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"content": "\u003cp>Some state governments and federal regulators were already moving to keep individuals’ reproductive health information private when a U.S. senator’s report last week offered a new jolt, describing how cellphone location data was used to send millions of anti-abortion ads to people who visited Planned Parenthood offices.\u003c/p>\n\u003cp>Federal law bars medical providers from sharing health data without a patient’s consent but doesn’t prevent digital tech companies from tracking menstrual cycles or an individual’s location and selling it to data brokers. Legislation for federal bans have never gained momentum, largely because of opposition from the tech industry.\u003c/p>\n\u003cp>Whether that should change has become another political fault line in a nation where most Republican-controlled states have restricted abortion — including 14 with bans in place at every stage of pregnancy — and most Democratic ones have sought to protect access since the U.S. Supreme Court in 2022 overturned Roe v. Wade.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Abortion rights advocates fear that that if such data is not kept private, it could be used not only in targeted ads but also in law enforcement investigations or by abortion opponents looking to harm those who seek to end pregnancies.\u003c/p>\n\u003cp>“It isn’t just sort of creepy,” said Washington state Rep. Vandana Slatter, the sponsor of a law her state adopted last year to rein in unauthorized use of health information. “It’s actually harmful.”\u003c/p>\n\u003cp>But so far, there’s no evidence of widespread use of this kind of data in law enforcement investigations.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Andrea Frey, lawyer for health care providers and digital health systems, Hooper Lundy Bookman\"]‘We’re really pushing forward with the free-flowing and seamless exchange of health care data with the intent of having information accessible so that providers can treat the whole person. Conversely, these privacy concerns come into play.’[/pullquote]“We’re generally talking about a future risk, not something that’s happening on the ground yet,” said Albert Fox Cahn, executive director of the Surveillance Technology Oversight Project and an advocate of protections.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.wyden.senate.gov/imo/media/doc/signed_near_letter_to_ftc_and_sec.pdf\">report last week from Sen. Ron Wyden\u003c/a>, an Oregon Democrat, showed the biggest known anti-abortion ad campaign directed to people who had been identified as having visited abortion providers.\u003c/p>\n\u003cp>Wyden’s investigation found that the information gathered by a now-defunct data broker called Near Intelligence was used by ads from The Veritas Society, a nonprofit founded by Wisconsin Right to Life. The ads targeted people who visited 600 locations in 48 states from 2019 through 2022. There were more than 14 million ads in Wisconsin alone.\u003c/p>\n\u003cp>Wyden called on the Federal Trade Commission to intervene in the bankruptcy case for Near to make sure the location information collected on Americans is destroyed and not sold to another data broker. He’s also asking the Securities Exchange Commission to investigate whether the company committed securities fraud by making misleading statements to investors about the senator’s investigation.\u003c/p>\n\u003cp>It’s not the first time the issue has come up.\u003c/p>\n\u003cp>\u003ca href=\"https://apnews.com/general-news-33f18b834c104df9b2901ef1bf38ae08\">Massachusetts reached a settlement\u003c/a> in 2017 with an ad agency that ran a similar campaign nearly a decade ago.\u003c/p>\n\u003cp>The \u003ca href=\"https://apnews.com/article/technology-health-idaho-federal-trade-commission-government-and-politics-a9aabfc0d25828bc4951c736aaab617a\">FTC sued one data broker\u003c/a>, Kochava, over similar claims in 2022 in an ongoing case, and settled last month with another, X-Mode Social, and its successor, Outlogic, which the government said sold location data of even users who opted out of such sharing. X-Mode was also found to have sold location data to the U.S. military.\u003c/p>\n\u003cp>In both cases, the FTC relied on a law against unfair or deceptive practices.\u003c/p>\n\u003cp>States are also passing or considering their own laws aimed specifically at protecting sensitive health information.\u003c/p>\n\u003cp>Washington’s Slatter, a Democrat, has worked on digital privacy issues for years, but wasn’t able to get a bill with comprehensive protections adopted in her state.\u003c/p>\n\u003cp>[aside label=\"Related Stories\" postID=\"news_11973441,news_11962088,news_11953205,forum_2010101904752\"]She said things changed when Roe was overturned. She went to a rally in 2022 and heard women talking about deleting period-tracking apps out of fear of how their data could be exploited.\u003c/p>\n\u003cp>When she introduced a health-specific data privacy bill last year, it wasn’t just lawyers and lobbyists testifying; women of all ages and from many walks of life showed up to support it, too.\u003c/p>\n\u003cp>The measure, which bars selling personal health data without a consumer’s consent and prohibits tracking who visits reproductive or sexual health facilities, was adopted with the support of nearly all the state’s Democratic lawmakers and opposition from all the Republicans.\u003c/p>\n\u003cp>Connecticut and Nevada adopted similar laws last year. New York enacted one that bars using tracking around health care facilities.\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=56.10.&lawCode=CIV\">California\u003c/a> and Maryland took another approach, enacting laws that prevent computerized health networks from sharing information about sensitive health care with other providers without consent.\u003c/p>\n\u003cp>“We’re really pushing forward with the free-flowing and seamless exchange of health care data with the intent of having information accessible so that providers can treat the whole person,” said Andrea Frey, a lawyer who represents health care providers and digital health systems. “Conversely, these privacy concerns come into play.”\u003c/p>\n\u003cp>Illinois, which already had a law limiting how health tracking data — measuring heart rates, steps and others — can be shared, adopted a new one last year that took effect Jan. 1 and that bans providing government license plate reading data to law enforcement in states with abortion bans.\u003c/p>\n\u003cp>Bills addressing the issue in some form have been introduced in several states this year, including Hawaii, Illinois, Maine, Maryland, Massachusetts, Missouri, South Carolina and Vermont.\u003c/p>\n\u003cp>In Virginia, legislation that would prohibit the issuance of search warrants, subpoenas or court orders for electronic or digital menstrual health data recently cleared both chambers of the Democratic-controlled General Assembly.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Virginia state Sen. Barbara Favola\"]‘The next step to enforcing an abortion ban could be accessing menstrual health data, which is why I’m trying to protect that data.’[/pullquote]Democratic Sen. Barbara Favola said she saw the bill as a necessary precaution when Republican politicians, including Virginia Gov. Glenn Youngkin, have sought restrictions on abortion.\u003c/p>\n\u003cp>“The next step to enforcing an abortion ban could be accessing menstrual health data, which is why I’m trying to protect that data,” Favola said in a committee hearing.\u003c/p>\n\u003cp>Opponents asked whether such data had ever been sought by law enforcement, and Favola responded that she wasn’t aware of a particular example.\u003c/p>\n\u003cp>“It’s just in search of a problem that does not exist,” said Republican Sen. Mark Peake.\u003c/p>\n\u003cp>Youngkin’s administration made it clear he opposed similar legislation last year, but his press office didn’t respond to a request for comment on where he stands on the current version.\u003c/p>\n\u003cp>Sean O’Brien, founder of the Yale Privacy Lab, says there is a problem with the way health information is being used, but he’s not sure laws will be the answer because companies could choose to ignore the potential consequences and continue scooping up and selling sensitive information.\u003c/p>\n\u003cp>“The software supply chain is extremely polluted with location tracking of individuals,” he said.\u003c/p>\n\u003cp>\u003cem>Mulvihill reported from Cherry Hill, New Jersey. Associated Press reporters Frank Bajak in Boston and Sarah Rankin in Richmond, Virginia, contributed to this article.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>She said things changed when Roe was overturned. She went to a rally in 2022 and heard women talking about deleting period-tracking apps out of fear of how their data could be exploited.\u003c/p>\n\u003cp>When she introduced a health-specific data privacy bill last year, it wasn’t just lawyers and lobbyists testifying; women of all ages and from many walks of life showed up to support it, too.\u003c/p>\n\u003cp>The measure, which bars selling personal health data without a consumer’s consent and prohibits tracking who visits reproductive or sexual health facilities, was adopted with the support of nearly all the state’s Democratic lawmakers and opposition from all the Republicans.\u003c/p>\n\u003cp>Connecticut and Nevada adopted similar laws last year. New York enacted one that bars using tracking around health care facilities.\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=56.10.&lawCode=CIV\">California\u003c/a> and Maryland took another approach, enacting laws that prevent computerized health networks from sharing information about sensitive health care with other providers without consent.\u003c/p>\n\u003cp>“We’re really pushing forward with the free-flowing and seamless exchange of health care data with the intent of having information accessible so that providers can treat the whole person,” said Andrea Frey, a lawyer who represents health care providers and digital health systems. “Conversely, these privacy concerns come into play.”\u003c/p>\n\u003cp>Illinois, which already had a law limiting how health tracking data — measuring heart rates, steps and others — can be shared, adopted a new one last year that took effect Jan. 1 and that bans providing government license plate reading data to law enforcement in states with abortion bans.\u003c/p>\n\u003cp>Bills addressing the issue in some form have been introduced in several states this year, including Hawaii, Illinois, Maine, Maryland, Massachusetts, Missouri, South Carolina and Vermont.\u003c/p>\n\u003cp>In Virginia, legislation that would prohibit the issuance of search warrants, subpoenas or court orders for electronic or digital menstrual health data recently cleared both chambers of the Democratic-controlled General Assembly.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Democratic Sen. Barbara Favola said she saw the bill as a necessary precaution when Republican politicians, including Virginia Gov. Glenn Youngkin, have sought restrictions on abortion.\u003c/p>\n\u003cp>“The next step to enforcing an abortion ban could be accessing menstrual health data, which is why I’m trying to protect that data,” Favola said in a committee hearing.\u003c/p>\n\u003cp>Opponents asked whether such data had ever been sought by law enforcement, and Favola responded that she wasn’t aware of a particular example.\u003c/p>\n\u003cp>“It’s just in search of a problem that does not exist,” said Republican Sen. Mark Peake.\u003c/p>\n\u003cp>Youngkin’s administration made it clear he opposed similar legislation last year, but his press office didn’t respond to a request for comment on where he stands on the current version.\u003c/p>\n\u003cp>Sean O’Brien, founder of the Yale Privacy Lab, says there is a problem with the way health information is being used, but he’s not sure laws will be the answer because companies could choose to ignore the potential consequences and continue scooping up and selling sensitive information.\u003c/p>\n\u003cp>“The software supply chain is extremely polluted with location tracking of individuals,” he said.\u003c/p>\n\u003cp>\u003cem>Mulvihill reported from Cherry Hill, New Jersey. Associated Press reporters Frank Bajak in Boston and Sarah Rankin in Richmond, Virginia, contributed to this article.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Certain opioid-treatment medications that help fight addiction and prevent overdoses may now be easier to access after \u003ca href=\"https://www.axios.com/2024/02/02/opioid-treatment-restrictionshttps://www.axios.com/2024/02/02/opioid-treatment-restrictions\">the federal government this month\u003c/a> loosened restrictions on obtaining them.\u003c/p>\n\u003cp>The updated rules essentially make permanent the pandemic-era changes that relaxed barriers to treatment, such as no longer requiring some patients to show up in person every day to take methadone and other medications — a change that cities like San Francisco found effective in increasing participation in such programs.\u003c/p>\n\u003cp>The relaxed rules come as San Francisco reported 806 overdose deaths in 2023 — more than any other year on record, according to \u003ca href=\"https://www.sf.gov/sites/default/files/2024-02/2024%2002_OCME%20Overdose%20Report.pdf\">updated figures (PDF)\u003c/a> from the city’s Office of the Chief Medical Examiner. In January 2024 alone, San Francisco reported 66 overdose deaths, mostly driven by fentanyl, a synthetic opioid about 50 times more potent than heroin.\u003c/p>\n\u003cp>Federal public health officials are watching the West Coast closely as the overdose crisis in this part of the country intensifies. The Biden administration has so far allocated $83 billion toward treatment programs, an increase of more than 40% over the previous administration’s investment, according to the White House.\u003c/p>\n\u003cp>On the same day, the Biden administration announced it was loosening restrictions, Dr. Rahul Gupta, director of the Office of National Drug Control Policy (aka “Biden’s drug czar”), spoke to KQED about addressing the opioid epidemic in San Francisco and elsewhere across the country.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ci>The following interview has been modified for clarity and length.\u003c/i>\u003c/p>\n\u003cp>\u003cb>KQED: What could San Francisco do \u003c/b>\u003cb>\u003ci>more of \u003c/i>\u003c/b>\u003cb>to try and stem its current tide of drug overdoses?\u003c/b>\u003c/p>\n\u003cp>\u003cstrong>Gupta\u003c/strong>: When we look at these types of epidemics across the country, where we find successful examples is where there’s a really good balance of both expanding treatment, accessing life-saving drugs, like Narcan, which actually are an opioid antagonist and connecting people to treatment. And one of the things that needs to be done is to ensure that naloxone (the generic name for Narcan) is available in more public spaces — malls and schools and restaurants and other offices. But at the same time, also going after the sort of the financial networks of drug trafficking.\u003c/p>\n\u003cp>Today’s announcement is really about expanding treatment access, removing barriers to treatment, providing more resources in terms of test strips for not just fentanyl but also xylazine, the animal tranquilizer that is now being found more and more mixed with fentanyl, and making the response so much more complicated. The goal here is really to prioritize saving lives, prioritize, getting people the assistance that they need in a not stigmatizing way. And that happens when we treat addiction as a disease.\u003c/p>\n\u003cp>\u003cb>Where does the administration stand right now on supervised consumption sites, where people can consume illegal drugs in a sterile, supervised environment? If Biden gets four more years, do you think we’ll see real change on that front?\u003c/b>\u003c/p>\n\u003cp>Let me first talk about the harm-reduction approach that this administration is taking — the first in history to do so. We’ve taken an approach to focus on three specific policies that include getting naloxone into the hands of people. Having opioid overdose reversal medication is really the best way to save lives immediately.\u003c/p>\n\u003cp>[aside label=\"more on the overdose crisis\" tag=\"fentanyl\"]Second is syringe-service programs. The third is drug checking. All three approaches are evidence-based and really supported by decades of data to demonstrate their efficacy. But also, result in cost savings, life savings.\u003c/p>\n\u003cp>There is federal litigation ongoing at this point (regarding supervised consumption sites), so I’ll stay away from commenting specifically on particular avenues beyond those that we have federal policy behind.\u003c/p>\n\u003cp>What is important in today’s announcement is to make permanent some of these COVID-era flexibilities, like take-home medications and telehealth provisions. These allow expansion of treatment access to people not only in urban areas but also in rural and marginalized communities because oftentimes, we know that there’s a disparate access to who gets treatment and who doesn’t get treatment.\u003c/p>\n\u003cp>For example, people behind bars. We know today there are about 2 million Americans behind bars, and two-thirds are there for something related to drugs. And yet, the treatment in incarceration or in custody is very uneven across the country.\u003c/p>\n\u003cp>Today’s announcement allows treatment programs within jails and prisons to not (have to) be designated as opioid-treatment providers. They can be a clinic and still be able to provide those lifesaving treatments.\u003c/p>\n\u003cp>\u003cb>I’ve spoken to incarcerated people who have told me about smuggling life-saving medications like buprenorphine into prisons. So, is this change aimed at addressing that? \u003c/b>\u003c/p>\n\u003cp>Yes. It is a top priority for the president to make sure we are doing something about these tens of thousands of people that are dying right after reentry each year. The Centers for Medicare & Medicaid Services is now allowing Medicaid waivers for states to apply to be able to allow treatment in custody 90 days before release. The whole idea here is to get people treatment when they are reentering society, so then they’re able to again get those vocational opportunities, educational opportunities, economic opportunities.\u003c/p>\n\u003cp>\u003cb>Has California applied for that waiver?\u003c/b>\u003c/p>\n\u003cp>Yes. California was the first one to apply and has already received that waiver. We’re working closely with the state on implementation.\u003c/p>\n\u003cp>\u003cb>Given the abundance of the illicit drug supply right now, when can we expect to see the current crisis to change? What are your projections?\u003c/b>\u003c/p>\n\u003cp>Last November, President Biden met with President Xi Jinping from the People’s Republic of China at the APEC summit in San Francisco, and Xi made a commitment to address the fentanyl supply chain.\u003c/p>\n\u003cp>Our team just returned from Beijing this week. We are confident that if (cooperation) continues forward, the supply of those chemicals that ultimately end up being turned into fentanyl in Mexico will be disrupted. So it’s going to be important for us to continue to hold those individual governments accountable.\u003c/p>\n\u003cp>As we address this, we still have to focus on the public health side of this at the same time. So, it’s important to view these as two sides of the same coin. And this is not like an overnight thing. It takes a while for these actions and policy changes to have effect.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>At the same time, we’re seeing people overdosing and dying. So, we have to continue with the public health efforts while addressing the supply side.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Second is syringe-service programs. The third is drug checking. All three approaches are evidence-based and really supported by decades of data to demonstrate their efficacy. But also, result in cost savings, life savings.\u003c/p>\n\u003cp>There is federal litigation ongoing at this point (regarding supervised consumption sites), so I’ll stay away from commenting specifically on particular avenues beyond those that we have federal policy behind.\u003c/p>\n\u003cp>What is important in today’s announcement is to make permanent some of these COVID-era flexibilities, like take-home medications and telehealth provisions. These allow expansion of treatment access to people not only in urban areas but also in rural and marginalized communities because oftentimes, we know that there’s a disparate access to who gets treatment and who doesn’t get treatment.\u003c/p>\n\u003cp>For example, people behind bars. We know today there are about 2 million Americans behind bars, and two-thirds are there for something related to drugs. And yet, the treatment in incarceration or in custody is very uneven across the country.\u003c/p>\n\u003cp>Today’s announcement allows treatment programs within jails and prisons to not (have to) be designated as opioid-treatment providers. They can be a clinic and still be able to provide those lifesaving treatments.\u003c/p>\n\u003cp>\u003cb>I’ve spoken to incarcerated people who have told me about smuggling life-saving medications like buprenorphine into prisons. So, is this change aimed at addressing that? \u003c/b>\u003c/p>\n\u003cp>Yes. It is a top priority for the president to make sure we are doing something about these tens of thousands of people that are dying right after reentry each year. The Centers for Medicare & Medicaid Services is now allowing Medicaid waivers for states to apply to be able to allow treatment in custody 90 days before release. The whole idea here is to get people treatment when they are reentering society, so then they’re able to again get those vocational opportunities, educational opportunities, economic opportunities.\u003c/p>\n\u003cp>\u003cb>Has California applied for that waiver?\u003c/b>\u003c/p>\n\u003cp>Yes. California was the first one to apply and has already received that waiver. We’re working closely with the state on implementation.\u003c/p>\n\u003cp>\u003cb>Given the abundance of the illicit drug supply right now, when can we expect to see the current crisis to change? What are your projections?\u003c/b>\u003c/p>\n\u003cp>Last November, President Biden met with President Xi Jinping from the People’s Republic of China at the APEC summit in San Francisco, and Xi made a commitment to address the fentanyl supply chain.\u003c/p>\n\u003cp>Our team just returned from Beijing this week. We are confident that if (cooperation) continues forward, the supply of those chemicals that ultimately end up being turned into fentanyl in Mexico will be disrupted. So it’s going to be important for us to continue to hold those individual governments accountable.\u003c/p>\n\u003cp>As we address this, we still have to focus on the public health side of this at the same time. So, it’s important to view these as two sides of the same coin. And this is not like an overnight thing. It takes a while for these actions and policy changes to have effect.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>A new state office charged with controlling the rising cost of health care in California is moving toward one of the most aggressive goals in the nation, aiming to cap cost increases to 3% a year.\u003c/p>\n\u003cp>You might not notice immediately if the Office of Health Care Affordability commits to the tentative goal it released last month and takes steps to enforce it. But, over time, experts say the cap on price increases could make a difference in how much Californians pay for health care.\u003c/p>\n\u003cp>“A 3.0% target places California on the path of a more sustainable, affordable and equitable health care system, slowing the trajectory of growth and improving affordability for all,” the office wrote in its recommendation.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Office of Health Care Affordability\"]‘A 3.0% target places California on the path of a more sustainable, affordable and equitable health care system, slowing the trajectory of growth and improving affordability for all.’[/pullquote]The agency’s announcement immediately drew criticism from health care industry representatives who called it “unrealistic” and “arbitrary.” They contend it could harm patients by reducing access to care if health providers are watching their spending reduce services.\u003c/p>\n\u003cp>Meanwhile, consumer advocates and health economists characterized it as a good first step in the state’s effort to control costs.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/health/2022/07/rising-health-care-costs/\">Gov. Gavin Newsom established the office\u003c/a> through a provision in the 2022 state budget. Its job is to collect health expenditure data from providers and insurers, analyze it and set limits on spending for the industry.\u003c/p>\n\u003cp>\u003ca href=\"https://www.chcf.org/publication/cost-commissions-eight-states-address-cost-growth/\">Eight other states\u003c/a> have cost benchmarks. At 3%, California’s would be one of the more stringent caps — third only to Connecticut and Nevada.\u003c/p>\n\u003cp>California’s proposed target would allow health care prices and spending to increase but slower than in recent years. Between 2015 and 2020, per capita health spending grew each year by an average of 5.2%, outpacing wages, according to the Office of Health Care Affordability.\u003c/p>\n\u003cp>Health spending in California reached $405 billion in 2020 — that’s $10,299 per person, according to federal data. This includes what private insurers, public programs and individuals pay for direct services and goods, such as hospital and physician care, prescription drugs and medical devices. It does not include the administrative costs of insurance or public health funding.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The office plans to roll out one statewide cap but may eventually create regional and sector-specific targets. Officials said they came up with the 3% figure because that is how much the annual median household income has changed over the last 20 years.\u003c/p>\n\u003cp>“Most importantly, tying to historical median household income growth signals that health care spending should not grow faster than the income of California families,” Vishaal Pegany, deputy director of the Office of Health Care Affordability, said during the most recent board meeting.\u003c/p>\n\u003cp>Providers and entities that fail to meet the proposed benchmark could have to make improvements or face financial penalties. They would not be punished in the program’s first year.\u003c/p>\n\u003cp>The \u003ca href=\"https://hcai.ca.gov/public-meetings/february-health-care-affordability-board-meeting/\">state’s health care affordability board\u003c/a> is scheduled to continue discussions this month and has until June 1 to approve a cost target that would go into effect in 2025 and last through 2029.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://e.infogram.com/d62c39a9-a90d-491d-a17f-680523ba32ad?parent_url=https%3A%2F%2Fcalmatters.org%2Fhealth%2F2024%2F02%2Fhealth-care-costs-cap%2F&src=embed#async_embed\" width=\"800\" height=\"730\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003ch2>No instant savings on health care costs\u003c/h2>\n\u003cp>Many Californians are struggling with health care costs. \u003ca href=\"https://www.chcf.org/blog/top-takeaways-california-health-policy-poll/#:~:text=Meanwhile%2C%20close%20to%204%20in,racial%20equity%20in%20health%20care.\">Four in 10 Californians have medical debt\u003c/a>, according to the California Health Care Foundation.\u003c/p>\n\u003cp>Data show that people are spending more of their income on health care. A recently published \u003ca href=\"https://laborcenter.berkeley.edu/wp-content/uploads/2024/01/Measuring-Consumer-Affordability-final.pdf\">study by the UC Berkeley Labor Center (PDF)\u003c/a> found that costs like deductibles are becoming more common. In 2002, 33% of private sector workers enrolled in coverage through their jobs had a deductible. By 2022, 77% of workers did.\u003c/p>\n\u003cp>[aside label=\"Related Stories\" postID=\"news_11974310,news_11970414,news_11949192\"]The size of those deductibles has grown exponentially. Between 2002 and 2022, deductibles for a single-person plan grew 380% or an average of 8.7% every year, researchers found. Deductibles for family plans grew 332% or 7.8% annually.\u003c/p>\n\u003cp>Consumers will probably not feel a difference immediately because the state’s plan is to slow the growth of health spending and not necessarily reduce it.\u003c/p>\n\u003cp>But over time, it could make a difference. Glenn Melnick, a health economist at the University of Southern California, gives this example: “If I have to pay 25% of my (health insurance) premium, let’s say I get it from work, if my premium goes up more slowly, my contribution will be less.”\u003c/p>\n\u003cp>“What if this target had been in place for the last 10 years?” he said.\u003c/p>\n\u003ch2>California providers criticize cap\u003c/h2>\n\u003cp>Representatives for hospitals and doctors caution that basing the spending cap solely on household income rather than taking into account what it costs them to provide care could result in less access and poorer quality of care for patients.\u003c/p>\n\u003cp>They argue the proposed cap doesn’t take into account things providers have no control over, such as general inflation, rising pharmaceutical costs and natural increases in spending driven by the state’s aging population.\u003c/p>\n\u003cp>“[The office’s] proposed target entirely ignores the drivers of health care spending. In doing so, it would force health care providers to significantly cut back on the care they provide or face penalties,” wrote Ben Johnson, vice president of policy at the California Hospital Association, in a letter to the board.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Ben Johnson, vice president of policy, California Hospital Association\"]‘[The office’s] proposed target entirely ignores the drivers of health care spending. In doing so, it would force health care providers to significantly cut back on the care they provide or face penalties.’[/pullquote]Some industry representatives noted specific access issues, such as narrow provider networks and long wait times, are already a top concern for the public. “A 3% target put in place for five years seems likely to result in wait times increasing,” Janice Rocco, chief of staff at the California Medical Association, said during the board’s recent meeting.\u003c/p>\n\u003cp>Dr. Richard Pan, a Sacramento pediatrician and former state senator who sits on the health care affordability board, said that for the state’s plan to truly work, the office and board would have to nail down the methodology behind the spending target so that the industry groups have confidence in it.\u003c/p>\n\u003cp>“We still have some time; these things need to be thought out,” Pan said. “Not everyone has to agree, but it has to be credible to the people that have to implement it.”\u003c/p>\n\u003cp>Melnick of USC said the industry’s argument that a cost-growth target would harm health access and quality is already an issue with today’s spending levels.\u003c/p>\n\u003cp>“A lot of people put off care because they can’t afford it,” he said. “That’s an access and quality impact.”\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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"title": "California Wants to Cap Medical Bills, but the Health Care Industry Pushes Back | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A new state office charged with controlling the rising cost of health care in California is moving toward one of the most aggressive goals in the nation, aiming to cap cost increases to 3% a year.\u003c/p>\n\u003cp>You might not notice immediately if the Office of Health Care Affordability commits to the tentative goal it released last month and takes steps to enforce it. But, over time, experts say the cap on price increases could make a difference in how much Californians pay for health care.\u003c/p>\n\u003cp>“A 3.0% target places California on the path of a more sustainable, affordable and equitable health care system, slowing the trajectory of growth and improving affordability for all,” the office wrote in its recommendation.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘A 3.0% target places California on the path of a more sustainable, affordable and equitable health care system, slowing the trajectory of growth and improving affordability for all.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The agency’s announcement immediately drew criticism from health care industry representatives who called it “unrealistic” and “arbitrary.” They contend it could harm patients by reducing access to care if health providers are watching their spending reduce services.\u003c/p>\n\u003cp>Meanwhile, consumer advocates and health economists characterized it as a good first step in the state’s effort to control costs.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/health/2022/07/rising-health-care-costs/\">Gov. Gavin Newsom established the office\u003c/a> through a provision in the 2022 state budget. Its job is to collect health expenditure data from providers and insurers, analyze it and set limits on spending for the industry.\u003c/p>\n\u003cp>\u003ca href=\"https://www.chcf.org/publication/cost-commissions-eight-states-address-cost-growth/\">Eight other states\u003c/a> have cost benchmarks. At 3%, California’s would be one of the more stringent caps — third only to Connecticut and Nevada.\u003c/p>\n\u003cp>California’s proposed target would allow health care prices and spending to increase but slower than in recent years. Between 2015 and 2020, per capita health spending grew each year by an average of 5.2%, outpacing wages, according to the Office of Health Care Affordability.\u003c/p>\n\u003cp>Health spending in California reached $405 billion in 2020 — that’s $10,299 per person, according to federal data. This includes what private insurers, public programs and individuals pay for direct services and goods, such as hospital and physician care, prescription drugs and medical devices. It does not include the administrative costs of insurance or public health funding.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The office plans to roll out one statewide cap but may eventually create regional and sector-specific targets. Officials said they came up with the 3% figure because that is how much the annual median household income has changed over the last 20 years.\u003c/p>\n\u003cp>“Most importantly, tying to historical median household income growth signals that health care spending should not grow faster than the income of California families,” Vishaal Pegany, deputy director of the Office of Health Care Affordability, said during the most recent board meeting.\u003c/p>\n\u003cp>Providers and entities that fail to meet the proposed benchmark could have to make improvements or face financial penalties. They would not be punished in the program’s first year.\u003c/p>\n\u003cp>The \u003ca href=\"https://hcai.ca.gov/public-meetings/february-health-care-affordability-board-meeting/\">state’s health care affordability board\u003c/a> is scheduled to continue discussions this month and has until June 1 to approve a cost target that would go into effect in 2025 and last through 2029.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://e.infogram.com/d62c39a9-a90d-491d-a17f-680523ba32ad?parent_url=https%3A%2F%2Fcalmatters.org%2Fhealth%2F2024%2F02%2Fhealth-care-costs-cap%2F&src=embed#async_embed\" width=\"800\" height=\"730\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003ch2>No instant savings on health care costs\u003c/h2>\n\u003cp>Many Californians are struggling with health care costs. \u003ca href=\"https://www.chcf.org/blog/top-takeaways-california-health-policy-poll/#:~:text=Meanwhile%2C%20close%20to%204%20in,racial%20equity%20in%20health%20care.\">Four in 10 Californians have medical debt\u003c/a>, according to the California Health Care Foundation.\u003c/p>\n\u003cp>Data show that people are spending more of their income on health care. A recently published \u003ca href=\"https://laborcenter.berkeley.edu/wp-content/uploads/2024/01/Measuring-Consumer-Affordability-final.pdf\">study by the UC Berkeley Labor Center (PDF)\u003c/a> found that costs like deductibles are becoming more common. In 2002, 33% of private sector workers enrolled in coverage through their jobs had a deductible. By 2022, 77% of workers did.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The size of those deductibles has grown exponentially. Between 2002 and 2022, deductibles for a single-person plan grew 380% or an average of 8.7% every year, researchers found. Deductibles for family plans grew 332% or 7.8% annually.\u003c/p>\n\u003cp>Consumers will probably not feel a difference immediately because the state’s plan is to slow the growth of health spending and not necessarily reduce it.\u003c/p>\n\u003cp>But over time, it could make a difference. Glenn Melnick, a health economist at the University of Southern California, gives this example: “If I have to pay 25% of my (health insurance) premium, let’s say I get it from work, if my premium goes up more slowly, my contribution will be less.”\u003c/p>\n\u003cp>“What if this target had been in place for the last 10 years?” he said.\u003c/p>\n\u003ch2>California providers criticize cap\u003c/h2>\n\u003cp>Representatives for hospitals and doctors caution that basing the spending cap solely on household income rather than taking into account what it costs them to provide care could result in less access and poorer quality of care for patients.\u003c/p>\n\u003cp>They argue the proposed cap doesn’t take into account things providers have no control over, such as general inflation, rising pharmaceutical costs and natural increases in spending driven by the state’s aging population.\u003c/p>\n\u003cp>“[The office’s] proposed target entirely ignores the drivers of health care spending. In doing so, it would force health care providers to significantly cut back on the care they provide or face penalties,” wrote Ben Johnson, vice president of policy at the California Hospital Association, in a letter to the board.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Some industry representatives noted specific access issues, such as narrow provider networks and long wait times, are already a top concern for the public. “A 3% target put in place for five years seems likely to result in wait times increasing,” Janice Rocco, chief of staff at the California Medical Association, said during the board’s recent meeting.\u003c/p>\n\u003cp>Dr. Richard Pan, a Sacramento pediatrician and former state senator who sits on the health care affordability board, said that for the state’s plan to truly work, the office and board would have to nail down the methodology behind the spending target so that the industry groups have confidence in it.\u003c/p>\n\u003cp>“We still have some time; these things need to be thought out,” Pan said. “Not everyone has to agree, but it has to be credible to the people that have to implement it.”\u003c/p>\n\u003cp>Melnick of USC said the industry’s argument that a cost-growth target would harm health access and quality is already an issue with today’s spending levels.\u003c/p>\n\u003cp>“A lot of people put off care because they can’t afford it,” he said. “That’s an access and quality impact.”\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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"content": "\u003cp>\u003ca href=\"#episode-transcript\">View the full episode transcript.\u003c/a>\u003c/p>\n\u003cp>California’s primary is just around the corner, on March 5, 2024. This year, there’s a statewide Proposition on your primary ballot, but don’t worry we’ve got you covered. Prop. 1 asks voters two big questions: Should mental health funding be used for housing? And should the state borrow money to build more housing and treatment facilities? There’s tons of interesting stuff to dig into on this one.\u003c/p>\n\u003ch2 id=\"episode-transcript\">Episode Transcript\u003c/h2>\n\u003cp>\u003cem>This is a computer-generated transcript. While our team has reviewed it, there may be errors.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> California. Primary day is just around the corner on March 5th, and this year Californians have a lot to consider. We’ve got the presidential primary. Of course, there’s a contentious Senate race and lots happening on the local level. And then we’ve got proposition one all about funding for mental health care and housing for the state’s most vulnerable residents. Here’s how prop one will read on your ballot.\u003c/p>\n\u003cp>\u003cstrong>Voice Over:\u003c/strong> Authorizes $6.38 billion in bonds to build mental health treatment facilities for those with mental health and substance use challenges. It provides housing for the homeless.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[baycuriouspodcastinfo]\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> Now, there are two big questions being asked in this prop should mental health funding be used for housing? And should the state borrow money to build more housing and treatment facilities? There is lots of interesting stuff to discuss here. We’ll dig in just ahead on be curious. I’m Olivia Allen Price. It is always a pleasure when prop voting time rolls around, because it means I get to talk to KQED politics correspondent guy Maserati. Hey, Guy.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Hey, Olivia.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> It’s been a minute, but here we are in a big election year. One of the first decisions that California voters are going to make is which way to go on prop one.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> That’s right. Proposition one is actually two pretty big ideas that are rolled up into one proposition. So it’s a bond measure. It’s also a reallocation of existing funds. So this was placed on the ballot by the state legislature because they need to go to the voters to get approval if they want to issue a bond. They also need to go to the voters to make a change to a ballot measure that voters previously approved back in 2004. So here we are.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> We’ll go step by step through all the moving parts of this one. But first, guy, can you walk us through the problems that proposition one is aiming to solve?\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Yeah. The big idea behind the proposition is focusing state dollars on people who are experiencing homelessness and who have severe behavioral health issues. So we know Californians who are experiencing homelessness. It’s not a monolith. You have people who maybe, you know, fell behind on rent, maybe people who are just looking for an affordable place to live. Prop one is not focused on those folks. But, there are a lot of people who are experiencing homelessness in California who have added challenges on top of that. UCSF did their massive study of the state’s homeless population. They found 27% of people living without shelter have been hospitalized for a mental health issue. They also found 65% of those people who are living without shelter have reported heavy substance abuse. These are the kinds of people who are prop one is aimed at helping.\u003c/p>\n\u003cp>So the idea is that of all the people in the state who are facing mental health challenges, these Californians, the ones who are living on the streets or at risk of living on the streets, are the ones who need to be prioritized. And so that’s where you get to kind of the political piece of all of this, which is that homelessness is a top priority for voters, especially kind of the visible suffering of people that you see on the streets. That’s become such a huge political issue, and it’s become a big issue for the man who is backing prop one. Governor Gavin Newsom, this is part of his kind of big swing to try to fix this issue.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> Okay. And broadly, what are we considering in proposition one?\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> So voters are being asked if the state should borrow money to build treatment facilities, build supportive housing, and if it should also change how existing mental health money gets spent, mainly by using more of that mental health money to build housing.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> Let’s dig into the details a bit more now. Like we said a minute ago, this prop has sort of two arms. And I want to start with that first arm the bond. Now a quick bond refresher. A bond is essentially a loan the government takes out to fund certain projects. In this case, it’s a loan the state will pay back with interest over the next 30 years.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Right. So prop one would allow the state to borrow money by issuing $6.38 billion in bonds. Most of that money, about $4.4 billion, is going to go towards building treatment facilities. Now, this is for, like we mentioned, the thousands of Californians who have mental health needs, who have substance abuse issues, who are at risk or are actually living on the street. So that could be kind of a short term crisis care facility or longer term, you know, residential facilities, rehab communities and even, you know, some outpatient services. So that’s about 4.4 billion.\u003c/p>\n\u003cp>Then the rest of the measure, roughly 2 billion, that’s going to go towards building affordable apartments that come with kind of onsite behavioral health services. Of that 2 billion. Now we’re breaking this down further. Of that 2 billion. About 1 billion would be specifically for veterans who have behavioral health challenges. So again, we’re talking about helping people who are most visibly suffering, people who are having, you know, psychotic episodes on the street, people who are living in tents.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> So what is all this investment actually going to do?\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Supporters of prop one say by spending this bond money, they’re going to be able to create 4350 housing units, another 6800 treatment slots. Obviously, this is all a drop in the bucket for the overall homeless population in California, which is estimated to be more than 180,000 people. But again, the idea of prop one is a focus less focus on a subgroup of people who are experiencing homelessness. Newsom says prop one is the solution to the decades of unintended consequences that kicked off when California closed its state mental hospitals, but didn’t create alternative places for people to live and get care. Here’s Newsom.\u003c/p>\n\u003cp>\u003cstrong>Gavin Newsom:\u003c/strong> The reforms that took place in the late 50s, in the 60s and the 70s, that bipartisan endeavor around deinstitutionalization. We had a peak 37,000, beds in the state of California in the 60s, 37,000 beds. Today, it’s about 5500.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> We actually do have a \u003ca href=\"https://www.kqed.org/news/11209729/did-the-emptying-of-mental-hospitals-contribute-to-homelessness-here\">Bay Curious episode about the closing of state mental hospitals and its impact on homelessness\u003c/a>. We’ll put a link in the show notes and transcript for this episode if you want to check that out. Guy, is there more detail on how this money will be allocated, like specific projects or even how much would go to, say, Alameda County versus Los Angeles County or anything like that? Right.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> That all hasn’t been laid out yet. I will say Newsom’s chief of staff, toxic KQED last summer about this prop. She said the administration, even though this had just started to move towards the ballot, they’re already looking at locations to build or refurbish, potential places with this bond money. I think really acknowledging that the process of building anything in California just takes a really long time.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> [00:06:50] Another discussion for another time. I think it’s always worth remembering that bond money isn’t free if voters approve it. How will this bond impact Californians over time?\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Right. So California would have to repay the bonds back over 30 years out of the state’s general fund. That’s where all our tax money ends up. And that works out to about $310 million a year, which because we’re talking about a really massive state budget, it’s actually only about one half of 1% of the general fund. Now, the state would have to pay interest on top of all of that. So over the course of three decades, we’d pay about $9 billion, not adjusted for inflation, to pay back what is a $6.38 billion bond on the ballot?\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> Okay, now on to the second arm of proposition one. So this measure would change how money collected for mental health services under Prop 63, which passed in 2004, is distributed. Okay. Start by taking us back 20 years to when voters approved the Mental Health Services Act.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Yeah, this was really wild for me. Going back and looking at the coverage of that campaign back in 2004, because the issues that the supporters of Prop 63 were trying to address are so similar to what supporters of prop one are talking about right now. It’s basically a feeling that since those state hospitals closed, California really stopped providing the necessary care for people who have these severe mental health challenges. And the result has been those same people end up on the streets, in tents in our county jails. So what the Mental Health Services Act did back in 2004 was create this 1% tax on income over $1 million. It’s since been kind of colloquially known as the millionaires tax. And that created this new bucket of money that the state could use for mental health services.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> So voters passed the Mental Health Services Act, which generates between two and a half and $3 billion per year. And that money now funds about a third of mental health services budgets for counties around the state. What counties especially like about this money is they have a lot of say in how it gets used. There aren’t a lot of strings attached.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Darrell Steinberg, who is currently the mayor of Sacramento back then in 2004, he was in the legislature and actually helped write the original Mental Health Services Act. He says the measure has been successful. It’s paid for a lot of services all across the state, from counseling to drop in centers to early intervention, having people come in to schools and classrooms and help teachers identify kids who might have mental health challenges. But he says the reason that all these years later, he’s now one of the leading supporters of changing it is because there hasn’t been enough focus on housing.\u003c/p>\n\u003cp>\u003cstrong>Darrell Steinberg:\u003c/strong> I think the counties have actually spent the money well, but what they haven’t done is spent it in a way that was focused on the most critical issues affecting our state.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> So the trade off that supporters of prop one are pitching to voters is basically, let’s give up the flexibility in how this money is spent in exchange for adding greater focus, specifically focus on housing.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> Tell me more about how they would limit flexibility that the counties have.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> So under prop one, if it passes, counties would be required to spend 30% of that millionaire tax money they get from the state, specifically on housing. So that could mean providing rental subsidies, building new housing, converting things like motels into housing with supportive services. So this would leave counties then with less money to spend on some of the other programs and services they’ve been providing in the mental health space. So they need to find the money elsewhere. Or in the case a lot of opponents are concerned about, they would need to scale back or cut some of these programs. Paul Simmons is one of the leaders of the No on prop one campaign. He recently led Depression and Bipolar Support Alliance California, which provides peer support for people with depression bipolar disorder. He says service providers in similar positions are really worried.\u003c/p>\n\u003cp>\u003cstrong>Paul Simmons:\u003c/strong> Adult respite centers and wellness centers are very, very much at risk. All peer support programs are just scared to death right now that they’re going to lose any funding they got from from the MSA funding.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> And you also have county governments who are really concerned about prop one, because right now they’re the ones that are getting this millionaires tax money. They are concerned that more of this money would go to the state. The state wants more say on how the millionaires tax money is spent. So you have many county supervisors who have come out against prop one. They’re concerned that if it passes, they’re going to have to cancel contracts with community based organizations or even perhaps reduce county staff.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> Right now, 95% of that million in our tax money goes to counties. What would that look like under prop one?\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Under prop one, it would be more like 90% with the state using its cut for things like increasing just the number of mental health care workers. And one other change I should note here is that counties under prop one would be able to spend some of this money on housing for folks who just have drug and alcohol addiction challenges, you know, substance abuse issues. They may not have a dual diagnosis, mental health issue. And right now, all the Mental Health Services Act funding under Prop 63, the millionaires tax, all of that has to be used for people with mental health conditions. This would actually change the name of the entire thing to the Behavioral Health Services Act.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> I see, so by calling it the behavioral rather than the Mental Health Services Act, it really broadens out the group of people who could be served by the money guy. Would this increase taxes for anybody?\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> No. And this is actually what makes this kind of controversial. It doesn’t increase the millionaires tax that funds the current Mental Health Services Act. So opponents of prop one say you have the same pot of money. You’re just stretching it in all these new directions by trying to focus on housing. Now, supporters like Newsom will say, that’s not the whole picture. There are all these other initiatives happening, you know, like Cal Aim, which try to get, for example, health plans to pay for some of these mental health services that prop 63, the Mental Health Services Act, has been doing for the last two. Years.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> What else do opponents have to say about this one?\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> So I think just like we broke down the measure into a couple parts, it might be helpful to break down where opponents are coming from on this pretty, pretty complex measure. So let’s start with the bonds. You have the state borrowing a lot of money to build these treatment facilities, supportive apartments. So you have conservatives, anti-tax groups like the Howard Jarvis Taxpayers Association. They oppose taking on that debt. And then there’s other conservatives who kind of jump on and say, we also don’t agree with the Housing First policy here, which is when someone with, say, a substance abuse problem is given housing before going through treatment.\u003c/p>\n\u003cp>And then there’s another piece of this, which is about what kind of housing can be built with this bond money, because prop one actually allows the money to be spent on locked facilities. These are, you know, places where people might get placed as a result of a conservatorship, where treatment is not voluntary. And this is pretty controversial. You get opposition not from conservatives on this, but you get opposition from groups like Disability Rights California, for example, who say these kind of lock facilities violate civil liberties and don’t have proven outcomes. Now, supporters of prop one say this is not going to be a huge piece of all the new facilities that get built, but that’s really an open question going forward.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> And what about the changes to how the existing prop 63 millionaires tax money is spent? Who is opposed to that?\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Yeah, that piece of prop one is opposed by some service providers, folks like Paul Simmons, who say if you’re focusing on helping people who are the most visible have the most acute needs, that’s a poor investment. If you’re taking that money from programs that try to provide help with mental health, substance abuse, when people are in school or when they’re in counseling.\u003c/p>\n\u003cp>\u003cstrong>Paul Simmons:\u003c/strong> But really, what they’re doing, from my perspective, is to take the money from the early intervention, take it from the upstream part and throw it all into downstream. You know, where people are having more trouble and in fact, forcing more people downstream.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> And so folks like Simmons are worried that if California puts less funding toward preventative upstream programs that support people you know, before their problems are most severe, we’re actually going to worsen some of the state’s problems.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> And who is in support of proposition one?\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Yeah, the biggest name in support is Governor Gavin Newsom. You know, for all the attention he’s gotten on political stunts, campaigning across the country, debating Florida Governor Ron DeSantis, the biggest policy focus he’s had in Sacramento has been at this intersection of behavioral health and homelessness. So just in the last few years, the governor signed bills to create care courts. So this kind of compels treatment, housing for people with severe mental illness. He also signed bills making it easier to place people in a conservative ship. Prop one is the latest step in that direction.\u003c/p>\n\u003cp>\u003cstrong>Gavin Newsom:\u003c/strong> This is, I think, the last big piece. We’ve got we’ve just we’ve radically changed the way we’re doing business. We created more flexibility, more tools, more accountability, more resources. Now we just we need more beds.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> And I think what’s notable about prop one is just the size of the coalition supporting it. So both these ideas, the bond measure and then these changes to mental health spending. They both passed with huge majorities in the legislature last year. Support from Democrats, support from Republicans. Now, you might say like, oh, when the governor comes out and says, this is my top priority, everyone’s going to get in line. But I also think it’s a fact that the broken status quo, we see people just visibly suffering on the street. That touches a lot of different parts of society. So you have, you know, leaders of California hospitals supporting this. They see many of these residents end up in their emergency rooms. You have groups representing firefighters, law enforcement behind this. They often get called to respond when someone is having a mental health episode. And then you have what might be the biggest group of backers, which are mayors. You know, they feel directly, you know, accountable to voters for what residents see on the street. And it’s why you have mayors like London Breed in San Francisco so vocally in support of prop one.\u003c/p>\n\u003cp>\u003cstrong>London Breed:\u003c/strong> I was just out in the Tenderloin and San Francisco, and it is clear that we need people to get the support that they need, especially those suffering from mental health and substance use disorder. Let’s get into campaign spending. What does it look like on this?\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Prop spending is very lopsided for this prop. You have supporters having raised more than $11 million to help push this measure through. Opponents, on the other hand, just about $1,000.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> Wow. So really kind of David and Goliath on the on spending.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> On the spending front for sure. Yeah.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> All right. Well, KQED political correspondent Guy Maserati, always a pleasure. Thank you.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Thanks, Olivia.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> In a nutshell, a vote yes on proposition one means you’d like to see funds from an existing tax on millionaires used not just for mental health care, but also people facing drug or alcohol challenges. You’d also like those funds to be used for housing people needing mental health or substance abuse care. Finally, you’d like California to borrow $6.4 billion to pay for more mental health and substance abuse treatment facilities and housing.\u003c/p>\n\u003cp>A vote no on proposition one means you’d like to keep the Mental Health Services Act in its current form, and or you do not want California to issue that $6.4 billion bond.\u003c/p>\n\u003cp>All right. We really hope that helped you make sense of what you’ll be voting on. Again, Election Day is March 5th, but ballots should be in your mailbox soon if they haven’t arrived yet. If you found this episode helpful, do us a favor and tell your friends all about it or share it out on your social media accounts. Thanks.\u003c/p>\n\u003cp>We’re already gearing up for our full sized Prop Fest series during the upcoming general election. If you’ve got questions about a prop, another race, or any other voting issue in California, head over to Bay curious.org and use the form at the top of the page to send that question our way.\u003c/p>\n\u003cp>Bay curious is made in San Francisco at member supported KQED. Our show is produced by Katrina Schwartz, Christopher Bill and me Olivia Allen Price. Additional support from Jen Chen, Katie Springer, Cesar Saldana, Maha Sanford, Hollie Kernan and the whole KQED family. I’m Olivia Ellen Price. Best of luck in your decision.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>[baycuriousquestion]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"#episode-transcript\">View the full episode transcript.\u003c/a>\u003c/p>\n\u003cp>California’s primary is just around the corner, on March 5, 2024. This year, there’s a statewide Proposition on your primary ballot, but don’t worry we’ve got you covered. Prop. 1 asks voters two big questions: Should mental health funding be used for housing? And should the state borrow money to build more housing and treatment facilities? There’s tons of interesting stuff to dig into on this one.\u003c/div>",
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"content": "\u003cdiv class=\"post-content post-body\">\u003ch2 id=\"episode-transcript\">Episode Transcript\u003c/h2>\n\u003cp>\u003cem>This is a computer-generated transcript. While our team has reviewed it, there may be errors.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> California. Primary day is just around the corner on March 5th, and this year Californians have a lot to consider. We’ve got the presidential primary. Of course, there’s a contentious Senate race and lots happening on the local level. And then we’ve got proposition one all about funding for mental health care and housing for the state’s most vulnerable residents. Here’s how prop one will read on your ballot.\u003c/p>\n\u003cp>\u003cstrong>Voice Over:\u003c/strong> Authorizes $6.38 billion in bonds to build mental health treatment facilities for those with mental health and substance use challenges. It provides housing for the homeless.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003caside class=\"alignleft utils-parseShortcode-shortcodes-__bayCuriousPodcastShortcode__bayCurious\">\u003cimg src=https://cdn.kqed.org/wp-content/uploads/2023/02/bayCuriousLogo.png alt=\"Bay Curious Podcast\" loading=\"lazy\" />\n \u003ca href=\"/news/series/baycurious\">Bay Curious\u003c/a> is a podcast that answers your questions about the Bay Area.\n Subscribe on \u003ca href=\"https://itunes.apple.com/us/podcast/bay-curious/id1172473406\" target=\"_blank\" rel=\"noopener noreferrer\">Apple Podcasts\u003c/a>,\n \u003ca href=\"http://www.npr.org/podcasts/500557090/bay-curious\" target=\"_blank\" rel=\"noopener noreferrer\">NPR One\u003c/a> or your favorite podcast platform.\u003c/aside>\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> Now, there are two big questions being asked in this prop should mental health funding be used for housing? And should the state borrow money to build more housing and treatment facilities? There is lots of interesting stuff to discuss here. We’ll dig in just ahead on be curious. I’m Olivia Allen Price. It is always a pleasure when prop voting time rolls around, because it means I get to talk to KQED politics correspondent guy Maserati. Hey, Guy.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Hey, Olivia.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> It’s been a minute, but here we are in a big election year. One of the first decisions that California voters are going to make is which way to go on prop one.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> That’s right. Proposition one is actually two pretty big ideas that are rolled up into one proposition. So it’s a bond measure. It’s also a reallocation of existing funds. So this was placed on the ballot by the state legislature because they need to go to the voters to get approval if they want to issue a bond. They also need to go to the voters to make a change to a ballot measure that voters previously approved back in 2004. So here we are.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> We’ll go step by step through all the moving parts of this one. But first, guy, can you walk us through the problems that proposition one is aiming to solve?\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Yeah. The big idea behind the proposition is focusing state dollars on people who are experiencing homelessness and who have severe behavioral health issues. So we know Californians who are experiencing homelessness. It’s not a monolith. You have people who maybe, you know, fell behind on rent, maybe people who are just looking for an affordable place to live. Prop one is not focused on those folks. But, there are a lot of people who are experiencing homelessness in California who have added challenges on top of that. UCSF did their massive study of the state’s homeless population. They found 27% of people living without shelter have been hospitalized for a mental health issue. They also found 65% of those people who are living without shelter have reported heavy substance abuse. These are the kinds of people who are prop one is aimed at helping.\u003c/p>\n\u003cp>So the idea is that of all the people in the state who are facing mental health challenges, these Californians, the ones who are living on the streets or at risk of living on the streets, are the ones who need to be prioritized. And so that’s where you get to kind of the political piece of all of this, which is that homelessness is a top priority for voters, especially kind of the visible suffering of people that you see on the streets. That’s become such a huge political issue, and it’s become a big issue for the man who is backing prop one. Governor Gavin Newsom, this is part of his kind of big swing to try to fix this issue.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> Okay. And broadly, what are we considering in proposition one?\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> So voters are being asked if the state should borrow money to build treatment facilities, build supportive housing, and if it should also change how existing mental health money gets spent, mainly by using more of that mental health money to build housing.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> Let’s dig into the details a bit more now. Like we said a minute ago, this prop has sort of two arms. And I want to start with that first arm the bond. Now a quick bond refresher. A bond is essentially a loan the government takes out to fund certain projects. In this case, it’s a loan the state will pay back with interest over the next 30 years.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Right. So prop one would allow the state to borrow money by issuing $6.38 billion in bonds. Most of that money, about $4.4 billion, is going to go towards building treatment facilities. Now, this is for, like we mentioned, the thousands of Californians who have mental health needs, who have substance abuse issues, who are at risk or are actually living on the street. So that could be kind of a short term crisis care facility or longer term, you know, residential facilities, rehab communities and even, you know, some outpatient services. So that’s about 4.4 billion.\u003c/p>\n\u003cp>Then the rest of the measure, roughly 2 billion, that’s going to go towards building affordable apartments that come with kind of onsite behavioral health services. Of that 2 billion. Now we’re breaking this down further. Of that 2 billion. About 1 billion would be specifically for veterans who have behavioral health challenges. So again, we’re talking about helping people who are most visibly suffering, people who are having, you know, psychotic episodes on the street, people who are living in tents.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> So what is all this investment actually going to do?\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Supporters of prop one say by spending this bond money, they’re going to be able to create 4350 housing units, another 6800 treatment slots. Obviously, this is all a drop in the bucket for the overall homeless population in California, which is estimated to be more than 180,000 people. But again, the idea of prop one is a focus less focus on a subgroup of people who are experiencing homelessness. Newsom says prop one is the solution to the decades of unintended consequences that kicked off when California closed its state mental hospitals, but didn’t create alternative places for people to live and get care. Here’s Newsom.\u003c/p>\n\u003cp>\u003cstrong>Gavin Newsom:\u003c/strong> The reforms that took place in the late 50s, in the 60s and the 70s, that bipartisan endeavor around deinstitutionalization. We had a peak 37,000, beds in the state of California in the 60s, 37,000 beds. Today, it’s about 5500.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> We actually do have a \u003ca href=\"https://www.kqed.org/news/11209729/did-the-emptying-of-mental-hospitals-contribute-to-homelessness-here\">Bay Curious episode about the closing of state mental hospitals and its impact on homelessness\u003c/a>. We’ll put a link in the show notes and transcript for this episode if you want to check that out. Guy, is there more detail on how this money will be allocated, like specific projects or even how much would go to, say, Alameda County versus Los Angeles County or anything like that? Right.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> That all hasn’t been laid out yet. I will say Newsom’s chief of staff, toxic KQED last summer about this prop. She said the administration, even though this had just started to move towards the ballot, they’re already looking at locations to build or refurbish, potential places with this bond money. I think really acknowledging that the process of building anything in California just takes a really long time.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> [00:06:50] Another discussion for another time. I think it’s always worth remembering that bond money isn’t free if voters approve it. How will this bond impact Californians over time?\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Right. So California would have to repay the bonds back over 30 years out of the state’s general fund. That’s where all our tax money ends up. And that works out to about $310 million a year, which because we’re talking about a really massive state budget, it’s actually only about one half of 1% of the general fund. Now, the state would have to pay interest on top of all of that. So over the course of three decades, we’d pay about $9 billion, not adjusted for inflation, to pay back what is a $6.38 billion bond on the ballot?\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> Okay, now on to the second arm of proposition one. So this measure would change how money collected for mental health services under Prop 63, which passed in 2004, is distributed. Okay. Start by taking us back 20 years to when voters approved the Mental Health Services Act.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Yeah, this was really wild for me. Going back and looking at the coverage of that campaign back in 2004, because the issues that the supporters of Prop 63 were trying to address are so similar to what supporters of prop one are talking about right now. It’s basically a feeling that since those state hospitals closed, California really stopped providing the necessary care for people who have these severe mental health challenges. And the result has been those same people end up on the streets, in tents in our county jails. So what the Mental Health Services Act did back in 2004 was create this 1% tax on income over $1 million. It’s since been kind of colloquially known as the millionaires tax. And that created this new bucket of money that the state could use for mental health services.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> So voters passed the Mental Health Services Act, which generates between two and a half and $3 billion per year. And that money now funds about a third of mental health services budgets for counties around the state. What counties especially like about this money is they have a lot of say in how it gets used. There aren’t a lot of strings attached.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Darrell Steinberg, who is currently the mayor of Sacramento back then in 2004, he was in the legislature and actually helped write the original Mental Health Services Act. He says the measure has been successful. It’s paid for a lot of services all across the state, from counseling to drop in centers to early intervention, having people come in to schools and classrooms and help teachers identify kids who might have mental health challenges. But he says the reason that all these years later, he’s now one of the leading supporters of changing it is because there hasn’t been enough focus on housing.\u003c/p>\n\u003cp>\u003cstrong>Darrell Steinberg:\u003c/strong> I think the counties have actually spent the money well, but what they haven’t done is spent it in a way that was focused on the most critical issues affecting our state.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> So the trade off that supporters of prop one are pitching to voters is basically, let’s give up the flexibility in how this money is spent in exchange for adding greater focus, specifically focus on housing.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> Tell me more about how they would limit flexibility that the counties have.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> So under prop one, if it passes, counties would be required to spend 30% of that millionaire tax money they get from the state, specifically on housing. So that could mean providing rental subsidies, building new housing, converting things like motels into housing with supportive services. So this would leave counties then with less money to spend on some of the other programs and services they’ve been providing in the mental health space. So they need to find the money elsewhere. Or in the case a lot of opponents are concerned about, they would need to scale back or cut some of these programs. Paul Simmons is one of the leaders of the No on prop one campaign. He recently led Depression and Bipolar Support Alliance California, which provides peer support for people with depression bipolar disorder. He says service providers in similar positions are really worried.\u003c/p>\n\u003cp>\u003cstrong>Paul Simmons:\u003c/strong> Adult respite centers and wellness centers are very, very much at risk. All peer support programs are just scared to death right now that they’re going to lose any funding they got from from the MSA funding.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> And you also have county governments who are really concerned about prop one, because right now they’re the ones that are getting this millionaires tax money. They are concerned that more of this money would go to the state. The state wants more say on how the millionaires tax money is spent. So you have many county supervisors who have come out against prop one. They’re concerned that if it passes, they’re going to have to cancel contracts with community based organizations or even perhaps reduce county staff.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> Right now, 95% of that million in our tax money goes to counties. What would that look like under prop one?\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Under prop one, it would be more like 90% with the state using its cut for things like increasing just the number of mental health care workers. And one other change I should note here is that counties under prop one would be able to spend some of this money on housing for folks who just have drug and alcohol addiction challenges, you know, substance abuse issues. They may not have a dual diagnosis, mental health issue. And right now, all the Mental Health Services Act funding under Prop 63, the millionaires tax, all of that has to be used for people with mental health conditions. This would actually change the name of the entire thing to the Behavioral Health Services Act.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> I see, so by calling it the behavioral rather than the Mental Health Services Act, it really broadens out the group of people who could be served by the money guy. Would this increase taxes for anybody?\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> No. And this is actually what makes this kind of controversial. It doesn’t increase the millionaires tax that funds the current Mental Health Services Act. So opponents of prop one say you have the same pot of money. You’re just stretching it in all these new directions by trying to focus on housing. Now, supporters like Newsom will say, that’s not the whole picture. There are all these other initiatives happening, you know, like Cal Aim, which try to get, for example, health plans to pay for some of these mental health services that prop 63, the Mental Health Services Act, has been doing for the last two. Years.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> What else do opponents have to say about this one?\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> So I think just like we broke down the measure into a couple parts, it might be helpful to break down where opponents are coming from on this pretty, pretty complex measure. So let’s start with the bonds. You have the state borrowing a lot of money to build these treatment facilities, supportive apartments. So you have conservatives, anti-tax groups like the Howard Jarvis Taxpayers Association. They oppose taking on that debt. And then there’s other conservatives who kind of jump on and say, we also don’t agree with the Housing First policy here, which is when someone with, say, a substance abuse problem is given housing before going through treatment.\u003c/p>\n\u003cp>And then there’s another piece of this, which is about what kind of housing can be built with this bond money, because prop one actually allows the money to be spent on locked facilities. These are, you know, places where people might get placed as a result of a conservatorship, where treatment is not voluntary. And this is pretty controversial. You get opposition not from conservatives on this, but you get opposition from groups like Disability Rights California, for example, who say these kind of lock facilities violate civil liberties and don’t have proven outcomes. Now, supporters of prop one say this is not going to be a huge piece of all the new facilities that get built, but that’s really an open question going forward.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> And what about the changes to how the existing prop 63 millionaires tax money is spent? Who is opposed to that?\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Yeah, that piece of prop one is opposed by some service providers, folks like Paul Simmons, who say if you’re focusing on helping people who are the most visible have the most acute needs, that’s a poor investment. If you’re taking that money from programs that try to provide help with mental health, substance abuse, when people are in school or when they’re in counseling.\u003c/p>\n\u003cp>\u003cstrong>Paul Simmons:\u003c/strong> But really, what they’re doing, from my perspective, is to take the money from the early intervention, take it from the upstream part and throw it all into downstream. You know, where people are having more trouble and in fact, forcing more people downstream.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> And so folks like Simmons are worried that if California puts less funding toward preventative upstream programs that support people you know, before their problems are most severe, we’re actually going to worsen some of the state’s problems.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> And who is in support of proposition one?\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Yeah, the biggest name in support is Governor Gavin Newsom. You know, for all the attention he’s gotten on political stunts, campaigning across the country, debating Florida Governor Ron DeSantis, the biggest policy focus he’s had in Sacramento has been at this intersection of behavioral health and homelessness. So just in the last few years, the governor signed bills to create care courts. So this kind of compels treatment, housing for people with severe mental illness. He also signed bills making it easier to place people in a conservative ship. Prop one is the latest step in that direction.\u003c/p>\n\u003cp>\u003cstrong>Gavin Newsom:\u003c/strong> This is, I think, the last big piece. We’ve got we’ve just we’ve radically changed the way we’re doing business. We created more flexibility, more tools, more accountability, more resources. Now we just we need more beds.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> And I think what’s notable about prop one is just the size of the coalition supporting it. So both these ideas, the bond measure and then these changes to mental health spending. They both passed with huge majorities in the legislature last year. Support from Democrats, support from Republicans. Now, you might say like, oh, when the governor comes out and says, this is my top priority, everyone’s going to get in line. But I also think it’s a fact that the broken status quo, we see people just visibly suffering on the street. That touches a lot of different parts of society. So you have, you know, leaders of California hospitals supporting this. They see many of these residents end up in their emergency rooms. You have groups representing firefighters, law enforcement behind this. They often get called to respond when someone is having a mental health episode. And then you have what might be the biggest group of backers, which are mayors. You know, they feel directly, you know, accountable to voters for what residents see on the street. And it’s why you have mayors like London Breed in San Francisco so vocally in support of prop one.\u003c/p>\n\u003cp>\u003cstrong>London Breed:\u003c/strong> I was just out in the Tenderloin and San Francisco, and it is clear that we need people to get the support that they need, especially those suffering from mental health and substance use disorder. Let’s get into campaign spending. What does it look like on this?\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Prop spending is very lopsided for this prop. You have supporters having raised more than $11 million to help push this measure through. Opponents, on the other hand, just about $1,000.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> Wow. So really kind of David and Goliath on the on spending.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> On the spending front for sure. Yeah.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> All right. Well, KQED political correspondent Guy Maserati, always a pleasure. Thank you.\u003c/p>\n\u003cp>\u003cstrong>Guy Marzorati:\u003c/strong> Thanks, Olivia.\u003c/p>\n\u003cp>\u003cstrong>Olivia Allen-Price:\u003c/strong> In a nutshell, a vote yes on proposition one means you’d like to see funds from an existing tax on millionaires used not just for mental health care, but also people facing drug or alcohol challenges. You’d also like those funds to be used for housing people needing mental health or substance abuse care. Finally, you’d like California to borrow $6.4 billion to pay for more mental health and substance abuse treatment facilities and housing.\u003c/p>\n\u003cp>A vote no on proposition one means you’d like to keep the Mental Health Services Act in its current form, and or you do not want California to issue that $6.4 billion bond.\u003c/p>\n\u003cp>All right. We really hope that helped you make sense of what you’ll be voting on. Again, Election Day is March 5th, but ballots should be in your mailbox soon if they haven’t arrived yet. If you found this episode helpful, do us a favor and tell your friends all about it or share it out on your social media accounts. Thanks.\u003c/p>\n\u003cp>We’re already gearing up for our full sized Prop Fest series during the upcoming general election. If you’ve got questions about a prop, another race, or any other voting issue in California, head over to Bay curious.org and use the form at the top of the page to send that question our way.\u003c/p>\n\u003cp>Bay curious is made in San Francisco at member supported KQED. Our show is produced by Katrina Schwartz, Christopher Bill and me Olivia Allen Price. Additional support from Jen Chen, Katie Springer, Cesar Saldana, Maha Sanford, Hollie Kernan and the whole KQED family. I’m Olivia Ellen Price. Best of luck in your decision.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\n\u003c/div>\u003c/div>"
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"content": "\u003cp>Optometrists at University of California campuses started a two-day strike on Tuesday over what they call labor law violations by their employer during negotiations for salaries and benefits. Hundreds of patients with appointments this week may have to reschedule.\u003c/p>\n\u003cp>The \u003ca href=\"https://drive.google.com/file/d/1HhlJjh9pipFhzWpXzBHW3VEY4vUUporQ/view\">work stoppage\u003c/a> comes as UC and the University Professional and Technical Employees, Communication Workers of America Local 9119, have failed over a year to agree on the terms of employment for more than 80 optometrists who joined the union in 2022. Both parties have recently filed unfair labor practice charges against each other with state regulators.[pullquote size=\"medium\" align=\"right\" citation=\"Dr. Nicole Mercho, optometrist, UCSF Health\"]‘We love our patients. But it just feels like this strike is the only option that we have left.’[/pullquote]\u003c/p>\n\u003cp>Union representatives said noncompetitive compensation and lack of career growth opportunities contribute to the recruitment of new talent and retention problems.\u003c/p>\n\u003cp>As a result, at UCSF Health, one of the nation’s top-ranked ophthalmology hospitals, some patients wait six to eight months for an appointment, said Dr. Nicole Mercho, 29, who works at the hospital’s Glaucoma Clinic.\u003c/p>\n\u003cp>UCSF optometrists, who see about 12 to 14 patients daily on a regular schedule, manage a variety of ocular diseases and eye infections in patients often referred to the hospital from as far away as Eureka, Modesto and Stockton.\u003c/p>\n\u003cp>“We love our patients. But it just feels like this strike is the only option that we have left,” Mercho said. “It’s very frustrating that UC has not really bargained in good faith. They’re kind of dragging their feet. They are not taking it seriously.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>A spokesperson for UC told KQED that each location would handle notifications for impacted patients by the work stoppage.\u003c/p>\n\u003cp>Since January 2023, the union and UC representatives have met nearly a dozen times to work through issues to integrate the newly represented optometrists into an existing contract agreement that covers 6,500 \u003ca href=\"https://ucnet.universityofcalifornia.edu/labor/bargaining-units/hx/index.html\">health care professional unit members\u003c/a>. But that process has come to a standstill, according to union representatives.\u003c/p>\n\u003cp>Last month, the union took its case to the California Public Employment Relations Board, \u003ca href=\"https://drive.google.com/file/d/1L11KqGzxt-O3EyMGns9lsuOCYjhqiPB5/view\">accusing\u003c/a> the university of violations that include refusing to disclose “essential” data for bargaining on wages and withholding contact information for new unit members for months.\u003c/p>\n\u003cfigure id=\"attachment_11974804\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11974804\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/UCSFHealth.jpg\" alt=\"The exterior shot of the UCSF Health building in San Francisco.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/UCSFHealth.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/UCSFHealth-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/UCSFHealth-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/UCSFHealth-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/UCSFHealth-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">The outside of UCSF Health, one of the nation’s top-ranked ophthalmology hospitals. \u003ccite>(Smith Collection/Gado/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Matias Campos, executive vice president at UPTE CWA Local 9119, said UC’s conduct undermines collective bargaining.\u003c/p>\n\u003cp>“We all have an interest in making sure that large public employers like the University of California are conducting themselves in an appropriate manner under labor law,” Campos told KQED. “And if a public institution like the university, that is subject to oversight, [and a] recipient of a tremendous amount of public resources, thinks that they can get away with committing unfair labor practices at the bargaining table, that should be alarming to every worker in California and every taxpayer in California.”[aside tag=\"uc-strike,union\" label=\"More Related Coverage\"]\u003c/p>\n\u003cp>UC responded by filing its own unfair labor practice \u003ca href=\"https://s3.documentcloud.org/documents/24409156/2024-02-02-uc-v-upte-perb.pdf\">charges\u003c/a> against UPTE CWA Local 9119 last week, rejecting the union’s accusations.\u003c/p>\n\u003cp>The university argued that it is simply insisting that the terms of a collective bargaining agreement that already applies to healthcare professionals in the unit also apply to optometrists and that this week’s work stoppage represented an “unlawful pre-impasse strike.”\u003c/p>\n\u003cp>“The University of California respects the rights of employees to organize and is committed to good-faith bargaining across our system with unions, including the University Professional and Technical Employees Union (UPTE),” said a UC spokesperson in a statement. “The University believes the planned UPTE action related to this limited group of employees is an unlawful exercise by the union.”\u003c/p>\n\u003cp>The spokesperson added that the two parties had reached tentative agreements on incentive compensation and other issues during the bargaining process.\u003c/p>\n\u003cp>The San Francisco Board of Supervisors is scheduled to vote Tuesday on \u003ca href=\"https://sfgov.legistar.com/LegislationDetail.aspx?ID=6503388&GUID=DC407C91-30E9-4BAA-A937-277B932BD49A\">a resolution\u003c/a>, sponsored by six members, supporting UPTE-CWA Local 9119 optometrists and urging UC’s administration to swiftly reach an agreement that recognizes the issues raised by the employees.\u003c/p>\n\u003cp>Optometrists plan to hold a picket line outside UC medical centers in San Francisco, Los Angeles, San Diego and Davis. San Francisco Supervisors Dean Preston and Hillary Ronen are expected to speak at a strike rally on Wednesday at UCSF.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Optometrists at University of California campuses started a two-day strike on Tuesday over what they call labor law violations by their employer during negotiations for salaries and benefits. Hundreds of patients with appointments this week may have to reschedule.\u003c/p>\n\u003cp>The \u003ca href=\"https://drive.google.com/file/d/1HhlJjh9pipFhzWpXzBHW3VEY4vUUporQ/view\">work stoppage\u003c/a> comes as UC and the University Professional and Technical Employees, Communication Workers of America Local 9119, have failed over a year to agree on the terms of employment for more than 80 optometrists who joined the union in 2022. Both parties have recently filed unfair labor practice charges against each other with state regulators.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Union representatives said noncompetitive compensation and lack of career growth opportunities contribute to the recruitment of new talent and retention problems.\u003c/p>\n\u003cp>As a result, at UCSF Health, one of the nation’s top-ranked ophthalmology hospitals, some patients wait six to eight months for an appointment, said Dr. Nicole Mercho, 29, who works at the hospital’s Glaucoma Clinic.\u003c/p>\n\u003cp>UCSF optometrists, who see about 12 to 14 patients daily on a regular schedule, manage a variety of ocular diseases and eye infections in patients often referred to the hospital from as far away as Eureka, Modesto and Stockton.\u003c/p>\n\u003cp>“We love our patients. But it just feels like this strike is the only option that we have left,” Mercho said. “It’s very frustrating that UC has not really bargained in good faith. They’re kind of dragging their feet. They are not taking it seriously.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>A spokesperson for UC told KQED that each location would handle notifications for impacted patients by the work stoppage.\u003c/p>\n\u003cp>Since January 2023, the union and UC representatives have met nearly a dozen times to work through issues to integrate the newly represented optometrists into an existing contract agreement that covers 6,500 \u003ca href=\"https://ucnet.universityofcalifornia.edu/labor/bargaining-units/hx/index.html\">health care professional unit members\u003c/a>. But that process has come to a standstill, according to union representatives.\u003c/p>\n\u003cp>Last month, the union took its case to the California Public Employment Relations Board, \u003ca href=\"https://drive.google.com/file/d/1L11KqGzxt-O3EyMGns9lsuOCYjhqiPB5/view\">accusing\u003c/a> the university of violations that include refusing to disclose “essential” data for bargaining on wages and withholding contact information for new unit members for months.\u003c/p>\n\u003cfigure id=\"attachment_11974804\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11974804\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/UCSFHealth.jpg\" alt=\"The exterior shot of the UCSF Health building in San Francisco.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/UCSFHealth.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/UCSFHealth-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/UCSFHealth-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/UCSFHealth-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/UCSFHealth-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">The outside of UCSF Health, one of the nation’s top-ranked ophthalmology hospitals. \u003ccite>(Smith Collection/Gado/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Matias Campos, executive vice president at UPTE CWA Local 9119, said UC’s conduct undermines collective bargaining.\u003c/p>\n\u003cp>“We all have an interest in making sure that large public employers like the University of California are conducting themselves in an appropriate manner under labor law,” Campos told KQED. “And if a public institution like the university, that is subject to oversight, [and a] recipient of a tremendous amount of public resources, thinks that they can get away with committing unfair labor practices at the bargaining table, that should be alarming to every worker in California and every taxpayer in California.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>UC responded by filing its own unfair labor practice \u003ca href=\"https://s3.documentcloud.org/documents/24409156/2024-02-02-uc-v-upte-perb.pdf\">charges\u003c/a> against UPTE CWA Local 9119 last week, rejecting the union’s accusations.\u003c/p>\n\u003cp>The university argued that it is simply insisting that the terms of a collective bargaining agreement that already applies to healthcare professionals in the unit also apply to optometrists and that this week’s work stoppage represented an “unlawful pre-impasse strike.”\u003c/p>\n\u003cp>“The University of California respects the rights of employees to organize and is committed to good-faith bargaining across our system with unions, including the University Professional and Technical Employees Union (UPTE),” said a UC spokesperson in a statement. “The University believes the planned UPTE action related to this limited group of employees is an unlawful exercise by the union.”\u003c/p>\n\u003cp>The spokesperson added that the two parties had reached tentative agreements on incentive compensation and other issues during the bargaining process.\u003c/p>\n\u003cp>The San Francisco Board of Supervisors is scheduled to vote Tuesday on \u003ca href=\"https://sfgov.legistar.com/LegislationDetail.aspx?ID=6503388&GUID=DC407C91-30E9-4BAA-A937-277B932BD49A\">a resolution\u003c/a>, sponsored by six members, supporting UPTE-CWA Local 9119 optometrists and urging UC’s administration to swiftly reach an agreement that recognizes the issues raised by the employees.\u003c/p>\n\u003cp>Optometrists plan to hold a picket line outside UC medical centers in San Francisco, Los Angeles, San Diego and Davis. San Francisco Supervisors Dean Preston and Hillary Ronen are expected to speak at a strike rally on Wednesday at UCSF.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>The Democratic mayor of San Francisco is pushing a pair of controversial public safety proposals on the March 5 ballot, including one that would require single adults on welfare to be screened and treated for illegal drug addiction or else lose cash assistance.\u003c/p>\n\u003cp>\u003ca href=\"https://apnews.com/domestic-general-news-3b2cac01584f4479b7b1da0bde1c8a88\">Mayor London Breed\u003c/a> also supports a ballot measure that would grant police more crime-fighting powers, such as using drones and surveillance cameras. In November, she’ll face cranky voters in a competitive reelection bid.\u003c/p>\n\u003cp>San Francisco is in a struggle to redefine itself after the pandemic left it in economic tatters and highlighted its \u003ca style=\"font-weight: var(--font-weight-reg)\" href=\"https://apnews.com/article/coronavirus-pandemic-sports-business-health-lifestyle-538efc664e9da0d2f0831f3f3ed9a4d7\">longstanding problems\u003c/a> with homelessness, drugs and property crime. Opponents say both ballot measures are wildly out of step with San Francisco’s support for privacy and civil liberties and will only hurt the marginalized communities the city prides itself on helping. [pullquote size=\"medium\" align=\"right\" citation=\"San Francisco Mayor London Breed\"]‘They said San Francisco makes it too easy for people to access and to use drugs on the streets of the city, and we need to do something a lot more aggressive.’[/pullquote]But Breed, the first Black woman to lead San Francisco, said at a January campaign stop that residents from poorer, Black and immigrant neighborhoods are pleading for more police, and recovery advocates are demanding change as more than 800 people died of accidental overdose last year — a record fueled by the abundance of cheap and potent fentanyl.\u003c/p>\n\u003cp>“They said San Francisco makes it too easy for people to access and to use drugs on the streets of the city, and we need to do something a lot more aggressive,” Breed said at Footprint, an athletic apparel and shoe store that has been repeatedly burglarized.\u003c/p>\n\u003cp>While Breed’s name isn’t on the presidential primary ballots going out now — San Francisco uses a method where residents rank mayoral candidates by preference a single time in November — the two measures she’s pushing are. They serve as an opening salvo for her reelection campaign as she faces off against fellow moderates who say her approach to the city’s problems has been weak.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Violent crimes are low in San Francisco, but the city has long struggled with quality-of-life crimes.\u003c/p>\n\u003cp>Breed said rates of retail theft and auto smash-ins have declined recently, thanks in large part to strategic operations by city police. Similarly, police have stepped up enforcement of drug laws, including by issuing citations to people using drugs in public as a way to disrupt the behavior and an opportunity to persuade the person cited to seek help.\u003c/p>\n\u003cp>But she said San Francisco needs to do more.\u003c/p>\n\u003cp>If approved by voters, Proposition F would offer another way to compel treatment by allowing the city to screen single adults on local welfare for substance abuse. People found to be abusing illegal drugs would be required to enroll in treatment if they want to receive cash assistance from the city, which maxes out at just over $700 a month. [aside label='More Stories on Public Health' tag='public-health']Opponents say coercion doesn’t work and homelessness may increase if the measure passes. Drug addicts are not criminals, they say, and there are not enough treatment beds and counseling services as it is.\u003c/p>\n\u003cp>A crackdown on drugs is reminiscent of the failed war on drugs that disproportionately harmed Black families, said Chris Ballard, co-executive director of Coleman Advocates, which pushes for improvements for Black and Latino youth in San Francisco.\u003c/p>\n\u003cp>“There are more ethical ways to address the issue aside from punitive measures, and that’s the proper way to take care of a community, to show true support,” he said.\u003c/p>\n\u003cp>Yet Trent Rhorer, executive director of the San Francisco Human Services Agency, which provides cash assistance and employment services to low-income residents without dependent children, said the current situation conflicts with the agency’s mission: to improve lives.\u003c/p>\n\u003cp>“To give someone who’s addicted to fentanyl $700 a month, I don’t think it helps improve their lives,” he said. “In fact, I think it does the opposite.”\u003c/p>\n\u003cp>Compelling treatment has become more acceptable in Democratic California, despite angst over the potential loss of civil liberties, as visible signs of homelessness and mental illness, fentanyl addiction, and unsafe street behavior surge.\u003c/p>\n\u003cp>Last year, several counties rolled out an alternative mental health court created by Democratic Gov. Gavin Newsom, former mayor of San Francisco, to fast-track people with untreated schizophrenia and related disorders into care, and in March, voters will take up a statewide mental health proposition, that some say will increase involuntary treatment.\u003c/p>\n\u003cp>Rhorer said the welfare program for single adults — which serves about 9,000 people per year — already asks applicants about substance abuse, with about 20% self-reporting an issue. A data check with the Department of Public Health revealed that almost one-third of recipients have been diagnosed with a substance use disorder, he said.\u003c/p>\n\u003cp>The ballot measure would replace that question with a more rigorous screening test that an addiction specialist would verify. If substance abuse is found, Rhorer said, the specialist and applicant would agree on treatment options that include residential care, a 12-step program, individual counseling and replacement medication. [pullquote size=\"medium\" align=\"right\" citation=\"Michael Hsu, store owner, Footprint USA\"]‘You’re sending the wrong message to these criminals.’[/pullquote]There is no requirement that the person be sober, only that they make good-faith efforts to attend their program, with the hope that “at one point a light bulb will go off,” Rhorer said.\u003c/p>\n\u003cp>The measure calls for the city to pay the rent of those accepted into the program for 30 days or longer to avoid eviction. About 30% of the people who fatally overdosed in 2023 were homeless, and more were living in subsidized city housing.\u003c/p>\n\u003cp>Besides authorizing drones, cameras and other modern technologies, Proposition E would reduce paperwork so police have more time to patrol. It would also allow police to pursue more suspects by vehicle, not just in cases of a violent felony or immediate threat to public safety — a policy store owner Michael Hsu learned of the hard way.\u003c/p>\n\u003cp>Hsu has had his Footprint store broken into multiple times since he took over in 2020, most recently on Jan. 1. Police arrived as the suspects were leaving but could not pursue them because no lives were at risk. Hsu, who lost about $20,000 in merchandise and damage, called that discouraging.\u003c/p>\n\u003cp>“You’re sending the wrong message to these criminals,” he said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Opponents say coercion doesn’t work and homelessness may increase if the measure passes. Drug addicts are not criminals, they say, and there are not enough treatment beds and counseling services as it is.\u003c/p>\n\u003cp>A crackdown on drugs is reminiscent of the failed war on drugs that disproportionately harmed Black families, said Chris Ballard, co-executive director of Coleman Advocates, which pushes for improvements for Black and Latino youth in San Francisco.\u003c/p>\n\u003cp>“There are more ethical ways to address the issue aside from punitive measures, and that’s the proper way to take care of a community, to show true support,” he said.\u003c/p>\n\u003cp>Yet Trent Rhorer, executive director of the San Francisco Human Services Agency, which provides cash assistance and employment services to low-income residents without dependent children, said the current situation conflicts with the agency’s mission: to improve lives.\u003c/p>\n\u003cp>“To give someone who’s addicted to fentanyl $700 a month, I don’t think it helps improve their lives,” he said. “In fact, I think it does the opposite.”\u003c/p>\n\u003cp>Compelling treatment has become more acceptable in Democratic California, despite angst over the potential loss of civil liberties, as visible signs of homelessness and mental illness, fentanyl addiction, and unsafe street behavior surge.\u003c/p>\n\u003cp>Last year, several counties rolled out an alternative mental health court created by Democratic Gov. Gavin Newsom, former mayor of San Francisco, to fast-track people with untreated schizophrenia and related disorders into care, and in March, voters will take up a statewide mental health proposition, that some say will increase involuntary treatment.\u003c/p>\n\u003cp>Rhorer said the welfare program for single adults — which serves about 9,000 people per year — already asks applicants about substance abuse, with about 20% self-reporting an issue. A data check with the Department of Public Health revealed that almost one-third of recipients have been diagnosed with a substance use disorder, he said.\u003c/p>\n\u003cp>The ballot measure would replace that question with a more rigorous screening test that an addiction specialist would verify. If substance abuse is found, Rhorer said, the specialist and applicant would agree on treatment options that include residential care, a 12-step program, individual counseling and replacement medication. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>There is no requirement that the person be sober, only that they make good-faith efforts to attend their program, with the hope that “at one point a light bulb will go off,” Rhorer said.\u003c/p>\n\u003cp>The measure calls for the city to pay the rent of those accepted into the program for 30 days or longer to avoid eviction. About 30% of the people who fatally overdosed in 2023 were homeless, and more were living in subsidized city housing.\u003c/p>\n\u003cp>Besides authorizing drones, cameras and other modern technologies, Proposition E would reduce paperwork so police have more time to patrol. It would also allow police to pursue more suspects by vehicle, not just in cases of a violent felony or immediate threat to public safety — a policy store owner Michael Hsu learned of the hard way.\u003c/p>\n\u003cp>Hsu has had his Footprint store broken into multiple times since he took over in 2020, most recently on Jan. 1. Police arrived as the suspects were leaving but could not pursue them because no lives were at risk. Hsu, who lost about $20,000 in merchandise and damage, called that discouraging.\u003c/p>\n\u003cp>“You’re sending the wrong message to these criminals,” he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>The deadline to enroll in a health care plan through Covered California — \u003ca href=\"https://www.coveredca.com/\">the state’s health insurance marketplace that offers hundreds of low-cost coverage plans\u003c/a> — has been extended until Friday, Feb. 9.\u003c/p>\n\u003cp>Previously, the deadline to sign up for a plan was Wednesday, Jan. 31.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Jessica Altman, executive director, Covered California\"]‘We want any Californian who needs health insurance to have the opportunity to get covered for the rest of 2024, and extending the open-enrollment period will ensure they have the time they need.’[/pullquote]State officials made the announcement \u003ca href=\"https://www.coveredca.com/newsroom/news-releases/2024/01/31/\">through a press release on Wednesday\u003c/a>, explaining that Covered California’s service center was recently taken offline in response to a cybersecurity incident that affected the third-party vendor that supports its phone lines. Many residents who tried to sign up for a health care plan by calling the service center experienced long wait times, the release said, which also noted that “at this time,” there was no indication that any members’ personal information was compromised.\u003c/p>\n\u003cp>“We want any Californian who needs health insurance to have the opportunity to get covered for the rest of 2024, and extending the open-enrollment period will ensure they have the time they need,” Covered California Executive Director Jessica Altman said.\u003c/p>\n\u003ch2>Ways to sign up\u003c/h2>\n\u003cp>Consumers have several ways to find a health care plan — not just over the phone. One option is visiting Covered California’s website at \u003ca href=\"https://www.coveredca.com/\">coveredca.com\u003c/a>.\u003c/p>\n\u003cp>If your job doesn’t provide health insurance and you don’t qualify for Medi-Cal, you may be eligible for a Covered California plan. Thanks to a mix of federal and state subsidies, many plans offer monthly premiums under $30.\u003c/p>\n\u003cp>If you are undocumented, you can also look for an insurance plan through Covered California — but you’ll have to meet the income requirements for Medi-Cal.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>California is one of two states \u003ca href=\"https://www.coveredca.com/learning-center/tax-penalty-details-and-exemptions/penalty/\">that requires residents to pay a penalty if uninsured\u003c/a>. The penalty for not having coverage the entire year would be at least $900 per adult when you file taxes this year. If you have a child under 18 that is dependent on you, that’s an additional $450 per kid.\u003c/p>\n\u003ch2>An increase in enrollment\u003c/h2>\n\u003cp>More than 243,000 people have already signed up this enrollment period, state officials said — \u003ca href=\"https://www.coveredca.com/newsroom/news-releases/2024/01/25/end-of-oe/\">a 13% increase from last year\u003c/a>. California already boasts one of the lowest uninsured rates in the country, with only 6.2% of non-elderly Californians lacking health insurance, \u003ca href=\"https://www.chcf.org/publication/california-achieves-lowest-uninsured-rate-ever-2022/\">according to a 2023 report from the California Health Care Foundation\u003c/a>. When the state launched its insurance marketplace in 2013, \u003ca href=\"https://calbudgetcenter.org/resources/continuing-the-path-towards-universal-health-coverage-in-california/#:~:text=The%20percentage%20of%20Californians%20without,uninsured%20rate%20was%20over%2017%25.\">the uninsured rate was around 17%\u003c/a>.\u003c/p>\n\u003cp>[aside label=\"Related Stories\" postID=\"news_11949192,news_11956545,news_11961980\"]The nation’s top health official, United States Health and Human Services Secretary Xavier Becerra, visited San Francisco on Tuesday to mark these new figures, and offered uninsured Californians a last push of encouragement to apply to Covered California (before the deadline extension was then announced on Wednesday).\u003c/p>\n\u003cp>“My mother would always say, \u003cem>mejor prevenir que remediar\u003c/em> — better to prevent than to remediate an illness,” Becerra said. “Health care insurance helps you prevent your children from becoming ill. If you don’t have insurance, you wait till they’re so ill they have to go to the hospital.”\u003c/p>\n\u003cp>At the national level, 21.3 million people nationwide enrolled in a health care plan this year through the Affordable Care Act (ACA) marketplaces. Many are receiving subsidies for their plans owing to the Inflation Reduction Act that Congress passed in 2022, and Becerra said he hoped Congress would vote to keep those subsidies in place.\u003c/p>\n\u003cp>Despite multiple attempts by Congressional Republicans each year to repeal ACA — also known as Obamacare — marketplaces have only grown since the health care law passed in 2010. “There was talk that when the Affordable Care Act launched, insurers would not buy in because it wouldn’t be a profitable enterprise for them,” Becerra said.\u003c/p>\n\u003cp>“Well, they’re in. Now what’s happening is they’re offering a panoply of plans; it’s tough to figure out which one is good for you,” he added.\u003c/p>\n\u003cp>“So we’re going to move more towards requiring the plans [to] provide some standardization, so people can make some good guesses about what might be good for them,” Becerra said.\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "The deadline for Covered California health care enrollment was extended to give Californians 'the time they need,' Covered California Executive Director Jessica Altman said.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The deadline to enroll in a health care plan through Covered California — \u003ca href=\"https://www.coveredca.com/\">the state’s health insurance marketplace that offers hundreds of low-cost coverage plans\u003c/a> — has been extended until Friday, Feb. 9.\u003c/p>\n\u003cp>Previously, the deadline to sign up for a plan was Wednesday, Jan. 31.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘We want any Californian who needs health insurance to have the opportunity to get covered for the rest of 2024, and extending the open-enrollment period will ensure they have the time they need.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>State officials made the announcement \u003ca href=\"https://www.coveredca.com/newsroom/news-releases/2024/01/31/\">through a press release on Wednesday\u003c/a>, explaining that Covered California’s service center was recently taken offline in response to a cybersecurity incident that affected the third-party vendor that supports its phone lines. Many residents who tried to sign up for a health care plan by calling the service center experienced long wait times, the release said, which also noted that “at this time,” there was no indication that any members’ personal information was compromised.\u003c/p>\n\u003cp>“We want any Californian who needs health insurance to have the opportunity to get covered for the rest of 2024, and extending the open-enrollment period will ensure they have the time they need,” Covered California Executive Director Jessica Altman said.\u003c/p>\n\u003ch2>Ways to sign up\u003c/h2>\n\u003cp>Consumers have several ways to find a health care plan — not just over the phone. One option is visiting Covered California’s website at \u003ca href=\"https://www.coveredca.com/\">coveredca.com\u003c/a>.\u003c/p>\n\u003cp>If your job doesn’t provide health insurance and you don’t qualify for Medi-Cal, you may be eligible for a Covered California plan. Thanks to a mix of federal and state subsidies, many plans offer monthly premiums under $30.\u003c/p>\n\u003cp>If you are undocumented, you can also look for an insurance plan through Covered California — but you’ll have to meet the income requirements for Medi-Cal.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>California is one of two states \u003ca href=\"https://www.coveredca.com/learning-center/tax-penalty-details-and-exemptions/penalty/\">that requires residents to pay a penalty if uninsured\u003c/a>. The penalty for not having coverage the entire year would be at least $900 per adult when you file taxes this year. If you have a child under 18 that is dependent on you, that’s an additional $450 per kid.\u003c/p>\n\u003ch2>An increase in enrollment\u003c/h2>\n\u003cp>More than 243,000 people have already signed up this enrollment period, state officials said — \u003ca href=\"https://www.coveredca.com/newsroom/news-releases/2024/01/25/end-of-oe/\">a 13% increase from last year\u003c/a>. California already boasts one of the lowest uninsured rates in the country, with only 6.2% of non-elderly Californians lacking health insurance, \u003ca href=\"https://www.chcf.org/publication/california-achieves-lowest-uninsured-rate-ever-2022/\">according to a 2023 report from the California Health Care Foundation\u003c/a>. When the state launched its insurance marketplace in 2013, \u003ca href=\"https://calbudgetcenter.org/resources/continuing-the-path-towards-universal-health-coverage-in-california/#:~:text=The%20percentage%20of%20Californians%20without,uninsured%20rate%20was%20over%2017%25.\">the uninsured rate was around 17%\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The nation’s top health official, United States Health and Human Services Secretary Xavier Becerra, visited San Francisco on Tuesday to mark these new figures, and offered uninsured Californians a last push of encouragement to apply to Covered California (before the deadline extension was then announced on Wednesday).\u003c/p>\n\u003cp>“My mother would always say, \u003cem>mejor prevenir que remediar\u003c/em> — better to prevent than to remediate an illness,” Becerra said. “Health care insurance helps you prevent your children from becoming ill. If you don’t have insurance, you wait till they’re so ill they have to go to the hospital.”\u003c/p>\n\u003cp>At the national level, 21.3 million people nationwide enrolled in a health care plan this year through the Affordable Care Act (ACA) marketplaces. Many are receiving subsidies for their plans owing to the Inflation Reduction Act that Congress passed in 2022, and Becerra said he hoped Congress would vote to keep those subsidies in place.\u003c/p>\n\u003cp>Despite multiple attempts by Congressional Republicans each year to repeal ACA — also known as Obamacare — marketplaces have only grown since the health care law passed in 2010. “There was talk that when the Affordable Care Act launched, insurers would not buy in because it wouldn’t be a profitable enterprise for them,” Becerra said.\u003c/p>\n\u003cp>“Well, they’re in. Now what’s happening is they’re offering a panoply of plans; it’s tough to figure out which one is good for you,” he added.\u003c/p>\n\u003cp>“So we’re going to move more towards requiring the plans [to] provide some standardization, so people can make some good guesses about what might be good for them,” Becerra said.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "bay-area-health-care-workers-protest-arms-sales-to-israel",
"title": "Bay Area Health Care Workers Protest Arms Sales to Israel",
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"content": "\u003cp>Bay Area health care workers rallied outside the San Leandro facility of military contractor L3Harris on Wednesday. About 200 nurses, pediatricians, psychiatrists and other doctors and activists gathered to protest what they call “war profiteering” by the company, which has provided surveillance technologies to Israel for years and whose components are used in missiles, warplanes and tanks.\u003c/p>\n\u003cp>“We are here today in front of L3Harris because we know with certainty that they are complicit in mass civilian casualties,” said Dr. Nida Bajwa, a family medicine doctor at San Francisco General Hospital.\u003c/p>\n\u003cp>Protesters pointed to “joint direct attack munitions,” or JDAMs, which Boeing manufactures with components from L3Harris. In a \u003ca href=\"https://www.amnesty.org/en/latest/news/2023/12/israel-opt-us-made-munitions-killed-43-civilians-in-two-documented-israeli-air-strikes-in-gaza-new-investigation/\">December report from Amnesty International\u003c/a>, these weapons were linked to “two deadly, unlawful air strikes on homes full of civilians” in Gaza on Oct. 10 and Oct. 22 that killed 43 people, including 19 children.\u003c/p>\n\u003cfigure id=\"attachment_11973553\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11973553\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-06-KQED.jpg\" alt=\"Healthcare workers rally in front of the L3 Harris office in San Leandro on Jan. 24, 2024.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-06-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-06-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-06-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-06-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-06-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-06-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Health care workers rally in front of the L3Harris office in San Leandro on Jan. 24, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Joint direct attack munitions are essentially an upgrade that converts unguided “dumb” bombs into precision-guided “smart” bombs. Protesters said this technology is being used to target hospitals and other vital civilian infrastructure in the Gaza Strip.\u003c/p>\n\u003cp>L3Harris did not respond to requests for comment.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Jess Ghannam, clinical professor of psychiatry, UCSF\"]‘We stand against the destruction of any health care facility, any hospital, the killing of any doctor, any nurse. For me, it’s personal because my colleagues, my friends, my peers have been killed in Gaza.’[/pullquote]“We stand against the destruction of any health care facility, any hospital, the killing of any doctor, any nurse,” said Jess Ghannam, a Palestinian American clinical professor of psychiatry at UCSF who has worked in Gaza for decades. “For me, it’s personal because my colleagues, my friends, my peers have been killed in Gaza.”\u003c/p>\n\u003cp>Since Oct. 7, at least 300 health care workers have died as a result of Israeli strikes in Gaza, \u003ca href=\"https://www.ochaopt.org/content/hostilities-gaza-strip-and-israel-reported-impact-day-68\">according to the United Nations\u003c/a>. A shortage of medical supplies has left doctors to perform surgeries and amputations without anesthesia or adequate sanitation.\u003c/p>\n\u003cp>“Mothers in Gaza are being forced to choose between risking their lives going to an already overwhelmed health care system or giving birth in the streets amidst rubble,” said Dr. Saba Ali, a pediatrician at UCSF. “In hospitals, mothers are undergoing cesarean sections without anesthesia, and at times without electricity. Some are being \u003ca href=\"https://news.un.org/en/story/2024/01/1145677\">discharged as early as three hours after giving birth\u003c/a> because health care facilities don’t have enough beds.”\u003c/p>\n\u003cfigure id=\"attachment_11973554\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11973554\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-07-KQED.jpg\" alt=\"Jess Ghannam speaks at a rally of healthcare workers in front of the L3 Harris office in San Leandro on Jan. 24, 2024.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-07-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-07-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-07-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-07-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-07-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-07-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jess Ghannam speaks at a rally of health care workers in front of the L3Harris office in San Leandro on Jan. 24, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In northern Gaza, seven out of 24 hospitals remain partially functional, and in southern Gaza, seven of 12 hospitals are partially functional, according to the World Health Organization.\u003c/p>\n\u003cp>Outside L3Harris, protesters painted the sidewalk with the words “war profiteer.” A \u003ca href=\"https://www.l3harris.com/sites/default/files/2023-12/LHX_InvestorDay_ExecutivePresentations_Final.pdf\">Dec. 12 report\u003c/a> for L3Harris investors stated that there was “increased demand for missiles driven by Ukraine (and) Israel.”\u003c/p>\n\u003cp>“A 2,000-pound bomb, somehow smart, dropped in the most densely populated area on the planet,” Ghannam said. “L3Harris has blood on its hands, it’s complicit, it’s culpable.”\u003c/p>\n\u003cfigure id=\"attachment_11973555\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11973555\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-08-KQED.jpg\" alt=\"Rally-goers raise their fists in support of Gaza in front of the L3 Harris office in San Leandro on Jan. 24, 2024.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-08-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-08-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-08-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-08-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-08-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-08-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Rallygoers raise their fists in support of Gaza in front of the L3Harris office in San Leandro on Jan. 24, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At the entrance to the facility, protesters hung banners that read “Stop Bombing Hospitals” and “Genocide Manufactured Here.” On a clothesline hung light blue scrubs, each printed with the name of a health care worker who died in Gaza. Between protesters speaking, they played audio clips of doctors in Gaza that described hospital walls shaking from nearby bombardment, airstrikes on hospitals killing patients and doctors and an operating room ceiling collapsing after an explosion.\u003c/p>\n\u003cp>Protest organizers said 200 employees left the facility by early afternoon, and operations were halted for the day.\u003c/p>\n\u003cfigure id=\"attachment_11973556\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11973556\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-09-KQED.jpg\" alt=\"The names of healthcare workers killed in Gaza are printed on scrubs hung in front of the L3 Harris office in San Leandro on Jan. 24, 2024.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-09-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-09-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-09-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-09-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-09-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-09-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The names of health care workers killed in Gaza are printed on scrubs hung in front of the L3Harris office in San Leandro on Jan. 24, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In another protest on Wednesday, nearly 50 students rallied at a meeting of UC regents at the UCSF Mission Bay Campus in San Francisco, calling on the university system to divest from companies they say are profiting from the war in Gaza.\u003c/p>\n\u003cp>[aside label=\"Related Stories\" postID=\"news_11972100,news_11971593,forum_2010101904469\"]Yara Kaadan, political director for Students for Justice in Palestine at UC Davis, said her campus has financial contracts with RTX (formerly Raytheon Technologies), which manufactures and sells weapons and military technology.\u003c/p>\n\u003cp>“We want this academic institution to invest its money in the community and education, not through war or the occupation of anybody in the Global South or the Middle East,” Kaadan said.\u003c/p>\n\u003cp>Kaadan also said the coalition was protesting \u003ca href=\"https://regents.universityofcalifornia.edu/regmeet/jan24/jointacadaudit.pdf\">item J3 on the UC Board of Regents’ agenda\u003c/a>, which she said, “seeks to ban any department or organization under UC jurisdiction from releasing any political statements that quote-unquote, go against UC values.”\u003c/p>\n\u003cp>“I think this is a huge violation of the First Amendment,” Kaadan said. “\u003cb>\u003c/b>People should be allowed to have political discourse within the system and have political agreements that don’t always align with the people who are in charge.”\u003c/p>\n\u003cp>The UC regents did not immediately respond to a request for comment.\u003c/p>\n\u003cp>\u003cem>KQED’s Madi Bolaños contributed reporting to this story.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Bay Area health care workers rallied outside the San Leandro facility of military contractor L3Harris on Wednesday. About 200 nurses, pediatricians, psychiatrists and other doctors and activists gathered to protest what they call “war profiteering” by the company, which has provided surveillance technologies to Israel for years and whose components are used in missiles, warplanes and tanks.\u003c/p>\n\u003cp>“We are here today in front of L3Harris because we know with certainty that they are complicit in mass civilian casualties,” said Dr. Nida Bajwa, a family medicine doctor at San Francisco General Hospital.\u003c/p>\n\u003cp>Protesters pointed to “joint direct attack munitions,” or JDAMs, which Boeing manufactures with components from L3Harris. In a \u003ca href=\"https://www.amnesty.org/en/latest/news/2023/12/israel-opt-us-made-munitions-killed-43-civilians-in-two-documented-israeli-air-strikes-in-gaza-new-investigation/\">December report from Amnesty International\u003c/a>, these weapons were linked to “two deadly, unlawful air strikes on homes full of civilians” in Gaza on Oct. 10 and Oct. 22 that killed 43 people, including 19 children.\u003c/p>\n\u003cfigure id=\"attachment_11973553\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11973553\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-06-KQED.jpg\" alt=\"Healthcare workers rally in front of the L3 Harris office in San Leandro on Jan. 24, 2024.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-06-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-06-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-06-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-06-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-06-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-06-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Health care workers rally in front of the L3Harris office in San Leandro on Jan. 24, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Joint direct attack munitions are essentially an upgrade that converts unguided “dumb” bombs into precision-guided “smart” bombs. Protesters said this technology is being used to target hospitals and other vital civilian infrastructure in the Gaza Strip.\u003c/p>\n\u003cp>L3Harris did not respond to requests for comment.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘We stand against the destruction of any health care facility, any hospital, the killing of any doctor, any nurse. For me, it’s personal because my colleagues, my friends, my peers have been killed in Gaza.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“We stand against the destruction of any health care facility, any hospital, the killing of any doctor, any nurse,” said Jess Ghannam, a Palestinian American clinical professor of psychiatry at UCSF who has worked in Gaza for decades. “For me, it’s personal because my colleagues, my friends, my peers have been killed in Gaza.”\u003c/p>\n\u003cp>Since Oct. 7, at least 300 health care workers have died as a result of Israeli strikes in Gaza, \u003ca href=\"https://www.ochaopt.org/content/hostilities-gaza-strip-and-israel-reported-impact-day-68\">according to the United Nations\u003c/a>. A shortage of medical supplies has left doctors to perform surgeries and amputations without anesthesia or adequate sanitation.\u003c/p>\n\u003cp>“Mothers in Gaza are being forced to choose between risking their lives going to an already overwhelmed health care system or giving birth in the streets amidst rubble,” said Dr. Saba Ali, a pediatrician at UCSF. “In hospitals, mothers are undergoing cesarean sections without anesthesia, and at times without electricity. Some are being \u003ca href=\"https://news.un.org/en/story/2024/01/1145677\">discharged as early as three hours after giving birth\u003c/a> because health care facilities don’t have enough beds.”\u003c/p>\n\u003cfigure id=\"attachment_11973554\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11973554\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-07-KQED.jpg\" alt=\"Jess Ghannam speaks at a rally of healthcare workers in front of the L3 Harris office in San Leandro on Jan. 24, 2024.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-07-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-07-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-07-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-07-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-07-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-07-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jess Ghannam speaks at a rally of health care workers in front of the L3Harris office in San Leandro on Jan. 24, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In northern Gaza, seven out of 24 hospitals remain partially functional, and in southern Gaza, seven of 12 hospitals are partially functional, according to the World Health Organization.\u003c/p>\n\u003cp>Outside L3Harris, protesters painted the sidewalk with the words “war profiteer.” A \u003ca href=\"https://www.l3harris.com/sites/default/files/2023-12/LHX_InvestorDay_ExecutivePresentations_Final.pdf\">Dec. 12 report\u003c/a> for L3Harris investors stated that there was “increased demand for missiles driven by Ukraine (and) Israel.”\u003c/p>\n\u003cp>“A 2,000-pound bomb, somehow smart, dropped in the most densely populated area on the planet,” Ghannam said. “L3Harris has blood on its hands, it’s complicit, it’s culpable.”\u003c/p>\n\u003cfigure id=\"attachment_11973555\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11973555\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-08-KQED.jpg\" alt=\"Rally-goers raise their fists in support of Gaza in front of the L3 Harris office in San Leandro on Jan. 24, 2024.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-08-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-08-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-08-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-08-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-08-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-08-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Rallygoers raise their fists in support of Gaza in front of the L3Harris office in San Leandro on Jan. 24, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At the entrance to the facility, protesters hung banners that read “Stop Bombing Hospitals” and “Genocide Manufactured Here.” On a clothesline hung light blue scrubs, each printed with the name of a health care worker who died in Gaza. Between protesters speaking, they played audio clips of doctors in Gaza that described hospital walls shaking from nearby bombardment, airstrikes on hospitals killing patients and doctors and an operating room ceiling collapsing after an explosion.\u003c/p>\n\u003cp>Protest organizers said 200 employees left the facility by early afternoon, and operations were halted for the day.\u003c/p>\n\u003cfigure id=\"attachment_11973556\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11973556\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-09-KQED.jpg\" alt=\"The names of healthcare workers killed in Gaza are printed on scrubs hung in front of the L3 Harris office in San Leandro on Jan. 24, 2024.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-09-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-09-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-09-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-09-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-09-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240124-HEALTCARE-GAZA-RALLY-MD-09-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The names of health care workers killed in Gaza are printed on scrubs hung in front of the L3Harris office in San Leandro on Jan. 24, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In another protest on Wednesday, nearly 50 students rallied at a meeting of UC regents at the UCSF Mission Bay Campus in San Francisco, calling on the university system to divest from companies they say are profiting from the war in Gaza.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Yara Kaadan, political director for Students for Justice in Palestine at UC Davis, said her campus has financial contracts with RTX (formerly Raytheon Technologies), which manufactures and sells weapons and military technology.\u003c/p>\n\u003cp>“We want this academic institution to invest its money in the community and education, not through war or the occupation of anybody in the Global South or the Middle East,” Kaadan said.\u003c/p>\n\u003cp>Kaadan also said the coalition was protesting \u003ca href=\"https://regents.universityofcalifornia.edu/regmeet/jan24/jointacadaudit.pdf\">item J3 on the UC Board of Regents’ agenda\u003c/a>, which she said, “seeks to ban any department or organization under UC jurisdiction from releasing any political statements that quote-unquote, go against UC values.”\u003c/p>\n\u003cp>“I think this is a huge violation of the First Amendment,” Kaadan said. “\u003cb>\u003c/b>People should be allowed to have political discourse within the system and have political agreements that don’t always align with the people who are in charge.”\u003c/p>\n\u003cp>The UC regents did not immediately respond to a request for comment.\u003c/p>\n\u003cp>\u003cem>KQED’s Madi Bolaños contributed reporting to this story.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cem>We regularly answer frequently asked questions about the coronavirus. If you have a question you’d like us to consider for a future post, email us at \u003c/em>\u003ca href=\"mailto:goatsandsoda@npr.org\">\u003cem>goatsandsoda@npr.org\u003c/em>\u003c/a>\u003cem> with the subject line: “Weekly Coronavirus Questions.” See an archive of our FAQs \u003c/em>\u003ca href=\"https://www.npr.org/tags/926361810/coronavirus-faqs\">\u003cem>here\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>As a physician and infectious disease epidemiologist, I’ve seen a lot of COVID-19 patients during the pandemic, and there’s a question I hear over and over:\u003c/p>\n\u003cp>\u003cstrong>How is it possible that my partner — or child or sibling or roommate — tested positive for COVID-19, and even though I slept in the same room or lived in the same house, I didn’t come down with the virus?\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Weren’t they breathing out infectious particles for days on end? And I assume I was breathing them in. \u003c/strong>\u003c/p>\n\u003cp>There is an answer to this question. But it’s a bit complicated.\u003c/p>\n\u003cp>First, let’s review how SARS-CoV-2, the virus that causes COVID-19, spreads. While some viruses are primarily passed through contact with the bodily fluids (Ebola) or skin (mpox) of someone who’s infected, SARS-CoV-2 is easier to catch. It’s spread \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/your-health/about-covid-19.html\">mainly\u003c/a> through the air in invisible aerosols (and to a lesser extent in large droplets) that the infected person emits while breathing, talking, sneezing, coughing, laughing or snoring. The aerosols can hang around in the air for hours, and others can inhale them.\u003c/p>\n\u003cp>So yes, if someone in your house is exhaling SARS-CoV-2-viral particles, you could breathe them in and become infected. But … here’s why that does not always happen.\u003c/p>\n\u003cp>There are two points to ponder. One: The person with COVID is not contagious at all times. Two: Different factors can reduce the risk of getting infected by a housemate.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003ch2>The incubation period\u003c/h2>\n\u003cp>For starters, someone who is sick with COVID-19 is not infectious from the moment they catch the virus to the moment they test negative (or their symptoms go away). Viruses like SARS-CoV-2 have different stages.\u003c/p>\n\u003cp>It all starts when you’re first exposed.\u003c/p>\n\u003cp>If you breathe in enough viral particles and your immune system doesn’t vanquish the pathogens you’ve inhaled, the timer starts for your case of COVID. The virus will incubate in your body until symptoms begin to appear. [aside postID=news_11972313 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240111-AT-HOME-COVID-TEST-GETTY-MB-KQED-1038x576.jpg']And when do you become contagious – marking the transition from the “latent” stage to the “infectious” stage? There’s no way to know the exact moment this happens. It’s a complex biological process, and for everyone, it will be a little different.\u003c/p>\n\u003cp>But we can make certain inferences.\u003c/p>\n\u003cp>For example, many people wonder: Can you be contagious before symptoms of COVID appear?\u003c/p>\n\u003cp>Early on in the pandemic, the answer was definitely yes – and that’s one reason why it was so hard to control COVID. We knew this from \u003ca href=\"https://www.nejm.org/doi/full/10.1056/nejmoa2008457\">studies\u003c/a> that showed transmission happening before the sick person had any symptoms. You would not necessarily know when you were exposed to someone contagious because they may have been “pre-symptomatic.”\u003c/p>\n\u003cp>But things have changed since 2020. Now, most of our immune systems can recognize the virus — as a result of previous exposures and/or being vaccinated. The immune system’s reaction to even a small amount of virus could be symptoms like coughing, sore throat, running nose or a fever. With our immune systems primed, the body’s response comes much more quickly than it would have back in 2020 when SARS-CoV-2 was a novel pathogen. So those symptoms could appear early on after exposure — even before we’re infectious. This was shown \u003ca href=\"https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciad582/7285011\">in a study\u003c/a> published in \u003cem>Clinical Infectious Disease\u003c/em> that examined people’s symptoms compared to how much virus they were carrying across the days of their infection.\u003c/p>\n\u003ch2>The infectious window\u003c/h2>\n\u003cp>The infectious window — the period during which you’re contagious — varies from person to person.\u003c/p>\n\u003cp>For some, it may only be a couple of days, whereas, for others, it can be a week or even longer (especially in people who are immunocompromised and can’t easily clear the virus).\u003c/p>\n\u003cp>If you’re lucky, your housemate will have a short window.\u003c/p>\n\u003cp>And then there’s the matter of quantity.\u003c/p>\n\u003cp>Many, if not most, people will transmit only small amounts of SARS-CoV-2 after getting infected.\u003c/p>\n\u003cp>Most of the spread of SARS-CoV-2 happens from a relatively small number of highly infectious people — called superspreaders. Research on transmission has shown a \u003ca href=\"https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-15915-1\">wide variation\u003c/a> in how many people get infected by one person.\u003c/p>\n\u003cp>Some superspreaders are just biologically capable of shedding a lot of viruses. One study published in November 2023 \u003ca href=\"https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciad701/7424866?login=true#432788078\">found an association\u003c/a> between higher BMI in men and higher viral loads. Other superspreaders could have a big network of people they come into contact with — for example, infecting \u003ca href=\"https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2770172\">on a bus\u003c/a> or in a \u003ca href=\"https://www.cdc.gov/mmwr/volumes/69/wr/mm6919e6.htm\">choir\u003c/a> setting.\u003c/p>\n\u003ch2>You can reduce the amount of pathogens you’re exposed to\u003c/h2>\n\u003cp>Just breathing in a pathogen doesn’t mean you’ll get sick. This is the difference between exposure versus actual infection.\u003c/p>\n\u003cp>For a pathogen to cause disease, you must be exposed to enough of it — the minimum infectious dose — so it can overcome your immune defenses. Some pathogens can do their work with a tiny infectious dose, meaning even just a few microbes or viral particles are sufficient to infect you, while others require a much heftier exposure. [aside label='More Stories on Public Health' tag='public-health']That’s why you’re unlikely to catch COVID from, say, dashing into a grocery store for a quick shop and perhaps breathing in a very small amount of virus. The \u003ca href=\"https://x.com/ChristoPhraser/status/1737513787563868270?s=20\">duration of exposure\u003c/a> and the concentration of the pathogen in its preferred route (air, for this virus) affect your chance of getting sick.\u003c/p>\n\u003cp>We are exposed to small amounts of pathogens all the time, but usually, it is not enough to cause disease. Sometimes, however, it is. A more sinister example of these principles is Coxiella burnetii, the bacteria that causes “Q Fever.” It can spread to people from animals, including farm animals, and is on the list of “\u003ca href=\"https://www.selectagents.gov/sat/list.htm\">select agents\u003c/a>” for bioterrorism concerns. The bacteria has a very low infectious dose, is stable in the environment and can spread so effectively that even living miles downwind of a farm is a risk factor.\u003c/p>\n\u003cp>Reducing the dose you are exposed to is one way to avoid infection. For SARS-CoV-2, opening windows can dilute the cloud of aerosols by bringing in fresh air.\u003c/p>\n\u003cp>If your home has a fan with an air filter or you’re using a HEPA air purifier, the infectious aerosol particles \u003ca href=\"https://blogs.cdc.gov/niosh-science-blog/2023/02/03/diy-filtration/\">can become trapped in the filter\u003c/a> rather than in your lungs.\u003c/p>\n\u003cp>To reiterate, the cumulative dose you inhale depends on the time you spend in a place and the concentration of viral particles there.\u003c/p>\n\u003cp>Masks that are worn correctly and consistently will also reduce that dose. If your housemate is infected and you wear an effective mask (a well-fitting N95, for example), the mask will trap most of the viral particles, reducing the amount you inhale. If the person with COVID masks up, that will decrease the quantity of pathogens they’re emitting into the air as well.\u003c/p>\n\u003ch2>Your immune system (or medications) could save you\u003c/h2>\n\u003cp>If you’ve been vaccinated or had a prior infection, your immune system could be able to knock out the pathogen. The older you get, the less effective your immune system will be. And if you have a medical condition that makes your immune system weaker — like cancer or chronic diseases like diabetes — that could also play a role in whether exposure to viral particles will lead to infection.\u003c/p>\n\u003cp>For healthy people exposed to a sick person, antiviral drugs (or antibiotics for bacteria) can often avert infection after exposure — this is called post-exposure prophylaxis and is used for many infections already, including \u003ca href=\"https://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medication-to-reduce-risk/post-exposure-prophylaxis/\">HIV\u003c/a>, \u003ca href=\"https://www.nejm.org/doi/full/10.1056/NEJMoa2211934\">gonorrhea, chlamydia and syphilis\u003c/a>. [aside postID=news_11966797 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2023/11/GettyImages-1387450682-672x372.jpg']In one study, researchers looked at whether those living at home with someone infected with COVID-19 were less likely to get sick if they used the antiviral Paxlovid. The study found a signal — \u003ca href=\"https://www.pfizer.com/news/press-release/press-release-detail/pfizer-shares-top-line-results-phase-23-epic-pep-study\">a 32% reduced risk\u003c/a> of getting sick compared to placebo — but did not meet statistical significance.\u003c/p>\n\u003cp>So, in conclusion, yes, you can live with someone with COVID and not catch it. Because infectious disease transmission is complicated.\u003c/p>\n\u003cp>And remember, we do see weird things happening with infectious diseases every single day. So yes, in theory, you could catch, say, mpox from dust particles on a patient’s blanket. This happened in a \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/32023204/\">famous case\u003c/a> from the U.K., but it is exceedingly rare.\u003c/p>\n\u003cp>But don’t fall for the trap of thinking that your single example represents the general trend.\u003c/p>\n\u003cp>When it comes to COVID, let me assure you: It is contagious — but remember, that doesn’t mean everyone who is in contact with someone infected will catch it.\u003c/p>\n\u003cp>I was infected a few weeks ago. My mother and sister were both in the car with me hours before I felt sick and tested positive. My sister got COVID days later. But my mother never got it.\u003c/p>\n\u003cp>\u003ca href=\"https://twitter.com/AbraarKaran?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor\">\u003cem>Abraar Karan\u003c/em>\u003c/a>\u003cem> is an infectious disease physician and researcher at Stanford University. He worked on the COVID-19 pandemic for the Massachusetts Department of Public Health and the mpox outbreak for the Los Angeles County Department of Public Health. \u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>We regularly answer frequently asked questions about the coronavirus. If you have a question you’d like us to consider for a future post, email us at \u003c/em>\u003ca href=\"mailto:goatsandsoda@npr.org\">\u003cem>goatsandsoda@npr.org\u003c/em>\u003c/a>\u003cem> with the subject line: “Weekly Coronavirus Questions.” See an archive of our FAQs \u003c/em>\u003ca href=\"https://www.npr.org/tags/926361810/coronavirus-faqs\">\u003cem>here\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>As a physician and infectious disease epidemiologist, I’ve seen a lot of COVID-19 patients during the pandemic, and there’s a question I hear over and over:\u003c/p>\n\u003cp>\u003cstrong>How is it possible that my partner — or child or sibling or roommate — tested positive for COVID-19, and even though I slept in the same room or lived in the same house, I didn’t come down with the virus?\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Weren’t they breathing out infectious particles for days on end? And I assume I was breathing them in. \u003c/strong>\u003c/p>\n\u003cp>There is an answer to this question. But it’s a bit complicated.\u003c/p>\n\u003cp>First, let’s review how SARS-CoV-2, the virus that causes COVID-19, spreads. While some viruses are primarily passed through contact with the bodily fluids (Ebola) or skin (mpox) of someone who’s infected, SARS-CoV-2 is easier to catch. It’s spread \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/your-health/about-covid-19.html\">mainly\u003c/a> through the air in invisible aerosols (and to a lesser extent in large droplets) that the infected person emits while breathing, talking, sneezing, coughing, laughing or snoring. The aerosols can hang around in the air for hours, and others can inhale them.\u003c/p>\n\u003cp>So yes, if someone in your house is exhaling SARS-CoV-2-viral particles, you could breathe them in and become infected. But … here’s why that does not always happen.\u003c/p>\n\u003cp>There are two points to ponder. One: The person with COVID is not contagious at all times. Two: Different factors can reduce the risk of getting infected by a housemate.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch2>The incubation period\u003c/h2>\n\u003cp>For starters, someone who is sick with COVID-19 is not infectious from the moment they catch the virus to the moment they test negative (or their symptoms go away). Viruses like SARS-CoV-2 have different stages.\u003c/p>\n\u003cp>It all starts when you’re first exposed.\u003c/p>\n\u003cp>If you breathe in enough viral particles and your immune system doesn’t vanquish the pathogens you’ve inhaled, the timer starts for your case of COVID. The virus will incubate in your body until symptoms begin to appear. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>And when do you become contagious – marking the transition from the “latent” stage to the “infectious” stage? There’s no way to know the exact moment this happens. It’s a complex biological process, and for everyone, it will be a little different.\u003c/p>\n\u003cp>But we can make certain inferences.\u003c/p>\n\u003cp>For example, many people wonder: Can you be contagious before symptoms of COVID appear?\u003c/p>\n\u003cp>Early on in the pandemic, the answer was definitely yes – and that’s one reason why it was so hard to control COVID. We knew this from \u003ca href=\"https://www.nejm.org/doi/full/10.1056/nejmoa2008457\">studies\u003c/a> that showed transmission happening before the sick person had any symptoms. You would not necessarily know when you were exposed to someone contagious because they may have been “pre-symptomatic.”\u003c/p>\n\u003cp>But things have changed since 2020. Now, most of our immune systems can recognize the virus — as a result of previous exposures and/or being vaccinated. The immune system’s reaction to even a small amount of virus could be symptoms like coughing, sore throat, running nose or a fever. With our immune systems primed, the body’s response comes much more quickly than it would have back in 2020 when SARS-CoV-2 was a novel pathogen. So those symptoms could appear early on after exposure — even before we’re infectious. This was shown \u003ca href=\"https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciad582/7285011\">in a study\u003c/a> published in \u003cem>Clinical Infectious Disease\u003c/em> that examined people’s symptoms compared to how much virus they were carrying across the days of their infection.\u003c/p>\n\u003ch2>The infectious window\u003c/h2>\n\u003cp>The infectious window — the period during which you’re contagious — varies from person to person.\u003c/p>\n\u003cp>For some, it may only be a couple of days, whereas, for others, it can be a week or even longer (especially in people who are immunocompromised and can’t easily clear the virus).\u003c/p>\n\u003cp>If you’re lucky, your housemate will have a short window.\u003c/p>\n\u003cp>And then there’s the matter of quantity.\u003c/p>\n\u003cp>Many, if not most, people will transmit only small amounts of SARS-CoV-2 after getting infected.\u003c/p>\n\u003cp>Most of the spread of SARS-CoV-2 happens from a relatively small number of highly infectious people — called superspreaders. Research on transmission has shown a \u003ca href=\"https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-15915-1\">wide variation\u003c/a> in how many people get infected by one person.\u003c/p>\n\u003cp>Some superspreaders are just biologically capable of shedding a lot of viruses. One study published in November 2023 \u003ca href=\"https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciad701/7424866?login=true#432788078\">found an association\u003c/a> between higher BMI in men and higher viral loads. Other superspreaders could have a big network of people they come into contact with — for example, infecting \u003ca href=\"https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2770172\">on a bus\u003c/a> or in a \u003ca href=\"https://www.cdc.gov/mmwr/volumes/69/wr/mm6919e6.htm\">choir\u003c/a> setting.\u003c/p>\n\u003ch2>You can reduce the amount of pathogens you’re exposed to\u003c/h2>\n\u003cp>Just breathing in a pathogen doesn’t mean you’ll get sick. This is the difference between exposure versus actual infection.\u003c/p>\n\u003cp>For a pathogen to cause disease, you must be exposed to enough of it — the minimum infectious dose — so it can overcome your immune defenses. Some pathogens can do their work with a tiny infectious dose, meaning even just a few microbes or viral particles are sufficient to infect you, while others require a much heftier exposure. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>That’s why you’re unlikely to catch COVID from, say, dashing into a grocery store for a quick shop and perhaps breathing in a very small amount of virus. The \u003ca href=\"https://x.com/ChristoPhraser/status/1737513787563868270?s=20\">duration of exposure\u003c/a> and the concentration of the pathogen in its preferred route (air, for this virus) affect your chance of getting sick.\u003c/p>\n\u003cp>We are exposed to small amounts of pathogens all the time, but usually, it is not enough to cause disease. Sometimes, however, it is. A more sinister example of these principles is Coxiella burnetii, the bacteria that causes “Q Fever.” It can spread to people from animals, including farm animals, and is on the list of “\u003ca href=\"https://www.selectagents.gov/sat/list.htm\">select agents\u003c/a>” for bioterrorism concerns. The bacteria has a very low infectious dose, is stable in the environment and can spread so effectively that even living miles downwind of a farm is a risk factor.\u003c/p>\n\u003cp>Reducing the dose you are exposed to is one way to avoid infection. For SARS-CoV-2, opening windows can dilute the cloud of aerosols by bringing in fresh air.\u003c/p>\n\u003cp>If your home has a fan with an air filter or you’re using a HEPA air purifier, the infectious aerosol particles \u003ca href=\"https://blogs.cdc.gov/niosh-science-blog/2023/02/03/diy-filtration/\">can become trapped in the filter\u003c/a> rather than in your lungs.\u003c/p>\n\u003cp>To reiterate, the cumulative dose you inhale depends on the time you spend in a place and the concentration of viral particles there.\u003c/p>\n\u003cp>Masks that are worn correctly and consistently will also reduce that dose. If your housemate is infected and you wear an effective mask (a well-fitting N95, for example), the mask will trap most of the viral particles, reducing the amount you inhale. If the person with COVID masks up, that will decrease the quantity of pathogens they’re emitting into the air as well.\u003c/p>\n\u003ch2>Your immune system (or medications) could save you\u003c/h2>\n\u003cp>If you’ve been vaccinated or had a prior infection, your immune system could be able to knock out the pathogen. The older you get, the less effective your immune system will be. And if you have a medical condition that makes your immune system weaker — like cancer or chronic diseases like diabetes — that could also play a role in whether exposure to viral particles will lead to infection.\u003c/p>\n\u003cp>For healthy people exposed to a sick person, antiviral drugs (or antibiotics for bacteria) can often avert infection after exposure — this is called post-exposure prophylaxis and is used for many infections already, including \u003ca href=\"https://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medication-to-reduce-risk/post-exposure-prophylaxis/\">HIV\u003c/a>, \u003ca href=\"https://www.nejm.org/doi/full/10.1056/NEJMoa2211934\">gonorrhea, chlamydia and syphilis\u003c/a>. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>In one study, researchers looked at whether those living at home with someone infected with COVID-19 were less likely to get sick if they used the antiviral Paxlovid. The study found a signal — \u003ca href=\"https://www.pfizer.com/news/press-release/press-release-detail/pfizer-shares-top-line-results-phase-23-epic-pep-study\">a 32% reduced risk\u003c/a> of getting sick compared to placebo — but did not meet statistical significance.\u003c/p>\n\u003cp>So, in conclusion, yes, you can live with someone with COVID and not catch it. Because infectious disease transmission is complicated.\u003c/p>\n\u003cp>And remember, we do see weird things happening with infectious diseases every single day. So yes, in theory, you could catch, say, mpox from dust particles on a patient’s blanket. This happened in a \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/32023204/\">famous case\u003c/a> from the U.K., but it is exceedingly rare.\u003c/p>\n\u003cp>But don’t fall for the trap of thinking that your single example represents the general trend.\u003c/p>\n\u003cp>When it comes to COVID, let me assure you: It is contagious — but remember, that doesn’t mean everyone who is in contact with someone infected will catch it.\u003c/p>\n\u003cp>I was infected a few weeks ago. My mother and sister were both in the car with me hours before I felt sick and tested positive. My sister got COVID days later. But my mother never got it.\u003c/p>\n\u003cp>\u003ca href=\"https://twitter.com/AbraarKaran?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor\">\u003cem>Abraar Karan\u003c/em>\u003c/a>\u003cem> is an infectious disease physician and researcher at Stanford University. He worked on the COVID-19 pandemic for the Massachusetts Department of Public Health and the mpox outbreak for the Los Angeles County Department of Public Health. \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "California's Ban on Flavored Tobacco Upheld by US Supreme Court",
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"content": "\u003cp>California is often at the cutting edge of public policy, so it isn’t rare that one of its laws ends up before the nation’s highest court. But that doesn’t always mean the more conservative U.S. Supreme Court is quick to throw out these laws.\u003c/p>\n\u003cp>Monday, for instance, the court decided, without comment, \u003cem>not\u003c/em> to hear a challenge from the tobacco industry to the state’s ban on flavored tobacco products.\u003c/p>\n\u003cp>The case stems from a 2020 law that \u003ca href=\"https://calmatters.org/health/2020/08/california-flavored-tobacco-ban/\">bans the sale of certain flavored tobacco products\u003c/a> and menthol cigarettes. The law was intended to protect kids and teens, who are often the targets of flavored tobacco ads and sometimes start with flavored tobacco products before becoming smokers.\u003c/p>\n\u003cp>But quickly after the law was passed, tobacco companies funded and qualified a referendum to overturn the law. However, the results did not go in their favor as Californians easily \u003ca href=\"https://calmatters.org/california-voter-guide-2022/propositions/prop-31-flavored-tobacco-ban/\">passed Proposition 31\u003c/a> in November 2022 and upheld the ban. Within days, R.J. Reynolds and other tobacco companies filed a lawsuit. They took\u003ca href=\"https://www.cnn.com/2024/01/08/politics/supreme-court-leaves-californias-ban-on-flavored-cigarettes-in-place/\"> \u003c/a>it to the Supreme Court, arguing that the U.S. Food and Drug Administration, not individual states, has the power to regulate cigarette sales.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>However, one case the Supreme Court \u003cem>will\u003c/em> consider concerns another pressing issue: housing. Today, the court is expected to hear oral arguments about the constitutionality of a “traffic impact mitigation fee” one resident, George Sheetz, had to \u003ca href=\"https://www.scotusblog.com/2024/01/latest-property-rights-fight-comes-before-justices/\">pay El Dorado County\u003c/a> to build a single-family home on his property. [aside label='More on California Law' tag='california-law']The case has major implications for developers who argue that impact fees such as the $23,000 levied against Sheetz are one of the reasons why it’s difficult \u003ca href=\"https://www.latimes.com/opinion/story/2024-01-08/california-u-s-supreme-court-sheetz-el-dorado-county-permit-fees-traffic-mitigation#:~:text=Sheetz%20vs.%20County%20of%20El,and%20in%20many%20other%20states.\">to construct affordable housing in the state\u003c/a>.\u003c/p>\n\u003cp>And a reminder of recent Supreme Court decisions impacting California:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Animal welfare:\u003c/strong> Last May, the high court sided with California voters and upheld Prop. 12, which was approved in 2018 to \u003ca href=\"https://calmatters.org/newsletters/whatmatters/2023/05/california-propositions-pigs/\">ban the sale of meat and egg products from farms\u003c/a> that do not raise their livestock, including pigs, in spaces that give the animals enough room to stand and turn around.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>\u003cstrong>Conversion therapy:\u003c/strong> The Supreme Court also turned down an opportunity in December to hear a case regarding a Washington state law that prohibits licensed therapists from \u003ca href=\"https://www.scotusblog.com/2023/12/justices-wont-hear-conversion-therapy-case/\">practicing conversion therapy\u003c/a>. California is one of several states with similar bans, which some argue violates the First Amendment rights of free speech and free exercise of religion.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>\u003cstrong>Concealed carry:\u003c/strong> With California’s ban on concealed weapons in most public places still tangled up in the courts, it’s unclear how the state will comply with the \u003ca href=\"https://calmatters.org/justice/2022/06/california-gun-laws-supreme-court/\">June 2022 Supreme Court ruling on concealed carry\u003c/a>. On Saturday, a panel of federal judges \u003ca href=\"https://apnews.com/article/california-concealed-carry-gun-law-appeal-7fcf523c22d7c72bd95abf73604df0ad\">upheld a former injunction\u003c/a>, preventing the ban from taking effect. Gov. Gavin Newsom \u003ca href=\"https://twitter.com/dvillasenorCA/status/1743808687687573799?s=20\">decried the decision\u003c/a>, saying it “puts the lives of Californians on the line.”\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California is often at the cutting edge of public policy, so it isn’t rare that one of its laws ends up before the nation’s highest court. But that doesn’t always mean the more conservative U.S. Supreme Court is quick to throw out these laws.\u003c/p>\n\u003cp>Monday, for instance, the court decided, without comment, \u003cem>not\u003c/em> to hear a challenge from the tobacco industry to the state’s ban on flavored tobacco products.\u003c/p>\n\u003cp>The case stems from a 2020 law that \u003ca href=\"https://calmatters.org/health/2020/08/california-flavored-tobacco-ban/\">bans the sale of certain flavored tobacco products\u003c/a> and menthol cigarettes. The law was intended to protect kids and teens, who are often the targets of flavored tobacco ads and sometimes start with flavored tobacco products before becoming smokers.\u003c/p>\n\u003cp>But quickly after the law was passed, tobacco companies funded and qualified a referendum to overturn the law. However, the results did not go in their favor as Californians easily \u003ca href=\"https://calmatters.org/california-voter-guide-2022/propositions/prop-31-flavored-tobacco-ban/\">passed Proposition 31\u003c/a> in November 2022 and upheld the ban. Within days, R.J. Reynolds and other tobacco companies filed a lawsuit. They took\u003ca href=\"https://www.cnn.com/2024/01/08/politics/supreme-court-leaves-californias-ban-on-flavored-cigarettes-in-place/\"> \u003c/a>it to the Supreme Court, arguing that the U.S. Food and Drug Administration, not individual states, has the power to regulate cigarette sales.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>However, one case the Supreme Court \u003cem>will\u003c/em> consider concerns another pressing issue: housing. Today, the court is expected to hear oral arguments about the constitutionality of a “traffic impact mitigation fee” one resident, George Sheetz, had to \u003ca href=\"https://www.scotusblog.com/2024/01/latest-property-rights-fight-comes-before-justices/\">pay El Dorado County\u003c/a> to build a single-family home on his property. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The case has major implications for developers who argue that impact fees such as the $23,000 levied against Sheetz are one of the reasons why it’s difficult \u003ca href=\"https://www.latimes.com/opinion/story/2024-01-08/california-u-s-supreme-court-sheetz-el-dorado-county-permit-fees-traffic-mitigation#:~:text=Sheetz%20vs.%20County%20of%20El,and%20in%20many%20other%20states.\">to construct affordable housing in the state\u003c/a>.\u003c/p>\n\u003cp>And a reminder of recent Supreme Court decisions impacting California:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Animal welfare:\u003c/strong> Last May, the high court sided with California voters and upheld Prop. 12, which was approved in 2018 to \u003ca href=\"https://calmatters.org/newsletters/whatmatters/2023/05/california-propositions-pigs/\">ban the sale of meat and egg products from farms\u003c/a> that do not raise their livestock, including pigs, in spaces that give the animals enough room to stand and turn around.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>\u003cstrong>Conversion therapy:\u003c/strong> The Supreme Court also turned down an opportunity in December to hear a case regarding a Washington state law that prohibits licensed therapists from \u003ca href=\"https://www.scotusblog.com/2023/12/justices-wont-hear-conversion-therapy-case/\">practicing conversion therapy\u003c/a>. California is one of several states with similar bans, which some argue violates the First Amendment rights of free speech and free exercise of religion.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>\u003cstrong>Concealed carry:\u003c/strong> With California’s ban on concealed weapons in most public places still tangled up in the courts, it’s unclear how the state will comply with the \u003ca href=\"https://calmatters.org/justice/2022/06/california-gun-laws-supreme-court/\">June 2022 Supreme Court ruling on concealed carry\u003c/a>. On Saturday, a panel of federal judges \u003ca href=\"https://apnews.com/article/california-concealed-carry-gun-law-appeal-7fcf523c22d7c72bd95abf73604df0ad\">upheld a former injunction\u003c/a>, preventing the ban from taking effect. Gov. Gavin Newsom \u003ca href=\"https://twitter.com/dvillasenorCA/status/1743808687687573799?s=20\">decried the decision\u003c/a>, saying it “puts the lives of Californians on the line.”\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"title": "'It's Just Too Much': Why Many Insured Californians Avoid Hospitals in This County",
"headTitle": "‘It’s Just Too Much’: Why Many Insured Californians Avoid Hospitals in This County | KQED",
"content": "\u003cp>Every three months, Bernie Medina takes a day off of work and drives an hour from Salinas to San José to see her oncologist. She was diagnosed with uterine cancer two years ago and needs regular checkups. Medina lives in Monterey County, but her health insurance forbids her from using any local hospital.\u003c/p>\n\u003cp>Medina and her wife Jeannie are both Salinas Union High School District teachers. They’re enrolled in a local government employee health insurance plan created a decade ago to save employees and employers money. To do that, it excludes all Monterey County hospitals and their affiliates. As the hospitals have gobbled up local doctors’ offices and urgent care centers, seeing specialists like Medina’s oncologist and getting emergency care have become more difficult.\u003c/p>\n\u003cp>“I think that the community would probably be shocked if they knew that the teachers, the people in our school districts, were not able to access our hospitals,” Jeannie Medina said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>They live in one of California’s most expensive health care markets, where experts said geographic isolation and lack of market competition combine to drive up prices at especially steep rates. Three hospitals in Monterey County — Community Hospital of the Monterey Peninsula, Natividad Medical Center and Mee Memorial Healthcare System — are in the top 10% of highest-priced hospitals in California, according to \u003ca href=\"https://www.rand.org/pubs/research_reports/RRA1144-1.html\">data collected by the research think tank RAND\u003c/a>.\u003c/p>\n\u003cp>A fourth hospital, Salinas Valley Health, is in the top 15% of highest-priced hospitals. The RAND data is compiled through voluntary disclosures from employers and includes price information for about 90% of California’s hospitals.\u003c/p>\n\u003cp>“Monterey is the definition of a market failure,” said Ivana Krajcinovic, an economist and vice president for a union health plan that supports hotel workers in the county.\u003c/p>\n\u003cfigure id=\"attachment_11971663\" class=\"wp-caption alignright\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11971663\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/121523_Monterey-County-Hospitals_MO_CM_10-copy.jpg\" alt=\"A medical center building seen from the street.\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/121523_Monterey-County-Hospitals_MO_CM_10-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/121523_Monterey-County-Hospitals_MO_CM_10-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/121523_Monterey-County-Hospitals_MO_CM_10-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/121523_Monterey-County-Hospitals_MO_CM_10-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/121523_Monterey-County-Hospitals_MO_CM_10-copy-1536x1024.jpg 1536w\" sizes=\"(max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">The emergency entrance of Salinas Valley Health in Salinas on Dec. 15, 2023. \u003ccite>(Manuel Orbegozo for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Though Monterey elicits images of pristine coastline, swanky restaurants and golf resorts for tourists, it is squarely a blue-collar county. The average annual salary is less than $58,000, and \u003ca href=\"https://www.montereycountywdb.org/wp-content/uploads/2023/02/Economic-Overview-Monterey-County-California.pdf\">fishing and agriculture comprise the county’s largest industry\u003c/a>.\u003c/p>\n\u003cp>Residents and labor advocates said the hospitals are so expensive they’re causing an access and “affordability crisis” on the Central Coast. They said the prices saddle thousands of people with medical debt and compel others to travel hours to give birth or have surgeries.\u003c/p>\n\u003cp>They’ve \u003ca href=\"https://laborcenter.berkeley.edu/why-are-health-care-prices-so-high-for-workers-in-monterey-county/\">taken their complaints to the state’s new Office of Health Care Affordability\u003c/a>, a department created by a \u003ca href=\"https://calmatters.org/health/2022/07/rising-health-care-costs/\">2022 law that’s intended to curb extreme price increases\u003c/a>. But the deal lawmakers struck with the industry to get the bill through the Legislature limits the office to looking only at future price increases, leaving Monterey County residents with little recourse for the existing medical costs there.\u003c/p>\n\u003cp>Hospital executives blame insurers for Monterey County’s affordability woes and argue that the rates hospitals charge are the only way to stay in business at a time when \u003ca href=\"https://calhospital.org/new-report-shows-patients-served-by-one-in-five-california-hospitals-are-at-risk-of-losing-their-hospital-due-to-closure/\">one in five California hospitals is at risk of closure\u003c/a>, according to a report commissioned by the California Hospital Association. Essential services would be cut, and jobs would be lost if prices were lowered, executives at two hospitals told CalMatters.\u003c/p>\n\u003cp>But, independent economists said Monterey hospitals have healthy profit margins and charge patients more than four times the amount needed to break even, based on a comparison with Medicare billing rates.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Jeannie Medina\"]‘I think that the community would probably be shocked if they knew that the teachers, the people in our school districts, were not able to access our hospitals.’[/pullquote]The cost of living in Monterey is high but “not as expensive as San Francisco or Los Angeles, and you see higher prices in Monterey,” said Christopher Whaley, a health economist and lead author of a RAND hospital price transparency study.\u003c/p>\n\u003cp>Even nationally, Monterey is an outlier, Krajcinovic said. Krajcinovic runs UNITE HERE HEALTH, a national insurance plan for the UNITE HERE hospitality workers union. The health plan pays the medical bills of more than 200,000 members across the country, and Monterey is far and away the most expensive place in the network, Krajcinovic said.\u003c/p>\n\u003cp>For comparison, the average price for one night in the hospital in Monterey was $12,300 in 2022, the health plan’s hospital payment data shows. In New York City, it was less than $7,000, and in Chicago, it was $3,500. The price reflects just the cost of the hospital room and does not include the cost of treatment, Krajcinovic said.\u003c/p>\n\u003cp>“We’d be better off putting people up at the Pebble Beach Lodge,” Krajcinovic said.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://flo.uri.sh/visualisation/16151834/embed?auto=1\" width=\"800\" height=\"600\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003ch2>Tough choices for Salinas families\u003c/h2>\n\u003cp>Things would be a lot easier for the Medina family if Bernie could use the hospital and treatment center just a couple of miles from where the family lives in Salinas, Jeannie Medina said.\u003c/p>\n\u003cp>On New Year’s Eve 2021, the Medinas drove more than 60 miles north to San José for Bernie’s cancer operation. For the next six weeks, as Bernie lost her hair and strength, Jeannie shuttled her to chemotherapy appointments about 20 miles from their home. The chemotherapy center was located in Monterey County, but it was difficult to find one that wasn’t owned by one of the four hospitals, they said.\u003c/p>\n\u003cp>In one instance, early in Bernie’s treatment, she was incorrectly told by the treatment center that a procedure to place a chemotherapy port would be covered by insurance at the Community Hospital of the Monterey Peninsula. She walked away from the procedure with a $25,000 bill, Jeannie Medina said.\u003c/p>\n\u003cfigure id=\"attachment_11971662\" class=\"wp-caption alignnone\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11971662\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/010224_Medina-Family_CM_01-copy.jpg\" alt=\"A family smile at the camera, two adults and two children.\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/010224_Medina-Family_CM_01-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/010224_Medina-Family_CM_01-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/010224_Medina-Family_CM_01-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/010224_Medina-Family_CM_01-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/010224_Medina-Family_CM_01-copy-1536x1024.jpg 1536w\" sizes=\"(max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">Bernie and Jeannie Medina are teachers in Salinas, where they live with their sons, Mark and Michael. When Bernie Medina was diagnosed with cancer, she was forbidden from using any of the local hospitals by her insurance plan. \u003ccite>(Courtesy of Jeannie Medina)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Both of the Medinas said they wish they could use the local hospitals and be supported by loved ones and people they know.\u003c/p>\n\u003cp>“We can’t use the hospitals that some of our spouses work at, that our children and our aunts and our uncles work at,” Jeannie Medina said.\u003c/p>\n\u003cp>If the Medinas opted for an insurance plan that includes the local hospitals, they would pay an extra $3,000 per month in premiums, about $30,000 annually.\u003c/p>\n\u003cp>“It’s just too much,” Jeannie Medina said.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Jeannie Medina\"]‘We can’t use the hospitals that some of our spouses work at, that our children and our aunts and our uncles work at … It’s just too much.’[/pullquote]They get insurance through a local plan called the Municipalities, Colleges, Schools Insurance Group, which serves government employees. It has about 10,500 members, 40% of whom are enrolled in the \u003ca href=\"https://www.mcsig.com/current-plans/\">plan that excludes the local hospitals\u003c/a>, group Executive Director Neddie Sarmiento said. That’s about 4,500 people, most of whom are teachers. The number grows every year, Sarmiento said.\u003c/p>\n\u003cp>Uninsured patients using the hospitals in emergencies are often on the hook for the full cost of medical care.\u003c/p>\n\u003cp>Farmworkers Araceli Ruiz and her husband do everything they can to avoid going to the hospital. They already have medical debt, and they can’t afford more.\u003c/p>\n\u003cp>In 2018, a kitchen accident left Ruiz badly burned and sent her to Natividad Medical Center, where treatment cost $5,000. In 2020, wracked by debilitating stomach pain, Ruiz went to Salinas Valley Health for an emergency gallbladder surgery. She was terrified of dying alone in a hospital overcrowded by COVID-19 patients, she said but believed she would die at home without medical care.\u003c/p>\n\u003cp>She said she now owes the hospitals $17,000. Faced with the choice between paying medical bills or paying rent and buying groceries, Ruiz and her husband can only cover their basic needs, she said.\u003c/p>\n\u003cp>“It is very, very difficult,” Ruiz said in Spanish. “All of this should be more accessible.”\u003c/p>\n\u003ch2>Monterey hospitals defend costs\u003c/h2>\n\u003cp>Local hospital executives fired back at critics of their prices, saying charging less would erode their financial stability and jeopardize health care delivery in the region.\u003c/p>\n\u003cp>“Discounting our rates to a level that does not sustain the long-term viability of our local hospital would be irresponsible. Buckling to rates that could result in large-scale layoffs or cutting vital services would be management malpractice,” said Matt Morgan, vice president and chief financial officer for Montage Health, the parent company of Community Hospital of the Monterey Peninsula, in a statement.\u003c/p>\n\u003cp>[aside label=\"Related Stories\" postID=\"news_11969051,news_11959175,news_11970414\"]Morgan pointed to two financially distressed hospitals in neighboring counties as examples of cheaper hospitals that could not remain viable. Hazel Hawkins Memorial Hospital in San Benito County declared bankruptcy in May, and \u003ca href=\"https://lookout.co/watsonville-community-hospital-survived-bankruptcy-will-it-survive-next-few-years/\">Watsonville Community Hospital\u003c/a> in Santa Cruz County which emerged from bankruptcy in 2022 after years of financial trouble.\u003c/p>\n\u003cp>Today, more than half of the state’s hospitals are \u003ca href=\"https://www.kaufmanhall.com/sites/default/files/2023-04/CHA-Financial-Impact-Report.pdf\">operating in the red\u003c/a>, according to a report from the California Hospital Association, the industry lobby. Fears of hospital closures became a reality when \u003ca href=\"https://calmatters.org/health/2023/01/hospital-closure/\">Madera Community Hospital in the San Joaquin Valley\u003c/a> shuttered one year ago, prompting lawmakers to create a $300 million \u003ca href=\"https://calmatters.org/health/2023/08/california-hospitals-bailout-loans/\">bailout loan fund for distressed hospitals\u003c/a>.\u003c/p>\n\u003cp>In an unsigned statement to CalMatters, Natividad Medical Center, the Salinas hospital managed by Monterey County, also said it would be “irresponsible for the hospital to operate at a loss.” Reducing commercial prices would result in “significant annual deficits” and jeopardize services, the statement said.\u003c/p>\n\u003cp>“For Natividad’s essential services to continue, we need adequate reimbursement,” the statement said. “Our community needs us to remain viable, accessible and fully operational.”\u003c/p>\n\u003cp>Salinas Valley Health, a publicly-run district hospital, did not respond to multiple requests for comment. County officials also declined to speak on the record.\u003c/p>\n\u003cp>Mee Memorial Healthcare System, a private hospital on the southern edge of the county, did not respond to requests for comment by the deadline. Mee Memorial has \u003ca href=\"https://www.montereycountyweekly.com/news/local_news/from-struggling-to-flourishing-mee-memorial-hospital-is-a-pandemic-success-story/article_4a32e2a6-8c6f-11ed-9991-f3e77610eef3.html\">faced immense financial difficulties in recent years\u003c/a> but posted significant profits in 2022.\u003c/p>\n\u003cp>Krajcinovic, with UNITE HERE HEALTH, said it’s shocking that the county’s taxpayer-supported hospitals, Natividad Medical Center and Salinas Valley Health, charge the same prices as the private hospitals.\u003c/p>\n\u003cp>“Frankly, how is a county hospital doing this?” she said.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://flo.uri.sh/visualisation/16324007/embed?auto=1\" width=\"800\" height=\"600\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>Morgan with Community Hospital of the Monterey Peninsula also blamed insurers for passing high premiums onto consumers. The hospital has kept price increases below 5% annually for the past five years, he said in his statement.\u003c/p>\n\u003cp>But according to the California Association of Health Plans, the industry lobby representing insurers, premium increases are directly tied to hospital prices. Hospital spending accounts for 37% of health care cost, the single largest share, spokesperson Mary Ellen Grant said.\u003c/p>\n\u003cp>“The best two examples of ever-increasing costs are prescription drugs and hospital costs,” Grant said.\u003c/p>\n\u003cp>Sarmiento, with the local government and school insurance group, said Monterey County hospital prices are the primary driver for premium increases for its plans. For example, the plan that excludes the local hospitals saw a 2.8% premium increase for 2024. In contrast, the plan with the next highest enrollment that allows members to use the hospitals had a 13.3% premium increase.\u003c/p>\n\u003ch2>Rates four times greater than Medicare\u003c/h2>\n\u003cp>Hospitals, including those in Monterey County, often argue that public insurance programs like Medicare don’t pay enough to make ends meet. When a hospital serves lots of patients with public insurance like Medicare or Medi-Cal, the state’s insurance program for Californians with very low income, they say they have to \u003ca href=\"https://www.aha.org/fact-sheets/2023-03-24-setting-record-straight-correcting-6-misleading-conclusions-medpacs-2023-report-hospital-payment\">charge commercial insurers more to make up the difference\u003c/a>.\u003c/p>\n\u003cp>According to state data, the county-run Natividad serves the \u003ca href=\"https://data.chhs.ca.gov/dataset/fourth-quarter-summary-hospital-utilization-discharges-by-payer-source\">highest proportion of Medi-Cal patients\u003c/a> at 63%. Community Hospital of the Monterey Peninsula serves the fewest at 18%, but it serves the highest proportion of Medicare patients at 46%.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Glenn Melnick, health economics expert and professor, USC Sol Price School of Public Policy\"]‘We don’t have enough competition to make competition work. Prices rise to the environment they’re in. If I’m one of these … hospitals, why would I give you a discount?’[/pullquote]RAND economist Whaley said research proves the hospital argument to be only partially true: \u003ca href=\"https://www.kff.org/medicare/issue-brief/how-much-more-than-medicare-do-private-insurers-pay-a-review-of-the-literature/\">Relatively efficient hospitals operate near Medicare rates\u003c/a>. It isn’t quite enough to pay all the bills, but reimbursement isn’t so inadequate that \u003ca href=\"https://jamanetwork.com/channels/health-forum/fullarticle/2760166\">private insurance\u003c/a> needs to make up five times the difference. Medicare rates are also calculated regionally to account for local cost of living and labor expenses.\u003c/p>\n\u003cp>The RAND data shows Monterey hospitals routinely charge more than four to five times the Medicare rate.\u003c/p>\n\u003cp>“The general consensus is (Medicare) is probably paying 80 to 85% of their costs,” said Patrick Pine, an administrator for an insurance plan that supports farmworkers in California. “How does a hospital justify charging three, four, five, six times or more Medicare?”\u003c/p>\n\u003cp>So, what is happening in Monterey County? Simply put, there’s not enough competition, said Glenn Melnick, an expert in health economics and professor at USC’s Sol Price School of Public Policy.\u003c/p>\n\u003cp>“We don’t have enough competition to make competition work,” Melnick said. “Prices rise to the environment they’re in. If I’m one of these … hospitals, why would I give you a discount?”\u003c/p>\n\u003ch2>Health plans save money with travel\u003c/h2>\n\u003cp>Local labor advocates said they’ve dealt with high hospital prices for decades and now want answers from the state.\u003c/p>\n\u003cp>For months, Office of Health Care Affordability board meetings in Sacramento have been filled with anecdotes during public comment of working-class residents in Monterey hit with exorbitant hospital bills, hounded by collections officers, and filing for bankruptcy.\u003c/p>\n\u003cp>Kati Bassler, president of the Salinas Valley Federation of Teachers, travels monthly to the meetings to share stories of her union members’ struggles to afford health care. More than 70% of the teachers in her union are enrolled in the health plan that excludes Monterey County hospitals, she said.\u003c/p>\n\u003cp>“Their practices are predatory,” she said. “They’ve been developing a monopoly-like practice… They’re unchecked.”\u003c/p>\n\u003cp>Pine, chief administrative officer of the Robert F. Kennedy Farm Workers Medical Plan, which insures about 7,000 United Farm Workers union members, has also started sharing data and stories with the state board.\u003c/p>\n\u003cp>Like the UNITE HERE HEALTH fund, the Robert F. Kennedy Farm Workers Medical Plan pays the medical bills directly for its members and can see the prices hospitals charge — a level of transparency that is unusual for most employer-sponsored health coverage, which typically uses health insurance companies to broker deals. The prices negotiated between hospitals and health insurers are usually a closely guarded industry secret.\u003c/p>\n\u003cfigure id=\"attachment_11971660\" class=\"wp-caption alignnone\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11971660\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/080923_Salinas-Farmworkers_SN_CM_16-copy.jpg\" alt=\"\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/080923_Salinas-Farmworkers_SN_CM_16-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/080923_Salinas-Farmworkers_SN_CM_16-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/080923_Salinas-Farmworkers_SN_CM_16-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/080923_Salinas-Farmworkers_SN_CM_16-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/080923_Salinas-Farmworkers_SN_CM_16-copy-1536x1024.jpg 1536w\" sizes=\"(max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">Farmworkers harvest strawberries in Salinas on Aug. 9, 2023. \u003ccite>(Semantha Norris/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A United Farm Workers analysis of billing codes showed Salinas Valley Health charged more than $420,000 to treat a farmworker’s parasitic infection while Watsonville Community Hospital, 25 miles to the north in Santa Cruz County, charged around $126,000 for the same treatment over the same number of days, Pine said. That’s more than three times as expensive, and it’s not unusual, Pine said.\u003c/p>\n\u003cp>The plan has saved money by paying for the transportation and lodging of Monterey County members who have procedures done in other counties.\u003c/p>\n\u003cp>“The California coast from Santa Barbara to about Marin County is the most expensive health care market in the state,” Pine said. “Monterey is an anomaly even among the most expensive.”\u003c/p>\n\u003cp>There may be little the new state agency can do. Officials can conduct a market analysis, but the law that created the Office of Health Care Affordability \u003ca href=\"https://calmatters.org/health/2022/07/rising-health-care-costs/\">limited its power to control future price increases\u003c/a>.\u003c/p>\n\u003cp>Elizabeth Landsberg, director of the state department of Health Care Access and Information, where the office is seated, declined to comment.\u003c/p>\n\u003cp>Advocates said they hope shining a light on the issue during board meetings will force hospitals to lower prices. The week before Christmas, Montage Health, which operates the Community Hospital of the Monterey Peninsula, \u003ca href=\"https://kion546.com/top-stories/2023/12/18/montage-health-forgiving-medical-debt-for-thousands-of-patients-who-were-treated-from-2020-2022/\">forgave $40 million of \u003c/a>\u003ca href=\"https://kion546.com/top-stories/2023/12/18/montage-health-forgiving-medical-debt-for-thousands-of-patients-who-were-treated-from-2020-2022/\" target=\"_blank\" rel=\"noreferrer noopener\">medical\u003c/a>\u003ca href=\"https://kion546.com/top-stories/2023/12/18/montage-health-forgiving-medical-debt-for-thousands-of-patients-who-were-treated-from-2020-2022/\"> debt\u003c/a> for 29,000 patients who utilized the hospital between 2020 and 2022.\u003c/p>\n\u003cp>“We’re hoping with bringing this to light, the hospitals will take a second look and say 200% of Medicare is enough. Let’s take double what it actually costs to run a hospital,” Krajcinovic said. “500% is highway robbery.”\u003c/p>\n\u003cp>\u003cem>CalMatters reporter Nicole Foy contributed to this story.\u003c/em>\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>Every three months, Bernie Medina takes a day off of work and drives an hour from Salinas to San José to see her oncologist. She was diagnosed with uterine cancer two years ago and needs regular checkups. Medina lives in Monterey County, but her health insurance forbids her from using any local hospital.\u003c/p>\n\u003cp>Medina and her wife Jeannie are both Salinas Union High School District teachers. They’re enrolled in a local government employee health insurance plan created a decade ago to save employees and employers money. To do that, it excludes all Monterey County hospitals and their affiliates. As the hospitals have gobbled up local doctors’ offices and urgent care centers, seeing specialists like Medina’s oncologist and getting emergency care have become more difficult.\u003c/p>\n\u003cp>“I think that the community would probably be shocked if they knew that the teachers, the people in our school districts, were not able to access our hospitals,” Jeannie Medina said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>They live in one of California’s most expensive health care markets, where experts said geographic isolation and lack of market competition combine to drive up prices at especially steep rates. Three hospitals in Monterey County — Community Hospital of the Monterey Peninsula, Natividad Medical Center and Mee Memorial Healthcare System — are in the top 10% of highest-priced hospitals in California, according to \u003ca href=\"https://www.rand.org/pubs/research_reports/RRA1144-1.html\">data collected by the research think tank RAND\u003c/a>.\u003c/p>\n\u003cp>A fourth hospital, Salinas Valley Health, is in the top 15% of highest-priced hospitals. The RAND data is compiled through voluntary disclosures from employers and includes price information for about 90% of California’s hospitals.\u003c/p>\n\u003cp>“Monterey is the definition of a market failure,” said Ivana Krajcinovic, an economist and vice president for a union health plan that supports hotel workers in the county.\u003c/p>\n\u003cfigure id=\"attachment_11971663\" class=\"wp-caption alignright\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11971663\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/121523_Monterey-County-Hospitals_MO_CM_10-copy.jpg\" alt=\"A medical center building seen from the street.\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/121523_Monterey-County-Hospitals_MO_CM_10-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/121523_Monterey-County-Hospitals_MO_CM_10-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/121523_Monterey-County-Hospitals_MO_CM_10-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/121523_Monterey-County-Hospitals_MO_CM_10-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/121523_Monterey-County-Hospitals_MO_CM_10-copy-1536x1024.jpg 1536w\" sizes=\"(max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">The emergency entrance of Salinas Valley Health in Salinas on Dec. 15, 2023. \u003ccite>(Manuel Orbegozo for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Though Monterey elicits images of pristine coastline, swanky restaurants and golf resorts for tourists, it is squarely a blue-collar county. The average annual salary is less than $58,000, and \u003ca href=\"https://www.montereycountywdb.org/wp-content/uploads/2023/02/Economic-Overview-Monterey-County-California.pdf\">fishing and agriculture comprise the county’s largest industry\u003c/a>.\u003c/p>\n\u003cp>Residents and labor advocates said the hospitals are so expensive they’re causing an access and “affordability crisis” on the Central Coast. They said the prices saddle thousands of people with medical debt and compel others to travel hours to give birth or have surgeries.\u003c/p>\n\u003cp>They’ve \u003ca href=\"https://laborcenter.berkeley.edu/why-are-health-care-prices-so-high-for-workers-in-monterey-county/\">taken their complaints to the state’s new Office of Health Care Affordability\u003c/a>, a department created by a \u003ca href=\"https://calmatters.org/health/2022/07/rising-health-care-costs/\">2022 law that’s intended to curb extreme price increases\u003c/a>. But the deal lawmakers struck with the industry to get the bill through the Legislature limits the office to looking only at future price increases, leaving Monterey County residents with little recourse for the existing medical costs there.\u003c/p>\n\u003cp>Hospital executives blame insurers for Monterey County’s affordability woes and argue that the rates hospitals charge are the only way to stay in business at a time when \u003ca href=\"https://calhospital.org/new-report-shows-patients-served-by-one-in-five-california-hospitals-are-at-risk-of-losing-their-hospital-due-to-closure/\">one in five California hospitals is at risk of closure\u003c/a>, according to a report commissioned by the California Hospital Association. Essential services would be cut, and jobs would be lost if prices were lowered, executives at two hospitals told CalMatters.\u003c/p>\n\u003cp>But, independent economists said Monterey hospitals have healthy profit margins and charge patients more than four times the amount needed to break even, based on a comparison with Medicare billing rates.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The cost of living in Monterey is high but “not as expensive as San Francisco or Los Angeles, and you see higher prices in Monterey,” said Christopher Whaley, a health economist and lead author of a RAND hospital price transparency study.\u003c/p>\n\u003cp>Even nationally, Monterey is an outlier, Krajcinovic said. Krajcinovic runs UNITE HERE HEALTH, a national insurance plan for the UNITE HERE hospitality workers union. The health plan pays the medical bills of more than 200,000 members across the country, and Monterey is far and away the most expensive place in the network, Krajcinovic said.\u003c/p>\n\u003cp>For comparison, the average price for one night in the hospital in Monterey was $12,300 in 2022, the health plan’s hospital payment data shows. In New York City, it was less than $7,000, and in Chicago, it was $3,500. The price reflects just the cost of the hospital room and does not include the cost of treatment, Krajcinovic said.\u003c/p>\n\u003cp>“We’d be better off putting people up at the Pebble Beach Lodge,” Krajcinovic said.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://flo.uri.sh/visualisation/16151834/embed?auto=1\" width=\"800\" height=\"600\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003ch2>Tough choices for Salinas families\u003c/h2>\n\u003cp>Things would be a lot easier for the Medina family if Bernie could use the hospital and treatment center just a couple of miles from where the family lives in Salinas, Jeannie Medina said.\u003c/p>\n\u003cp>On New Year’s Eve 2021, the Medinas drove more than 60 miles north to San José for Bernie’s cancer operation. For the next six weeks, as Bernie lost her hair and strength, Jeannie shuttled her to chemotherapy appointments about 20 miles from their home. The chemotherapy center was located in Monterey County, but it was difficult to find one that wasn’t owned by one of the four hospitals, they said.\u003c/p>\n\u003cp>In one instance, early in Bernie’s treatment, she was incorrectly told by the treatment center that a procedure to place a chemotherapy port would be covered by insurance at the Community Hospital of the Monterey Peninsula. She walked away from the procedure with a $25,000 bill, Jeannie Medina said.\u003c/p>\n\u003cfigure id=\"attachment_11971662\" class=\"wp-caption alignnone\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11971662\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/010224_Medina-Family_CM_01-copy.jpg\" alt=\"A family smile at the camera, two adults and two children.\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/010224_Medina-Family_CM_01-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/010224_Medina-Family_CM_01-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/010224_Medina-Family_CM_01-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/010224_Medina-Family_CM_01-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/010224_Medina-Family_CM_01-copy-1536x1024.jpg 1536w\" sizes=\"(max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">Bernie and Jeannie Medina are teachers in Salinas, where they live with their sons, Mark and Michael. When Bernie Medina was diagnosed with cancer, she was forbidden from using any of the local hospitals by her insurance plan. \u003ccite>(Courtesy of Jeannie Medina)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Both of the Medinas said they wish they could use the local hospitals and be supported by loved ones and people they know.\u003c/p>\n\u003cp>“We can’t use the hospitals that some of our spouses work at, that our children and our aunts and our uncles work at,” Jeannie Medina said.\u003c/p>\n\u003cp>If the Medinas opted for an insurance plan that includes the local hospitals, they would pay an extra $3,000 per month in premiums, about $30,000 annually.\u003c/p>\n\u003cp>“It’s just too much,” Jeannie Medina said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘We can’t use the hospitals that some of our spouses work at, that our children and our aunts and our uncles work at … It’s just too much.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>They get insurance through a local plan called the Municipalities, Colleges, Schools Insurance Group, which serves government employees. It has about 10,500 members, 40% of whom are enrolled in the \u003ca href=\"https://www.mcsig.com/current-plans/\">plan that excludes the local hospitals\u003c/a>, group Executive Director Neddie Sarmiento said. That’s about 4,500 people, most of whom are teachers. The number grows every year, Sarmiento said.\u003c/p>\n\u003cp>Uninsured patients using the hospitals in emergencies are often on the hook for the full cost of medical care.\u003c/p>\n\u003cp>Farmworkers Araceli Ruiz and her husband do everything they can to avoid going to the hospital. They already have medical debt, and they can’t afford more.\u003c/p>\n\u003cp>In 2018, a kitchen accident left Ruiz badly burned and sent her to Natividad Medical Center, where treatment cost $5,000. In 2020, wracked by debilitating stomach pain, Ruiz went to Salinas Valley Health for an emergency gallbladder surgery. She was terrified of dying alone in a hospital overcrowded by COVID-19 patients, she said but believed she would die at home without medical care.\u003c/p>\n\u003cp>She said she now owes the hospitals $17,000. Faced with the choice between paying medical bills or paying rent and buying groceries, Ruiz and her husband can only cover their basic needs, she said.\u003c/p>\n\u003cp>“It is very, very difficult,” Ruiz said in Spanish. “All of this should be more accessible.”\u003c/p>\n\u003ch2>Monterey hospitals defend costs\u003c/h2>\n\u003cp>Local hospital executives fired back at critics of their prices, saying charging less would erode their financial stability and jeopardize health care delivery in the region.\u003c/p>\n\u003cp>“Discounting our rates to a level that does not sustain the long-term viability of our local hospital would be irresponsible. Buckling to rates that could result in large-scale layoffs or cutting vital services would be management malpractice,” said Matt Morgan, vice president and chief financial officer for Montage Health, the parent company of Community Hospital of the Monterey Peninsula, in a statement.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Morgan pointed to two financially distressed hospitals in neighboring counties as examples of cheaper hospitals that could not remain viable. Hazel Hawkins Memorial Hospital in San Benito County declared bankruptcy in May, and \u003ca href=\"https://lookout.co/watsonville-community-hospital-survived-bankruptcy-will-it-survive-next-few-years/\">Watsonville Community Hospital\u003c/a> in Santa Cruz County which emerged from bankruptcy in 2022 after years of financial trouble.\u003c/p>\n\u003cp>Today, more than half of the state’s hospitals are \u003ca href=\"https://www.kaufmanhall.com/sites/default/files/2023-04/CHA-Financial-Impact-Report.pdf\">operating in the red\u003c/a>, according to a report from the California Hospital Association, the industry lobby. Fears of hospital closures became a reality when \u003ca href=\"https://calmatters.org/health/2023/01/hospital-closure/\">Madera Community Hospital in the San Joaquin Valley\u003c/a> shuttered one year ago, prompting lawmakers to create a $300 million \u003ca href=\"https://calmatters.org/health/2023/08/california-hospitals-bailout-loans/\">bailout loan fund for distressed hospitals\u003c/a>.\u003c/p>\n\u003cp>In an unsigned statement to CalMatters, Natividad Medical Center, the Salinas hospital managed by Monterey County, also said it would be “irresponsible for the hospital to operate at a loss.” Reducing commercial prices would result in “significant annual deficits” and jeopardize services, the statement said.\u003c/p>\n\u003cp>“For Natividad’s essential services to continue, we need adequate reimbursement,” the statement said. “Our community needs us to remain viable, accessible and fully operational.”\u003c/p>\n\u003cp>Salinas Valley Health, a publicly-run district hospital, did not respond to multiple requests for comment. County officials also declined to speak on the record.\u003c/p>\n\u003cp>Mee Memorial Healthcare System, a private hospital on the southern edge of the county, did not respond to requests for comment by the deadline. Mee Memorial has \u003ca href=\"https://www.montereycountyweekly.com/news/local_news/from-struggling-to-flourishing-mee-memorial-hospital-is-a-pandemic-success-story/article_4a32e2a6-8c6f-11ed-9991-f3e77610eef3.html\">faced immense financial difficulties in recent years\u003c/a> but posted significant profits in 2022.\u003c/p>\n\u003cp>Krajcinovic, with UNITE HERE HEALTH, said it’s shocking that the county’s taxpayer-supported hospitals, Natividad Medical Center and Salinas Valley Health, charge the same prices as the private hospitals.\u003c/p>\n\u003cp>“Frankly, how is a county hospital doing this?” she said.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://flo.uri.sh/visualisation/16324007/embed?auto=1\" width=\"800\" height=\"600\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>Morgan with Community Hospital of the Monterey Peninsula also blamed insurers for passing high premiums onto consumers. The hospital has kept price increases below 5% annually for the past five years, he said in his statement.\u003c/p>\n\u003cp>But according to the California Association of Health Plans, the industry lobby representing insurers, premium increases are directly tied to hospital prices. Hospital spending accounts for 37% of health care cost, the single largest share, spokesperson Mary Ellen Grant said.\u003c/p>\n\u003cp>“The best two examples of ever-increasing costs are prescription drugs and hospital costs,” Grant said.\u003c/p>\n\u003cp>Sarmiento, with the local government and school insurance group, said Monterey County hospital prices are the primary driver for premium increases for its plans. For example, the plan that excludes the local hospitals saw a 2.8% premium increase for 2024. In contrast, the plan with the next highest enrollment that allows members to use the hospitals had a 13.3% premium increase.\u003c/p>\n\u003ch2>Rates four times greater than Medicare\u003c/h2>\n\u003cp>Hospitals, including those in Monterey County, often argue that public insurance programs like Medicare don’t pay enough to make ends meet. When a hospital serves lots of patients with public insurance like Medicare or Medi-Cal, the state’s insurance program for Californians with very low income, they say they have to \u003ca href=\"https://www.aha.org/fact-sheets/2023-03-24-setting-record-straight-correcting-6-misleading-conclusions-medpacs-2023-report-hospital-payment\">charge commercial insurers more to make up the difference\u003c/a>.\u003c/p>\n\u003cp>According to state data, the county-run Natividad serves the \u003ca href=\"https://data.chhs.ca.gov/dataset/fourth-quarter-summary-hospital-utilization-discharges-by-payer-source\">highest proportion of Medi-Cal patients\u003c/a> at 63%. Community Hospital of the Monterey Peninsula serves the fewest at 18%, but it serves the highest proportion of Medicare patients at 46%.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘We don’t have enough competition to make competition work. Prices rise to the environment they’re in. If I’m one of these … hospitals, why would I give you a discount?’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>RAND economist Whaley said research proves the hospital argument to be only partially true: \u003ca href=\"https://www.kff.org/medicare/issue-brief/how-much-more-than-medicare-do-private-insurers-pay-a-review-of-the-literature/\">Relatively efficient hospitals operate near Medicare rates\u003c/a>. It isn’t quite enough to pay all the bills, but reimbursement isn’t so inadequate that \u003ca href=\"https://jamanetwork.com/channels/health-forum/fullarticle/2760166\">private insurance\u003c/a> needs to make up five times the difference. Medicare rates are also calculated regionally to account for local cost of living and labor expenses.\u003c/p>\n\u003cp>The RAND data shows Monterey hospitals routinely charge more than four to five times the Medicare rate.\u003c/p>\n\u003cp>“The general consensus is (Medicare) is probably paying 80 to 85% of their costs,” said Patrick Pine, an administrator for an insurance plan that supports farmworkers in California. “How does a hospital justify charging three, four, five, six times or more Medicare?”\u003c/p>\n\u003cp>So, what is happening in Monterey County? Simply put, there’s not enough competition, said Glenn Melnick, an expert in health economics and professor at USC’s Sol Price School of Public Policy.\u003c/p>\n\u003cp>“We don’t have enough competition to make competition work,” Melnick said. “Prices rise to the environment they’re in. If I’m one of these … hospitals, why would I give you a discount?”\u003c/p>\n\u003ch2>Health plans save money with travel\u003c/h2>\n\u003cp>Local labor advocates said they’ve dealt with high hospital prices for decades and now want answers from the state.\u003c/p>\n\u003cp>For months, Office of Health Care Affordability board meetings in Sacramento have been filled with anecdotes during public comment of working-class residents in Monterey hit with exorbitant hospital bills, hounded by collections officers, and filing for bankruptcy.\u003c/p>\n\u003cp>Kati Bassler, president of the Salinas Valley Federation of Teachers, travels monthly to the meetings to share stories of her union members’ struggles to afford health care. More than 70% of the teachers in her union are enrolled in the health plan that excludes Monterey County hospitals, she said.\u003c/p>\n\u003cp>“Their practices are predatory,” she said. “They’ve been developing a monopoly-like practice… They’re unchecked.”\u003c/p>\n\u003cp>Pine, chief administrative officer of the Robert F. Kennedy Farm Workers Medical Plan, which insures about 7,000 United Farm Workers union members, has also started sharing data and stories with the state board.\u003c/p>\n\u003cp>Like the UNITE HERE HEALTH fund, the Robert F. Kennedy Farm Workers Medical Plan pays the medical bills directly for its members and can see the prices hospitals charge — a level of transparency that is unusual for most employer-sponsored health coverage, which typically uses health insurance companies to broker deals. The prices negotiated between hospitals and health insurers are usually a closely guarded industry secret.\u003c/p>\n\u003cfigure id=\"attachment_11971660\" class=\"wp-caption alignnone\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11971660\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/080923_Salinas-Farmworkers_SN_CM_16-copy.jpg\" alt=\"\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/080923_Salinas-Farmworkers_SN_CM_16-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/080923_Salinas-Farmworkers_SN_CM_16-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/080923_Salinas-Farmworkers_SN_CM_16-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/080923_Salinas-Farmworkers_SN_CM_16-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/080923_Salinas-Farmworkers_SN_CM_16-copy-1536x1024.jpg 1536w\" sizes=\"(max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">Farmworkers harvest strawberries in Salinas on Aug. 9, 2023. \u003ccite>(Semantha Norris/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A United Farm Workers analysis of billing codes showed Salinas Valley Health charged more than $420,000 to treat a farmworker’s parasitic infection while Watsonville Community Hospital, 25 miles to the north in Santa Cruz County, charged around $126,000 for the same treatment over the same number of days, Pine said. That’s more than three times as expensive, and it’s not unusual, Pine said.\u003c/p>\n\u003cp>The plan has saved money by paying for the transportation and lodging of Monterey County members who have procedures done in other counties.\u003c/p>\n\u003cp>“The California coast from Santa Barbara to about Marin County is the most expensive health care market in the state,” Pine said. “Monterey is an anomaly even among the most expensive.”\u003c/p>\n\u003cp>There may be little the new state agency can do. Officials can conduct a market analysis, but the law that created the Office of Health Care Affordability \u003ca href=\"https://calmatters.org/health/2022/07/rising-health-care-costs/\">limited its power to control future price increases\u003c/a>.\u003c/p>\n\u003cp>Elizabeth Landsberg, director of the state department of Health Care Access and Information, where the office is seated, declined to comment.\u003c/p>\n\u003cp>Advocates said they hope shining a light on the issue during board meetings will force hospitals to lower prices. The week before Christmas, Montage Health, which operates the Community Hospital of the Monterey Peninsula, \u003ca href=\"https://kion546.com/top-stories/2023/12/18/montage-health-forgiving-medical-debt-for-thousands-of-patients-who-were-treated-from-2020-2022/\">forgave $40 million of \u003c/a>\u003ca href=\"https://kion546.com/top-stories/2023/12/18/montage-health-forgiving-medical-debt-for-thousands-of-patients-who-were-treated-from-2020-2022/\" target=\"_blank\" rel=\"noreferrer noopener\">medical\u003c/a>\u003ca href=\"https://kion546.com/top-stories/2023/12/18/montage-health-forgiving-medical-debt-for-thousands-of-patients-who-were-treated-from-2020-2022/\"> debt\u003c/a> for 29,000 patients who utilized the hospital between 2020 and 2022.\u003c/p>\n\u003cp>“We’re hoping with bringing this to light, the hospitals will take a second look and say 200% of Medicare is enough. Let’s take double what it actually costs to run a hospital,” Krajcinovic said. “500% is highway robbery.”\u003c/p>\n\u003cp>\u003cem>CalMatters reporter Nicole Foy contributed to this story.\u003c/em>\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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"slug": "california-becomes-first-state-to-offer-health-insurance-to-all-eligible-undocumented-adults",
"title": "California Will Soon Be First State to Offer Health Insurance to Eligible Undocumented Adults",
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"headTitle": "California Will Soon Be First State to Offer Health Insurance to Eligible Undocumented Adults | KQED",
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"content": "\u003cp>\u003cem>Lea este artículo en \u003ca href=\"https://calmatters.org/calmatters-en-espanol/2023/12/california-se-convierte-en-el-primer-estado-en-ofrecer-seguro-medico-a-todos-los-adultos-indocumentados-elegibles/\">español\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>Perla Lopez hands a stack of papers to Baudeilio, a 44-year-old undocumented immigrant and day laborer. She has just helped him apply for Medi-Cal at the benefits center at St. John’s Community Health in South Los Angeles.\u003c/p>\n\u003cp>“If you see anything you don’t understand from the county, come back here,” Lopez tells Baudeilio in Spanish.\u003c/p>\n\u003cp>The application takes less than 20 minutes. The paperwork, though brief, marks a major milestone in California’s decades-long expansion of health care for undocumented immigrants.\u003c/p>\n\u003cp>Beginning Jan. 1, for the first time, undocumented immigrants of all ages will qualify for Medi-Cal, the state’s health insurance program for extremely low-income people. It makes \u003ca href=\"https://www.kff.org/racial-equity-and-health-policy/fact-sheet/key-facts-on-health-coverage-of-immigrants/\" target=\"_blank\" rel=\"noreferrer noopener\">California the only state\u003c/a> to fund comprehensive health care for undocumented immigrants.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Baudeilio, who has been denied coverage before and asked that his last name not be published to protect him from immigration authorities, will join more than 700,000 undocumented immigrants between the ages of 26 and 49 who will become eligible for Medi-Cal as part of the state’s final expansion of the program — the realization of a long-awaited dream for Californians without legal status.\u003c/p>\n\u003cp>“This is the culmination of literally decades of work, and it’s huge,” said Sarah Dar, policy director for the California Immigrant Policy Center. “It’s huge because of all the work and effort and advocacy that went into making this possible, and it’s also huge because of the impact that it’s going to have.”\u003c/p>\n\u003cp>Gov. Gavin Newsom and the state’s Democratic-led Legislature have committed more than $4 billion annually to the Medi-Cal expansion. \u003ca href=\"https://ebudget.ca.gov/2022-23/pdf/Enacted/BudgetSummary/HealthandHumanServices.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Newsom’s 2022 budget\u003c/a> made the latest expansion possible, and though the state is now headed into a \u003ca href=\"https://calmatters.org/politics/2023/12/budget-deficit-california/\" target=\"_blank\" rel=\"noreferrer noopener\">$68 billion deficit\u003c/a>, advocates said the positive impact Medi-Cal will have on individual health is priceless.[aside label=\"more Medi-cal-coverage\" tag=\"medi-cal\"]The change resonates deeply with Lopez, who is herself undocumented and eligible to work through the Deferred Action for Childhood Arrivals program.\u003c/p>\n\u003cp>Last year, when the state \u003ca href=\"https://calmatters.org/health/2022/02/medi-cal-expansion-immigrants/\" target=\"_blank\" rel=\"noreferrer noopener\">expanded Medi-Cal to older immigrants over 50\u003c/a>, Lopez’s mother was finally able to get medication and blood testing equipment for her diabetes. This year, surrounded by tinsel and other Christmas decorations in her brightly lit office, Lopez is happy she gets to deliver good news to undocumented patients.\u003c/p>\n\u003cp>“It really touches me,” she said. “It’s a stressor we take away from them. … For people with health issues, Medi-Cal really makes a difference.”\u003c/p>\n\u003cp>The clinic where Lopez works estimates about 13,000 of its patients will become eligible for Medi-Cal in the new year. They’re part of the largest group in California’s ambitious plan to close the insurance gap. Los Angeles County alone accounts for roughly half of the enrollees who are expected to qualify for Medi-Cal.\u003c/p>\n\u003cp>“It’s an exciting moment for our patients as well as for us,” said Annie Uraga, benefits counselor coordinator at St. John’s Community Health. “They’re ready. Many of them are in need or waiting for specialist visits.”\u003c/p>\n\u003ch2>California’s health insurance expansion\u003c/h2>\n\u003cp>The final expansion comes nine years after then-Gov. Jerry Brown signed the 2015 law making undocumented children eligible for state insurance, and it is due to the efforts of advocates trekking to the Capitol to plead their case.\u003c/p>\n\u003cp>“When we talk to people who are impacted by this, the difference it makes in their lives is something that truly numbers and words cannot even describe,” Dar, with the California Immigrant Policy Center, said. “In many cases, people have lived for decades without any kind of health care whatsoever.”\u003c/p>\n\u003cp>Full-scope Medi-Cal, which offers access to primary and preventive care, specialists, pharmaceuticals, and other wraparound services, will change lives, Dar said. California does not share immigration information with federal authorities, and enrolling in Medi-Cal will not threaten chances to pursue legal residency.\u003c/p>\n\u003cp>The California Immigrant Policy Center and consumer advocacy group Health Access California have been the leading force in the campaign to eliminate citizenship requirements for Medi-Cal. The work was not easy, even in left-leaning California. Many moderate Democrats voted against the legislation or refrained from weighing in on the debate in the early days, Dar said, but slowly, public opinion and political will shifted.\u003c/p>\n\u003cp>About \u003ca href=\"https://www.ppic.org/publication/immigrants-and-health-in-california/\" target=\"_blank\" rel=\"noreferrer noopener\">66% of California adults supported health coverage\u003c/a> for undocumented immigrants in March 2021, up from 54% in 2015, according to a survey by the Public Policy Institute of California.\u003c/p>\n\u003cp>\u003ca href=\"https://www.sacbee.com/news/politics-government/article239976023.html\" target=\"_blank\" rel=\"noreferrer noopener\">Former Republican President Donald Trump\u003c/a> lambasted California’s expansion for young adults in 2020 and claimed California and other states would “bankrupt our nation by providing free taxpayer-funded health care to millions of illegal aliens.” California Republican leaders, though less harsh in their condemnation of the state’s immigration policies in recent years, have \u003ca href=\"https://src.senate.ca.gov/content/highlights-and-analysis-2022-23-governors-budget\" target=\"_blank\" rel=\"noreferrer noopener\">accused Newsom of overloading the state’s budget\u003c/a> and Medi-Cal system.\u003c/p>\n\u003cp>“Medi-Cal is already strained by serving 14.6 million Californians —more than a third of the state’s population. Adding 764,000 more individuals to the system will certainly exacerbate current provider access problems,” the Senate Republican Caucus said in a January 2022 budget analysis.\u003c/p>\n\u003cp>For his part, Newsom has played a critical role in propelling the movement forward, said Rachel Linn Gish, communications director for Health Access California. Newsom, who took office in 2019, campaigned on the \u003ca href=\"https://www.politico.com/states/california/story/2018/11/29/how-newsoms-big-win-gives-him-a-mandate-on-health-care-715530\" target=\"_blank\" rel=\"noreferrer noopener\">promise of establishing universal health care in California\u003c/a>, and advocates have spent the duration of his governorship pushing him to keep that promise.[pullquote align=\"right\" size=\"medium\" citation=\"Rachel Linn Gish, Health Access California\"]‘You cannot talk about coverage for all if you’re not talking about coverage for everyone regardless of their immigration status.’[/pullquote]“You cannot talk about coverage for all if you’re not talking about coverage for everyone regardless of their immigration status,” Linn Gish said. “Gov. Newsom made it a major platform of his from day one, and I think it’s hard to untie those two things.”\u003c/p>\n\u003cp>Newsom has faced pressure to do more for undocumented immigrants and to do it faster. Advocates and some legislators lobbied Newsom to roll out this last expansion sooner, in part because of the \u003ca href=\"https://calmatters.org/california-divide/2022/01/omicron-essential-workers-alone/\" target=\"_blank\" rel=\"noreferrer noopener\">disproportionate toll COVID-19 took on essential workers\u003c/a>, many of whom are undocumented.\u003c/p>\n\u003cp>This expansion is \u003ca href=\"https://ebudget.ca.gov/2022-23/pdf/Enacted/BudgetSummary/HealthandHumanServices.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">projected to cost\u003c/a> more than $835 million in the next six months and $2.6 billion every year after that. Previous expansions, which opened the door to more than 1.1 million undocumented enrollees, cost the state approximately $1.6 billion annually, according to \u003ca href=\"https://lao.ca.gov/Publications/Report/4423\" target=\"_blank\" rel=\"noreferrer noopener\">past Legislative Analyst’s Office reports\u003c/a>. The total $4 billion price tag, though significant, represents a fraction of Medi-Cal’s expansive $37 billion budget.\u003c/p>\n\u003cp>Still, many \u003ca href=\"https://calmatters.org/health/2022/02/medi-cal-expansion-immigrants/\" target=\"_blank\" rel=\"noreferrer noopener\">undocumented Californians will remain ineligible\u003c/a>\u003ca href=\"https://calmatters.org/health/2022/02/medi-cal-expansion-immigrants/\"> for health insurance\u003c/a>. Roughly half a million immigrants make too much money to qualify for Medi-Cal but still can’t afford private insurance. Advocates want to expand Covered California to include that population, but the state’s ballooning deficit makes that unlikely in the near future.\u003c/p>\n\u003ch2>Health disparities among undocumented immigrants\u003c/h2>\n\u003cp>Many undocumented immigrants avoid medical care, making it difficult to compare their health to other California residents. Some studies indicate they experience \u003ca href=\"https://www.ppic.org/publication/health-conditions-and-health-care-among-californias-undocumented-immigrants/\">higher rates of chronic conditions\u003c/a> like heart disease, asthma and high blood pressure. Immigrants without legal status in California are also \u003ca href=\"https://link.springer.com/article/10.1007/s11113-021-09689-w\">more likely to suffer from \u003c/a>\u003ca href=\"https://link.springer.com/article/10.1007/s11113-021-09689-w\" target=\"_blank\" rel=\"noreferrer noopener\">mental\u003c/a>\u003ca href=\"https://link.springer.com/article/10.1007/s11113-021-09689-w\"> distress and self-report poor health\u003c/a>.\u003c/p>\n\u003cp>Dr. Efrain Talamantes, chief operating officer at AltaMed in Los Angeles, the largest federally qualified health center in California, said he frequently sees young, undocumented individuals who feel healthy but “already are having the end damage of chronic conditions that have not been detected.”\u003c/p>\n\u003cp>The new Medi-Cal expansion will allow Talamantes and others who serve undocumented communities to give patients affordable, high-level care. Although California offers many undocumented immigrants emergency Medi-Cal, and \u003ca href=\"https://dhs.lacounty.gov/my-health-la/\">some counties fund their own programs\u003c/a>, services can be disjointed with monthslong wait times.\u003c/p>\n\u003cp>“When these patients now receive Medi-Cal and are part of a managed care health care plan with us, then we’re responsible for their entire care from primary and specialty to hospital care,” Talamantes said.\u003c/p>\n\u003cp>Miriam Pozuelos is one such potential beneficiary. The Los Angeles-area mother said the expansion lifts a huge financial burden from her family. She and her husband now pay out-of-pocket for any medical services and often go without. Both have already applied to full-scope Medi-Cal for January.\u003c/p>\n\u003cp>“When me and my family heard about this expansion, we were just really hoping that it would actually come true and that we can start getting the care that we need and not be worried about ‘I have to pay this enormous bill,’” Pozuelos said in Spanish.\u003c/p>\n\u003cp>Back at the St. John’s Community Health benefits center, Lopez helps another undocumented immigrant renew his emergency Medi-Cal, which will automatically roll over to full-scope next month. Wilder, 41, who requested his last name be withheld to protect him from immigration authorities, said he needs two root canals totaling $8,000. He has searched for months for a cheaper option without success, he said. He also needs medication for high blood pressure but can’t always afford it.\u003c/p>\n\u003cp>The Medi-Cal expansion means he’ll finally be able to take care of his health, Wilder said.\u003c/p>\n\u003cp>“It’s nice seeing them leaving happy and smiling,” Lopez said. “Even if it takes us three hours, they leave with a sense of relief that they can see the doctor.”\u003c/p>\n\u003cp>[ad floatright]\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\n",
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"excerpt": "Beginning Jan. 1, undocumented immigrants of all ages will qualify for Medi-Cal, the state's health insurance program for people with extremely low-income.",
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"title": "California Will Soon Be First State to Offer Health Insurance to Eligible Undocumented Adults | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Lea este artículo en \u003ca href=\"https://calmatters.org/calmatters-en-espanol/2023/12/california-se-convierte-en-el-primer-estado-en-ofrecer-seguro-medico-a-todos-los-adultos-indocumentados-elegibles/\">español\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>Perla Lopez hands a stack of papers to Baudeilio, a 44-year-old undocumented immigrant and day laborer. She has just helped him apply for Medi-Cal at the benefits center at St. John’s Community Health in South Los Angeles.\u003c/p>\n\u003cp>“If you see anything you don’t understand from the county, come back here,” Lopez tells Baudeilio in Spanish.\u003c/p>\n\u003cp>The application takes less than 20 minutes. The paperwork, though brief, marks a major milestone in California’s decades-long expansion of health care for undocumented immigrants.\u003c/p>\n\u003cp>Beginning Jan. 1, for the first time, undocumented immigrants of all ages will qualify for Medi-Cal, the state’s health insurance program for extremely low-income people. It makes \u003ca href=\"https://www.kff.org/racial-equity-and-health-policy/fact-sheet/key-facts-on-health-coverage-of-immigrants/\" target=\"_blank\" rel=\"noreferrer noopener\">California the only state\u003c/a> to fund comprehensive health care for undocumented immigrants.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Baudeilio, who has been denied coverage before and asked that his last name not be published to protect him from immigration authorities, will join more than 700,000 undocumented immigrants between the ages of 26 and 49 who will become eligible for Medi-Cal as part of the state’s final expansion of the program — the realization of a long-awaited dream for Californians without legal status.\u003c/p>\n\u003cp>“This is the culmination of literally decades of work, and it’s huge,” said Sarah Dar, policy director for the California Immigrant Policy Center. “It’s huge because of all the work and effort and advocacy that went into making this possible, and it’s also huge because of the impact that it’s going to have.”\u003c/p>\n\u003cp>Gov. Gavin Newsom and the state’s Democratic-led Legislature have committed more than $4 billion annually to the Medi-Cal expansion. \u003ca href=\"https://ebudget.ca.gov/2022-23/pdf/Enacted/BudgetSummary/HealthandHumanServices.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Newsom’s 2022 budget\u003c/a> made the latest expansion possible, and though the state is now headed into a \u003ca href=\"https://calmatters.org/politics/2023/12/budget-deficit-california/\" target=\"_blank\" rel=\"noreferrer noopener\">$68 billion deficit\u003c/a>, advocates said the positive impact Medi-Cal will have on individual health is priceless.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The change resonates deeply with Lopez, who is herself undocumented and eligible to work through the Deferred Action for Childhood Arrivals program.\u003c/p>\n\u003cp>Last year, when the state \u003ca href=\"https://calmatters.org/health/2022/02/medi-cal-expansion-immigrants/\" target=\"_blank\" rel=\"noreferrer noopener\">expanded Medi-Cal to older immigrants over 50\u003c/a>, Lopez’s mother was finally able to get medication and blood testing equipment for her diabetes. This year, surrounded by tinsel and other Christmas decorations in her brightly lit office, Lopez is happy she gets to deliver good news to undocumented patients.\u003c/p>\n\u003cp>“It really touches me,” she said. “It’s a stressor we take away from them. … For people with health issues, Medi-Cal really makes a difference.”\u003c/p>\n\u003cp>The clinic where Lopez works estimates about 13,000 of its patients will become eligible for Medi-Cal in the new year. They’re part of the largest group in California’s ambitious plan to close the insurance gap. Los Angeles County alone accounts for roughly half of the enrollees who are expected to qualify for Medi-Cal.\u003c/p>\n\u003cp>“It’s an exciting moment for our patients as well as for us,” said Annie Uraga, benefits counselor coordinator at St. John’s Community Health. “They’re ready. Many of them are in need or waiting for specialist visits.”\u003c/p>\n\u003ch2>California’s health insurance expansion\u003c/h2>\n\u003cp>The final expansion comes nine years after then-Gov. Jerry Brown signed the 2015 law making undocumented children eligible for state insurance, and it is due to the efforts of advocates trekking to the Capitol to plead their case.\u003c/p>\n\u003cp>“When we talk to people who are impacted by this, the difference it makes in their lives is something that truly numbers and words cannot even describe,” Dar, with the California Immigrant Policy Center, said. “In many cases, people have lived for decades without any kind of health care whatsoever.”\u003c/p>\n\u003cp>Full-scope Medi-Cal, which offers access to primary and preventive care, specialists, pharmaceuticals, and other wraparound services, will change lives, Dar said. California does not share immigration information with federal authorities, and enrolling in Medi-Cal will not threaten chances to pursue legal residency.\u003c/p>\n\u003cp>The California Immigrant Policy Center and consumer advocacy group Health Access California have been the leading force in the campaign to eliminate citizenship requirements for Medi-Cal. The work was not easy, even in left-leaning California. Many moderate Democrats voted against the legislation or refrained from weighing in on the debate in the early days, Dar said, but slowly, public opinion and political will shifted.\u003c/p>\n\u003cp>About \u003ca href=\"https://www.ppic.org/publication/immigrants-and-health-in-california/\" target=\"_blank\" rel=\"noreferrer noopener\">66% of California adults supported health coverage\u003c/a> for undocumented immigrants in March 2021, up from 54% in 2015, according to a survey by the Public Policy Institute of California.\u003c/p>\n\u003cp>\u003ca href=\"https://www.sacbee.com/news/politics-government/article239976023.html\" target=\"_blank\" rel=\"noreferrer noopener\">Former Republican President Donald Trump\u003c/a> lambasted California’s expansion for young adults in 2020 and claimed California and other states would “bankrupt our nation by providing free taxpayer-funded health care to millions of illegal aliens.” California Republican leaders, though less harsh in their condemnation of the state’s immigration policies in recent years, have \u003ca href=\"https://src.senate.ca.gov/content/highlights-and-analysis-2022-23-governors-budget\" target=\"_blank\" rel=\"noreferrer noopener\">accused Newsom of overloading the state’s budget\u003c/a> and Medi-Cal system.\u003c/p>\n\u003cp>“Medi-Cal is already strained by serving 14.6 million Californians —more than a third of the state’s population. Adding 764,000 more individuals to the system will certainly exacerbate current provider access problems,” the Senate Republican Caucus said in a January 2022 budget analysis.\u003c/p>\n\u003cp>For his part, Newsom has played a critical role in propelling the movement forward, said Rachel Linn Gish, communications director for Health Access California. Newsom, who took office in 2019, campaigned on the \u003ca href=\"https://www.politico.com/states/california/story/2018/11/29/how-newsoms-big-win-gives-him-a-mandate-on-health-care-715530\" target=\"_blank\" rel=\"noreferrer noopener\">promise of establishing universal health care in California\u003c/a>, and advocates have spent the duration of his governorship pushing him to keep that promise.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“You cannot talk about coverage for all if you’re not talking about coverage for everyone regardless of their immigration status,” Linn Gish said. “Gov. Newsom made it a major platform of his from day one, and I think it’s hard to untie those two things.”\u003c/p>\n\u003cp>Newsom has faced pressure to do more for undocumented immigrants and to do it faster. Advocates and some legislators lobbied Newsom to roll out this last expansion sooner, in part because of the \u003ca href=\"https://calmatters.org/california-divide/2022/01/omicron-essential-workers-alone/\" target=\"_blank\" rel=\"noreferrer noopener\">disproportionate toll COVID-19 took on essential workers\u003c/a>, many of whom are undocumented.\u003c/p>\n\u003cp>This expansion is \u003ca href=\"https://ebudget.ca.gov/2022-23/pdf/Enacted/BudgetSummary/HealthandHumanServices.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">projected to cost\u003c/a> more than $835 million in the next six months and $2.6 billion every year after that. Previous expansions, which opened the door to more than 1.1 million undocumented enrollees, cost the state approximately $1.6 billion annually, according to \u003ca href=\"https://lao.ca.gov/Publications/Report/4423\" target=\"_blank\" rel=\"noreferrer noopener\">past Legislative Analyst’s Office reports\u003c/a>. The total $4 billion price tag, though significant, represents a fraction of Medi-Cal’s expansive $37 billion budget.\u003c/p>\n\u003cp>Still, many \u003ca href=\"https://calmatters.org/health/2022/02/medi-cal-expansion-immigrants/\" target=\"_blank\" rel=\"noreferrer noopener\">undocumented Californians will remain ineligible\u003c/a>\u003ca href=\"https://calmatters.org/health/2022/02/medi-cal-expansion-immigrants/\"> for health insurance\u003c/a>. Roughly half a million immigrants make too much money to qualify for Medi-Cal but still can’t afford private insurance. Advocates want to expand Covered California to include that population, but the state’s ballooning deficit makes that unlikely in the near future.\u003c/p>\n\u003ch2>Health disparities among undocumented immigrants\u003c/h2>\n\u003cp>Many undocumented immigrants avoid medical care, making it difficult to compare their health to other California residents. Some studies indicate they experience \u003ca href=\"https://www.ppic.org/publication/health-conditions-and-health-care-among-californias-undocumented-immigrants/\">higher rates of chronic conditions\u003c/a> like heart disease, asthma and high blood pressure. Immigrants without legal status in California are also \u003ca href=\"https://link.springer.com/article/10.1007/s11113-021-09689-w\">more likely to suffer from \u003c/a>\u003ca href=\"https://link.springer.com/article/10.1007/s11113-021-09689-w\" target=\"_blank\" rel=\"noreferrer noopener\">mental\u003c/a>\u003ca href=\"https://link.springer.com/article/10.1007/s11113-021-09689-w\"> distress and self-report poor health\u003c/a>.\u003c/p>\n\u003cp>Dr. Efrain Talamantes, chief operating officer at AltaMed in Los Angeles, the largest federally qualified health center in California, said he frequently sees young, undocumented individuals who feel healthy but “already are having the end damage of chronic conditions that have not been detected.”\u003c/p>\n\u003cp>The new Medi-Cal expansion will allow Talamantes and others who serve undocumented communities to give patients affordable, high-level care. Although California offers many undocumented immigrants emergency Medi-Cal, and \u003ca href=\"https://dhs.lacounty.gov/my-health-la/\">some counties fund their own programs\u003c/a>, services can be disjointed with monthslong wait times.\u003c/p>\n\u003cp>“When these patients now receive Medi-Cal and are part of a managed care health care plan with us, then we’re responsible for their entire care from primary and specialty to hospital care,” Talamantes said.\u003c/p>\n\u003cp>Miriam Pozuelos is one such potential beneficiary. The Los Angeles-area mother said the expansion lifts a huge financial burden from her family. She and her husband now pay out-of-pocket for any medical services and often go without. Both have already applied to full-scope Medi-Cal for January.\u003c/p>\n\u003cp>“When me and my family heard about this expansion, we were just really hoping that it would actually come true and that we can start getting the care that we need and not be worried about ‘I have to pay this enormous bill,’” Pozuelos said in Spanish.\u003c/p>\n\u003cp>Back at the St. John’s Community Health benefits center, Lopez helps another undocumented immigrant renew his emergency Medi-Cal, which will automatically roll over to full-scope next month. Wilder, 41, who requested his last name be withheld to protect him from immigration authorities, said he needs two root canals totaling $8,000. He has searched for months for a cheaper option without success, he said. He also needs medication for high blood pressure but can’t always afford it.\u003c/p>\n\u003cp>The Medi-Cal expansion means he’ll finally be able to take care of his health, Wilder said.\u003c/p>\n\u003cp>“It’s nice seeing them leaving happy and smiling,” Lopez said. “Even if it takes us three hours, they leave with a sense of relief that they can see the doctor.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"tagline": "The flip side of gentrification, told through one town",
"info": "Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?",
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},
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"tagline": "Exploring the Bay Area, one question at a time",
"info": "KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.",
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"order": 8
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},
"link": "https://www.cityarts.net",
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"order": 1
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"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
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"source": "Commonwealth Club of California"
},
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"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
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"order": 9
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"hidden-brain": {
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"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
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"source": "NPR"
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"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
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"airtime": "SUN 7:30pm-8pm",
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"hyphenacion": {
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"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"jerrybrown": {
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"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"order": 18
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},
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"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
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},
"link": "/radio/program/latino-usa",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
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},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
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},
"masters-of-scale": {
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"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
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"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
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