or delayed legislative attempts to increase penalties on refineries\u003c/a> that violate air quality laws in California. The most recent bill, proposed by Assemblymember Buffy Wicks (D-Oakland), would increase the ceiling of many of those penalties to $30,000 per violation. That bill, \u003ca href=\"https://legiscan.com/CA/bill/AB1465/2023\">AB 1465\u003c/a>, is on hold.\u003c/p>\n\u003cp>Air district officials say 13 of Chevron’s violations settled in the recent deal were tied to an \u003ca href=\"https://www.kqed.org/news/11860389/chevron-says-flawed-electrical-diagram-triggered-major-flaring-incident\">incident on Nov. 2, 2020,\u003c/a> when an incorrectly labeled electrical diagram caused a power outage leading to the flaring of more than 100,000 pounds of sulfur dioxide and other chemicals.\u003c/p>\n\u003cp>The agency says 11 other violations were connected to a \u003ca href=\"https://www.cchealth.org/home/showpublisheddocument/28612/638337601986530000\">malfunction at the Richmond refinery on March 9, 2023,\u003c/a> when a hydrogen-producing plant tripped offline thanks to an electrical equipment malfunction. On the same day, a fire broke out thanks to a pump seal leak.\u003c/p>\n\u003cp>For years, Chevron’s Richmond refinery has flared more than the Bay Area’s other refineries.\u003c/p>\n\u003cp>The company argues that its “flaring performance has been steadily improving over the past few years.”\u003c/p>\n\u003cp>“To supplement these efforts, we will be formalizing an operator training program related to flare reduction and conducting a comprehensive assessment of previous flaring events to identify if any additional corrective actions are warranted,” the company said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Regulators say 71 of the violations are connected to \u003ca href=\"https://www.kqed.org/news/11894150/chevron-refinery-malfunction-during-storm-shut-down-processing-units-causing-fire-and-toxic-flaring\">several days of pollution releases from the Richmond refinery that began Oct. 24, 2021\u003c/a>, when one of the Bay Area’s strongest storms in recent years brought significant rain to the region. The refinery sustained a series of malfunctions that led to three days of flaring and significant concerns by Richmond area residents.\u003c/p>\n\u003cp>Two weeks after the releases started, the City Council asked Chevron executives to explain what happened in a public hearing. \u003ca href=\"https://www.kqed.org/news/11895438/richmond-to-chevron-listen-to-our-residents-concerns-about-your-problems\">Residents who showed up to the virtual meeting left upset\u003c/a>. They complained that company representatives did not have an explanation for what caused the major refinery malfunction. One of them, Randy Joseph, told the council and the company that he learned nothing from the hearing.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Reached two and a half years later, on the heels of the deal that essentially closes the book on that accident, Joseph said his dissatisfaction with Chevron has not subsided.\u003c/p>\n\u003cp>“Chevron always has the answers,” Joseph said in an interview. “They just refuse to share with us. They know they’re polluting. They also know they can come and say nothing and get away with it,” he said.\u003c/p>\n\u003cp>A few months after the October 2021 incident, \u003ca href=\"https://www.kqed.org/news/11901875/chevron-richmond-refinery-roof-leak-october-2021-flaring-incident\">KQED reported that problems started when an atmospheric river storm poured rain through a leaky roof into a key part of the refinery\u003c/a>, triggering significant power and steam loss. That, in turn, knocked half a dozen petroleum processing units offline, caused a small fire, and resulted in several days in which the refinery flared off toxic gases.\u003c/p>\n\u003cp>“They never came back to City Council. They never came back and explained. They never came back to apologize,” said Joseph, who is a community organizer with the group Reimagine Richmond and said he only learned of the cause of that accident from KQED’s reporting.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Chevron says it informs the public and the air district about its releases. The company points out that residents can check real-time air quality data through \u003ca href=\"https://richmondairmonitoring.org/\">the refinery’s fenceline monitoring system\u003c/a>. The causes of many flaring events are posted several months later on \u003ca href=\"https://www.baaqmd.gov/about-air-quality/research-and-data/flare-data/flare-causal-reports\">the air district’s website\u003c/a>.\u003c/p>\n\u003cp>“Chevron Richmond also will be implementing various improvements to our flare monitoring and sampling systems and setting up ways to discuss flaring events and other air quality issues directly with our community,” the company said through its representative.\u003c/p>\n\u003cp>The 71 violations for the October 2021 incident involve times in which Chevron broke public nuisance, permit condition, visible emission and flare monitoring regulations, according to Kristine Roselius, an air district spokesperson. But the settlement essentially obscures the fine amount for each penalty.\u003c/p>\n\u003cp>“We accounted for the seriousness of these violations in determining an appropriate overall penalty amount for all the covered violations, but there is no allocation of specific dollar amounts to each individual violation, Roselius said in an email.\u003c/p>\n\u003cp>In the last decade, the oil industry \u003ca href=\"https://www.kqed.org/news/11960699/oil-industry-sets-back-efforts-to-increase-fines-against-polluting-california-refineries-yet-again\">has successfully killed or delayed legislative attempts to increase penalties on refineries\u003c/a> that violate air quality laws in California. The most recent bill, proposed by Assemblymember Buffy Wicks (D-Oakland), would increase the ceiling of many of those penalties to $30,000 per violation. That bill, \u003ca href=\"https://legiscan.com/CA/bill/AB1465/2023\">AB 1465\u003c/a>, is on hold.\u003c/p>\n\u003cp>Air district officials say 13 of Chevron’s violations settled in the recent deal were tied to an \u003ca href=\"https://www.kqed.org/news/11860389/chevron-says-flawed-electrical-diagram-triggered-major-flaring-incident\">incident on Nov. 2, 2020,\u003c/a> when an incorrectly labeled electrical diagram caused a power outage leading to the flaring of more than 100,000 pounds of sulfur dioxide and other chemicals.\u003c/p>\n\u003cp>The agency says 11 other violations were connected to a \u003ca href=\"https://www.cchealth.org/home/showpublisheddocument/28612/638337601986530000\">malfunction at the Richmond refinery on March 9, 2023,\u003c/a> when a hydrogen-producing plant tripped offline thanks to an electrical equipment malfunction. On the same day, a fire broke out thanks to a pump seal leak.\u003c/p>\n\u003cp>For years, Chevron’s Richmond refinery has flared more than the Bay Area’s other refineries.\u003c/p>\n\u003cp>The company argues that its “flaring performance has been steadily improving over the past few years.”\u003c/p>\n\u003cp>“To supplement these efforts, we will be formalizing an operator training program related to flare reduction and conducting a comprehensive assessment of previous flaring events to identify if any additional corrective actions are warranted,” the company said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp class=\"p1\">\u003ca href=\"#episode-transcript\">\u003ci>View the full episode transcript.\u003c/i>\u003c/a>\u003c/p>\n\u003cp>Every child in California under 3 is entitled to early intervention services like physical, speech, and occupational therapy if they show signs that they need developmental support. Experts say getting these services early and in-person is critical for babies’ development, and that it can actually reduce the need for special education services later in life.\u003c/p>\n\u003cp>But many families aren’t receiving the care they need. KQED’s Daisy Nguyen explains why.\u003c/p>\n\u003cp>\u003cb>Links: \u003c/b>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://www.kqed.org/news/11980312/a-caregivers-guide-to-navigating-early-intervention-services\">‘Early Start’ 101: Here’s How Families Can Access Early Intervention Services for Younger Kids\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" frameborder=\"0\" height=\"200\" scrolling=\"no\" src=\"https://playlist.megaphone.fm/?e=KQINC5200793499\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003ch2 id=\"episode-transcript\">Episode Transcript\u003c/h2>\n\u003cp>\u003ci>This is a computer-generated transcript. While our team has reviewed it, there may be errors.\u003c/i>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>I’m Ericka Cruz Guevarra and welcome to the Bay. Local news to keep you rooted. Baby brains have lots to absorb early on. They’re learning how to walk and talk, and their brains are most adaptable in the first three years of life. That makes it a crucial period, because if the child shows signs of delays in their development, those first three years are the time to intervene.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>Receiving early intervention services could really change the developmental path of a child. It could make a big difference, but it has to be given during this period.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>In California, babies are entitled to help from the state. They show signs of developmental delay, and it happens through a program known as Early Start. But many of the neediest families aren’t getting that help today. I talked with KQED early childhood education reporter Daisy Nguyen about the barriers to getting babies crucial, life altering services on time.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>Reyna Balladares, is a foster parent who lives in the tenderloin.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>Then she became a foster parent, during the pandemic. She told me that at the time when the, you know, the world was shutting down, she wanted to open up her home to help foster children. She first took care of a baby boy for about six months. And, I think that was a really good experience for her, even though ultimately, you know, that the child was placed in a different home.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>And then she met this little girl, this newborn baby in 2021.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>She told me that she just remembered the the baby’s smile and just how sweet her face was. How she lit up when she saw her second city.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>You know, it broke her heart that the situation, that in which this girl came to her. But the little glimmer of hope when she saw that the girl was making some progress in her development, really reinforced her desire to want to advocate for this, for this little girl.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>When did Reyna start to notice this little girl struggling a little bit in her development?\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>She said this child was just slow to begin walking and talking. And I think because Reyna had raised two daughters, she had some personal experience.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>She just felt something wasn’t right. And she she said she mentioned this to doctors who initially told her this is normal. That was slightly dismissive. But she was certain that there was something going on. And ultimately, after seeing specialists, it was confirmed to her that this little girl needed a lot of early intervention services, essentially to help her reach her potential. It was recommended that this little girl receives a physical therapy, speech therapy, occupational therapy, and feeding therapy.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>We’re talking about really important services that kids need very early on. And I mean, I have to imagine time is of the essence. Why was it so hard for Rina to get the services that she needed for this baby girl? Why did she have to push so hard?\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>When I learned was just that the regional center has been overwhelmed, especially since the pandemic, with just a high caseload of children seeking services and probably some staffing shortages, not only at the regional center, but also with a shortage of early intervention providers. Families have to really push to get the services that they need in a timely manner and in the way that they want it to receive it, meaning if they want it to happen in the natural environment of the child.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>Reyna said that what she stumbled upon was just a lot of resistance by the therapist to come to the tenderloin, where she lives. She told me that the regional center coordinators told her that the therapists were just afraid to come to the tenderloin because they felt unsafe.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>What does Reyna say about what it was like to not have therapists willing to meet with her foster daughter in person?\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>She just felt it was unjust that it was because of where she lives. The therapists weren’t coming there to provide the services that her foster daughter crucially needed.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>What happened instead was that she was given an alternative, but it wasn’t what she wanted. So the Golden Gate Regional Center was telling her that she could take her foster child to the different clinics across San Francisco to make all these different appointments, which kind of stacked up during the week for her. She had to take a lot of time out of her working days.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>But the other alternative was to have these services done through zoom.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>It wasn’t ideal. She said her foster child would not respond to the therapist or just not want to sit in front of a screen.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>I want to step back a little bit, Daisy, and talk a little bit more about what early intervention services are, what kind of services are we talking about? Exactly? And I know these services are also things that families are entitled to. Right.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>Children with developmental delays are entitled to receive a host of early intervention services to enhance their ability to sit or walk or talk. The services could include physical therapy, speech therapy, occupational therapy. It could even include equipment that helps young children maintain or improve certain skills, or parents could also receive some counseling and training to support their child’s developmental needs.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>Getting the services as early as possible is crucial for children. Experts say that’s because this is a period when children’s brain are rapidly developing, and so they’re more adaptable. So receiving early intervention services could really change the developmental path of a child. It could make a big difference.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>But it has to be given during this period. This is a federal program that’s administered in California by a network of nonprofit regional centers. So in the Bay area, the Golden Gate Regional Center is responsible for coordinating these services for families in San Francisco, Marin, and San Mateo County.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>What are the bigger systemic problems with the state system for these early intervention services?\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>This program has always been plagued by understaffing and underinvestment by the government. The therapist who would provide these services. They are not paid a competitive rate. The rates in which the providers get paid have never been as competitive as what the private market is able to pay for these services, and so they’re just less incentivized to to provide services through this program.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>And so they’re in demand, which means that the number of families who who need the service, who requested these services and are eligible for these services have to kind of wait sometimes just to get it. The other issue is that they don’t get paid to travel to a family’s home.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>So as an alternative, what they’re able to offer to families is appointments in their offices or through telehealth, meaning appointments through zoom. And but for these some of these families, this is not what they considered an ideal way for their children to receive these services. They consider it substandard.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Coming up, how underfunding has hurt those who need the most help and how do we fix this? Stay with us.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>I want to talk more Daisy through, I guess, some of the consequences of this inadequate funding, as you were kind of just starting to talk about. What did you find?\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>Doctor Jennifer Albon is a pediatrician at UCSF.\u003c/p>\n\u003cp>\u003cstrong>Dr. Jennifer Albon: \u003c/strong>Most of my young patients are needing early intervention services.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>So she just is seeing, you know, growing geographic and socioeconomic disparities when it comes to who gets early intervention services in their home.\u003c/p>\n\u003cp>\u003cstrong>Dr. Jennifer Albon: \u003c/strong>I have many families who, like, live in certain neighborhoods of San Francisco, and the regional center has flat out told them and told us that there’s not providers who will go to your neighborhood, even within San Francisco.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>What does Doctor Albon say about the importance of providing this treatment in these children’s homes, but specifically no matter where they live?\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>She says it’s just more ideal because children learn best when they’re in familiar surroundings.\u003c/p>\n\u003cp>\u003cstrong>Dr. Jennifer Albon: \u003c/strong>You know, they get scared of coming into like, offices and other things like that. So it’s harder for them to participate when it’s not like their natural environments.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>The parents are also receiving some of the training themselves, so that for the rest of that week, when there’s no therapy, they’re able to practice what they’ve been trained to, you know, by the therapists to do.\u003c/p>\n\u003cp>\u003cstrong>Dr. Jennifer Albon: \u003c/strong>The goal for it to be kind of in their natural environment is that they have all of their regular things. And the and the therapists are showing the family what to do with what they have at home or in these natural environments.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>And I should add that it is it’s a lot. It’s a law where it says that services should ideally be provided in the natural environment. The growth in online therapies have made it accessible for many people. But I think in the case with young children, it’s it’s created more inequities.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Will these issues that we’re talking about are systemic, as you described earlier, and they’re also not all new, but what can we do to fix this problem?\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>I spoke with leaders of the regional centers, and they say that’s really like the you know, they recognize that this is a distressing situation that they’ve been trying to address for a long time, and they can’t compel therapists to see children in person if they’re just not getting, you know, they’re not being paid enough to do it. And so they’re really calling for greater investment by the state and federal government in the program.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>The state has been gradually been increasing the reimbursement rates for early intervention services. But this budget year, Governor Gavin Newsom wants to delay full implementation of the increases, and the regional center leaders are saying like they they really don’t think delay is a good idea, because increasing the rate is encouraging the therapists to do the work to go and see children in the natural environment. And also it’s encouraging them to to hire more people.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>Ultra regional center services Sacramento and about 9 or 10 surrounding counties, and they receive some federal pandemic aid money to implement a pilot project, where they offered an incentive to therapists to go to underserved zip codes and also hard to reach areas in their region. And they noticed that these incentives, which is I think it was something like $200 per visit, that they saw an increase in the number of children seen in these underserved areas. So clearly, you know, money talks.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Coming back to Reyna Balladares, what is she going to do next?\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>Her foster child just turned three, which means she is, quote unquote, aged out of, early intervention services. And Raina believes that she could have made much more progress if she had received consistent services. Her daughter now will need more, special education services through the San Francisco Unified School District.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>That is kind of heartbreaking, because it sounds like she wasn’t able to get the critical services she needed on time. But at the same time, Raina seems like this very active parent who knows a lot and who really pushed to make sure her kid got the services she needed. But I also imagine there’s probably lots of families who struggle to navigate these services, or maybe just don’t even have the time to and I mean, just maybe give up.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>I think that’s what compelled, Reyna to speak with me, because she would she wanted to speak out on behalf of those parents who you can imagine. I think having a child who, if you’re. Especially if you’re a first time parent, just absorbing the news that your child has a developmental delay. These families are often in crisis, and they don’t have the time to make constant calls to the regional center and push for these types of services.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Ultimately, Reyna wants to adopt the the baby girl, right?\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>She fell in love with this child.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>She is much closer to getting the adoption approved bundle.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>And when I met with them, I mean, you can just see this clear bond. And, she she just wants to do what’s best for this little girl.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Well, Daisy, thank you so much for breaking this down for us. I really appreciate it.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>Yeah. No problem.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>That was Daisy Nguyen, an early childhood education reporter for KQED. This 38 minute conversation with Daisy was cut down and edited by our intern, Ellie Prickett-Morgan and our senior editor, Alan Montecillo. Maria Esquinca is our producer. She scored this episode and added all the tape music courtesy of the Audio Network. Special thanks as well to Carlos Cabrera-Lomelí.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>By the way, did you know that the Bay is listener supported? Meaning our funders are people just like you? So if you appreciate the value that the Bay brings to your life, consider becoming a KQED member. Just go to KQED.org/Donate. The Bay is a production of listener supported KQED in San Francisco. I’m Ericka Cruz Guevarra. Thanks for listening. Talk to you next time.\u003c/p>\n\n",
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"headline": "Babies and Toddlers With Developmental Delays Are Entitled to Care. Many Aren't Getting It",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"p1\">\u003ca href=\"#episode-transcript\">\u003ci>View the full episode transcript.\u003c/i>\u003c/a>\u003c/p>\n\u003cp>Every child in California under 3 is entitled to early intervention services like physical, speech, and occupational therapy if they show signs that they need developmental support. Experts say getting these services early and in-person is critical for babies’ development, and that it can actually reduce the need for special education services later in life.\u003c/p>\n\u003cp>But many families aren’t receiving the care they need. KQED’s Daisy Nguyen explains why.\u003c/p>\n\u003cp>\u003cb>Links: \u003c/b>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://www.kqed.org/news/11980312/a-caregivers-guide-to-navigating-early-intervention-services\">‘Early Start’ 101: Here’s How Families Can Access Early Intervention Services for Younger Kids\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" frameborder=\"0\" height=\"200\" scrolling=\"no\" src=\"https://playlist.megaphone.fm/?e=KQINC5200793499\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\u003c/div>",
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"content": "\u003cdiv class=\"post-content post-body\">\u003ch2 id=\"episode-transcript\">Episode Transcript\u003c/h2>\n\u003cp>\u003ci>This is a computer-generated transcript. While our team has reviewed it, there may be errors.\u003c/i>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>I’m Ericka Cruz Guevarra and welcome to the Bay. Local news to keep you rooted. Baby brains have lots to absorb early on. They’re learning how to walk and talk, and their brains are most adaptable in the first three years of life. That makes it a crucial period, because if the child shows signs of delays in their development, those first three years are the time to intervene.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>Receiving early intervention services could really change the developmental path of a child. It could make a big difference, but it has to be given during this period.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>In California, babies are entitled to help from the state. They show signs of developmental delay, and it happens through a program known as Early Start. But many of the neediest families aren’t getting that help today. I talked with KQED early childhood education reporter Daisy Nguyen about the barriers to getting babies crucial, life altering services on time.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>Reyna Balladares, is a foster parent who lives in the tenderloin.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>Then she became a foster parent, during the pandemic. She told me that at the time when the, you know, the world was shutting down, she wanted to open up her home to help foster children. She first took care of a baby boy for about six months. And, I think that was a really good experience for her, even though ultimately, you know, that the child was placed in a different home.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>And then she met this little girl, this newborn baby in 2021.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>She told me that she just remembered the the baby’s smile and just how sweet her face was. How she lit up when she saw her second city.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>You know, it broke her heart that the situation, that in which this girl came to her. But the little glimmer of hope when she saw that the girl was making some progress in her development, really reinforced her desire to want to advocate for this, for this little girl.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>When did Reyna start to notice this little girl struggling a little bit in her development?\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>She said this child was just slow to begin walking and talking. And I think because Reyna had raised two daughters, she had some personal experience.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>She just felt something wasn’t right. And she she said she mentioned this to doctors who initially told her this is normal. That was slightly dismissive. But she was certain that there was something going on. And ultimately, after seeing specialists, it was confirmed to her that this little girl needed a lot of early intervention services, essentially to help her reach her potential. It was recommended that this little girl receives a physical therapy, speech therapy, occupational therapy, and feeding therapy.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>We’re talking about really important services that kids need very early on. And I mean, I have to imagine time is of the essence. Why was it so hard for Rina to get the services that she needed for this baby girl? Why did she have to push so hard?\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>When I learned was just that the regional center has been overwhelmed, especially since the pandemic, with just a high caseload of children seeking services and probably some staffing shortages, not only at the regional center, but also with a shortage of early intervention providers. Families have to really push to get the services that they need in a timely manner and in the way that they want it to receive it, meaning if they want it to happen in the natural environment of the child.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>Reyna said that what she stumbled upon was just a lot of resistance by the therapist to come to the tenderloin, where she lives. She told me that the regional center coordinators told her that the therapists were just afraid to come to the tenderloin because they felt unsafe.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>What does Reyna say about what it was like to not have therapists willing to meet with her foster daughter in person?\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>She just felt it was unjust that it was because of where she lives. The therapists weren’t coming there to provide the services that her foster daughter crucially needed.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>What happened instead was that she was given an alternative, but it wasn’t what she wanted. So the Golden Gate Regional Center was telling her that she could take her foster child to the different clinics across San Francisco to make all these different appointments, which kind of stacked up during the week for her. She had to take a lot of time out of her working days.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>But the other alternative was to have these services done through zoom.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>It wasn’t ideal. She said her foster child would not respond to the therapist or just not want to sit in front of a screen.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>I want to step back a little bit, Daisy, and talk a little bit more about what early intervention services are, what kind of services are we talking about? Exactly? And I know these services are also things that families are entitled to. Right.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>Children with developmental delays are entitled to receive a host of early intervention services to enhance their ability to sit or walk or talk. The services could include physical therapy, speech therapy, occupational therapy. It could even include equipment that helps young children maintain or improve certain skills, or parents could also receive some counseling and training to support their child’s developmental needs.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>Getting the services as early as possible is crucial for children. Experts say that’s because this is a period when children’s brain are rapidly developing, and so they’re more adaptable. So receiving early intervention services could really change the developmental path of a child. It could make a big difference.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>But it has to be given during this period. This is a federal program that’s administered in California by a network of nonprofit regional centers. So in the Bay area, the Golden Gate Regional Center is responsible for coordinating these services for families in San Francisco, Marin, and San Mateo County.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>What are the bigger systemic problems with the state system for these early intervention services?\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>This program has always been plagued by understaffing and underinvestment by the government. The therapist who would provide these services. They are not paid a competitive rate. The rates in which the providers get paid have never been as competitive as what the private market is able to pay for these services, and so they’re just less incentivized to to provide services through this program.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>And so they’re in demand, which means that the number of families who who need the service, who requested these services and are eligible for these services have to kind of wait sometimes just to get it. The other issue is that they don’t get paid to travel to a family’s home.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>So as an alternative, what they’re able to offer to families is appointments in their offices or through telehealth, meaning appointments through zoom. And but for these some of these families, this is not what they considered an ideal way for their children to receive these services. They consider it substandard.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Coming up, how underfunding has hurt those who need the most help and how do we fix this? Stay with us.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>I want to talk more Daisy through, I guess, some of the consequences of this inadequate funding, as you were kind of just starting to talk about. What did you find?\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>Doctor Jennifer Albon is a pediatrician at UCSF.\u003c/p>\n\u003cp>\u003cstrong>Dr. Jennifer Albon: \u003c/strong>Most of my young patients are needing early intervention services.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>So she just is seeing, you know, growing geographic and socioeconomic disparities when it comes to who gets early intervention services in their home.\u003c/p>\n\u003cp>\u003cstrong>Dr. Jennifer Albon: \u003c/strong>I have many families who, like, live in certain neighborhoods of San Francisco, and the regional center has flat out told them and told us that there’s not providers who will go to your neighborhood, even within San Francisco.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>What does Doctor Albon say about the importance of providing this treatment in these children’s homes, but specifically no matter where they live?\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>She says it’s just more ideal because children learn best when they’re in familiar surroundings.\u003c/p>\n\u003cp>\u003cstrong>Dr. Jennifer Albon: \u003c/strong>You know, they get scared of coming into like, offices and other things like that. So it’s harder for them to participate when it’s not like their natural environments.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>The parents are also receiving some of the training themselves, so that for the rest of that week, when there’s no therapy, they’re able to practice what they’ve been trained to, you know, by the therapists to do.\u003c/p>\n\u003cp>\u003cstrong>Dr. Jennifer Albon: \u003c/strong>The goal for it to be kind of in their natural environment is that they have all of their regular things. And the and the therapists are showing the family what to do with what they have at home or in these natural environments.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>And I should add that it is it’s a lot. It’s a law where it says that services should ideally be provided in the natural environment. The growth in online therapies have made it accessible for many people. But I think in the case with young children, it’s it’s created more inequities.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Will these issues that we’re talking about are systemic, as you described earlier, and they’re also not all new, but what can we do to fix this problem?\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>I spoke with leaders of the regional centers, and they say that’s really like the you know, they recognize that this is a distressing situation that they’ve been trying to address for a long time, and they can’t compel therapists to see children in person if they’re just not getting, you know, they’re not being paid enough to do it. And so they’re really calling for greater investment by the state and federal government in the program.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>The state has been gradually been increasing the reimbursement rates for early intervention services. But this budget year, Governor Gavin Newsom wants to delay full implementation of the increases, and the regional center leaders are saying like they they really don’t think delay is a good idea, because increasing the rate is encouraging the therapists to do the work to go and see children in the natural environment. And also it’s encouraging them to to hire more people.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>Ultra regional center services Sacramento and about 9 or 10 surrounding counties, and they receive some federal pandemic aid money to implement a pilot project, where they offered an incentive to therapists to go to underserved zip codes and also hard to reach areas in their region. And they noticed that these incentives, which is I think it was something like $200 per visit, that they saw an increase in the number of children seen in these underserved areas. So clearly, you know, money talks.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Coming back to Reyna Balladares, what is she going to do next?\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>Her foster child just turned three, which means she is, quote unquote, aged out of, early intervention services. And Raina believes that she could have made much more progress if she had received consistent services. Her daughter now will need more, special education services through the San Francisco Unified School District.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>That is kind of heartbreaking, because it sounds like she wasn’t able to get the critical services she needed on time. But at the same time, Raina seems like this very active parent who knows a lot and who really pushed to make sure her kid got the services she needed. But I also imagine there’s probably lots of families who struggle to navigate these services, or maybe just don’t even have the time to and I mean, just maybe give up.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>I think that’s what compelled, Reyna to speak with me, because she would she wanted to speak out on behalf of those parents who you can imagine. I think having a child who, if you’re. Especially if you’re a first time parent, just absorbing the news that your child has a developmental delay. These families are often in crisis, and they don’t have the time to make constant calls to the regional center and push for these types of services.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Ultimately, Reyna wants to adopt the the baby girl, right?\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>She fell in love with this child.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>She is much closer to getting the adoption approved bundle.\u003c/p>\n\u003cp>\u003cstrong>Reyna Balladares: \u003c/strong>\u003cem>[speaking spanish]\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>And when I met with them, I mean, you can just see this clear bond. And, she she just wants to do what’s best for this little girl.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Well, Daisy, thank you so much for breaking this down for us. I really appreciate it.\u003c/p>\n\u003cp>\u003cstrong>Daisy Nguyen: \u003c/strong>Yeah. No problem.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>That was Daisy Nguyen, an early childhood education reporter for KQED. This 38 minute conversation with Daisy was cut down and edited by our intern, Ellie Prickett-Morgan and our senior editor, Alan Montecillo. Maria Esquinca is our producer. She scored this episode and added all the tape music courtesy of the Audio Network. Special thanks as well to Carlos Cabrera-Lomelí.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>By the way, did you know that the Bay is listener supported? Meaning our funders are people just like you? So if you appreciate the value that the Bay brings to your life, consider becoming a KQED member. Just go to KQED.org/Donate. The Bay is a production of listener supported KQED in San Francisco. I’m Ericka Cruz Guevarra. Thanks for listening. Talk to you next time.\u003c/p>\n\n\u003c/div>"
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"slug": "health-care-for-health-care-workers-hundreds-stage-2-day-strike-at-daly-city-hospital",
"title": "‘Health Care for Health Care Workers’: Hundreds Stage 2-Day Strike at Daly City Hospital",
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"content": "\u003cp>Hundreds of workers at AHMC Seton Medical Center in Daly City walked off the job on Monday as part of a two-day strike to demand the hospital reverse changes it recently made to their health care plans.\u003c/p>\n\u003cp>“We’re striking for better medical benefits, something that actually covers our families, that pays the bills,” said Christina Caridis, an X-ray technician, who was among the throng of hospital staff on the picket line hoisting signs that said “Health Care for Health Care Workers.”\u003c/p>\n\u003cp>“We all have outstanding bills; we’ve gone to collections, and these are bills that they (the hospital) were supposed to pay,” she said.\u003c/p>\n\u003cp>The union representing the workers said the hospital’s administration dramatically changed health care options at the beginning of the year after workers’ previous contract expired, forcing them to pay up to $6,000 a year to maintain their coverage or accept a new plan with limited access to local doctors and hospitals.\u003c/p>\n\u003cp>“I’m worried about my family, my kids not having basic insurance that works,” said Juliya Vinogradsky, a respiratory therapist at Seton, noting that the new, more affordable plan has very few options for local care. “The closest doctors are about 45 minutes to an hour’s drive.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The two-day strike, expected to continue through Tuesday, follows \u003ca href=\"https://www.smdailyjournal.com/news/local/seton-nurses-call-for-better-working-conditions/article_66cb8e32-1eaf-11ed-8290-cfd8dd2926c1.html\">a number of previous labor disputes at the facility\u003c/a> since 2020 when \u003ca href=\"https://www.mercurynews.com/2020/08/14/ahmc-healthcare-finalizes-purchase-of-seton-medical-center/\">AHMC Healthcare purchased the hospital\u003c/a> out of bankruptcy. Since then, the Los Angeles-based company has “gutted patient care services and initiated several rounds of layoffs, cutting non-nurse staffing by nearly 25%,” according to the National Union of Healthcare Workers, which represents more than 400 Seton workers, including nursing assistants, licensed vocational nurses, respiratory therapists, housekeepers and medical technicians.[aside label=\"more health coverage\" tag=\"health\"]The union is still negotiating a new contract with the company and said that while it’s “near agreement” on wages, it won’t consider any deal that doesn’t fully restore workers’ health benefits.\u003c/p>\n\u003cp>“I am mainly here for better health care. This health insurance affects my 6-month-old daughter,” said Rachelle Ortua, a material management technician at Seton, who joined the picket line on Monday. “I’m not even worried about myself. I’m only worried about my daughter.”\u003c/p>\n\u003cp>Ortua said she and her daughter now have to drive at least 45 minutes to see a pediatrician who is covered by her new insurance plan. And the closest hospital with emergency pediatric care, she said, is even further away.\u003c/p>\n\u003cp>“I have chronic asthma, and I’m afraid my daughter has it,” Ortua said. “If she has it and she needs to get admitted, you’re telling me that [with] this health care, I have to travel an hour and a half away for her to be admitted into the hospital? I’m not OK with that.”\u003c/p>\n\u003cp>The union also said it fears that AHMC plans to further drain resources and eventually shutter the safety-net hospital that has primarily served lower-income immigrant communities in northern San Mateo County and San Francisco for generations. When it purchased the hospital in August 2020, the company, in an agreement with the state, committed to keeping it open for at least five and a half years — roughly midway through 2026.\u003c/p>\n\u003cp>But Seton’s administrator said concerns about its commitment to the well-being of its workers and patients are unfounded, calling the strike “unnecessary.” It accused the union of prioritizing “a contract negotiating tactic over patient and community care.”\u003c/p>\n\u003cp>The hospital has offered workers “outstanding wages and extraordinary medical benefits,” including 16% pay increases over three years, the option of free medical benefits for employees and their families, and a generous paid time off package, Seton said in a statement on Monday.\u003c/p>\n\u003cp>Since purchasing Seton in August 2020, when the facility “teetered on the edge of closure,” AMHC has pledged to keep the hospital open and make it financially viable by investing $100 million in repairs and upgrades and undertaking a $75 million seismic retrofit, the statement said.\u003c/p>\n\u003cp>“We have been working diligently to ensure Northern San Mateo County has a community hospital for years to come,” Sarkis Vartanian, the hospital’s head administrator, said in the statement. “My focus has been to provide high-quality, affordable care that meets the needs of our community.”\u003c/p>\n\u003cp>But many workers and local officials said the current state of the hospital suggests otherwise.\u003c/p>\n\u003cp>“They’re supposed to get new equipment and they didn’t get new equipment,” said Daly City Councilmember Pamela DiGiovanni, who joined workers on the picket line on Monday. “One of the doctors told me the bulbs are out in some of the operating rooms. It’s just terrible.”\u003c/p>\n\u003cp>DiGiovanni said she’s been calling Vartanian about these issues “three times a day, and he has not called me back.”\u003c/p>\n\u003cp>The hospital operators have failed to “fix and repair equipment that we need and provide the resources that we need to treat our patients,” Caridis, the X-ray technician, added. “In my personal specialty, I have no equipment to do the procedures that I need to do on a safe basis. We cancel a lot of patients.”\u003c/p>\n\u003cp>Workers like Ortua, the material management technician, acknowledged that the hospital is a business with financial constraints but said penalizing its workers and patients is both unethical and foolhardy.\u003c/p>\n\u003cp>“I understand trying to save money but treating your employees this way, you’ll never save money that way,” she said. “You’re going to lose people and end up losing the hospital. The least you can do is provide us with proper health care.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>KQED’s Sydney Johnson and Matthew Green contributed reporting to this story.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Hundreds of workers at AHMC Seton Medical Center in Daly City walked off the job on Monday as part of a two-day strike to demand the hospital reverse changes it recently made to their health care plans.\u003c/p>\n\u003cp>“We’re striking for better medical benefits, something that actually covers our families, that pays the bills,” said Christina Caridis, an X-ray technician, who was among the throng of hospital staff on the picket line hoisting signs that said “Health Care for Health Care Workers.”\u003c/p>\n\u003cp>“We all have outstanding bills; we’ve gone to collections, and these are bills that they (the hospital) were supposed to pay,” she said.\u003c/p>\n\u003cp>The union representing the workers said the hospital’s administration dramatically changed health care options at the beginning of the year after workers’ previous contract expired, forcing them to pay up to $6,000 a year to maintain their coverage or accept a new plan with limited access to local doctors and hospitals.\u003c/p>\n\u003cp>“I’m worried about my family, my kids not having basic insurance that works,” said Juliya Vinogradsky, a respiratory therapist at Seton, noting that the new, more affordable plan has very few options for local care. “The closest doctors are about 45 minutes to an hour’s drive.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The two-day strike, expected to continue through Tuesday, follows \u003ca href=\"https://www.smdailyjournal.com/news/local/seton-nurses-call-for-better-working-conditions/article_66cb8e32-1eaf-11ed-8290-cfd8dd2926c1.html\">a number of previous labor disputes at the facility\u003c/a> since 2020 when \u003ca href=\"https://www.mercurynews.com/2020/08/14/ahmc-healthcare-finalizes-purchase-of-seton-medical-center/\">AHMC Healthcare purchased the hospital\u003c/a> out of bankruptcy. Since then, the Los Angeles-based company has “gutted patient care services and initiated several rounds of layoffs, cutting non-nurse staffing by nearly 25%,” according to the National Union of Healthcare Workers, which represents more than 400 Seton workers, including nursing assistants, licensed vocational nurses, respiratory therapists, housekeepers and medical technicians.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The union is still negotiating a new contract with the company and said that while it’s “near agreement” on wages, it won’t consider any deal that doesn’t fully restore workers’ health benefits.\u003c/p>\n\u003cp>“I am mainly here for better health care. This health insurance affects my 6-month-old daughter,” said Rachelle Ortua, a material management technician at Seton, who joined the picket line on Monday. “I’m not even worried about myself. I’m only worried about my daughter.”\u003c/p>\n\u003cp>Ortua said she and her daughter now have to drive at least 45 minutes to see a pediatrician who is covered by her new insurance plan. And the closest hospital with emergency pediatric care, she said, is even further away.\u003c/p>\n\u003cp>“I have chronic asthma, and I’m afraid my daughter has it,” Ortua said. “If she has it and she needs to get admitted, you’re telling me that [with] this health care, I have to travel an hour and a half away for her to be admitted into the hospital? I’m not OK with that.”\u003c/p>\n\u003cp>The union also said it fears that AHMC plans to further drain resources and eventually shutter the safety-net hospital that has primarily served lower-income immigrant communities in northern San Mateo County and San Francisco for generations. When it purchased the hospital in August 2020, the company, in an agreement with the state, committed to keeping it open for at least five and a half years — roughly midway through 2026.\u003c/p>\n\u003cp>But Seton’s administrator said concerns about its commitment to the well-being of its workers and patients are unfounded, calling the strike “unnecessary.” It accused the union of prioritizing “a contract negotiating tactic over patient and community care.”\u003c/p>\n\u003cp>The hospital has offered workers “outstanding wages and extraordinary medical benefits,” including 16% pay increases over three years, the option of free medical benefits for employees and their families, and a generous paid time off package, Seton said in a statement on Monday.\u003c/p>\n\u003cp>Since purchasing Seton in August 2020, when the facility “teetered on the edge of closure,” AMHC has pledged to keep the hospital open and make it financially viable by investing $100 million in repairs and upgrades and undertaking a $75 million seismic retrofit, the statement said.\u003c/p>\n\u003cp>“We have been working diligently to ensure Northern San Mateo County has a community hospital for years to come,” Sarkis Vartanian, the hospital’s head administrator, said in the statement. “My focus has been to provide high-quality, affordable care that meets the needs of our community.”\u003c/p>\n\u003cp>But many workers and local officials said the current state of the hospital suggests otherwise.\u003c/p>\n\u003cp>“They’re supposed to get new equipment and they didn’t get new equipment,” said Daly City Councilmember Pamela DiGiovanni, who joined workers on the picket line on Monday. “One of the doctors told me the bulbs are out in some of the operating rooms. It’s just terrible.”\u003c/p>\n\u003cp>DiGiovanni said she’s been calling Vartanian about these issues “three times a day, and he has not called me back.”\u003c/p>\n\u003cp>The hospital operators have failed to “fix and repair equipment that we need and provide the resources that we need to treat our patients,” Caridis, the X-ray technician, added. “In my personal specialty, I have no equipment to do the procedures that I need to do on a safe basis. We cancel a lot of patients.”\u003c/p>\n\u003cp>Workers like Ortua, the material management technician, acknowledged that the hospital is a business with financial constraints but said penalizing its workers and patients is both unethical and foolhardy.\u003c/p>\n\u003cp>“I understand trying to save money but treating your employees this way, you’ll never save money that way,” she said. “You’re going to lose people and end up losing the hospital. The least you can do is provide us with proper health care.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>KQED’s Sydney Johnson and Matthew Green contributed reporting to this story.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>A new program to test wastewater for substances like fentanyl, methamphetamine and cocaine is giving San Francisco’s health officials a new window into the city’s pressing overdose crisis.\u003c/p>\n\u003cp>The effort comes as San Francisco recently experienced the \u003ca href=\"https://www.kqed.org/news/11972898/2023-was-san-franciscos-deadliest-year-for-drug-overdoses-new-data-confirms\">worst year for overdose deaths\u003c/a> on record in 2023, when 806 people died of accidental overdose.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Jeffrey Hom, director of population behavioral health, San Francisco Department of Public Health\"]‘For the first time, we have data that can shed light on the amounts of drugs that are being used in the city here. This is something that we haven’t had before.’[/pullquote]“For the first time, we have data that can shed light on the amounts of drugs that are being used in the city here,” said Jeffrey Hom, director of population behavioral health for the San Francisco Department of Public Health. “This is something that we haven’t had before. So much of the data that we look at within the health department is based on individuals who are receiving a certain service or who have experienced a certain outcome, like a nonfatal overdose.”\u003c/p>\n\u003cp>San Francisco health officials started tracking drug use and supply trends in November 2023 to monitor the presence of different drugs and to also check for changes in the illicit drug supply.\u003c/p>\n\u003cp>Wastewater samples are collected every two weeks from two different locations, one on the city’s west side and another on the east side. Currently, the city is checking for fentanyl, cocaine and methamphetamine, as well as all three substances in their metabolized form. The samples are then sent to a lab where they are analyzed, and the results are shared back with the city.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Early results from the first four months of testing show there were often higher concentrations of drugs, including fentanyl, cocaine and methamphetamine on the east side of the city compared with the west. That largely tracks with geographic data from the Office of the Chief Medical Examiner, which releases monthly reports on overdoses in the city.\u003c/p>\n\u003cp>Fentanyl, a potent opioid about 50 times stronger than heroin, has contributed to the majority of recent overdose deaths in San Francisco.\u003c/p>\n\u003cp>However, the wastewater data showed much higher concentrations of stimulants across the city. For example, there were 1552 milligrams of methamphetamine per 1000 people per day found in samples collected on the east side of the city on March 7, 2024, compared to 34 milligrams of fentanyl.\u003c/p>\n\u003cp>[aside label=\"Related Stories\" postID=\"news_11969903,news_11975973,news_11979144\"]That doesn’t necessarily mean there are more people using stimulants, however. The body metabolizes each substance differently, making it hard to compare the prevalence of individual substances. Instead, Hom said, the city is using the findings to monitor changes in the drug supply and use trends over time.\u003c/p>\n\u003cp>“We’re not able to directly compare those and make an assumption that many more people or that much more stimulants are being used because of the way these drugs are metabolized in the body. So trying to make the comparison between drugs is difficult,” Hom said.\u003c/p>\n\u003cp>Public health officials say they hope to use the data to advise the public on overdose risk and drug supply trends.\u003c/p>\n\u003cp>The effort is part of a study funded by the National Institute on Drug Abuse, which ends in August, that San Francisco and other local municipalities are participating in. But the city’s health officials say they hope to expand and continue the program after the study wraps up.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Jeffrey Hom, director of population behavioral health, San Francisco Department of Public Health\"]‘Much of the potential for this kind of surveillance revolves around the opportunity to identify new drugs or something that’s just starting to make its way into the drug supply here.’[/pullquote]San Francisco previously used wastewater testing during the COVID-19 pandemic to track the rise and fall of the virus on a population level. However, the city is not alone in its endeavor to use the technology for the overdose crisis as well. \u003ca href=\"https://www.kqed.org/science/1982720/marin-health-officials-track-illicit-drug-use-by-testing-wastewater\">Marin County\u003c/a> started using the approach in July 2023. Public health officials there issued a health advisory about an increase in fentanyl overdoses that aligned with the wastewater testing, which showed higher rates and amounts of fentanyl in the same period.\u003c/p>\n\u003cp>“Much of the potential for this kind of surveillance revolves around the opportunity to identify new drugs or something that’s just starting to make its way into the drug supply here,” Hom said. “I am hopeful as we look to the next iteration of this that we not only increase the frequency of testing, but increase the number of drugs and especially novel drugs so our response can be timely and focused.”\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“For the first time, we have data that can shed light on the amounts of drugs that are being used in the city here,” said Jeffrey Hom, director of population behavioral health for the San Francisco Department of Public Health. “This is something that we haven’t had before. So much of the data that we look at within the health department is based on individuals who are receiving a certain service or who have experienced a certain outcome, like a nonfatal overdose.”\u003c/p>\n\u003cp>San Francisco health officials started tracking drug use and supply trends in November 2023 to monitor the presence of different drugs and to also check for changes in the illicit drug supply.\u003c/p>\n\u003cp>Wastewater samples are collected every two weeks from two different locations, one on the city’s west side and another on the east side. Currently, the city is checking for fentanyl, cocaine and methamphetamine, as well as all three substances in their metabolized form. The samples are then sent to a lab where they are analyzed, and the results are shared back with the city.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Early results from the first four months of testing show there were often higher concentrations of drugs, including fentanyl, cocaine and methamphetamine on the east side of the city compared with the west. That largely tracks with geographic data from the Office of the Chief Medical Examiner, which releases monthly reports on overdoses in the city.\u003c/p>\n\u003cp>Fentanyl, a potent opioid about 50 times stronger than heroin, has contributed to the majority of recent overdose deaths in San Francisco.\u003c/p>\n\u003cp>However, the wastewater data showed much higher concentrations of stimulants across the city. For example, there were 1552 milligrams of methamphetamine per 1000 people per day found in samples collected on the east side of the city on March 7, 2024, compared to 34 milligrams of fentanyl.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>That doesn’t necessarily mean there are more people using stimulants, however. The body metabolizes each substance differently, making it hard to compare the prevalence of individual substances. Instead, Hom said, the city is using the findings to monitor changes in the drug supply and use trends over time.\u003c/p>\n\u003cp>“We’re not able to directly compare those and make an assumption that many more people or that much more stimulants are being used because of the way these drugs are metabolized in the body. So trying to make the comparison between drugs is difficult,” Hom said.\u003c/p>\n\u003cp>Public health officials say they hope to use the data to advise the public on overdose risk and drug supply trends.\u003c/p>\n\u003cp>The effort is part of a study funded by the National Institute on Drug Abuse, which ends in August, that San Francisco and other local municipalities are participating in. But the city’s health officials say they hope to expand and continue the program after the study wraps up.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>When the world shut down during the pandemic, Reyna Balladares decided to open her apartment in San Francisco’s Tenderloin neighborhood to a foster child.\u003c/p>\n\u003cp>A single mother of two grown daughters, Balladares heard from a social-worker friend about the challenges of finding a home for foster children and wanted to help.\u003c/p>\n\u003cp>Balladares took care of a baby boy for six months, and then in 2021, she got paired up with a newborn girl. As months went by, Balladares noticed she was slow to begin walking and talking.[pullquote size=\"medium\" align=\"right\" citation=\"Reyna Balladares, foster parent and San Francisco resident\"]‘They’re afraid to come to this community.’[/pullquote]A pediatrician recommended that the girl get physical, speech, occupational and feeding therapy to support her development. Balladares was referred to \u003ca href=\"https://www.dds.ca.gov/services/early-start/\">Early Start\u003c/a>, California’s early intervention program for infants and toddlers with developmental delays, which approved the treatments.\u003c/p>\n\u003cp>However, getting connected to certain therapists took months.\u003c/p>\n\u003cp>When Balladares asked a program coordinator about the long wait, she learned few therapists were willing to make house calls to her neighborhood, which has been at the center of the city’s homelessness and \u003ca href=\"https://www.kqed.org/news/11972898/2023-was-san-franciscos-deadliest-year-for-drug-overdoses-new-data-confirms\">drug crisis\u003c/a>.\u003c/p>\n\u003cp>“They’re afraid to come to this community,” she said.\u003c/p>\n\u003cp>And that kept the girl from getting the services she was entitled to receive.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>California established Early Start in 1986 in response to a federal law guaranteeing early intervention services for children under 3, regardless of their families’ income levels. A network of nonprofit regional centers is responsible for determining a child’s eligibility for developmental support and arranging those services.\u003c/p>\n\u003cp>Getting services early on is crucial, \u003ca href=\"https://www.cdc.gov/ncbddd/actearly/whyActEarly.html\">experts say,\u003c/a> because babies’ brains are more adaptable during the first three years of life, and the intervention can head off the need for special education services later on.\u003c/p>\n\u003cp>The law also requires that children receive the services in their home, daycare or other “natural environments” as much as possible because young children learn best \u003ca href=\"https://www.pacer.org/ec/early-intervention/natural-environments.asp\">when they’re in familiar surroundings\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_11977975\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11977975 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240301-EARLY-START-DEVELOPMENTAL-DELAYS-KSM-08-KQED.jpg\" alt=\"A collection of kids' toys sits on a beige and blue table beside a white wall.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240301-EARLY-START-DEVELOPMENTAL-DELAYS-KSM-08-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240301-EARLY-START-DEVELOPMENTAL-DELAYS-KSM-08-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240301-EARLY-START-DEVELOPMENTAL-DELAYS-KSM-08-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240301-EARLY-START-DEVELOPMENTAL-DELAYS-KSM-08-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240301-EARLY-START-DEVELOPMENTAL-DELAYS-KSM-08-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240301-EARLY-START-DEVELOPMENTAL-DELAYS-KSM-08-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A small table and chair with children’s toys in Reyna Balladares’ home in San Francisco on Feb. 26, 2024. \u003ccite>(Kathryn Styer-Martínez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Advocates tell KQED they see a growing divide between who gets quality services and who doesn’t.\u003c/p>\n\u003cp>“There’s vast inequities,” said Jennifer Albon, a pediatrician who treats children with high health care needs at UCSF Medical Center at Mount Zion.\u003c/p>\n\u003cp>She said several patients who live in the Tenderloin and other low-income districts like the Bayview did not receive at-home therapies because the Golden Gate Regional Center, which coordinates early intervention services in San Francisco, San Mateo and Marin counties, couldn’t find providers willing to see children there.[pullquote size=\"medium\" align=\"right\" citation=\"Jennifer Albon, pediatrician, UCSF Medical Center at Mount Zion\"]‘Families who are well-resourced and live in nicer areas, those are the only families who are getting that care in their natural environment, even though [they don’t have] the most need.’[/pullquote]“The regional center has flat-out told them and told us that there’s no providers who will go to your neighborhood,” she said. “Families who are well-resourced and live in nicer areas, those are the only families who are getting that care in their natural environment, even though [they don’t have] the most need.”\u003c/p>\n\u003cp>Child care centers in the Tenderloin are also impacted.\u003c/p>\n\u003cp>Heidi Lamar, director of Compass Children’s Center, said when she noticed a therapist had stopped showing up to work with a child, she reached out to a case manager at Golden Gate Regional Center or GGRC.\u003c/p>\n\u003cp>The case manager replied in an email message to Lamar: “The provider is not coming anymore because she was shoved onto the sidewalk by someone on the street while walking to Compass. She had previously been yelled at, cursed at, and followed by a man on a bicycle while walking to Compass on another occasion.”\u003c/p>\n\u003cp>The case manager acknowledged increased difficulty finding providers willing to go to the Tenderloin.[aside postID=news_11958841 hero='https://ww2.kqed.org/app/uploads/sites/10/2023/08/230822-HOME-HEALTHCARE-WORKER-LM-KQED-1020x680.jpg']“We can’t compel therapists to provide services in situations where they don’t feel safe,” the case manager wrote. “We just keep our fingers crossed that the providers don’t drop the families entirely.”\u003c/p>\n\u003cp>The Tenderloin has long been plagued by drug dealing, homelessness and mental illness — conditions that residents and business owners say \u003ca href=\"https://www.sfchronicle.com/sf/article/tenderloin-little-saigon-homeless-18601130.php\">have worsened since the pandemic\u003c/a>, despite city efforts to increase safety in the area.\u003c/p>\n\u003cp>It’s also a refuge for thousands of lower-income and immigrant families who come seeking affordable housing and social support from organizations like Compass. Another child care center — Wu Yee Children’s Services — hires a “street usher” to escort kids to playgrounds in the neighborhood.\u003c/p>\n\u003cp>“I’m sure you’ve seen in the news our neighborhood is struggling. There were two daytime shootings outside our school building in the last few months,” Lamar said. “But this is where we work every day; this is where our children and our families live. We have to serve them. We have to find a way.”\u003c/p>\n\u003cp>Frustrated by the delay in services, Lamar hired a speech and language pathologist to work on-site with children who have difficulty communicating.\u003c/p>\n\u003cp>Another parent, Ashley Chac, said she waited nine months to get a GGRC coordinator to respond to her request for occupational and physical therapy for her 1 1/2-year-old daughter.[pullquote size=\"medium\" align=\"right\" citation=\"Heidi Lamar, director, Compass Children’s Center\"]‘ … This is where we work every day, this is where our children and our families live. We have to serve them. We have to find a way.’[/pullquote]Chac said she’s upset about missing early intervention during a stage when it can make the greatest impact on her daughter’s development.\u003c/p>\n\u003cp>“Time is of the essence for her,” Chac said. “I’m mad that we fell through the cracks.”\u003c/p>\n\u003cp>Eric Zigman, executive director of the GGRC, said he’s keenly aware of providers’ reluctance to serve certain neighborhoods and calls it a distressing situation. He said his hands are tied as long as the state pays providers less than the market rate for their services.\u003c/p>\n\u003cp>“Until those rates are changed, we can’t control every action of every provider,” Zigman said.\u003c/p>\n\u003cp>Inadequate funding and a shortage of providers have limited regional centers’ ability to improve access and delivery of Early Start services, according to \u003ca href=\"https://calbudgetcenter.org/resources/california-can-better-support-infants-toddlers-with-disabilities-or-developmental-delays/\">a 2022 analysis of the program by the California Budget & Policy Center\u003c/a>.\u003c/p>\n\u003cp>Early Start’s problems have raised enough of a concern that the federal Office of Special Education Programs deemed California “\u003ca href=\"https://sites.ed.gov/idea/idea-files/2023-spp-apr-and-state-determination-letters-part-c-california/\">needs assistance\u003c/a>” to improve outcomes for children who receive early intervention services.\u003c/p>\n\u003ch2>Pushing back against Zoom therapy\u003c/h2>\n\u003cp>Advocates say that a growing reliance on telehealth is also leading to substandard care.\u003c/p>\n\u003cp>California allowed remote delivery of early intervention services at the beginning of the pandemic to ensure children continued to receive care. But as the threat of COVID-19 subsided, advocates said the practice continued.\u003c/p>\n\u003cp>Intervening early and in the child’s home should be the “gold standard,” said Amy Westling, executive director of the Association of Regional Center Agencies. However, the regional centers have a hard time finding providers and paying them a competitive rate, she said.\u003c/p>\n\u003cp>“If the service can’t be provided in the natural environment or we can’t identify a provider to do so, we don’t want to say then, ‘We’re not going to offer some alternative,’” Westling said.\u003c/p>\n\u003cp>Left without choices, Balladares tried virtual therapy, but she couldn’t get her foster daughter to focus or respond to the therapist. She said children need to form relationships in person in order to learn.\u003c/p>\n\u003cp>“Nothing replaces a person-to-person relationship, especially for a child,” she said.[pullquote size=\"medium\" align=\"right\" citation=\"Amy Westling, executive director, Association of Regional Center Agencies\"]‘If the service can’t be provided in the natural environment or we can’t identify a provider to do so, we don’t want to say then, ‘We’re not going to offer some alternative.”[/pullquote]In the end, Balladares had to cut back her work hours to take the girl to multiple appointments at different clinics each week.\u003c/p>\n\u003cp>“Running with [her] from one place to another, sometimes trying to make two different appointments in one day … then rushing home to prepare our meals,” she said. “She was exhausted, and so was I.”\u003c/p>\n\u003cp>After two years of therapies, Balladares said, the toddler hasn’t made as much progress as she hoped. After turning 3 last month, she is no longer eligible to receive services under Early Start and will require more therapies through the San Francisco Unified School District.\u003c/p>\n\u003cp>Critics say some therapists or their agencies are exploiting a loophole in the law that allows telehealth services if the child’s parents or guardians agree to the arrangement.\u003c/p>\n\u003cp>“How people took advantage of that was they said to the parent, ‘We can see your child next week virtually, but if we see them in person, it will take several months,’” said Elaine Westlake, a physical therapist who has been demanding a clearer policy on the use of telehealth for Early Start services. “So, of course, the parent says, ‘Well, I guess virtual.’”\u003c/p>\n\u003cp>Westlake said she saw a growing problem when parents in the Tenderloin wondered why she was the only therapist making home visits while others offered their services remotely. She thinks providers are leaning on telehealth because it saves on travel time. What’s more, Medi-Cal pays the same amount whether services are delivered remotely or in person.[aside postID=news_11961256 hero='https://ww2.kqed.org/app/uploads/sites/10/2023/09/023_KQED_LaBombaPreschool_04202023-1020x680.jpg']“It’s plain economics because you can see one child after the other [via telehealth],” Westlake said.\u003c/p>\n\u003cp>Westlake said she is not compensated for the time she spends driving to a child’s home or daycare for each physical therapy appointment. She’s seen the positive impact of that effort. Two recent patients were born prematurely and spent months in neonatal intensive-care units.\u003c/p>\n\u003cp>“When they came home from the hospital, the parents were afraid to even move them,” Westlake said. Now, she said, both children are walking, running and climbing.\u003c/p>\n\u003cp>“That never would have happened if I had not seen them in person,” Westlake said.\u003c/p>\n\u003cp>New York’s health department recently \u003ca href=\"https://www.health.ny.gov/community/infants_children/early_intervention/docs/eip_telehealth_guidance_document.pdf\">issued guidance on using telehealth\u003c/a> after the state’s comptroller \u003ca href=\"https://www.health.ny.gov/community/infants_children/early_intervention/docs/eip_telehealth_guidance_document.pdf\">issued an audit\u003c/a> that found many eligible children didn’t receive early intervention services or faced delays. The guidance lays out scenarios where telehealth is allowed and requires that early intervention providers document how they delivered the services.\u003c/p>\n\u003cp>Lawmakers there are also considering a 5% increase in payments for in-person services and an extra 4% for serving hard-to-reach or underserved areas.\u003c/p>\n\u003cp>In Northern California, a pilot project funded by the American Rescue Plan aimed at boosting in-person therapies showed promising results, according to Lori Banales, executive director of Alta California Regional Center, which serves Sacramento and nine surrounding counties.\u003c/p>\n\u003cfigure id=\"attachment_11978893\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11978893 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240309-EARLY-START-DEVELOPMENTAL-DELAYS-MD-01-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240309-EARLY-START-DEVELOPMENTAL-DELAYS-MD-01-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240309-EARLY-START-DEVELOPMENTAL-DELAYS-MD-01-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240309-EARLY-START-DEVELOPMENTAL-DELAYS-MD-01-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240309-EARLY-START-DEVELOPMENTAL-DELAYS-MD-01-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240309-EARLY-START-DEVELOPMENTAL-DELAYS-MD-01-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240309-EARLY-START-DEVELOPMENTAL-DELAYS-MD-01-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Reyna Balladares and her 3-year-old foster child in San Francisco on March 9, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The project offered $200 incentives for therapies done in underserved areas, in languages other than English or during hours that would accommodate parents’ work schedules, Banales said. Furthermore, $10,000 internship grants also helped early intervention providers to hire more bilingual therapists.\u003c/p>\n\u003cp>“We know that this works. Money does talk,” she said.\u003c/p>\n\u003cp>While California has been gradually raising reimbursement rates for providers, Gov. Gavin Newsom wants to delay fully funding the increases to save $1 billion in the next budget year as he moves to close a $38 billion shortfall. That would hinder ongoing efforts to grow the workforce and could lead to longer waits for services, according to\u003ca href=\"https://lao.ca.gov/reports/2024/4837/DDS-Budget-021324.pdf\"> a report by the state Legislative Analyst’s Office\u003c/a>.[pullquote size=\"medium\" align=\"right\" citation=\"Lori Banales, executive director, Alta California Regional Center\"]‘The very rapid growth puts a lot of pressure on a system where there’s just not enough clinicians. So I think there’s a lot of work to be done to close some of those gaps at this point.’[/pullquote]Some recent policy changes included hiring more regional center coordinators to lower caseloads and expanding eligibility for Early Start services, which is expected to add 10% more children into a program currently serving 56,000 infants and toddlers.\u003c/p>\n\u003cp>Westling said that’s a lot of change all at once.\u003c/p>\n\u003cp>“The very rapid growth puts a lot of pressure on a system where there’s just not enough clinicians,” she said. “So, I think there’s a lot of work to be done to close some of those gaps at this point.”\u003c/p>\n\u003cp>Until reform takes hold, Westlake urges her fellow therapists to uphold their code of ethics and care for kids in their natural environments — just as they did before telehealth came along.\u003c/p>\n\u003cp>“We did it before, and we can certainly do it again,” she said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "In California, infants and toddlers with developmental delays qualify for in-home therapy through the Early Start program. Yet families in low-income neighborhoods, like the Tenderloin and the Bayview, face barriers as therapists refuse to provide services there, forcing parents to choose between inconvenient travel or remote therapy.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When the world shut down during the pandemic, Reyna Balladares decided to open her apartment in San Francisco’s Tenderloin neighborhood to a foster child.\u003c/p>\n\u003cp>A single mother of two grown daughters, Balladares heard from a social-worker friend about the challenges of finding a home for foster children and wanted to help.\u003c/p>\n\u003cp>Balladares took care of a baby boy for six months, and then in 2021, she got paired up with a newborn girl. As months went by, Balladares noticed she was slow to begin walking and talking.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>A pediatrician recommended that the girl get physical, speech, occupational and feeding therapy to support her development. Balladares was referred to \u003ca href=\"https://www.dds.ca.gov/services/early-start/\">Early Start\u003c/a>, California’s early intervention program for infants and toddlers with developmental delays, which approved the treatments.\u003c/p>\n\u003cp>However, getting connected to certain therapists took months.\u003c/p>\n\u003cp>When Balladares asked a program coordinator about the long wait, she learned few therapists were willing to make house calls to her neighborhood, which has been at the center of the city’s homelessness and \u003ca href=\"https://www.kqed.org/news/11972898/2023-was-san-franciscos-deadliest-year-for-drug-overdoses-new-data-confirms\">drug crisis\u003c/a>.\u003c/p>\n\u003cp>“They’re afraid to come to this community,” she said.\u003c/p>\n\u003cp>And that kept the girl from getting the services she was entitled to receive.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>California established Early Start in 1986 in response to a federal law guaranteeing early intervention services for children under 3, regardless of their families’ income levels. A network of nonprofit regional centers is responsible for determining a child’s eligibility for developmental support and arranging those services.\u003c/p>\n\u003cp>Getting services early on is crucial, \u003ca href=\"https://www.cdc.gov/ncbddd/actearly/whyActEarly.html\">experts say,\u003c/a> because babies’ brains are more adaptable during the first three years of life, and the intervention can head off the need for special education services later on.\u003c/p>\n\u003cp>The law also requires that children receive the services in their home, daycare or other “natural environments” as much as possible because young children learn best \u003ca href=\"https://www.pacer.org/ec/early-intervention/natural-environments.asp\">when they’re in familiar surroundings\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_11977975\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11977975 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240301-EARLY-START-DEVELOPMENTAL-DELAYS-KSM-08-KQED.jpg\" alt=\"A collection of kids' toys sits on a beige and blue table beside a white wall.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240301-EARLY-START-DEVELOPMENTAL-DELAYS-KSM-08-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240301-EARLY-START-DEVELOPMENTAL-DELAYS-KSM-08-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240301-EARLY-START-DEVELOPMENTAL-DELAYS-KSM-08-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240301-EARLY-START-DEVELOPMENTAL-DELAYS-KSM-08-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240301-EARLY-START-DEVELOPMENTAL-DELAYS-KSM-08-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240301-EARLY-START-DEVELOPMENTAL-DELAYS-KSM-08-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A small table and chair with children’s toys in Reyna Balladares’ home in San Francisco on Feb. 26, 2024. \u003ccite>(Kathryn Styer-Martínez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Advocates tell KQED they see a growing divide between who gets quality services and who doesn’t.\u003c/p>\n\u003cp>“There’s vast inequities,” said Jennifer Albon, a pediatrician who treats children with high health care needs at UCSF Medical Center at Mount Zion.\u003c/p>\n\u003cp>She said several patients who live in the Tenderloin and other low-income districts like the Bayview did not receive at-home therapies because the Golden Gate Regional Center, which coordinates early intervention services in San Francisco, San Mateo and Marin counties, couldn’t find providers willing to see children there.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“The regional center has flat-out told them and told us that there’s no providers who will go to your neighborhood,” she said. “Families who are well-resourced and live in nicer areas, those are the only families who are getting that care in their natural environment, even though [they don’t have] the most need.”\u003c/p>\n\u003cp>Child care centers in the Tenderloin are also impacted.\u003c/p>\n\u003cp>Heidi Lamar, director of Compass Children’s Center, said when she noticed a therapist had stopped showing up to work with a child, she reached out to a case manager at Golden Gate Regional Center or GGRC.\u003c/p>\n\u003cp>The case manager replied in an email message to Lamar: “The provider is not coming anymore because she was shoved onto the sidewalk by someone on the street while walking to Compass. She had previously been yelled at, cursed at, and followed by a man on a bicycle while walking to Compass on another occasion.”\u003c/p>\n\u003cp>The case manager acknowledged increased difficulty finding providers willing to go to the Tenderloin.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“We can’t compel therapists to provide services in situations where they don’t feel safe,” the case manager wrote. “We just keep our fingers crossed that the providers don’t drop the families entirely.”\u003c/p>\n\u003cp>The Tenderloin has long been plagued by drug dealing, homelessness and mental illness — conditions that residents and business owners say \u003ca href=\"https://www.sfchronicle.com/sf/article/tenderloin-little-saigon-homeless-18601130.php\">have worsened since the pandemic\u003c/a>, despite city efforts to increase safety in the area.\u003c/p>\n\u003cp>It’s also a refuge for thousands of lower-income and immigrant families who come seeking affordable housing and social support from organizations like Compass. Another child care center — Wu Yee Children’s Services — hires a “street usher” to escort kids to playgrounds in the neighborhood.\u003c/p>\n\u003cp>“I’m sure you’ve seen in the news our neighborhood is struggling. There were two daytime shootings outside our school building in the last few months,” Lamar said. “But this is where we work every day; this is where our children and our families live. We have to serve them. We have to find a way.”\u003c/p>\n\u003cp>Frustrated by the delay in services, Lamar hired a speech and language pathologist to work on-site with children who have difficulty communicating.\u003c/p>\n\u003cp>Another parent, Ashley Chac, said she waited nine months to get a GGRC coordinator to respond to her request for occupational and physical therapy for her 1 1/2-year-old daughter.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Chac said she’s upset about missing early intervention during a stage when it can make the greatest impact on her daughter’s development.\u003c/p>\n\u003cp>“Time is of the essence for her,” Chac said. “I’m mad that we fell through the cracks.”\u003c/p>\n\u003cp>Eric Zigman, executive director of the GGRC, said he’s keenly aware of providers’ reluctance to serve certain neighborhoods and calls it a distressing situation. He said his hands are tied as long as the state pays providers less than the market rate for their services.\u003c/p>\n\u003cp>“Until those rates are changed, we can’t control every action of every provider,” Zigman said.\u003c/p>\n\u003cp>Inadequate funding and a shortage of providers have limited regional centers’ ability to improve access and delivery of Early Start services, according to \u003ca href=\"https://calbudgetcenter.org/resources/california-can-better-support-infants-toddlers-with-disabilities-or-developmental-delays/\">a 2022 analysis of the program by the California Budget & Policy Center\u003c/a>.\u003c/p>\n\u003cp>Early Start’s problems have raised enough of a concern that the federal Office of Special Education Programs deemed California “\u003ca href=\"https://sites.ed.gov/idea/idea-files/2023-spp-apr-and-state-determination-letters-part-c-california/\">needs assistance\u003c/a>” to improve outcomes for children who receive early intervention services.\u003c/p>\n\u003ch2>Pushing back against Zoom therapy\u003c/h2>\n\u003cp>Advocates say that a growing reliance on telehealth is also leading to substandard care.\u003c/p>\n\u003cp>California allowed remote delivery of early intervention services at the beginning of the pandemic to ensure children continued to receive care. But as the threat of COVID-19 subsided, advocates said the practice continued.\u003c/p>\n\u003cp>Intervening early and in the child’s home should be the “gold standard,” said Amy Westling, executive director of the Association of Regional Center Agencies. However, the regional centers have a hard time finding providers and paying them a competitive rate, she said.\u003c/p>\n\u003cp>“If the service can’t be provided in the natural environment or we can’t identify a provider to do so, we don’t want to say then, ‘We’re not going to offer some alternative,’” Westling said.\u003c/p>\n\u003cp>Left without choices, Balladares tried virtual therapy, but she couldn’t get her foster daughter to focus or respond to the therapist. She said children need to form relationships in person in order to learn.\u003c/p>\n\u003cp>“Nothing replaces a person-to-person relationship, especially for a child,” she said.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>In the end, Balladares had to cut back her work hours to take the girl to multiple appointments at different clinics each week.\u003c/p>\n\u003cp>“Running with [her] from one place to another, sometimes trying to make two different appointments in one day … then rushing home to prepare our meals,” she said. “She was exhausted, and so was I.”\u003c/p>\n\u003cp>After two years of therapies, Balladares said, the toddler hasn’t made as much progress as she hoped. After turning 3 last month, she is no longer eligible to receive services under Early Start and will require more therapies through the San Francisco Unified School District.\u003c/p>\n\u003cp>Critics say some therapists or their agencies are exploiting a loophole in the law that allows telehealth services if the child’s parents or guardians agree to the arrangement.\u003c/p>\n\u003cp>“How people took advantage of that was they said to the parent, ‘We can see your child next week virtually, but if we see them in person, it will take several months,’” said Elaine Westlake, a physical therapist who has been demanding a clearer policy on the use of telehealth for Early Start services. “So, of course, the parent says, ‘Well, I guess virtual.’”\u003c/p>\n\u003cp>Westlake said she saw a growing problem when parents in the Tenderloin wondered why she was the only therapist making home visits while others offered their services remotely. She thinks providers are leaning on telehealth because it saves on travel time. What’s more, Medi-Cal pays the same amount whether services are delivered remotely or in person.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“It’s plain economics because you can see one child after the other [via telehealth],” Westlake said.\u003c/p>\n\u003cp>Westlake said she is not compensated for the time she spends driving to a child’s home or daycare for each physical therapy appointment. She’s seen the positive impact of that effort. Two recent patients were born prematurely and spent months in neonatal intensive-care units.\u003c/p>\n\u003cp>“When they came home from the hospital, the parents were afraid to even move them,” Westlake said. Now, she said, both children are walking, running and climbing.\u003c/p>\n\u003cp>“That never would have happened if I had not seen them in person,” Westlake said.\u003c/p>\n\u003cp>New York’s health department recently \u003ca href=\"https://www.health.ny.gov/community/infants_children/early_intervention/docs/eip_telehealth_guidance_document.pdf\">issued guidance on using telehealth\u003c/a> after the state’s comptroller \u003ca href=\"https://www.health.ny.gov/community/infants_children/early_intervention/docs/eip_telehealth_guidance_document.pdf\">issued an audit\u003c/a> that found many eligible children didn’t receive early intervention services or faced delays. The guidance lays out scenarios where telehealth is allowed and requires that early intervention providers document how they delivered the services.\u003c/p>\n\u003cp>Lawmakers there are also considering a 5% increase in payments for in-person services and an extra 4% for serving hard-to-reach or underserved areas.\u003c/p>\n\u003cp>In Northern California, a pilot project funded by the American Rescue Plan aimed at boosting in-person therapies showed promising results, according to Lori Banales, executive director of Alta California Regional Center, which serves Sacramento and nine surrounding counties.\u003c/p>\n\u003cfigure id=\"attachment_11978893\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11978893 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240309-EARLY-START-DEVELOPMENTAL-DELAYS-MD-01-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240309-EARLY-START-DEVELOPMENTAL-DELAYS-MD-01-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240309-EARLY-START-DEVELOPMENTAL-DELAYS-MD-01-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240309-EARLY-START-DEVELOPMENTAL-DELAYS-MD-01-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240309-EARLY-START-DEVELOPMENTAL-DELAYS-MD-01-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240309-EARLY-START-DEVELOPMENTAL-DELAYS-MD-01-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/03/240309-EARLY-START-DEVELOPMENTAL-DELAYS-MD-01-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Reyna Balladares and her 3-year-old foster child in San Francisco on March 9, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The project offered $200 incentives for therapies done in underserved areas, in languages other than English or during hours that would accommodate parents’ work schedules, Banales said. Furthermore, $10,000 internship grants also helped early intervention providers to hire more bilingual therapists.\u003c/p>\n\u003cp>“We know that this works. Money does talk,” she said.\u003c/p>\n\u003cp>While California has been gradually raising reimbursement rates for providers, Gov. Gavin Newsom wants to delay fully funding the increases to save $1 billion in the next budget year as he moves to close a $38 billion shortfall. That would hinder ongoing efforts to grow the workforce and could lead to longer waits for services, according to\u003ca href=\"https://lao.ca.gov/reports/2024/4837/DDS-Budget-021324.pdf\"> a report by the state Legislative Analyst’s Office\u003c/a>.\u003c/p>\u003c/div>",
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"content": "‘The very rapid growth puts a lot of pressure on a system where there’s just not enough clinicians. So I think there’s a lot of work to be done to close some of those gaps at this point.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Some recent policy changes included hiring more regional center coordinators to lower caseloads and expanding eligibility for Early Start services, which is expected to add 10% more children into a program currently serving 56,000 infants and toddlers.\u003c/p>\n\u003cp>Westling said that’s a lot of change all at once.\u003c/p>\n\u003cp>“The very rapid growth puts a lot of pressure on a system where there’s just not enough clinicians,” she said. “So, I think there’s a lot of work to be done to close some of those gaps at this point.”\u003c/p>\n\u003cp>Until reform takes hold, Westlake urges her fellow therapists to uphold their code of ethics and care for kids in their natural environments — just as they did before telehealth came along.\u003c/p>\n\u003cp>“We did it before, and we can certainly do it again,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>The rate of overdose deaths in San Francisco remained steady in the first two months of 2024, according to data released Monday from the Office of the Chief Medical Examiner.\u003c/p>\n\u003cp>The new data shows there were 131 overdose deaths in San Francisco between January and February of this year. That’s compared to 136 overdose deaths over the same period a year ago. There were 811 overdose deaths in San Francisco in all of 2023.\u003c/p>\n\u003cp>Most of these overdoses involved fentanyl, an opioid about 50 times stronger than heroin. But many people who die from an overdose in the city are combining substances with fentanyl, like methamphetamine or cocaine.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Hillary Kunins, director, Behavioral Health and Mental Health SF\"]‘We want everyone to know, even though addiction is a chronic illness, recovery is possible.’[/pullquote]In response, city health officials say they are expanding opportunities for contingency management, a positive-reinforcement-based model that’s primarily used for adjusting methamphetamine and cocaine use.\u003c/p>\n\u003cp>“Recovering from stimulants improves an individual’s health and reduces their overall risk of overdose,” Christy Soran, deputy medical director of substance use services for the Department of Public Health, told reporters on Tuesday.\u003c/p>\n\u003cp>Unlike opioid addiction or alcoholism, there are no government-approved medications for stimulant-use disorder. Contingency management offers another option. People participating typically attend weekly or regular meetings with a group and counselor, and they take a drug test for the substance they are targeting. If the test is negative, a small stipend, such as a gift card, is offered.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" title=\"Percent of overdoses in Jan. – Feb. 2024 involving at least this drug\n\" aria-label=\"Bar Chart\" id=\"datawrapper-chart-df81A\" src=\"https://datawrapper.dwcdn.net/df81A/3/\" scrolling=\"no\" frameborder=\"0\" style=\"border: none;\" width=\"600\" height=\"321\" data-external=\"1\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6768930/\">Veterans Affairs\u003c/a> has used contingency management for decades. A \u003ca href=\"https://www.sciencedirect.com/science/article/abs/pii/S0376871618300784\">2018 study\u003c/a> found that, on average, VA patients attended more than half of their counseling sessions, and 91% of participants tested negative for the targeted substance.\u003c/p>\n\u003cp>[aside postID=\"news_11965813,news_11972898,news_11967618\" label=\"Related Stories\"]San Francisco’s embrace of contingency management is not new. But its expansion comes alongside statewide efforts to grow access to the model.\u003c/p>\n\u003cp>In 2021, California became the first state to cover contingency management through Medi-Cal.\u003c/p>\n\u003cp>The state has also allocated $58.5 million to pilot contingency management programs in \u003ca href=\"https://www.dhcs.ca.gov/Pages/DMC-ODS-Contingency-Management.aspx\">nearly two dozen other California counties\u003c/a>. In those programs, each patient receives a maximum of $599 over six months, after which they are referred for follow-up recovery programs and services.\u003c/p>\n\u003cp>Locally, the San Francisco Department of Public Health provides contingency management at the \u003ca href=\"https://citywide.ucsf.edu/stimulant-treatment-outpatient-program-stop\">Citywide Clinic’s Stimulant Treatment Outpatient Program\u003c/a>, the \u003ca href=\"https://psych.ucsf.edu/news/office-based-buprenorphine-induction-clinics-work-highlighted-national-magazine\">Office-Based Buprenorphine Induction Clinic\u003c/a> and \u003ca href=\"https://sf.gov/reports/october-2022/overdose-prevention-plan-2022\">Project HOUDINI LINK\u003c/a>. The San Francisco AIDS Foundation and others also provide similar programs.\u003c/p>\n\u003cp>Meanwhile, San Francisco has been working to increase opioid addiction treatments like buprenorphine or methadone medications as overdose deaths have remained at epidemic levels.\u003c/p>\n\u003cp>“These medications, specifically buprenorphine and methadone, each reduce a person’s risk of dying by approximately 50%,” Hillary Kunins, director of Behavioral Health and Mental Health SF for the San Francisco Department of Public Health, said on Tuesday to reporters. “I really cannot understate the effectiveness of these medications. They save lives, and they are within every person’s reach.”\u003c/p>\n\u003cp>Buprenorphine is available across the San Francisco Health Network, including in primary care and hospital settings.\u003c/p>\n\u003cp>“We want everyone to know, even though addiction is a chronic illness, recovery is possible,” Kunins said. “There is a way out of addiction and into a healthier life.”\u003cbr>\n[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>In response, city health officials say they are expanding opportunities for contingency management, a positive-reinforcement-based model that’s primarily used for adjusting methamphetamine and cocaine use.\u003c/p>\n\u003cp>“Recovering from stimulants improves an individual’s health and reduces their overall risk of overdose,” Christy Soran, deputy medical director of substance use services for the Department of Public Health, told reporters on Tuesday.\u003c/p>\n\u003cp>Unlike opioid addiction or alcoholism, there are no government-approved medications for stimulant-use disorder. Contingency management offers another option. People participating typically attend weekly or regular meetings with a group and counselor, and they take a drug test for the substance they are targeting. If the test is negative, a small stipend, such as a gift card, is offered.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" title=\"Percent of overdoses in Jan. – Feb. 2024 involving at least this drug\n\" aria-label=\"Bar Chart\" id=\"datawrapper-chart-df81A\" src=\"https://datawrapper.dwcdn.net/df81A/3/\" scrolling=\"no\" frameborder=\"0\" style=\"border: none;\" width=\"600\" height=\"321\" data-external=\"1\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6768930/\">Veterans Affairs\u003c/a> has used contingency management for decades. A \u003ca href=\"https://www.sciencedirect.com/science/article/abs/pii/S0376871618300784\">2018 study\u003c/a> found that, on average, VA patients attended more than half of their counseling sessions, and 91% of participants tested negative for the targeted substance.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>San Francisco’s embrace of contingency management is not new. But its expansion comes alongside statewide efforts to grow access to the model.\u003c/p>\n\u003cp>In 2021, California became the first state to cover contingency management through Medi-Cal.\u003c/p>\n\u003cp>The state has also allocated $58.5 million to pilot contingency management programs in \u003ca href=\"https://www.dhcs.ca.gov/Pages/DMC-ODS-Contingency-Management.aspx\">nearly two dozen other California counties\u003c/a>. In those programs, each patient receives a maximum of $599 over six months, after which they are referred for follow-up recovery programs and services.\u003c/p>\n\u003cp>Locally, the San Francisco Department of Public Health provides contingency management at the \u003ca href=\"https://citywide.ucsf.edu/stimulant-treatment-outpatient-program-stop\">Citywide Clinic’s Stimulant Treatment Outpatient Program\u003c/a>, the \u003ca href=\"https://psych.ucsf.edu/news/office-based-buprenorphine-induction-clinics-work-highlighted-national-magazine\">Office-Based Buprenorphine Induction Clinic\u003c/a> and \u003ca href=\"https://sf.gov/reports/october-2022/overdose-prevention-plan-2022\">Project HOUDINI LINK\u003c/a>. The San Francisco AIDS Foundation and others also provide similar programs.\u003c/p>\n\u003cp>Meanwhile, San Francisco has been working to increase opioid addiction treatments like buprenorphine or methadone medications as overdose deaths have remained at epidemic levels.\u003c/p>\n\u003cp>“These medications, specifically buprenorphine and methadone, each reduce a person’s risk of dying by approximately 50%,” Hillary Kunins, director of Behavioral Health and Mental Health SF for the San Francisco Department of Public Health, said on Tuesday to reporters. “I really cannot understate the effectiveness of these medications. They save lives, and they are within every person’s reach.”\u003c/p>\n\u003cp>Buprenorphine is available across the San Francisco Health Network, including in primary care and hospital settings.\u003c/p>\n\u003cp>“We want everyone to know, even though addiction is a chronic illness, recovery is possible,” Kunins said. “There is a way out of addiction and into a healthier life.”\u003cbr>\n\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cem>\u003ca href=\"https://www.kqed.org/liveblog/election-2024\">\u003cstrong>Primary Election 2024 Live Updates: Follow KQED reporters as we cover election results from across California and the Bay Area.\u003c/strong>\u003c/a>\u003c/em>\u003c/p>\n\u003cp>California voters on Tuesday appear to be supportive of Proposition 1, a landmark reform to the state’s mental health funding and a top priority for Gov. Gavin Newsom.\u003c/p>\n\u003cp>At last count, 53% of voters supported the measure, which will fund new treatment facilities and earmark existing mental health funding for housing. That’s with about 38% of votes tallied. It passes with a majority vote.\u003c/p>\n\u003cp>Newsom crafted Proposition 1 to focus on a specific subset of Californians experiencing homelessness: those with severe mental health or substance abuse challenges. The governor called it the last piece of his reforms to programs at the intersection of homelessness and behavioral health — following the creation of a civil court system that allows judges to order people into treatment and housing for residents with severe mental illness, and a subsequent expansion of the state’s conservatorship law.\u003c/p>\n\u003cp>Proposition 1 included a $6.38 billion bond to fund the construction of residential care facilities and supportive housing — including apartments with wrap-around services dedicated for veterans. It also would changed the Mental Health Services Act, approved by voters in 2004, by shifting money from California counties and mental health service providers toward the construction of housing and care facilities. It also would expanded the class of people who are eligible under the act to include Californians with substance abuse issues who don’t have a mental health diagnosis.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Supporters said the measure will finally provide the stable shelter for unhoused Californians with mental illness that disappeared when the state closed its controversial mental health hospitals in the 1960s and 1970s. A \u003ca href=\"https://www.kqed.org/forum/2010101893673/what-ucsfs-statewide-homelessness-study-found-out-about-the-causes-of-californias-crisis\">statewide survey of Californians experiencing homelessness\u003c/a> published last year by UCSF found 27% of participants had been hospitalized for a mental health condition.\u003c/p>\n\u003cp>But the measure faced opposition from fiscal conservatives over the size of the bond. Meanwhile, mental health service providers feared the new emphasis on housing would lead to less funding for less visible programs, such as peer support groups or drop-in counseling. And civil liberties advocates worried that too many of the new treatment facilities would be restrictive, locked beds.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Big donors across the state poured $21.6 million into the Yes on Prop 1 campaign, including Uber, the Federated Indians of Graton Rancheria, Kaiser Permanente and influential groups representing correctional officers and hospitals. Their shared interest? A desire to build facilities for Californians who often end up in emergency rooms and correctional facilities — and just as likely, a chance to contribute to a political victory for the governor.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>\u003ca href=\"https://www.kqed.org/liveblog/election-2024\">\u003cstrong>Primary Election 2024 Live Updates: Follow KQED reporters as we cover election results from across California and the Bay Area.\u003c/strong>\u003c/a>\u003c/em>\u003c/p>\n\u003cp>California voters on Tuesday appear to be supportive of Proposition 1, a landmark reform to the state’s mental health funding and a top priority for Gov. Gavin Newsom.\u003c/p>\n\u003cp>At last count, 53% of voters supported the measure, which will fund new treatment facilities and earmark existing mental health funding for housing. That’s with about 38% of votes tallied. It passes with a majority vote.\u003c/p>\n\u003cp>Newsom crafted Proposition 1 to focus on a specific subset of Californians experiencing homelessness: those with severe mental health or substance abuse challenges. The governor called it the last piece of his reforms to programs at the intersection of homelessness and behavioral health — following the creation of a civil court system that allows judges to order people into treatment and housing for residents with severe mental illness, and a subsequent expansion of the state’s conservatorship law.\u003c/p>\n\u003cp>Proposition 1 included a $6.38 billion bond to fund the construction of residential care facilities and supportive housing — including apartments with wrap-around services dedicated for veterans. It also would changed the Mental Health Services Act, approved by voters in 2004, by shifting money from California counties and mental health service providers toward the construction of housing and care facilities. It also would expanded the class of people who are eligible under the act to include Californians with substance abuse issues who don’t have a mental health diagnosis.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Supporters said the measure will finally provide the stable shelter for unhoused Californians with mental illness that disappeared when the state closed its controversial mental health hospitals in the 1960s and 1970s. A \u003ca href=\"https://www.kqed.org/forum/2010101893673/what-ucsfs-statewide-homelessness-study-found-out-about-the-causes-of-californias-crisis\">statewide survey of Californians experiencing homelessness\u003c/a> published last year by UCSF found 27% of participants had been hospitalized for a mental health condition.\u003c/p>\n\u003cp>But the measure faced opposition from fiscal conservatives over the size of the bond. Meanwhile, mental health service providers feared the new emphasis on housing would lead to less funding for less visible programs, such as peer support groups or drop-in counseling. And civil liberties advocates worried that too many of the new treatment facilities would be restrictive, locked beds.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Big donors across the state poured $21.6 million into the Yes on Prop 1 campaign, including Uber, the Federated Indians of Graton Rancheria, Kaiser Permanente and influential groups representing correctional officers and hospitals. Their shared interest? A desire to build facilities for Californians who often end up in emergency rooms and correctional facilities — and just as likely, a chance to contribute to a political victory for the governor.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Death Rate Among America's Unhoused Population Akin to 'Natural Disaster or War,' New Study Finds",
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"content": "\u003cp>For many people, living on the streets of California is a death sentence.\u003c/p>\n\u003cp>That’s according to a \u003ca href=\"https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2023.01039\">recent study\u003c/a> that took the first deep look into mortality rates in unhoused communities throughout the country. It found the death rate more than tripled between 2011 and 2020. The findings make clear that as the number of unhoused Californians is soaring, it’s also becoming more dangerous to be unhoused. And it means the stakes are sky-high when it comes to state and local efforts to combat the crisis: People’s lives are on the line.\u003c/p>\n\u003cp>The study’s co-author, Matthew Fowle of the University of Pennsylvania, said the 238% increase was “astonishing.”\u003c/p>\n\u003cp>“It’s unlike any other mortality trend that we really see in demography,” he said. “It’s comparable to something like a natural disaster or war.”[pullquote align=\"right\" size=\"medium\" citation=\"Dr. Margot Kushel, director of UCSF Benioff Homelessness and Housing Initiative\"]‘There is increasing evidence that you can prevent a lot of these deaths just by getting people housed.’[/pullquote]Overdoses played a major role in the deaths studied. But people also are dying at increased rates of things that might be avoided if they had a home or regular access to preventative medical care, such as exposure to heat and cold, traffic injuries, cardiovascular disease and diabetes.\u003c/p>\n\u003cp>“It’s just so hard to do that when you’re living on the streets or living in a shelter,” said Fowle, a postdoctoral fellow at the university’s Housing Initiative at Penn program. “Your main concern is, ‘Can I stay warm and dry for the night? Can I get enough food to eat?’ You can’t think about these other longer-term things that might be affecting your health until, in many cases, it’s too late.”\u003c/p>\n\u003cp>Some of the increase in the mortality rate may be attributable to county death records keeping better track of who is unhoused, Fowle said. Other than that, he and his team aren’t sure what else is behind the rising death rates — more research is needed, he said.\u003c/p>\n\u003cp>“Clearly, something is occurring across the country,” Fowle said.\u003c/p>\n\u003cp>The study, published this month in the health policy research journal Health Affairs, appears to be the first to look at death rates and causes of death in homeless communities nationwide. Data on this subject is spotty, as the feds and most states (including California) don’t require medical examiners to list someone’s housing status in their death records.\u003c/p>\n\u003cp>Fowle’s study looked at 22,143 deaths of unhoused residents in 22 localities across 10 states and Washington, D.C. — including eight California counties. The death rate among unhoused residents across all 22 localities increased from 814 per 100,000 in 2011 to 2,752 per 100,000 in 2020.\u003c/p>\n\u003cp>Among the general population, the nationwide mortality rate was much lower: 1,027 deaths per 100,000 people in 2020, \u003ca href=\"https://wonder.cdc.gov/controller/datarequest/D158;jsessionid=1D9C4FFB8CB6C9272489654C4B6A\">according to the Centers for Disease Control and Prevention\u003c/a>.\u003c/p>\n\u003cp>In California, the study looked at Alameda, Los Angeles, Orange, Sacramento, San Diego, San Mateo, Santa Clara and Solano counties. In those counties, the mortality rate more than doubled between 2015 and 2020. Some of those counties didn’t start collecting data until 2015.\u003c/p>\n\u003cp>Like most information on unhoused populations, the data has limitations. For example, it uses mortality rates based on the \u003ca href=\"https://calmatters.org/housing/2024/01/california-homeless-point-in-time-count-2024/\">federally mandated point-in-time population counts\u003c/a>, which are inexact estimates of the country’s homeless communities.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Nationwide, drug and alcohol overdoses were the leading cause of fatalities among unhoused people, accounting for nearly a third of all deaths. Overdoses caused 986 deaths per 100,000 unhoused people in 2020, a 488% increase from 2011.\u003c/p>\n\u003cp>The \u003ca href=\"https://calmatters.org/explainers/california-opioid-crisis/\">opioid crisis and the increased prevalence of fentanyl\u003c/a> played a huge role in those numbers, Fowle said. But deaths also may be driven by \u003ca href=\"https://calmatters.org/housing/2023/04/california-homeless-city-laws/\">new efforts throughout California and beyond to crack down on people sleeping in public places\u003c/a>, he said. When people use drugs in a homeless encampment surrounded by people they know and trust, or even alone on a busy downtown street, there’s a greater chance someone will see them and intervene if they overdose. If law enforcement breaks up their camps and pushes them out of downtown, they often go to isolated areas such as creek beds, where they’re harder to help in an emergency.\u003c/p>\n\u003cp>When someone is displaced from their camp, they also become less able to access a safe supply of drugs — putting them at greater risk for consuming something laced with fentanyl, said Dr. Margot Kushel, director of the UCSF Benioff Homelessness and Housing Initiative.\u003c/p>\n\u003cp>Another reason being homeless has become more deadly? The homeless population is getting older, Kushel said.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/health/2023/02/california-homeless-seniors/\">The number of Californians 55 and older who sought homelessness services soared 84% between 2017 and 2021\u003c/a>, according to the state’s Homeless Data Integration System. That’s compared to a 43% increase across all age groups. In other words, more people older than 50 are becoming unhoused for the first time.\u003c/p>\n\u003cp>“As the homeless population continues to age, you’re just going to see death rates keep going up and up and up,” Kushel said. “You expect that, and it’s horrendous.”[aside label=\"more homelessness coverage\" tag=\"homelessness\"]The average age of death in the University of Pennsylvania study was 51 — more than 27 years younger than the average U.S. life expectancy during that period.\u003c/p>\n\u003cp>Deaths attributed to cardiovascular disease, the second-leading cause of death, increased 172% between 2011 and 2020. Other causes that saw major increases include diabetes, infection, cancer, homicide and exposure.\u003c/p>\n\u003cp>Being homeless is incredibly bad for your health, Kushel said. As soon as someone loses their housing, everything else starts to fall apart. Drug use tends to get worse, people lose the medication that treats their chronic illnesses, and they don’t go to the doctor for preventative care because they’re too busy worrying about where they’ll sleep or what they’ll eat. That means something like a small infection can turn life-threatening quickly.\u003c/p>\n\u003cp>And once someone is diagnosed with a serious illness, treatment is much harder on the street. A \u003ca href=\"https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2023.01003\">recent study of veterans with cancer, co-authored by Kushel\u003c/a>, found that those without housing were 10% to 20% more likely to die than those with housing. And among formerly unhoused veterans who had since found housing, the risk of dying plummeted, the study found.\u003c/p>\n\u003cp>“There is increasing evidence that you can prevent a lot of these deaths just by getting people housed,” Kushel said.\u003c/p>\n\u003cp>Clinicians who treat people on the street watch in real time as conditions for their patients become more deadly. Whenever outreach workers call Dr. Susan Partovi, medical director of Homeless Health Care Los Angeles and author of the memoir \u003cem>Renegade MD\u003c/em>, the first thing she asks is, “Who died?”\u003c/p>\n\u003cp>All too often, it’s someone she knew.\u003c/p>\n\u003cp>“It’s really heartbreaking when you know someone, and you know their humor, and you know their dreams, and you know their past history, and you know their ups and downs in life,” she said. “And you’re kind of in the trenches with them and their struggles. And then they die. It’s just so disheartening. It’s just so sad.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Overdoses played a major role in the deaths studied. But people also are dying at increased rates of things that might be avoided if they had a home or regular access to preventative medical care, such as exposure to heat and cold, traffic injuries, cardiovascular disease and diabetes.\u003c/p>\n\u003cp>“It’s just so hard to do that when you’re living on the streets or living in a shelter,” said Fowle, a postdoctoral fellow at the university’s Housing Initiative at Penn program. “Your main concern is, ‘Can I stay warm and dry for the night? Can I get enough food to eat?’ You can’t think about these other longer-term things that might be affecting your health until, in many cases, it’s too late.”\u003c/p>\n\u003cp>Some of the increase in the mortality rate may be attributable to county death records keeping better track of who is unhoused, Fowle said. Other than that, he and his team aren’t sure what else is behind the rising death rates — more research is needed, he said.\u003c/p>\n\u003cp>“Clearly, something is occurring across the country,” Fowle said.\u003c/p>\n\u003cp>The study, published this month in the health policy research journal Health Affairs, appears to be the first to look at death rates and causes of death in homeless communities nationwide. Data on this subject is spotty, as the feds and most states (including California) don’t require medical examiners to list someone’s housing status in their death records.\u003c/p>\n\u003cp>Fowle’s study looked at 22,143 deaths of unhoused residents in 22 localities across 10 states and Washington, D.C. — including eight California counties. The death rate among unhoused residents across all 22 localities increased from 814 per 100,000 in 2011 to 2,752 per 100,000 in 2020.\u003c/p>\n\u003cp>Among the general population, the nationwide mortality rate was much lower: 1,027 deaths per 100,000 people in 2020, \u003ca href=\"https://wonder.cdc.gov/controller/datarequest/D158;jsessionid=1D9C4FFB8CB6C9272489654C4B6A\">according to the Centers for Disease Control and Prevention\u003c/a>.\u003c/p>\n\u003cp>In California, the study looked at Alameda, Los Angeles, Orange, Sacramento, San Diego, San Mateo, Santa Clara and Solano counties. In those counties, the mortality rate more than doubled between 2015 and 2020. Some of those counties didn’t start collecting data until 2015.\u003c/p>\n\u003cp>Like most information on unhoused populations, the data has limitations. For example, it uses mortality rates based on the \u003ca href=\"https://calmatters.org/housing/2024/01/california-homeless-point-in-time-count-2024/\">federally mandated point-in-time population counts\u003c/a>, which are inexact estimates of the country’s homeless communities.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Nationwide, drug and alcohol overdoses were the leading cause of fatalities among unhoused people, accounting for nearly a third of all deaths. Overdoses caused 986 deaths per 100,000 unhoused people in 2020, a 488% increase from 2011.\u003c/p>\n\u003cp>The \u003ca href=\"https://calmatters.org/explainers/california-opioid-crisis/\">opioid crisis and the increased prevalence of fentanyl\u003c/a> played a huge role in those numbers, Fowle said. But deaths also may be driven by \u003ca href=\"https://calmatters.org/housing/2023/04/california-homeless-city-laws/\">new efforts throughout California and beyond to crack down on people sleeping in public places\u003c/a>, he said. When people use drugs in a homeless encampment surrounded by people they know and trust, or even alone on a busy downtown street, there’s a greater chance someone will see them and intervene if they overdose. If law enforcement breaks up their camps and pushes them out of downtown, they often go to isolated areas such as creek beds, where they’re harder to help in an emergency.\u003c/p>\n\u003cp>When someone is displaced from their camp, they also become less able to access a safe supply of drugs — putting them at greater risk for consuming something laced with fentanyl, said Dr. Margot Kushel, director of the UCSF Benioff Homelessness and Housing Initiative.\u003c/p>\n\u003cp>Another reason being homeless has become more deadly? The homeless population is getting older, Kushel said.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/health/2023/02/california-homeless-seniors/\">The number of Californians 55 and older who sought homelessness services soared 84% between 2017 and 2021\u003c/a>, according to the state’s Homeless Data Integration System. That’s compared to a 43% increase across all age groups. In other words, more people older than 50 are becoming unhoused for the first time.\u003c/p>\n\u003cp>“As the homeless population continues to age, you’re just going to see death rates keep going up and up and up,” Kushel said. “You expect that, and it’s horrendous.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The average age of death in the University of Pennsylvania study was 51 — more than 27 years younger than the average U.S. life expectancy during that period.\u003c/p>\n\u003cp>Deaths attributed to cardiovascular disease, the second-leading cause of death, increased 172% between 2011 and 2020. Other causes that saw major increases include diabetes, infection, cancer, homicide and exposure.\u003c/p>\n\u003cp>Being homeless is incredibly bad for your health, Kushel said. As soon as someone loses their housing, everything else starts to fall apart. Drug use tends to get worse, people lose the medication that treats their chronic illnesses, and they don’t go to the doctor for preventative care because they’re too busy worrying about where they’ll sleep or what they’ll eat. That means something like a small infection can turn life-threatening quickly.\u003c/p>\n\u003cp>And once someone is diagnosed with a serious illness, treatment is much harder on the street. A \u003ca href=\"https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2023.01003\">recent study of veterans with cancer, co-authored by Kushel\u003c/a>, found that those without housing were 10% to 20% more likely to die than those with housing. And among formerly unhoused veterans who had since found housing, the risk of dying plummeted, the study found.\u003c/p>\n\u003cp>“There is increasing evidence that you can prevent a lot of these deaths just by getting people housed,” Kushel said.\u003c/p>\n\u003cp>Clinicians who treat people on the street watch in real time as conditions for their patients become more deadly. Whenever outreach workers call Dr. Susan Partovi, medical director of Homeless Health Care Los Angeles and author of the memoir \u003cem>Renegade MD\u003c/em>, the first thing she asks is, “Who died?”\u003c/p>\n\u003cp>All too often, it’s someone she knew.\u003c/p>\n\u003cp>“It’s really heartbreaking when you know someone, and you know their humor, and you know their dreams, and you know their past history, and you know their ups and downs in life,” she said. “And you’re kind of in the trenches with them and their struggles. And then they die. It’s just so disheartening. It’s just so sad.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "'Another Path': San Mateo County to Launch Unarmed Mental Health Crisis Response Program",
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"content": "\u003cp>San Mateo County is launching an unarmed mobile response team program to address an array of mental health crises without involving law enforcement.\u003c/p>\n\u003cp>County supervisors on Tuesday unanimously approved a $4.9 million contract with Alameda-based Telecare Corporation to provide the service through June 2025.\u003c/p>\n\u003cp>“There are many people in the community that are afraid or more agitated when they interact with law enforcement, and this response model addresses that and provides another path,” District 2 Supervisor Noelia Corzo told KQED, noting that county residents have requested this service for years.\u003c/p>\n\u003cp>The program is set to launch in May, initially with one team active on weekday nights. By August, it’s expected to scale up to five teams working 24/7, with two additional teams on call.\u003c/p>\n\u003cp>Teams are expected to include one behavioral health clinician and one “peer support specialist” trained in de-escalation and crisis intervention.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Working independently of law enforcement, teams will be tasked with responding to mental health-related calls anywhere in the county and connecting people to appropriate services.\u003c/p>\n\u003cp>Each team will also carry and be trained to administer the opioid overdose-reversal drug naloxone.\u003c/p>\n\u003cp>Corzo said she thinks the program could have prevented \u003ca href=\"https://www.kqed.org/news/11696828/san-mateo-d-a-says-man-who-died-after-deputy-tased-him-was-unarmed\">the death of Chinedu Okobi\u003c/a>, a 36-year-old unarmed man from Redwood City with a history of mental health issues who was killed during an interaction with law enforcement in 2018.\u003c/p>\n\u003cp>“Had this service been available, I think the outcome would have been different,” she said.\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"mental-health-crisis\"]Sheriff’s deputies used a Taser on Okobi multiple times during a struggle that began when they saw him jaywalking on a busy street in Millbrae. He became unresponsive after deputies restrained him.\u003c/p>\n\u003cp>An autopsy revealed he had died of cardiac arrest, partially attributed to the Taser shocks — the \u003ca href=\"https://www.mercurynews.com/2019/02/12/redwood-city-axon-defends-taser-safety-at-supes-meeting-after-3-deaths-last-year/\">third person in the county that year to die after being Tased by law enforcement.\u003c/a>\u003c/p>\n\u003cp>Okobi’s family eventually \u003ca href=\"https://sfstandard.com/2023/02/06/bay-area-taser-death-leads-to-massive-payout-as-nation-mourns-police-killings/\">settled a lawsuit with the county for $4.5 million\u003c/a>.\u003c/p>\n\u003cp>The crisis response program will build on \u003ca href=\"https://sanmateocrisis.org/transparency\">existing services\u003c/a> available in different parts of the county, in which behavioral health professionals go along with law enforcement officers on certain calls. Additionally, a countywide mobile crisis team for youth currently responds to certain mental health-related calls involving people who are 25 and under.\u003c/p>\n\u003cp>Coordinating the various services and dispatching the appropriate response will be key to making this program effective, according to Jei Africa, the county’s director of Behavioral Health and Recovery Services.\u003c/p>\n\u003cp>“The coordination piece is really the challenge right now we’re trying to face,” Africa said during Tuesday’s meeting. “When we get the call, which is the most appropriate response? Which is the quickest response?”\u003c/p>\n\u003cp>Calls to the program will be routed through local nonprofit StarVista’s crisis call center, which operates a 24/7 hotline and fields an average of more than 1,000 calls a month. A new phone number will also be launched for the mobile crisis response team, with the goal of eventually re-routing all relevant 911 and 988 (national suicide prevention hotline) calls back to the team.\u003c/p>\n\u003cp>The new program comes on the heels of \u003ca href=\"https://www.dhcs.ca.gov/Documents/Mobile-Crisis-FAQ.pdf\">a state policy\u003c/a> enacted last June requiring counties that deliver Medi-Cal services to provide mobile crisis response teams to address behavioral health concerns — with some of those costs expected to be reimbursed through Medi-Cal.\u003c/p>\n\u003cp>The state policy mandates that teams have specific training and be able to respond to calls in urban areas within an hour and in rural areas within 90 minutes. It also requires teams to conduct follow-up visits within three days and to follow certain data collection and assessment guidelines.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The program will create a resource for “anyone who’s ever hesitated to call the police,” Corzo said. “It really is the support that our most vulnerable community members need.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>San Mateo County is launching an unarmed mobile response team program to address an array of mental health crises without involving law enforcement.\u003c/p>\n\u003cp>County supervisors on Tuesday unanimously approved a $4.9 million contract with Alameda-based Telecare Corporation to provide the service through June 2025.\u003c/p>\n\u003cp>“There are many people in the community that are afraid or more agitated when they interact with law enforcement, and this response model addresses that and provides another path,” District 2 Supervisor Noelia Corzo told KQED, noting that county residents have requested this service for years.\u003c/p>\n\u003cp>The program is set to launch in May, initially with one team active on weekday nights. By August, it’s expected to scale up to five teams working 24/7, with two additional teams on call.\u003c/p>\n\u003cp>Teams are expected to include one behavioral health clinician and one “peer support specialist” trained in de-escalation and crisis intervention.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Working independently of law enforcement, teams will be tasked with responding to mental health-related calls anywhere in the county and connecting people to appropriate services.\u003c/p>\n\u003cp>Each team will also carry and be trained to administer the opioid overdose-reversal drug naloxone.\u003c/p>\n\u003cp>Corzo said she thinks the program could have prevented \u003ca href=\"https://www.kqed.org/news/11696828/san-mateo-d-a-says-man-who-died-after-deputy-tased-him-was-unarmed\">the death of Chinedu Okobi\u003c/a>, a 36-year-old unarmed man from Redwood City with a history of mental health issues who was killed during an interaction with law enforcement in 2018.\u003c/p>\n\u003cp>“Had this service been available, I think the outcome would have been different,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Sheriff’s deputies used a Taser on Okobi multiple times during a struggle that began when they saw him jaywalking on a busy street in Millbrae. He became unresponsive after deputies restrained him.\u003c/p>\n\u003cp>An autopsy revealed he had died of cardiac arrest, partially attributed to the Taser shocks — the \u003ca href=\"https://www.mercurynews.com/2019/02/12/redwood-city-axon-defends-taser-safety-at-supes-meeting-after-3-deaths-last-year/\">third person in the county that year to die after being Tased by law enforcement.\u003c/a>\u003c/p>\n\u003cp>Okobi’s family eventually \u003ca href=\"https://sfstandard.com/2023/02/06/bay-area-taser-death-leads-to-massive-payout-as-nation-mourns-police-killings/\">settled a lawsuit with the county for $4.5 million\u003c/a>.\u003c/p>\n\u003cp>The crisis response program will build on \u003ca href=\"https://sanmateocrisis.org/transparency\">existing services\u003c/a> available in different parts of the county, in which behavioral health professionals go along with law enforcement officers on certain calls. Additionally, a countywide mobile crisis team for youth currently responds to certain mental health-related calls involving people who are 25 and under.\u003c/p>\n\u003cp>Coordinating the various services and dispatching the appropriate response will be key to making this program effective, according to Jei Africa, the county’s director of Behavioral Health and Recovery Services.\u003c/p>\n\u003cp>“The coordination piece is really the challenge right now we’re trying to face,” Africa said during Tuesday’s meeting. “When we get the call, which is the most appropriate response? Which is the quickest response?”\u003c/p>\n\u003cp>Calls to the program will be routed through local nonprofit StarVista’s crisis call center, which operates a 24/7 hotline and fields an average of more than 1,000 calls a month. A new phone number will also be launched for the mobile crisis response team, with the goal of eventually re-routing all relevant 911 and 988 (national suicide prevention hotline) calls back to the team.\u003c/p>\n\u003cp>The new program comes on the heels of \u003ca href=\"https://www.dhcs.ca.gov/Documents/Mobile-Crisis-FAQ.pdf\">a state policy\u003c/a> enacted last June requiring counties that deliver Medi-Cal services to provide mobile crisis response teams to address behavioral health concerns — with some of those costs expected to be reimbursed through Medi-Cal.\u003c/p>\n\u003cp>The state policy mandates that teams have specific training and be able to respond to calls in urban areas within an hour and in rural areas within 90 minutes. It also requires teams to conduct follow-up visits within three days and to follow certain data collection and assessment guidelines.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The program will create a resource for “anyone who’s ever hesitated to call the police,” Corzo said. “It really is the support that our most vulnerable community members need.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "everybody-is-just-scrambling-nationwide-cyber-attack-delays-bay-area-pharmacy-orders",
"title": "'Everybody Is Just Scrambling': Nationwide Cyber Attack Delays Bay Area Pharmacy Orders",
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"content": "\u003cp>\u003cem>Updated 8 p.m. Monday\u003c/em>\u003c/p>\n\u003cp>People across the Bay Area are clamoring to fill essential medications after a\u003ca href=\"https://www.reuters.com/business/healthcare-pharmaceuticals/change-healthcare-network-hit-by-cybersecurity-attack-2024-02-22/\"> cyber attack last Wednesday\u003c/a> disrupted data transmission lines between health care providers, insurance companies and pharmacies.\u003c/p>\n\u003cp>East Bay resident Alison Hightower is among them.\u003c/p>\n\u003cp>For two days, she has been trying to refill a medication her husband takes for nerve damage. When she tried to pick it up, the pharmacist at her local Safeway on College Avenue in Oakland said they had been unable to fill most prescriptions since the hack against UnitedHealth Group Inc. last week. [pullquote size=\"medium\" align=\"right\" citation=\"Alison Hightower, East Bay resident\"]‘I stopped at the pharmacy, and they said they are totally shut down and can’t do anything. This will have a huge snowballing effect. …’[/pullquote]“I stopped at the pharmacy, and they said they are totally shut down and can’t do anything,” Hightower told KQED. “This will have a huge snowballing effect. My husband is scrambling to get his medication refilled.”\u003c/p>\n\u003cp>Since the cyber attack, \u003ca href=\"https://www.latimes.com/business/story/2024-02-23/unitedhealth-blames-nation-state-threat-in-hack-disrupting-pharmacy-orders\">pharmacies across the country\u003c/a> — including those at Safeway, Walgreens and CVS — have been unable to fill some prescription orders because the computer system that forwards prescriptions from doctors and processes insurance was disconnected after the hack at UnitedHealth’s technology unit, called Change Healthcare.\u003c/p>\n\u003cp>A spokesperson for Safeway confirmed that people filling online prescriptions may experience a delay due to the nationwide outage with Optum, a third-party healthcare technology vendor owned by UnitedHealth. Other insurance providers including Medicare were also affected.\u003c/p>\n\u003cp>UnitedHealth is Alameda County’s largest health insurer. It’s not clear when the service will be restored. As of noon on Monday \u003ca href=\"https://status.changehealthcare.com/incidents/hqpjz25fn3n7\">Optum reported that the disruption is expected to continue\u003c/a> through at least the end of the day.\u003c/p>\n\u003cfigure id=\"attachment_11977122\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11977122\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240226-PHARMACY-HACK-MD-02-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240226-PHARMACY-HACK-MD-02-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240226-PHARMACY-HACK-MD-02-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240226-PHARMACY-HACK-MD-02-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240226-PHARMACY-HACK-MD-02-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240226-PHARMACY-HACK-MD-02-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240226-PHARMACY-HACK-MD-02-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A Safeway store in Oakland on Feb. 26, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Change Healthcare is experiencing a cybersecurity issue, and our experts are working to address the matter,” the company said in a statement on its website. “Once we became aware of the outside threat, in the interest of protecting our partners and patients, we took immediate action to disconnect our systems to prevent further impact.”\u003c/p>\n\u003cp>Hindering access to medication can be life-threatening.\u003c/p>\n\u003cp>“Our pharmacy operations and the vast majority of prescriptions are not being impacted by this third-party issue,” a spokesperson for Walgreens said in an email. “For the small percentage that may be affected, we have procedures in place so that we can continue to process and fill these prescriptions with minimal delay or interruption.” [aside label='More on Public Health' tag='health'] “Safeway would like to reassure customers and the public that our pharmacy locations are open for business and serving customers,” a spokesperson for Safeway said in an email. “We are working quickly to address this matter and apologize for any inconvenience this may cause.”\u003c/p>\n\u003cp>CVS, which also relies on UnitedHealth technology, said earlier in a prepared statement that the company is still filling prescriptions, but “in certain cases, we are not able to process insurance claims, which our business continuity plan is addressing to ensure patients continue to have access to their prescriptions.” KQED has reached out to CVS for further comment but as of Monday evening has not received a response.\u003c/p>\n\u003cp>The issue is impacting different medications and particularly controlled substances like pain medications and ADHD medication, which are more heavily regulated by the federal government, Ruzly Mantara, a pharmacist in San Francisco, told KQED on Monday.\u003c/p>\n\u003cp>Pharmacists like Mantara need help to convey the news and to provide patients with their medications.\u003c/p>\n\u003cp>“This has never happened before. We are taking this one step at a time,” Mantara told KQED. “The best thing we can do is ask for their patience at this time.” [pullquote size=\"medium\" align=\"right\" citation=\"Ruzly Mantara, pharmacist, San Francisco\"]‘We are able to get faxes and phone calls, but there are some prescriptions that can’t be faxed or called in, so that’s an issue. It creates a big problem.’[/pullquote]As of Sunday afternoon, Mantara said that the computer system could process most insurance plans again but that the pharmacy was still not able to receive prescriptions from doctors.\u003c/p>\n\u003cp>So far, options remain limited for customers who can’t pay out of pocket or don’t have a written prescription.\u003c/p>\n\u003cp>“We are able to get faxes and phone calls, but there are some prescriptions that can’t be faxed or called in, so that’s an issue,” Mantara said. “It creates a big problem.”\u003c/p>\n\u003cp>Hightower’s husband’s medication is expensive and tightly regulated, she said, so paying out of pocket or sending over a written prescription are both unfeasible. She and her husband are continuing to assess their options.\u003c/p>\n\u003cp>“His drug is under more severe regulation, so they don’t keep it in stock, and they have to special order it,” Hightower said. “Everybody is just scrambling.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Updated 8 p.m. Monday\u003c/em>\u003c/p>\n\u003cp>People across the Bay Area are clamoring to fill essential medications after a\u003ca href=\"https://www.reuters.com/business/healthcare-pharmaceuticals/change-healthcare-network-hit-by-cybersecurity-attack-2024-02-22/\"> cyber attack last Wednesday\u003c/a> disrupted data transmission lines between health care providers, insurance companies and pharmacies.\u003c/p>\n\u003cp>East Bay resident Alison Hightower is among them.\u003c/p>\n\u003cp>For two days, she has been trying to refill a medication her husband takes for nerve damage. When she tried to pick it up, the pharmacist at her local Safeway on College Avenue in Oakland said they had been unable to fill most prescriptions since the hack against UnitedHealth Group Inc. last week. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“I stopped at the pharmacy, and they said they are totally shut down and can’t do anything,” Hightower told KQED. “This will have a huge snowballing effect. My husband is scrambling to get his medication refilled.”\u003c/p>\n\u003cp>Since the cyber attack, \u003ca href=\"https://www.latimes.com/business/story/2024-02-23/unitedhealth-blames-nation-state-threat-in-hack-disrupting-pharmacy-orders\">pharmacies across the country\u003c/a> — including those at Safeway, Walgreens and CVS — have been unable to fill some prescription orders because the computer system that forwards prescriptions from doctors and processes insurance was disconnected after the hack at UnitedHealth’s technology unit, called Change Healthcare.\u003c/p>\n\u003cp>A spokesperson for Safeway confirmed that people filling online prescriptions may experience a delay due to the nationwide outage with Optum, a third-party healthcare technology vendor owned by UnitedHealth. Other insurance providers including Medicare were also affected.\u003c/p>\n\u003cp>UnitedHealth is Alameda County’s largest health insurer. It’s not clear when the service will be restored. As of noon on Monday \u003ca href=\"https://status.changehealthcare.com/incidents/hqpjz25fn3n7\">Optum reported that the disruption is expected to continue\u003c/a> through at least the end of the day.\u003c/p>\n\u003cfigure id=\"attachment_11977122\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11977122\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240226-PHARMACY-HACK-MD-02-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240226-PHARMACY-HACK-MD-02-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240226-PHARMACY-HACK-MD-02-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240226-PHARMACY-HACK-MD-02-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240226-PHARMACY-HACK-MD-02-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240226-PHARMACY-HACK-MD-02-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/240226-PHARMACY-HACK-MD-02-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A Safeway store in Oakland on Feb. 26, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Change Healthcare is experiencing a cybersecurity issue, and our experts are working to address the matter,” the company said in a statement on its website. “Once we became aware of the outside threat, in the interest of protecting our partners and patients, we took immediate action to disconnect our systems to prevent further impact.”\u003c/p>\n\u003cp>Hindering access to medication can be life-threatening.\u003c/p>\n\u003cp>“Our pharmacy operations and the vast majority of prescriptions are not being impacted by this third-party issue,” a spokesperson for Walgreens said in an email. “For the small percentage that may be affected, we have procedures in place so that we can continue to process and fill these prescriptions with minimal delay or interruption.” \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp> “Safeway would like to reassure customers and the public that our pharmacy locations are open for business and serving customers,” a spokesperson for Safeway said in an email. “We are working quickly to address this matter and apologize for any inconvenience this may cause.”\u003c/p>\n\u003cp>CVS, which also relies on UnitedHealth technology, said earlier in a prepared statement that the company is still filling prescriptions, but “in certain cases, we are not able to process insurance claims, which our business continuity plan is addressing to ensure patients continue to have access to their prescriptions.” KQED has reached out to CVS for further comment but as of Monday evening has not received a response.\u003c/p>\n\u003cp>The issue is impacting different medications and particularly controlled substances like pain medications and ADHD medication, which are more heavily regulated by the federal government, Ruzly Mantara, a pharmacist in San Francisco, told KQED on Monday.\u003c/p>\n\u003cp>Pharmacists like Mantara need help to convey the news and to provide patients with their medications.\u003c/p>\n\u003cp>“This has never happened before. We are taking this one step at a time,” Mantara told KQED. “The best thing we can do is ask for their patience at this time.” \u003c/p>\u003c/div>",
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"slug": "sf-close-to-goal-of-400-new-residential-treatment-beds-but-obstacles-to-care-remain",
"title": "SF Close to Reaching Goal of 400 New Residential Treatment Beds, but Major Obstacles to Care Remain",
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"headTitle": "SF Close to Reaching Goal of 400 New Residential Treatment Beds, but Major Obstacles to Care Remain | KQED",
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"content": "\u003cp>San Francisco is closing in on its goal to add 400 new residential treatment beds for people suffering from mental illness and substance-use disorders.\u003c/p>\n\u003cp>Despite ongoing staffing issues at many care facilities, the city is just 44 beds shy of reaching the\u003ca href=\"https://www.sfdph.org/dph/files/MHR/SFDPH_Behavioral_Health_Bed_Optimization_Report_FINAL.pdf\"> expansion goal that its Department of Public Health set in 2021\u003c/a>, and now has a total of nearly 2,600 beds, health officials told members of the Board of Supervisors Budget and Finance Committee on Wednesday.\u003c/p>\n\u003cp>“While there are gaps depending on staffing, overall, there is an increase in residential care,” said Hillary Kunins, San Francisco’s director of behavioral health services.\u003c/p>\n\u003cp>But some supervisors said they were fed up with what they called uneven progress in meeting the city’s dire need for more affordable live-in treatment programs, and argued the city still lacked a comprehensive data collection system for tracking how many people actually use the beds.\u003c/p>\n\u003cp>“Are we making progress? Are we falling behind? Are we running in place?” Supervisor Rafael Mandelman said at the hearing. “Based on the way we are tracking these numbers, I don’t know whether we have more San Franciscans getting that level of care today than we did five years ago.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The city has new tools, \u003ca href=\"https://www.kqed.org/news/11963122/californias-care-court-program-starts-amid-concerns-over-effectiveness\">like Care Court\u003c/a>, to place people under mandated treatment, he added, but “we have that basic problem of not having places for people to get care.”\u003c/p>\n\u003cp>The majority of the city’s treatment beds (1,861) are used in programs focused on mental health, with roughly 700 other beds reserved for substance-use disorder treatment, \u003ca href=\"https://sfgov.legistar.com/View.ashx?M=F&ID=12694517&GUID=5CFC2D44-69D9-4F39-AC19-823BF447515F\">according to the city’s Department of Public Health\u003c/a>. Those entering and exiting residential care programs can now also receive support from the department’s \u003ca href=\"https://www.sfchronicle.com/sf/article/Will-new-S-F-program-catch-people-with-addiction-17154742.php\">Office of Coordinated Care\u003c/a>, which opened its doors in 2022.\u003c/p>\n\u003cp>That current total number of beds marks a 20% increase from the city’s baseline bed count in 2020. And more treatment programs are slated to come online this year, including an 18-bed facility for people with co-occurring mental health and substance-use disorders and a 10-bed center for younger adults, health officials said.\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"mental-health-treatment\"]But a significant number of those beds often remain unfilled, despite high demand, due in large part to ongoing citywide staffing shortages. In the first half of the current fiscal year, staffing challenges reduced the behavioral health system’s capacity by up to 20%, said Kunins, the behavioral health services director.\u003c/p>\n\u003cp>“Behavioral health workforce retention and recruitment are significant challenges,” she told supervisors at Wednesday’s hearing.\u003c/p>\n\u003cp>The hearing comes as San Francisco continues to face a converging crisis around overdose deaths, mental illness and homelessness. At the same time, many of the city’s private home board-and-care facilities have closed down in recent years, putting more pressure on the public system to provide residential care, particularly for seniors and adults with disabilities.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11939793/were-down-to-the-wire-again-feds-to-decide-this-week-if-laguna-honda-must-resume-patient-transfers\">Laguna Honda Hospital\u003c/a>, one of the city’s largest skilled nursing facilities, has also not admitted a new patient for nearly two years after federal regulators decertified the facility in 2022. The hospital typically serves lower-income, older residents but also provides various mental and behavioral health services.\u003c/p>\n\u003cp>Supervisor Myrna Melgar, whose district includes Laguna Honda, said there needs to be greater statewide investment into residential treatment.\u003c/p>\n\u003cp>“There is a need for beds in California, not just San Francisco. Why don’t we treat this like infrastructure?” she said. “The way we are counting the need is wack.”\u003c/p>\n\u003cp>Barriers to treatment also go beyond just the number of beds available, said Tanya Mara, who works with the city’s jail health services. She told supervisors it took three weeks to get one client into treatment because of a legal backlog.\u003c/p>\n\u003cp>“She had failed to appear in court in Alameda, but because of our close relationships with county behavioral health, we got them on the phone and got that warrant lifted so we could place her,” Mara said. “It’s frustrating and requires skilled, fiery social workers who will keep pushing all of these systems.”\u003c/p>\n\u003cp>Adam Francis, senior director for policy and advocacy at San Francisco Marin Medical Society, noted that while the bed data is imperfect, it helps get the city closer to addressing its mental health and addiction crisis.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“These are real human lives we are talking about. Not just beds,” he said during public comment. “These are mothers and sons and brothers. When they fall through the cracks, it’s devastating.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>San Francisco is closing in on its goal to add 400 new residential treatment beds for people suffering from mental illness and substance-use disorders.\u003c/p>\n\u003cp>Despite ongoing staffing issues at many care facilities, the city is just 44 beds shy of reaching the\u003ca href=\"https://www.sfdph.org/dph/files/MHR/SFDPH_Behavioral_Health_Bed_Optimization_Report_FINAL.pdf\"> expansion goal that its Department of Public Health set in 2021\u003c/a>, and now has a total of nearly 2,600 beds, health officials told members of the Board of Supervisors Budget and Finance Committee on Wednesday.\u003c/p>\n\u003cp>“While there are gaps depending on staffing, overall, there is an increase in residential care,” said Hillary Kunins, San Francisco’s director of behavioral health services.\u003c/p>\n\u003cp>But some supervisors said they were fed up with what they called uneven progress in meeting the city’s dire need for more affordable live-in treatment programs, and argued the city still lacked a comprehensive data collection system for tracking how many people actually use the beds.\u003c/p>\n\u003cp>“Are we making progress? Are we falling behind? Are we running in place?” Supervisor Rafael Mandelman said at the hearing. “Based on the way we are tracking these numbers, I don’t know whether we have more San Franciscans getting that level of care today than we did five years ago.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The city has new tools, \u003ca href=\"https://www.kqed.org/news/11963122/californias-care-court-program-starts-amid-concerns-over-effectiveness\">like Care Court\u003c/a>, to place people under mandated treatment, he added, but “we have that basic problem of not having places for people to get care.”\u003c/p>\n\u003cp>The majority of the city’s treatment beds (1,861) are used in programs focused on mental health, with roughly 700 other beds reserved for substance-use disorder treatment, \u003ca href=\"https://sfgov.legistar.com/View.ashx?M=F&ID=12694517&GUID=5CFC2D44-69D9-4F39-AC19-823BF447515F\">according to the city’s Department of Public Health\u003c/a>. Those entering and exiting residential care programs can now also receive support from the department’s \u003ca href=\"https://www.sfchronicle.com/sf/article/Will-new-S-F-program-catch-people-with-addiction-17154742.php\">Office of Coordinated Care\u003c/a>, which opened its doors in 2022.\u003c/p>\n\u003cp>That current total number of beds marks a 20% increase from the city’s baseline bed count in 2020. And more treatment programs are slated to come online this year, including an 18-bed facility for people with co-occurring mental health and substance-use disorders and a 10-bed center for younger adults, health officials said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>But a significant number of those beds often remain unfilled, despite high demand, due in large part to ongoing citywide staffing shortages. In the first half of the current fiscal year, staffing challenges reduced the behavioral health system’s capacity by up to 20%, said Kunins, the behavioral health services director.\u003c/p>\n\u003cp>“Behavioral health workforce retention and recruitment are significant challenges,” she told supervisors at Wednesday’s hearing.\u003c/p>\n\u003cp>The hearing comes as San Francisco continues to face a converging crisis around overdose deaths, mental illness and homelessness. At the same time, many of the city’s private home board-and-care facilities have closed down in recent years, putting more pressure on the public system to provide residential care, particularly for seniors and adults with disabilities.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11939793/were-down-to-the-wire-again-feds-to-decide-this-week-if-laguna-honda-must-resume-patient-transfers\">Laguna Honda Hospital\u003c/a>, one of the city’s largest skilled nursing facilities, has also not admitted a new patient for nearly two years after federal regulators decertified the facility in 2022. The hospital typically serves lower-income, older residents but also provides various mental and behavioral health services.\u003c/p>\n\u003cp>Supervisor Myrna Melgar, whose district includes Laguna Honda, said there needs to be greater statewide investment into residential treatment.\u003c/p>\n\u003cp>“There is a need for beds in California, not just San Francisco. Why don’t we treat this like infrastructure?” she said. “The way we are counting the need is wack.”\u003c/p>\n\u003cp>Barriers to treatment also go beyond just the number of beds available, said Tanya Mara, who works with the city’s jail health services. She told supervisors it took three weeks to get one client into treatment because of a legal backlog.\u003c/p>\n\u003cp>“She had failed to appear in court in Alameda, but because of our close relationships with county behavioral health, we got them on the phone and got that warrant lifted so we could place her,” Mara said. “It’s frustrating and requires skilled, fiery social workers who will keep pushing all of these systems.”\u003c/p>\n\u003cp>Adam Francis, senior director for policy and advocacy at San Francisco Marin Medical Society, noted that while the bed data is imperfect, it helps get the city closer to addressing its mental health and addiction crisis.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“These are real human lives we are talking about. Not just beds,” he said during public comment. “These are mothers and sons and brothers. When they fall through the cracks, it’s devastating.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"headTitle": "$57 Million in California Aid Helps Reopen Shuttered Madera County Hospital | KQED",
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"content": "\u003cp>A California hospital that left a county of 160,000 people without \u003ca href=\"https://calmatters.org/category/health/\">critical emergency care\u003c/a> when it shut down 13 months ago took a significant step toward reopening last week, and it could begin accepting patients as early as this summer.\u003c/p>\n\u003cp>That’s good news for the residents of Madera County, but the court-approved deal to revive the hospital elicited mixed reactions among some San Joaquin Valley leaders who wanted a different option.\u003c/p>\n\u003cp>A bankruptcy court last week approved a bid from a Modesto-based hospital management company, \u003ca href=\"https://americanam.org/\">American Advanced Management, Inc\u003c/a>., to take over and reopen Madera Community Hospital.\u003c/p>\n\u003cp>That decision effectively shot down a last-minute proposal from industry powerhouses \u003ca href=\"https://calmatters.org/health/2024/02/madera-community-hospital-ucsf/\">UCSF Health and Adventist Health\u003c/a>. Several lawmakers from the region had endorsed the UCSF-Adventist plan and said in written statements after the bankruptcy hearing that they were still pulling for that proposal.\u003c/p>\n\u003cp>The hospital’s reopening is close but not quite a done deal. Madera County and other parties have another week to appeal the decision. The California Department of Public Health also must approve the hospital’s change-of-management application.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Matthew Beehler, chief strategy officer, American Advanced Management\"]‘Our focus has always been on reopening this hospital as quickly as possible to improve the health and lives of community members.’[/pullquote]The Madera hospital’s closure alarmed the Legislature last year, leading it to create a $300 million bailout fund for \u003ca href=\"https://calmatters.org/health/2023/08/california-hospitals-bailout-loans/\">financially distressed hospitals\u003c/a>. The Madera hospital is eligible for $57 million from that fund.\u003c/p>\n\u003cp>American Advanced Management has submitted its management plan to the California Department of Health Care Access and Information to unlock that money. The department said it is still reviewing the application.\u003c/p>\n\u003cp>Matthew Beehler, chief strategy officer at American Advanced Management, said that pending these approvals, the hospital will be on track to reopen within 4 to 6 months. The company has committed $30 million on top of what the state will chip in to reopen the hospital.\u003c/p>\n\u003cp>“Our focus has always been on reopening this hospital as quickly as possible to improve the health and lives of community members,” he said in a written statement after the bankruptcy hearing.\u003c/p>\n\u003ch2>11th-hour bid for Madera hospital\u003c/h2>\n\u003cp>After months of scrambling to find suitors, \u003ca href=\"https://www.fresnobee.com/news/local/article283253198.html\">Madera Community Hospital entered negotiations\u003c/a> with the American Advanced Management last fall. Then, earlier this month, UCSF Health and Adventist Health announced that they, too, were interested in taking over the hospital and that they’d team up to enter a bid.\u003c/p>\n\u003cp>For months, lawmakers representing the Madera area \u003ca href=\"https://calmatters.org/health/2023/04/hospital-closures-california/\">pushed for the UC Health system\u003c/a> to take over the hospital with the idea that it could bring much-needed resources to the valley. In a press conference earlier this month, they called the proposed UCSF and Adventist partnership “a dream come true.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But the UCSF and Adventist bid came too late. Judge René Lastreto of the U.S. Bankruptcy Court for the Eastern District of California said during last week’s hearing that it didn’t “behoove the creditors or the estate to continue to delay this any further” by entertaining the new proposal.\u003c/p>\n\u003cp>Democratic lawmakers Sen. Anna Caballero, Assemblymember Esmeralda Soria and Assemblymember Joaquin Arambula said they were disappointed the court didn’t give UCSF and Adventist more of a hearing.\u003c/p>\n\u003cp>“We hoped that the court would have granted UCSF, Adventist Health, and Madera County the opportunity to move forward and provide a full presentation of their joint venture to purchase and reopen Madera Community Hospital — to show what it could mean immediately for the residents and the long-term viability of this hospital for the region,” they said in a written statement.\u003c/p>\n\u003ch2>Reopening in sight, but no maternity ward\u003c/h2>\n\u003cp>American Advanced Management plans to reopen the hospital with an emergency room, an intensive care unit, medical imaging and a laboratory, but it will not immediately reopen labor and delivery, \u003ca href=\"https://fresnoland.org/2024/02/12/madera-hospital-reopening-plan-2/\">Fresnoland first reported\u003c/a>.\u003c/p>\n\u003cp>[aside label=\"Related Stories\" postID=\"news_11959175,news_11958245,news_11968579\"]That means pregnant patients will continue to travel to Fresno or Merced counties to give birth. \u003ca href=\"https://calmatters.org/health/2023/11/california-hospitals-close-maternity-wards/\">Maternity wards in California are closing\u003c/a> at an accelerated pace. Last year, in addition to Madera Community’s total closure, 11 other hospitals terminated their maternity services.\u003c/p>\n\u003cp>Beehler at American Advanced Management said the company decided not to reinstate a maternity ward because obstetrics is a resource-intensive department that is poorly reimbursed. Other hospitals have released similar statements when announcing the elimination of labor and delivery.\u003c/p>\n\u003cp>“Reopening maternity would be like reopening two hospitals at the same time,” Beehler said.\u003c/p>\n\u003cp>Madera Community Hospital delivered 735 babies in 2022 and another 720 in 2021. The county has a slightly higher birth rate than the state’s \u003ca>at 57.9 births per 1,000 women\u003c/a>.\u003c/p>\n\u003cp>Beehler said the company plans to provide prenatal services through the hospital’s clinics.\u003c/p>\n\u003ch2>Quick hiring key to reopening\u003c/h2>\n\u003cp>Sara Bosse, Madera County’s public health director, told the court last week that a critical element to the hospital’s reopening is how soon a new operator will be able to hire the necessary staff. She said that UCSF and Adventist could more easily attract providers to work in Madera.\u003c/p>\n\u003cp>“A physician that is looking for a position and is actively being recruited they probably would consider a position with UCSF before they would look at a position with an entity they may have not heard of before,” Bosse later told CalMatters.\u003c/p>\n\u003cp>Lawyers for American Advanced Management argued there was no evidence that the smaller hospital operator would have any trouble hiring staff. American Advanced Management is known for buying and managing distressed facilities in largely rural parts of the state. It operates hospitals in Colusa, Glenn and Coalinga.\u003c/p>\n\u003cp>Securing a strong workforce is critical, especially in an area that has long struggled with a shortage of\u003ca href=\"https://chhs.fresnostate.edu/ccphc/documents/SJVPHC%20RHEA%20Report%20Final%203.22.2022%20.pdf\"> primary care providers and specialists (PDF)\u003c/a> compared to wealthier parts of California.\u003c/p>\n\u003cp>“All of those things have to happen pretty quickly in order for any organization to open up a hospital and get it to a place that’s solvent,” Bosse said. “Both bringing on workforce and attracting patients.”\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that\u003c/em> \u003cem>people have access to the care they need, when they need it, at a price they can afford. Visit \u003c/em>\u003ca href=\"http://www.chcf.org/\">\u003cem>www.chcf.org\u003c/em>\u003c/a>\u003cem> to learn more.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A California hospital that left a county of 160,000 people without \u003ca href=\"https://calmatters.org/category/health/\">critical emergency care\u003c/a> when it shut down 13 months ago took a significant step toward reopening last week, and it could begin accepting patients as early as this summer.\u003c/p>\n\u003cp>That’s good news for the residents of Madera County, but the court-approved deal to revive the hospital elicited mixed reactions among some San Joaquin Valley leaders who wanted a different option.\u003c/p>\n\u003cp>A bankruptcy court last week approved a bid from a Modesto-based hospital management company, \u003ca href=\"https://americanam.org/\">American Advanced Management, Inc\u003c/a>., to take over and reopen Madera Community Hospital.\u003c/p>\n\u003cp>That decision effectively shot down a last-minute proposal from industry powerhouses \u003ca href=\"https://calmatters.org/health/2024/02/madera-community-hospital-ucsf/\">UCSF Health and Adventist Health\u003c/a>. Several lawmakers from the region had endorsed the UCSF-Adventist plan and said in written statements after the bankruptcy hearing that they were still pulling for that proposal.\u003c/p>\n\u003cp>The hospital’s reopening is close but not quite a done deal. Madera County and other parties have another week to appeal the decision. The California Department of Public Health also must approve the hospital’s change-of-management application.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The Madera hospital’s closure alarmed the Legislature last year, leading it to create a $300 million bailout fund for \u003ca href=\"https://calmatters.org/health/2023/08/california-hospitals-bailout-loans/\">financially distressed hospitals\u003c/a>. The Madera hospital is eligible for $57 million from that fund.\u003c/p>\n\u003cp>American Advanced Management has submitted its management plan to the California Department of Health Care Access and Information to unlock that money. The department said it is still reviewing the application.\u003c/p>\n\u003cp>Matthew Beehler, chief strategy officer at American Advanced Management, said that pending these approvals, the hospital will be on track to reopen within 4 to 6 months. The company has committed $30 million on top of what the state will chip in to reopen the hospital.\u003c/p>\n\u003cp>“Our focus has always been on reopening this hospital as quickly as possible to improve the health and lives of community members,” he said in a written statement after the bankruptcy hearing.\u003c/p>\n\u003ch2>11th-hour bid for Madera hospital\u003c/h2>\n\u003cp>After months of scrambling to find suitors, \u003ca href=\"https://www.fresnobee.com/news/local/article283253198.html\">Madera Community Hospital entered negotiations\u003c/a> with the American Advanced Management last fall. Then, earlier this month, UCSF Health and Adventist Health announced that they, too, were interested in taking over the hospital and that they’d team up to enter a bid.\u003c/p>\n\u003cp>For months, lawmakers representing the Madera area \u003ca href=\"https://calmatters.org/health/2023/04/hospital-closures-california/\">pushed for the UC Health system\u003c/a> to take over the hospital with the idea that it could bring much-needed resources to the valley. In a press conference earlier this month, they called the proposed UCSF and Adventist partnership “a dream come true.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But the UCSF and Adventist bid came too late. Judge René Lastreto of the U.S. Bankruptcy Court for the Eastern District of California said during last week’s hearing that it didn’t “behoove the creditors or the estate to continue to delay this any further” by entertaining the new proposal.\u003c/p>\n\u003cp>Democratic lawmakers Sen. Anna Caballero, Assemblymember Esmeralda Soria and Assemblymember Joaquin Arambula said they were disappointed the court didn’t give UCSF and Adventist more of a hearing.\u003c/p>\n\u003cp>“We hoped that the court would have granted UCSF, Adventist Health, and Madera County the opportunity to move forward and provide a full presentation of their joint venture to purchase and reopen Madera Community Hospital — to show what it could mean immediately for the residents and the long-term viability of this hospital for the region,” they said in a written statement.\u003c/p>\n\u003ch2>Reopening in sight, but no maternity ward\u003c/h2>\n\u003cp>American Advanced Management plans to reopen the hospital with an emergency room, an intensive care unit, medical imaging and a laboratory, but it will not immediately reopen labor and delivery, \u003ca href=\"https://fresnoland.org/2024/02/12/madera-hospital-reopening-plan-2/\">Fresnoland first reported\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>That means pregnant patients will continue to travel to Fresno or Merced counties to give birth. \u003ca href=\"https://calmatters.org/health/2023/11/california-hospitals-close-maternity-wards/\">Maternity wards in California are closing\u003c/a> at an accelerated pace. Last year, in addition to Madera Community’s total closure, 11 other hospitals terminated their maternity services.\u003c/p>\n\u003cp>Beehler at American Advanced Management said the company decided not to reinstate a maternity ward because obstetrics is a resource-intensive department that is poorly reimbursed. Other hospitals have released similar statements when announcing the elimination of labor and delivery.\u003c/p>\n\u003cp>“Reopening maternity would be like reopening two hospitals at the same time,” Beehler said.\u003c/p>\n\u003cp>Madera Community Hospital delivered 735 babies in 2022 and another 720 in 2021. The county has a slightly higher birth rate than the state’s \u003ca>at 57.9 births per 1,000 women\u003c/a>.\u003c/p>\n\u003cp>Beehler said the company plans to provide prenatal services through the hospital’s clinics.\u003c/p>\n\u003ch2>Quick hiring key to reopening\u003c/h2>\n\u003cp>Sara Bosse, Madera County’s public health director, told the court last week that a critical element to the hospital’s reopening is how soon a new operator will be able to hire the necessary staff. She said that UCSF and Adventist could more easily attract providers to work in Madera.\u003c/p>\n\u003cp>“A physician that is looking for a position and is actively being recruited they probably would consider a position with UCSF before they would look at a position with an entity they may have not heard of before,” Bosse later told CalMatters.\u003c/p>\n\u003cp>Lawyers for American Advanced Management argued there was no evidence that the smaller hospital operator would have any trouble hiring staff. American Advanced Management is known for buying and managing distressed facilities in largely rural parts of the state. It operates hospitals in Colusa, Glenn and Coalinga.\u003c/p>\n\u003cp>Securing a strong workforce is critical, especially in an area that has long struggled with a shortage of\u003ca href=\"https://chhs.fresnostate.edu/ccphc/documents/SJVPHC%20RHEA%20Report%20Final%203.22.2022%20.pdf\"> primary care providers and specialists (PDF)\u003c/a> compared to wealthier parts of California.\u003c/p>\n\u003cp>“All of those things have to happen pretty quickly in order for any organization to open up a hospital and get it to a place that’s solvent,” Bosse said. “Both bringing on workforce and attracting patients.”\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that\u003c/em> \u003cem>people have access to the care they need, when they need it, at a price they can afford. Visit \u003c/em>\u003ca href=\"http://www.chcf.org/\">\u003cem>www.chcf.org\u003c/em>\u003c/a>\u003cem> to learn more.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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