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"content": "\u003cp>\u003cem>Lea este artículo en \u003ca href=\"https://calmatters.org/calmatters-en-espanol/2023/12/las-carisimas-facturas-por-uso-de-ambulancias-endeudaron-a-estas-familias-pero-una-nueva-ley-de-california-prohibe-la-practica/\">español\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>The COVID-19 pandemic took a brutal toll on Danielle Miele’s family. But after two exorbitant ambulance bills, she’s now scared to call 911.\u003c/p>\n\u003cp>Her teenage son attempted suicide in 2022, Miele said. His mental health deteriorated during the pandemic, and he needed an ambulance transfer from the Roseville emergency room, where Miele took him to a treatment center in San Mateo. The ambulance company hit Miele with a $9,000 out-of-network charge, which was sent to collections “almost immediately,” she said.[pullquote align=\"right\" size=\"medium\" citation=\"Katie Van Deynze, Health Access California\"]‘It’s the last remaining gap, but it’s a really big one. You could be insured, but it doesn’t matter.’[/pullquote]The virus also left Miele with seizures that mimic the symptoms of a heart attack, she said. Miele called 911 the first time a seizure happened. The 15-minute ride to the hospital cost $4,000 without help from insurance, she said.\u003c/p>\n\u003cp>“The last time I had one of my seizures, I basically said, ‘I’m going to die here at home. … I’m not getting another ambulance,’” Miele said. “I’d maybe rather die at home than have more medical debt.”\u003c/p>\n\u003cp>A \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB716\" target=\"_blank\" rel=\"noreferrer noopener\">new California law\u003c/a> that takes effect Jan. 1 targets the kind of “surprise” ambulance bills that put Miele’s family in debt, even though they had medical insurance. These bills take the form of out-of-network charges for privately insured patients without control over which ambulance company responds to a call for help.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Under the new law, patients will only have to pay the equivalent of what they would have paid for an in-network service. Health insurance and ambulance companies will have to settle the bill directly even if they don’t have an existing contract.\u003c/p>\n\u003cp>Supporters of the new law argue it will make a big difference for thousands of families like Miele’s. The second time that Miele’s son needed an emergency psychiatric hold, the ambulance company that arrived was part of the family’s insurance network. Their co-pay: $83.\u003c/p>\n\u003cp>Ambulance companies did not oppose the legislation, which includes guarantees that health insurance plans reimburse them for services.\u003c/p>\n\u003ch2>Millions in surprise bills\u003c/h2>\n\u003cp>The California Association of Health Plans, which represents insurers, opposed the bill before it became law because of its potential to increase premiums by $67.3 million statewide. In contrast, people with private health insurance stand to save approximately $44.5 million in \u003ca href=\"https://www.chbrp.org/sites/default/files/bill-documents/AB716/AB%20716%20Final.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">direct\u003c/a>\u003ca href=\"https://www.chbrp.org/sites/default/files/bill-documents/AB716/AB%20716%20Final.pdf\"> charges for ambulance rides\u003c/a>, according to a legislative analysis.\u003c/p>\n\u003cp>Katie Van Deynze, a legislative advocate for Health Access California, a consumer advocacy group that sponsored the legislation, said the law closes a longstanding gap in California’s \u003ca href=\"https://www.insurance.ca.gov/01-consumers/110-health/60-resources/NoSupriseBills.cfm\" target=\"_blank\" rel=\"noreferrer noopener\">consumer\u003c/a>\u003ca href=\"https://www.insurance.ca.gov/01-consumers/110-health/60-resources/NoSupriseBills.cfm\"> protections against surprise medical billing\u003c/a> for patients with private insurance.\u003c/p>\n\u003cp>“It’s the last remaining gap, but it’s a really big one,” she said. “You could be insured, but it doesn’t matter.”\u003c/p>\n\u003cfigure id=\"attachment_11971057\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM.jpeg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11971057\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM.jpeg\" alt=\"A woman with glasses, sitting on an easy chair, holds a little boy on her lap.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM.jpeg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM-800x533.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM-1020x680.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM-1536x1024.jpeg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM-1920x1280.jpeg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lainey Arebalo and her son Brady sitting in the living room of her parents’ home in Templeton, California, on Dec. 19, 2023. Minutes after Arebalo gave birth to Brady, doctors had him transported by ambulance to a neonatal intensive care unit, leaving the family with a hefty ambulance bill. \u003ccite>(Larry Valenzuela/CalMatters, CatchLight Local)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Approximately 14 million Californians with state-regulated private health plans will benefit from the law’s protections. According to an analysis by the Kaiser Family Foundation, \u003ca href=\"https://www.healthsystemtracker.org/brief/ground-ambulance-rides-and-potential-for-surprise-billing/#Among%20privately%20insured%20non-elderly%20people%20with%20an%20emergency%20room%20(ER)%20visit,%20the%20share%20who%20arrived%20to%20the%20ER%20by%20ambulance,%202018\">73% of all ground ambulance \u003c/a>\u003ca href=\"https://www.healthsystemtracker.org/brief/ground-ambulance-rides-and-potential-for-surprise-billing/#Among%20privately%20insured%20non-elderly%20people%20with%20an%20emergency%20room%20(ER)%20visit,%20the%20share%20who%20arrived%20to%20the%20ER%20by%20ambulance,%202018\" target=\"_blank\" rel=\"noreferrer noopener\">transports\u003c/a> in California resulted in an out-of-network charge in 2018 among people with large employer insurance. California also has the nation’s \u003ca href=\"https://publicinterestnetwork.org/wp-content/uploads/2022/12/EMERGENCY-The-high-cost-of-ambulance-surprise-bills-USPIRG-Education-Fund-December-2022-Final.pdf#=page9\" target=\"_blank\" rel=\"noreferrer noopener\">highest median surprise ambulance bill\u003c/a>, at $1,209, according to a study published last year by the U.S. Public Interest Research Group.\u003c/p>\n\u003cp>In a statement at the time of the law’s passage, Assemblymember \u003ca href=\"https://calmatters.org/legislator-tracker/tasha-boerner-horvath-1973/\">Tasha Boerner\u003c/a>, the Democrat from Carlsbad who authored the measure, said people have no control over which ambulance company picks them up in a time of crisis.\u003c/p>\n\u003cp>“The last thing anyone should be thinking about when they call 911 is whether they can afford the ambulance ride,” Boerner said in her statement.\u003c/p>\n\u003cp>[aside label=\"more health coverage\" tag=\"health-care\"]The law also protects uninsured people from receiving an expensive ambulance bill by limiting their out-of-pocket cost to the Medi-Cal or Medicare rate, whichever is greater. Medi-Cal is the state’s health insurance program for very low-income residents and already protects its enrollees from these types of bills.\u003c/p>\n\u003cp>About 6 million Californians enrolled in federally regulated health plans, many of whom work for multi-state or multinational companies, won’t be shielded by the law. Californians can ask their employer what kind of health plan they offer.\u003c/p>\n\u003ch2>$4,400 bill for newborn’s ambulance trip\u003c/h2>\n\u003cp>Lainey Arebalo is thankful that future emergencies will be covered in California. Her health insurance company doesn’t contract with any ambulance companies in San Luis Obispo County, where she and her family live, leaving them with no choice but to pay out of pocket.\u003c/p>\n\u003cp>In September, minutes after Arebalo gave birth to her son Brady, doctors decided to transfer him to a larger hospital about 20 miles away. Brady wasn’t breathing properly and needed to be admitted to a neonatal intensive care unit. The ambulance came and whisked him away.\u003c/p>\n\u003cp>Over the next month, letters started arriving from the ambulance company: Arebalo owed $4,400 for the transfer, she said.\u003c/p>\n\u003cp>“Here I am, you know, less than two months after giving birth, being told I would be sent to collections,” she said.\u003c/p>\n\u003cp>Insurance covered nearly all of Brady’s five-day hospital stay, which totaled $109,000, Arebalo said, but wouldn’t pay for the out-of-network ambulance ride. Eventually, insurance paid about a third of the bill after Arebalo filed a grievance, but the remaining unexpected expense still cut into the family’s finances.\u003c/p>\n\u003cp>She ended her maternity leave early to return to work as a special education teacher to help pay the bills and is now on a payment plan of $200 per month.\u003c/p>\n\u003cp>“It was definitely a surprise bill and one that I’m still paying,” Arebalo said.\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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"content": "\u003cdiv class=\"post-body\">\u003cp>The virus also left Miele with seizures that mimic the symptoms of a heart attack, she said. Miele called 911 the first time a seizure happened. The 15-minute ride to the hospital cost $4,000 without help from insurance, she said.\u003c/p>\n\u003cp>“The last time I had one of my seizures, I basically said, ‘I’m going to die here at home. … I’m not getting another ambulance,’” Miele said. “I’d maybe rather die at home than have more medical debt.”\u003c/p>\n\u003cp>A \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB716\" target=\"_blank\" rel=\"noreferrer noopener\">new California law\u003c/a> that takes effect Jan. 1 targets the kind of “surprise” ambulance bills that put Miele’s family in debt, even though they had medical insurance. These bills take the form of out-of-network charges for privately insured patients without control over which ambulance company responds to a call for help.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Under the new law, patients will only have to pay the equivalent of what they would have paid for an in-network service. Health insurance and ambulance companies will have to settle the bill directly even if they don’t have an existing contract.\u003c/p>\n\u003cp>Supporters of the new law argue it will make a big difference for thousands of families like Miele’s. The second time that Miele’s son needed an emergency psychiatric hold, the ambulance company that arrived was part of the family’s insurance network. Their co-pay: $83.\u003c/p>\n\u003cp>Ambulance companies did not oppose the legislation, which includes guarantees that health insurance plans reimburse them for services.\u003c/p>\n\u003ch2>Millions in surprise bills\u003c/h2>\n\u003cp>The California Association of Health Plans, which represents insurers, opposed the bill before it became law because of its potential to increase premiums by $67.3 million statewide. In contrast, people with private health insurance stand to save approximately $44.5 million in \u003ca href=\"https://www.chbrp.org/sites/default/files/bill-documents/AB716/AB%20716%20Final.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">direct\u003c/a>\u003ca href=\"https://www.chbrp.org/sites/default/files/bill-documents/AB716/AB%20716%20Final.pdf\"> charges for ambulance rides\u003c/a>, according to a legislative analysis.\u003c/p>\n\u003cp>Katie Van Deynze, a legislative advocate for Health Access California, a consumer advocacy group that sponsored the legislation, said the law closes a longstanding gap in California’s \u003ca href=\"https://www.insurance.ca.gov/01-consumers/110-health/60-resources/NoSupriseBills.cfm\" target=\"_blank\" rel=\"noreferrer noopener\">consumer\u003c/a>\u003ca href=\"https://www.insurance.ca.gov/01-consumers/110-health/60-resources/NoSupriseBills.cfm\"> protections against surprise medical billing\u003c/a> for patients with private insurance.\u003c/p>\n\u003cp>“It’s the last remaining gap, but it’s a really big one,” she said. “You could be insured, but it doesn’t matter.”\u003c/p>\n\u003cfigure id=\"attachment_11971057\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM.jpeg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11971057\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM.jpeg\" alt=\"A woman with glasses, sitting on an easy chair, holds a little boy on her lap.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM.jpeg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM-800x533.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM-1020x680.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM-1536x1024.jpeg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM-1920x1280.jpeg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lainey Arebalo and her son Brady sitting in the living room of her parents’ home in Templeton, California, on Dec. 19, 2023. Minutes after Arebalo gave birth to Brady, doctors had him transported by ambulance to a neonatal intensive care unit, leaving the family with a hefty ambulance bill. \u003ccite>(Larry Valenzuela/CalMatters, CatchLight Local)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Approximately 14 million Californians with state-regulated private health plans will benefit from the law’s protections. According to an analysis by the Kaiser Family Foundation, \u003ca href=\"https://www.healthsystemtracker.org/brief/ground-ambulance-rides-and-potential-for-surprise-billing/#Among%20privately%20insured%20non-elderly%20people%20with%20an%20emergency%20room%20(ER)%20visit,%20the%20share%20who%20arrived%20to%20the%20ER%20by%20ambulance,%202018\">73% of all ground ambulance \u003c/a>\u003ca href=\"https://www.healthsystemtracker.org/brief/ground-ambulance-rides-and-potential-for-surprise-billing/#Among%20privately%20insured%20non-elderly%20people%20with%20an%20emergency%20room%20(ER)%20visit,%20the%20share%20who%20arrived%20to%20the%20ER%20by%20ambulance,%202018\" target=\"_blank\" rel=\"noreferrer noopener\">transports\u003c/a> in California resulted in an out-of-network charge in 2018 among people with large employer insurance. California also has the nation’s \u003ca href=\"https://publicinterestnetwork.org/wp-content/uploads/2022/12/EMERGENCY-The-high-cost-of-ambulance-surprise-bills-USPIRG-Education-Fund-December-2022-Final.pdf#=page9\" target=\"_blank\" rel=\"noreferrer noopener\">highest median surprise ambulance bill\u003c/a>, at $1,209, according to a study published last year by the U.S. Public Interest Research Group.\u003c/p>\n\u003cp>In a statement at the time of the law’s passage, Assemblymember \u003ca href=\"https://calmatters.org/legislator-tracker/tasha-boerner-horvath-1973/\">Tasha Boerner\u003c/a>, the Democrat from Carlsbad who authored the measure, said people have no control over which ambulance company picks them up in a time of crisis.\u003c/p>\n\u003cp>“The last thing anyone should be thinking about when they call 911 is whether they can afford the ambulance ride,” Boerner said in her statement.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The law also protects uninsured people from receiving an expensive ambulance bill by limiting their out-of-pocket cost to the Medi-Cal or Medicare rate, whichever is greater. Medi-Cal is the state’s health insurance program for very low-income residents and already protects its enrollees from these types of bills.\u003c/p>\n\u003cp>About 6 million Californians enrolled in federally regulated health plans, many of whom work for multi-state or multinational companies, won’t be shielded by the law. Californians can ask their employer what kind of health plan they offer.\u003c/p>\n\u003ch2>$4,400 bill for newborn’s ambulance trip\u003c/h2>\n\u003cp>Lainey Arebalo is thankful that future emergencies will be covered in California. Her health insurance company doesn’t contract with any ambulance companies in San Luis Obispo County, where she and her family live, leaving them with no choice but to pay out of pocket.\u003c/p>\n\u003cp>In September, minutes after Arebalo gave birth to her son Brady, doctors decided to transfer him to a larger hospital about 20 miles away. Brady wasn’t breathing properly and needed to be admitted to a neonatal intensive care unit. The ambulance came and whisked him away.\u003c/p>\n\u003cp>Over the next month, letters started arriving from the ambulance company: Arebalo owed $4,400 for the transfer, she said.\u003c/p>\n\u003cp>“Here I am, you know, less than two months after giving birth, being told I would be sent to collections,” she said.\u003c/p>\n\u003cp>Insurance covered nearly all of Brady’s five-day hospital stay, which totaled $109,000, Arebalo said, but wouldn’t pay for the out-of-network ambulance ride. Eventually, insurance paid about a third of the bill after Arebalo filed a grievance, but the remaining unexpected expense still cut into the family’s finances.\u003c/p>\n\u003cp>She ended her maternity leave early to return to work as a special education teacher to help pay the bills and is now on a payment plan of $200 per month.\u003c/p>\n\u003cp>“It was definitely a surprise bill and one that I’m still paying,” Arebalo said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that\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\u003c/div>\u003c/p>",
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"headTitle": "‘This Is Not Rocket Science’: A Doctor’s Mission to Overcome Children’s Fear of Needles | KQED",
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"content": "\u003cp>Any new parent has been through it: The distress of seeing your child scream at the doctor’s office. The torture of having to hold them down as the clinician sticks them with one vaccine after another.\u003c/p>\n\u003cp>“The first shots he got, I probably cried more than he did,” said Remy Anthes, rocking her 6-month-old son, Dorian, in his stroller.[pullquote align =\"right:\" size=\"medium\" citation=\"Dr. Stefan Friedrichsdorf, medical director of UCSF's Stad Center for Pediatric Pain\"]‘We can pretty much promise to completely take away the pain and the anxiety caused by needles, vaccination, blood draws.’[/pullquote]“The look in her eyes, it’s hard to take,” said Jill Lovitt of her infant daughter, Jenna, who recently received her vaccines. “Like, ‘What are you letting them do to me? Why?’”\u003c/p>\n\u003cp>Some kids remember that pain and internalize the fear. Like when Julia Cramer’s 3-year-old daughter, Maya, had her blood drawn for an allergy test in Petaluma.\u003c/p>\n\u003cp>“After that, she had a fear of blue gloves,” Cramer said. “I went to the grocery store, and she saw someone wearing blue gloves, stocking the vegetables, and she started freaking out and crying.”\u003ci> \u003c/i>\u003c/p>\n\u003cp>Pediatricians see this all the time. Research suggests that children’s biggest source of pain in the health care system is\u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/25554755/\"> needle pokes\u003c/a>, including in kids who are being treated for serious illness. Especially in some lower- and moderate-income countries, many hospitals that treat pediatric cancer don’t use central lines or small catheters, so every time a child needs blood drawn or IV medications, they get poked.\u003c/p>\n\u003cp>Picture the medical student trying 17 times to find a vein.\u003c/p>\n\u003cp>“This is so bad that many children and many parents decide not to continue the treatment. Even here in the United States,” Dr. Stefan Friedrichsdorf, medical director of UCSF’s \u003ca href=\"https://www.ucsfbenioffchildrens.org/clinics/pediatric-pain-palliative-and-integrative-medicine-center\">Stad Center for Pediatric Pain\u003c/a>, told an audience during November’s End Well conference in Los Angeles.\u003c/p>\n\u003cp>The trauma follows kids: \u003ca href=\"https://www.cdc.gov/vaccines/pubs/pinkbook/vac-admin.html\">An estimated 25% of adults\u003c/a> have a fear of needles that began in childhood. And roughly 16%\u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/30109720/\"> of adults refuse flu vaccinations\u003c/a> because of it.\u003c/p>\n\u003cfigure id=\"attachment_11970963\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231218-OuchlessNeedles-04-BL-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11970963\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231218-OuchlessNeedles-04-BL-qut.jpg\" alt=\"A man with glasses and a stethoscope blows on a mini pinwheel\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231218-OuchlessNeedles-04-BL-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231218-OuchlessNeedles-04-BL-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231218-OuchlessNeedles-04-BL-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231218-OuchlessNeedles-04-BL-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231218-OuchlessNeedles-04-BL-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Stefan Friedrichsdorf, medical director of Stad Center for Pediatric Pain, demonstrates one of the distraction techniques he uses for children receiving shots at UCSF Benioff Children’s Hospital in San Francisco on Dec. 18, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Friedrichsdorf said he has a solution: the Ouchless Jab Challenge.\u003c/p>\n\u003cp>“We can pretty much promise to completely take away the pain and the anxiety caused by needles, vaccination, blood draws,” he said. “This is not rocket science.”\u003c/p>\n\u003cp>He outlines the series of simple steps clinicians and parents can follow:\u003c/p>\n\u003cul>\n\u003cli>Apply numbing cream — over-the-counter lidocaine — 30 minutes before a shot\u003c/li>\n\u003cli>Breastfeed babies or give them a pacifier dipped in sugar water to comfort them while getting a shot\u003c/li>\n\u003cli>Use distractions, like teddy bears, pinwheels, or bubbles, to divert attention away from the needle.\u003c/li>\n\u003cli>Don’t pin kids down. Parents should hold children in their laps instead.\u003c/li>\n\u003c/ul>\n\u003cp>[aside label=\"related coverage\" tag=\"palliative-care\"]Friedrichsdorf is leading the rollout of these new protocols this year at UCSF Benioff Children’s Hospitals in San Francisco and Oakland after launching a similar effort in Minnesota. Parents will have to take a leading role in demanding these measures at other local medical centers, he said, because the tolerance and acceptance of children’s pain is so entrenched among clinicians.\u003c/p>\n\u003cp>“We are taught to see pain as an unfortunate but inevitable side effect of good treatment,” said Dr. Diane Meier, a palliative care specialist at Mount Sinai in New York. “We learn to repress that feeling of distress at the pain we are causing because otherwise we can’t do our jobs.”\u003c/p>\n\u003cp>During her medical training, Meier had to hold kids down for procedures, a task she hated. It drove her away from pediatrics. She went into geriatrics instead and later helped lead \u003ca href=\"https://resident360.nejm.org/content-items/history-of-palliative-care\">the modern movement\u003c/a> to promote palliative care in medicine, which didn’t become \u003ca href=\"https://www.mercurynews.com/2012/02/05/young-doctors-flock-toward-new-specialty-in-end-of-life-care/?clearUserState=true\">an accredited specialty\u003c/a> in the U.S. until 2006.\u003c/p>\n\u003cp>Meier thinks the campaign to eliminate needle pain and anxiety should be applied to everyone.\u003c/p>\n\u003cp>“Just like in children and infants, people with dementia have no idea why human beings are approaching them to stick needles in them,” she said.\u003c/p>\n\u003cp>Friedrichsdorf’s techniques would likely work in this population, too, Meier said. Numbing cream, distraction, something sweet in the mouth, and perhaps music from the patient’s youth that they remember and can sing along to would all be helpful.\u003c/p>\n\u003cp>“It’s worthy of study, and it’s worthy of serious attention,” she said.\u003cbr>\n[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“The look in her eyes, it’s hard to take,” said Jill Lovitt of her infant daughter, Jenna, who recently received her vaccines. “Like, ‘What are you letting them do to me? Why?’”\u003c/p>\n\u003cp>Some kids remember that pain and internalize the fear. Like when Julia Cramer’s 3-year-old daughter, Maya, had her blood drawn for an allergy test in Petaluma.\u003c/p>\n\u003cp>“After that, she had a fear of blue gloves,” Cramer said. “I went to the grocery store, and she saw someone wearing blue gloves, stocking the vegetables, and she started freaking out and crying.”\u003ci> \u003c/i>\u003c/p>\n\u003cp>Pediatricians see this all the time. Research suggests that children’s biggest source of pain in the health care system is\u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/25554755/\"> needle pokes\u003c/a>, including in kids who are being treated for serious illness. Especially in some lower- and moderate-income countries, many hospitals that treat pediatric cancer don’t use central lines or small catheters, so every time a child needs blood drawn or IV medications, they get poked.\u003c/p>\n\u003cp>Picture the medical student trying 17 times to find a vein.\u003c/p>\n\u003cp>“This is so bad that many children and many parents decide not to continue the treatment. Even here in the United States,” Dr. Stefan Friedrichsdorf, medical director of UCSF’s \u003ca href=\"https://www.ucsfbenioffchildrens.org/clinics/pediatric-pain-palliative-and-integrative-medicine-center\">Stad Center for Pediatric Pain\u003c/a>, told an audience during November’s End Well conference in Los Angeles.\u003c/p>\n\u003cp>The trauma follows kids: \u003ca href=\"https://www.cdc.gov/vaccines/pubs/pinkbook/vac-admin.html\">An estimated 25% of adults\u003c/a> have a fear of needles that began in childhood. And roughly 16%\u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/30109720/\"> of adults refuse flu vaccinations\u003c/a> because of it.\u003c/p>\n\u003cfigure id=\"attachment_11970963\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231218-OuchlessNeedles-04-BL-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11970963\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231218-OuchlessNeedles-04-BL-qut.jpg\" alt=\"A man with glasses and a stethoscope blows on a mini pinwheel\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231218-OuchlessNeedles-04-BL-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231218-OuchlessNeedles-04-BL-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231218-OuchlessNeedles-04-BL-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231218-OuchlessNeedles-04-BL-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231218-OuchlessNeedles-04-BL-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Stefan Friedrichsdorf, medical director of Stad Center for Pediatric Pain, demonstrates one of the distraction techniques he uses for children receiving shots at UCSF Benioff Children’s Hospital in San Francisco on Dec. 18, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Friedrichsdorf said he has a solution: the Ouchless Jab Challenge.\u003c/p>\n\u003cp>“We can pretty much promise to completely take away the pain and the anxiety caused by needles, vaccination, blood draws,” he said. “This is not rocket science.”\u003c/p>\n\u003cp>He outlines the series of simple steps clinicians and parents can follow:\u003c/p>\n\u003cul>\n\u003cli>Apply numbing cream — over-the-counter lidocaine — 30 minutes before a shot\u003c/li>\n\u003cli>Breastfeed babies or give them a pacifier dipped in sugar water to comfort them while getting a shot\u003c/li>\n\u003cli>Use distractions, like teddy bears, pinwheels, or bubbles, to divert attention away from the needle.\u003c/li>\n\u003cli>Don’t pin kids down. Parents should hold children in their laps instead.\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Friedrichsdorf is leading the rollout of these new protocols this year at UCSF Benioff Children’s Hospitals in San Francisco and Oakland after launching a similar effort in Minnesota. Parents will have to take a leading role in demanding these measures at other local medical centers, he said, because the tolerance and acceptance of children’s pain is so entrenched among clinicians.\u003c/p>\n\u003cp>“We are taught to see pain as an unfortunate but inevitable side effect of good treatment,” said Dr. Diane Meier, a palliative care specialist at Mount Sinai in New York. “We learn to repress that feeling of distress at the pain we are causing because otherwise we can’t do our jobs.”\u003c/p>\n\u003cp>During her medical training, Meier had to hold kids down for procedures, a task she hated. It drove her away from pediatrics. She went into geriatrics instead and later helped lead \u003ca href=\"https://resident360.nejm.org/content-items/history-of-palliative-care\">the modern movement\u003c/a> to promote palliative care in medicine, which didn’t become \u003ca href=\"https://www.mercurynews.com/2012/02/05/young-doctors-flock-toward-new-specialty-in-end-of-life-care/?clearUserState=true\">an accredited specialty\u003c/a> in the U.S. until 2006.\u003c/p>\n\u003cp>Meier thinks the campaign to eliminate needle pain and anxiety should be applied to everyone.\u003c/p>\n\u003cp>“Just like in children and infants, people with dementia have no idea why human beings are approaching them to stick needles in them,” she said.\u003c/p>\n\u003cp>Friedrichsdorf’s techniques would likely work in this population, too, Meier said. Numbing cream, distraction, something sweet in the mouth, and perhaps music from the patient’s youth that they remember and can sing along to would all be helpful.\u003c/p>\n\u003cp>“It’s worthy of study, and it’s worthy of serious attention,” she said.\u003cbr>\n\u003c/p>\u003c/div>",
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"content": "\u003cp>Oakland native De’andre Devereaux is no stranger to Treasure Island, a former military base along the Bay Bridge, halfway between Oakland and San Francisco. Up until about a year ago, he was unhoused, and the 55-year-old would spend afternoons on the quiet island panhandling for food and cash.\u003c/p>\n\u003cp>Devereaux now lives on the island, but his life couldn’t look more different. After choosing to enter treatment for a substance-use disorder last winter, he’s now living at a 70-bed sober, supportive living community that opened on Treasure Island in April. [pullquote size=\"medium\" align=\"right\" citation=\"De’andre Devereaux, resident of a HealthRight 360 program on Treasure Island\"]‘I’ve been in and out of rehabs since I was like 24 because I wasn’t ready to get my life together. I finally got tired, and I haven’t looked back … this changed my life.’[/pullquote]“I’ve been in and out of rehabs since I was like 24 because I wasn’t ready to get my life together,” Devereaux told KQED at a holiday party for residents in the program in December. “I finally got tired and I haven’t looked back, and I’m happy for that because this changed my life.”\u003c/p>\n\u003cp>Residents can enter the step-down program after completing a separate rehabilitation program and live there between nine months and two years. They are also connected with recovery coaches who assist with job readiness and navigating public benefits and medications. Everyone in the program simultaneously participates in outpatient recovery services.\u003c/p>\n\u003cp>The program helped Devereaux line up a job as an in-home service provider for older people and those with disabilities — a job he said he loves.\u003c/p>\n\u003cp>“It feels good doing that, giving back,” he said as holiday music played and neighbors mingled at the facility on Gateview Avenue. The Department of Public Health and HealthRight 360 operates the community, a statewide health care nonprofit that provides substance-use treatment.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For most residents who spoke to KQED, having a safe place to call home and a supportive environment to help navigate the ups and downs of recovery has made the biggest difference in their journey with sobriety.\u003c/p>\n\u003cp>“The real thing is getting people off the streets and into a place where the fog can lift, you know? Because when you’re in a sober mind, and you finally do kick that drug, that’s a major thing,” said William Pecknold Jr., another resident. “I don’t know if everybody wants help, you know, but for those who do, this is where you can get it.”\u003c/p>\n\u003cfigure id=\"attachment_11970626\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11970626\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED.jpg\" alt=\"A person wearing a hood stands beside a fence in a residential area.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">William Pecknold Jr. stands in the backyard of HealthRight 360’s Recovery Residence program. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As an ironworker, Pecknold has helped build the literal framework for prominent Bay Area structures like 131 Fremont Street in San Francisco. However, he struggled with alcohol addiction and later turned to methamphetamine when he was unhoused.\u003c/p>\n\u003cp>He got sober during a stay in prison, then quickly entered drug treatment programs after his release last December. The experience sent him down a new path, but, he said, everyone’s journey looks different. [pullquote size=\"medium\" align=\"right\" citation=\"William Pecknold Jr., resident of a HealthRight 360 program on Treasure Island\"]‘I don’t think it’s anyone else’s decision but the individual. I just know one thing for a fact. This place saved my life. It really did.’[/pullquote]“I don’t think it’s anyone else’s decision but the individual,” Pecknold said. “I just know one thing for a fact. This place saved my life. It really did.”\u003c/p>\n\u003cp>The residential step-down program is part of the city’s ongoing effort to increase the number of behavioral health care beds by 400, or 20% — a goal determined by the City’s \u003ca href=\"https://www.sfdph.org/dph/files/MHR/SFDPH_Behavioral_Health_Bed_Optimization_Report_FINAL.pdf\">Behavioral Health Bed Optimization Report\u003c/a> released in 2020.\u003c/p>\n\u003cp>The site is part of a broader behavioral health program that collectively currently offers 128 beds across the island. The step-down facility is scheduled to be rebuilt by 2028 as part of a multistory building with health services and housing overseen by the Department of Public Health.\u003c/p>\n\u003cp>Still, the program is not running at full capacity yet due to a lack of trained staff. As of Thursday, 87 people were using the broader program’s 128 beds. At the Gateview site, in particular, it has just over half of the staff it needs and only 39 residents for its 70 beds so far, according to officials at HealthRight 360. [aside label='More Stories on Housing' tag='housing']San Francisco is set to open three more projects across the city next year as part of the \u003ca href=\"https://www.sf.gov/sites/default/files/2022-06/SFDPH%20Bed%20Expansion%20Dashboard%206.22.22%20Final.pdf.pdf\">bed expansion\u003c/a>. That includes a 30-bed care facility for people with mental health and substance-use issues, a 10-person mental health program for transitional-age youth, and a 16-bed urgent care facility.\u003c/p>\n\u003cp>But the city’s goal to add more beds is an ever-moving target. While more beds have been added, \u003ca href=\"https://missionlocal.org/2022/08/despite-rosy-press-board-and-cares-continue-to-go-quietly/\">other behavioral health facilities and beds across the city’s network have shuttered\u003c/a> as the overdose epidemic and housing crisis collide.\u003c/p>\n\u003cp>Residents in the step-down program are encouraged and supported to move out after a period of time. However, some housing and healthcare advocates argue that temporary programs can destabilize residents who have to move frequently from place to place. Many point to permanent supportive housing as the ultimate north star for making a dent in the housing and addiction crisis. [pullquote size=\"medium\" align=\"right\" citation=\"Vitka Eisen, CEO, HealthRight 360\"]‘Our hope is that they can build their support in the earliest part of their recovery journey and their journey post-treatment.’[/pullquote]Eisen has been through residential treatment and said she views the issue as a “both-and,” arguing that there is a need for housing where people exiting drug detoxification or inpatient programs can build community, find work and secure longer-term housing.\u003c/p>\n\u003cp>“If we can develop permanent housing and affordable housing for people, that is the most important thing to do. But these services are unique. When people are just leaving intensive residential treatment, they’re less likely to be isolated here,” said Vitka Eisen, CEO of HealthRight 360. “Our hope is that they can build their support in the earliest part of their recovery journey and their journey post-treatment.”\u003c/p>\n\u003cp>\u003ci>Information on publicly available substance-use treatment in San Francisco and how to get care for yourself or a loved one can be found at \u003ca href=\"https://findtreatment-sf.org/\">findtreatment-sf.org\u003c/a>.\u003c/i>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Oakland native De’andre Devereaux is no stranger to Treasure Island, a former military base along the Bay Bridge, halfway between Oakland and San Francisco. Up until about a year ago, he was unhoused, and the 55-year-old would spend afternoons on the quiet island panhandling for food and cash.\u003c/p>\n\u003cp>Devereaux now lives on the island, but his life couldn’t look more different. After choosing to enter treatment for a substance-use disorder last winter, he’s now living at a 70-bed sober, supportive living community that opened on Treasure Island in April. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“I’ve been in and out of rehabs since I was like 24 because I wasn’t ready to get my life together,” Devereaux told KQED at a holiday party for residents in the program in December. “I finally got tired and I haven’t looked back, and I’m happy for that because this changed my life.”\u003c/p>\n\u003cp>Residents can enter the step-down program after completing a separate rehabilitation program and live there between nine months and two years. They are also connected with recovery coaches who assist with job readiness and navigating public benefits and medications. Everyone in the program simultaneously participates in outpatient recovery services.\u003c/p>\n\u003cp>The program helped Devereaux line up a job as an in-home service provider for older people and those with disabilities — a job he said he loves.\u003c/p>\n\u003cp>“It feels good doing that, giving back,” he said as holiday music played and neighbors mingled at the facility on Gateview Avenue. The Department of Public Health and HealthRight 360 operates the community, a statewide health care nonprofit that provides substance-use treatment.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For most residents who spoke to KQED, having a safe place to call home and a supportive environment to help navigate the ups and downs of recovery has made the biggest difference in their journey with sobriety.\u003c/p>\n\u003cp>“The real thing is getting people off the streets and into a place where the fog can lift, you know? Because when you’re in a sober mind, and you finally do kick that drug, that’s a major thing,” said William Pecknold Jr., another resident. “I don’t know if everybody wants help, you know, but for those who do, this is where you can get it.”\u003c/p>\n\u003cfigure id=\"attachment_11970626\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11970626\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED.jpg\" alt=\"A person wearing a hood stands beside a fence in a residential area.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">William Pecknold Jr. stands in the backyard of HealthRight 360’s Recovery Residence program. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As an ironworker, Pecknold has helped build the literal framework for prominent Bay Area structures like 131 Fremont Street in San Francisco. However, he struggled with alcohol addiction and later turned to methamphetamine when he was unhoused.\u003c/p>\n\u003cp>He got sober during a stay in prison, then quickly entered drug treatment programs after his release last December. The experience sent him down a new path, but, he said, everyone’s journey looks different. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“I don’t think it’s anyone else’s decision but the individual,” Pecknold said. “I just know one thing for a fact. This place saved my life. It really did.”\u003c/p>\n\u003cp>The residential step-down program is part of the city’s ongoing effort to increase the number of behavioral health care beds by 400, or 20% — a goal determined by the City’s \u003ca href=\"https://www.sfdph.org/dph/files/MHR/SFDPH_Behavioral_Health_Bed_Optimization_Report_FINAL.pdf\">Behavioral Health Bed Optimization Report\u003c/a> released in 2020.\u003c/p>\n\u003cp>The site is part of a broader behavioral health program that collectively currently offers 128 beds across the island. The step-down facility is scheduled to be rebuilt by 2028 as part of a multistory building with health services and housing overseen by the Department of Public Health.\u003c/p>\n\u003cp>Still, the program is not running at full capacity yet due to a lack of trained staff. As of Thursday, 87 people were using the broader program’s 128 beds. At the Gateview site, in particular, it has just over half of the staff it needs and only 39 residents for its 70 beds so far, according to officials at HealthRight 360. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>San Francisco is set to open three more projects across the city next year as part of the \u003ca href=\"https://www.sf.gov/sites/default/files/2022-06/SFDPH%20Bed%20Expansion%20Dashboard%206.22.22%20Final.pdf.pdf\">bed expansion\u003c/a>. That includes a 30-bed care facility for people with mental health and substance-use issues, a 10-person mental health program for transitional-age youth, and a 16-bed urgent care facility.\u003c/p>\n\u003cp>But the city’s goal to add more beds is an ever-moving target. While more beds have been added, \u003ca href=\"https://missionlocal.org/2022/08/despite-rosy-press-board-and-cares-continue-to-go-quietly/\">other behavioral health facilities and beds across the city’s network have shuttered\u003c/a> as the overdose epidemic and housing crisis collide.\u003c/p>\n\u003cp>Residents in the step-down program are encouraged and supported to move out after a period of time. However, some housing and healthcare advocates argue that temporary programs can destabilize residents who have to move frequently from place to place. Many point to permanent supportive housing as the ultimate north star for making a dent in the housing and addiction crisis. \u003c/p>\u003c/div>",
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"content": "‘Our hope is that they can build their support in the earliest part of their recovery journey and their journey post-treatment.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Eisen has been through residential treatment and said she views the issue as a “both-and,” arguing that there is a need for housing where people exiting drug detoxification or inpatient programs can build community, find work and secure longer-term housing.\u003c/p>\n\u003cp>“If we can develop permanent housing and affordable housing for people, that is the most important thing to do. But these services are unique. When people are just leaving intensive residential treatment, they’re less likely to be isolated here,” said Vitka Eisen, CEO of HealthRight 360. “Our hope is that they can build their support in the earliest part of their recovery journey and their journey post-treatment.”\u003c/p>\n\u003cp>\u003ci>Information on publicly available substance-use treatment in San Francisco and how to get care for yourself or a loved one can be found at \u003ca href=\"https://findtreatment-sf.org/\">findtreatment-sf.org\u003c/a>.\u003c/i>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "Over 930,000 Californians Lost Medi-Cal Coverage This Year Due to ‘Procedural Reasons’",
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"content": "\u003cp>\u003cem>Lea este artículo en \u003ca href=\"https://calmatters.org/calmatters-en-espanol/2023/12/me-dijeron-que-no-tengo-cobertura-californianos-sorprendidos-por-haber-perdido-su-seguro-de-medi-cal/\">español\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>Florinda Miguel took her 6-year-old daughter for a routine dentist appointment in early December, only to find out that her Medi-Cal coverage had lapsed.\u003c/p>\n\u003cp>It took her by surprise. She hadn’t needed to renew her kids’ Medi-Cal coverage in almost four years. The Los Angeles resident said she doesn’t recall getting any notices or renewal paperwork in the mail this year.\u003c/p>\n\u003cp>“I don’t know if they sent it, if it was lost. I don’t know, but I didn’t get it,” Miguel said.\u003c/p>\n\u003cp>Without coverage, her daughter’s dental exam would cost $60, plus the cost of any additional work that needed to be done, so Miguel postponed it until she could get her Medi-Cal reinstated.\u003c/p>\n\u003cp>This spring, \u003ca href=\"https://calmatters.org/health/2023/07/medi-cal-eligibility-california-review/\">states restarted their annual eligibility reviews\u003c/a> for lower-income people enrolled in Medicaid — better known as Medi-Cal in California — after the federal government paused them in 2020 so recipients could automatically maintain their health benefits during the COVID-19 pandemic.[pullquote align=\"right\" size=\"medium\" citation=\"Celia Valdez, Maternal and Child Health Access\"]‘During COVID, the message was ignore, ignore, don’t worry. For close to four years, we told people not to worry, and then all of a sudden, they had to worry.’[/pullquote]Now, six months into the renewed eligibility process, thousands of eligible Californians are finding out, often during doctor’s visits, that they’ve lost their coverage due to missing or incomplete paperwork.\u003c/p>\n\u003cp>More than 930,000 people have had their Medi-Cal coverage terminated this year, according to state data. The vast majority of them — close to 90% — lost coverage because of so-called “procedural reasons,” often entailing problems with paperwork. \u003ca href=\"https://www.kff.org/report-section/medicaid-enrollment-and-unwinding-tracker-overview/\">California has the country’s fourth highest rate\u003c/a> of terminations linked to procedural issues, according to the health policy research organization KFF (formerly known as the Kaiser Family Foundation).\u003c/p>\n\u003cp>Among Californians eligible for Medi-Cal renewals, 47% retained coverage, 15% were kicked off for paperwork problems, 2% no longer qualified and 35% are still under review, the KFF tracker shows.\u003c/p>\n\u003cp>People who lose their \u003ca href=\"https://www.dhcs.ca.gov/keep-your-Medi-Cal/Pages/I-got-a-renewal-form.aspx\">Medi-Cal coverage but are still eligible\u003c/a> can hop back on within a 90-day grace period as long as they submit any missing information through the mail or online. As of October, the program covered 15.1 million people in California.\u003c/p>\n\u003cp>“During COVID, the message was ignore, ignore, don’t worry. For close to four years, we told people not to worry, and then all of a sudden, they had to worry,” said Celia Valdez, director of outreach and education at the Los Angeles nonprofit Maternal and Child Health Access. Her organization helped Miguel reinstate her kids’ Medi-Cal. But experiences like Miguel’s are common, she said.\u003c/p>\n\u003cp>“Many [enrollees] are saying, ‘I couldn’t fill my prescription, I went to the doctor and they told me I have no coverage,’” Valdez said.\u003c/p>\n\u003cp>People who are being disenrolled for “procedural reasons” tend to fall into several buckets, including those who are new to the program and may not understand that they now have to respond to yearly reviews, said Yingjia Huang, assistant deputy director at the California Department of Health Care Services, the state agency that oversees the Medi-Cal program.\u003c/p>\n\u003cp>Other people may now have health insurance through an employer and are not filling out their paperwork because they no longer need Medi-Cal nor would they qualify, Huang said. And some who moved during the pandemic may not have received the renewal alert this year because they neglected to report their new address to their county Medi-Cal office.[aside label=\"more on medi-cal\" tag=\"medi-cal\"]And in some cases, advocates add, county offices may not be processing paperwork on time that was submitted close to the deadline.\u003c/p>\n\u003cp>The Children’s Partnership, a nonprofit children’s advocacy organization, last week \u003ca href=\"https://childrenspartnership.org/wp-content/uploads/2023/03/101691-000_Packard_FinishLine_CA_Deck.pptx.pdf\">published a report \u003c/a>about parents’ and guardians’ experiences with renewing their families’ Medi-Cal. The report noted several obstacles that parents said contributed to their children losing coverage, including unreturned phone calls, long call wait times, confusing instructions, limited access to translators, feelings of discrimination, and lack of awareness.\u003c/p>\n\u003cp>According to the report, gaps in coverage led to delays in care, missed medications and out-of-pocket costs for families.\u003c/p>\n\u003cp>Huang, with the Department of Health Care Services, said the state is working to increase the number of people whose coverage can be renewed automatically using state electronic databases that can verify an enrollee’s income and eligibility.\u003c/p>\n\u003cp>“Our [automatic renewal] rates historically have been lower than many of the other states — they probably have more electronic sources and databases that they can use,” Huang said. She noted the state has been receiving automation tips and technical assistance from the federal government to increase the number of cases that can be renewed automatically.\u003c/p>\n\u003cp>“That just eases the administrative burden on our members as well as our counties,” Huang said.\u003c/p>\n\u003cp>Valdez and other health advocates said there are significant gaps in support for people who have questions or need assistance. She said that calling county Medi-Cal offices can result in hours-long waits, and organizations like hers have limited capacity to fill in the gaps. People who are not connected to an advocate or an enrollment counselor could get lost in the process.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Among the \u003ca href=\"https://calmatters.org/health/2023/09/what-to-do-if-you-lose-medi-cal-health-insurance/\">top questions and comments\u003c/a> from people seeking assistance is that the paperwork is too much or too confusing, said Kimberley Graham, director of patient access at AltaMed Health Services, a clinic system in Los Angeles and Orange counties that provides enrollment services.\u003c/p>\n\u003cp>“And they don’t know what to do. So often, the packets are opened, but they’re completely blank,” Graham said. “The next question is, ‘Do I have to do this every year?’”\u003c/p>\n\u003cp>The answer, she said, is “yes.”\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>\n",
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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/me-dijeron-que-no-tengo-cobertura-californianos-sorprendidos-por-haber-perdido-su-seguro-de-medi-cal/\">español\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>Florinda Miguel took her 6-year-old daughter for a routine dentist appointment in early December, only to find out that her Medi-Cal coverage had lapsed.\u003c/p>\n\u003cp>It took her by surprise. She hadn’t needed to renew her kids’ Medi-Cal coverage in almost four years. The Los Angeles resident said she doesn’t recall getting any notices or renewal paperwork in the mail this year.\u003c/p>\n\u003cp>“I don’t know if they sent it, if it was lost. I don’t know, but I didn’t get it,” Miguel said.\u003c/p>\n\u003cp>Without coverage, her daughter’s dental exam would cost $60, plus the cost of any additional work that needed to be done, so Miguel postponed it until she could get her Medi-Cal reinstated.\u003c/p>\n\u003cp>This spring, \u003ca href=\"https://calmatters.org/health/2023/07/medi-cal-eligibility-california-review/\">states restarted their annual eligibility reviews\u003c/a> for lower-income people enrolled in Medicaid — better known as Medi-Cal in California — after the federal government paused them in 2020 so recipients could automatically maintain their health benefits during the COVID-19 pandemic.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Now, six months into the renewed eligibility process, thousands of eligible Californians are finding out, often during doctor’s visits, that they’ve lost their coverage due to missing or incomplete paperwork.\u003c/p>\n\u003cp>More than 930,000 people have had their Medi-Cal coverage terminated this year, according to state data. The vast majority of them — close to 90% — lost coverage because of so-called “procedural reasons,” often entailing problems with paperwork. \u003ca href=\"https://www.kff.org/report-section/medicaid-enrollment-and-unwinding-tracker-overview/\">California has the country’s fourth highest rate\u003c/a> of terminations linked to procedural issues, according to the health policy research organization KFF (formerly known as the Kaiser Family Foundation).\u003c/p>\n\u003cp>Among Californians eligible for Medi-Cal renewals, 47% retained coverage, 15% were kicked off for paperwork problems, 2% no longer qualified and 35% are still under review, the KFF tracker shows.\u003c/p>\n\u003cp>People who lose their \u003ca href=\"https://www.dhcs.ca.gov/keep-your-Medi-Cal/Pages/I-got-a-renewal-form.aspx\">Medi-Cal coverage but are still eligible\u003c/a> can hop back on within a 90-day grace period as long as they submit any missing information through the mail or online. As of October, the program covered 15.1 million people in California.\u003c/p>\n\u003cp>“During COVID, the message was ignore, ignore, don’t worry. For close to four years, we told people not to worry, and then all of a sudden, they had to worry,” said Celia Valdez, director of outreach and education at the Los Angeles nonprofit Maternal and Child Health Access. Her organization helped Miguel reinstate her kids’ Medi-Cal. But experiences like Miguel’s are common, she said.\u003c/p>\n\u003cp>“Many [enrollees] are saying, ‘I couldn’t fill my prescription, I went to the doctor and they told me I have no coverage,’” Valdez said.\u003c/p>\n\u003cp>People who are being disenrolled for “procedural reasons” tend to fall into several buckets, including those who are new to the program and may not understand that they now have to respond to yearly reviews, said Yingjia Huang, assistant deputy director at the California Department of Health Care Services, the state agency that oversees the Medi-Cal program.\u003c/p>\n\u003cp>Other people may now have health insurance through an employer and are not filling out their paperwork because they no longer need Medi-Cal nor would they qualify, Huang said. And some who moved during the pandemic may not have received the renewal alert this year because they neglected to report their new address to their county Medi-Cal office.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>And in some cases, advocates add, county offices may not be processing paperwork on time that was submitted close to the deadline.\u003c/p>\n\u003cp>The Children’s Partnership, a nonprofit children’s advocacy organization, last week \u003ca href=\"https://childrenspartnership.org/wp-content/uploads/2023/03/101691-000_Packard_FinishLine_CA_Deck.pptx.pdf\">published a report \u003c/a>about parents’ and guardians’ experiences with renewing their families’ Medi-Cal. The report noted several obstacles that parents said contributed to their children losing coverage, including unreturned phone calls, long call wait times, confusing instructions, limited access to translators, feelings of discrimination, and lack of awareness.\u003c/p>\n\u003cp>According to the report, gaps in coverage led to delays in care, missed medications and out-of-pocket costs for families.\u003c/p>\n\u003cp>Huang, with the Department of Health Care Services, said the state is working to increase the number of people whose coverage can be renewed automatically using state electronic databases that can verify an enrollee’s income and eligibility.\u003c/p>\n\u003cp>“Our [automatic renewal] rates historically have been lower than many of the other states — they probably have more electronic sources and databases that they can use,” Huang said. She noted the state has been receiving automation tips and technical assistance from the federal government to increase the number of cases that can be renewed automatically.\u003c/p>\n\u003cp>“That just eases the administrative burden on our members as well as our counties,” Huang said.\u003c/p>\n\u003cp>Valdez and other health advocates said there are significant gaps in support for people who have questions or need assistance. She said that calling county Medi-Cal offices can result in hours-long waits, and organizations like hers have limited capacity to fill in the gaps. People who are not connected to an advocate or an enrollment counselor could get lost in the process.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Among the \u003ca href=\"https://calmatters.org/health/2023/09/what-to-do-if-you-lose-medi-cal-health-insurance/\">top questions and comments\u003c/a> from people seeking assistance is that the paperwork is too much or too confusing, said Kimberley Graham, director of patient access at AltaMed Health Services, a clinic system in Los Angeles and Orange counties that provides enrollment services.\u003c/p>\n\u003cp>“And they don’t know what to do. So often, the packets are opened, but they’re completely blank,” Graham said. “The next question is, ‘Do I have to do this every year?’”\u003c/p>\n\u003cp>The answer, she said, is “yes.”\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>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>A fatal strain of bird flu is tearing through Sonoma County poultry populations, leading to mass euthanization efforts as farmers work to stop the spread of the virus.\u003c/p>\n\u003cp>In less than a month, four Sonoma County farms have detected the highly pathogenic avian influenza strain that’s been found in bird populations across the state, country and world. [pullquote size=\"medium\" align=\"right\" citation=\"Jennifer Reichardt, chief operating officer, Liberty Ducks\"]‘There was never going to be a good time for this to hit, but during the holidays, it is especially hard.’[/pullquote]More than half a million ducks and hens have been affected at those four farms experiencing outbreaks, according to an \u003ca href=\"https://www.aphis.usda.gov/aphis/ourfocus/animalhealth/animal-disease-information/avian/avian-influenza/hpai-2022/2022-hpai-commercial-backyard-flocks\">online infection tracker by the U.S. Department of Agriculture.\u003c/a> Across California, the number is more than 1.3 million.\u003c/p>\n\u003cp>Dayna Ghirardelli, executive director of the Sonoma County Farm Bureau, said the outbreaks are a devastating hit to farms in the area.\u003c/p>\n\u003cp>“Everyone’s doing all they can and just praying daily and losing sleep, hoping that we’ve seen the worst of it and, you know, that it doesn’t continue to spread in our area or anywhere for that matter,” Ghirardelli said.\u003c/p>\n\u003cp>Because of the highly contagious nature of the virus, all birds in a commercial flock where avian flu is detected must be euthanized. According to the USDA, commercial flocks are operations with 1,000 or more birds (domestic poultry).\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Bill Mattos, president of the California Poultry Federation, says prices could go up soon as hundreds of thousands of birds are euthanized and others at nearby farms are quarantined.\u003c/p>\n\u003cp>“Because we’ve lost so many ducks and we have a small duck population in California, that could affect pricing more at restaurants than anywhere else,” Mattos said.\u003c/p>\n\u003cp>The first reported outbreak occurred in late November at a duck breeding facility where nearly 170,000 ducks were affected. [pullquote size=\"medium\" align=\"right\" citation=\"Bill Mattos, president, California Poultry Federation\"]‘Because we’ve lost so many ducks and we have a small duck population in California, that could affect pricing more at restaurants than anywhere else.’[/pullquote]Then last week, Liberty Ducks Chief Operating Officer Jennifer Reichardt announced on\u003ca href=\"https://www.gofundme.com/f/save-the-liberty-ducks-family-farm\"> a GoFundMe page\u003c/a> that one of their farm locations detected the virus among a population of nearly 5,000 ducks.\u003c/p>\n\u003cp>Liberty Ducks is a supplier to several fine dining restaurants in Sonoma and other parts of the Bay Area.\u003c/p>\n\u003cp>“There was never going to be a good time for this to hit, but during the holidays, it is especially hard,” Reichardt said in an email. “These should have been our biggest three weeks of the year, and it’s been severely crippled with the outbreak.”\u003c/p>\n\u003cp>Mattos also warned about the possibility of rising egg prices, as has occurred in previous years when avian flu numbers were high.\u003c/p>\n\u003cp>“The price of eggs could change if we lose more [egg] layers in California. … We just saw 3 million layer chickens in Ohio have bird flu and have to be depopulated,” Mattos said. “And a lot of the Ohio birds come into California because they meet our cage-free standards. So the price will depend on if this affects more than California.” [aside label='More Stories on Farmworkers' tag='farmworkers']Mattos made those remarks before the discovery of the latest Sonoma County outbreak at an unnamed egg-laying operation where 270,000 birds were affected, the largest single outbreak in California in the past two months.\u003c/p>\n\u003cp>This Eurasian H5N1 strain of the avian flu has been in California since 2022 and was first detected among waterfowl populations, which are often responsible for spreading the virus to new areas. Now, cases are on the rise again as wild birds embark on their annual migration south, according to the California Department of Fish and Wildlife.\u003c/p>\n\u003cp>Peter Tira, a CDFW public information officer, said infection numbers among wild bird populations don’t seem to be as high as last fall. But he added that the migration is beginning later than usual this year, meaning more birds, possibly more infected birds, are on the way.\u003c/p>\n\u003cp>Tira said once the winter passes and birds begin to migrate north again, the disease should begin to dissipate again.\u003c/p>\n\u003cp>Though even if cases subside, this avian flu strain could be sticking around for a while. [pullquote size=\"medium\" align=\"right\" citation=\"Maurice Pitesky, professor, UC Davis School of Veterinary Medicine-Cooperative Extension\"]‘… We’re probably going to be in some kind of persistent cycle with this specific strain of influenza for a while.’[/pullquote]Maurice Pitesky, a professor at the UC Davis School of Veterinary Medicine-Cooperative Extension, said the outbreak is akin to a global pandemic among poultry.\u003c/p>\n\u003cp>According to the \u003ca href=\"https://www.aphis.usda.gov/aphis/ourfocus/animalhealth/animal-disease-information/avian/avian-influenza/hpai-2022/2022-hpai-commercial-backyard-flocks\">USDA\u003c/a>, over 4.6 million birds have been killed so far this year compared to the almost 58 million birds killed last year when the outbreak began. The disease has been found in dozens of countries across five continents, according to the World Health Organization.\u003c/p>\n\u003cp>“I think most people at this point view the virus as somewhat endemic in the waterfowl population,” Pitesky said. “As long as the virus infects the ducklings and goslings that these adults are hatching, we’re probably going to be in some kind of persistent cycle with this specific strain of influenza for a while.”\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A fatal strain of bird flu is tearing through Sonoma County poultry populations, leading to mass euthanization efforts as farmers work to stop the spread of the virus.\u003c/p>\n\u003cp>In less than a month, four Sonoma County farms have detected the highly pathogenic avian influenza strain that’s been found in bird populations across the state, country and world. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>More than half a million ducks and hens have been affected at those four farms experiencing outbreaks, according to an \u003ca href=\"https://www.aphis.usda.gov/aphis/ourfocus/animalhealth/animal-disease-information/avian/avian-influenza/hpai-2022/2022-hpai-commercial-backyard-flocks\">online infection tracker by the U.S. Department of Agriculture.\u003c/a> Across California, the number is more than 1.3 million.\u003c/p>\n\u003cp>Dayna Ghirardelli, executive director of the Sonoma County Farm Bureau, said the outbreaks are a devastating hit to farms in the area.\u003c/p>\n\u003cp>“Everyone’s doing all they can and just praying daily and losing sleep, hoping that we’ve seen the worst of it and, you know, that it doesn’t continue to spread in our area or anywhere for that matter,” Ghirardelli said.\u003c/p>\n\u003cp>Because of the highly contagious nature of the virus, all birds in a commercial flock where avian flu is detected must be euthanized. According to the USDA, commercial flocks are operations with 1,000 or more birds (domestic poultry).\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Bill Mattos, president of the California Poultry Federation, says prices could go up soon as hundreds of thousands of birds are euthanized and others at nearby farms are quarantined.\u003c/p>\n\u003cp>“Because we’ve lost so many ducks and we have a small duck population in California, that could affect pricing more at restaurants than anywhere else,” Mattos said.\u003c/p>\n\u003cp>The first reported outbreak occurred in late November at a duck breeding facility where nearly 170,000 ducks were affected. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Then last week, Liberty Ducks Chief Operating Officer Jennifer Reichardt announced on\u003ca href=\"https://www.gofundme.com/f/save-the-liberty-ducks-family-farm\"> a GoFundMe page\u003c/a> that one of their farm locations detected the virus among a population of nearly 5,000 ducks.\u003c/p>\n\u003cp>Liberty Ducks is a supplier to several fine dining restaurants in Sonoma and other parts of the Bay Area.\u003c/p>\n\u003cp>“There was never going to be a good time for this to hit, but during the holidays, it is especially hard,” Reichardt said in an email. “These should have been our biggest three weeks of the year, and it’s been severely crippled with the outbreak.”\u003c/p>\n\u003cp>Mattos also warned about the possibility of rising egg prices, as has occurred in previous years when avian flu numbers were high.\u003c/p>\n\u003cp>“The price of eggs could change if we lose more [egg] layers in California. … We just saw 3 million layer chickens in Ohio have bird flu and have to be depopulated,” Mattos said. “And a lot of the Ohio birds come into California because they meet our cage-free standards. So the price will depend on if this affects more than California.” \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Mattos made those remarks before the discovery of the latest Sonoma County outbreak at an unnamed egg-laying operation where 270,000 birds were affected, the largest single outbreak in California in the past two months.\u003c/p>\n\u003cp>This Eurasian H5N1 strain of the avian flu has been in California since 2022 and was first detected among waterfowl populations, which are often responsible for spreading the virus to new areas. Now, cases are on the rise again as wild birds embark on their annual migration south, according to the California Department of Fish and Wildlife.\u003c/p>\n\u003cp>Peter Tira, a CDFW public information officer, said infection numbers among wild bird populations don’t seem to be as high as last fall. But he added that the migration is beginning later than usual this year, meaning more birds, possibly more infected birds, are on the way.\u003c/p>\n\u003cp>Tira said once the winter passes and birds begin to migrate north again, the disease should begin to dissipate again.\u003c/p>\n\u003cp>Though even if cases subside, this avian flu strain could be sticking around for a while. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Maurice Pitesky, a professor at the UC Davis School of Veterinary Medicine-Cooperative Extension, said the outbreak is akin to a global pandemic among poultry.\u003c/p>\n\u003cp>According to the \u003ca href=\"https://www.aphis.usda.gov/aphis/ourfocus/animalhealth/animal-disease-information/avian/avian-influenza/hpai-2022/2022-hpai-commercial-backyard-flocks\">USDA\u003c/a>, over 4.6 million birds have been killed so far this year compared to the almost 58 million birds killed last year when the outbreak began. The disease has been found in dozens of countries across five continents, according to the World Health Organization.\u003c/p>\n\u003cp>“I think most people at this point view the virus as somewhat endemic in the waterfowl population,” Pitesky said. “As long as the virus infects the ducklings and goslings that these adults are hatching, we’re probably going to be in some kind of persistent cycle with this specific strain of influenza for a while.”\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>As the number of overdose deaths in San Francisco \u003ca href=\"https://www.kqed.org/news/11967618/san-francisco-projected-to-reach-highest-overdose-death-toll-in-2023\">surpasses previous years\u003c/a>, city officials are expanding wastewater testing for fentanyl and other substances to better inform public health responses.\u003c/p>\n\u003cp>The Department of Public Health on Thursday announced its wastewater analysis plan, the same day that the Office of the Medical Examiner released its latest dataset showing that there have been more overdose deaths in San Francisco this year than in previous years. [pullquote size=\"medium\" align=\"right\" citation=\"Dr. Hillary Kunins, director of behavioral health services, San Francisco Department of Public Health\"]‘Data from wastewater testing will help provide information about the presence of risky substances in San Francisco and prompt more strategic interventions aimed at saving lives.’[/pullquote]There were 752 overdose deaths in San Francisco from January to November 2023, preliminary data from the medical examiner shows. In 2020, the worst year on record previously, there were 726 overdose deaths.\u003c/p>\n\u003cp>“We need all the tools available to identify the presence of substances that may be used to halt and reverse this deadly epidemic,” said Dr. Hillary Kunins, director of behavioral health services at SFDPH. “Data from wastewater testing will help provide information about the presence of risky substances in San Francisco and prompt more strategic interventions aimed at saving lives.”\u003c/p>\n\u003cp>Fentanyl, an opioid about 50 times stronger than heroin, is the most common substance associated with the recent spike in overdose deaths in San Francisco and across other major West Coast cities. It is commonly used in surgical settings under medical supervision.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The city will also be monitoring wastewater for levels of methamphetamine, amphetamine, cocaine and xylazine, which have been used in combination with fentanyl in some overdoses and also naloxone, a fast-acting opioid overdose reversal medicine.\u003c/p>\n\u003cp>San Francisco is among 70 different U.S. regions working with the National Institute on Drug Abuse to measure the presence of the substances through wastewater testing. [pullquote size=\"medium\" align=\"right\" citation=\"Jeffrey Hom, director of population behavioral health, San Francisco\"]‘Elevated levels of drugs and drug metabolites could be used to predict higher risk periods of overdose and could prompt interventions by the city.’[/pullquote]The idea is to have better foresight into what substances are present in the illicit drug supply and to direct public health resources in response.\u003c/p>\n\u003cp>“There is no other way for us to understand, at a population level, what all the different drugs being consumed are,” said Jeffrey Hom, director of population behavioral health for San Francisco, at a press conference on Thursday. “Elevated levels of drugs and drug metabolites could be used to predict higher risk periods of overdose and could prompt interventions by the city.”\u003c/p>\n\u003cp>Research from other jurisdictions already monitoring wastewater for opioids and other substances has shown some correlation between rising levels of risky substances and increased overdose deaths as well as calls to 911 for overdose response. [aside postID=news_11965813 hero='https://ww2.kqed.org/app/uploads/sites/10/2023/10/GettyImages-53134889-1020x680.jpg']“This can help us explain other trends we are seeing and that can help guide our response,” Hom said.\u003c/p>\n\u003cp>Today’s grim milestone was projected months ago by experts tracking the evolution of the opioid crisis across the country. Before fentanyl arrived in California’s illicit drug supply, roughly around 2019, several East Coast cities saw overdoses skyrocket just a few years earlier, also largely due to fentanyl.\u003c/p>\n\u003cp>In San Francisco, overdose deaths are concentrated in the Tenderloin and South of Market neighborhoods, medical examiner data shows. The majority of overdose deaths in 2023 were among white San Franciscans. However, rates among Black and Latinx residents are increasing much faster than for white residents.\u003c/p>\n\u003cp>At Thursday’s press conference, health officials called on the federal government to fund more public health responses to the crisis.\u003c/p>\n\u003cp>“The fentanyl crisis is a national one, and it’s affecting cities like San Francisco,” Kunins said. “We need the support and resources of the federal government, and this program is an example.”\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>As the number of overdose deaths in San Francisco \u003ca href=\"https://www.kqed.org/news/11967618/san-francisco-projected-to-reach-highest-overdose-death-toll-in-2023\">surpasses previous years\u003c/a>, city officials are expanding wastewater testing for fentanyl and other substances to better inform public health responses.\u003c/p>\n\u003cp>The Department of Public Health on Thursday announced its wastewater analysis plan, the same day that the Office of the Medical Examiner released its latest dataset showing that there have been more overdose deaths in San Francisco this year than in previous years. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“This can help us explain other trends we are seeing and that can help guide our response,” Hom said.\u003c/p>\n\u003cp>Today’s grim milestone was projected months ago by experts tracking the evolution of the opioid crisis across the country. Before fentanyl arrived in California’s illicit drug supply, roughly around 2019, several East Coast cities saw overdoses skyrocket just a few years earlier, also largely due to fentanyl.\u003c/p>\n\u003cp>In San Francisco, overdose deaths are concentrated in the Tenderloin and South of Market neighborhoods, medical examiner data shows. The majority of overdose deaths in 2023 were among white San Franciscans. However, rates among Black and Latinx residents are increasing much faster than for white residents.\u003c/p>\n\u003cp>At Thursday’s press conference, health officials called on the federal government to fund more public health responses to the crisis.\u003c/p>\n\u003cp>“The fentanyl crisis is a national one, and it’s affecting cities like San Francisco,” Kunins said. “We need the support and resources of the federal government, and this program is an example.”\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>A state occupational safety board on Thursday approved new temporary emergency regulations to stall a surge of silicosis, an irreversible lung disease disabling and killing countertop fabrication workers who handle engineered stone.\u003c/p>\n\u003cp>The factory-made material, commonly used to make kitchen countertops, is \u003ca href=\"https://www.kqed.org/news/11969381/california-regulators-to-vote-on-emergency-rules-for-stonecutters-safety\">uniquely hazardous to workers\u003c/a> because of the toxic silica dust it releases when cut or drilled.\u003c/p>\n\u003cp>The state \u003ca href=\"https://www.dir.ca.gov/oshsb/oshsb.html\">Occupational Safety & Health Standards Board\u003c/a>, a seven-member body appointed by Gov. Gavin Newsom, voted to simplify and strengthen current protections in the industry.\u003c/p>\n\u003cp>“Clearly, this is a seriously hazardous material similar to what asbestos is,” said Laura Stock, a board member who supported the regulation changes. “Can we, in fact, create a circumstance where we use this hazardous material, but workers are protected? That’s what we can learn.”\u003c/p>\n\u003cp>The vote came a day after Australia announced it \u003ca href=\"https://www.theguardian.com/australia-news/2023/dec/13/engineered-stone-bench-top-ban-confirmed-begin-2024-when\">would ban\u003c/a> the use and imports of all engineered stone products starting next year.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Inhaling tiny, airborne silica particles has led to silicosis among builders, miners and stonemasons for centuries. But cutting engineered stone is linked to an accelerated and more aggressive form of the disease because it may contain more than 93% silica, much more than natural stones.\u003c/p>\n\u003cp>No silicosis cases were associated with artificial stone recorded before 2010 in California, according to the state’s Department of Public Health. The agency has now identified 100 stonecutters who contracted the disease in the last five years. At least 10 have died.\u003c/p>\n\u003cp>[aside label=\"more on silicosis\" tag=\"silicosis\"]Nearly all of the workers are young to middle-aged Latino immigrants. Some must rely on oxygen machines to breathe while they await lung transplants, including a \u003ca href=\"https://www.kqed.org/news/11956246/california-fast-tracks-rules-to-protect-stonecutters-from-horrible-deaths\">27-year-old man profiled by KQED\u003c/a>.\u003c/p>\n\u003cp>“No amount of business is worth the lives lost and the suffering this is generating,” Dr. Jane Fazio, a pulmonologist at Olive View-UCLA Medical Center who has diagnosed and treated dozens of silicosis patients, said during public comment. “Almost weekly, I have to sit down with able-bodied men in my clinic, and give them a death sentence.”\u003c/p>\n\u003cp>“I take away their livelihoods, and I watch as their wives and children try to understand that they will lose their loved one,” she said.\u003c/p>\n\u003cp>Hundreds more cases are expected if harmful exposure continues, according to officials with the California Division of Occupational Safety and Health, known as Cal/OSHA.\u003c/p>\n\u003cp>The agency estimates that most of the roughly 800 stone fabrication shops in the state don’t comply with current safety rules, which require employers to monitor permissible silica levels before taking protective steps.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.dir.ca.gov/OSHSB/Respirable-Crystalline-Silica-Emergency.html\">new emergency regulations\u003c/a> effectively prohibit the dry cutting of engineered stone with 0.1% or more silica or natural stone with 10% or more. High-risk tasks such as drilling and polishing require wet-cutting saws or other tools that spread water on the material to suppress dust.\u003c/p>\n\u003cp>Some industry representatives urged the board to postpone its vote and said the new requirements would be too costly and drive businesses out of state. But several medical professionals countered that California could not afford to wait.\u003c/p>\n\u003cp>Cal/OSHA officials said they plan to conduct proactive inspections of stone fabrication shops and will also gain new enforcement tools. Inspectors who observe the dry cutting of engineered stone must issue an \u003ca href=\"https://www.dir.ca.gov/DOSHPol/P&PC-8.pdf\">order prohibiting the use\u003c/a> of employees’ labor until the hazards are fixed.\u003c/p>\n\u003cp>“Adoption of the silica emergency temporary standard will absolutely save lives,” Cal/OSHA Chief Jeff Killip told board members.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The standard goes into effect on Dec. 29 and lasts for one year. Cal/OSHA officials said they will work to craft permanent silica regulations.\u003c/p>\n\n",
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"excerpt": "The new temporary emergency regulations are intended to stem the recent surge of silicosis, an irreversible lung disease that has disabled and killed countertop fabrication workers who handle engineered stone.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A state occupational safety board on Thursday approved new temporary emergency regulations to stall a surge of silicosis, an irreversible lung disease disabling and killing countertop fabrication workers who handle engineered stone.\u003c/p>\n\u003cp>The factory-made material, commonly used to make kitchen countertops, is \u003ca href=\"https://www.kqed.org/news/11969381/california-regulators-to-vote-on-emergency-rules-for-stonecutters-safety\">uniquely hazardous to workers\u003c/a> because of the toxic silica dust it releases when cut or drilled.\u003c/p>\n\u003cp>The state \u003ca href=\"https://www.dir.ca.gov/oshsb/oshsb.html\">Occupational Safety & Health Standards Board\u003c/a>, a seven-member body appointed by Gov. Gavin Newsom, voted to simplify and strengthen current protections in the industry.\u003c/p>\n\u003cp>“Clearly, this is a seriously hazardous material similar to what asbestos is,” said Laura Stock, a board member who supported the regulation changes. “Can we, in fact, create a circumstance where we use this hazardous material, but workers are protected? That’s what we can learn.”\u003c/p>\n\u003cp>The vote came a day after Australia announced it \u003ca href=\"https://www.theguardian.com/australia-news/2023/dec/13/engineered-stone-bench-top-ban-confirmed-begin-2024-when\">would ban\u003c/a> the use and imports of all engineered stone products starting next year.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Inhaling tiny, airborne silica particles has led to silicosis among builders, miners and stonemasons for centuries. But cutting engineered stone is linked to an accelerated and more aggressive form of the disease because it may contain more than 93% silica, much more than natural stones.\u003c/p>\n\u003cp>No silicosis cases were associated with artificial stone recorded before 2010 in California, according to the state’s Department of Public Health. The agency has now identified 100 stonecutters who contracted the disease in the last five years. At least 10 have died.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Nearly all of the workers are young to middle-aged Latino immigrants. Some must rely on oxygen machines to breathe while they await lung transplants, including a \u003ca href=\"https://www.kqed.org/news/11956246/california-fast-tracks-rules-to-protect-stonecutters-from-horrible-deaths\">27-year-old man profiled by KQED\u003c/a>.\u003c/p>\n\u003cp>“No amount of business is worth the lives lost and the suffering this is generating,” Dr. Jane Fazio, a pulmonologist at Olive View-UCLA Medical Center who has diagnosed and treated dozens of silicosis patients, said during public comment. “Almost weekly, I have to sit down with able-bodied men in my clinic, and give them a death sentence.”\u003c/p>\n\u003cp>“I take away their livelihoods, and I watch as their wives and children try to understand that they will lose their loved one,” she said.\u003c/p>\n\u003cp>Hundreds more cases are expected if harmful exposure continues, according to officials with the California Division of Occupational Safety and Health, known as Cal/OSHA.\u003c/p>\n\u003cp>The agency estimates that most of the roughly 800 stone fabrication shops in the state don’t comply with current safety rules, which require employers to monitor permissible silica levels before taking protective steps.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.dir.ca.gov/OSHSB/Respirable-Crystalline-Silica-Emergency.html\">new emergency regulations\u003c/a> effectively prohibit the dry cutting of engineered stone with 0.1% or more silica or natural stone with 10% or more. High-risk tasks such as drilling and polishing require wet-cutting saws or other tools that spread water on the material to suppress dust.\u003c/p>\n\u003cp>Some industry representatives urged the board to postpone its vote and said the new requirements would be too costly and drive businesses out of state. But several medical professionals countered that California could not afford to wait.\u003c/p>\n\u003cp>Cal/OSHA officials said they plan to conduct proactive inspections of stone fabrication shops and will also gain new enforcement tools. Inspectors who observe the dry cutting of engineered stone must issue an \u003ca href=\"https://www.dir.ca.gov/DOSHPol/P&PC-8.pdf\">order prohibiting the use\u003c/a> of employees’ labor until the hazards are fixed.\u003c/p>\n\u003cp>“Adoption of the silica emergency temporary standard will absolutely save lives,” Cal/OSHA Chief Jeff Killip told board members.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The standard goes into effect on Dec. 29 and lasts for one year. Cal/OSHA officials said they will work to craft permanent silica regulations.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>[dropcap]K[/dropcap]atrina Turner’s eyes lit up when her father, Pat Turner, and his fiancée, Elaine Sheffer, walked through the door of the beige stucco house in the Sacramento County community of Fair Oaks, where she lives. She made soft moaning sounds as her parents embraced her. Katrina is 43 years old, developmentally disabled and nonverbal, but she has her own ways of communicating.\u003c/p>\n\u003cp>Katrina’s family has been worried about her. Just a few months after she moved to this group home for people with disabilities who need 24-hour care, known as an Enhanced Behavioral Supports Home (EBSH), mysterious injuries started appearing on her body. There were holes in her walls, and Katrina had become less responsive.\u003c/p>\n\u003cp>Turner and Sheffer were used to facilities letting Katrina down. Children with disabilities are \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2022/04/12/1091679303/a-report-on-violence-against-kids-with-disabilities-is-sobering-if-not-surprisin\">far more likely to experience abuse\u003c/a>, and they said Katrina is no exception. Scars from past placements mark her skin, they said, and although she’s barely middle-aged, Katrina walks with the stooped shuffle of someone much older. But her family had hoped that here, at the Illinois Home — an EBSH named for the street where it’s located — Katrina had finally found a place where she’d get the 24\u003cspan style=\"font-weight: 400;\">– \u003c/span>7 care she needed.\u003c/p>\n\u003cp>Instead, Turner and Sheffer’s concerns have turned into a full-fledged investigation of the management and practices at the Illinois Home.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>EBSHs are supposed to be more tightly regulated than any other type of group home in the state. However, a KQED investigation into the Illinois Home and the company that operated it until June 2023 has revealed that staff were not meeting even minimum standards of care. Allegations of mistreatment are difficult to prove because the main victim, Katrina, is nonverbal. However, investigation records, state reports, and testimony from whistleblowers suggest that she suffered abuse and neglect for months at the hands of staffers, and state regulators failed to act promptly.\u003c/p>\n\u003ch2>As small group homes proliferate, so do oversight concerns\u003c/h2>\n\u003cp>The Department of Developmental Services (DDS) is the state agency charged with supporting the roughly 400,000 people in California who live with developmental disabilities like autism, cerebral palsy, or Down syndrome. DDS \u003ca href=\"https://www.dds.ca.gov/wp-content/uploads/2023/05/2023-May-Revision-Master-for-Internet-Linked.pdf\">oversees a budget of more than $14 billion\u003c/a>, nearly as much as the state’s correctional system. The agency funds thousands of organizations that provide services — like day programs, behavioral therapy, and group homes like the Illinois Home, where Katrina lives. Only four residents live in each home, a system designed to meet the high needs of the residents. These homes, often just converted houses in residential neighborhoods, replaced the large state-run institutions that state lawmakers voted to move away from in 2012. Advocates had high hopes that in these smaller settings, disabled Californians like Katrina would finally get the care promised to them by law.\u003c/p>\n\u003cp>“We’re concerned that in practice, some of these homes are at risk of turning into the very types of institutional placements they’ve been designed to prevent, just on a smaller scale,” said Will Leiner, managing attorney at \u003ca href=\"https://www.disabilityrightsca.org/\">Disability Rights California\u003c/a>, a nonprofit that advocates for the rights of disabled Californians.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Elaine Sheffer\"]‘We were hopeful because an EBSH home is overseen by the state. We were hopeful that this would mean there wouldn’t be such an opportunity for neglect or abuse… We thought everything was gonna be OK. But it’s not. It’s horrible.’[/pullquote]Leiner is also concerned by what he said is a staggering growth in the number of EBSHs.The first one opened in 2017, and now, just six years later, nearly 70 licensed EBSHs operate in California. And while they are smaller than the institutions that came before, they aren’t always well regulated. In 2022, the \u003ca href=\"https://www.auditor.ca.gov/pdfs/reports/2021-107.pdf\">California State Auditor found that DDS had failed to ensure residential facilities like EBSHs received the inspections and oversight\u003c/a> that state law requires. Furthermore, the State Auditor noted the same issue in a 2016 audit and “recommended then that DDS require the regional centers to address the issue. However, DDS has yet to take adequate action to ensure that the regional centers perform these reviews.”\u003c/p>\n\u003ch2>Katrina’s life in group home care\u003c/h2>\n\u003cp>Since she was a child, Katrina Turner has lived in group care facilities. She was often destructive, sometimes hurting herself or others, which made finding a stable living situation difficult. She bounced from one home to another, frequently experiencing mistreatment, according to her family. At one point, she spent over six months in a hospital room because the state wasn’t able to find a suitable placement for her.\u003c/p>\n\u003cp>Her family was determined to get her somewhere safe. So when they heard about an opening at an EBSH near their home in Sacramento, they were excited.\u003c/p>\n\u003cp>“We were hopeful because an EBSH home is overseen by the state,” Sheffer said. “We were hopeful that this would mean there wouldn’t be such an opportunity for neglect or abuse. She moved to the home, and we thought everything was gonna be OK. But it’s not. It’s horrible.”\u003c/p>\n\u003cfigure id=\"attachment_11965507\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11965507\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-030-BL-KQED.jpg\" alt=\"A person with long hair looks through stacks of paperwork.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-030-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-030-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-030-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-030-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-030-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-030-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Elaine Sheffer goes through paperwork related to her stepdaughter Katrina Turner at home in Sacramento. Investigation records, state reports and testimony from whistleblowers suggest that Turner suffered abuse and neglect for months at the hands of staffers at the Illinois Home. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Katrina moved into the Illinois Home in March 2021. The facility was under investigation by the state at the time, something Turner said they knew nothing about.\u003c/p>\n\u003cp>Just a few months into her stay, a new company, Sevita Health, took over its operation. Sevita is one of the country’s largest operators of group homes and care facilities. Turner and Sheffer didn’t question the acquisition at the time, but about a year into Katrina’s residency there, her family began to suspect something wasn’t right.\u003c/p>\n\u003ch2>Abuse and mistreatment\u003c/h2>\n\u003cp>In February 2022, Elaine Sheffer received a surprising text and then an email from a Sevita staff member, Kylie LeBlanc.\u003c/p>\n\u003cp>A copy of the email obtained by KQED described a series of abusive incidents involving Katrina. Attached photos showed Katrina looking mournfully at the camera, with a deep, raised purple blotch spreading below her eye.\u003c/p>\n\u003cp>“When I walked in, Katrina had a black eye, and I was like, ‘Oh my God,’” LeBlanc said. “And my coworker said, ‘Kylie, it’s not even the worst part.’”\u003c/p>\n\u003cp>Along the walls of Katrina’s room, exactly at the height of her head, was a row of holes. LeBlanc believed they were caused by Katrina banging her head against the wall.\u003c/p>\n\u003cp>According to LeBlanc, the coworker told her, “‘I know people are locking her in the room. They’re closing the door and holding it shut while sitting in a chair.’”\u003c/p>\n\u003cp>Because of her history of self-injury, Katrina is supposed to be monitored at all times. Being locked in her room would have been confusing and frightening for her, LeBlanc said, and she may have resorted to self-injury.\u003c/p>\n\u003cp>\u003ca href=\"https://s3.documentcloud.org/documents/24214201/katrina-turner-combined-shift-notes_redacted.pdf\">Shift notes\u003c/a> provided by \u003cspan style=\"font-weight: 400;\">Katrina’s family and \u003c/span>another former Sevita employee showed that Katrina had repeatedly suffered injuries during night shifts in the weeks leading up to the black eye, including bruises.\u003c/p>\n\u003cp>Turner and Sheffer said they weren’t notified about the black eye by Sevita Health, as is required. They believed that, had LeBlanc not reached out, the family would have been kept in the dark. They also believed Katrina had suffered a concussion from the incident.\u003c/p>\n\u003cp>“She was also at that point having issues with throwing up and losing control of her bowels,” LeBlanc said. “Which is another sign of some kind of head injury or a concussion.”\u003c/p>\n\u003ch2>Inaction from regulators and Sevita Health\u003c/h2>\n\u003cp>LeBlanc said that she submitted complaints about the treatment of residents to Sevita Health’s HR department but that the company did not take action. So, she took her concerns directly to \u003ca href=\"https://www.altaregional.org/\">Alta Regional Center\u003c/a>, a state-funded nonprofit conducting safety checks, and \u003ca href=\"https://www.cdss.ca.gov/inforesources/community-care-licensing\">Community Care Licensing\u003c/a>, a state regulator investigating complaints. She sent documents describing the concussion incident, as well as evidence that staff had been mismanaging residents’ medications. \u003ca href=\"https://www.documentcloud.org/documents/24214193-pra-rem-ca-consolidated_redacted_v3#document/p25\">Documents KQED obtained from Community Care Licensing\u003c/a> corroborate LeBlanc’s claims.\u003c/p>\n\u003cp>Additional shift notes show Katrina was repeatedly \u003ca href=\"https://s3.documentcloud.org/documents/24214201/katrina-turner-combined-shift-notes_redacted.pdf\">found drinking from a toilet\u003c/a> and a sprinkler head outside. These reports suggested to Katrina’s family that she was not receiving enough water, indicating serious neglect.\u003c/p>\n\u003cp>After an initial meeting with representatives from the regulating agencies, LeBlanc was hopeful that change was coming to the Illinois Home.\u003c/p>\n\u003cp>“They said they were gonna do things to fix it,” she said. “And absolutely nothing happened.”\u003c/p>\n\u003cp>Alta Regional Center \u003ca href=\"https://s3.documentcloud.org/documents/24214342/acrcs-kqed-response-7-28-23.pdf\">said it did take action\u003c/a>. In response to KQED’s questions, Alta wrote that between March 2022 and June 2023, the Illinois Home was “required to develop a corrective action plan and the Regional Center stopped referring new individuals for placement there.” This practice is known as “sanctioning” and is a way to blacklist a facility. But, though the Illinois Home was prevented from taking in new clients, Katrina and the other residents remained.\u003c/p>\n\u003ch2>‘Absolutely no oversight’\u003c/h2>\n\u003cp>Around the same time LeBlanc was blowing the whistle on practices at the Illinois Home, Sevita hired a new administrator named Ileya Silva to oversee it. She’d worked in group homes for 20 years and had developed a reputation for doing things by the book.\u003c/p>\n\u003cp>Silva was shocked by what she found at the Illinois Home. It appeared to her that during the eight months between Sevita’s acquisition of the home in July 2021 and her hiring, there had been “absolutely no oversight.” A \u003ca href=\"https://s3.documentcloud.org/documents/24214200/acrc-faclity-action-report-tech-log_redacted.pdf\">facility report from Alta Regional Center\u003c/a> reinforces Silva’s account.\u003c/p>\n\u003cp>That means Sevita was not doing the \u003ca href=\"https://www.cdss.ca.gov/portals/9/regs/ebshman2.pdf?ver=2017-03-22-093058-240\">typical things required to operate an EBSH\u003c/a>, including internal audits, check-ins and inspections. Silva said employees were severely undertrained and lacked even the most basic knowledge of the regulations.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Ileya Silva\"]‘I don’t want this to be the situation where I turn on the news one day and one of the clients has died. I just can’t have that on my conscience — that I didn’t say something, I didn’t do something.’[/pullquote]The Alta Regional facility report shows that staff members at all levels were behind on training and missing certifications. Some staff didn’t even have the required experience to work at an EBSH.\u003c/p>\n\u003cp>To compound the problems, the home was chronically under-staffed and employees worked long hours — sometimes 16 or even 24-hour shifts, according to Silva and LeBlanc.\u003c/p>\n\u003cp>And the Illinois Home wasn’t an isolated case, Silva said. Sevita operated two other group homes nearby and at least 20 other homes throughout California.\u003c/p>\n\u003cp>“It was very systemic,” Silva said. “They would send staff from other facilities, and they were at the same deficit. They didn’t have the understanding. They didn’t know the [regulations].”\u003c/p>\n\u003cfigure id=\"attachment_11965511\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11965511\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-050-BL-KQED.jpg\" alt=\"A person with long hair stands beside a tree outside and looks at the camera.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-050-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-050-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-050-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-050-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-050-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-050-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Ileya Silva, a former group home administrator at the home where Katrina Turner lived, stands outside her home in Sacramento. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>KQED provided Sevita Health with a detailed list of allegations and questions. The company declined to comment on specifics, citing the privacy of their residents, \u003ca href=\"https://s3.documentcloud.org/documents/24214218/sevita-statement_california-mentor_kalw.pdf\">but did provide a general statement\u003c/a>: “Sevita promotes ethical practices at all levels of the organization, and we remain committed to our core values of integrity, respect, inclusion, and growth.”\u003c/p>\n\u003ch2>Medication mismanagement\u003c/h2>\n\u003cp>One of the clearest examples of just how bad things were at the Illinois Home was how staff handled medications. Every dose of every medication in an EBSH is supposed to be documented, both for the safety of residents and to prevent misuse.\u003c/p>\n\u003cp>“In this field, staff do steal medications,” Silva said. “It’s why there are so many checks and balances.”\u003c/p>\n\u003cp>Silva said the standard protocol was to destroy unused medications at the end of each month. At the Illinois Home, however, “they had a year’s worth of backed-up meds that had not been destroyed.\u003c/p>\n\u003cp>“I have photos of a giant, gallon freezer bag that had maybe 150 pills in it,” Silva said. “Didn’t state what the medications were, didn’t state who the medications belonged to.”\u003c/p>\n\u003cp>Silva also noticed that all of the residents were on multiple strong medications at extremely high dosages. Katrina, for example, was on anti-psychotics, sedatives, and other powerful medications.\u003c/p>\n\u003cp>“It’s not very often that you’re gonna see all of the meds, and so many of them, prescribed at the maxed-out level,” she said.\u003c/p>\n\u003cfigure id=\"attachment_11965510\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11965510\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-043-BL-KQED.jpg\" alt=\"A sheet of paper with sections crossed out.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-043-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-043-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-043-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-043-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-043-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-043-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Ileya Silva goes through paperwork related to Katrina Turner’s treatment at the Illinois Home. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>California welfare code \u003ca href=\"https://codes.findlaw.com/ca/welfare-and-institutions-code/wic-sect-4502.html\">says that people with developmental disabilities have a right to be free from harm\u003c/a>, including “excessive medication.” When medications are used to sedate a resident or make them more compliant, that’s \u003ca href=\"https://www.law.cornell.edu/regulations/california/22-CCR-72018#:~:text=Chemical%20restraint%20means%20a%20drug,treat%20the%20patient%27s%20medical%20symptoms\">considered chemical restraint by the state\u003c/a> and is only permitted in very limited circumstances. Silva was concerned that all the residents in the home were being chemically restrained. It was a concern shared by Katrina’s family.\u003c/p>\n\u003cp>“She’s walking hunched over, and she walks like a little old lady,” Sheffer said. “And her mouth is open, and she’s drooling. And we’re like, this is not Katrina.”\u003c/p>\n\u003ch2>Van ride violence\u003c/h2>\n\u003cp>One of the most shocking instances of abuse came in June 2022. Illinois Home staff often transported residents to appointments and activities in a van. Katrina sometimes took her seatbelt off and attempted to stand up while the van was moving. Reports show that several staff members would slam on the brakes rather than gently helping her back to her seat, causing her to fly across the van.\u003c/p>\n\u003cp>“So that explains a lot of the bruises that she had on her lower back and the front of her legs,” Sheffer said.\u003c/p>\n\u003cp>\u003ca href=\"https://www.documentcloud.org/documents/24214193-pra-rem-ca-consolidated_redacted_v3#document/p19\">Reports from a Community Care Licensing investigation\u003c/a> indicate that three different staff members were “brake checking” residents over several months. One staffer \u003ca href=\"https://www.documentcloud.org/documents/24214193-pra-rem-ca-consolidated_redacted_v3#document/p65\">is quoted as saying\u003c/a> that the driver of the van “Will brake check two to three times. Then she was laughing like it’s a joke. Happens all the time.”\u003c/p>\n\u003cp>Silva suspended the three employees accused of brake-checking Katrina and the other residents. Shortly after that, one of the employees quit, and \u003ca href=\"https://www.documentcloud.org/documents/24214193-pra-rem-ca-consolidated_redacted_v3#document/p81\">the other two were terminated\u003c/a>.\u003c/p>\n\u003cp>“I don’t want this to be the situation where I turn on the news one day, and one of the clients has died,” Silva said. “And I just can’t have that on my conscience — that I didn’t say something, I didn’t do something.”\u003c/p>\n\u003cp>In response to the incidents, \u003ca href=\"https://s3.documentcloud.org/documents/24214344/dds-kqed-response-7-28-23.pdf\">regulators increased pressure on Sevita to improve conditions\u003c/a>, but the company would continue operating the home for another year. Community Care Licensing issued citations, but documents show the penalties were relatively low. As of August 2023, The Illinois Home had been fined just over $1,500. That’s in contrast to the home’s \u003ca href=\"https://s3.documentcloud.org/documents/24214344/dds-kqed-response-7-28-23.pdf\">yearly revenue of over $1.5 million\u003c/a>.\u003c/p>\n\u003cp>In response to KQED’s questions about the Illinois Home and the abuse Katrina Turner suffered, Community Care Licensing wrote, “The Department licenses facilities in accordance with state law.”\u003c/p>\n\u003cp>In a separate response, \u003ca href=\"https://s3.documentcloud.org/documents/24214344/dds-kqed-response-7-28-23.pdf\">DDS wrote\u003c/a>, “The actions described in these claims are inexcusable. They not only are inconsistent with the Department of Developmental Services’ (DDS’) expectations for care, but they also are entirely counter to what we stand for and what we expect in the care and support for the individuals who receive regional center services.”\u003c/p>\n\u003ch2>Private equity firms reap profits amid a track record of abuse\u003c/h2>\n\u003cp>Regulators may have responded slowly and with too little force, but Illeya Silva reserves the bulk of her anger for Sevita Health management, who she said could have taken it upon themselves to respond to allegations of abuse and mismanagement. Instead, she said management ignored regulations, failed to follow up on complaints, and fostered a culture of negligence.\u003c/p>\n\u003cp>Again, Sevita would not respond to specific allegations.\u003c/p>\n\u003cp>Sevita Health is part of a growing trend of private equity investment in the health care industry. The company is owned by two private equity firms: \u003ca href=\"https://www.centerbridge.com/\">Centerbridge Partners\u003c/a> and \u003ca href=\"https://vistria.com/\">The Vistria Group\u003c/a>. Private equity firms use money from investors to purchase private companies and then seek to increase their profitability, often by cutting costs. In health care fields, this can include reducing expenditures on staffing, training, and overhead.\u003c/p>\n\u003cp>In fact, the name Sevita Health only goes back to 2021, \u003ca href=\"https://www.prnewswire.com/news-releases/nations-leader-in-specialized-health-care-moves-forward-under-a-new-brand-301381984.html\">when the company rebranded itself\u003c/a>. The company’s previous name, The Mentor Network, had developed a strong negative reputation.\u003c/p>\n\u003cp>“It has had a host of allegations of abuse, neglect, mistreatment of people under Mentor Network’s care,” said Eileen O’Grady, a lead researcher at the \u003ca href=\"https://pestakeholder.org/\">Private Equity Stakeholder Project\u003c/a>, a nonprofit that researches private equity’s impact on communities and industries, including group homes. In 2022, she \u003ca href=\"https://pestakeholder.org/wp-content/uploads/2022/02/PESP_Youth_BH_Report_2022.pdf\">authored a report\u003c/a> that digs into the allegations that have swirled around the company.\u003c/p>\n\u003cp>[aside label='Related Coverage' tag='disability-community']One of The Mentor Network/Sevita’s major lines of business is running youth foster homes. In 2017, \u003ca href=\"https://www.documentcloud.org/documents/4111642-An-Examination-of-Foster-Care-in-the-United.html#document/p10/a382165\">a U.S. Senate investigation found that, over a decade, at least 86 children died at homes run by the company\u003c/a>, many more than the national average. And the committee found that the company only conducted internal investigations in 13 of those deaths.\u003c/p>\n\u003cp>That Senate investigation was partly prompted by a sweeping \u003ca href=\"https://www.buzzfeednews.com/article/aramroston/fostering-profits\">2015 investigation by Buzzfeed News\u003c/a>. In one article, Buzzfeed “identified deaths, sex abuse, and blunders in screening, training, and overseeing foster parents at the nation’s largest for-profit foster care company.”\u003c/p>\n\u003cp>In 2020, the U.S. Senate investigated Sevita subsidiaries in Oregon and Iowa that ran homes for disabled adults. \u003ca href=\"https://www.finance.senate.gov/imo/media/doc/120220%20Life%20at%20Cypress%20House%20-%20An%20Examination%20of%20Care%20Provided%20by%20MENTOR%20Oregon.pdf\">It found residents were subjected to abuse\u003c/a>, including sexual abuse, substandard care, lack of training, and extreme neglect. In one 2017 case in Oregon, a resident’s bed sores became so severe after months of neglect they had to be relocated to a hospital over 200 miles away for treatment.\u003c/p>\n\u003cp>In 2018, a Sevita program supervisor in Iowa \u003ca href=\"https://www.finance.senate.gov/imo/media/doc/2020-12-03%20FINAL%20Investigative%20Report%20(REM%20Iowa).pdf\">groomed a developmentally disabled resident for months\u003c/a> before sexually abusing them. The supervisor was eventually arrested and pleaded guilty.\u003c/p>\n\u003cp>Throughout that time, The Mentor Network/Sevita was also highly profitable.\u003c/p>\n\u003cp>“The last two private equity firms that bought it in March 2019, CenterBridge Partners and the Vistria Group, have piled debt onto [Sevita Health] and used the proceeds of that debt to pay themselves hundreds of millions of dollars,” O’Grady said. “It’s unconscionable that they should be making profits hand over fist while the company is continuing to mistreat the people under its care.”\u003c/p>\n\u003ch2>A dysfunctional cycle\u003c/h2>\n\u003cp>Through the fall of 2022, Ileya Silva continued to push for more transparency and accountability within the company, which she said strained her relationships with her superiors.\u003c/p>\n\u003cp>“I was seen as a problem because I wasn’t moving in the manner of ‘we’re protecting company over all else,’” she said.\u003c/p>\n\u003cp>Eventually, Silva was suspended from her job.\u003c/p>\n\u003cp>On June 30, 2023, \u003ca href=\"https://s3.documentcloud.org/documents/24214344/dds-kqed-response-7-28-23.pdf\">Sevita Health voluntarily gave up the operation of the Illinois Home\u003c/a> after increased pressure from regulators — nearly a year and a half after Katrina’s black eye and concussion incident. According to the Department of Developmental Services, Sevita Health no longer operates any EBSHs in California. However, it continues to run 24 residential facilities and a number of day programs for adults with developmental disabilities in California.\u003c/p>\n\u003cfigure id=\"attachment_11965505\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11965505\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-020-BL-KQED.jpg\" alt=\"Three people sit at a picnic table in a park.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-020-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-020-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-020-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-020-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-020-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-020-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Elaine Sheffer and Pat Turner spend time with Katrina Turner at Miller Park in the suburbs of Sacramento on Oct. 23. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Katrina Turner’s family said they’ve met with the new home operators, and their impressions were positive. But, due to the trauma of the past year and a half, they remain unconvinced that the system will protect Katrina if things go south again.\u003c/p>\n\u003cp>One potential bright spot for Katrina’s family is a bill slowly making its way through the state Legislature over the past year. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB1147\">Assembly Bill 1147\u003c/a>, or The Disability Equity and Accountability Act, aims to address some of the systemic issues facing California’s developmental disability system. Among other changes, the bill would force regional centers and private nonprofits that contract with DDS, such as Alta Regional, to be more transparent by subjecting them to the state’s Public Records Act. It would also strengthen DDS’s ability to hold regional centers and service providers like Sevita accountable for failing to meet standards of care. However, regional centers have succeeded in removing key components of the bill and \u003ca href=\"https://www.sacbee.com/news/politics-government/capitol-alert/article278312728.html\">remain strongly opposed\u003c/a>.\u003c/p>\n\u003cp>\u003cem>This story was produced as a part of the USC Annenberg Center for Health Journalism’s 2022 Data Journalism Fellowship.\u003c/em>\u003c/p>\n\u003cp>\u003cem>A \u003ca href=\"https://www.kalw.org/withoutavoice\">series of stories\u003c/a> about this investigation first aired on KALW.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Investigation records, state reports, family and whistleblower testimony suggest Katrina Turner suffered abuse and neglect for months at a group home near Sacramento — and state regulators failed to act promptly.",
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"title": "Whistleblowers Call Out California Group Home for Abuse Against Disabled Residents | KQED",
"description": "Investigation records, state reports, family and whistleblower testimony suggest Katrina Turner suffered abuse and neglect for months at a group home near Sacramento — and state regulators failed to act promptly.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">K\u003c/span>\u003c/p>\u003cp>atrina Turner’s eyes lit up when her father, Pat Turner, and his fiancée, Elaine Sheffer, walked through the door of the beige stucco house in the Sacramento County community of Fair Oaks, where she lives. She made soft moaning sounds as her parents embraced her. Katrina is 43 years old, developmentally disabled and nonverbal, but she has her own ways of communicating.\u003c/p>\n\u003cp>Katrina’s family has been worried about her. Just a few months after she moved to this group home for people with disabilities who need 24-hour care, known as an Enhanced Behavioral Supports Home (EBSH), mysterious injuries started appearing on her body. There were holes in her walls, and Katrina had become less responsive.\u003c/p>\n\u003cp>Turner and Sheffer were used to facilities letting Katrina down. Children with disabilities are \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2022/04/12/1091679303/a-report-on-violence-against-kids-with-disabilities-is-sobering-if-not-surprisin\">far more likely to experience abuse\u003c/a>, and they said Katrina is no exception. Scars from past placements mark her skin, they said, and although she’s barely middle-aged, Katrina walks with the stooped shuffle of someone much older. But her family had hoped that here, at the Illinois Home — an EBSH named for the street where it’s located — Katrina had finally found a place where she’d get the 24\u003cspan style=\"font-weight: 400;\">– \u003c/span>7 care she needed.\u003c/p>\n\u003cp>Instead, Turner and Sheffer’s concerns have turned into a full-fledged investigation of the management and practices at the Illinois Home.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>EBSHs are supposed to be more tightly regulated than any other type of group home in the state. However, a KQED investigation into the Illinois Home and the company that operated it until June 2023 has revealed that staff were not meeting even minimum standards of care. Allegations of mistreatment are difficult to prove because the main victim, Katrina, is nonverbal. However, investigation records, state reports, and testimony from whistleblowers suggest that she suffered abuse and neglect for months at the hands of staffers, and state regulators failed to act promptly.\u003c/p>\n\u003ch2>As small group homes proliferate, so do oversight concerns\u003c/h2>\n\u003cp>The Department of Developmental Services (DDS) is the state agency charged with supporting the roughly 400,000 people in California who live with developmental disabilities like autism, cerebral palsy, or Down syndrome. DDS \u003ca href=\"https://www.dds.ca.gov/wp-content/uploads/2023/05/2023-May-Revision-Master-for-Internet-Linked.pdf\">oversees a budget of more than $14 billion\u003c/a>, nearly as much as the state’s correctional system. The agency funds thousands of organizations that provide services — like day programs, behavioral therapy, and group homes like the Illinois Home, where Katrina lives. Only four residents live in each home, a system designed to meet the high needs of the residents. These homes, often just converted houses in residential neighborhoods, replaced the large state-run institutions that state lawmakers voted to move away from in 2012. Advocates had high hopes that in these smaller settings, disabled Californians like Katrina would finally get the care promised to them by law.\u003c/p>\n\u003cp>“We’re concerned that in practice, some of these homes are at risk of turning into the very types of institutional placements they’ve been designed to prevent, just on a smaller scale,” said Will Leiner, managing attorney at \u003ca href=\"https://www.disabilityrightsca.org/\">Disability Rights California\u003c/a>, a nonprofit that advocates for the rights of disabled Californians.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘We were hopeful because an EBSH home is overseen by the state. We were hopeful that this would mean there wouldn’t be such an opportunity for neglect or abuse… We thought everything was gonna be OK. But it’s not. It’s horrible.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Leiner is also concerned by what he said is a staggering growth in the number of EBSHs.The first one opened in 2017, and now, just six years later, nearly 70 licensed EBSHs operate in California. And while they are smaller than the institutions that came before, they aren’t always well regulated. In 2022, the \u003ca href=\"https://www.auditor.ca.gov/pdfs/reports/2021-107.pdf\">California State Auditor found that DDS had failed to ensure residential facilities like EBSHs received the inspections and oversight\u003c/a> that state law requires. Furthermore, the State Auditor noted the same issue in a 2016 audit and “recommended then that DDS require the regional centers to address the issue. However, DDS has yet to take adequate action to ensure that the regional centers perform these reviews.”\u003c/p>\n\u003ch2>Katrina’s life in group home care\u003c/h2>\n\u003cp>Since she was a child, Katrina Turner has lived in group care facilities. She was often destructive, sometimes hurting herself or others, which made finding a stable living situation difficult. She bounced from one home to another, frequently experiencing mistreatment, according to her family. At one point, she spent over six months in a hospital room because the state wasn’t able to find a suitable placement for her.\u003c/p>\n\u003cp>Her family was determined to get her somewhere safe. So when they heard about an opening at an EBSH near their home in Sacramento, they were excited.\u003c/p>\n\u003cp>“We were hopeful because an EBSH home is overseen by the state,” Sheffer said. “We were hopeful that this would mean there wouldn’t be such an opportunity for neglect or abuse. She moved to the home, and we thought everything was gonna be OK. But it’s not. It’s horrible.”\u003c/p>\n\u003cfigure id=\"attachment_11965507\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11965507\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-030-BL-KQED.jpg\" alt=\"A person with long hair looks through stacks of paperwork.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-030-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-030-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-030-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-030-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-030-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-030-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Elaine Sheffer goes through paperwork related to her stepdaughter Katrina Turner at home in Sacramento. Investigation records, state reports and testimony from whistleblowers suggest that Turner suffered abuse and neglect for months at the hands of staffers at the Illinois Home. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Katrina moved into the Illinois Home in March 2021. The facility was under investigation by the state at the time, something Turner said they knew nothing about.\u003c/p>\n\u003cp>Just a few months into her stay, a new company, Sevita Health, took over its operation. Sevita is one of the country’s largest operators of group homes and care facilities. Turner and Sheffer didn’t question the acquisition at the time, but about a year into Katrina’s residency there, her family began to suspect something wasn’t right.\u003c/p>\n\u003ch2>Abuse and mistreatment\u003c/h2>\n\u003cp>In February 2022, Elaine Sheffer received a surprising text and then an email from a Sevita staff member, Kylie LeBlanc.\u003c/p>\n\u003cp>A copy of the email obtained by KQED described a series of abusive incidents involving Katrina. Attached photos showed Katrina looking mournfully at the camera, with a deep, raised purple blotch spreading below her eye.\u003c/p>\n\u003cp>“When I walked in, Katrina had a black eye, and I was like, ‘Oh my God,’” LeBlanc said. “And my coworker said, ‘Kylie, it’s not even the worst part.’”\u003c/p>\n\u003cp>Along the walls of Katrina’s room, exactly at the height of her head, was a row of holes. LeBlanc believed they were caused by Katrina banging her head against the wall.\u003c/p>\n\u003cp>According to LeBlanc, the coworker told her, “‘I know people are locking her in the room. They’re closing the door and holding it shut while sitting in a chair.’”\u003c/p>\n\u003cp>Because of her history of self-injury, Katrina is supposed to be monitored at all times. Being locked in her room would have been confusing and frightening for her, LeBlanc said, and she may have resorted to self-injury.\u003c/p>\n\u003cp>\u003ca href=\"https://s3.documentcloud.org/documents/24214201/katrina-turner-combined-shift-notes_redacted.pdf\">Shift notes\u003c/a> provided by \u003cspan style=\"font-weight: 400;\">Katrina’s family and \u003c/span>another former Sevita employee showed that Katrina had repeatedly suffered injuries during night shifts in the weeks leading up to the black eye, including bruises.\u003c/p>\n\u003cp>Turner and Sheffer said they weren’t notified about the black eye by Sevita Health, as is required. They believed that, had LeBlanc not reached out, the family would have been kept in the dark. They also believed Katrina had suffered a concussion from the incident.\u003c/p>\n\u003cp>“She was also at that point having issues with throwing up and losing control of her bowels,” LeBlanc said. “Which is another sign of some kind of head injury or a concussion.”\u003c/p>\n\u003ch2>Inaction from regulators and Sevita Health\u003c/h2>\n\u003cp>LeBlanc said that she submitted complaints about the treatment of residents to Sevita Health’s HR department but that the company did not take action. So, she took her concerns directly to \u003ca href=\"https://www.altaregional.org/\">Alta Regional Center\u003c/a>, a state-funded nonprofit conducting safety checks, and \u003ca href=\"https://www.cdss.ca.gov/inforesources/community-care-licensing\">Community Care Licensing\u003c/a>, a state regulator investigating complaints. She sent documents describing the concussion incident, as well as evidence that staff had been mismanaging residents’ medications. \u003ca href=\"https://www.documentcloud.org/documents/24214193-pra-rem-ca-consolidated_redacted_v3#document/p25\">Documents KQED obtained from Community Care Licensing\u003c/a> corroborate LeBlanc’s claims.\u003c/p>\n\u003cp>Additional shift notes show Katrina was repeatedly \u003ca href=\"https://s3.documentcloud.org/documents/24214201/katrina-turner-combined-shift-notes_redacted.pdf\">found drinking from a toilet\u003c/a> and a sprinkler head outside. These reports suggested to Katrina’s family that she was not receiving enough water, indicating serious neglect.\u003c/p>\n\u003cp>After an initial meeting with representatives from the regulating agencies, LeBlanc was hopeful that change was coming to the Illinois Home.\u003c/p>\n\u003cp>“They said they were gonna do things to fix it,” she said. “And absolutely nothing happened.”\u003c/p>\n\u003cp>Alta Regional Center \u003ca href=\"https://s3.documentcloud.org/documents/24214342/acrcs-kqed-response-7-28-23.pdf\">said it did take action\u003c/a>. In response to KQED’s questions, Alta wrote that between March 2022 and June 2023, the Illinois Home was “required to develop a corrective action plan and the Regional Center stopped referring new individuals for placement there.” This practice is known as “sanctioning” and is a way to blacklist a facility. But, though the Illinois Home was prevented from taking in new clients, Katrina and the other residents remained.\u003c/p>\n\u003ch2>‘Absolutely no oversight’\u003c/h2>\n\u003cp>Around the same time LeBlanc was blowing the whistle on practices at the Illinois Home, Sevita hired a new administrator named Ileya Silva to oversee it. She’d worked in group homes for 20 years and had developed a reputation for doing things by the book.\u003c/p>\n\u003cp>Silva was shocked by what she found at the Illinois Home. It appeared to her that during the eight months between Sevita’s acquisition of the home in July 2021 and her hiring, there had been “absolutely no oversight.” A \u003ca href=\"https://s3.documentcloud.org/documents/24214200/acrc-faclity-action-report-tech-log_redacted.pdf\">facility report from Alta Regional Center\u003c/a> reinforces Silva’s account.\u003c/p>\n\u003cp>That means Sevita was not doing the \u003ca href=\"https://www.cdss.ca.gov/portals/9/regs/ebshman2.pdf?ver=2017-03-22-093058-240\">typical things required to operate an EBSH\u003c/a>, including internal audits, check-ins and inspections. Silva said employees were severely undertrained and lacked even the most basic knowledge of the regulations.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘I don’t want this to be the situation where I turn on the news one day and one of the clients has died. I just can’t have that on my conscience — that I didn’t say something, I didn’t do something.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The Alta Regional facility report shows that staff members at all levels were behind on training and missing certifications. Some staff didn’t even have the required experience to work at an EBSH.\u003c/p>\n\u003cp>To compound the problems, the home was chronically under-staffed and employees worked long hours — sometimes 16 or even 24-hour shifts, according to Silva and LeBlanc.\u003c/p>\n\u003cp>And the Illinois Home wasn’t an isolated case, Silva said. Sevita operated two other group homes nearby and at least 20 other homes throughout California.\u003c/p>\n\u003cp>“It was very systemic,” Silva said. “They would send staff from other facilities, and they were at the same deficit. They didn’t have the understanding. They didn’t know the [regulations].”\u003c/p>\n\u003cfigure id=\"attachment_11965511\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11965511\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-050-BL-KQED.jpg\" alt=\"A person with long hair stands beside a tree outside and looks at the camera.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-050-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-050-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-050-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-050-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-050-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-050-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Ileya Silva, a former group home administrator at the home where Katrina Turner lived, stands outside her home in Sacramento. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>KQED provided Sevita Health with a detailed list of allegations and questions. The company declined to comment on specifics, citing the privacy of their residents, \u003ca href=\"https://s3.documentcloud.org/documents/24214218/sevita-statement_california-mentor_kalw.pdf\">but did provide a general statement\u003c/a>: “Sevita promotes ethical practices at all levels of the organization, and we remain committed to our core values of integrity, respect, inclusion, and growth.”\u003c/p>\n\u003ch2>Medication mismanagement\u003c/h2>\n\u003cp>One of the clearest examples of just how bad things were at the Illinois Home was how staff handled medications. Every dose of every medication in an EBSH is supposed to be documented, both for the safety of residents and to prevent misuse.\u003c/p>\n\u003cp>“In this field, staff do steal medications,” Silva said. “It’s why there are so many checks and balances.”\u003c/p>\n\u003cp>Silva said the standard protocol was to destroy unused medications at the end of each month. At the Illinois Home, however, “they had a year’s worth of backed-up meds that had not been destroyed.\u003c/p>\n\u003cp>“I have photos of a giant, gallon freezer bag that had maybe 150 pills in it,” Silva said. “Didn’t state what the medications were, didn’t state who the medications belonged to.”\u003c/p>\n\u003cp>Silva also noticed that all of the residents were on multiple strong medications at extremely high dosages. Katrina, for example, was on anti-psychotics, sedatives, and other powerful medications.\u003c/p>\n\u003cp>“It’s not very often that you’re gonna see all of the meds, and so many of them, prescribed at the maxed-out level,” she said.\u003c/p>\n\u003cfigure id=\"attachment_11965510\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11965510\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-043-BL-KQED.jpg\" alt=\"A sheet of paper with sections crossed out.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-043-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-043-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-043-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-043-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-043-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-043-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Ileya Silva goes through paperwork related to Katrina Turner’s treatment at the Illinois Home. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>California welfare code \u003ca href=\"https://codes.findlaw.com/ca/welfare-and-institutions-code/wic-sect-4502.html\">says that people with developmental disabilities have a right to be free from harm\u003c/a>, including “excessive medication.” When medications are used to sedate a resident or make them more compliant, that’s \u003ca href=\"https://www.law.cornell.edu/regulations/california/22-CCR-72018#:~:text=Chemical%20restraint%20means%20a%20drug,treat%20the%20patient%27s%20medical%20symptoms\">considered chemical restraint by the state\u003c/a> and is only permitted in very limited circumstances. Silva was concerned that all the residents in the home were being chemically restrained. It was a concern shared by Katrina’s family.\u003c/p>\n\u003cp>“She’s walking hunched over, and she walks like a little old lady,” Sheffer said. “And her mouth is open, and she’s drooling. And we’re like, this is not Katrina.”\u003c/p>\n\u003ch2>Van ride violence\u003c/h2>\n\u003cp>One of the most shocking instances of abuse came in June 2022. Illinois Home staff often transported residents to appointments and activities in a van. Katrina sometimes took her seatbelt off and attempted to stand up while the van was moving. Reports show that several staff members would slam on the brakes rather than gently helping her back to her seat, causing her to fly across the van.\u003c/p>\n\u003cp>“So that explains a lot of the bruises that she had on her lower back and the front of her legs,” Sheffer said.\u003c/p>\n\u003cp>\u003ca href=\"https://www.documentcloud.org/documents/24214193-pra-rem-ca-consolidated_redacted_v3#document/p19\">Reports from a Community Care Licensing investigation\u003c/a> indicate that three different staff members were “brake checking” residents over several months. One staffer \u003ca href=\"https://www.documentcloud.org/documents/24214193-pra-rem-ca-consolidated_redacted_v3#document/p65\">is quoted as saying\u003c/a> that the driver of the van “Will brake check two to three times. Then she was laughing like it’s a joke. Happens all the time.”\u003c/p>\n\u003cp>Silva suspended the three employees accused of brake-checking Katrina and the other residents. Shortly after that, one of the employees quit, and \u003ca href=\"https://www.documentcloud.org/documents/24214193-pra-rem-ca-consolidated_redacted_v3#document/p81\">the other two were terminated\u003c/a>.\u003c/p>\n\u003cp>“I don’t want this to be the situation where I turn on the news one day, and one of the clients has died,” Silva said. “And I just can’t have that on my conscience — that I didn’t say something, I didn’t do something.”\u003c/p>\n\u003cp>In response to the incidents, \u003ca href=\"https://s3.documentcloud.org/documents/24214344/dds-kqed-response-7-28-23.pdf\">regulators increased pressure on Sevita to improve conditions\u003c/a>, but the company would continue operating the home for another year. Community Care Licensing issued citations, but documents show the penalties were relatively low. As of August 2023, The Illinois Home had been fined just over $1,500. That’s in contrast to the home’s \u003ca href=\"https://s3.documentcloud.org/documents/24214344/dds-kqed-response-7-28-23.pdf\">yearly revenue of over $1.5 million\u003c/a>.\u003c/p>\n\u003cp>In response to KQED’s questions about the Illinois Home and the abuse Katrina Turner suffered, Community Care Licensing wrote, “The Department licenses facilities in accordance with state law.”\u003c/p>\n\u003cp>In a separate response, \u003ca href=\"https://s3.documentcloud.org/documents/24214344/dds-kqed-response-7-28-23.pdf\">DDS wrote\u003c/a>, “The actions described in these claims are inexcusable. They not only are inconsistent with the Department of Developmental Services’ (DDS’) expectations for care, but they also are entirely counter to what we stand for and what we expect in the care and support for the individuals who receive regional center services.”\u003c/p>\n\u003ch2>Private equity firms reap profits amid a track record of abuse\u003c/h2>\n\u003cp>Regulators may have responded slowly and with too little force, but Illeya Silva reserves the bulk of her anger for Sevita Health management, who she said could have taken it upon themselves to respond to allegations of abuse and mismanagement. Instead, she said management ignored regulations, failed to follow up on complaints, and fostered a culture of negligence.\u003c/p>\n\u003cp>Again, Sevita would not respond to specific allegations.\u003c/p>\n\u003cp>Sevita Health is part of a growing trend of private equity investment in the health care industry. The company is owned by two private equity firms: \u003ca href=\"https://www.centerbridge.com/\">Centerbridge Partners\u003c/a> and \u003ca href=\"https://vistria.com/\">The Vistria Group\u003c/a>. Private equity firms use money from investors to purchase private companies and then seek to increase their profitability, often by cutting costs. In health care fields, this can include reducing expenditures on staffing, training, and overhead.\u003c/p>\n\u003cp>In fact, the name Sevita Health only goes back to 2021, \u003ca href=\"https://www.prnewswire.com/news-releases/nations-leader-in-specialized-health-care-moves-forward-under-a-new-brand-301381984.html\">when the company rebranded itself\u003c/a>. The company’s previous name, The Mentor Network, had developed a strong negative reputation.\u003c/p>\n\u003cp>“It has had a host of allegations of abuse, neglect, mistreatment of people under Mentor Network’s care,” said Eileen O’Grady, a lead researcher at the \u003ca href=\"https://pestakeholder.org/\">Private Equity Stakeholder Project\u003c/a>, a nonprofit that researches private equity’s impact on communities and industries, including group homes. In 2022, she \u003ca href=\"https://pestakeholder.org/wp-content/uploads/2022/02/PESP_Youth_BH_Report_2022.pdf\">authored a report\u003c/a> that digs into the allegations that have swirled around the company.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>One of The Mentor Network/Sevita’s major lines of business is running youth foster homes. In 2017, \u003ca href=\"https://www.documentcloud.org/documents/4111642-An-Examination-of-Foster-Care-in-the-United.html#document/p10/a382165\">a U.S. Senate investigation found that, over a decade, at least 86 children died at homes run by the company\u003c/a>, many more than the national average. And the committee found that the company only conducted internal investigations in 13 of those deaths.\u003c/p>\n\u003cp>That Senate investigation was partly prompted by a sweeping \u003ca href=\"https://www.buzzfeednews.com/article/aramroston/fostering-profits\">2015 investigation by Buzzfeed News\u003c/a>. In one article, Buzzfeed “identified deaths, sex abuse, and blunders in screening, training, and overseeing foster parents at the nation’s largest for-profit foster care company.”\u003c/p>\n\u003cp>In 2020, the U.S. Senate investigated Sevita subsidiaries in Oregon and Iowa that ran homes for disabled adults. \u003ca href=\"https://www.finance.senate.gov/imo/media/doc/120220%20Life%20at%20Cypress%20House%20-%20An%20Examination%20of%20Care%20Provided%20by%20MENTOR%20Oregon.pdf\">It found residents were subjected to abuse\u003c/a>, including sexual abuse, substandard care, lack of training, and extreme neglect. In one 2017 case in Oregon, a resident’s bed sores became so severe after months of neglect they had to be relocated to a hospital over 200 miles away for treatment.\u003c/p>\n\u003cp>In 2018, a Sevita program supervisor in Iowa \u003ca href=\"https://www.finance.senate.gov/imo/media/doc/2020-12-03%20FINAL%20Investigative%20Report%20(REM%20Iowa).pdf\">groomed a developmentally disabled resident for months\u003c/a> before sexually abusing them. The supervisor was eventually arrested and pleaded guilty.\u003c/p>\n\u003cp>Throughout that time, The Mentor Network/Sevita was also highly profitable.\u003c/p>\n\u003cp>“The last two private equity firms that bought it in March 2019, CenterBridge Partners and the Vistria Group, have piled debt onto [Sevita Health] and used the proceeds of that debt to pay themselves hundreds of millions of dollars,” O’Grady said. “It’s unconscionable that they should be making profits hand over fist while the company is continuing to mistreat the people under its care.”\u003c/p>\n\u003ch2>A dysfunctional cycle\u003c/h2>\n\u003cp>Through the fall of 2022, Ileya Silva continued to push for more transparency and accountability within the company, which she said strained her relationships with her superiors.\u003c/p>\n\u003cp>“I was seen as a problem because I wasn’t moving in the manner of ‘we’re protecting company over all else,’” she said.\u003c/p>\n\u003cp>Eventually, Silva was suspended from her job.\u003c/p>\n\u003cp>On June 30, 2023, \u003ca href=\"https://s3.documentcloud.org/documents/24214344/dds-kqed-response-7-28-23.pdf\">Sevita Health voluntarily gave up the operation of the Illinois Home\u003c/a> after increased pressure from regulators — nearly a year and a half after Katrina’s black eye and concussion incident. According to the Department of Developmental Services, Sevita Health no longer operates any EBSHs in California. However, it continues to run 24 residential facilities and a number of day programs for adults with developmental disabilities in California.\u003c/p>\n\u003cfigure id=\"attachment_11965505\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11965505\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-020-BL-KQED.jpg\" alt=\"Three people sit at a picnic table in a park.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-020-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-020-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-020-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-020-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-020-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231023-DisabilityCareHomes-020-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Elaine Sheffer and Pat Turner spend time with Katrina Turner at Miller Park in the suburbs of Sacramento on Oct. 23. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Katrina Turner’s family said they’ve met with the new home operators, and their impressions were positive. But, due to the trauma of the past year and a half, they remain unconvinced that the system will protect Katrina if things go south again.\u003c/p>\n\u003cp>One potential bright spot for Katrina’s family is a bill slowly making its way through the state Legislature over the past year. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB1147\">Assembly Bill 1147\u003c/a>, or The Disability Equity and Accountability Act, aims to address some of the systemic issues facing California’s developmental disability system. Among other changes, the bill would force regional centers and private nonprofits that contract with DDS, such as Alta Regional, to be more transparent by subjecting them to the state’s Public Records Act. It would also strengthen DDS’s ability to hold regional centers and service providers like Sevita accountable for failing to meet standards of care. However, regional centers have succeeded in removing key components of the bill and \u003ca href=\"https://www.sacbee.com/news/politics-government/capitol-alert/article278312728.html\">remain strongly opposed\u003c/a>.\u003c/p>\n\u003cp>\u003cem>This story was produced as a part of the USC Annenberg Center for Health Journalism’s 2022 Data Journalism Fellowship.\u003c/em>\u003c/p>\n\u003cp>\u003cem>A \u003ca href=\"https://www.kalw.org/withoutavoice\">series of stories\u003c/a> about this investigation first aired on KALW.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Jorge Estrella Moreno remembers the day he arrived at the studio apartment he shares with his wife and collapsed on the bed, weighed down by sadness and worry.\u003c/p>\n\u003cp>His wife asked him what was wrong. “I have bad news,” he recalled telling her as he cried.\u003c/p>\n\u003cp>That day nearly a year ago, a doctor had diagnosed him with silicosis, an often fatal lung disease. Estrella Moreno, who lives in San Francisco, had unknowingly inhaled toxic silica dust for years while power-cutting slabs of engineered stone to make kitchen countertops and floor panelings. [pullquote size=\"medium\" align=\"right\" citation=\"Jorge Estrella Moreno, stonecutter, San Francisco\"]‘It felt like my world fell apart. It’s very sad to live with this disease because I’m alive today, but tomorrow, who knows? And my family still needs me.’[/pullquote]His lungs were irreversibly damaged, he remembers the doctor saying. There was no cure.\u003c/p>\n\u003cp>“It felt like my world fell apart,” the 48-year-old father of three told KQED in Spanish. “It’s very sad to live with this disease because I’m alive today, but tomorrow, who knows? And my family still needs me.”\u003c/p>\n\u003cp>On Thursday, a California occupational safety board is \u003ca href=\"https://www.dir.ca.gov/OSHSB/Respirable-Crystalline-Silica-Emergency.html\">set to vote\u003c/a> on approving new emergency regulations to protect countertop fabrication workers handling engineered stone, a factory-made product that can have a much higher silica content than natural stone. The material has been linked to an accelerated and more aggressive form of silicosis with a \u003ca href=\"https://www.dir.ca.gov/OSHSB/documents/Respirable-Crystalline-Silica-Emergency-FOE.pdf\">fatality rate of 19%\u003c/a> in the industry, according to state workplace regulators.\u003c/p>\n\u003cp>Medical professionals have known the health risks of inhaling silica dust for centuries. Silica is a mineral found in the earth’s crust. Cutting granite, sandstone and other stones releases \u003ca href=\"https://depts.washington.edu/silica/silica.html#:~:text=The%20most%20common%20form%20of,%2C%20silicon%20carbide%2C%20and%20silicone.\">crystalline silica\u003c/a> into the air. When inhaled, tiny particles can get lodged in the lungs and, over decades, lead to scarring and difficulty breathing.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But artificial stone, a popular and relatively new material in the U.S. market, is \u003ca href=\"https://www.dir.ca.gov/oshsb/documents/petition-597-CalOSHAeval.pdf\">uniquely hazardous\u003c/a> to stonecutters because it may contain more than 93% silica, according to officials with the California Division of Occupational Safety and Health, or Cal/OSHA.\u003c/p>\n\u003cp>Dozens of young to middle-aged countertop fabrication workers in California, overwhelmingly Latino immigrants, have been disabled or killed by the disease in recent years. Some died while awaiting lung transplants. Others must rely on oxygen machines, including a \u003ca href=\"https://www.kqed.org/news/11956246/california-fast-tracks-rules-to-protect-stonecutters-from-horrible-deaths\">27-year-old man\u003c/a> featured in a KQED story in July.\u003c/p>\n\u003cp>Nationwide, 165 people died from silicosis between 2018 and 2021, said Nick Spinelli, a spokesperson for the Centers for Disease Control and Prevention, though the data is not specific to the countertop fabrication industry. [pullquote size=\"medium\" align=\"right\" citation=\"Dr. Sheiphali Gandhi, occupational pulmonologist, UCSF\"]‘It’s a public health disaster. We will keep seeing patients because a lot of people have already been exposed. So I think that, really, we are looking to improve things like five to 10 years down the road.’[/pullquote]There were no silicosis cases associated with artificial stone recorded before 2010 in California, according to the state’s Department of Public Health. However, the agency identified 93 stone workers who had contracted the disease in the last five years. As of Nov. 30, at least 10 had died.\u003c/p>\n\u003cp>Hundreds more are expected to be diagnosed with silicosis if harmful exposures continue. That’s partly because most of the roughly 800 stone fabrication shops in California are small and often don’t have the capacity to comply with existing safety regulations, Cal/OSHA officials said. The agency is now working to streamline and strengthen rules to stall the risk of silica exposure, which can also cause lung cancer.\u003c/p>\n\u003cp>“It’s a public health disaster,” said Dr. Sheiphali Gandhi, an occupational pulmonologist at UCSF who participated in a Cal/OSHA advisory committee to bolster existing silica standards. “We will keep seeing patients because a lot of people have already been exposed. So I think that, really, we are looking to improve things like five to 10 years down the road.”\u003c/p>\n\u003cp>The \u003ca href=\"https://www.dir.ca.gov/OSHSB/Respirable-Crystalline-Silica-Emergency.html\">emergency regulations\u003c/a>, if approved by the Occupational Safety and Health Standards Board, would restrict the dry cutting of artificial stone with more than 0.1% crystalline silica and natural stone that contains more than 10%. Tasks such as power cutting or drilling would require the use of wet-cutting saws or other tools that cover a material’s surface with water to suppress the dust. Employers would also be required to provide workers with powered air-purifying respirators or other highly protective masks.\u003c/p>\n\u003cp>Current \u003ca href=\"https://www.dir.ca.gov/title8/1532_3.html#:~:text=(1)%20Permissible%20exposure%20limit%20(,as%20an%208%2Dhour%20TWA.\">rules\u003c/a> say employers must first complete sophisticated air monitoring of permissible silica levels before determining required protective steps.\u003c/p>\n\u003cp>“The fact that we’re actually defining high risk based on the type of work rather than the air monitoring is a huge step in the right direction,” said Gandhi, who has diagnosed several silicosis patients, including Estrella Moreno. “Ideally, the best thing is to eliminate the toxic substance altogether. But if we are working with it, how can we do it safely?”\u003c/p>\n\u003cp>Estrella Moreno began working as a stonecutter in San Francisco shortly after immigrating from Mexico more than two decades ago. He liked using his hands to carve stone and install projects in kitchens and living rooms.\u003c/p>\n\u003cfigure id=\"attachment_11964918\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11964918\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-003-BL-KQED.jpg\" alt=\"A hand holds a phone showing the photo of a stone fireplace.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-003-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-003-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-003-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-003-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-003-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-003-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jorge Moreno holds a photo on his phone of stonecutting work from his job at his home in San Francisco on Oct. 17, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At his home in the Lower Nob Hill neighborhood, Estrella Moreno’s eyes lit up as he pointed to the smooth stone tables he had made. He proudly pulled up photographs on his phone of modern chimney panels and kitchen countertops he had also crafted.\u003c/p>\n\u003cp>It’s an “honest job” that allowed him to raise his three kids in the U.S., he said, even though he doesn’t know how to read and write. His parents never sent him to school as a child. Even before Estrella Moreno was orphaned by age 11, he worked in agricultural fields sowing corn and other crops in Michoacan. He’s provided for himself ever since. [pullquote size=\"medium\" align=\"right\" citation=\"Jorge Estrella Moreno, stonecutter, San Francisco\"]‘One comes to this country to support one’s family, to get ahead. Unfortunately, this turned out to be a dangerous job.’[/pullquote]“One comes to this country to support one’s family, to get ahead. Unfortunately, this turned out to be a dangerous job,” Estrella Moreno said before burying his head in his hands.\u003c/p>\n\u003cp>Silicosis makes him feel like he’s asphyxiating when walking uphill. Talking requires loud breaths in between words. Exertion can make him dizzy, Estrella Moreno said. His family has been warned that he might need an oxygen machine or a lung transplant as the disease progresses.\u003c/p>\n\u003cp>Yet, Estrella Moreno has refused to quit his job as a stonecutter, where he earns about $28 an hour.\u003c/p>\n\u003cp>“I have no other option. I have to work to support my family and pay rent,” said Estrella Moreno, adding that one of his sons is struggling with mental illness and can’t work. He needs money to pay for his son’s care.\u003c/p>\n\u003cfigure id=\"attachment_11964920\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11964920\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-012-BL-KQED.jpg\" alt=\"A hand holds a photo of an adult with three children.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-012-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-012-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-012-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-012-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-012-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-012-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jorge Moreno holds a photo of his family when his kids were younger at their home in San Francisco on Oct. 17, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Estrella Moreno’s eldest daughter, Rosa Estrella, told KQED she has pleaded with her father to stop working. A medical assistant, she said she has watched in anguish as her dad can no longer do things they enjoyed together, like a carefree walk in the park.\u003c/p>\n\u003cp>She said she wanted to save money to pay for college and eventually become a nurse. Instead, she is looking for a second job to help her parents.\u003c/p>\n\u003cp>“I have to think of them first,” Rosa Estrella, 29, said. “It’s so hard to be in this situation and watch my dad go through this and struggle so much.” [pullquote size=\"medium\" align=\"right\" citation=\"Rosa Estrella, daughter of Jorge Estrella Moreno\"]‘It’s so hard to be in this situation and watch my dad go through this and struggle so much.’[/pullquote]Artificial stone workers in Israel, Spain, Australia and other countries have contracted a rapid onset of silicosis, which \u003ca href=\"https://www.cdc.gov/niosh/topics/silica/risks.html#:~:text=The%20type%20with%20the%20quickest,causing%20severe%20illness%20or%20death.\">can start developing\u003c/a> after only a few months of very high exposure.\u003c/p>\n\u003cp>In Australia, occupational safety authorities recently \u003ca href=\"https://www.safeworkaustralia.gov.au/sites/default/files/2023-10/decision_ris_-_prohibition_on_the_use_of_engineered_stone_-_27_october_2023.pdf\">recommended\u003c/a> a national ban on using all engineered stone, including newer products manufacturers have developed with 50% or less silica content.\u003c/p>\n\u003cp>Cal/OSHA officials \u003ca href=\"https://www.dir.ca.gov/oshsb/documents/petition-597-CalOSHAeval.pdf\">warned\u003c/a> that if widespread non-compliance with safety rules continues, the state should also develop plans to prohibit the use of engineered stone products, something major manufacturers and distributors vehemently oppose.\u003c/p>\n\u003cp>Public health officials in Los Angeles County, the state’s silicosis epicenter, recently \u003ca href=\"https://file.lacounty.gov/SDSInter/bos/bc/1150183_SilicosisPreventionandCareItem10BoardAgendaof6.6.2023.pdf\">concluded\u003c/a> that a local ban, which would only apply to the county’s unincorporated areas, could help protect workers and encourage safer alternatives.\u003c/p>\n\u003cp>Major artificial stone manufacturers maintain the material is being handled safely when appropriate measures, such as wet cutting and ventilation, are followed and that a ban would unnecessarily kill jobs.\u003c/p>\n\u003cfigure id=\"attachment_11964919\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11964919 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-009-BL-KQED.jpg\" alt=\"A person wearing a baseball cap lies down on a bed.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-009-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-009-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-009-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-009-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-009-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-009-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jorge Estrella Moreno rests while his wife Maria Valencia reads the bible at their home in San Francisco on Oct. 17, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Silicosis is entirely preventable,” said Eric Rose, a spokesman with the Stone Coalition, which represents manufacturers, distributors and fabricators. “Any contractor that follows Cal/OSHA’s guidelines ensures that any product cutting is done safely and with little risk to workers. Almost all experts agree that what is being cut matters less than how the stone is cut.”\u003c/p>\n\u003cp>Top manufacturers, such as Cosentino, a company based in Spain, and the Israel-based Caesarstone, have told California regulators that they support creating a licensing program to sell engineered stone slabs only to fabrication businesses equipped to handle them safely.\u003c/p>\n\u003cp>Engineered stone, also known as quartz, is made of crushed stone bonded with adhesives and resins compacted into slabs in factories. Demand for it \u003ca href=\"https://www.freedoniagroup.com/industry-study/engineered-stone-countertops-4395.htm\">skyrocketed\u003c/a> in the U.S. over the last decade, becoming the top countertop material with a market size of \u003ca href=\"https://www.dir.ca.gov/OSHSB/documents/Respirable-Crystalline-Silica-Emergency-FOE.pdf\">$17.7 billion\u003c/a>, according to a Cal/OSHA review.\u003c/p>\n\u003cp>Consumers prefer it because it’s usually cheaper than natural stones such as marble. Its nonporous surface makes it easy to clean and difficult to stain, and it comes in a variety of colors and patterns. [pullquote size=\"medium\" align=\"right\" citation=\"James Nevin, attorney for Jorge Estrella Moreno and other plaintiffs\"]‘These companies knew they were selling a deadly product that was going to kill workers who have to fabricate it before it gets to the consumer.’[/pullquote]Estrella Moreno said he first cut engineered stone slabs in 2007. But he said he didn’t know until his diagnosis about the risk of inhaling the fine dust clouds as he worked. He said he wore an N95 mask, but those are less efficient at filtering silica particles than other respirators.\u003c/p>\n\u003cp>Estrella Moreno blames the manufacturers and suppliers of engineered stone that he and his wife have sued for damages. Almost 60 fabrication workers with silicosis in California are also suing, according to James Nevin, an attorney for Estrella Moreno and other plaintiffs.\u003c/p>\n\u003cp>The lawsuits allege that the largest manufacturers — Caesarstone, Cosentino and Cambria, which is based in the U.S. — failed to adequately label and warn of the hazards of their products and didn’t issue effective instructions on how to use them safely.\u003c/p>\n\u003cp>“These companies knew they were selling a deadly product that was going to kill workers who have to fabricate it before it gets to the consumer,” Nevin said. “If there’s not a more clear case for a lawsuit, I don’t know what is.”\u003c/p>\n\u003cp>Maria Valencia, Estrella Moreno’s wife, said she and her husband hope that by speaking up, they help prevent others from going through the suffering their family is experiencing.\u003c/p>\n\u003cp>“The companies that are producing those materials that are so toxic, that have so much silica, they just want to enrich themselves at the expense of so many people they are going to kill,” said Valencia, 49, who works as a manager at a fast food restaurant. “For me, it’s an injustice that they are putting people in that risk. It’s inhumane.”\u003c/p>\n\u003cp>Caesarstone, Cosentino and Cambria declined to comment on the lawsuits.\u003c/p>\n\u003cp>Earlier this year, the owner of Cosentino \u003ca href=\"https://www.reuters.com/business/owner-spains-cosentino-admits-concealing-cause-silicosis-1900-workers-2023-02-07/\">admitted negligence\u003c/a> in a Spanish court for hiding the health risks of one of its best-selling artificial stone products, which allegedly led to nearly 1,900 workers developing silicosis. He agreed to pay 1.1 million euros to five stonemasons, one of whom had died and was given a six-month suspended sentence as part of a plea deal.\u003c/p>\n\u003cp>In the Bay Area, the father and son duo, who run a well-established stone fabrication facility in Santa Clara, are also calling for solutions, including a more regulated distribution market, stricter enforcement, and the sale of engineered stone products developed with a lower silica content. [aside label='More Stories on Workers’ Rights' tag='workers-rights']Manny De Oliveira, who founded United Marble & Granite Inc. in 1998, and his son, Shawn, lamented what they described as a proliferation of slab yards and stone distributors along nearby highways that sell engineered stone to “anyone with a credit card.” That’s led to “poor guys that don’t even speak English that get taken advantage of” laboring in the back of a truck or store “with just a T-shirt pulled up to cover their nose,” said De Oliveira, 67.\u003c/p>\n\u003cp>The De Oliveiras estimate that a small fabrication shop, with just two or three workers, would need to invest hundreds of thousands of dollars in basic equipment and other measures to keep workers safe.\u003c/p>\n\u003cp>On a recent visit to the company’s cavernous workspace, a KQED reporter observed employees in hardhats operating large robotic saws neatly slicing stone slabs layered in water from a computer screen. Others held smaller tools, releasing a water flow as they cut pieces. And in a blocked-off area, two workers wearing white industrial coveralls and powered air-purifying respirators finished the edges of a countertop as a ventilation system sucked dust into a duct with a running water curtain.\u003c/p>\n\u003cp>“If you go to a lot of other shops, you’ll see this activity without the machines, without the suit. That’s the problem — guys are working dry without engineering controls, the equipment or protection,” Shawn De Oliveira, 42, said. “Everybody wants to be a fabricator, but nobody wants to do the safety part because it’s expensive. And the customer doesn’t even know what’s going on.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Jorge Estrella Moreno remembers the day he arrived at the studio apartment he shares with his wife and collapsed on the bed, weighed down by sadness and worry.\u003c/p>\n\u003cp>His wife asked him what was wrong. “I have bad news,” he recalled telling her as he cried.\u003c/p>\n\u003cp>That day nearly a year ago, a doctor had diagnosed him with silicosis, an often fatal lung disease. Estrella Moreno, who lives in San Francisco, had unknowingly inhaled toxic silica dust for years while power-cutting slabs of engineered stone to make kitchen countertops and floor panelings. \u003c/p>\u003c/div>",
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"content": "‘It felt like my world fell apart. It’s very sad to live with this disease because I’m alive today, but tomorrow, who knows? And my family still needs me.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>His lungs were irreversibly damaged, he remembers the doctor saying. There was no cure.\u003c/p>\n\u003cp>“It felt like my world fell apart,” the 48-year-old father of three told KQED in Spanish. “It’s very sad to live with this disease because I’m alive today, but tomorrow, who knows? And my family still needs me.”\u003c/p>\n\u003cp>On Thursday, a California occupational safety board is \u003ca href=\"https://www.dir.ca.gov/OSHSB/Respirable-Crystalline-Silica-Emergency.html\">set to vote\u003c/a> on approving new emergency regulations to protect countertop fabrication workers handling engineered stone, a factory-made product that can have a much higher silica content than natural stone. The material has been linked to an accelerated and more aggressive form of silicosis with a \u003ca href=\"https://www.dir.ca.gov/OSHSB/documents/Respirable-Crystalline-Silica-Emergency-FOE.pdf\">fatality rate of 19%\u003c/a> in the industry, according to state workplace regulators.\u003c/p>\n\u003cp>Medical professionals have known the health risks of inhaling silica dust for centuries. Silica is a mineral found in the earth’s crust. Cutting granite, sandstone and other stones releases \u003ca href=\"https://depts.washington.edu/silica/silica.html#:~:text=The%20most%20common%20form%20of,%2C%20silicon%20carbide%2C%20and%20silicone.\">crystalline silica\u003c/a> into the air. When inhaled, tiny particles can get lodged in the lungs and, over decades, lead to scarring and difficulty breathing.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But artificial stone, a popular and relatively new material in the U.S. market, is \u003ca href=\"https://www.dir.ca.gov/oshsb/documents/petition-597-CalOSHAeval.pdf\">uniquely hazardous\u003c/a> to stonecutters because it may contain more than 93% silica, according to officials with the California Division of Occupational Safety and Health, or Cal/OSHA.\u003c/p>\n\u003cp>Dozens of young to middle-aged countertop fabrication workers in California, overwhelmingly Latino immigrants, have been disabled or killed by the disease in recent years. Some died while awaiting lung transplants. Others must rely on oxygen machines, including a \u003ca href=\"https://www.kqed.org/news/11956246/california-fast-tracks-rules-to-protect-stonecutters-from-horrible-deaths\">27-year-old man\u003c/a> featured in a KQED story in July.\u003c/p>\n\u003cp>Nationwide, 165 people died from silicosis between 2018 and 2021, said Nick Spinelli, a spokesperson for the Centers for Disease Control and Prevention, though the data is not specific to the countertop fabrication industry. \u003c/p>\u003c/div>",
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"content": "‘It’s a public health disaster. We will keep seeing patients because a lot of people have already been exposed. So I think that, really, we are looking to improve things like five to 10 years down the road.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>There were no silicosis cases associated with artificial stone recorded before 2010 in California, according to the state’s Department of Public Health. However, the agency identified 93 stone workers who had contracted the disease in the last five years. As of Nov. 30, at least 10 had died.\u003c/p>\n\u003cp>Hundreds more are expected to be diagnosed with silicosis if harmful exposures continue. That’s partly because most of the roughly 800 stone fabrication shops in California are small and often don’t have the capacity to comply with existing safety regulations, Cal/OSHA officials said. The agency is now working to streamline and strengthen rules to stall the risk of silica exposure, which can also cause lung cancer.\u003c/p>\n\u003cp>“It’s a public health disaster,” said Dr. Sheiphali Gandhi, an occupational pulmonologist at UCSF who participated in a Cal/OSHA advisory committee to bolster existing silica standards. “We will keep seeing patients because a lot of people have already been exposed. So I think that, really, we are looking to improve things like five to 10 years down the road.”\u003c/p>\n\u003cp>The \u003ca href=\"https://www.dir.ca.gov/OSHSB/Respirable-Crystalline-Silica-Emergency.html\">emergency regulations\u003c/a>, if approved by the Occupational Safety and Health Standards Board, would restrict the dry cutting of artificial stone with more than 0.1% crystalline silica and natural stone that contains more than 10%. Tasks such as power cutting or drilling would require the use of wet-cutting saws or other tools that cover a material’s surface with water to suppress the dust. Employers would also be required to provide workers with powered air-purifying respirators or other highly protective masks.\u003c/p>\n\u003cp>Current \u003ca href=\"https://www.dir.ca.gov/title8/1532_3.html#:~:text=(1)%20Permissible%20exposure%20limit%20(,as%20an%208%2Dhour%20TWA.\">rules\u003c/a> say employers must first complete sophisticated air monitoring of permissible silica levels before determining required protective steps.\u003c/p>\n\u003cp>“The fact that we’re actually defining high risk based on the type of work rather than the air monitoring is a huge step in the right direction,” said Gandhi, who has diagnosed several silicosis patients, including Estrella Moreno. “Ideally, the best thing is to eliminate the toxic substance altogether. But if we are working with it, how can we do it safely?”\u003c/p>\n\u003cp>Estrella Moreno began working as a stonecutter in San Francisco shortly after immigrating from Mexico more than two decades ago. He liked using his hands to carve stone and install projects in kitchens and living rooms.\u003c/p>\n\u003cfigure id=\"attachment_11964918\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11964918\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-003-BL-KQED.jpg\" alt=\"A hand holds a phone showing the photo of a stone fireplace.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-003-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-003-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-003-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-003-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-003-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-003-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jorge Moreno holds a photo on his phone of stonecutting work from his job at his home in San Francisco on Oct. 17, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At his home in the Lower Nob Hill neighborhood, Estrella Moreno’s eyes lit up as he pointed to the smooth stone tables he had made. He proudly pulled up photographs on his phone of modern chimney panels and kitchen countertops he had also crafted.\u003c/p>\n\u003cp>It’s an “honest job” that allowed him to raise his three kids in the U.S., he said, even though he doesn’t know how to read and write. His parents never sent him to school as a child. Even before Estrella Moreno was orphaned by age 11, he worked in agricultural fields sowing corn and other crops in Michoacan. He’s provided for himself ever since. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“One comes to this country to support one’s family, to get ahead. Unfortunately, this turned out to be a dangerous job,” Estrella Moreno said before burying his head in his hands.\u003c/p>\n\u003cp>Silicosis makes him feel like he’s asphyxiating when walking uphill. Talking requires loud breaths in between words. Exertion can make him dizzy, Estrella Moreno said. His family has been warned that he might need an oxygen machine or a lung transplant as the disease progresses.\u003c/p>\n\u003cp>Yet, Estrella Moreno has refused to quit his job as a stonecutter, where he earns about $28 an hour.\u003c/p>\n\u003cp>“I have no other option. I have to work to support my family and pay rent,” said Estrella Moreno, adding that one of his sons is struggling with mental illness and can’t work. He needs money to pay for his son’s care.\u003c/p>\n\u003cfigure id=\"attachment_11964920\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11964920\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-012-BL-KQED.jpg\" alt=\"A hand holds a photo of an adult with three children.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-012-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-012-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-012-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-012-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-012-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-012-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jorge Moreno holds a photo of his family when his kids were younger at their home in San Francisco on Oct. 17, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Estrella Moreno’s eldest daughter, Rosa Estrella, told KQED she has pleaded with her father to stop working. A medical assistant, she said she has watched in anguish as her dad can no longer do things they enjoyed together, like a carefree walk in the park.\u003c/p>\n\u003cp>She said she wanted to save money to pay for college and eventually become a nurse. Instead, she is looking for a second job to help her parents.\u003c/p>\n\u003cp>“I have to think of them first,” Rosa Estrella, 29, said. “It’s so hard to be in this situation and watch my dad go through this and struggle so much.” \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Artificial stone workers in Israel, Spain, Australia and other countries have contracted a rapid onset of silicosis, which \u003ca href=\"https://www.cdc.gov/niosh/topics/silica/risks.html#:~:text=The%20type%20with%20the%20quickest,causing%20severe%20illness%20or%20death.\">can start developing\u003c/a> after only a few months of very high exposure.\u003c/p>\n\u003cp>In Australia, occupational safety authorities recently \u003ca href=\"https://www.safeworkaustralia.gov.au/sites/default/files/2023-10/decision_ris_-_prohibition_on_the_use_of_engineered_stone_-_27_october_2023.pdf\">recommended\u003c/a> a national ban on using all engineered stone, including newer products manufacturers have developed with 50% or less silica content.\u003c/p>\n\u003cp>Cal/OSHA officials \u003ca href=\"https://www.dir.ca.gov/oshsb/documents/petition-597-CalOSHAeval.pdf\">warned\u003c/a> that if widespread non-compliance with safety rules continues, the state should also develop plans to prohibit the use of engineered stone products, something major manufacturers and distributors vehemently oppose.\u003c/p>\n\u003cp>Public health officials in Los Angeles County, the state’s silicosis epicenter, recently \u003ca href=\"https://file.lacounty.gov/SDSInter/bos/bc/1150183_SilicosisPreventionandCareItem10BoardAgendaof6.6.2023.pdf\">concluded\u003c/a> that a local ban, which would only apply to the county’s unincorporated areas, could help protect workers and encourage safer alternatives.\u003c/p>\n\u003cp>Major artificial stone manufacturers maintain the material is being handled safely when appropriate measures, such as wet cutting and ventilation, are followed and that a ban would unnecessarily kill jobs.\u003c/p>\n\u003cfigure id=\"attachment_11964919\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11964919 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-009-BL-KQED.jpg\" alt=\"A person wearing a baseball cap lies down on a bed.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-009-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-009-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-009-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-009-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-009-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231017-StonecutterSilicosis-009-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jorge Estrella Moreno rests while his wife Maria Valencia reads the bible at their home in San Francisco on Oct. 17, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Silicosis is entirely preventable,” said Eric Rose, a spokesman with the Stone Coalition, which represents manufacturers, distributors and fabricators. “Any contractor that follows Cal/OSHA’s guidelines ensures that any product cutting is done safely and with little risk to workers. Almost all experts agree that what is being cut matters less than how the stone is cut.”\u003c/p>\n\u003cp>Top manufacturers, such as Cosentino, a company based in Spain, and the Israel-based Caesarstone, have told California regulators that they support creating a licensing program to sell engineered stone slabs only to fabrication businesses equipped to handle them safely.\u003c/p>\n\u003cp>Engineered stone, also known as quartz, is made of crushed stone bonded with adhesives and resins compacted into slabs in factories. Demand for it \u003ca href=\"https://www.freedoniagroup.com/industry-study/engineered-stone-countertops-4395.htm\">skyrocketed\u003c/a> in the U.S. over the last decade, becoming the top countertop material with a market size of \u003ca href=\"https://www.dir.ca.gov/OSHSB/documents/Respirable-Crystalline-Silica-Emergency-FOE.pdf\">$17.7 billion\u003c/a>, according to a Cal/OSHA review.\u003c/p>\n\u003cp>Consumers prefer it because it’s usually cheaper than natural stones such as marble. Its nonporous surface makes it easy to clean and difficult to stain, and it comes in a variety of colors and patterns. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Estrella Moreno said he first cut engineered stone slabs in 2007. But he said he didn’t know until his diagnosis about the risk of inhaling the fine dust clouds as he worked. He said he wore an N95 mask, but those are less efficient at filtering silica particles than other respirators.\u003c/p>\n\u003cp>Estrella Moreno blames the manufacturers and suppliers of engineered stone that he and his wife have sued for damages. Almost 60 fabrication workers with silicosis in California are also suing, according to James Nevin, an attorney for Estrella Moreno and other plaintiffs.\u003c/p>\n\u003cp>The lawsuits allege that the largest manufacturers — Caesarstone, Cosentino and Cambria, which is based in the U.S. — failed to adequately label and warn of the hazards of their products and didn’t issue effective instructions on how to use them safely.\u003c/p>\n\u003cp>“These companies knew they were selling a deadly product that was going to kill workers who have to fabricate it before it gets to the consumer,” Nevin said. “If there’s not a more clear case for a lawsuit, I don’t know what is.”\u003c/p>\n\u003cp>Maria Valencia, Estrella Moreno’s wife, said she and her husband hope that by speaking up, they help prevent others from going through the suffering their family is experiencing.\u003c/p>\n\u003cp>“The companies that are producing those materials that are so toxic, that have so much silica, they just want to enrich themselves at the expense of so many people they are going to kill,” said Valencia, 49, who works as a manager at a fast food restaurant. “For me, it’s an injustice that they are putting people in that risk. It’s inhumane.”\u003c/p>\n\u003cp>Caesarstone, Cosentino and Cambria declined to comment on the lawsuits.\u003c/p>\n\u003cp>Earlier this year, the owner of Cosentino \u003ca href=\"https://www.reuters.com/business/owner-spains-cosentino-admits-concealing-cause-silicosis-1900-workers-2023-02-07/\">admitted negligence\u003c/a> in a Spanish court for hiding the health risks of one of its best-selling artificial stone products, which allegedly led to nearly 1,900 workers developing silicosis. He agreed to pay 1.1 million euros to five stonemasons, one of whom had died and was given a six-month suspended sentence as part of a plea deal.\u003c/p>\n\u003cp>In the Bay Area, the father and son duo, who run a well-established stone fabrication facility in Santa Clara, are also calling for solutions, including a more regulated distribution market, stricter enforcement, and the sale of engineered stone products developed with a lower silica content. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Manny De Oliveira, who founded United Marble & Granite Inc. in 1998, and his son, Shawn, lamented what they described as a proliferation of slab yards and stone distributors along nearby highways that sell engineered stone to “anyone with a credit card.” That’s led to “poor guys that don’t even speak English that get taken advantage of” laboring in the back of a truck or store “with just a T-shirt pulled up to cover their nose,” said De Oliveira, 67.\u003c/p>\n\u003cp>The De Oliveiras estimate that a small fabrication shop, with just two or three workers, would need to invest hundreds of thousands of dollars in basic equipment and other measures to keep workers safe.\u003c/p>\n\u003cp>On a recent visit to the company’s cavernous workspace, a KQED reporter observed employees in hardhats operating large robotic saws neatly slicing stone slabs layered in water from a computer screen. Others held smaller tools, releasing a water flow as they cut pieces. And in a blocked-off area, two workers wearing white industrial coveralls and powered air-purifying respirators finished the edges of a countertop as a ventilation system sucked dust into a duct with a running water curtain.\u003c/p>\n\u003cp>“If you go to a lot of other shops, you’ll see this activity without the machines, without the suit. That’s the problem — guys are working dry without engineering controls, the equipment or protection,” Shawn De Oliveira, 42, said. “Everybody wants to be a fabricator, but nobody wants to do the safety part because it’s expensive. And the customer doesn’t even know what’s going on.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Things didn’t go as planned when DeAnna Jones, 31, delivered her first child in Oakland three years ago.\u003c/p>\n\u003cp>She wanted to have a natural birth, but early contractions led doctors to medically induce her labor a week earlier than her due date. Her daughter’s birth turned out well, but she wished she had known more going into the experience.\u003c/p>\n\u003cp>“I did have a birth plan, and getting induced was not part of that,” Jones said. “So when it came at 39 weeks to be induced, I was like, okay … but I didn’t necessarily say why or can I wait until I’m actually 40 weeks or things that I probably should have asked.”\u003c/p>\n\u003cfigure id=\"attachment_11968844\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11968844\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-023-JY-qut.jpg\" alt=\"Two African American women smiles as they go over a chart.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-023-JY-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-023-JY-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-023-JY-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-023-JY-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-023-JY-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">BElovedBIRTH Black Centering midwife Chantal Davis (left) holds up an infographic on decision making alongside program director Jyesha Wren (right) during a group care session for expectant Black mothers at the Alameda Wellness Center in Oakland on Wednesday, Nov. 8, 2023. \u003ccite>(Juliana Yamada/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Jones didn’t feel mistreated during her experience at the Wilma Chan Highland Hospital Campus, but it gave her pause when she became pregnant again.\u003c/p>\n\u003cp>So Jones was excited when, around eight weeks into her second pregnancy, she was invited to participate in a group perinatal care program that’s trying to improve the patient experience for Black women like her who live in Alameda County. The program, called BElovedBIRTH Black Centering, is resulting in healthier births and prompting state officials to look into expanding it to other public hospitals in California.\u003c/p>\n\u003cp>The program groups up to a dozen Black women in similar stages of pregnancy and offers them care from a team of Black doctors, midwives, doulas, nutritionists, breastfeeding experts and other wellness professionals. Participants receive a range of services before, during and after giving birth — from childbirth education to mental health support and social services.\u003c/p>\n\u003cfigure id=\"attachment_11968845\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11968845\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-014-JY-qut.jpg\" alt=\"African American women smile as they sit in a circle and listen to one of them speak.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-014-JY-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-014-JY-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-014-JY-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-014-JY-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-014-JY-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Latasha Dixon (center) acts out a decision-making scenario during a BElovedBIRTH Black Centering group care session for expectant Black mothers at the Alameda Wellness Center. \u003ccite>(Juliana Yamada/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The program also harnesses donations from the community to give away fresh produce, baby supplies, postpartum meal deliveries and pregnancy portraits with a professional photographer.\u003c/p>\n\u003cp>“We have really adopted the ‘it takes a village’ mindset and the commitment to say, okay, if we know better, we have to do better,” said Jyesha Wren, a midwife and director of the program.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Jyesha Wren, director, BElovedBIRTH Black Centering\"]‘We have really adopted the ‘it takes a village’ mindset and the commitment to say, okay, if we know better, we have to do better.’[/pullquote]Wren, along with the Alameda Health System, which operates Highland Hospital and other community health centers, and the Alameda County Public Health Department, launched the program in 2020 to address the alarming rate of pregnancy-related deaths and complications affecting Black women. So far, the $3.5 million public-private initiative has served more than 200 patients who qualify for Medi-Cal because of their low income.\u003c/p>\n\u003cp>American women are dying during pregnancy or in the year after \u003ca href=\"https://www.commonwealthfund.org/blog/2022/us-maternal-mortality-crisis-continues-worsen-international-comparison\">at a far higher rate than in other wealthy nations\u003c/a>, and \u003ca href=\"https://www.cdc.gov/healthequity/features/maternal-mortality/index.html\">Black women are three times as likely to die\u003c/a> from giving birth as white mothers.\u003c/p>\n\u003cp>While California’s maternal mortality rate has been \u003ca href=\"https://www.cmqcc.org/research/maternal-mortality-review-ca-pamr/ca-pamr-recent-data\">lower than the rest of the \u003c/a>country in the last decade, \u003ca href=\"https://www.nber.org/system/files/working_papers/w30693/w30693.pdf\">a landmark study of babies born in the state (PDF)\u003c/a> between 2007 and 2016 found that childbirth is riskier for Black women, regardless of their socioeconomic status. The study, which examines birth, death and hospitalization records with income tax and demographic data, found that high-income Black mothers have the same risk of dying in the first year after giving birth as the poorest white mothers.\u003c/p>\n\u003cp>“There are many factors that may be driving this, but the primary factor behind all of that is racism in all of its forms, whether that’s structural or institutional or interpersonal racism,” said Kim Harley, a researcher at UC Berkeley’s School of Public Health. “We see that impacting the whole life course of Black birthing people, and it’s shown in the outcomes that they have during pregnancy.”\u003c/p>\n\u003cfigure id=\"attachment_11968851\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11968851\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-019-JY-qut.jpg\" alt=\"A pregnant African American woman looks on as someone handles a catheter in a room with chairs.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-019-JY-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-019-JY-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-019-JY-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-019-JY-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-019-JY-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">DeAnna Jones watches as BElovedBIRTH Black Centering team members demonstrate a balloon catheter procedure during birth at a group care session for expectant Black mothers at the Alameda Wellness Center. \u003ccite>(Juliana Yamada/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>More recently, a survey of 2,400 mothers by the U.S. Centers for Disease Control and Prevention found that \u003ca href=\"https://www.cdc.gov/vitalsigns/respectful-maternity-care/index.html\">one in five women said they had been mistreated \u003c/a>while receiving maternity care. Mistreatment was reported most often by Black, Hispanic and multiracial moms and those with public or no insurance. What’s more, almost half of the women surveyed said they held back in asking questions or sharing concerns with their providers because they didn’t want to “make a big deal” or not feeling confident that they knew what they were talking about.\u003c/p>\n\u003ch2>A unique model of care\u003c/h2>\n\u003cp>BElovedBIRTH combines several strategies, such as having a doula provide nonmedical support during a birth, that \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10292163/\">has been shown to improve outcomes\u003c/a> for Black mothers and their babies.\u003c/p>\n\u003cp>While typical prenatal checkups last about 15 minutes and can leave parents feeling rushed and overwhelmed, BElovedBIRTH takes a different approach. Participants partake in group prenatal care, also known as centering, where they get two hours to learn about what’s happening to their bodies and ask questions.\u003c/p>\n\u003cfigure id=\"attachment_11968848\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11968848\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-028-JY-qut.jpg\" alt=\"A pregnant woman is laying down and receiving prenatal care from another woman.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-028-JY-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-028-JY-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-028-JY-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-028-JY-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-028-JY-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Midwife Chantal Davis finishes checking Taj’ae Harris’ baby’s heartbeat during a checkup at BElovedBIRTH Black Centering’s group care session for expectant Black mothers at the Alameda Wellness Center. \u003ccite>(Juliana Yamada/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>BElovedBIRTH participants meet twice a month at a clinic located in a former shopping mall in East Oakland, but the setting feels nothing like a medical office. Portraits of pregnant Black people hang on the wall and mellow Afrobeat music plays in the background. There’s a lounge filled with books where women sip tea and chat with each other.\u003c/p>\n\u003cp>[aside label=\"Related Stories\" postID=\"news_11965919,news_11943821,news_11958841\"]During a recent visit, six women, including DeAnna Jones, took turns going behind a room divider where a nurse measured their blood pressure and their baby’s heartbeat.\u003c/p>\n\u003cp>Then, they formed a circle to learn from a team of Black midwives and doulas about different methods for speeding up labor and the pros and cons of each one. They also role-played what it might be like if their deliveries don’t go as planned.\u003c/p>\n\u003cp>Dressed in a T-shirt that exposed her full belly, Jones went over a scenario where she was admitted to the hospital with high blood pressure. A midwife suggested speeding up contractions with medication or a balloon-like device to widen her cervix.\u003c/p>\n\u003cp>Jones weighed the risks and benefits of using either method or doing nothing at all and asked: “Is there a possibility that I can wait a little bit?” A doula stepped in and asked if she needed more time to discuss the options.\u003c/p>\n\u003cp>Jones said, “Yes,” seemingly relieved to have that choice.\u003c/p>\n\u003cfigure id=\"attachment_11968849\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11968849\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-016-JY-qut.jpg\" alt=\"An African American woman holds a natal chart in front of a class.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-016-JY-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-016-JY-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-016-JY-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-016-JY-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-016-JY-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Doula Mysti Dyse holds up a chart displaying cervix dilation during a BElovedBIRTH Black Centering group care session for expectant Black mothers at the Alameda Wellness Center. \u003ccite>(Juliana Yamada/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The purpose of the exercise was to empower patients to make informed decisions.\u003c/p>\n\u003cp>“These things may seem kind of simple and basic, but the sad reality is that in most medicalized health care, they’re not happening,” Wren said.\u003c/p>\n\u003cp>“There’s no time for them to get information. There’s no time for them to be actually taking charge of their health care in that way and knowing what’s going on with their bodies and making their decisions and having them respected.”\u003c/p>\n\u003cfigure id=\"attachment_11968850\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11968850\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-007-JY-qut.jpg\" alt=\"An African American woman smiles as she sits in front of a whiteboard with writing on it.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-007-JY-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-007-JY-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-007-JY-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-007-JY-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-007-JY-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">BElovedBIRTH Black Centering Program Director Jyesha Wren holds a group care session for expectant Black mothers at the Alameda Wellness Center. \u003ccite>(Juliana Yamada/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In an independent survey of Black moms who participated in the program, the majority said they felt less stressed during pregnancy and more prepared to advocate for themselves.\u003c/p>\n\u003cp>Taj’ae Harris, 20, said before coming here, much of what she knew about childbirth came from TikTok and YouTube.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Taj’ae Harris, program participant\"]‘I’ve been learning a lot of things, like the steps, like coping during labor, different tools being used, different things to ask the doctors, different things to make you feel safe.’[/pullquote]“But then actually coming in here and learning even more stuff, it all, like, pieced together,” she said. “So I’ve been learning a lot of things, like the steps, like coping during labor, different tools being used, different things to ask the doctors, different things to make you feel safe.”\u003c/p>\n\u003cp>Meanwhile, Jones said she feels more confident as she prepares for her second delivery.\u003c/p>\n\u003cp>“I wish I had this program then, but now that I’m in it, I’m excited and ready to go,” she said.\u003c/p>\n\u003cp>An ongoing study led by Harley, the reproductive epidemiologist at UC Berkeley, found that the BElovedBIRTH participants’ babies had a higher rate of being born at full term and with a healthy birth weight than other Black babies born at Highland, which is Alameda County’s main public hospital.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The California Department of Health Care Services, which administers Medi-Cal, is exploring ways to make a program like BElovedBIRTH financially sustainable so it can be implemented in other public health systems.\u003c/p>\n\u003cp>The program would expand the state’s recent efforts to\u003ca href=\"https://www.cdph.ca.gov/Programs/CFH/DMCAH/PEI/Pages/default.aspx\"> improve health equity for new parents and babies\u003c/a>. The state already expanded postpartum care and access to doulas for Medi-Cal patients. It’s starting to offer unconditional cash, ranging from $600 to $1000 per month, to pregnant people in certain communities who are at high risk for preterm birth or postpartum complications. The state’s pilot project is an expansion of \u003ca href=\"https://pretermbirthca.ucsf.edu/expecting-justice\">a San Francisco experiment that provides extra cash and doula care for Black and Pacific Islander pregnant people\u003c/a> — two groups that have the highest preterm birth rate in the city.\u003c/p>\n\u003cp>The state is also putting pressure on perinatal care providers to comply with a law requiring that their workers undergo unconscious bias training.\u003c/p>\n\u003cfigure id=\"attachment_11968854\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11968854\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-025-JY-qut.jpg\" alt=\"Five African American women sit in a room, smiling and conversing.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-025-JY-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-025-JY-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-025-JY-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-025-JY-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-025-JY-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">From left to right: Monique Gomez, Taj’ae Harris, and Latasha Dixon attend a BElovedBIRTH Black Centering group care session for expectant Black mothers alongside midwife Chantal Davis and doula Mystic Dyse at the Alameda Wellness Center. \u003ccite>(Juliana Yamada/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But two years after that law took effect, \u003ca href=\"https://www.kqed.org/news/11965919/california-hospitals-ignored-bias-training-despite-high-black-maternal-death-rate\">an investigation by the state Department of Justice\u003c/a> found only 17% of those providers began training their employees.\u003c/p>\n\u003cp>Wren said mandating unconscious bias training is a step in the right direction, but she thinks advancing health equity will also require empowering pregnant Black people so that they can demand a higher standard of care and holding health care providers accountable.\u003c/p>\n\u003cp>“It really is a matter of life and death for our health system to do things differently because we know that if we continue to deliver health care in the way that we have, we’ll continue to have preventable morbidity and mortality,” she said.\u003c/p>\n\u003ch2>A legacy of fighting for health equity\u003c/h2>\n\u003cp>Wren says the BElovedBIRTH Black Centering is thriving because of grassroots support in a community with a tradition of activism. It draws inspiration from the Black Panthers Party, which operated more than a dozen free medical clinics for Black communities in Oakland and elsewhere in the 1960s and 70s.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Jyesha Wren, director, BElovedBIRTH Black Centering\"]‘It really is a matter of life and death for our health system to do things differently because we know that if we continue to deliver health care in the way that we have, we’ll continue to have preventable morbidity and mortality.’[/pullquote]They “really recognized the health impacts of racism in all of its forms and the need to do community-centered health care work that was by and for us,” she said.\u003c/p>\n\u003cp>The Oakland area also benefits from having a larger than usual pool of Black midwives, doulas and maternity care providers.\u003c/p>\n\u003cp>Wren credits the former head of Highland Hospital’s Maternal and Child Health department for taking the unusual step in the 1980s of including midwives in the labor and delivery room. That wasn’t common practice then but has since been shown to lower birth complications. The move created a robust midwife department, and some of its staff members are now supporting BElovedBIRTH participants.\u003c/p>\n\u003cfigure id=\"attachment_11968855\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11968855\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-003-JY-qut.jpg\" alt=\"A wall full of photos, cards, messages.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-003-JY-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-003-JY-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-003-JY-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-003-JY-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-003-JY-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Pregnancy portraits fill the walls of BElovedBIRTH Black Centering at the Alameda Wellness Center. \u003ccite>(Juliana Yamada/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The doctor who advocated for midwives was James Jackson. His son, James E.T. Jackson, is now CEO of Alameda Health System.\u003c/p>\n\u003cp>“He understood their value, and what the Beloved program has shown is that the cohort model and working with midwives and doulas create a safe space for these mothers that they did not have before,” he said.\u003c/p>\n\u003cp>Alameda Health System is encouraged by the outcomes, the younger Jackson said and is looking to expand the program to other ethnic groups experiencing disproportionate rates of maternal and infant mortality.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "A new group prenatal care program called BElovedBIRTH Black Centering is resulting in healthier births and prompting state officials to look into expanding it to other public hospitals in California.",
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"title": "Maternity Group Care for and by Black People Is Improving Outcomes in Oakland | KQED",
"description": "A new group prenatal care program called BElovedBIRTH Black Centering is resulting in healthier births and prompting state officials to look into expanding it to other public hospitals in California.",
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"headline": "Maternity Group Care for and by Black People Is Improving Outcomes in Oakland",
"datePublished": "2023-12-04T07:30:45-08:00",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Things didn’t go as planned when DeAnna Jones, 31, delivered her first child in Oakland three years ago.\u003c/p>\n\u003cp>She wanted to have a natural birth, but early contractions led doctors to medically induce her labor a week earlier than her due date. Her daughter’s birth turned out well, but she wished she had known more going into the experience.\u003c/p>\n\u003cp>“I did have a birth plan, and getting induced was not part of that,” Jones said. “So when it came at 39 weeks to be induced, I was like, okay … but I didn’t necessarily say why or can I wait until I’m actually 40 weeks or things that I probably should have asked.”\u003c/p>\n\u003cfigure id=\"attachment_11968844\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11968844\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-023-JY-qut.jpg\" alt=\"Two African American women smiles as they go over a chart.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-023-JY-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-023-JY-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-023-JY-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-023-JY-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-023-JY-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">BElovedBIRTH Black Centering midwife Chantal Davis (left) holds up an infographic on decision making alongside program director Jyesha Wren (right) during a group care session for expectant Black mothers at the Alameda Wellness Center in Oakland on Wednesday, Nov. 8, 2023. \u003ccite>(Juliana Yamada/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Jones didn’t feel mistreated during her experience at the Wilma Chan Highland Hospital Campus, but it gave her pause when she became pregnant again.\u003c/p>\n\u003cp>So Jones was excited when, around eight weeks into her second pregnancy, she was invited to participate in a group perinatal care program that’s trying to improve the patient experience for Black women like her who live in Alameda County. The program, called BElovedBIRTH Black Centering, is resulting in healthier births and prompting state officials to look into expanding it to other public hospitals in California.\u003c/p>\n\u003cp>The program groups up to a dozen Black women in similar stages of pregnancy and offers them care from a team of Black doctors, midwives, doulas, nutritionists, breastfeeding experts and other wellness professionals. Participants receive a range of services before, during and after giving birth — from childbirth education to mental health support and social services.\u003c/p>\n\u003cfigure id=\"attachment_11968845\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11968845\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-014-JY-qut.jpg\" alt=\"African American women smile as they sit in a circle and listen to one of them speak.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-014-JY-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-014-JY-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-014-JY-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-014-JY-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-014-JY-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Latasha Dixon (center) acts out a decision-making scenario during a BElovedBIRTH Black Centering group care session for expectant Black mothers at the Alameda Wellness Center. \u003ccite>(Juliana Yamada/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The program also harnesses donations from the community to give away fresh produce, baby supplies, postpartum meal deliveries and pregnancy portraits with a professional photographer.\u003c/p>\n\u003cp>“We have really adopted the ‘it takes a village’ mindset and the commitment to say, okay, if we know better, we have to do better,” said Jyesha Wren, a midwife and director of the program.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Wren, along with the Alameda Health System, which operates Highland Hospital and other community health centers, and the Alameda County Public Health Department, launched the program in 2020 to address the alarming rate of pregnancy-related deaths and complications affecting Black women. So far, the $3.5 million public-private initiative has served more than 200 patients who qualify for Medi-Cal because of their low income.\u003c/p>\n\u003cp>American women are dying during pregnancy or in the year after \u003ca href=\"https://www.commonwealthfund.org/blog/2022/us-maternal-mortality-crisis-continues-worsen-international-comparison\">at a far higher rate than in other wealthy nations\u003c/a>, and \u003ca href=\"https://www.cdc.gov/healthequity/features/maternal-mortality/index.html\">Black women are three times as likely to die\u003c/a> from giving birth as white mothers.\u003c/p>\n\u003cp>While California’s maternal mortality rate has been \u003ca href=\"https://www.cmqcc.org/research/maternal-mortality-review-ca-pamr/ca-pamr-recent-data\">lower than the rest of the \u003c/a>country in the last decade, \u003ca href=\"https://www.nber.org/system/files/working_papers/w30693/w30693.pdf\">a landmark study of babies born in the state (PDF)\u003c/a> between 2007 and 2016 found that childbirth is riskier for Black women, regardless of their socioeconomic status. The study, which examines birth, death and hospitalization records with income tax and demographic data, found that high-income Black mothers have the same risk of dying in the first year after giving birth as the poorest white mothers.\u003c/p>\n\u003cp>“There are many factors that may be driving this, but the primary factor behind all of that is racism in all of its forms, whether that’s structural or institutional or interpersonal racism,” said Kim Harley, a researcher at UC Berkeley’s School of Public Health. “We see that impacting the whole life course of Black birthing people, and it’s shown in the outcomes that they have during pregnancy.”\u003c/p>\n\u003cfigure id=\"attachment_11968851\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11968851\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-019-JY-qut.jpg\" alt=\"A pregnant African American woman looks on as someone handles a catheter in a room with chairs.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-019-JY-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-019-JY-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-019-JY-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-019-JY-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-019-JY-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">DeAnna Jones watches as BElovedBIRTH Black Centering team members demonstrate a balloon catheter procedure during birth at a group care session for expectant Black mothers at the Alameda Wellness Center. \u003ccite>(Juliana Yamada/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>More recently, a survey of 2,400 mothers by the U.S. Centers for Disease Control and Prevention found that \u003ca href=\"https://www.cdc.gov/vitalsigns/respectful-maternity-care/index.html\">one in five women said they had been mistreated \u003c/a>while receiving maternity care. Mistreatment was reported most often by Black, Hispanic and multiracial moms and those with public or no insurance. What’s more, almost half of the women surveyed said they held back in asking questions or sharing concerns with their providers because they didn’t want to “make a big deal” or not feeling confident that they knew what they were talking about.\u003c/p>\n\u003ch2>A unique model of care\u003c/h2>\n\u003cp>BElovedBIRTH combines several strategies, such as having a doula provide nonmedical support during a birth, that \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10292163/\">has been shown to improve outcomes\u003c/a> for Black mothers and their babies.\u003c/p>\n\u003cp>While typical prenatal checkups last about 15 minutes and can leave parents feeling rushed and overwhelmed, BElovedBIRTH takes a different approach. Participants partake in group prenatal care, also known as centering, where they get two hours to learn about what’s happening to their bodies and ask questions.\u003c/p>\n\u003cfigure id=\"attachment_11968848\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11968848\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-028-JY-qut.jpg\" alt=\"A pregnant woman is laying down and receiving prenatal care from another woman.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-028-JY-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-028-JY-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-028-JY-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-028-JY-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-028-JY-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Midwife Chantal Davis finishes checking Taj’ae Harris’ baby’s heartbeat during a checkup at BElovedBIRTH Black Centering’s group care session for expectant Black mothers at the Alameda Wellness Center. \u003ccite>(Juliana Yamada/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>BElovedBIRTH participants meet twice a month at a clinic located in a former shopping mall in East Oakland, but the setting feels nothing like a medical office. Portraits of pregnant Black people hang on the wall and mellow Afrobeat music plays in the background. There’s a lounge filled with books where women sip tea and chat with each other.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>During a recent visit, six women, including DeAnna Jones, took turns going behind a room divider where a nurse measured their blood pressure and their baby’s heartbeat.\u003c/p>\n\u003cp>Then, they formed a circle to learn from a team of Black midwives and doulas about different methods for speeding up labor and the pros and cons of each one. They also role-played what it might be like if their deliveries don’t go as planned.\u003c/p>\n\u003cp>Dressed in a T-shirt that exposed her full belly, Jones went over a scenario where she was admitted to the hospital with high blood pressure. A midwife suggested speeding up contractions with medication or a balloon-like device to widen her cervix.\u003c/p>\n\u003cp>Jones weighed the risks and benefits of using either method or doing nothing at all and asked: “Is there a possibility that I can wait a little bit?” A doula stepped in and asked if she needed more time to discuss the options.\u003c/p>\n\u003cp>Jones said, “Yes,” seemingly relieved to have that choice.\u003c/p>\n\u003cfigure id=\"attachment_11968849\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11968849\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-016-JY-qut.jpg\" alt=\"An African American woman holds a natal chart in front of a class.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-016-JY-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-016-JY-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-016-JY-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-016-JY-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-016-JY-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Doula Mysti Dyse holds up a chart displaying cervix dilation during a BElovedBIRTH Black Centering group care session for expectant Black mothers at the Alameda Wellness Center. \u003ccite>(Juliana Yamada/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The purpose of the exercise was to empower patients to make informed decisions.\u003c/p>\n\u003cp>“These things may seem kind of simple and basic, but the sad reality is that in most medicalized health care, they’re not happening,” Wren said.\u003c/p>\n\u003cp>“There’s no time for them to get information. There’s no time for them to be actually taking charge of their health care in that way and knowing what’s going on with their bodies and making their decisions and having them respected.”\u003c/p>\n\u003cfigure id=\"attachment_11968850\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11968850\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-007-JY-qut.jpg\" alt=\"An African American woman smiles as she sits in front of a whiteboard with writing on it.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-007-JY-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-007-JY-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-007-JY-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-007-JY-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-007-JY-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">BElovedBIRTH Black Centering Program Director Jyesha Wren holds a group care session for expectant Black mothers at the Alameda Wellness Center. \u003ccite>(Juliana Yamada/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In an independent survey of Black moms who participated in the program, the majority said they felt less stressed during pregnancy and more prepared to advocate for themselves.\u003c/p>\n\u003cp>Taj’ae Harris, 20, said before coming here, much of what she knew about childbirth came from TikTok and YouTube.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘I’ve been learning a lot of things, like the steps, like coping during labor, different tools being used, different things to ask the doctors, different things to make you feel safe.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“But then actually coming in here and learning even more stuff, it all, like, pieced together,” she said. “So I’ve been learning a lot of things, like the steps, like coping during labor, different tools being used, different things to ask the doctors, different things to make you feel safe.”\u003c/p>\n\u003cp>Meanwhile, Jones said she feels more confident as she prepares for her second delivery.\u003c/p>\n\u003cp>“I wish I had this program then, but now that I’m in it, I’m excited and ready to go,” she said.\u003c/p>\n\u003cp>An ongoing study led by Harley, the reproductive epidemiologist at UC Berkeley, found that the BElovedBIRTH participants’ babies had a higher rate of being born at full term and with a healthy birth weight than other Black babies born at Highland, which is Alameda County’s main public hospital.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The California Department of Health Care Services, which administers Medi-Cal, is exploring ways to make a program like BElovedBIRTH financially sustainable so it can be implemented in other public health systems.\u003c/p>\n\u003cp>The program would expand the state’s recent efforts to\u003ca href=\"https://www.cdph.ca.gov/Programs/CFH/DMCAH/PEI/Pages/default.aspx\"> improve health equity for new parents and babies\u003c/a>. The state already expanded postpartum care and access to doulas for Medi-Cal patients. It’s starting to offer unconditional cash, ranging from $600 to $1000 per month, to pregnant people in certain communities who are at high risk for preterm birth or postpartum complications. The state’s pilot project is an expansion of \u003ca href=\"https://pretermbirthca.ucsf.edu/expecting-justice\">a San Francisco experiment that provides extra cash and doula care for Black and Pacific Islander pregnant people\u003c/a> — two groups that have the highest preterm birth rate in the city.\u003c/p>\n\u003cp>The state is also putting pressure on perinatal care providers to comply with a law requiring that their workers undergo unconscious bias training.\u003c/p>\n\u003cfigure id=\"attachment_11968854\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11968854\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-025-JY-qut.jpg\" alt=\"Five African American women sit in a room, smiling and conversing.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-025-JY-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-025-JY-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-025-JY-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-025-JY-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-025-JY-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">From left to right: Monique Gomez, Taj’ae Harris, and Latasha Dixon attend a BElovedBIRTH Black Centering group care session for expectant Black mothers alongside midwife Chantal Davis and doula Mystic Dyse at the Alameda Wellness Center. \u003ccite>(Juliana Yamada/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But two years after that law took effect, \u003ca href=\"https://www.kqed.org/news/11965919/california-hospitals-ignored-bias-training-despite-high-black-maternal-death-rate\">an investigation by the state Department of Justice\u003c/a> found only 17% of those providers began training their employees.\u003c/p>\n\u003cp>Wren said mandating unconscious bias training is a step in the right direction, but she thinks advancing health equity will also require empowering pregnant Black people so that they can demand a higher standard of care and holding health care providers accountable.\u003c/p>\n\u003cp>“It really is a matter of life and death for our health system to do things differently because we know that if we continue to deliver health care in the way that we have, we’ll continue to have preventable morbidity and mortality,” she said.\u003c/p>\n\u003ch2>A legacy of fighting for health equity\u003c/h2>\n\u003cp>Wren says the BElovedBIRTH Black Centering is thriving because of grassroots support in a community with a tradition of activism. It draws inspiration from the Black Panthers Party, which operated more than a dozen free medical clinics for Black communities in Oakland and elsewhere in the 1960s and 70s.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>They “really recognized the health impacts of racism in all of its forms and the need to do community-centered health care work that was by and for us,” she said.\u003c/p>\n\u003cp>The Oakland area also benefits from having a larger than usual pool of Black midwives, doulas and maternity care providers.\u003c/p>\n\u003cp>Wren credits the former head of Highland Hospital’s Maternal and Child Health department for taking the unusual step in the 1980s of including midwives in the labor and delivery room. That wasn’t common practice then but has since been shown to lower birth complications. The move created a robust midwife department, and some of its staff members are now supporting BElovedBIRTH participants.\u003c/p>\n\u003cfigure id=\"attachment_11968855\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11968855\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-003-JY-qut.jpg\" alt=\"A wall full of photos, cards, messages.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-003-JY-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-003-JY-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-003-JY-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-003-JY-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/20231108-Alameda-Black-Maternal-Health-003-JY-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Pregnancy portraits fill the walls of BElovedBIRTH Black Centering at the Alameda Wellness Center. \u003ccite>(Juliana Yamada/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The doctor who advocated for midwives was James Jackson. His son, James E.T. Jackson, is now CEO of Alameda Health System.\u003c/p>\n\u003cp>“He understood their value, and what the Beloved program has shown is that the cohort model and working with midwives and doulas create a safe space for these mothers that they did not have before,” he said.\u003c/p>\n\u003cp>Alameda Health System is encouraged by the outcomes, the younger Jackson said and is looking to expand the program to other ethnic groups experiencing disproportionate rates of maternal and infant mortality.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cem>Updated 11:15 a.m., December 13\u003c/em>\u003c/p>\n\u003cp>The 2023-2024 winter respiratory virus season is here. And alongside \u003ca href=\"https://www.kqed.org/news/11957790/the-new-covid-eris-variant-and-rising-cases-what-you-need-to-know\">the latest COVID-19 variant \u003c/a>and\u003ca href=\"https://www.kqed.org/news/11961649/when-should-i-get-2023-flu-shot-safe-with-new-covid-vaccine-rsv\"> the return of flu season\u003c/a>, RSV is once again on the rise around the Bay Area.\u003c/p>\n\u003cp>RSV — which stands for Respiratory Syncytial (\u003ca href=\"https://www.cdc.gov/rsv/index.html\">pronounced “sin-SISH-uhl”\u003c/a>) Virus — usually causes “mild, cold-like symptoms,” according to the U.S. Centers for Disease Control and Prevention. But in infants, young children and adults over 60, this respiratory virus can attack a weakened immune system to cause severe sickness, leading to hospitalization and even — in serious cases — death.\u003c/p>\n\u003cp>People in these age groups and the people who care for them are often warned by their health care providers about the dangers of RSV transmission and offered vaccination against the virus. However, there are a lot of people who may not even know RSV exists, let alone how dangerous it can be to spread it to others accidentally — even if getting infected themselves only means mild symptoms.\u003c/p>\n\u003cp>Keep reading for what to know about RSV testing, how to spot an RSV infection, incubation periods, and who’s eligible for the new RSV vaccine.\u003c/p>\n\u003cp>\u003cstrong>Jump straight to:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#anchor1\">How bad is RSV in the Bay Area now?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#anchor2\">Can I get tested?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#anchor3\">How do I know if my “cold” is actually RSV?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#anchor4\">If I get infected but I’m not high risk, what should I do?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#anchor5\">Why are younger and older people more at risk, and when is it time to seek medical attention?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#anchor6\">Who can get the RSV vaccine?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003ch2>\u003ca id=\"anchor1\">\u003c/a>How bad is RSV around the Bay Area right now?\u003c/h2>\n\u003cp>In its weekly report, on Dec. 8, the CDC said that \u003ca href=\"https://www.cdc.gov/respiratory-viruses/data-research/dashboard/snapshot.html\">the U.S. is “experiencing elevated RSV activity, particularly among young children\u003c/a>” — and that there is currently \u003ca href=\"https://www.cdc.gov/respiratory-viruses/index.html\">“high overall respiratory illness activity” in California.\u003c/a>\u003c/p>\n\u003cp>The impacts on the state’s hospital capacity are already being felt, and \u003ca href=\"https://www.kqed.org/science/1985786/bay-area-covid-flu-cases-on-the-rise-but-not-surging-like-last-year\">three-quarters of intensive care beds around California are full\u003c/a>, according to the CDC.\u003c/p>\n\u003cp>\u003ca href=\"https://www.wastewaterscan.org/en/about\">The WastewaterSCAN project\u003c/a> monitors the presence of viruses — including RSV, COVID-19 and the flu — in wastewater across the U.S. Alexandria Boehm, a Stanford professor of civil and environmental engineering, who helps lead the project, provided KQED with the latest snapshot data on Nov. 30, that found RSV “levels are trending up and high,” and that “all sites in the Bay Area are categorized as in the high wastewater category” for the virus. This upward trend indicates that the Bay Area is “headed towards \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9844019/\">the levels we saw last year”\u003c/a>. \u003ca href=\"https://www.kqed.org/science/1985786/bay-area-covid-flu-cases-on-the-rise-but-not-surging-like-last-year\">Levels of flu and COVID are also increasing in local wastewater, said Boehm\u003c/a>. [pullquote align=\"right\" size=\"medium\" citation=\"Dr.Peter Chin-Hong, UCSF infectious disease specialist\"]‘If you don’t feel like your whole body is on fire, and it feels like a cold — these days, chances are that it’s going to be RSV.’[/pullquote]\u003c/p>\n\u003cp>In Santa Clara County, health officials recently warned of a dramatic increase in winter viruses in the county’s wastewater — and an especially sharp rise in RSV levels, which the county’s Deputy Health Officer Dr. Sarah Rudman said had doubled in the month leading up to Thanksgiving.\u003c/p>\n\u003cp>“That worries me,” Rudman told KQED on Monday, “that especially after this holiday weekend with everyone’s travel and gathering there, we’re going to see even higher levels [afterward].”\u003c/p>\n\u003cp>Dr. Peter Chin-Hong, an infectious disease specialist at UCSF, said that when it comes to lab testing at his hospital right now, more tests are coming back positive for RSV than for the flu or COVID-19.\u003c/p>\n\u003ch2>\u003ca id=\"anchor2\">\u003c/a>What about testing for RSV?\u003c/h2>\n\u003cp>At-home testing for RSV isn’t available in the way it is for COVID-19. The only places you’d typically have access to a formal RSV test are at an urgent care center, the emergency room, or elsewhere in a hospital, Chin-Hong said.\u003c/p>\n\u003cp>“I think in the future it’d be great to have a home test for COVID, flu and RSV,” he said. “But right now, we just have COVID [testing] at home.”\u003c/p>\n\u003cp>Chin-Hong acknowledges the downsides of being unable to access an RSV test outside of these clinical settings. “It’s good to know so that you don’t infect the very young and very old, who can have more serious consequences,” he said.\u003c/p>\n\u003cp>And on that note …\u003c/p>\n\u003ch2>\u003ca id=\"anchor3\">\u003c/a>So, what are RSV symptoms? How are they different from COVID-19 or the flu?\u003c/h2>\n\u003cp>RSV, Chin-Hong said, “seems like a cold for most people. But that ‘cold’ infecting somebody under two, or older than 60, can land them in the hospital.”\u003c/p>\n\u003cp>According to the CDC,\u003ca href=\"https://www.cdc.gov/rsv/about/symptoms.html\"> the symptoms of RSV infection\u003c/a> “usually appear in stages and not all at once,” and can include:\u003c/p>\n\u003cul>\n\u003cli>Runny nose\u003c/li>\n\u003cli>Decrease in appetite\u003c/li>\n\u003cli>Coughing\u003c/li>\n\u003cli>Sneezing\u003c/li>\n\u003cli>Fever\u003c/li>\n\u003cli>Wheezing\u003c/li>\n\u003c/ul>\n\u003cp>One big exception to this list: In some very young infants with RSV, the CDC said that “the only symptoms may be irritability, decreased activity, and breathing difficulties.”\u003c/p>\n\u003cp>Wheezing could be the particular symptom that might indicate you’ve got RSV rather than another respiratory virus, Chin-Hong said — although wheezing can still be a symptom of those other viruses, too.\u003c/p>\n\u003cp>So, if you’re unlikely to get access to an RSV test, how can you tell if what feels like a bad cold is actually RSV — or the flu? Chin-Hong said there are a few things that might help you tell the difference:\u003c/p>\n\u003cp>\u003cb>The speed and severity of symptoms\u003c/b>\u003c/p>\n\u003cp>Chin-Hong said the onset of symptoms for the flu will be sudden and severe, with fever and muscle pain. “You feel like a garbage truck hits you very suddenly,” he said.\u003c/p>\n\u003cp>Influenza, which, like RSV (and COVID-19), is already spreading throughout the Bay Area this winter, can cause serious problems even in healthy people of any age. \u003ca href=\"https://www.kqed.org/news/11961649/when-should-i-get-2023-flu-shot-safe-with-new-covid-vaccine-rsv\">Some people are also at higher risk of developing serious flu-related complications if they get sick\u003c/a>, including those aged 65 years and older, people of any age with certain chronic medical conditions (such as asthma, diabetes, or heart disease), pregnant people and children younger than 5 years.\u003c/p>\n\u003cp>The CDC estimates that\u003ca href=\"https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm\"> last year’s flu season resulted in as many as 58,000 deaths from flu\u003c/a> and up to 650,000 flu hospitalizations. WastewaterSCAN’s Boehm noted, in her team’s latest snapshot, that wastewater levels for influenza are “starting to trend up, which suggests influenza infections are starting to rise in our region,” and that based on last year’s records, “we fully expect the levels to keep increasing.”\u003c/p>\n\u003cp>If you haven’t already, \u003ca href=\"https://www.kqed.org/news/11961649/when-should-i-get-2023-flu-shot-safe-with-new-covid-vaccine-rsv\">consider getting your flu shot as soon as possible\u003c/a>. \u003ca href=\"https://www.cdc.gov/flu/treatment/treatment.htm\">Read more from the CDC about what to do if you get the flu.\u003c/a>\u003c/p>\n\u003cp>If your cold symptoms are more progressive, but you’re repeatedly testing negative for COVID-19, seriously consider the possibility that you have RSV.\u003c/p>\n\u003cp>Or, as Chin-Hong puts it: “If you don’t feel like your whole body is on fire, and it feels like a cold — these days, chances are that it’s going to be RSV.”\u003c/p>\n\u003cp>\u003cb>The incubation period\u003c/b>\u003c/p>\n\u003cp>RSV has a longer incubation period than COVID-19 or a cold — the amount of time between exposure to the virus and getting sick.\u003c/p>\n\u003cp>Right now, the latest COVID-19 subvariants have an incubation period of three to five days, and a cold will take 24 to 72 hours to incubate after exposure. But RSV has a longer incubation period of “four to six days,” Chin-Hong said. So, if you know you’ve been exposed to RSV but haven’t gotten sick after a few days, unfortunately, it’s unwise to presume you’ve escaped infection.\u003cbr>\n[ad fullwidth]\u003cbr>\nWhile people infected with RSV are usually contagious for “3 to 8 days,” according to the CDC, \u003ca href=\"https://www.cdc.gov/rsv/about/transmission.html\">they can also “become contagious a day or two before they start showing signs of illness”\u003c/a> — similar to those infected with COVID-19.\u003c/p>\n\u003ch2>\u003ca id=\"anchor4\">\u003c/a>What should I do if I have RSV but I’m not at higher risk?\u003c/h2>\n\u003cp>If you’re not at higher risk for severe RSV but you’re pretty sure you’ve got it, what now?\u003c/p>\n\u003cp>\u003cb>Manage your symptoms\u003c/b>\u003c/p>\n\u003cp>The CDC said that antiviral medication is “not routinely recommended” to fight an RSV infection — in contrast to COVID-19, for which \u003ca href=\"https://www.kqed.org/news/11966797/paxlovid-free-eligibility-california-2023\">the antiviral drug Paxlovid is often prescribed\u003c/a>, or for the flu, for which \u003ca href=\"https://www.cdc.gov/flu/treatment/whatyoushould.htm\">antiviral drugs like Tamiflu can be taken\u003c/a>.[aside label=\"more virus-related coverage\" tag=\"coronavirus-resources-and-explainers\"]Most RSV infections, the agency said, “go away on their own in a week or two.”\u003c/p>\n\u003cp>So, if you’re an adult who’s not at higher risk for severe RSV, \u003ca href=\"https://www.cdc.gov/rsv/about/symptoms.html\">the CDC recommends managing fever and pain symptoms \u003c/a>with over-the-counter fever reducers and pain relievers, such as acetaminophen or ibuprofen. It’s also important to drink fluids to prevent getting dehydrated.\u003c/p>\n\u003cp>\u003cb>Stay home as much as you can\u003c/b>\u003c/p>\n\u003cp>Remember, the big difference between having “just” a cold and having RSV is that if you spread RSV, you’re potentially endangering infants and older people who are at much higher risk from it. The best thing to do is keep away from others as much as possible while you’re sick — especially infants and people aged 60 and older. And “definitely don’t go out if you have a fever,” Chin-Hong said — “that’s probably the highest risk.”\u003c/p>\n\u003cp>What if you really can’t stay indoors away from others? Then it’s time to wear a well-fitted face covering like an N95 or KN95 mask, Chin-Hong said. By masking, you’ll reduce the risks of spreading the virus to those around you.\u003c/p>\n\u003ch2>\u003ca id=\"anchor5\">\u003c/a>Why are younger and older people more at risk from RSV?\u003c/h2>\n\u003cp>There are two age groups at the highest risk for severe disease, hospitalization and death from RSV:\u003c/p>\n\u003cp>\u003cb>Infants and young children\u003c/b>\u003c/p>\n\u003cp>Every year, as many as \u003ca href=\"https://www.cdc.gov/rsv/high-risk/infants-young-children.html\">80,000 children under 5 years old are hospitalized in the U.S. because of RSV\u003c/a>, according to an estimate from the CDC. Children at the greatest risk from RSV include:\u003c/p>\n\u003cul>\n\u003cli>Premature infants\u003c/li>\n\u003cli>Infants up to 12 months, especially (6 months and younger)\u003c/li>\n\u003cli>Children younger than 2 years with chronic lung disease or congenital (present from birth) heart disease\u003c/li>\n\u003cli>Children with weakened immune systems\u003c/li>\n\u003cli>Children with neuromuscular disorders.\u003c/li>\n\u003c/ul>\n\u003cp>Part of the danger of RSV is how it can bring on more severe infections, including:\u003c/p>\n\u003cul>\n\u003cli>Bronchiolitis: when the small airways in the lungs are inflamed\u003c/li>\n\u003cli>Pneumonia: when the lungs are infected.\u003c/li>\n\u003c/ul>\n\u003cp>The CDC said that RSV is “the most common cause of bronchiolitis and pneumonia in children younger than 1 year of age.”\u003c/p>\n\u003cp>These statistics can seem scary — and RSV does undoubtedly pose a threat to many younger children. But for context, the CDC notes that\u003ca href=\"https://www.cdc.gov/rsv/high-risk/infants-young-children.html\"> “almost all children will have had an RSV infection by their second birthday.”\u003c/a>\u003c/p>\n\u003cp>If an infant or young child gets infected with RSV, parents and caregivers can always call their provider’s advice line, added Chin-Hong, who said to watch for red flags, including when a young child is having difficulty feeding or breathing, or is wheezing and lethargic. “Infants with quote-unquote ‘colds’ who have any of those [symptoms] should be brought into the hospital or urgent care or the emergency room for advice,” he said.\u003c/p>\n\u003cp>\u003cb>People age 60 and older\u003c/b>\u003c/p>\n\u003cp>RSV poses a particular risk to older people because of how our immune systems weaken with age. Every year, between \u003ca href=\"https://www.cdc.gov/rsv/high-risk/older-adults.html\">60,000 and 160,000 older adults in the U.S. are hospitalized with RSV, \u003c/a>and as many as 10,000 die from it, The CDC estimates.\u003c/p>\n\u003cp>In addition to causing more severe infections like bronchiolitis and pneumonia, the virus can also exacerbate existing health conditions — including asthma, chronic obstructive pulmonary disease and congestive heart failure.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdc.gov/rsv/high-risk/older-adults.html\">Some younger adults are also at higher risk from RSV\u003c/a>. These groups include folks with chronic heart or lung disease, weakened immune systems or certain other underlying medical conditions.\u003c/p>\n\u003cp>When should older adults — or their caregivers — seek medical attention due to a potential RSV infection? Chin-Hong said that one of the main concerns for this age group is developing pneumonia, of which a new shortness of breath can be a symptom. Oxygen levels can also be monitored with an at-home pulse oximeter — if a person’s levels drop below 93%, Chin-Hong said that’s a sign to head to the emergency room.\u003c/p>\n\u003ch2>\u003cb>When RSV means being hospitalized\u003c/b>\u003c/h2>\n\u003cp>What does hospitalization actually mean for infants and older adults with severe RSV?\u003c/p>\n\u003cp>Hospitalization often occurs if the patient is having trouble breathing or has become dehydrated — and once in the hospital, they may require extra oxygen or fluids given through an IV if they can’t eat or drink enough on their own.\u003c/p>\n\u003cp>A patient might also need to be intubated with a breathing tube inserted through the mouth, and be given mechanical ventilation to help them breathe again. While this sounds scary, hospitalization usually lasts for only a few days “in most of these cases,” according to the CDC.\u003c/p>\n\u003ch2>\u003ca id=\"anchor6\">\u003c/a>Who can get the RSV vaccine?\u003c/h2>\n\u003cp>In addition to the general benefits of vaccination against the virus, Chin-Hong notes that “there isn’t any good therapy for RSV” currently — making a preventative vaccine even more important.\u003c/p>\n\u003cp>In May, the U.S. Food and Drug Administration \u003ca href=\"https://www.fda.gov/news-events/press-announcements/fda-approves-first-respiratory-syncytial-virus-rsv-vaccine\">approved the first RSV vaccine for older adults\u003c/a>, and, several months later, \u003ca href=\"https://www.fda.gov/news-events/press-announcements/fda-approves-first-vaccine-pregnant-individuals-prevent-rsv-infants\">approved another one for pregnant people\u003c/a>, as well as a separate preventative antibody treatment for infants.\u003c/p>\n\u003cp>RSV vaccines for these groups are available through health care providers and pharmacies, with the shots covered partly or fully by most health insurance plans.\u003c/p>\n\u003cp>\u003cb>Adults age 60 and older\u003c/b>\u003c/p>\n\u003cp>The CDC recommends this group “should talk with their health care provider about whether RSV vaccination is right for them.” There is no upper age limit for getting an RSV vaccination, which is given as a single shot. \u003ca href=\"https://www.cdc.gov/vaccines/vpd/rsv/public/older-adults.html\">Read more about older adults and the RSV vaccine\u003c/a>, and about \u003ca href=\"https://www.cdc.gov/respiratory-viruses/whats-new/how-to-get-your-vaccines.html\">health insurance coverage for this vaccine.\u003c/a>\u003c/p>\n\u003cp>\u003cb>People between 32 and 36 weeks of pregnancy\u003c/b>\u003c/p>\n\u003cp>Vaccinations for pregnant people are one of two ways that infants can be immunized against RSV — in this case, to pass on the benefits to the fetus. The CDC said that a baby born to a mother who got the RSV vaccine “at least two weeks before delivery” will have protection — and “in most cases,” that baby then won’t require a later RSV immunization. \u003ca href=\"https://www.cdc.gov/vaccines/vpd/rsv/public/pregnancy.html\">Read more about pregnant people and the RSV vaccine\u003c/a>, and about\u003ca href=\"https://www.cdc.gov/vaccines/vpd/rsv/public/pregnancy.html\"> health insurance coverage for this maternal vaccine\u003c/a>.\u003c/p>\n\u003cp>\u003cb>Infants\u003c/b>\u003c/p>\n\u003cp>A preventive antibody — not a vaccine — can also be given directly to a baby after birth if a maternal vaccine isn’t an option. This form of immunization is recommended for children younger than 8 months of age during their first RSV season. In some cases, this immunization is extended to children under 24 months of age “with certain conditions that place them at increased risk for severe RSV disease,” the CDC said. \u003ca href=\"https://www.cdc.gov/vaccines/vpd/rsv/public/child.html\">Read more about RSV immunization for infants and young children\u003c/a> and about \u003ca href=\"https://www.cdc.gov/respiratory-viruses/whats-new/how-to-get-your-vaccines.html\">health insurance coverage for this immunization.\u003c/a>\u003c/p>\n\u003cp>\u003ci>KQED’s Sara Hossaini and Lesley McClurg contributed reporting to this story.\u003c/i>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Updated 11:15 a.m., December 13\u003c/em>\u003c/p>\n\u003cp>The 2023-2024 winter respiratory virus season is here. And alongside \u003ca href=\"https://www.kqed.org/news/11957790/the-new-covid-eris-variant-and-rising-cases-what-you-need-to-know\">the latest COVID-19 variant \u003c/a>and\u003ca href=\"https://www.kqed.org/news/11961649/when-should-i-get-2023-flu-shot-safe-with-new-covid-vaccine-rsv\"> the return of flu season\u003c/a>, RSV is once again on the rise around the Bay Area.\u003c/p>\n\u003cp>RSV — which stands for Respiratory Syncytial (\u003ca href=\"https://www.cdc.gov/rsv/index.html\">pronounced “sin-SISH-uhl”\u003c/a>) Virus — usually causes “mild, cold-like symptoms,” according to the U.S. Centers for Disease Control and Prevention. But in infants, young children and adults over 60, this respiratory virus can attack a weakened immune system to cause severe sickness, leading to hospitalization and even — in serious cases — death.\u003c/p>\n\u003cp>People in these age groups and the people who care for them are often warned by their health care providers about the dangers of RSV transmission and offered vaccination against the virus. However, there are a lot of people who may not even know RSV exists, let alone how dangerous it can be to spread it to others accidentally — even if getting infected themselves only means mild symptoms.\u003c/p>\n\u003cp>Keep reading for what to know about RSV testing, how to spot an RSV infection, incubation periods, and who’s eligible for the new RSV vaccine.\u003c/p>\n\u003cp>\u003cstrong>Jump straight to:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#anchor1\">How bad is RSV in the Bay Area now?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#anchor2\">Can I get tested?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#anchor3\">How do I know if my “cold” is actually RSV?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#anchor4\">If I get infected but I’m not high risk, what should I do?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#anchor5\">Why are younger and older people more at risk, and when is it time to seek medical attention?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#anchor6\">Who can get the RSV vaccine?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003ch2>\u003ca id=\"anchor1\">\u003c/a>How bad is RSV around the Bay Area right now?\u003c/h2>\n\u003cp>In its weekly report, on Dec. 8, the CDC said that \u003ca href=\"https://www.cdc.gov/respiratory-viruses/data-research/dashboard/snapshot.html\">the U.S. is “experiencing elevated RSV activity, particularly among young children\u003c/a>” — and that there is currently \u003ca href=\"https://www.cdc.gov/respiratory-viruses/index.html\">“high overall respiratory illness activity” in California.\u003c/a>\u003c/p>\n\u003cp>The impacts on the state’s hospital capacity are already being felt, and \u003ca href=\"https://www.kqed.org/science/1985786/bay-area-covid-flu-cases-on-the-rise-but-not-surging-like-last-year\">three-quarters of intensive care beds around California are full\u003c/a>, according to the CDC.\u003c/p>\n\u003cp>\u003ca href=\"https://www.wastewaterscan.org/en/about\">The WastewaterSCAN project\u003c/a> monitors the presence of viruses — including RSV, COVID-19 and the flu — in wastewater across the U.S. Alexandria Boehm, a Stanford professor of civil and environmental engineering, who helps lead the project, provided KQED with the latest snapshot data on Nov. 30, that found RSV “levels are trending up and high,” and that “all sites in the Bay Area are categorized as in the high wastewater category” for the virus. This upward trend indicates that the Bay Area is “headed towards \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9844019/\">the levels we saw last year”\u003c/a>. \u003ca href=\"https://www.kqed.org/science/1985786/bay-area-covid-flu-cases-on-the-rise-but-not-surging-like-last-year\">Levels of flu and COVID are also increasing in local wastewater, said Boehm\u003c/a>. \u003c/p>\u003c/div>",
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"content": "‘If you don’t feel like your whole body is on fire, and it feels like a cold — these days, chances are that it’s going to be RSV.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In Santa Clara County, health officials recently warned of a dramatic increase in winter viruses in the county’s wastewater — and an especially sharp rise in RSV levels, which the county’s Deputy Health Officer Dr. Sarah Rudman said had doubled in the month leading up to Thanksgiving.\u003c/p>\n\u003cp>“That worries me,” Rudman told KQED on Monday, “that especially after this holiday weekend with everyone’s travel and gathering there, we’re going to see even higher levels [afterward].”\u003c/p>\n\u003cp>Dr. Peter Chin-Hong, an infectious disease specialist at UCSF, said that when it comes to lab testing at his hospital right now, more tests are coming back positive for RSV than for the flu or COVID-19.\u003c/p>\n\u003ch2>\u003ca id=\"anchor2\">\u003c/a>What about testing for RSV?\u003c/h2>\n\u003cp>At-home testing for RSV isn’t available in the way it is for COVID-19. The only places you’d typically have access to a formal RSV test are at an urgent care center, the emergency room, or elsewhere in a hospital, Chin-Hong said.\u003c/p>\n\u003cp>“I think in the future it’d be great to have a home test for COVID, flu and RSV,” he said. “But right now, we just have COVID [testing] at home.”\u003c/p>\n\u003cp>Chin-Hong acknowledges the downsides of being unable to access an RSV test outside of these clinical settings. “It’s good to know so that you don’t infect the very young and very old, who can have more serious consequences,” he said.\u003c/p>\n\u003cp>And on that note …\u003c/p>\n\u003ch2>\u003ca id=\"anchor3\">\u003c/a>So, what are RSV symptoms? How are they different from COVID-19 or the flu?\u003c/h2>\n\u003cp>RSV, Chin-Hong said, “seems like a cold for most people. But that ‘cold’ infecting somebody under two, or older than 60, can land them in the hospital.”\u003c/p>\n\u003cp>According to the CDC,\u003ca href=\"https://www.cdc.gov/rsv/about/symptoms.html\"> the symptoms of RSV infection\u003c/a> “usually appear in stages and not all at once,” and can include:\u003c/p>\n\u003cul>\n\u003cli>Runny nose\u003c/li>\n\u003cli>Decrease in appetite\u003c/li>\n\u003cli>Coughing\u003c/li>\n\u003cli>Sneezing\u003c/li>\n\u003cli>Fever\u003c/li>\n\u003cli>Wheezing\u003c/li>\n\u003c/ul>\n\u003cp>One big exception to this list: In some very young infants with RSV, the CDC said that “the only symptoms may be irritability, decreased activity, and breathing difficulties.”\u003c/p>\n\u003cp>Wheezing could be the particular symptom that might indicate you’ve got RSV rather than another respiratory virus, Chin-Hong said — although wheezing can still be a symptom of those other viruses, too.\u003c/p>\n\u003cp>So, if you’re unlikely to get access to an RSV test, how can you tell if what feels like a bad cold is actually RSV — or the flu? Chin-Hong said there are a few things that might help you tell the difference:\u003c/p>\n\u003cp>\u003cb>The speed and severity of symptoms\u003c/b>\u003c/p>\n\u003cp>Chin-Hong said the onset of symptoms for the flu will be sudden and severe, with fever and muscle pain. “You feel like a garbage truck hits you very suddenly,” he said.\u003c/p>\n\u003cp>Influenza, which, like RSV (and COVID-19), is already spreading throughout the Bay Area this winter, can cause serious problems even in healthy people of any age. \u003ca href=\"https://www.kqed.org/news/11961649/when-should-i-get-2023-flu-shot-safe-with-new-covid-vaccine-rsv\">Some people are also at higher risk of developing serious flu-related complications if they get sick\u003c/a>, including those aged 65 years and older, people of any age with certain chronic medical conditions (such as asthma, diabetes, or heart disease), pregnant people and children younger than 5 years.\u003c/p>\n\u003cp>The CDC estimates that\u003ca href=\"https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm\"> last year’s flu season resulted in as many as 58,000 deaths from flu\u003c/a> and up to 650,000 flu hospitalizations. WastewaterSCAN’s Boehm noted, in her team’s latest snapshot, that wastewater levels for influenza are “starting to trend up, which suggests influenza infections are starting to rise in our region,” and that based on last year’s records, “we fully expect the levels to keep increasing.”\u003c/p>\n\u003cp>If you haven’t already, \u003ca href=\"https://www.kqed.org/news/11961649/when-should-i-get-2023-flu-shot-safe-with-new-covid-vaccine-rsv\">consider getting your flu shot as soon as possible\u003c/a>. \u003ca href=\"https://www.cdc.gov/flu/treatment/treatment.htm\">Read more from the CDC about what to do if you get the flu.\u003c/a>\u003c/p>\n\u003cp>If your cold symptoms are more progressive, but you’re repeatedly testing negative for COVID-19, seriously consider the possibility that you have RSV.\u003c/p>\n\u003cp>Or, as Chin-Hong puts it: “If you don’t feel like your whole body is on fire, and it feels like a cold — these days, chances are that it’s going to be RSV.”\u003c/p>\n\u003cp>\u003cb>The incubation period\u003c/b>\u003c/p>\n\u003cp>RSV has a longer incubation period than COVID-19 or a cold — the amount of time between exposure to the virus and getting sick.\u003c/p>\n\u003cp>Right now, the latest COVID-19 subvariants have an incubation period of three to five days, and a cold will take 24 to 72 hours to incubate after exposure. But RSV has a longer incubation period of “four to six days,” Chin-Hong said. So, if you know you’ve been exposed to RSV but haven’t gotten sick after a few days, unfortunately, it’s unwise to presume you’ve escaped infection.\u003cbr>\n\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cbr>\nWhile people infected with RSV are usually contagious for “3 to 8 days,” according to the CDC, \u003ca href=\"https://www.cdc.gov/rsv/about/transmission.html\">they can also “become contagious a day or two before they start showing signs of illness”\u003c/a> — similar to those infected with COVID-19.\u003c/p>\n\u003ch2>\u003ca id=\"anchor4\">\u003c/a>What should I do if I have RSV but I’m not at higher risk?\u003c/h2>\n\u003cp>If you’re not at higher risk for severe RSV but you’re pretty sure you’ve got it, what now?\u003c/p>\n\u003cp>\u003cb>Manage your symptoms\u003c/b>\u003c/p>\n\u003cp>The CDC said that antiviral medication is “not routinely recommended” to fight an RSV infection — in contrast to COVID-19, for which \u003ca href=\"https://www.kqed.org/news/11966797/paxlovid-free-eligibility-california-2023\">the antiviral drug Paxlovid is often prescribed\u003c/a>, or for the flu, for which \u003ca href=\"https://www.cdc.gov/flu/treatment/whatyoushould.htm\">antiviral drugs like Tamiflu can be taken\u003c/a>.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Most RSV infections, the agency said, “go away on their own in a week or two.”\u003c/p>\n\u003cp>So, if you’re an adult who’s not at higher risk for severe RSV, \u003ca href=\"https://www.cdc.gov/rsv/about/symptoms.html\">the CDC recommends managing fever and pain symptoms \u003c/a>with over-the-counter fever reducers and pain relievers, such as acetaminophen or ibuprofen. It’s also important to drink fluids to prevent getting dehydrated.\u003c/p>\n\u003cp>\u003cb>Stay home as much as you can\u003c/b>\u003c/p>\n\u003cp>Remember, the big difference between having “just” a cold and having RSV is that if you spread RSV, you’re potentially endangering infants and older people who are at much higher risk from it. The best thing to do is keep away from others as much as possible while you’re sick — especially infants and people aged 60 and older. And “definitely don’t go out if you have a fever,” Chin-Hong said — “that’s probably the highest risk.”\u003c/p>\n\u003cp>What if you really can’t stay indoors away from others? Then it’s time to wear a well-fitted face covering like an N95 or KN95 mask, Chin-Hong said. By masking, you’ll reduce the risks of spreading the virus to those around you.\u003c/p>\n\u003ch2>\u003ca id=\"anchor5\">\u003c/a>Why are younger and older people more at risk from RSV?\u003c/h2>\n\u003cp>There are two age groups at the highest risk for severe disease, hospitalization and death from RSV:\u003c/p>\n\u003cp>\u003cb>Infants and young children\u003c/b>\u003c/p>\n\u003cp>Every year, as many as \u003ca href=\"https://www.cdc.gov/rsv/high-risk/infants-young-children.html\">80,000 children under 5 years old are hospitalized in the U.S. because of RSV\u003c/a>, according to an estimate from the CDC. Children at the greatest risk from RSV include:\u003c/p>\n\u003cul>\n\u003cli>Premature infants\u003c/li>\n\u003cli>Infants up to 12 months, especially (6 months and younger)\u003c/li>\n\u003cli>Children younger than 2 years with chronic lung disease or congenital (present from birth) heart disease\u003c/li>\n\u003cli>Children with weakened immune systems\u003c/li>\n\u003cli>Children with neuromuscular disorders.\u003c/li>\n\u003c/ul>\n\u003cp>Part of the danger of RSV is how it can bring on more severe infections, including:\u003c/p>\n\u003cul>\n\u003cli>Bronchiolitis: when the small airways in the lungs are inflamed\u003c/li>\n\u003cli>Pneumonia: when the lungs are infected.\u003c/li>\n\u003c/ul>\n\u003cp>The CDC said that RSV is “the most common cause of bronchiolitis and pneumonia in children younger than 1 year of age.”\u003c/p>\n\u003cp>These statistics can seem scary — and RSV does undoubtedly pose a threat to many younger children. But for context, the CDC notes that\u003ca href=\"https://www.cdc.gov/rsv/high-risk/infants-young-children.html\"> “almost all children will have had an RSV infection by their second birthday.”\u003c/a>\u003c/p>\n\u003cp>If an infant or young child gets infected with RSV, parents and caregivers can always call their provider’s advice line, added Chin-Hong, who said to watch for red flags, including when a young child is having difficulty feeding or breathing, or is wheezing and lethargic. “Infants with quote-unquote ‘colds’ who have any of those [symptoms] should be brought into the hospital or urgent care or the emergency room for advice,” he said.\u003c/p>\n\u003cp>\u003cb>People age 60 and older\u003c/b>\u003c/p>\n\u003cp>RSV poses a particular risk to older people because of how our immune systems weaken with age. Every year, between \u003ca href=\"https://www.cdc.gov/rsv/high-risk/older-adults.html\">60,000 and 160,000 older adults in the U.S. are hospitalized with RSV, \u003c/a>and as many as 10,000 die from it, The CDC estimates.\u003c/p>\n\u003cp>In addition to causing more severe infections like bronchiolitis and pneumonia, the virus can also exacerbate existing health conditions — including asthma, chronic obstructive pulmonary disease and congestive heart failure.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdc.gov/rsv/high-risk/older-adults.html\">Some younger adults are also at higher risk from RSV\u003c/a>. These groups include folks with chronic heart or lung disease, weakened immune systems or certain other underlying medical conditions.\u003c/p>\n\u003cp>When should older adults — or their caregivers — seek medical attention due to a potential RSV infection? Chin-Hong said that one of the main concerns for this age group is developing pneumonia, of which a new shortness of breath can be a symptom. Oxygen levels can also be monitored with an at-home pulse oximeter — if a person’s levels drop below 93%, Chin-Hong said that’s a sign to head to the emergency room.\u003c/p>\n\u003ch2>\u003cb>When RSV means being hospitalized\u003c/b>\u003c/h2>\n\u003cp>What does hospitalization actually mean for infants and older adults with severe RSV?\u003c/p>\n\u003cp>Hospitalization often occurs if the patient is having trouble breathing or has become dehydrated — and once in the hospital, they may require extra oxygen or fluids given through an IV if they can’t eat or drink enough on their own.\u003c/p>\n\u003cp>A patient might also need to be intubated with a breathing tube inserted through the mouth, and be given mechanical ventilation to help them breathe again. While this sounds scary, hospitalization usually lasts for only a few days “in most of these cases,” according to the CDC.\u003c/p>\n\u003ch2>\u003ca id=\"anchor6\">\u003c/a>Who can get the RSV vaccine?\u003c/h2>\n\u003cp>In addition to the general benefits of vaccination against the virus, Chin-Hong notes that “there isn’t any good therapy for RSV” currently — making a preventative vaccine even more important.\u003c/p>\n\u003cp>In May, the U.S. Food and Drug Administration \u003ca href=\"https://www.fda.gov/news-events/press-announcements/fda-approves-first-respiratory-syncytial-virus-rsv-vaccine\">approved the first RSV vaccine for older adults\u003c/a>, and, several months later, \u003ca href=\"https://www.fda.gov/news-events/press-announcements/fda-approves-first-vaccine-pregnant-individuals-prevent-rsv-infants\">approved another one for pregnant people\u003c/a>, as well as a separate preventative antibody treatment for infants.\u003c/p>\n\u003cp>RSV vaccines for these groups are available through health care providers and pharmacies, with the shots covered partly or fully by most health insurance plans.\u003c/p>\n\u003cp>\u003cb>Adults age 60 and older\u003c/b>\u003c/p>\n\u003cp>The CDC recommends this group “should talk with their health care provider about whether RSV vaccination is right for them.” There is no upper age limit for getting an RSV vaccination, which is given as a single shot. \u003ca href=\"https://www.cdc.gov/vaccines/vpd/rsv/public/older-adults.html\">Read more about older adults and the RSV vaccine\u003c/a>, and about \u003ca href=\"https://www.cdc.gov/respiratory-viruses/whats-new/how-to-get-your-vaccines.html\">health insurance coverage for this vaccine.\u003c/a>\u003c/p>\n\u003cp>\u003cb>People between 32 and 36 weeks of pregnancy\u003c/b>\u003c/p>\n\u003cp>Vaccinations for pregnant people are one of two ways that infants can be immunized against RSV — in this case, to pass on the benefits to the fetus. The CDC said that a baby born to a mother who got the RSV vaccine “at least two weeks before delivery” will have protection — and “in most cases,” that baby then won’t require a later RSV immunization. \u003ca href=\"https://www.cdc.gov/vaccines/vpd/rsv/public/pregnancy.html\">Read more about pregnant people and the RSV vaccine\u003c/a>, and about\u003ca href=\"https://www.cdc.gov/vaccines/vpd/rsv/public/pregnancy.html\"> health insurance coverage for this maternal vaccine\u003c/a>.\u003c/p>\n\u003cp>\u003cb>Infants\u003c/b>\u003c/p>\n\u003cp>A preventive antibody — not a vaccine — can also be given directly to a baby after birth if a maternal vaccine isn’t an option. This form of immunization is recommended for children younger than 8 months of age during their first RSV season. In some cases, this immunization is extended to children under 24 months of age “with certain conditions that place them at increased risk for severe RSV disease,” the CDC said. \u003ca href=\"https://www.cdc.gov/vaccines/vpd/rsv/public/child.html\">Read more about RSV immunization for infants and young children\u003c/a> and about \u003ca href=\"https://www.cdc.gov/respiratory-viruses/whats-new/how-to-get-your-vaccines.html\">health insurance coverage for this immunization.\u003c/a>\u003c/p>\n\u003cp>\u003ci>KQED’s Sara Hossaini and Lesley McClurg contributed reporting to this story.\u003c/i>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "San Francisco Projected to Reach Highest Overdose Death Toll in 2023",
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"content": "\u003cp>San Francisco is on track to hit a tragic milestone by the end of the year — with more fatal overdoses projected in 2023 than any on record.\u003c/p>\n\u003cp>“It is absolutely bleak, but it is not unexpected,” said Alex Kral, an epidemiologist at the independent nonprofit research institute RTI International. “Absent any new huge impactful interventions, I would continue to expect us to get worse for a couple of years until it would stabilize. But stabilized still means bad.” [pullquote size=\"medium\" align=\"right\" citation=\"Alex Kral, epidemiologist, RTI International\"]‘It is absolutely bleak, but it is not unexpected.’[/pullquote]There were 692 accidental overdose deaths from January to October of this year, with 65 occurring in October, according to the latest \u003ca href=\"https://sf.gov/sites/default/files/2023-11/2023%2011_OCME%20Overdose%20Report.pdf\">medical examiner data\u003c/a> released Wednesday.\u003c/p>\n\u003cp>The new data supports projections made months ago that the city could eclipse its tragic milestone from 2020, when a total of 726 overdose deaths occurred.\u003c/p>\n\u003cp>Kral has studied drug use and overdoses in San Francisco for nearly 30 years. His estimation that overdose deaths may continue to rise is based on patterns in the East Coast, where fentanyl became more common in the illicit drug supply about 10 years ago, before hitting the West Coast.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>On top of a deadlier drug supply, Kral says widening economic inequality, coupled with the region’s severe lack of affordable housing and out-of-reach treatment options, have fueled overdose deaths.\u003c/p>\n\u003cp>“We have seen on the East Coast that it really took about five years or so for things to continue to skyrocket before leveling off,” Kral said. “In San Francisco, fentanyl didn’t really show up in a large way until 2019, so we are still in year three or four of that huge increase.”\u003c/p>\n\u003cp>The majority of overdose deaths occurring in San Francisco — and elsewhere across the West Coast — involve fentanyl, an opioid about 50 times stronger than heroin. Many overdose deaths in the report involved combinations of substances with fentanyl, including methamphetamine and cocaine.\u003c/p>\n\u003cp>In response to rising overdoses, local public health officials have dramatically expanded the availability of \u003ca href=\"https://www.kqed.org/news/11945418/san-francisco-has-doubled-participants-of-this-opioid-treatment-heres-why\">buprenorphine\u003c/a> and \u003ca href=\"https://www.kqed.org/news/11941618/sfs-mobile-clinics-made-opioid-treatment-more-accessible-during-the-pandemic-but-will-they-stay\">methadone\u003c/a>, medications that can curb opioid cravings and withdrawal and \u003ca href=\"https://www.kqed.org/news/11959733/san-franciscans-want-you-to-know-recovery-is-possible\">help with recovery\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_11967667\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11967667 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/11/230831-SAFE-USE-POP-UP-MD-05-qut.jpg\" alt=\"Boxes of Narcan are on a table.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/11/230831-SAFE-USE-POP-UP-MD-05-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/11/230831-SAFE-USE-POP-UP-MD-05-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/11/230831-SAFE-USE-POP-UP-MD-05-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/11/230831-SAFE-USE-POP-UP-MD-05-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/11/230831-SAFE-USE-POP-UP-MD-05-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Boxes of Narcan, the overdose prevention drug, at a safe drug use pop-up site created by volunteers with Concerned Public Response in San Francisco on Aug. 31, 2023. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In addition, the \u003ca href=\"https://www.kqed.org/news/11947448/there-to-save-a-life-san-francisco-bars-fight-fentanyl-overdoses-with-narcan\">widespread distribution of Narcan\u003c/a>, a fast-acting medicine that can reverse an opioid overdose, has saved countless lives. The city also plans to add new residential treatment beds in 2024 to its current total of 2,550.\u003c/p>\n\u003cp>“We must remain nimble in our overdose prevention efforts, including getting more people who use drugs into treatment with medications for opioid use disorder in outpatient and residential treatment settings,” reads a press statement from the Department of Public Health, released after the data was published. [pullquote size=\"medium\" align=\"right\" citation=\"San Francisco Mayor London Breed\"]‘Fentanyl is devastating communities in cities all across our country like no other drug we’ve ever experienced before and this crisis demands additional urgent intervention efforts.’[/pullquote]While these public health resources have been growing, Mayor London Breed has also charged local and \u003ca href=\"https://www.kqed.org/news/11948062/newsom-taps-chp-national-guard-to-fight-san-franciscos-fentanyl-crisis\">state law enforcement\u003c/a> to crack down harder on drug trafficking as well as increase \u003ca href=\"https://www.kqed.org/news/11950520/compassion-is-killing-people-london-breed-pushes-for-more-arrests-to-tackle-sfs-drug-crisis\">arrests for public drug use and dealing\u003c/a>.\u003c/p>\n\u003cp>That included bringing in the CalGuard and California Highway Patrol to work with San Francisco police, and this week, she joined 36 other U.S. mayors in asking President Joe Biden for additional support to tackle the drug supply.\u003c/p>\n\u003cp>“Fentanyl is devastating communities in cities all across our country like no other drug we’ve ever experienced before and this crisis demands additional urgent intervention efforts,” said Mayor Breed in a press statement announcing the federal funding request. “President Biden’s funding request gets at the heart of what we need — more funding for treatment to help those struggling with addiction and to prevent overdoses, and support for public safety and enforcement efforts to hold those accountable who are profiting off this deadly drug.”\u003c/p>\n\u003cp>Meanwhile, public health advocates have been pushing the city for years to open a supervised consumption site where people can use drugs in a medically supervised setting, and doctors can be available to reverse overdoses and connect users to other social or health services.\u003c/p>\n\u003cp>More than 200 such facilities operate globally, including in New York City. Rhode Island also plans to open up an overdose prevention center with funding it won from lawsuits against opioid manufacturers.\u003c/p>\n\u003cfigure id=\"attachment_11967676\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11967676 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/11/015_KQED_GubbioProjectLydiaBransten_03092023-qut.jpg\" alt=\"A sign that reads the Gubbio Project in San Francisco.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/11/015_KQED_GubbioProjectLydiaBransten_03092023-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/11/015_KQED_GubbioProjectLydiaBransten_03092023-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/11/015_KQED_GubbioProjectLydiaBransten_03092023-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/11/015_KQED_GubbioProjectLydiaBransten_03092023-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/11/015_KQED_GubbioProjectLydiaBransten_03092023-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A sign for the Gubbio Project, a nonprofit offering services for unhoused people, hangs on the front gate in San Francisco on March 9, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>San Francisco ran a safe consumption site in 2022, a year when overdose deaths dipped. There were 333 overdoses reversed at the facility, and no deaths took place. The site drew in hundreds of people a day for meals, showers and overdose prevention help but closed down after 11 months of operation. The city has not reopened a similar site since. [pullquote size=\"medium\" align=\"right\" citation=\"Lydia Bransten, executive director, Gubbio Project\"]‘There are a lot of words to run [supervised consumption sites], but nothing to say we will be there for you if something happens legally. That has really put people in a position where they don’t feel safe to be able to do it.’[/pullquote]Supervised consumption sites are one aspect of local drug response, along with residential treatment, medication-assisted treatment, abstinence, law enforcement coordination and better access to housing and health care. But they have been hard to open in San Francisco since \u003ca href=\"https://www.kqed.org/news/11923303/sf-health-groups-determined-to-forge-ahead-with-safe-consumption-site-despite-newsoms-veto\">Gov. Gavin Newsom vetoed a bill\u003c/a> allowing the city to pilot them.\u003c/p>\n\u003cp>Supporters like Lydia Bransten, executive director of the Gubbio Project, said supervised consumption sites could make a significant difference in simply saving lives and slowing the uptick in overdose deaths.\u003c/p>\n\u003cp>She was one of about a dozen volunteers who ran a \u003ca href=\"https://www.kqed.org/news/11959803/in-act-of-civil-disobedience-activists-set-up-safe-drug-consumption-site-in-san-francisco\">pop-up overdose prevention center\u003c/a> in August, where two lives were saved from overdoses during the civil disobedience act.\u003c/p>\n\u003cp>Gubbio Project was also one nonprofit that the city had pegged to privately run safe consumption services last year when the city announced a plan to open so-called “wellness hubs” with various overdose prevention services.\u003c/p>\n\u003cp>But after months of dragging the idea along with no progress, Bransten said the plan is at a “dead end.” [aside label='More Stories on Health' tag='health']“There are a lot of words to run [supervised consumption sites], but nothing to say we will be there for you if something happens legally. That has really put people in a position where they don’t feel safe to be able to do it,” Bransten said.\u003c/p>\n\u003cp>Her organization offers a space to sleep and gives away hygiene kits to people experiencing homelessness. It also provides wellness services like massages and interfaith chaplains for people who come through its doors in the Mission neighborhood.\u003c/p>\n\u003cp>Many people who rely on Gubbio’s basic needs services also use drugs, Bransten said. The rising overdose toll has hit the community hard.\u003c/p>\n\u003cp>“We lost two people in our direct community last month, both of whom had been using drugs for decades and have been in and out of treatment multiple times,” Bransten told KQED. “This is a tragedy that is hitting not only San Francisco but cities around the country, and it will take a federal response to be able to take down some of the barriers to help us be able to curb these overdose deaths.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "New data shows there were 692 accidental overdose deaths in San Francisco from January to October of this year, surpassing the city’s prior records.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>San Francisco is on track to hit a tragic milestone by the end of the year — with more fatal overdoses projected in 2023 than any on record.\u003c/p>\n\u003cp>“It is absolutely bleak, but it is not unexpected,” said Alex Kral, an epidemiologist at the independent nonprofit research institute RTI International. “Absent any new huge impactful interventions, I would continue to expect us to get worse for a couple of years until it would stabilize. But stabilized still means bad.” \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>There were 692 accidental overdose deaths from January to October of this year, with 65 occurring in October, according to the latest \u003ca href=\"https://sf.gov/sites/default/files/2023-11/2023%2011_OCME%20Overdose%20Report.pdf\">medical examiner data\u003c/a> released Wednesday.\u003c/p>\n\u003cp>The new data supports projections made months ago that the city could eclipse its tragic milestone from 2020, when a total of 726 overdose deaths occurred.\u003c/p>\n\u003cp>Kral has studied drug use and overdoses in San Francisco for nearly 30 years. His estimation that overdose deaths may continue to rise is based on patterns in the East Coast, where fentanyl became more common in the illicit drug supply about 10 years ago, before hitting the West Coast.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>On top of a deadlier drug supply, Kral says widening economic inequality, coupled with the region’s severe lack of affordable housing and out-of-reach treatment options, have fueled overdose deaths.\u003c/p>\n\u003cp>“We have seen on the East Coast that it really took about five years or so for things to continue to skyrocket before leveling off,” Kral said. “In San Francisco, fentanyl didn’t really show up in a large way until 2019, so we are still in year three or four of that huge increase.”\u003c/p>\n\u003cp>The majority of overdose deaths occurring in San Francisco — and elsewhere across the West Coast — involve fentanyl, an opioid about 50 times stronger than heroin. Many overdose deaths in the report involved combinations of substances with fentanyl, including methamphetamine and cocaine.\u003c/p>\n\u003cp>In response to rising overdoses, local public health officials have dramatically expanded the availability of \u003ca href=\"https://www.kqed.org/news/11945418/san-francisco-has-doubled-participants-of-this-opioid-treatment-heres-why\">buprenorphine\u003c/a> and \u003ca href=\"https://www.kqed.org/news/11941618/sfs-mobile-clinics-made-opioid-treatment-more-accessible-during-the-pandemic-but-will-they-stay\">methadone\u003c/a>, medications that can curb opioid cravings and withdrawal and \u003ca href=\"https://www.kqed.org/news/11959733/san-franciscans-want-you-to-know-recovery-is-possible\">help with recovery\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_11967667\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11967667 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/11/230831-SAFE-USE-POP-UP-MD-05-qut.jpg\" alt=\"Boxes of Narcan are on a table.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/11/230831-SAFE-USE-POP-UP-MD-05-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/11/230831-SAFE-USE-POP-UP-MD-05-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/11/230831-SAFE-USE-POP-UP-MD-05-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/11/230831-SAFE-USE-POP-UP-MD-05-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/11/230831-SAFE-USE-POP-UP-MD-05-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Boxes of Narcan, the overdose prevention drug, at a safe drug use pop-up site created by volunteers with Concerned Public Response in San Francisco on Aug. 31, 2023. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In addition, the \u003ca href=\"https://www.kqed.org/news/11947448/there-to-save-a-life-san-francisco-bars-fight-fentanyl-overdoses-with-narcan\">widespread distribution of Narcan\u003c/a>, a fast-acting medicine that can reverse an opioid overdose, has saved countless lives. The city also plans to add new residential treatment beds in 2024 to its current total of 2,550.\u003c/p>\n\u003cp>“We must remain nimble in our overdose prevention efforts, including getting more people who use drugs into treatment with medications for opioid use disorder in outpatient and residential treatment settings,” reads a press statement from the Department of Public Health, released after the data was published. \u003c/p>\u003c/div>",
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"content": "‘Fentanyl is devastating communities in cities all across our country like no other drug we’ve ever experienced before and this crisis demands additional urgent intervention efforts.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>While these public health resources have been growing, Mayor London Breed has also charged local and \u003ca href=\"https://www.kqed.org/news/11948062/newsom-taps-chp-national-guard-to-fight-san-franciscos-fentanyl-crisis\">state law enforcement\u003c/a> to crack down harder on drug trafficking as well as increase \u003ca href=\"https://www.kqed.org/news/11950520/compassion-is-killing-people-london-breed-pushes-for-more-arrests-to-tackle-sfs-drug-crisis\">arrests for public drug use and dealing\u003c/a>.\u003c/p>\n\u003cp>That included bringing in the CalGuard and California Highway Patrol to work with San Francisco police, and this week, she joined 36 other U.S. mayors in asking President Joe Biden for additional support to tackle the drug supply.\u003c/p>\n\u003cp>“Fentanyl is devastating communities in cities all across our country like no other drug we’ve ever experienced before and this crisis demands additional urgent intervention efforts,” said Mayor Breed in a press statement announcing the federal funding request. “President Biden’s funding request gets at the heart of what we need — more funding for treatment to help those struggling with addiction and to prevent overdoses, and support for public safety and enforcement efforts to hold those accountable who are profiting off this deadly drug.”\u003c/p>\n\u003cp>Meanwhile, public health advocates have been pushing the city for years to open a supervised consumption site where people can use drugs in a medically supervised setting, and doctors can be available to reverse overdoses and connect users to other social or health services.\u003c/p>\n\u003cp>More than 200 such facilities operate globally, including in New York City. Rhode Island also plans to open up an overdose prevention center with funding it won from lawsuits against opioid manufacturers.\u003c/p>\n\u003cfigure id=\"attachment_11967676\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11967676 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/11/015_KQED_GubbioProjectLydiaBransten_03092023-qut.jpg\" alt=\"A sign that reads the Gubbio Project in San Francisco.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/11/015_KQED_GubbioProjectLydiaBransten_03092023-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/11/015_KQED_GubbioProjectLydiaBransten_03092023-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/11/015_KQED_GubbioProjectLydiaBransten_03092023-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/11/015_KQED_GubbioProjectLydiaBransten_03092023-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/11/015_KQED_GubbioProjectLydiaBransten_03092023-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A sign for the Gubbio Project, a nonprofit offering services for unhoused people, hangs on the front gate in San Francisco on March 9, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>San Francisco ran a safe consumption site in 2022, a year when overdose deaths dipped. There were 333 overdoses reversed at the facility, and no deaths took place. The site drew in hundreds of people a day for meals, showers and overdose prevention help but closed down after 11 months of operation. The city has not reopened a similar site since. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Supervised consumption sites are one aspect of local drug response, along with residential treatment, medication-assisted treatment, abstinence, law enforcement coordination and better access to housing and health care. But they have been hard to open in San Francisco since \u003ca href=\"https://www.kqed.org/news/11923303/sf-health-groups-determined-to-forge-ahead-with-safe-consumption-site-despite-newsoms-veto\">Gov. Gavin Newsom vetoed a bill\u003c/a> allowing the city to pilot them.\u003c/p>\n\u003cp>Supporters like Lydia Bransten, executive director of the Gubbio Project, said supervised consumption sites could make a significant difference in simply saving lives and slowing the uptick in overdose deaths.\u003c/p>\n\u003cp>She was one of about a dozen volunteers who ran a \u003ca href=\"https://www.kqed.org/news/11959803/in-act-of-civil-disobedience-activists-set-up-safe-drug-consumption-site-in-san-francisco\">pop-up overdose prevention center\u003c/a> in August, where two lives were saved from overdoses during the civil disobedience act.\u003c/p>\n\u003cp>Gubbio Project was also one nonprofit that the city had pegged to privately run safe consumption services last year when the city announced a plan to open so-called “wellness hubs” with various overdose prevention services.\u003c/p>\n\u003cp>But after months of dragging the idea along with no progress, Bransten said the plan is at a “dead end.” \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“There are a lot of words to run [supervised consumption sites], but nothing to say we will be there for you if something happens legally. That has really put people in a position where they don’t feel safe to be able to do it,” Bransten said.\u003c/p>\n\u003cp>Her organization offers a space to sleep and gives away hygiene kits to people experiencing homelessness. It also provides wellness services like massages and interfaith chaplains for people who come through its doors in the Mission neighborhood.\u003c/p>\n\u003cp>Many people who rely on Gubbio’s basic needs services also use drugs, Bransten said. The rising overdose toll has hit the community hard.\u003c/p>\n\u003cp>“We lost two people in our direct community last month, both of whom had been using drugs for decades and have been in and out of treatment multiple times,” Bransten told KQED. “This is a tragedy that is hitting not only San Francisco but cities around the country, and it will take a federal response to be able to take down some of the barriers to help us be able to curb these overdose deaths.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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