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"slug": "in-act-of-civil-disobedience-activists-set-up-safe-drug-consumption-site-in-san-francisco",
"title": "In Act of Civil Disobedience, Activists Set Up Safe Drug Consumption Site in San Francisco",
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"content": "\u003cp>At least two lives were saved on Thursday at \u003ca href=\"https://www.kqed.org/news/11923303/sf-health-groups-determined-to-forge-ahead-with-safe-consumption-site-despite-newsoms-veto\">a supervised consumption site in San Francisco\u003c/a>, also known as an overdose prevention site, where residents can consume drugs in a safe environment and trained staff are able to prevent overdoses. With the city on track this year to record the highest number of overdose deaths yet, the site was organized by public health advocates as a way to put pressure on leaders to open such a facility permanently.\u003c/p>\n\u003cp>“This is a public response to the fact that there are nearly three people a day dying of overdose in San Francisco. While we continue to talk about how to best prevent loss of life, people continue to die,” said Lydia Bransten, who was volunteering at the event. “So today is a day of action, where we are saying ‘Look how easy this is.’ It’s a very simple response to a complicated issue.”\u003c/p>\n\u003cfigure id=\"attachment_11959779\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://ww2.kqed.org/news/230831-safe-use-pop-up-md-03-kqed/\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959779\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED.jpg\" alt=\"A person with blue-rimmed glasses stands beside some tents outdoors.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lydia Bransten, a member of Concerned Public Response, volunteered at the safe consumption site. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The set-up was simple: Two E-Z UP tents were stationed in an alleyway between Polk and Van Ness on Willow Street, and underneath, people could smoke or inject their pre-obtained drugs in a safer and more private setting than on the sidewalk or elsewhere out in the public. Trained staff were present to supervise and provide water and snacks, or to administer Narcan and respirators in the event of an overdose.\u003c/p>\n\u003cp>Organizers set up the site after long delays by city leaders in opening planned “wellness hubs” with these safe consumption services. The city has already allocated $18.9 million to open the wellness hubs, which would include a variety of health and hygiene services for people experiencing homelessness or substance use disorder. Private funding would then be used to support safe consumption services, which research shows help reduce overdose deaths and operate in nearly 200 places around the globe.\u003c/p>\n\u003cp>Supporters like Bransten said that the sites are meant to be one part of a broader coordinated response to overdoses and substance use disorder, alongside expanded treatment options, mental health care and housing opportunities.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The pop-up event, held on International Overdose Awareness Day (Aug. 31), comes as \u003ca href=\"https://sf.gov/resource/2020/ocme-accidental-overdose-reports\">San Francisco is currently on pace to have its highest year for overdose deaths\u003c/a>, exceeding the record set in 2020 when 725 people lost their lives to drug overdose. In the first half of this year, 473 people died from accidental drug overdose in San Francisco, according to the medical examiner’s office.\u003c/p>\n\u003cp>The majority (80%) of those deaths involved fentanyl, an opioid 50 times stronger than heroin.\u003c/p>\n\u003cp>In addition to the safe consumption site, volunteers spoke with people in the area about safer ways to consume drugs, treatment options, and handed out donuts and water to anyone who was simply hungry.\u003c/p>\n\u003cfigure id=\"attachment_11959780\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://ww2.kqed.org/news/230831-safe-use-pop-up-md-04-kqed/\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959780\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED.jpg\" alt=\"A group of people congregate around a table in an outdoor setting.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Michael Scarce (second from left) greets a community member visiting the safe drug consumption site created by volunteers with Concerned Public Response. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The site was not only a demonstration of civil disobedience — \u003ca href=\"https://www.kqed.org/science/1980034/california-allows-supervised-illicit-drug-use-to-prevent-overdoses\">Gov. Gavin Newsom vetoed a bill in 2022 that would have allowed San Francisco to pilot the sites\u003c/a> — but also a functional facility. At least two overdoses were reversed at the site on Thursday.\u003c/p>\n\u003cp>“This is exactly what we are here to do. If we can prevent even a fraction of the overdose deaths, that’s important,” said Eli Smith, an EMT who helped reverse an overdose at the site on Thursday. “It was really great to be able to help out.”\u003c/p>\n\u003cp>J.M., who did not use a full name to protect his privacy, was staying in the alley where the demonstration took place, and noticed his friend stopped breathing after consuming fentanyl. So he hurried down to the other side of the alley, where the site was set up, and grabbed Narcan. Smith, the EMT, grabbed his medical kit and ran to follow J.M. to the friend, who was lying unresponsive on the sidewalk behind a concrete divider.\u003c/p>\n\u003cp>J.M. administered two rounds of Narcan, a nasal spray that can reverse an opioid overdose, and Smith followed with a respirator pump to provide oxygen. Soon, J.M.’s friend was breathing and slowly back on his feet, and paramedics arrived on scene to follow up. The friend chose not to leave with the paramedics, and walked away on foot.[aside label=\"Related Stories\" postID=\"news_11959733,news_11923303,news_11943309\"]“You saved his life,” Supervisor Hillary Ronen, who was at the safe consumption site on Thursday supporting the volunteers, told J.M.\u003c/p>\n\u003cp>Volunteers at the demonstration also handed out clean needles, which can prevent transmission of HIV and Hepatitis C between drug users, as well as other supplies to cut down on the physical harms associated with drug use, like alcohol wipes, fentanyl test strips and clean smoking supplies.\u003c/p>\n\u003cdiv class=\"mceTemp\">\u003c/div>\n\u003cp>Tom, Rich and Henry, who didn’t share their last names due to privacy concerns, heard about the site after organizers reached out to people living on the streets nearby. They walked over to pick up Narcan, wipes and clean needles, and they used the supervised consumption area.\u003c/p>\n\u003cp>“It’s pretty incredible how accessible this is,” said Tom. “We come across people that really do need this. We need way more [sites like this].”\u003c/p>\n\u003cp>The three men have all lost friends to overdose. Narcan, they said, has been an incredible tool to keep each other alive, but said it can be scary to use without a medical professional present. The trained staff on site gave them more reassurance that they would be okay, Tom said.\u003c/p>\n\u003cp>“People are going to use drugs no matter what, you know? Why not have a safe place where you can make sure people don’t die and there aren’t predators hanging around when you’re using,” Tom said.\u003c/p>\n\u003cfigure id=\"attachment_11959782\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959782\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED.jpg\" alt=\"A sidewalk covered with people's names and drawing of hearts.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A memorial to deceased loved ones at the safe consumption site. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Safe consumption sites can also provide other essential services like showers and laundry, free meals, and sign-ups to housing or drug treatment.\u003c/p>\n\u003cp>Sky and Q, who declined to share their last names, are currently living on the street near where the site was set up. They picked up some donuts, water and a glass pipe from the booth, and even ran into some friends.\u003c/p>\n\u003cp>“I try to use all the drop-in resources like this, this stuff is really helpful. I always keep Narcan on me in case someone needs one,” said Sky, 20. “I think people would see a lot less of what they don’t like seeing, like shoplifting and stuff, if we had more of this. It helps provide things people can’t get for themselves.”\u003c/p>\n\u003cp>More than 200 safe consumption sites operate globally, including in countries with multiple sites like France, Germany and Norway. Zero overdose deaths have been recorded in these facilities.\u003c/p>\n\u003cp>But San Francisco and California government leaders have long delayed opening safe consumption sites, which are also known as overdose prevention centers.\u003c/p>\n\u003cp>The Tenderloin Center, in United Nations Plaza, offered safe consumption services while it was open for 11 months in 2022, before city officials closed it down.\u003c/p>\n\u003cp>But local businesses complained that the facility drew crowds of people waiting for services just outside the Civic Center BART station, and \u003ca href=\"https://www.kqed.org/news/11923129/sf-political-leaders-speak-at-rally-opposing-safe-injection-sites-even-as-many-privately-say-they-support-them\">other residents and political leaders criticized\u003c/a> the model for failing to connect many people to longer-term drug treatment.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11915870/inside-san-franciscos-tenderloin-center-that-serves-hundreds-every-day\">Inside the Tenderloin Center\u003c/a>, however, hundreds of people arrived daily to get their basic needs met. In total, 333 overdoses were reversed by trained staff there and no one died on the premises, research on the facility shows.\u003c/p>\n\u003cp>Smith, the EMT who helped reverse overdoses at the demonstration on Thursday, witnessed hundreds of overdoses reversed at the Tenderloin Center while he was working there.\u003c/p>\n\u003cp>One woman at the pop-up site on Thursday said she would visit the Tenderloin Center “everyday” back when it was still open for a hot meal, showers and a safe place away from the sidewalk to smoke.\u003c/p>\n\u003cfigure id=\"attachment_11959777\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959777\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED.jpg\" alt=\"Two tents set up on a sidewalk on a city block.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Concerned Public Response safe drug consumption site on Aug. 31, 2023. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Mayor London Breed, whose sister died of a drug overdose, supports supervised consumption services. But opening one in San Francisco has been a slow battle. Gavin Newsom vetoed legislation that would have allowed the city to pilot the services. Meanwhile, Rhode Island and New York City have moved ahead with plans and programs despite legal uncertainties.\u003c/p>\n\u003cp>“The mayor continues to support safe consumption sites. These are complicated legal issues that we continue to navigate with our nonprofit partners,” a spokesperson from the mayor’s office said in an email to KQED.\u003c/p>\n\u003cp>After Newsom’s veto, San Francisco leaders funded so-called “wellness hubs” instead, to serve as low-barrier drop-in health facilities that could offer similar services as the Tenderloin Center, with \u003ca href=\"https://www.kqed.org/news/11943309/sf-supervisors-carve-path-for-privately-run-safe-consumption-sites-but-can-nonprofits-fund-them-alone&sa=D&source=docs&ust=1693523375935961&usg=AOvVaw3NGVB6_gFojpUoI4tJe-un\">a private nonprofit funding and running the safe consumption sites at these hubs\u003c/a>, similar to the model used in New York City.\u003c/p>\n\u003cp>Supervisor Ronen stressed that opening up wellness hubs with safe consumption sites is a priority in her remaining time in office.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“Overdose prevention sites, they are not a nefarious, scary thing. Take a look at one in public. We are offering a space where we can watch people to make sure they don’t die. That’s it, it’s that simple,” said Ronen. “We want to provide love, tell people we care about them, and want to support them to eventually get into treatment and get well. But in the meantime, we need to keep them alive to get there.”\u003c/p>\n\n",
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"excerpt": "A group of health practitioners and activists protested delays by city leaders to address the overdose crisis — and saved lives in the process.",
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"title": "In Act of Civil Disobedience, Activists Set Up Safe Drug Consumption Site in San Francisco | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>At least two lives were saved on Thursday at \u003ca href=\"https://www.kqed.org/news/11923303/sf-health-groups-determined-to-forge-ahead-with-safe-consumption-site-despite-newsoms-veto\">a supervised consumption site in San Francisco\u003c/a>, also known as an overdose prevention site, where residents can consume drugs in a safe environment and trained staff are able to prevent overdoses. With the city on track this year to record the highest number of overdose deaths yet, the site was organized by public health advocates as a way to put pressure on leaders to open such a facility permanently.\u003c/p>\n\u003cp>“This is a public response to the fact that there are nearly three people a day dying of overdose in San Francisco. While we continue to talk about how to best prevent loss of life, people continue to die,” said Lydia Bransten, who was volunteering at the event. “So today is a day of action, where we are saying ‘Look how easy this is.’ It’s a very simple response to a complicated issue.”\u003c/p>\n\u003cfigure id=\"attachment_11959779\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://ww2.kqed.org/news/230831-safe-use-pop-up-md-03-kqed/\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959779\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED.jpg\" alt=\"A person with blue-rimmed glasses stands beside some tents outdoors.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-03-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lydia Bransten, a member of Concerned Public Response, volunteered at the safe consumption site. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The set-up was simple: Two E-Z UP tents were stationed in an alleyway between Polk and Van Ness on Willow Street, and underneath, people could smoke or inject their pre-obtained drugs in a safer and more private setting than on the sidewalk or elsewhere out in the public. Trained staff were present to supervise and provide water and snacks, or to administer Narcan and respirators in the event of an overdose.\u003c/p>\n\u003cp>Organizers set up the site after long delays by city leaders in opening planned “wellness hubs” with these safe consumption services. The city has already allocated $18.9 million to open the wellness hubs, which would include a variety of health and hygiene services for people experiencing homelessness or substance use disorder. Private funding would then be used to support safe consumption services, which research shows help reduce overdose deaths and operate in nearly 200 places around the globe.\u003c/p>\n\u003cp>Supporters like Bransten said that the sites are meant to be one part of a broader coordinated response to overdoses and substance use disorder, alongside expanded treatment options, mental health care and housing opportunities.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The pop-up event, held on International Overdose Awareness Day (Aug. 31), comes as \u003ca href=\"https://sf.gov/resource/2020/ocme-accidental-overdose-reports\">San Francisco is currently on pace to have its highest year for overdose deaths\u003c/a>, exceeding the record set in 2020 when 725 people lost their lives to drug overdose. In the first half of this year, 473 people died from accidental drug overdose in San Francisco, according to the medical examiner’s office.\u003c/p>\n\u003cp>The majority (80%) of those deaths involved fentanyl, an opioid 50 times stronger than heroin.\u003c/p>\n\u003cp>In addition to the safe consumption site, volunteers spoke with people in the area about safer ways to consume drugs, treatment options, and handed out donuts and water to anyone who was simply hungry.\u003c/p>\n\u003cfigure id=\"attachment_11959780\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://ww2.kqed.org/news/230831-safe-use-pop-up-md-04-kqed/\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959780\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED.jpg\" alt=\"A group of people congregate around a table in an outdoor setting.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-04-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Michael Scarce (second from left) greets a community member visiting the safe drug consumption site created by volunteers with Concerned Public Response. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The site was not only a demonstration of civil disobedience — \u003ca href=\"https://www.kqed.org/science/1980034/california-allows-supervised-illicit-drug-use-to-prevent-overdoses\">Gov. Gavin Newsom vetoed a bill in 2022 that would have allowed San Francisco to pilot the sites\u003c/a> — but also a functional facility. At least two overdoses were reversed at the site on Thursday.\u003c/p>\n\u003cp>“This is exactly what we are here to do. If we can prevent even a fraction of the overdose deaths, that’s important,” said Eli Smith, an EMT who helped reverse an overdose at the site on Thursday. “It was really great to be able to help out.”\u003c/p>\n\u003cp>J.M., who did not use a full name to protect his privacy, was staying in the alley where the demonstration took place, and noticed his friend stopped breathing after consuming fentanyl. So he hurried down to the other side of the alley, where the site was set up, and grabbed Narcan. Smith, the EMT, grabbed his medical kit and ran to follow J.M. to the friend, who was lying unresponsive on the sidewalk behind a concrete divider.\u003c/p>\n\u003cp>J.M. administered two rounds of Narcan, a nasal spray that can reverse an opioid overdose, and Smith followed with a respirator pump to provide oxygen. Soon, J.M.’s friend was breathing and slowly back on his feet, and paramedics arrived on scene to follow up. The friend chose not to leave with the paramedics, and walked away on foot.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“You saved his life,” Supervisor Hillary Ronen, who was at the safe consumption site on Thursday supporting the volunteers, told J.M.\u003c/p>\n\u003cp>Volunteers at the demonstration also handed out clean needles, which can prevent transmission of HIV and Hepatitis C between drug users, as well as other supplies to cut down on the physical harms associated with drug use, like alcohol wipes, fentanyl test strips and clean smoking supplies.\u003c/p>\n\u003cdiv class=\"mceTemp\">\u003c/div>\n\u003cp>Tom, Rich and Henry, who didn’t share their last names due to privacy concerns, heard about the site after organizers reached out to people living on the streets nearby. They walked over to pick up Narcan, wipes and clean needles, and they used the supervised consumption area.\u003c/p>\n\u003cp>“It’s pretty incredible how accessible this is,” said Tom. “We come across people that really do need this. We need way more [sites like this].”\u003c/p>\n\u003cp>The three men have all lost friends to overdose. Narcan, they said, has been an incredible tool to keep each other alive, but said it can be scary to use without a medical professional present. The trained staff on site gave them more reassurance that they would be okay, Tom said.\u003c/p>\n\u003cp>“People are going to use drugs no matter what, you know? Why not have a safe place where you can make sure people don’t die and there aren’t predators hanging around when you’re using,” Tom said.\u003c/p>\n\u003cfigure id=\"attachment_11959782\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959782\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED.jpg\" alt=\"A sidewalk covered with people's names and drawing of hearts.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-06-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A memorial to deceased loved ones at the safe consumption site. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Safe consumption sites can also provide other essential services like showers and laundry, free meals, and sign-ups to housing or drug treatment.\u003c/p>\n\u003cp>Sky and Q, who declined to share their last names, are currently living on the street near where the site was set up. They picked up some donuts, water and a glass pipe from the booth, and even ran into some friends.\u003c/p>\n\u003cp>“I try to use all the drop-in resources like this, this stuff is really helpful. I always keep Narcan on me in case someone needs one,” said Sky, 20. “I think people would see a lot less of what they don’t like seeing, like shoplifting and stuff, if we had more of this. It helps provide things people can’t get for themselves.”\u003c/p>\n\u003cp>More than 200 safe consumption sites operate globally, including in countries with multiple sites like France, Germany and Norway. Zero overdose deaths have been recorded in these facilities.\u003c/p>\n\u003cp>But San Francisco and California government leaders have long delayed opening safe consumption sites, which are also known as overdose prevention centers.\u003c/p>\n\u003cp>The Tenderloin Center, in United Nations Plaza, offered safe consumption services while it was open for 11 months in 2022, before city officials closed it down.\u003c/p>\n\u003cp>But local businesses complained that the facility drew crowds of people waiting for services just outside the Civic Center BART station, and \u003ca href=\"https://www.kqed.org/news/11923129/sf-political-leaders-speak-at-rally-opposing-safe-injection-sites-even-as-many-privately-say-they-support-them\">other residents and political leaders criticized\u003c/a> the model for failing to connect many people to longer-term drug treatment.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11915870/inside-san-franciscos-tenderloin-center-that-serves-hundreds-every-day\">Inside the Tenderloin Center\u003c/a>, however, hundreds of people arrived daily to get their basic needs met. In total, 333 overdoses were reversed by trained staff there and no one died on the premises, research on the facility shows.\u003c/p>\n\u003cp>Smith, the EMT who helped reverse overdoses at the demonstration on Thursday, witnessed hundreds of overdoses reversed at the Tenderloin Center while he was working there.\u003c/p>\n\u003cp>One woman at the pop-up site on Thursday said she would visit the Tenderloin Center “everyday” back when it was still open for a hot meal, showers and a safe place away from the sidewalk to smoke.\u003c/p>\n\u003cfigure id=\"attachment_11959777\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959777\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED.jpg\" alt=\"Two tents set up on a sidewalk on a city block.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/230831-SAFE-USE-POP-UP-MD-01-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Concerned Public Response safe drug consumption site on Aug. 31, 2023. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Mayor London Breed, whose sister died of a drug overdose, supports supervised consumption services. But opening one in San Francisco has been a slow battle. Gavin Newsom vetoed legislation that would have allowed the city to pilot the services. Meanwhile, Rhode Island and New York City have moved ahead with plans and programs despite legal uncertainties.\u003c/p>\n\u003cp>“The mayor continues to support safe consumption sites. These are complicated legal issues that we continue to navigate with our nonprofit partners,” a spokesperson from the mayor’s office said in an email to KQED.\u003c/p>\n\u003cp>After Newsom’s veto, San Francisco leaders funded so-called “wellness hubs” instead, to serve as low-barrier drop-in health facilities that could offer similar services as the Tenderloin Center, with \u003ca href=\"https://www.kqed.org/news/11943309/sf-supervisors-carve-path-for-privately-run-safe-consumption-sites-but-can-nonprofits-fund-them-alone&sa=D&source=docs&ust=1693523375935961&usg=AOvVaw3NGVB6_gFojpUoI4tJe-un\">a private nonprofit funding and running the safe consumption sites at these hubs\u003c/a>, similar to the model used in New York City.\u003c/p>\n\u003cp>Supervisor Ronen stressed that opening up wellness hubs with safe consumption sites is a priority in her remaining time in office.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Overdose prevention sites, they are not a nefarious, scary thing. Take a look at one in public. We are offering a space where we can watch people to make sure they don’t die. That’s it, it’s that simple,” said Ronen. “We want to provide love, tell people we care about them, and want to support them to eventually get into treatment and get well. But in the meantime, we need to keep them alive to get there.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "These San Franciscans Say Recovery From Drug Addiction Is Possible",
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"content": "\u003cp>In the first half of 2023, 473 people — at least — died from accidental drug overdose in San Francisco, according to the medical examiner’s office.\u003c/p>\n\u003cp>The majority (80%) of those deaths involved\u003ca href=\"https://www.kqed.org/news/tag/fentanyl\"> fentanyl\u003c/a>, an opioid 50 times stronger than heroin. This year, the overdose rate is currently on pace to be the highest for overdose deaths in the city’s history, exceeding the record set in 2020 when 725 people died due to drug overdose.\u003c/p>\n\u003cp>The overdose epidemic in San Francisco has continued to escalate despite attempts from city leaders to expand access to treatment and \u003ca href=\"https://www.kqed.org/news/11948062/newsom-taps-chp-national-guard-to-fight-san-franciscos-fentanyl-crisis\">tap the National Guard\u003c/a> to throttle drug supply trafficking.\u003c/p>\n\u003cp>The situation is bleak, but it’s not without hope. Recovery is possible.\u003c/p>\n\u003cp>What follows is the story of three San Francisco residents, who share their journey through recovery and life beyond drug addiction.\u003c/p>\n\u003cp>KQED is publishing these stories on Aug. 31, International Overdose Awareness Day, and the week the Biden administration has designated to “honor and remember those who have lost their lives to the drug overdose epidemic.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003ch2>Jean\u003c/h2>\n\u003cp>San Francisco has long been a city where people come to reinvent themselves. Sometimes, it just takes a little while.\u003c/p>\n\u003cp>Take Jean, now 60, a mother and longtime San Francisco resident.\u003c/p>\n\u003cp>Jean, who is not using her last name to protect her privacy, grew up in Berkeley and faced numerous traumatizing experiences, including abuse at a young age. She started consuming drugs at just 9 years old to cope with feelings and cover up shame. Over the years, Jean developed addictions to cocaine, alcohol and heroin.[pullquote size=\"medium\" align=\"right\" citation=\"Jean, San Francisco resident in recovery\"]‘I sought help because I knew that I couldn’t get out of my drug addiction by myself. … It can be a new beginning, and the energy you put into that, you’re going to get back.’[/pullquote]“I basically did a lot of things in order to support a heroin habit and a cocaine habit and alcohol. And it just got progressively worse,” Jean told KQED of her experience with addiction.\u003c/p>\n\u003cp>When she was diagnosed with cancer later on in her life, she thought she might not make it.\u003c/p>\n\u003cp>But Jean defied the odds she gave herself and beat cancer. Armed with a new perspective, she decided it was time to fight her addiction, too.\u003c/p>\n\u003cp>She started by going to Zuckerberg San Francisco General Hospital and asking for help. There, she got connected to an \u003ca href=\"https://dsaam.org/otop/\">outpatient treatment program\u003c/a>.\u003c/p>\n\u003cp>“I sought help because I knew that I couldn’t get out of my drug addiction by myself,” she said. “I got help and throughout that process. I learned about addiction. I learned that it’s a disease, it’s something that you can work through and that doesn’t have to take all your life away. It can be a new beginning, and the energy you put into that, you’re going to get back.”\u003c/p>\n\u003cp>Through her treatment, Jean was connected to substance-use counselors like Louie Ramos and had access to medications that helped ease cravings and withdrawal. She also participated in a detox program at \u003ca href=\"https://www.healthright360.org/\">HealthRight360\u003c/a>, a nonprofit that provides mental health therapy and substance-use treatment for extremely low-income residents in San Francisco and other parts of California.\u003c/p>\n\u003cp>Today, Jean is living a life she once couldn’t imagine: sober and living on her own in an apartment near the Giants’ baseball stadium. She’s established a new community of friends who support her changes and understand the challenges she faces.\u003c/p>\n\u003cp>She wants other people in similar positions to know they can do the same.\u003c/p>\n\u003cfigure id=\"attachment_11959603\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959603\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED.jpg\" alt='Two people walk down a hallway beneath a banner that reads \"Welcome to OTOP.\"' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jean, 60, walks with counselor Louie Ramos, UCSF/OTOP clinical supervisor, through the Opiate Treatment Outpatient Program (OTOP) at Zuckerberg San Francisco General Hospital in San Francisco on Aug. 29, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“There is a way out. There is freedom from addiction. It’s possible to come out from under fentanyl. You really just have to keep putting your best foot forward,” Jean said.\u003c/p>\n\u003cp>While Jean walked into San Francisco General on her own, San Francisco has a handful of teams that respond to overdoses and drug-related medical problems on the street. They include the \u003ca href=\"https://sf.gov/street-overdose-response-team\">Street Overdose Response Team\u003c/a>, Post Overdose Engagement Team, and the Bridge and Engagement Services Team Neighborhoods program, which aims to identify individuals who may be in crisis and connect them to long-term behavioral health services.\u003c/p>\n\u003cp>Getting connected to methadone, a medication that can help relieve addiction cravings and withdrawal symptoms, was a crucial stepping stone in recovering from addiction, Jean said.[pullquote size=\"medium\" align=\"right\" citation=\"Louie Ramos, substance-use counselor, Zuckerberg San Francisco General Hospital\"]‘I’ve been doing this job for many years, and I just want people to know that recovery is very possible. Treatment is accessible.’[/pullquote]San Francisco has been simultaneously working to expand ways people can get connected to methadone and other medication-assisted treatments for drug addiction, through \u003ca href=\"https://www.kqed.org/news/11941618/sfs-mobile-clinics-made-opioid-treatment-more-accessible-during-the-pandemic-but-will-they-stay\">mobile clinics\u003c/a>, longer open hours at brick-and-mortar clinics in the city and even \u003ca href=\"https://www.kqed.org/news/11945418/san-francisco-has-doubled-participants-of-this-opioid-treatment-heres-why\">delivery services in supportive housing buildings\u003c/a>.\u003c/p>\n\u003cp>“I’ve been doing this job for many years, and I just want people to know that recovery is very possible. Treatment is accessible,” said Ramos, who is a clinical site supervisor for one of San Francisco General’s mobile methadone clinics in the Bayview. “A lot of people are reluctant to seek services, and you don’t want to force or impose. It takes a while to build trust and not everybody is able to do everything at once. You have to walk with them continuously, through the ups and downs, [and] let them know they are not being judged.”\u003c/p>\n\u003cp>It wasn’t a linear path to where she is today. At several points since deciding she wanted to quit using, Jean relapsed. One time, it happened after someone she knew sexually assaulted her.\u003c/p>\n\u003cp>“I went towards street drugs to ease my pain instead of reaching out to the recovery community, so it led me down a path that took a long time to come out of,” Jean said, after an appointment with her counselor on a recent Wednesday afternoon. “But I did.”\u003c/p>\n\u003ch2>Juliana and Michael\u003c/h2>\n\u003cp>Juliana, 29, and her partner Michael, 31, fell in love dancing at raves and music festivals in their early 20s. Michael worked up the courage to talk to her at a show in Las Vegas, and the two kept in touch at various music events. The two made their relationship official after attending the Coachella Valley Music and Arts Festival in Indio, California.\u003c/p>\n\u003cp>“She was super beautiful, and I just knew that she was really cool. She liked the same things as me,” Michael said. “After Coachella, I was like, I got to make her my girlfriend.”[pullquote size=\"medium\" align=\"right\" citation=\"Juliana, San Francisco resident in recovery\"]‘The three things we always made sure we had were a car, a hotel and drugs, always.’[/pullquote]The duo had fun getting lost in the music together. But drugs were common in the festival scene, and Michael already struggled with an addiction to smoking oxycontin when they met.\u003c/p>\n\u003cp>Juliana eventually consumed harder drugs with Michael, including heroin and fentanyl, and the two spent several years drifting between family members’ houses in San José and Santa Rosa, and many nights in and out of jail for drug use and shoplifting. They talked about getting help and quitting drugs, but it still felt too far off, and too expensive, so they delayed.\u003c/p>\n\u003cp>“The three things we always made sure we had were a car, a hotel and drugs, always,” Juliana said.\u003c/p>\n\u003cp>During the pandemic, they stayed in hotels in San Francisco. But their lives suddenly changed one day in 2021.\u003c/p>\n\u003cp>Juliana felt an extremely sharp pain in her abdomen and checked into the hospital. There, she discovered that she not only was pregnant, but was in labor and about to give birth.\u003c/p>\n\u003cp>“She wasn’t active in my stomach, and I didn’t have morning sickness. I didn’t really have the regular pregnancy signs,” said Juliana, referring to her baby girl.\u003c/p>\n\u003cp>Michael was equally shocked.\u003c/p>\n\u003cfigure id=\"attachment_11959601\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959601\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED.jpg\" alt=\"Two adults and one infant sit on the floor and play together with blocks.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Juliana and Michael play blocks with their daughter Paloma at their home in San Francisco on Aug. 29, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“If we had known that we were having a baby, I would have been too scared to be a father. I wasn’t ready. But it just happened all of the sudden. They let me in and said, congratulations, you have a daughter. I felt a connection immediately, her smile, I was like, ‘Oh my God, I have a daughter.’”\u003c/p>\n\u003cp>Child protective services and Family Treatment Court quickly approached them, helping create a plan for how they would re-establish their lives together and welcome home their baby.\u003c/p>\n\u003cp>Juliana and Michael entered treatment and joined groups to help them in their recovery. That included living at \u003ca href=\"https://www.hamiltonfamilies.org/\">Hamilton Families\u003c/a>, a transitional housing program where they stayed while starting their recovery journey.[pullquote size=\"medium\" align=\"right\" citation=\"Michael, San Francisco resident in recovery\"]‘We basically had to learn how to be a couple again, without the drugs, because that was part of our relationship for so long. We had to relearn how to be a normal couple, and not only that, but parents.’[/pullquote]Meanwhile, Juliana worked with \u003ca href=\"https://obgyn.ucsf.edu/san-francisco-general-hospital/team-lily\">Team Lily, a group at San Francisco General Hospital\u003c/a> that supports pregnant people and new parents who are experiencing homelessness, substance-use disorders, incarceration and other challenges.\u003c/p>\n\u003cp>Just like Jean, Michael and Juliana relapsed during their effort to stay sober. They separated for a short period of time during their treatment programs and used again after reuniting.\u003c/p>\n\u003cp>“It was a problem of not being able to set boundaries with each other,” Juliana said.\u003c/p>\n\u003cp>Michael agrees.\u003c/p>\n\u003cp>“We basically had to learn how to be a couple again, without the drugs, because that was part of our relationship for so long,” he said. “We had to relearn how to be a normal couple, and not only that, but parents.”\u003c/p>\n\u003cfigure id=\"attachment_11959600\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959600\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED.jpg\" alt=\"A framed photo of a group of people in an official looking setting.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A photo sits on a shelf from a graduation ceremony for the San Francisco Family Treatment Court at the home of Juliana and Michael in San Francisco on Aug. 29, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>With help from their case manager, the two were able to get back on track and hold on to the progress they made, including their housing and future as a family together.\u003c/p>\n\u003cp>Juliana added that the city’s prenatal program for those experiencing homelessness “connected us with a bunch of things that helped us get back on our feet, like health insurance, and just showed us a lot of options that were available to us that we didn’t know about.”\u003c/p>\n\u003cp>Methadone has been a big part of their recovery. Each month, Juliana will visit an outpatient treatment program to refill her prescription of opioid addiction medication and take a drug test before meeting with a counselor.[aside postID=news_11954871 hero='https://ww2.kqed.org/app/uploads/sites/10/2023/07/RS66620_20230623-SFAIDSFoundation-004-BL-KQED-1020x680.jpg']“Some people look at methadone in a bad light. But honestly, it’s the only thing that helps me stop smoking. My life is so much better and I’m happy and able to have a family and be a father. All this just wouldn’t be possible without it,” Michael said.\u003c/p>\n\u003cp>Today, the couple is raising their baby, Paloma, in a bright apartment in the Richmond District, while continuing to meet with recovery groups and other programs that have supported their journey.\u003c/p>\n\u003cp>Michael is leading a group for fathers within the prenatal program that helped his family. He’s also taking a course on mental health and substance abuse to further his training in counseling facilitation. Juliana has plans to someday return to hairstyling and has maintained a cosmetology license.\u003c/p>\n\u003cp>It’s not always an easy journey, but it’s given the two more faith in what they can overcome.\u003c/p>\n\u003cp>“If you can find an addiction together,” Michael said, “you can find recovery together.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In the first half of 2023, 473 people — at least — died from accidental drug overdose in San Francisco, according to the medical examiner’s office.\u003c/p>\n\u003cp>The majority (80%) of those deaths involved\u003ca href=\"https://www.kqed.org/news/tag/fentanyl\"> fentanyl\u003c/a>, an opioid 50 times stronger than heroin. This year, the overdose rate is currently on pace to be the highest for overdose deaths in the city’s history, exceeding the record set in 2020 when 725 people died due to drug overdose.\u003c/p>\n\u003cp>The overdose epidemic in San Francisco has continued to escalate despite attempts from city leaders to expand access to treatment and \u003ca href=\"https://www.kqed.org/news/11948062/newsom-taps-chp-national-guard-to-fight-san-franciscos-fentanyl-crisis\">tap the National Guard\u003c/a> to throttle drug supply trafficking.\u003c/p>\n\u003cp>The situation is bleak, but it’s not without hope. Recovery is possible.\u003c/p>\n\u003cp>What follows is the story of three San Francisco residents, who share their journey through recovery and life beyond drug addiction.\u003c/p>\n\u003cp>KQED is publishing these stories on Aug. 31, International Overdose Awareness Day, and the week the Biden administration has designated to “honor and remember those who have lost their lives to the drug overdose epidemic.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch2>Jean\u003c/h2>\n\u003cp>San Francisco has long been a city where people come to reinvent themselves. Sometimes, it just takes a little while.\u003c/p>\n\u003cp>Take Jean, now 60, a mother and longtime San Francisco resident.\u003c/p>\n\u003cp>Jean, who is not using her last name to protect her privacy, grew up in Berkeley and faced numerous traumatizing experiences, including abuse at a young age. She started consuming drugs at just 9 years old to cope with feelings and cover up shame. Over the years, Jean developed addictions to cocaine, alcohol and heroin.\u003c/p>\u003c/div>",
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"content": "‘I sought help because I knew that I couldn’t get out of my drug addiction by myself. … It can be a new beginning, and the energy you put into that, you’re going to get back.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“I basically did a lot of things in order to support a heroin habit and a cocaine habit and alcohol. And it just got progressively worse,” Jean told KQED of her experience with addiction.\u003c/p>\n\u003cp>When she was diagnosed with cancer later on in her life, she thought she might not make it.\u003c/p>\n\u003cp>But Jean defied the odds she gave herself and beat cancer. Armed with a new perspective, she decided it was time to fight her addiction, too.\u003c/p>\n\u003cp>She started by going to Zuckerberg San Francisco General Hospital and asking for help. There, she got connected to an \u003ca href=\"https://dsaam.org/otop/\">outpatient treatment program\u003c/a>.\u003c/p>\n\u003cp>“I sought help because I knew that I couldn’t get out of my drug addiction by myself,” she said. “I got help and throughout that process. I learned about addiction. I learned that it’s a disease, it’s something that you can work through and that doesn’t have to take all your life away. It can be a new beginning, and the energy you put into that, you’re going to get back.”\u003c/p>\n\u003cp>Through her treatment, Jean was connected to substance-use counselors like Louie Ramos and had access to medications that helped ease cravings and withdrawal. She also participated in a detox program at \u003ca href=\"https://www.healthright360.org/\">HealthRight360\u003c/a>, a nonprofit that provides mental health therapy and substance-use treatment for extremely low-income residents in San Francisco and other parts of California.\u003c/p>\n\u003cp>Today, Jean is living a life she once couldn’t imagine: sober and living on her own in an apartment near the Giants’ baseball stadium. She’s established a new community of friends who support her changes and understand the challenges she faces.\u003c/p>\n\u003cp>She wants other people in similar positions to know they can do the same.\u003c/p>\n\u003cfigure id=\"attachment_11959603\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959603\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED.jpg\" alt='Two people walk down a hallway beneath a banner that reads \"Welcome to OTOP.\"' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68433_230829-ODAwareness-22-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jean, 60, walks with counselor Louie Ramos, UCSF/OTOP clinical supervisor, through the Opiate Treatment Outpatient Program (OTOP) at Zuckerberg San Francisco General Hospital in San Francisco on Aug. 29, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“There is a way out. There is freedom from addiction. It’s possible to come out from under fentanyl. You really just have to keep putting your best foot forward,” Jean said.\u003c/p>\n\u003cp>While Jean walked into San Francisco General on her own, San Francisco has a handful of teams that respond to overdoses and drug-related medical problems on the street. They include the \u003ca href=\"https://sf.gov/street-overdose-response-team\">Street Overdose Response Team\u003c/a>, Post Overdose Engagement Team, and the Bridge and Engagement Services Team Neighborhoods program, which aims to identify individuals who may be in crisis and connect them to long-term behavioral health services.\u003c/p>\n\u003cp>Getting connected to methadone, a medication that can help relieve addiction cravings and withdrawal symptoms, was a crucial stepping stone in recovering from addiction, Jean said.\u003c/p>\u003c/div>",
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"content": "‘I’ve been doing this job for many years, and I just want people to know that recovery is very possible. Treatment is accessible.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>San Francisco has been simultaneously working to expand ways people can get connected to methadone and other medication-assisted treatments for drug addiction, through \u003ca href=\"https://www.kqed.org/news/11941618/sfs-mobile-clinics-made-opioid-treatment-more-accessible-during-the-pandemic-but-will-they-stay\">mobile clinics\u003c/a>, longer open hours at brick-and-mortar clinics in the city and even \u003ca href=\"https://www.kqed.org/news/11945418/san-francisco-has-doubled-participants-of-this-opioid-treatment-heres-why\">delivery services in supportive housing buildings\u003c/a>.\u003c/p>\n\u003cp>“I’ve been doing this job for many years, and I just want people to know that recovery is very possible. Treatment is accessible,” said Ramos, who is a clinical site supervisor for one of San Francisco General’s mobile methadone clinics in the Bayview. “A lot of people are reluctant to seek services, and you don’t want to force or impose. It takes a while to build trust and not everybody is able to do everything at once. You have to walk with them continuously, through the ups and downs, [and] let them know they are not being judged.”\u003c/p>\n\u003cp>It wasn’t a linear path to where she is today. At several points since deciding she wanted to quit using, Jean relapsed. One time, it happened after someone she knew sexually assaulted her.\u003c/p>\n\u003cp>“I went towards street drugs to ease my pain instead of reaching out to the recovery community, so it led me down a path that took a long time to come out of,” Jean said, after an appointment with her counselor on a recent Wednesday afternoon. “But I did.”\u003c/p>\n\u003ch2>Juliana and Michael\u003c/h2>\n\u003cp>Juliana, 29, and her partner Michael, 31, fell in love dancing at raves and music festivals in their early 20s. Michael worked up the courage to talk to her at a show in Las Vegas, and the two kept in touch at various music events. The two made their relationship official after attending the Coachella Valley Music and Arts Festival in Indio, California.\u003c/p>\n\u003cp>“She was super beautiful, and I just knew that she was really cool. She liked the same things as me,” Michael said. “After Coachella, I was like, I got to make her my girlfriend.”\u003c/p>\u003c/div>",
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"content": "‘The three things we always made sure we had were a car, a hotel and drugs, always.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The duo had fun getting lost in the music together. But drugs were common in the festival scene, and Michael already struggled with an addiction to smoking oxycontin when they met.\u003c/p>\n\u003cp>Juliana eventually consumed harder drugs with Michael, including heroin and fentanyl, and the two spent several years drifting between family members’ houses in San José and Santa Rosa, and many nights in and out of jail for drug use and shoplifting. They talked about getting help and quitting drugs, but it still felt too far off, and too expensive, so they delayed.\u003c/p>\n\u003cp>“The three things we always made sure we had were a car, a hotel and drugs, always,” Juliana said.\u003c/p>\n\u003cp>During the pandemic, they stayed in hotels in San Francisco. But their lives suddenly changed one day in 2021.\u003c/p>\n\u003cp>Juliana felt an extremely sharp pain in her abdomen and checked into the hospital. There, she discovered that she not only was pregnant, but was in labor and about to give birth.\u003c/p>\n\u003cp>“She wasn’t active in my stomach, and I didn’t have morning sickness. I didn’t really have the regular pregnancy signs,” said Juliana, referring to her baby girl.\u003c/p>\n\u003cp>Michael was equally shocked.\u003c/p>\n\u003cfigure id=\"attachment_11959601\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959601\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED.jpg\" alt=\"Two adults and one infant sit on the floor and play together with blocks.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68426_230829-ODAwareness-14-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Juliana and Michael play blocks with their daughter Paloma at their home in San Francisco on Aug. 29, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“If we had known that we were having a baby, I would have been too scared to be a father. I wasn’t ready. But it just happened all of the sudden. They let me in and said, congratulations, you have a daughter. I felt a connection immediately, her smile, I was like, ‘Oh my God, I have a daughter.’”\u003c/p>\n\u003cp>Child protective services and Family Treatment Court quickly approached them, helping create a plan for how they would re-establish their lives together and welcome home their baby.\u003c/p>\n\u003cp>Juliana and Michael entered treatment and joined groups to help them in their recovery. That included living at \u003ca href=\"https://www.hamiltonfamilies.org/\">Hamilton Families\u003c/a>, a transitional housing program where they stayed while starting their recovery journey.\u003c/p>\u003c/div>",
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"content": "‘We basically had to learn how to be a couple again, without the drugs, because that was part of our relationship for so long. We had to relearn how to be a normal couple, and not only that, but parents.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Meanwhile, Juliana worked with \u003ca href=\"https://obgyn.ucsf.edu/san-francisco-general-hospital/team-lily\">Team Lily, a group at San Francisco General Hospital\u003c/a> that supports pregnant people and new parents who are experiencing homelessness, substance-use disorders, incarceration and other challenges.\u003c/p>\n\u003cp>Just like Jean, Michael and Juliana relapsed during their effort to stay sober. They separated for a short period of time during their treatment programs and used again after reuniting.\u003c/p>\n\u003cp>“It was a problem of not being able to set boundaries with each other,” Juliana said.\u003c/p>\n\u003cp>Michael agrees.\u003c/p>\n\u003cp>“We basically had to learn how to be a couple again, without the drugs, because that was part of our relationship for so long,” he said. “We had to relearn how to be a normal couple, and not only that, but parents.”\u003c/p>\n\u003cfigure id=\"attachment_11959600\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959600\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED.jpg\" alt=\"A framed photo of a group of people in an official looking setting.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS68420_230829-ODAwareness-09-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A photo sits on a shelf from a graduation ceremony for the San Francisco Family Treatment Court at the home of Juliana and Michael in San Francisco on Aug. 29, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>With help from their case manager, the two were able to get back on track and hold on to the progress they made, including their housing and future as a family together.\u003c/p>\n\u003cp>Juliana added that the city’s prenatal program for those experiencing homelessness “connected us with a bunch of things that helped us get back on our feet, like health insurance, and just showed us a lot of options that were available to us that we didn’t know about.”\u003c/p>\n\u003cp>Methadone has been a big part of their recovery. Each month, Juliana will visit an outpatient treatment program to refill her prescription of opioid addiction medication and take a drug test before meeting with a counselor.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“Some people look at methadone in a bad light. But honestly, it’s the only thing that helps me stop smoking. My life is so much better and I’m happy and able to have a family and be a father. All this just wouldn’t be possible without it,” Michael said.\u003c/p>\n\u003cp>Today, the couple is raising their baby, Paloma, in a bright apartment in the Richmond District, while continuing to meet with recovery groups and other programs that have supported their journey.\u003c/p>\n\u003cp>Michael is leading a group for fathers within the prenatal program that helped his family. He’s also taking a course on mental health and substance abuse to further his training in counseling facilitation. Juliana has plans to someday return to hairstyling and has maintained a cosmetology license.\u003c/p>\n\u003cp>It’s not always an easy journey, but it’s given the two more faith in what they can overcome.\u003c/p>\n\u003cp>“If you can find an addiction together,” Michael said, “you can find recovery together.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "California Advocates Push to Decriminalize Psychedelics With Therapeutic Benefits",
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"headTitle": "California Advocates Push to Decriminalize Psychedelics With Therapeutic Benefits | KQED",
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"content": "\u003cp>Psychedelics are having a moment. A nationwide push to bring magic mushrooms and other psychedelics into the mainstream is gaining traction, and some Californians want in.\u003c/p>\n\u003cp>While hallucinogens are often associated with the drug culture of the 1960s, today’s movement on psychedelics is largely about using them to help treat the nation’s ballooning mental health crisis. Growing research portrays the drugs as a promising tool in helping people heal from various mental illnesses, including depression and post-traumatic stress disorder.[pullquote size=\"medium\" align=\"right\" citation=\"Jennifer Mitchell, neurology professor, UC San Francisco\"]‘[Psychedelics] are actually exceedingly safe physiologically; psychologically is where we get into trouble.’[/pullquote]Now several proposals floating around in California seek to make psychedelics more accessible for therapeutic and personal use. These include one legislative proposal that would decriminalize use of certain natural hallucinogens and two pending initiatives for next year’s ballot — one that would legalize the use and sale of psilocybin mushrooms, and a second that would fund a $5 billion agency to research and develop psychedelic therapies.\u003c/p>\n\u003cp>One recent \u003ca href=\"https://psychedelics.berkeley.edu/bcsp-first-study-results/\">UC Berkeley survey\u003c/a> offers a glimpse of where the public currently stands on these types of reforms. For example, more than 60% of those surveyed supported psychedelics for therapeutic use. Also, 78% supported making it easier for researchers to further study psychedelics. Meanwhile, 49% said they supported removing criminal penalties for personal use.\u003c/p>\n\u003cp>Some researchers, doctors and parents urge caution around personal use because psychedelics aren’t for everyone and potential risks are still not all that well understood. Use of these substances should be done with safeguards in place, they say.\u003c/p>\n\u003cp>The bill to decriminalize plant-based psychedelics faces a key test this week at a hearing that could determine whether it moves forward this year. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240SB58\">Senate Bill 58\u003c/a>, by state Sen. Scott Wiener, a San Francisco Democrat, would ensure that people do not get arrested for possessing and ingesting specified quantities of psilocybin and psilocin, the psychoactive ingredient in hallucinogenic mushrooms; mescaline; ibogaine; and dimethyltryptamine, or DMT.\u003c/p>\n\u003cp>The bill does not, however, legalize the sale of any of these substances.\u003c/p>\n\u003cp>“A huge number of people right now in California are using psychedelics, despite the fact that it is banned,” Wiener said during an Assembly Health Committee hearing last month.[aside postID=\"science_1982857,forum_2010101883458,news_11873841\" label=\"Related Stories\"]Decriminalizing these substances, he argued, promotes responsible use. “If you think you’re doing something wrong, you’re less likely to seek information or talk to someone about how to be safe,” he said.\u003c/p>\n\u003cp>His bill would also order the state’s health agency to form a workgroup that would make recommendations regarding supervised medical use of these psychedelics — although any psychedelic-assisted therapies first need approval from the U.S. Food and Drug Administration.\u003c/p>\n\u003cp>This is the second time Wiener has tried to decriminalize psychedelics; the first failed last year. This time around, his bill is more narrow in that it excludes synthetic psychedelics, such as LSD.\u003c/p>\n\u003cp>If Wiener’s bill makes it through the Legislature and across the governor’s desk, California would follow Oregon and Colorado, where voters have already decriminalized psychedelics. Some cities in the Golden State are a step ahead — \u003ca href=\"https://www.sfchronicle.com/bayarea/article/Oakland-expected-to-vote-tonight-on-whether-to-13937792.php\">Oakland\u003c/a>, \u003ca href=\"https://sfstandard.com/2022/11/01/san-francisco-has-effectively-decriminalized-mushrooms-now-what/\">San Francisco\u003c/a>, \u003ca href=\"https://www.santacruzsentinel.com/2020/01/29/santa-cruz-decriminalizes-natural-psychedelics/\">Santa Cruz\u003c/a> and most recently \u003ca href=\"https://www.berkeleyside.org/2023/07/12/berkeley-psychedelics-decriminalization\">Berkeley\u003c/a>, have already passed measures that order law enforcement to back off arresting people for using plant-based psychedelics.\u003c/p>\n\u003ch2>Benefits and risks of psychedelics\u003c/h2>\n\u003cp>Supporters of decriminalization point to \u003ca href=\"https://maps.org/mdma/ptsd/\">promising data about some psychedelic-assisted therapies\u003c/a> now in \u003ca href=\"https://clinicaltrials.gov/study/NCT03537014\">end stages of clinical trials\u003c/a>, such as the use of MDMA (commonly known as “ecstasy”) to treat symptoms in patients with post-traumatic stress disorder.\u003c/p>\n\u003cp>Additionally, psilocybin, found in hallucinogenic mushrooms, is being studied for treating depression. For example, early data from The Johns Hopkins Center for Psychedelic and Consciousness Research, has shown that \u003ca href=\"https://journals.sagepub.com/doi/10.1177/02698811211073759\">psilocybin therapy can reduce major depressive disorder symptoms\u003c/a> for up to a year.\u003c/p>\n\u003cp>Wiener has taken combat veterans and retired first responders to testify before the Legislature about their “transformational” experiences using psychedelics to help relieve suicidal thoughts and PTSD symptoms.\u003c/p>\n\u003cp>According to the U.S. Veterans Affairs Department, \u003ca href=\"https://www.ptsd.va.gov/understand/common/common_adults.asp\">about 6% of the U.S. population\u003c/a> will have PTSD at some point in their lives. About \u003ca href=\"https://www.nimh.nih.gov/health/statistics/mental-illness#:~:text=Mental%20illnesses%20are%20common%20in,(57.8%20million%20in%202021).\">one in five adults live with a mental illness\u003c/a>, according to some national estimates.\u003c/p>\n\u003cp>Researchers believe public attention on the worsening mental health crisis during the COVID-19 pandemic may also play a role in this renewed interest in psychedelics.\u003c/p>\n\u003cp>“Suddenly you’ve got this discussion about mental health issues in a way that, at least in American culture, we really hadn’t been discussing,” said Jennifer Mitchell, a neurology professor at the University of California, San Francisco who has been working on the development of psychedelic therapies and collecting safety data.\u003c/p>\n\u003cp>Mitchell opposes Wiener’s decriminalization bill because she believes access to psychedelics for therapeutic use should come before personal use.\u003c/p>\n\u003cp>Currently, psychedelics are only allowed for clinical research. If and once therapies are approved by the FDA, those lessons, she argues, could then help inform safety guidelines for personal access.\u003c/p>\n\u003cp>“[Psychedelics] are actually exceedingly safe physiologically; psychologically is where we get into trouble,” Mitchell said. “Because if you take a drug and think you can fly, you’re capable of self-harm. If you take a drug and think you can breathe underwater, you are capable of self-harm. And those are the types of reasons why when you take a psychedelic, we want you to be in a facilitated environment where you’re being watched and well maintained.”\u003c/p>\n\u003ch2>A California mother’s campaign\u003c/h2>\n\u003cp>One powerful voice opposing Wiener’s bill is \u003ca href=\"https://www.sfgate.com/politics/article/moms-not-cops-biggest-roadblock-calif-drug-reform-18200005.php\">a coalition led by mothers\u003c/a> who have lost a child to an adverse reaction after ingesting psychedelics. Kristin Nash, for one, has widely shared the story of her son who died 21 months before his college graduation. In \u003ca href=\"https://themicrodose.substack.com/p/5-questions-for-kristin-nash\">blogs and Op-Eds\u003c/a>, Nash has shared that in 2020, Will took two grams of psilocybin mushrooms and in his altered state mistook a jar of protein powder for a water jug and suffocated.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Nash now \u003ca href=\"https://www.williamgnash.org/\">runs a foundation named after her son\u003c/a>, William, through which she works to raise awareness and advocates for harm-reduction efforts, such as better tracking of adverse reactions and training for college campus responders. Nash said she is not against allowing veterans and others to use these substances for treatment, but she’d like to see Wiener’s bill amended so it includes safety measures for personal use.\u003c/p>\n\u003cp>Nash, who also has a background in public health and most recently worked at an AIDS nonprofit, is a participating author in a Stanford-led study (yet to be peer reviewed), that showed \u003ca href=\"https://www.medrxiv.org/content/10.1101/2023.08.18.23294275v1\">emergency room visits in California linked to hallucinogens\u003c/a> jumped 84% from 2,260 in 2016 to 4,161 in 2021. But that data includes a spectrum of substances, from plant-based psychedelics to MDMA and ketamine. Authors note that currently data is collected in a way that makes it difficult to comb for specific substances.\u003c/p>\n\u003cp>“I don’t believe people should be arrested for possessing and using mushrooms,” Nash told CalMatters. “These are being used whether we legalize them or not. And so I would argue that we need these safeguards. When we make this policy shift, we know that use will increase further, that adverse events will increase further, and so I feel like we don’t have to choose between social justice, equitable access and safety, we can do all of those things.”\u003c/p>\n\u003ch2>Mushrooms on the ballot\u003c/h2>\n\u003cp>California voters may hear more about psychedelics next year even if Wiener’s bill fails as advocacy groups attempt to qualify ballot initiatives for the November 2024 election.\u003c/p>\n\u003cp>One group, \u003ca href=\"https://decrimca.org/\">Decriminalize California\u003c/a>, is looking to legalize hallucinogenic mushrooms. Its proposal goes further than Wiener’s bill by legalizing not only possession, but also the sale and commercialization of these substances. If approved by voters, the measure would go into effect in January 2025.\u003c/p>\n\u003cp>“Originally we wanted to go for all psychedelics, but the problem was there wasn’t enough public comprehension about what else was out there,” said Ryan Munevar, campaign director at Decriminalize California. Noting that voters are a lot more familiar and likely more comfortable with magic mushrooms than any other psychedelic drug.\u003c/p>\n\u003cp>A separate measure would ask voters to approve $5 billion in bonds to create a government agency that would focus on psychedelic research with the goal of developing therapeutics. The idea, according to proponents, is to dedicate more resources to research that shows promise but has for long been underfunded.\u003c/p>\n\u003cp>Dr. Jeannie Fontana, the chief executive officer of \u003ca href=\"https://www.treatcalifornia.org/\">TREAT California\u003c/a>, who is spearheading this initiative, said California’s lead on innovation makes it the ideal location for this type of research. TREAT stands for Treatments, Research, Education, Access and Therapies.\u003c/p>\n\u003cp>“The federal government is not there yet. They recognize the problem, but they just don’t know how to deal with this psychedelic hangover from the ’60s and ’70s,” Fontana said. “California is a progressive citizenry. We are innovators and leaders in many things.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Psychedelics like mushrooms and mescaline could be decriminalized in California as advocates tout their therapeutic potential.",
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"title": "California Advocates Push to Decriminalize Psychedelics With Therapeutic Benefits | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Psychedelics are having a moment. A nationwide push to bring magic mushrooms and other psychedelics into the mainstream is gaining traction, and some Californians want in.\u003c/p>\n\u003cp>While hallucinogens are often associated with the drug culture of the 1960s, today’s movement on psychedelics is largely about using them to help treat the nation’s ballooning mental health crisis. Growing research portrays the drugs as a promising tool in helping people heal from various mental illnesses, including depression and post-traumatic stress disorder.\u003c/p>\u003c/div>",
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"content": "‘[Psychedelics] are actually exceedingly safe physiologically; psychologically is where we get into trouble.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Now several proposals floating around in California seek to make psychedelics more accessible for therapeutic and personal use. These include one legislative proposal that would decriminalize use of certain natural hallucinogens and two pending initiatives for next year’s ballot — one that would legalize the use and sale of psilocybin mushrooms, and a second that would fund a $5 billion agency to research and develop psychedelic therapies.\u003c/p>\n\u003cp>One recent \u003ca href=\"https://psychedelics.berkeley.edu/bcsp-first-study-results/\">UC Berkeley survey\u003c/a> offers a glimpse of where the public currently stands on these types of reforms. For example, more than 60% of those surveyed supported psychedelics for therapeutic use. Also, 78% supported making it easier for researchers to further study psychedelics. Meanwhile, 49% said they supported removing criminal penalties for personal use.\u003c/p>\n\u003cp>Some researchers, doctors and parents urge caution around personal use because psychedelics aren’t for everyone and potential risks are still not all that well understood. Use of these substances should be done with safeguards in place, they say.\u003c/p>\n\u003cp>The bill to decriminalize plant-based psychedelics faces a key test this week at a hearing that could determine whether it moves forward this year. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240SB58\">Senate Bill 58\u003c/a>, by state Sen. Scott Wiener, a San Francisco Democrat, would ensure that people do not get arrested for possessing and ingesting specified quantities of psilocybin and psilocin, the psychoactive ingredient in hallucinogenic mushrooms; mescaline; ibogaine; and dimethyltryptamine, or DMT.\u003c/p>\n\u003cp>The bill does not, however, legalize the sale of any of these substances.\u003c/p>\n\u003cp>“A huge number of people right now in California are using psychedelics, despite the fact that it is banned,” Wiener said during an Assembly Health Committee hearing last month.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Decriminalizing these substances, he argued, promotes responsible use. “If you think you’re doing something wrong, you’re less likely to seek information or talk to someone about how to be safe,” he said.\u003c/p>\n\u003cp>His bill would also order the state’s health agency to form a workgroup that would make recommendations regarding supervised medical use of these psychedelics — although any psychedelic-assisted therapies first need approval from the U.S. Food and Drug Administration.\u003c/p>\n\u003cp>This is the second time Wiener has tried to decriminalize psychedelics; the first failed last year. This time around, his bill is more narrow in that it excludes synthetic psychedelics, such as LSD.\u003c/p>\n\u003cp>If Wiener’s bill makes it through the Legislature and across the governor’s desk, California would follow Oregon and Colorado, where voters have already decriminalized psychedelics. Some cities in the Golden State are a step ahead — \u003ca href=\"https://www.sfchronicle.com/bayarea/article/Oakland-expected-to-vote-tonight-on-whether-to-13937792.php\">Oakland\u003c/a>, \u003ca href=\"https://sfstandard.com/2022/11/01/san-francisco-has-effectively-decriminalized-mushrooms-now-what/\">San Francisco\u003c/a>, \u003ca href=\"https://www.santacruzsentinel.com/2020/01/29/santa-cruz-decriminalizes-natural-psychedelics/\">Santa Cruz\u003c/a> and most recently \u003ca href=\"https://www.berkeleyside.org/2023/07/12/berkeley-psychedelics-decriminalization\">Berkeley\u003c/a>, have already passed measures that order law enforcement to back off arresting people for using plant-based psychedelics.\u003c/p>\n\u003ch2>Benefits and risks of psychedelics\u003c/h2>\n\u003cp>Supporters of decriminalization point to \u003ca href=\"https://maps.org/mdma/ptsd/\">promising data about some psychedelic-assisted therapies\u003c/a> now in \u003ca href=\"https://clinicaltrials.gov/study/NCT03537014\">end stages of clinical trials\u003c/a>, such as the use of MDMA (commonly known as “ecstasy”) to treat symptoms in patients with post-traumatic stress disorder.\u003c/p>\n\u003cp>Additionally, psilocybin, found in hallucinogenic mushrooms, is being studied for treating depression. For example, early data from The Johns Hopkins Center for Psychedelic and Consciousness Research, has shown that \u003ca href=\"https://journals.sagepub.com/doi/10.1177/02698811211073759\">psilocybin therapy can reduce major depressive disorder symptoms\u003c/a> for up to a year.\u003c/p>\n\u003cp>Wiener has taken combat veterans and retired first responders to testify before the Legislature about their “transformational” experiences using psychedelics to help relieve suicidal thoughts and PTSD symptoms.\u003c/p>\n\u003cp>According to the U.S. Veterans Affairs Department, \u003ca href=\"https://www.ptsd.va.gov/understand/common/common_adults.asp\">about 6% of the U.S. population\u003c/a> will have PTSD at some point in their lives. About \u003ca href=\"https://www.nimh.nih.gov/health/statistics/mental-illness#:~:text=Mental%20illnesses%20are%20common%20in,(57.8%20million%20in%202021).\">one in five adults live with a mental illness\u003c/a>, according to some national estimates.\u003c/p>\n\u003cp>Researchers believe public attention on the worsening mental health crisis during the COVID-19 pandemic may also play a role in this renewed interest in psychedelics.\u003c/p>\n\u003cp>“Suddenly you’ve got this discussion about mental health issues in a way that, at least in American culture, we really hadn’t been discussing,” said Jennifer Mitchell, a neurology professor at the University of California, San Francisco who has been working on the development of psychedelic therapies and collecting safety data.\u003c/p>\n\u003cp>Mitchell opposes Wiener’s decriminalization bill because she believes access to psychedelics for therapeutic use should come before personal use.\u003c/p>\n\u003cp>Currently, psychedelics are only allowed for clinical research. If and once therapies are approved by the FDA, those lessons, she argues, could then help inform safety guidelines for personal access.\u003c/p>\n\u003cp>“[Psychedelics] are actually exceedingly safe physiologically; psychologically is where we get into trouble,” Mitchell said. “Because if you take a drug and think you can fly, you’re capable of self-harm. If you take a drug and think you can breathe underwater, you are capable of self-harm. And those are the types of reasons why when you take a psychedelic, we want you to be in a facilitated environment where you’re being watched and well maintained.”\u003c/p>\n\u003ch2>A California mother’s campaign\u003c/h2>\n\u003cp>One powerful voice opposing Wiener’s bill is \u003ca href=\"https://www.sfgate.com/politics/article/moms-not-cops-biggest-roadblock-calif-drug-reform-18200005.php\">a coalition led by mothers\u003c/a> who have lost a child to an adverse reaction after ingesting psychedelics. Kristin Nash, for one, has widely shared the story of her son who died 21 months before his college graduation. In \u003ca href=\"https://themicrodose.substack.com/p/5-questions-for-kristin-nash\">blogs and Op-Eds\u003c/a>, Nash has shared that in 2020, Will took two grams of psilocybin mushrooms and in his altered state mistook a jar of protein powder for a water jug and suffocated.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Nash now \u003ca href=\"https://www.williamgnash.org/\">runs a foundation named after her son\u003c/a>, William, through which she works to raise awareness and advocates for harm-reduction efforts, such as better tracking of adverse reactions and training for college campus responders. Nash said she is not against allowing veterans and others to use these substances for treatment, but she’d like to see Wiener’s bill amended so it includes safety measures for personal use.\u003c/p>\n\u003cp>Nash, who also has a background in public health and most recently worked at an AIDS nonprofit, is a participating author in a Stanford-led study (yet to be peer reviewed), that showed \u003ca href=\"https://www.medrxiv.org/content/10.1101/2023.08.18.23294275v1\">emergency room visits in California linked to hallucinogens\u003c/a> jumped 84% from 2,260 in 2016 to 4,161 in 2021. But that data includes a spectrum of substances, from plant-based psychedelics to MDMA and ketamine. Authors note that currently data is collected in a way that makes it difficult to comb for specific substances.\u003c/p>\n\u003cp>“I don’t believe people should be arrested for possessing and using mushrooms,” Nash told CalMatters. “These are being used whether we legalize them or not. And so I would argue that we need these safeguards. When we make this policy shift, we know that use will increase further, that adverse events will increase further, and so I feel like we don’t have to choose between social justice, equitable access and safety, we can do all of those things.”\u003c/p>\n\u003ch2>Mushrooms on the ballot\u003c/h2>\n\u003cp>California voters may hear more about psychedelics next year even if Wiener’s bill fails as advocacy groups attempt to qualify ballot initiatives for the November 2024 election.\u003c/p>\n\u003cp>One group, \u003ca href=\"https://decrimca.org/\">Decriminalize California\u003c/a>, is looking to legalize hallucinogenic mushrooms. Its proposal goes further than Wiener’s bill by legalizing not only possession, but also the sale and commercialization of these substances. If approved by voters, the measure would go into effect in January 2025.\u003c/p>\n\u003cp>“Originally we wanted to go for all psychedelics, but the problem was there wasn’t enough public comprehension about what else was out there,” said Ryan Munevar, campaign director at Decriminalize California. Noting that voters are a lot more familiar and likely more comfortable with magic mushrooms than any other psychedelic drug.\u003c/p>\n\u003cp>A separate measure would ask voters to approve $5 billion in bonds to create a government agency that would focus on psychedelic research with the goal of developing therapeutics. The idea, according to proponents, is to dedicate more resources to research that shows promise but has for long been underfunded.\u003c/p>\n\u003cp>Dr. Jeannie Fontana, the chief executive officer of \u003ca href=\"https://www.treatcalifornia.org/\">TREAT California\u003c/a>, who is spearheading this initiative, said California’s lead on innovation makes it the ideal location for this type of research. TREAT stands for Treatments, Research, Education, Access and Therapies.\u003c/p>\n\u003cp>“The federal government is not there yet. They recognize the problem, but they just don’t know how to deal with this psychedelic hangover from the ’60s and ’70s,” Fontana said. “California is a progressive citizenry. We are innovators and leaders in many things.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "California Families Can Expect Eligibility Limits in CARE Courts Rollout",
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"headTitle": "California Families Can Expect Eligibility Limits in CARE Courts Rollout | KQED",
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"content": "\u003cp>Under the low hum of cold fluorescent lights in a nondescript office park in Orange County, dozens of Californians gathered to find out if they could get help for their loved ones under the state’s new \u003ca href=\"https://www.kqed.org/news/tag/care-court\">CARE Court\u003c/a> system.\u003c/p>\n\u003cp>Unless that loved one has a medical diagnosis specific to schizophrenia or some other psychotic disorders, the answer is probably not.\u003c/p>\n\u003cp>The mid-August meeting was a series held by a mental health advocacy group in Orange County with the officials in charge of implementing CARE Court, which starts in October, about what the new system can and cannot do.\u003c/p>\n\u003cp>“What we’re here to do is share the facts to help manage expectations,” said Veronica Kelley, Orange County’s chief of mental health and recovery services.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Community Assistance, Recovery, and Empowerment (CARE) Court was Gov. Gavin Newsom’s \u003ca href=\"https://calmatters.org/housing/2022/09/california-lawmakers-approved-care-court-what-comes-next/\">biggest legislative priority\u003c/a> last year — what state lawmakers and local politicians hoped would be one answer to California’s dual, overlapping homelessness and mental health crises.\u003c/p>\n\u003cp>The new program allows family members and others to petition someone with untreated mental illness into civil courts, where a judge would order a treatment plan and require county mental health departments to provide it.\u003c/p>\n\u003cp>Backed by millions in new state funds, it’s a mandate for those departments at a time when Californians have become increasingly frustrated with one of the most visible consequences of the state’s trenchant homelessness crisis — people with the most severe mental illnesses languishing on the streets. [pullquote size=\"medium\" align=\"right\" citation=\"Luke Bergmann, director, San Diego County Behavioral Health Services\"]‘[CARE Court’s] not going to be this thing that dramatically changes homelessness.’[/pullquote] Counties will be judged on how well they’re able to get people, who may be resistant to help, inside and into treatment, even though CARE Court is not exclusively a program targeting homelessness. Local mental health officials are warning it won’t be a panacea.\u003c/p>\n\u003cp>“There’s been a presumption — and this is, to be clear, driven by how the administration talked about CARE Court at the outset — a broad presumption that CARE Court is going to fix homelessness or have a broad impact on the nexus of homelessness and behavioral health,” said Luke Bergmann, director of the San Diego County Behavioral Health Services department.\u003c/p>\n\u003cp>In reality, he said, it’s “actually going to be a pretty small program. It’s not going to be this thing that dramatically changes homelessness.”\u003c/p>\n\u003cp>The program aims to walk the line between forced treatment and completely voluntary treatment for those with the gravest needs. Disability rights groups decry it as a violation of a person’s civil liberties, and a potential path \u003ca href=\"https://calmatters.org/justice/2021/07/britney-spears-conservatorship/\">toward conservatorship\u003c/a> and the loss of legal rights for those who repeatedly decline care.\u003c/p>\n\u003cfigure id=\"attachment_11959338\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959338\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts02.jpg\" alt='An office full of people sit at tables looking toward a woman with a purple blouse who speaks from a microphone and holding index cards in her other hand. A flat-screen television hangs above her head displaying \"What is in a CARE Agreement Plan?\"' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Annette Mugrditchian, deputy director, speaks to community members about CARE Court at the Behavioral Health Training Center in Orange County. \u003ccite>(Lauren Justice/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>CARE Court \u003ca href=\"https://www.latimes.com/california/story/2023-01-26/disability-advocates-lawsuit-care-court-newsom-mental-illness-addiction-homeless\">survived a legal challenge\u003c/a> from Disability Rights California and other civil rights groups earlier this year. The group sat on a state working group for the program’s implementation and will monitor its rollout.\u003c/p>\n\u003cp>The program was welcomed by some family members of those with severe mental illness, who have complained that the state’s privacy and patients’ rights laws only allow their loved ones to \u003ca href=\"https://calmatters.org/projects/mentally-ill-forced-treatment-conservatorship-california-debate/\">be compelled into treatment \u003c/a>when in crisis, trapping them in a revolving door of short-term hospital stays and homelessness.\u003c/p>\n\u003cp>The first courts will open across the state in about a month. Seven counties, urban and rural, have been deep in preparation to be the first to roll out the program in October.\u003c/p>\n\u003cp>Los Angeles County, whose roughly 75,000-person unhoused population is the state’s largest, will start the program in December; the rest of the state will follow next year.\u003c/p>\n\u003cp>Those in the first group — San Francisco, Orange, San Diego, Riverside, Stanislaus, Glenn and Tuolumne counties — have had numerous questions to address, such as:\u003c/p>\n\u003cul>\n\u003cli>Who will find and serve respondents with their CARE Court petition if the respondent is unhoused?\u003c/li>\n\u003cli>How can county courts make the paperwork-heavy petition process easy for family members?\u003c/li>\n\u003cli>How many mental health treatment beds will counties need to add?\u003c/li>\n\u003cli>Where will people live after completing the court-ordered plans?\u003c/li>\n\u003c/ul>\n\u003cp>The state estimates between 7,000 and 12,000 people will qualify. They needn’t be homeless to receive the services, though many who qualify are likely to be unhoused. The state’s homeless population on any given night last year topped 171,000. [aside postID=news_11955211 hero='https://ww2.kqed.org/app/uploads/sites/10/2023/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-1020x680.jpg'] A UC San Francisco \u003ca href=\"https://homelessness.ucsf.edu/sites/default/files/2023-06/CASPEH_Report_62023.pdf\">study of homelessness statewide (PDF)\u003c/a> this year found that more than a quarter of unhoused people had been hospitalized at some point in their lives for a mental health problem; the homeless services authority in Los Angeles \u003ca href=\"https://www.lahsa.org/documents?id=3422-2019-greater-los-angeles-homeless-count-los-angeles-continuum-of-care.pdf\">has estimated (PDF)\u003c/a> a quarter of the city’s homeless adults has a severe mental illness. But CARE Court is targeted at an even narrower set of diagnoses and circumstances.\u003c/p>\n\u003cp>So counties are also playing a careful game of “level-setting,” Bergman said, “about what this thing will actually be.”\u003c/p>\n\u003cp>Still, local officials see the program as an opportunity to get more people into mental health care who haven’t been treated, before their condition deteriorates to the point of being put in conservatorships.\u003c/p>\n\u003cp>And the state’s Department of Health Care Services says it will be looking out for whether the program reduces emergency room visits, police encounters, short-term hospital stays and involuntary psychiatric holds — and whether it helps people find stable housing.\u003c/p>\n\u003ch2>Managing expectations\u003c/h2>\n\u003cp>One major uncertainty counties face, officials say, is even knowing how many cases they’ll get.\u003c/p>\n\u003cp>That’s in part because the law allows a wide range of people to petition for someone to be in CARE Court, including family members, roommates, health care providers, paramedics, hospital officials or homeless outreach workers.\u003c/p>\n\u003cp>But the list of actual conditions the program targets is narrow. It’s limited to schizophrenia and related illnesses. [pullquote size=\"medium\" align=\"right\" citation=\"Michelle Doty Cabrera, director, County Behavioral Health Directors Association\"]‘What the public thinks CARE Court is and what it is are definitely two very different things.’[/pullquote] That could disappoint those whose loved ones have other diagnoses — and create an unknown amount of work for counties if a flood of those family members file petitions. Behavioral health departments must evaluate each person if it’s not clear whether they qualify for the program.\u003c/p>\n\u003cp>San Diego County estimates it will get 1,000 petitions in the first year and establish court-ordered treatment plans for 250 people; the remainder likely will either not qualify or will agree to services voluntarily, Bergmann said. Orange County expects about 1,400 petitions and anywhere from 400 to 600 treatment plans.\u003c/p>\n\u003cp>Officials in Riverside County don’t even have an estimate, citing varying data there on the prevalence of schizophrenia in the unhoused population.\u003c/p>\n\u003cp>“We really think it’s unknowable,” said Marcus Cannon, the county’s deputy behavioral health director.\u003c/p>\n\u003cp>Counties want the state to help them manage public expectations. Both Kelley and Cannon said they’ve heard from local leaders who have floated having city workers file petitions for a wide swath of unhoused residents, to get them indoors.\u003c/p>\n\u003cp>“What the public thinks CARE Court is and what it is are definitely two very different things,” said Michelle Doty Cabrera, director of \u003ca href=\"https://www.cbhda.org/\">the County Behavioral Health Directors Association\u003c/a>.\u003c/p>\n\u003cp>In an emailed statement, state Department of Health Care Services spokesperson Sami Gallegos said that counties “are managing public relations among local elected officials and others” to spread the message about who the program is and isn’t for.\u003c/p>\n\u003cp>After learning of the narrow eligibility criteria at a community meeting in August, Nancy Beltran considered her options.\u003c/p>\n\u003cp>Beltran, of Anaheim, said she lives with a family member whose psychotic condition caused him to hit another relative in 2020, landing him in the hospital against his will. She said he’s refused treatment and doesn’t believe he’s sick. Another psychotic episode earlier this year didn’t qualify him for hospitalization, she said, because the symptoms weren’t as severe.\u003c/p>\n\u003cp>“I didn’t want it to get to that point,” she said. “I don’t want him to be incarcerated. I want it to be the least restrictive, least traumatic experience.”\u003c/p>\n\u003cp>She’s still not sure whether the program is for her family member, because they haven’t gotten a clear diagnosis, she said.\u003c/p>\n\u003cp>Beltran said she also wishes the program could help a friend, who is already enrolled in therapy sessions for diagnosed schizophrenia, find a place to live. Her friend’s condition, she said, deteriorates because he is unhoused, but he remains on waiting lists for housing. But CARE Court, she was disappointed to learn at the meetings, is only for those with untreated schizophrenia.\u003c/p>\n\u003ch2>Threading a needle\u003c/h2>\n\u003cp>Everyone involved in CARE Court in Orange County — from the judge who would ultimately order treatment to the public defender who will represent respondents to the behavioral health officials responsible for finding, diagnosing and treating them — had the same message for the public: The program will be voluntary.\u003c/p>\n\u003cp>Critics, however,\u003cstrong> \u003c/strong>contend that there’s no way a court process can be voluntary, since at some point there is a judge’s order. By law, counties must try at least twice to persuade a respondent to accept treatment before a judge orders it. Even then, the treatment plan, which can include therapy, medication and housing, doesn’t come with much enforcement. Medication can be ordered, but not forcibly administered.\u003c/p>\n\u003cfigure id=\"attachment_11959344\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959344\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts03.jpg\" alt=\"A bald man in a business suit speaks to a crowd as he sits at a table holding a microphone in his hand.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Judge Ebrahim Baytieh speaks to community members about CARE Court, a new program that will be implemented in the fall. \u003ccite>(Lauren Justice/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Over the course of a year, respondents will attend court hearings to see whether they’re adhering to the treatment and whether the county is providing it. Counties can be fined as much as $1,000 a day for not providing the care; if the person fails to complete treatment they could be considered for conservatorship.\u003c/p>\n\u003cp>But county officials stressed that’s not the goal.\u003c/p>\n\u003cp>“We have tried for 40 years in this wonderful country of ours to force people with mental illness” to be treated, Orange County Superior Court Judge Ebrahim Baytieh told family members at another community meeting, in a church in Cypress. “Study after study has found it doesn’t work. We all know there’s no magical answer. But we will be patient, and we will be persistent.”\u003c/p>\n\u003cp>Kelley’s department is training its workers and peer supporters — people who also have mental illness or have recovered who can help guide a respondent through CARE Court — in a well-regarded communication method \u003ca href=\"https://leapinstitute.org/about/#:~:text=LEAP%20(Listen%2DEmpathize%2DAgree,and%20the%20treatment%20they%20need.\">called LEAP\u003c/a> to persuade respondents to accept care. It will offer services to those in CARE Court under a “whatever it takes” approach, whether it’s a ride to the doctor’s office, help to enroll in food stamps, addiction treatment, or temporary housing.\u003c/p>\n\u003cp>The task will take time.\u003c/p>\n\u003cp>At the community meetings, Kelley and her colleagues repeatedly described a pilot program she ran as behavioral health director in San Bernardino County. The program took referrals from family, police or other community members who wanted to prod those who were resistant to mental health treatment. [pullquote size=\"medium\" align=\"right\" citation=\"Orange County Superior Court Judge Ebrahim Baytieh\"]‘We have tried for 40 years in this wonderful country of ours to force people with mental illness” [to be treated]. … We all know there’s no magical answer. But we will be patient, and we will be persistent.’[/pullquote] The time it took for county workers using the LEAP method to persuade respondents to enter treatment varied, Kelley said. But on average, she said it took 20 visits if a respondent was housed — and 40 visits if they were unhoused. Visit times varied, from a few minutes to a whole day so that the whole process could take weeks or months, Kelley said.\u003c/p>\n\u003cp>The timetables set by law for CARE Court are much tighter.\u003c/p>\n\u003cp>If counties initially determine a client won’t agree to treatment, they get 14 days to try again before the next court hearing. Kelley said the judges in her county are sympathetic toward those concerns, but not all counties will get such flexibility.\u003c/p>\n\u003cp>“I can’t do 40 face-to-face visits in 14 days,” she said.\u003c/p>\n\u003cp>Civil rights advocates balked at the counties’ suggestion that any program involving the pressure of the judicial system, even a non-criminal court, could be voluntary.\u003c/p>\n\u003cp>“If you’re trying to engage somebody, and there’s a petition that involves a court,” there’s less hope of building genuine trust, said Keris Myrick, a mental health advocate who lives with schizophrenia and a board member of Disability Rights California.\u003c/p>\n\u003cp>The group is particularly concerned the court process could be ineffective or harmful among Black residents, who are overrepresented both in California’s homeless population and among people diagnosed with schizophrenia.\u003c/p>\n\u003cp>Myrick, who is Black, said she has been subject to involuntary treatment and described harrowing experiences during which she was handcuffed in the back of a police car or strapped down to a gurney for hours before a doctor visited. She said one thing that actually helped her recover was having a peer supporter who was also African American and related to her experiences, eventually persuading her to get treatment on her own terms.\u003c/p>\n\u003cp>She later ran a peer support program in Los Angeles County and trained workers in the county mental health department. Myrick says the state needs to expand those services, as well as housing and social supports to help people live stable lives, without the threat of a judicial order.\u003c/p>\n\u003cp>Alex Barnard, a sociologist at New York University who has studied involuntary mental health treatment in California, is skeptical about whether the state can appease both civil libertarians and those who want more aggressive treatment. But he said the program’s mandate of a year of persistent engagement is promising.\u003c/p>\n\u003cp>“If CARE Courts work, it will probably be because of that,” he said. “It creates some accountability on the provider to keep trying to work with somebody who might be very challenging, and elsewhere in the system would just have their file closed out.”\u003c/p>\n\u003ch2>Long-term resources\u003c/h2>\n\u003cp>Those implementation questions are among a list of other practical hurdles counties face for the program to be successful.\u003c/p>\n\u003cp>There’s long-term funding. The first seven counties were given $26 million in one-time state grants to start the programs; some have estimated annual costs of the services themselves will \u003ca href=\"https://sfstandard.com/2023/04/20/newsoms-care-court-faces-50-million-hurdle-in-san-francisco-as-key-deadline-approaches/\">far exceed\u003c/a> those allotments.\u003c/p>\n\u003cp>The state says most services will be covered by Medi-Cal or private insurance, and expects counties to submit reimbursement requests, including the costs of going to court or finding respondents.\u003c/p>\n\u003cp>But the \u003ca href=\"https://www.kqed.org/news/11923034/were-drowning-why-kaiser-mental-health-workers-are-striking#:~:text=Kaiser%20administrators%20point%20to%20what,15%20statement.\">nationwide shortage of behavioral health workers\u003c/a> has made it a challenge for some departments to hire. In San Diego County, Bergmann’s department plans to add 55 new staff, including 10 clinicians, for CARE Court. Only 35% have been hired so far, a spokesperson said. [aside label='More on Public Health' tag='public-health'] And there’s housing and beds, which all agree are crucial to making treatment a success.\u003c/p>\n\u003cp>Health officials believe most people who qualify for CARE Court will need a more intensive treatment placement in the beginning, while some may be able to be placed in residential facilities or their own apartments after being stabilized.\u003c/p>\n\u003cp>But there are shortages across that spectrum. A \u003ca href=\"https://www.rand.org/pubs/research_reports/RRA1824-1-v2.html\">2021 Rand analysis\u003c/a> found the state is short more than 4,700 psychiatric inpatient treatment beds and nearly 3,000 residential facility beds such as \u003ca href=\"https://calmatters.org/projects/board-and-care-homes-closing-in-california-mental-health-crisis/\">board-and-cares\u003c/a>—long-term housing for people with severe mental illness and one option for respondents to live after they complete CARE Court.\u003c/p>\n\u003cp>Included in last year’s state budget was \u003ca href=\"https://bridgehousing.buildingcalhhs.com/county-behavioral-health-agencies/\">nearly $1 billion\u003c/a> in new funding for counties to expand temporary housing placements for those with mental illness, with priority given to people in CARE Court.\u003c/p>\n\u003cp>Orange County and some others are using the grants to open new treatment beds. In San Diego, Bergmann’s department will use the money to pay for board-and-care placements. Significant new infrastructure, however, will take years to complete. Over the past five years, Bergmann said, the county has lost a fifth of those residential facilities.\u003c/p>\n\u003cp>“In the near term, those funds will help us help people with the fewest resources to compete more” for placements, he said. “It’s not going to all of a sudden create a net increase in infrastructure.”\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://calmatters.org/author/marisa-kendall/\">Marisa Kendall\u003c/a> contributed to this reporting.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Gov. Gavin Newsom’s plan to encourage people with mental illnesses to accept treatment starts this fall. Counties responsible say it may be more modest than advertised.",
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"title": "California Families Can Expect Eligibility Limits in CARE Courts Rollout | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Under the low hum of cold fluorescent lights in a nondescript office park in Orange County, dozens of Californians gathered to find out if they could get help for their loved ones under the state’s new \u003ca href=\"https://www.kqed.org/news/tag/care-court\">CARE Court\u003c/a> system.\u003c/p>\n\u003cp>Unless that loved one has a medical diagnosis specific to schizophrenia or some other psychotic disorders, the answer is probably not.\u003c/p>\n\u003cp>The mid-August meeting was a series held by a mental health advocacy group in Orange County with the officials in charge of implementing CARE Court, which starts in October, about what the new system can and cannot do.\u003c/p>\n\u003cp>“What we’re here to do is share the facts to help manage expectations,” said Veronica Kelley, Orange County’s chief of mental health and recovery services.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Community Assistance, Recovery, and Empowerment (CARE) Court was Gov. Gavin Newsom’s \u003ca href=\"https://calmatters.org/housing/2022/09/california-lawmakers-approved-care-court-what-comes-next/\">biggest legislative priority\u003c/a> last year — what state lawmakers and local politicians hoped would be one answer to California’s dual, overlapping homelessness and mental health crises.\u003c/p>\n\u003cp>The new program allows family members and others to petition someone with untreated mental illness into civil courts, where a judge would order a treatment plan and require county mental health departments to provide it.\u003c/p>\n\u003cp>Backed by millions in new state funds, it’s a mandate for those departments at a time when Californians have become increasingly frustrated with one of the most visible consequences of the state’s trenchant homelessness crisis — people with the most severe mental illnesses languishing on the streets. \u003c/p>\u003c/div>",
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"content": "‘[CARE Court’s] not going to be this thing that dramatically changes homelessness.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp> Counties will be judged on how well they’re able to get people, who may be resistant to help, inside and into treatment, even though CARE Court is not exclusively a program targeting homelessness. Local mental health officials are warning it won’t be a panacea.\u003c/p>\n\u003cp>“There’s been a presumption — and this is, to be clear, driven by how the administration talked about CARE Court at the outset — a broad presumption that CARE Court is going to fix homelessness or have a broad impact on the nexus of homelessness and behavioral health,” said Luke Bergmann, director of the San Diego County Behavioral Health Services department.\u003c/p>\n\u003cp>In reality, he said, it’s “actually going to be a pretty small program. It’s not going to be this thing that dramatically changes homelessness.”\u003c/p>\n\u003cp>The program aims to walk the line between forced treatment and completely voluntary treatment for those with the gravest needs. Disability rights groups decry it as a violation of a person’s civil liberties, and a potential path \u003ca href=\"https://calmatters.org/justice/2021/07/britney-spears-conservatorship/\">toward conservatorship\u003c/a> and the loss of legal rights for those who repeatedly decline care.\u003c/p>\n\u003cfigure id=\"attachment_11959338\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959338\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts02.jpg\" alt='An office full of people sit at tables looking toward a woman with a purple blouse who speaks from a microphone and holding index cards in her other hand. A flat-screen television hangs above her head displaying \"What is in a CARE Agreement Plan?\"' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts02-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Annette Mugrditchian, deputy director, speaks to community members about CARE Court at the Behavioral Health Training Center in Orange County. \u003ccite>(Lauren Justice/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>CARE Court \u003ca href=\"https://www.latimes.com/california/story/2023-01-26/disability-advocates-lawsuit-care-court-newsom-mental-illness-addiction-homeless\">survived a legal challenge\u003c/a> from Disability Rights California and other civil rights groups earlier this year. The group sat on a state working group for the program’s implementation and will monitor its rollout.\u003c/p>\n\u003cp>The program was welcomed by some family members of those with severe mental illness, who have complained that the state’s privacy and patients’ rights laws only allow their loved ones to \u003ca href=\"https://calmatters.org/projects/mentally-ill-forced-treatment-conservatorship-california-debate/\">be compelled into treatment \u003c/a>when in crisis, trapping them in a revolving door of short-term hospital stays and homelessness.\u003c/p>\n\u003cp>The first courts will open across the state in about a month. Seven counties, urban and rural, have been deep in preparation to be the first to roll out the program in October.\u003c/p>\n\u003cp>Los Angeles County, whose roughly 75,000-person unhoused population is the state’s largest, will start the program in December; the rest of the state will follow next year.\u003c/p>\n\u003cp>Those in the first group — San Francisco, Orange, San Diego, Riverside, Stanislaus, Glenn and Tuolumne counties — have had numerous questions to address, such as:\u003c/p>\n\u003cul>\n\u003cli>Who will find and serve respondents with their CARE Court petition if the respondent is unhoused?\u003c/li>\n\u003cli>How can county courts make the paperwork-heavy petition process easy for family members?\u003c/li>\n\u003cli>How many mental health treatment beds will counties need to add?\u003c/li>\n\u003cli>Where will people live after completing the court-ordered plans?\u003c/li>\n\u003c/ul>\n\u003cp>The state estimates between 7,000 and 12,000 people will qualify. They needn’t be homeless to receive the services, though many who qualify are likely to be unhoused. The state’s homeless population on any given night last year topped 171,000. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp> A UC San Francisco \u003ca href=\"https://homelessness.ucsf.edu/sites/default/files/2023-06/CASPEH_Report_62023.pdf\">study of homelessness statewide (PDF)\u003c/a> this year found that more than a quarter of unhoused people had been hospitalized at some point in their lives for a mental health problem; the homeless services authority in Los Angeles \u003ca href=\"https://www.lahsa.org/documents?id=3422-2019-greater-los-angeles-homeless-count-los-angeles-continuum-of-care.pdf\">has estimated (PDF)\u003c/a> a quarter of the city’s homeless adults has a severe mental illness. But CARE Court is targeted at an even narrower set of diagnoses and circumstances.\u003c/p>\n\u003cp>So counties are also playing a careful game of “level-setting,” Bergman said, “about what this thing will actually be.”\u003c/p>\n\u003cp>Still, local officials see the program as an opportunity to get more people into mental health care who haven’t been treated, before their condition deteriorates to the point of being put in conservatorships.\u003c/p>\n\u003cp>And the state’s Department of Health Care Services says it will be looking out for whether the program reduces emergency room visits, police encounters, short-term hospital stays and involuntary psychiatric holds — and whether it helps people find stable housing.\u003c/p>\n\u003ch2>Managing expectations\u003c/h2>\n\u003cp>One major uncertainty counties face, officials say, is even knowing how many cases they’ll get.\u003c/p>\n\u003cp>That’s in part because the law allows a wide range of people to petition for someone to be in CARE Court, including family members, roommates, health care providers, paramedics, hospital officials or homeless outreach workers.\u003c/p>\n\u003cp>But the list of actual conditions the program targets is narrow. It’s limited to schizophrenia and related illnesses. \u003c/p>\u003c/div>",
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"content": "‘What the public thinks CARE Court is and what it is are definitely two very different things.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp> That could disappoint those whose loved ones have other diagnoses — and create an unknown amount of work for counties if a flood of those family members file petitions. Behavioral health departments must evaluate each person if it’s not clear whether they qualify for the program.\u003c/p>\n\u003cp>San Diego County estimates it will get 1,000 petitions in the first year and establish court-ordered treatment plans for 250 people; the remainder likely will either not qualify or will agree to services voluntarily, Bergmann said. Orange County expects about 1,400 petitions and anywhere from 400 to 600 treatment plans.\u003c/p>\n\u003cp>Officials in Riverside County don’t even have an estimate, citing varying data there on the prevalence of schizophrenia in the unhoused population.\u003c/p>\n\u003cp>“We really think it’s unknowable,” said Marcus Cannon, the county’s deputy behavioral health director.\u003c/p>\n\u003cp>Counties want the state to help them manage public expectations. Both Kelley and Cannon said they’ve heard from local leaders who have floated having city workers file petitions for a wide swath of unhoused residents, to get them indoors.\u003c/p>\n\u003cp>“What the public thinks CARE Court is and what it is are definitely two very different things,” said Michelle Doty Cabrera, director of \u003ca href=\"https://www.cbhda.org/\">the County Behavioral Health Directors Association\u003c/a>.\u003c/p>\n\u003cp>In an emailed statement, state Department of Health Care Services spokesperson Sami Gallegos said that counties “are managing public relations among local elected officials and others” to spread the message about who the program is and isn’t for.\u003c/p>\n\u003cp>After learning of the narrow eligibility criteria at a community meeting in August, Nancy Beltran considered her options.\u003c/p>\n\u003cp>Beltran, of Anaheim, said she lives with a family member whose psychotic condition caused him to hit another relative in 2020, landing him in the hospital against his will. She said he’s refused treatment and doesn’t believe he’s sick. Another psychotic episode earlier this year didn’t qualify him for hospitalization, she said, because the symptoms weren’t as severe.\u003c/p>\n\u003cp>“I didn’t want it to get to that point,” she said. “I don’t want him to be incarcerated. I want it to be the least restrictive, least traumatic experience.”\u003c/p>\n\u003cp>She’s still not sure whether the program is for her family member, because they haven’t gotten a clear diagnosis, she said.\u003c/p>\n\u003cp>Beltran said she also wishes the program could help a friend, who is already enrolled in therapy sessions for diagnosed schizophrenia, find a place to live. Her friend’s condition, she said, deteriorates because he is unhoused, but he remains on waiting lists for housing. But CARE Court, she was disappointed to learn at the meetings, is only for those with untreated schizophrenia.\u003c/p>\n\u003ch2>Threading a needle\u003c/h2>\n\u003cp>Everyone involved in CARE Court in Orange County — from the judge who would ultimately order treatment to the public defender who will represent respondents to the behavioral health officials responsible for finding, diagnosing and treating them — had the same message for the public: The program will be voluntary.\u003c/p>\n\u003cp>Critics, however,\u003cstrong> \u003c/strong>contend that there’s no way a court process can be voluntary, since at some point there is a judge’s order. By law, counties must try at least twice to persuade a respondent to accept treatment before a judge orders it. Even then, the treatment plan, which can include therapy, medication and housing, doesn’t come with much enforcement. Medication can be ordered, but not forcibly administered.\u003c/p>\n\u003cfigure id=\"attachment_11959344\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11959344\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMCareCourts03.jpg\" alt=\"A bald man in a business suit speaks to a crowd as he sits at a table holding a microphone in his hand.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMCareCourts03-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Judge Ebrahim Baytieh speaks to community members about CARE Court, a new program that will be implemented in the fall. \u003ccite>(Lauren Justice/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Over the course of a year, respondents will attend court hearings to see whether they’re adhering to the treatment and whether the county is providing it. Counties can be fined as much as $1,000 a day for not providing the care; if the person fails to complete treatment they could be considered for conservatorship.\u003c/p>\n\u003cp>But county officials stressed that’s not the goal.\u003c/p>\n\u003cp>“We have tried for 40 years in this wonderful country of ours to force people with mental illness” to be treated, Orange County Superior Court Judge Ebrahim Baytieh told family members at another community meeting, in a church in Cypress. “Study after study has found it doesn’t work. We all know there’s no magical answer. But we will be patient, and we will be persistent.”\u003c/p>\n\u003cp>Kelley’s department is training its workers and peer supporters — people who also have mental illness or have recovered who can help guide a respondent through CARE Court — in a well-regarded communication method \u003ca href=\"https://leapinstitute.org/about/#:~:text=LEAP%20(Listen%2DEmpathize%2DAgree,and%20the%20treatment%20they%20need.\">called LEAP\u003c/a> to persuade respondents to accept care. It will offer services to those in CARE Court under a “whatever it takes” approach, whether it’s a ride to the doctor’s office, help to enroll in food stamps, addiction treatment, or temporary housing.\u003c/p>\n\u003cp>The task will take time.\u003c/p>\n\u003cp>At the community meetings, Kelley and her colleagues repeatedly described a pilot program she ran as behavioral health director in San Bernardino County. The program took referrals from family, police or other community members who wanted to prod those who were resistant to mental health treatment. \u003c/p>\u003c/div>",
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"content": "‘We have tried for 40 years in this wonderful country of ours to force people with mental illness” [to be treated]. … We all know there’s no magical answer. But we will be patient, and we will be persistent.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp> The time it took for county workers using the LEAP method to persuade respondents to enter treatment varied, Kelley said. But on average, she said it took 20 visits if a respondent was housed — and 40 visits if they were unhoused. Visit times varied, from a few minutes to a whole day so that the whole process could take weeks or months, Kelley said.\u003c/p>\n\u003cp>The timetables set by law for CARE Court are much tighter.\u003c/p>\n\u003cp>If counties initially determine a client won’t agree to treatment, they get 14 days to try again before the next court hearing. Kelley said the judges in her county are sympathetic toward those concerns, but not all counties will get such flexibility.\u003c/p>\n\u003cp>“I can’t do 40 face-to-face visits in 14 days,” she said.\u003c/p>\n\u003cp>Civil rights advocates balked at the counties’ suggestion that any program involving the pressure of the judicial system, even a non-criminal court, could be voluntary.\u003c/p>\n\u003cp>“If you’re trying to engage somebody, and there’s a petition that involves a court,” there’s less hope of building genuine trust, said Keris Myrick, a mental health advocate who lives with schizophrenia and a board member of Disability Rights California.\u003c/p>\n\u003cp>The group is particularly concerned the court process could be ineffective or harmful among Black residents, who are overrepresented both in California’s homeless population and among people diagnosed with schizophrenia.\u003c/p>\n\u003cp>Myrick, who is Black, said she has been subject to involuntary treatment and described harrowing experiences during which she was handcuffed in the back of a police car or strapped down to a gurney for hours before a doctor visited. She said one thing that actually helped her recover was having a peer supporter who was also African American and related to her experiences, eventually persuading her to get treatment on her own terms.\u003c/p>\n\u003cp>She later ran a peer support program in Los Angeles County and trained workers in the county mental health department. Myrick says the state needs to expand those services, as well as housing and social supports to help people live stable lives, without the threat of a judicial order.\u003c/p>\n\u003cp>Alex Barnard, a sociologist at New York University who has studied involuntary mental health treatment in California, is skeptical about whether the state can appease both civil libertarians and those who want more aggressive treatment. But he said the program’s mandate of a year of persistent engagement is promising.\u003c/p>\n\u003cp>“If CARE Courts work, it will probably be because of that,” he said. “It creates some accountability on the provider to keep trying to work with somebody who might be very challenging, and elsewhere in the system would just have their file closed out.”\u003c/p>\n\u003ch2>Long-term resources\u003c/h2>\n\u003cp>Those implementation questions are among a list of other practical hurdles counties face for the program to be successful.\u003c/p>\n\u003cp>There’s long-term funding. The first seven counties were given $26 million in one-time state grants to start the programs; some have estimated annual costs of the services themselves will \u003ca href=\"https://sfstandard.com/2023/04/20/newsoms-care-court-faces-50-million-hurdle-in-san-francisco-as-key-deadline-approaches/\">far exceed\u003c/a> those allotments.\u003c/p>\n\u003cp>The state says most services will be covered by Medi-Cal or private insurance, and expects counties to submit reimbursement requests, including the costs of going to court or finding respondents.\u003c/p>\n\u003cp>But the \u003ca href=\"https://www.kqed.org/news/11923034/were-drowning-why-kaiser-mental-health-workers-are-striking#:~:text=Kaiser%20administrators%20point%20to%20what,15%20statement.\">nationwide shortage of behavioral health workers\u003c/a> has made it a challenge for some departments to hire. In San Diego County, Bergmann’s department plans to add 55 new staff, including 10 clinicians, for CARE Court. Only 35% have been hired so far, a spokesperson said. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp> And there’s housing and beds, which all agree are crucial to making treatment a success.\u003c/p>\n\u003cp>Health officials believe most people who qualify for CARE Court will need a more intensive treatment placement in the beginning, while some may be able to be placed in residential facilities or their own apartments after being stabilized.\u003c/p>\n\u003cp>But there are shortages across that spectrum. A \u003ca href=\"https://www.rand.org/pubs/research_reports/RRA1824-1-v2.html\">2021 Rand analysis\u003c/a> found the state is short more than 4,700 psychiatric inpatient treatment beds and nearly 3,000 residential facility beds such as \u003ca href=\"https://calmatters.org/projects/board-and-care-homes-closing-in-california-mental-health-crisis/\">board-and-cares\u003c/a>—long-term housing for people with severe mental illness and one option for respondents to live after they complete CARE Court.\u003c/p>\n\u003cp>Included in last year’s state budget was \u003ca href=\"https://bridgehousing.buildingcalhhs.com/county-behavioral-health-agencies/\">nearly $1 billion\u003c/a> in new funding for counties to expand temporary housing placements for those with mental illness, with priority given to people in CARE Court.\u003c/p>\n\u003cp>Orange County and some others are using the grants to open new treatment beds. In San Diego, Bergmann’s department will use the money to pay for board-and-care placements. Significant new infrastructure, however, will take years to complete. Over the past five years, Bergmann said, the county has lost a fifth of those residential facilities.\u003c/p>\n\u003cp>“In the near term, those funds will help us help people with the fewest resources to compete more” for placements, he said. “It’s not going to all of a sudden create a net increase in infrastructure.”\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://calmatters.org/author/marisa-kendall/\">Marisa Kendall\u003c/a> contributed to this reporting.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "17 Struggling California Hospitals Accept Millions in Interest-Free Loans",
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"headTitle": "17 Struggling California Hospitals Accept Millions in Interest-Free Loans | KQED",
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"content": "\u003cp>Seventeen \u003ca href=\"https://hcai.ca.gov/california-announces-300-million-in-financial-support-for-community-hospitals-across-the-state/\">financially distressed California hospitals\u003c/a> — including three that filed for bankruptcy earlier this year — will receive close to $300 million in interest-free loans, state officials announced Thursday.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/health/2023/01/hospital-closure/\">Madera Community Hospital\u003c/a>, which closed its doors in January, stands to receive the biggest chunk, $52 million. The money comes from the Distressed Hospital Loan Program, which the Legislature created to support rural and independent hospitals that faced financial challenges coming out of the COVID-19 pandemic.\u003c/p>\n\u003cp>The Madera hospital had requested $80 million, but the money it received is expected to be enough to fund a reopening for the rural hospital about 25 miles north of Fresno.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Adventist Health, which operates hospitals in four West Coast states, last month announced a proposal to take over Madera’s operations through a management agreement, contingent on it receiving the state funds. In a letter outlining its terms, Adventist \u003ca href=\"https://calmatters.org/wp-content/uploads/2023/08/Madera-LOI-20230727-final.pdf\">projected needing $55 million to reopen (PDF)\u003c/a> and another $30 million to sustain operations in the second year.[aside postID=news_11958245 hero='https://ww2.kqed.org/app/uploads/sites/10/2023/08/033023_Hollister_Hospital_LV_CM_01-1020x680.jpg']Madera will initially receive $2 million to cover immediate operating costs. Officials at Adventist Health and Madera Community will have to submit a “comprehensive hospital turnaround plan” and, if approved, will then become eligible to receive the remaining $50 million.\u003c/p>\n\u003cp>“This financial assistance is an important step in the right direction to help Madera Community Hospital reopen its doors to the community. We have more work to do, but I’m proud to have led this effort,” said Assemblymember Esmeralda Soria, a Fresno Democrat whose district includes Madera and who authored legislation that led to the loan program.\u003c/p>\n\u003cp>Adventist Health in a written statement said it is working with “community partners and stakeholders in developing a thoughtful, comprehensive hospital turnaround plan.”\u003c/p>\n\u003cp>Beverly Hospital, located east of Los Angeles, will receive $5 million to cover operations while it is in bankruptcy. The hospital applied for $35 million, but it is now set to be bought by Adventist Health White Memorial. A bankruptcy judge last week approved \u003ca href=\"https://oag.ca.gov/system/files/media/bh-638.pdf\">Adventist’s $39 million purchase of Beverly (PDF)\u003c/a>.[pullquote size=\"medium\" align=\"right\" citation=\"State Treasurer Fiona Ma\"]‘The hospitals approved for this program have shown a detailed plan for financial recovery and these funds will help them keep the doors open so they can keep serving their communities.’[/pullquote]Another bankrupt hospital, Hazel Hawkins Memorial, will receive the $10 million it requested. It’s the only source of emergency care in San Benito County, a rural community east of Monterey.\u003c/p>\n\u003cp>“The hospitals approved for this program have shown a detailed plan for financial recovery and these funds will help them keep the doors open so they can keep serving their communities,” said State Treasurer Fiona Ma, whose office is helping administer the funds. Ma said her team has already begun providing instructions and assistance to the awarded hospitals.\u003c/p>\n\u003ch2>Biggest loans to distressed hospitals\u003c/h2>\n\u003cp>The Department of Health Care Access and Information reviewed applications and selected hospitals for the program. Thirty hospitals applied for loans.\u003c/p>\n\u003cp>Other hospitals that will receive significant funding include the following:\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://www.tricitymed.org/wp-content/uploads/2023/07/agenda-packet.Special-Meeting-7.27.23.pdf\">Tri-City Medical Center (PDF)\u003c/a> in San Diego will receive $33.2 million. The hospital recently announced plans to suspend its labor and delivery services amid “financial losses.”\u003c/li>\n\u003cli>\u003ca href=\"https://calmatters.org/health/2023/01/hospital-closure/\">Kaweah Delta Health Care District\u003c/a> in Visalia will get a $20.8 million loan. This hospital laid off 130 employees late last year.\u003c/li>\n\u003cli>\u003ca href=\"https://inewsource.org/2023/02/07/el-centro-hospital-financial-problems/\">El Centro Regional Medical Center\u003c/a> in Imperial County, which in January closed its maternity ward, will receive $28 million.\u003c/li>\n\u003cli>\u003ca href=\"https://pmhd.org/\">Pioneers Memorial Healthcare District\u003c/a>, Imperial County’s only other hospital, also is set to receive $28 million.\u003c/li>\n\u003cli>\u003ca href=\"https://www.dameronhospital.org/\">Dameron Hospital\u003c/a> in Stockton, now also being managed by Adventist Health, will be loaned $29 million.\u003c/li>\n\u003c/ul>\n\u003ch2>Vulnerable California hospitals\u003c/h2>\n\u003cp>Most California hospitals are part of large networks that can navigate turbulent financial periods. A number of community and independent hospitals have struggled for years, especially after the peak of the pandemic. Some recently reduced services or laid off staff.[aside label='More on Health Care' tag='health-care']Hospitals have pointed to a number of factors for their distressed state — increased labor costs, and inadequate reimbursement from public insurance programs, Medicare and Medi-Cal, and in \u003ca href=\"https://fresnoland.org/2023/03/01/reimbursements-rates-madera-hospital-closure/\">some cases private insurance.\u003c/a>\u003c/p>\n\u003cp>Some hospitals began to ask the state for help late last year, but the closure of Madera Community Hospital prompted more urgency from lawmakers. It shut its doors after Trinity Health, a large Catholic health system, pulled out of negotiations to purchase the hospital.\u003c/p>\n\u003cp>Madera Community Hospital in the San Joaquin Valley was the only general acute care hospital in the county of about 160,000 people. The closest emergency rooms are about \u003ca href=\"https://www.fresnobee.com/news/local/article272712840.html\">30 and 40 minutes drive away in Fresno and Merced\u003c/a>.\u003c/p>\n\u003cp>The Distressed Hospital Loan Program closes at the end of 2031. Hospitals will get an 18-month grace period and then will have to repay loans over a six-year period.\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "The Distressed Hospital Loan Program provides interest-free loans to struggling medical centers in an effort to combat rising costs exacerbated by the pandemic.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Seventeen \u003ca href=\"https://hcai.ca.gov/california-announces-300-million-in-financial-support-for-community-hospitals-across-the-state/\">financially distressed California hospitals\u003c/a> — including three that filed for bankruptcy earlier this year — will receive close to $300 million in interest-free loans, state officials announced Thursday.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/health/2023/01/hospital-closure/\">Madera Community Hospital\u003c/a>, which closed its doors in January, stands to receive the biggest chunk, $52 million. The money comes from the Distressed Hospital Loan Program, which the Legislature created to support rural and independent hospitals that faced financial challenges coming out of the COVID-19 pandemic.\u003c/p>\n\u003cp>The Madera hospital had requested $80 million, but the money it received is expected to be enough to fund a reopening for the rural hospital about 25 miles north of Fresno.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Adventist Health, which operates hospitals in four West Coast states, last month announced a proposal to take over Madera’s operations through a management agreement, contingent on it receiving the state funds. In a letter outlining its terms, Adventist \u003ca href=\"https://calmatters.org/wp-content/uploads/2023/08/Madera-LOI-20230727-final.pdf\">projected needing $55 million to reopen (PDF)\u003c/a> and another $30 million to sustain operations in the second year.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Madera will initially receive $2 million to cover immediate operating costs. Officials at Adventist Health and Madera Community will have to submit a “comprehensive hospital turnaround plan” and, if approved, will then become eligible to receive the remaining $50 million.\u003c/p>\n\u003cp>“This financial assistance is an important step in the right direction to help Madera Community Hospital reopen its doors to the community. We have more work to do, but I’m proud to have led this effort,” said Assemblymember Esmeralda Soria, a Fresno Democrat whose district includes Madera and who authored legislation that led to the loan program.\u003c/p>\n\u003cp>Adventist Health in a written statement said it is working with “community partners and stakeholders in developing a thoughtful, comprehensive hospital turnaround plan.”\u003c/p>\n\u003cp>Beverly Hospital, located east of Los Angeles, will receive $5 million to cover operations while it is in bankruptcy. The hospital applied for $35 million, but it is now set to be bought by Adventist Health White Memorial. A bankruptcy judge last week approved \u003ca href=\"https://oag.ca.gov/system/files/media/bh-638.pdf\">Adventist’s $39 million purchase of Beverly (PDF)\u003c/a>.\u003c/p>\u003c/div>",
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"content": "‘The hospitals approved for this program have shown a detailed plan for financial recovery and these funds will help them keep the doors open so they can keep serving their communities.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Another bankrupt hospital, Hazel Hawkins Memorial, will receive the $10 million it requested. It’s the only source of emergency care in San Benito County, a rural community east of Monterey.\u003c/p>\n\u003cp>“The hospitals approved for this program have shown a detailed plan for financial recovery and these funds will help them keep the doors open so they can keep serving their communities,” said State Treasurer Fiona Ma, whose office is helping administer the funds. Ma said her team has already begun providing instructions and assistance to the awarded hospitals.\u003c/p>\n\u003ch2>Biggest loans to distressed hospitals\u003c/h2>\n\u003cp>The Department of Health Care Access and Information reviewed applications and selected hospitals for the program. Thirty hospitals applied for loans.\u003c/p>\n\u003cp>Other hospitals that will receive significant funding include the following:\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://www.tricitymed.org/wp-content/uploads/2023/07/agenda-packet.Special-Meeting-7.27.23.pdf\">Tri-City Medical Center (PDF)\u003c/a> in San Diego will receive $33.2 million. The hospital recently announced plans to suspend its labor and delivery services amid “financial losses.”\u003c/li>\n\u003cli>\u003ca href=\"https://calmatters.org/health/2023/01/hospital-closure/\">Kaweah Delta Health Care District\u003c/a> in Visalia will get a $20.8 million loan. This hospital laid off 130 employees late last year.\u003c/li>\n\u003cli>\u003ca href=\"https://inewsource.org/2023/02/07/el-centro-hospital-financial-problems/\">El Centro Regional Medical Center\u003c/a> in Imperial County, which in January closed its maternity ward, will receive $28 million.\u003c/li>\n\u003cli>\u003ca href=\"https://pmhd.org/\">Pioneers Memorial Healthcare District\u003c/a>, Imperial County’s only other hospital, also is set to receive $28 million.\u003c/li>\n\u003cli>\u003ca href=\"https://www.dameronhospital.org/\">Dameron Hospital\u003c/a> in Stockton, now also being managed by Adventist Health, will be loaned $29 million.\u003c/li>\n\u003c/ul>\n\u003ch2>Vulnerable California hospitals\u003c/h2>\n\u003cp>Most California hospitals are part of large networks that can navigate turbulent financial periods. A number of community and independent hospitals have struggled for years, especially after the peak of the pandemic. Some recently reduced services or laid off staff.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Hospitals have pointed to a number of factors for their distressed state — increased labor costs, and inadequate reimbursement from public insurance programs, Medicare and Medi-Cal, and in \u003ca href=\"https://fresnoland.org/2023/03/01/reimbursements-rates-madera-hospital-closure/\">some cases private insurance.\u003c/a>\u003c/p>\n\u003cp>Some hospitals began to ask the state for help late last year, but the closure of Madera Community Hospital prompted more urgency from lawmakers. It shut its doors after Trinity Health, a large Catholic health system, pulled out of negotiations to purchase the hospital.\u003c/p>\n\u003cp>Madera Community Hospital in the San Joaquin Valley was the only general acute care hospital in the county of about 160,000 people. The closest emergency rooms are about \u003ca href=\"https://www.fresnobee.com/news/local/article272712840.html\">30 and 40 minutes drive away in Fresno and Merced\u003c/a>.\u003c/p>\n\u003cp>The Distressed Hospital Loan Program closes at the end of 2031. Hospitals will get an 18-month grace period and then will have to repay loans over a six-year period.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Alvin Vallejo, a public health nurse in San Francisco, steps inside a dilapidated apartment building in the Tenderloin neighborhood.\u003c/p>\n\u003cp>He climbs a narrow staircase to visit a client on the third floor recovering from a high-risk pregnancy and a difficult birth. Vallejo turns down the hall, passes a communal bathroom, and knocks on a door.\u003c/p>\n\u003cp>Dayanis, a 35-year-old mother cradling a newborn dressed in a turquoise onesie, answers the door. (Only her first name is used to protect her medical privacy.)\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Last year, she and her husband immigrated from Cuba, determined for a better life. They left two adolescent daughters behind with relatives. Their newest child, Abraham José, was unplanned.\u003c/p>\n\u003cp>Maternal mortality is at its \u003ca href=\"https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2021/maternal-mortality-rates-2021.htm\">highest level\u003c/a> since 1965. But a new state bill, \u003ca href=\"https://legiscan.com/CA/text/AB1057/id/2701737\">AB 1057\u003c/a>, aims to improve conditions by helping more at-risk families like Dayanis’ receive \u003ca href=\"https://www.cdph.ca.gov/Programs/CFH/DMCAH/CHVP/Pages/default.aspx\">medical care at home in the early postpartum period\u003c/a> to ensure she and the baby thrive.[pullquote size=\"medium\" align=\"right\" citation=\"Michelle Gibbons, executive director, County Health Executives Association of California\"]‘How awesome is it to have a nurse come into your home and just be there to support you? … This offers quality care in an intimate setting and engagement with a nurse.’[/pullquote]Dayanis ushers Vallejo inside the orderly but tiny, tightly packed room. A makeshift kitchen lines one wall with a single burner and a tiny fridge. Dayanis sits on a twin bed before covering her baby’s ears as the wails from a nearby police siren fill the space.\u003c/p>\n\u003cp>Vallejo pulls up a metal chair and opens his clipboard before asking questions about medications, vitamins, unusual symptoms and eating habits. Dayanis says she’s recuperating well.\u003c/p>\n\u003cp>Vallejo routinely measures her blood pressure. Dayanis’s pulse is a touch high, but he assures her it’s nothing to worry about. He then asks about the baby.\u003c/p>\n\u003cp>During Vallejo’s visit, Dayanis rocks her son gently as he closes his eyes. She assures Vallejo that her baby, Abraham, is well, but he doesn’t like drinking from a bottle.[aside label='More Stories on Health Care' tag='health-care']So Vallejo offers to order a new one to help. After about an hour and a half, the appointment concludes and Vallejo schedules a time to return the following week.\u003c/p>\n\u003cp>“Wow. How awesome is it to have a nurse come into your home and just be there to support you?” asks Michelle Gibbons, executive director of the County Health Executives Association of California. “Everybody wants to do what’s best for your kid, and yet, not knowing if you’re actually doing what’s best for your kid. This offers quality care in an intimate setting and engagement with a nurse.”\u003c/p>\n\u003cp>She says public health nurses provide education on child development, nutrition, housing, and safety and also offer mental health screenings. \u003ca href=\"https://www.cdph.ca.gov/Programs/CFH/DMCAH/CHVP/CDPH%20Document%20Library/CHVP-AnnualFederalReportSummary-2020.pdf\">Research (PDF)\u003c/a> suggests that home-visiting programs increase breastfeeding rates and lead to lower cases of child abuse and substance abuse.\u003c/p>\n\u003cp>“It’s just one strategy to be able to address some of the disparities that we see in getting these kids off to a really good start in life,” Gibbons said.[pullquote size=\"medium\" align=\"right\" citation=\"Dayanis, mother\"]‘I have been well taken care of. I am very grateful.’[/pullquote]She added that she would love to see the program address more people, including options for the unhoused and families with more than one child. It’s why, she says, her group is backing AB 1057. The bill would expand the number of evidenced-based, home-visiting models that can be implemented. The legislation was unanimously passed in the state Assembly. Now, the proposal is before the Senate.\u003c/p>\n\u003cp>Back inside Dayanis’ studio, she says home health visits have improved her mental health and connected her to useful services like housing. Soon, her family plans to move into a city-supported unit nearby with two bedrooms and a private bathroom.\u003c/p>\n\u003cp>“I have been well taken care of,” Dayanis said in Spanish. “I am very grateful.”\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>So Vallejo offers to order a new one to help. After about an hour and a half, the appointment concludes and Vallejo schedules a time to return the following week.\u003c/p>\n\u003cp>“Wow. How awesome is it to have a nurse come into your home and just be there to support you?” asks Michelle Gibbons, executive director of the County Health Executives Association of California. “Everybody wants to do what’s best for your kid, and yet, not knowing if you’re actually doing what’s best for your kid. This offers quality care in an intimate setting and engagement with a nurse.”\u003c/p>\n\u003cp>She says public health nurses provide education on child development, nutrition, housing, and safety and also offer mental health screenings. \u003ca href=\"https://www.cdph.ca.gov/Programs/CFH/DMCAH/CHVP/CDPH%20Document%20Library/CHVP-AnnualFederalReportSummary-2020.pdf\">Research (PDF)\u003c/a> suggests that home-visiting programs increase breastfeeding rates and lead to lower cases of child abuse and substance abuse.\u003c/p>\n\u003cp>“It’s just one strategy to be able to address some of the disparities that we see in getting these kids off to a really good start in life,” Gibbons said.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>She added that she would love to see the program address more people, including options for the unhoused and families with more than one child. It’s why, she says, her group is backing AB 1057. The bill would expand the number of evidenced-based, home-visiting models that can be implemented. The legislation was unanimously passed in the state Assembly. Now, the proposal is before the Senate.\u003c/p>\n\u003cp>Back inside Dayanis’ studio, she says home health visits have improved her mental health and connected her to useful services like housing. Soon, her family plans to move into a city-supported unit nearby with two bedrooms and a private bathroom.\u003c/p>\n\u003cp>“I have been well taken care of,” Dayanis said in Spanish. “I am very grateful.”\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>When Dr. Yohualli Anaya first noticed a lack of representation of Latina physicians in the U.S., she hoped to discover a different outcome when she embarked on a similar study — this time looking at California demographics. Latinos make up nearly 40% of the state’s population.[pullquote size=\"medium\" align=\"right\" citation=\"Dr. Yohualli Anaya, associate professor, University of Wisconsin-Madison\"]‘It’s something that I encounter on a day-to-day basis. It’s constantly being reminded of the lack of representation of Latina physicians.’[/pullquote]Anaya, the lead author of a new report published this month by UCLA’s Latino Policy and Politics Institute, found “disappointing” results when further examining nationwide trends.\u003c/p>\n\u003cp>“A reminder of the work that still needs to be done,” said Anaya, an associate professor of family medicine and community health at the University of Wisconsin-Madison. “There are so few of us that are in the clinic exam rooms with our patients, in the medical schools teaching our medical students. It’s something that I encounter on a day-to-day basis. It’s constantly being reminded of the lack of representation of Latina physicians.”\u003c/p>\n\u003cp>The study, which draws on census data from 2014–18, finds Latinas accounted for nearly 3% of California doctors. That’s slightly higher than the nationwide number at 2%.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Another detail that stood out to Anaya is that Latina physicians were almost 36 times more likely to speak Spanish at home compared to non-Hispanic white physicians.\u003c/p>\n\u003cp>“This is about ensuring equitable health care delivery for all populations. And Latino populations certainly deserve to have equitable health care delivery,” she said.\u003c/p>\n\u003cp>Anaya spoke more about the study’s results and what can be done to improve the shortage with KQED’s Alexander Gonzalez. Their conversation was edited for brevity and clarity.\u003c/p>\n\u003cp>\u003cstrong>Alexander Gonzalez: Why are we seeing these numbers? What’s driving this?\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Dr. Yohualli Anaya:\u003c/strong> It’s a multitude of things that are leading to this lack of representation. In the report, I highlight the different stages of the educational pathway where we can do some interventions to improve these numbers. We really need an approach that is addressing each of these levels because doing one or the other is going to be insufficient. We have been making some efforts and yet our efforts have been insufficient thus far.\u003c/p>\n\u003cp>\u003cstrong>It sounds like this is a really systemic issue and it’s going to take looking at people’s education as young as high school. Is that fair to say?\u003c/strong>\u003c/p>\n\u003cp>I would say even earlier, from an early age. So, if we invest in the quality of the education that our students are receiving, then we’re going to have students that are even more qualified and better prepared to enter college, succeed in college [and] enter medical school.\u003c/p>\n\u003cp>\u003cstrong>The tuition for medical education is typically steep. How much of the issue is related to costs based on the numbers reported in this study?\u003c/strong>\u003c/p>\n\u003cp>It is definitely a contributor. And if we are thinking about being inclusive in our recruitment rates, we want students and physicians who represent the full scope of the patients we’re taking care of. And that not only includes diversity in race and ethnicity, that also includes diversity in socioeconomic status.[aside label='More on Health Care' tag='health-care']Let’s say we want more students who are of immigrant background, who are first generation; these students are likely to be affected by socioeconomic disadvantage. They’re likely to be underrepresented in medicine. They’ve also been shown in research to practice in underserved communities. So supporting students in community college, supporting students who are underrepresented minorities with scholarships, with programs for extended research opportunities, and ensuring their success through their undergraduate career is going to then funnel additional students into medical school.\u003c/p>\n\u003cp>\u003cstrong>What’s another recommendation for helping improve the shortage?\u003c/strong>\u003c/p>\n\u003cp>We are at risk of losing a number of both students and existing health care workers in the workforce if we lose the ability for students to have \u003ca href=\"https://www.uscis.gov/DACA\">DACA\u003c/a> (Deferred Action for Childhood Arrivals) and maintain work authorization and stay in the educational pathway. Protecting the ability of undocumented students to pursue and study and practice medicine in the United States is going to ensure that we continue to build our numbers and that we don’t lose numbers when we already don’t have numbers to lose\u003cem>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Anaya, the lead author of a new report published this month by UCLA’s Latino Policy and Politics Institute, found “disappointing” results when further examining nationwide trends.\u003c/p>\n\u003cp>“A reminder of the work that still needs to be done,” said Anaya, an associate professor of family medicine and community health at the University of Wisconsin-Madison. “There are so few of us that are in the clinic exam rooms with our patients, in the medical schools teaching our medical students. It’s something that I encounter on a day-to-day basis. It’s constantly being reminded of the lack of representation of Latina physicians.”\u003c/p>\n\u003cp>The study, which draws on census data from 2014–18, finds Latinas accounted for nearly 3% of California doctors. That’s slightly higher than the nationwide number at 2%.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Another detail that stood out to Anaya is that Latina physicians were almost 36 times more likely to speak Spanish at home compared to non-Hispanic white physicians.\u003c/p>\n\u003cp>“This is about ensuring equitable health care delivery for all populations. And Latino populations certainly deserve to have equitable health care delivery,” she said.\u003c/p>\n\u003cp>Anaya spoke more about the study’s results and what can be done to improve the shortage with KQED’s Alexander Gonzalez. Their conversation was edited for brevity and clarity.\u003c/p>\n\u003cp>\u003cstrong>Alexander Gonzalez: Why are we seeing these numbers? What’s driving this?\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Dr. Yohualli Anaya:\u003c/strong> It’s a multitude of things that are leading to this lack of representation. In the report, I highlight the different stages of the educational pathway where we can do some interventions to improve these numbers. We really need an approach that is addressing each of these levels because doing one or the other is going to be insufficient. We have been making some efforts and yet our efforts have been insufficient thus far.\u003c/p>\n\u003cp>\u003cstrong>It sounds like this is a really systemic issue and it’s going to take looking at people’s education as young as high school. Is that fair to say?\u003c/strong>\u003c/p>\n\u003cp>I would say even earlier, from an early age. So, if we invest in the quality of the education that our students are receiving, then we’re going to have students that are even more qualified and better prepared to enter college, succeed in college [and] enter medical school.\u003c/p>\n\u003cp>\u003cstrong>The tuition for medical education is typically steep. How much of the issue is related to costs based on the numbers reported in this study?\u003c/strong>\u003c/p>\n\u003cp>It is definitely a contributor. And if we are thinking about being inclusive in our recruitment rates, we want students and physicians who represent the full scope of the patients we’re taking care of. And that not only includes diversity in race and ethnicity, that also includes diversity in socioeconomic status.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Let’s say we want more students who are of immigrant background, who are first generation; these students are likely to be affected by socioeconomic disadvantage. They’re likely to be underrepresented in medicine. They’ve also been shown in research to practice in underserved communities. So supporting students in community college, supporting students who are underrepresented minorities with scholarships, with programs for extended research opportunities, and ensuring their success through their undergraduate career is going to then funnel additional students into medical school.\u003c/p>\n\u003cp>\u003cstrong>What’s another recommendation for helping improve the shortage?\u003c/strong>\u003c/p>\n\u003cp>We are at risk of losing a number of both students and existing health care workers in the workforce if we lose the ability for students to have \u003ca href=\"https://www.uscis.gov/DACA\">DACA\u003c/a> (Deferred Action for Childhood Arrivals) and maintain work authorization and stay in the educational pathway. Protecting the ability of undocumented students to pursue and study and practice medicine in the United States is going to ensure that we continue to build our numbers and that we don’t lose numbers when we already don’t have numbers to lose\u003cem>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cem>Lea esta historia en \u003ca href=\"https://calmatters.org/calmatters-en-espanol/2023/08/tres-hospitales-de-california-se-declararon-en-bancarrota-este-ano-y-las-cadenas-de-servicios-de-salud-podrian-mantenerlos-con-vida/\">español\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>Three California hospitals that declared bankruptcy earlier this year are hashing out deals that could bring back or save much-needed health-care services for their communities.\u003c/p>\n\u003cp>Defunct Madera Community Hospital in the San Joaquin Valley, cash-strapped Beverly Community Hospital east of Los Angeles and Hazel Hawkins Memorial Hospital in rural San Benito County are trying to clinch lifelines in deals with health chains that have a reputation for revitalizing distressed hospitals.\u003c/p>\n\u003cp>The proposals are far from the finish line, but they present a glimpse of hope for residents who face longer journeys to emergency rooms and increased risk when local medical centers close. Two of the three — Madera Community and Hazel Hawkins — are the only hospitals in their counties.\u003c/p>\n\u003cp>“This is really great news. There will be a number of stages, and the first stage is for [partnering chains] to indicate their interest,” said state Sen. Anna Caballero, a Democrat whose district includes Madera and San Benito counties. “Now there’s a lot of work that has to happen in a very quick period of time.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Madera Community, which shut down at the start of the year, is trying to secure a management agreement with Adventist Health, \u003ca href=\"https://www.definitivehc.com/resources/healthcare-insights/top-largest-california-health-systems-number-beds#:~:text=Which%20health%20systems%20have%20the,the%20top%20of%20our%20list.\">the seventh largest health system\u003c/a> in the state. As proposed, Adventist would take over operations of \u003ca href=\"https://calmatters.org/health/2023/01/hospital-closure/\">the closed hospital\u003c/a> and its affiliated rural clinics. If all goes according to plan, Madera Community could reopen in six-to-nine months.\u003c/p>\n\u003cp>Adventist Health is also a candidate to buy Beverly Community Hospital in the city of Montebello outside of Los Angeles. That hospital has to secure a deal ahead of a key bankruptcy court deadline this week.\u003c/p>\n\u003cp>Meanwhile, Hazel Hawkins Memorial Hospital in Hollister recently announced a proposed “lease to own” partnership with American Advanced Management, a company that operates six other California hospitals.\u003c/p>\n\u003cp>The three are among a handful of hospitals that in the past year or so publicly announced their financial troubles. The state responded this spring with a \u003ca href=\"https://calmatters.org/health/2023/05/hospital-closures-california-2/\">$300 million interest-free loan program\u003c/a> that can provide emergency funds to hospitals. The state is expected to distribute the money later this month. The three bankrupt hospitals have already asked for $125 million.\u003c/p>\n\u003ch2>Saving Madera Community Hospital\u003c/h2>\n\u003cp>The proposed partnership in Madera is largely dependent on Madera Community securing an $80 million loan from the state’s \u003ca href=\"https://hcai.ca.gov/construction-finance/distressed-hospital-loan-program/\">Distressed Hospital Loan Program\u003c/a>.\u003c/p>\n\u003cp>Karen Paolinelli, chief executive of Madera Community Hospital, told CalMatters that while she recognizes the requested amount is substantial, her hospital is the only one that is currently closed. “It is very expensive to reopen a hospital,” she said. “We don’t want to just reopen, we want to be sustainable; we don’t want to be back here in a couple of years.”[pullquote size=\"medium\" align=\"right\" citation=\"Karen Paolinelli, chief executive of Madera Community Hospital\"]‘We don’t want to just reopen, we want to be sustainable; we don’t want to be back here in a couple of years.’[/pullquote]Madera is also awaiting \u003ca href=\"https://sd14.senate.ca.gov/news/press-release/caballero-bigelow-land-budget-deal-madera-hospital-allowing-it-continue-provide\">another $5 million in state funding\u003c/a> that was granted in last year’s budget but placed on hold when the hospital closed.\u003c/p>\n\u003cp>In a \u003ca href=\"https://calmatters.org/wp-content/uploads/2023/08/Madera-LOI-20230727-final.pdf\">letter outlining its terms (PDF)\u003c/a>, Adventist Health said it will require at least $55 million to fund staffing, supplies, maintenance, training and services in the first year, and another $30 million in the second year. Madera Community Hospital would have to pay Adventist a management fee.\u003c/p>\n\u003cp>In exchange, the health system would provide its management expertise and personnel to support Madera’s reopening. According to the proposal, Adventist would have the option to purchase the hospital after three years.\u003c/p>\n\u003cfigure id=\"attachment_11958264\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11958264\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/010423-MaderCommnityHospital-LV_08-CM-800x533.jpeg\" alt=\"Empty building covered with a tarp.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/010423-MaderCommnityHospital-LV_08-CM-800x533.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/010423-MaderCommnityHospital-LV_08-CM-1020x680.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/010423-MaderCommnityHospital-LV_08-CM-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/010423-MaderCommnityHospital-LV_08-CM-1536x1024.jpeg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/010423-MaderCommnityHospital-LV_08-CM-1920x1280.jpeg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/010423-MaderCommnityHospital-LV_08-CM.jpeg 2000w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Outlines of the Madera Community Hospital sign being covered by a tarp at the Emergency Room entrance of the hospital on Jan. 2, 2023. Madera County Sheriff Tyson Pogue announced a state of emergency for the county when the hospital shut its doors due to bankruptcy. \u003ccite>(Larry Valenzuela, CalMatters/CatchLight Local)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Paolinelli said a management agreement is the hospital’s best bet at reopening. It has not found a buyer for a straightforward sale. Paolinelli said she has not discussed with Adventist whether she will stay on as head of the hospital.\u003c/p>\n\u003cp>Adventist Health has experience reopening closed hospitals. For example, five years ago Adventist reopened and rebranded what was once known as \u003ca href=\"https://www.visaliatimesdelta.com/story/news/2019/04/30/tulare-regional-medical-center-no-more-adventist-makes-official/3621956002/\">Tulare Regional Medical Center\u003c/a>. That hospital is now Adventist Health Tulare.\u003c/p>\n\u003ch2>Obstacles to Beverly hospital’s sale\u003c/h2>\n\u003cp>Beverly Community, a 202-bed hospital in Montebello east of Los Angeles, filed for bankruptcy in April. It \u003ca href=\"https://beverly.org/public-notice-march-16-2023/\">suspended a number of services\u003c/a> by June, including maternity, pediatric and outpatient radiology.\u003c/p>\n\u003cp>The Attorney General’s office last month announced the conditional approval of the hospital’s sale to a Glendale-based chain called American Healthcare Systems. That proposed deal is quickly dissolving.\u003c/p>\n\u003cp>According to bankruptcy court documents, bondholders raised concerns about American Healthcare Systems’ ability to support the hospital financially. Recent filings show that Beverly Hospital is now exploring an alternative transaction with Adventist Health.\u003c/p>\n\u003cp>“Given Beverly Hospital’s critically low cash position and as of now uncertainty about state funding (from loan program), the bid from Adventist Health represents Beverly’s greatest chance of continuing to serve the community it has served for the past 75 years,” said Justin Bernbrock, a lawyer for Beverly Hospital.\u003c/p>\n\u003cp>This month will be key for the hospital. Beverly is losing about $5 million a month and projects to run out of cash by September, court documents show. The hospital applied for $35 million from the Distressed Hospital Loan Program.\u003c/p>\n\u003cp>On Thursday, the hospital is due to present a deal proposal to a bankruptcy court judge.\u003c/p>\n\u003ch2>Hazel Hawkins takes first step with potential partner\u003c/h2>\n\u003cp>The 25-bed Hazel Hawkins Memorial Hospital is San Benito County’s sole hospital. After months of looking for potential partners, management at Hazel Hawkins recently announced that it received a “letter of intent” from Modesto-based American Advanced Management.\u003c/p>\n\u003cp>The small chain is a private, for-profit company that operates six other hospitals in the state. It’s proposing to lease Hazel Hawkins \u003ca href=\"https://www.hazelhawkins.com/documents/content/8.7.23-SBHCD-Board-of-Directors-Special-Meeting.pdf\">for five-to-10 years (PDF)\u003c/a> before having the option to purchase the hospital.\u003c/p>\n\u003cp>American Advanced Management has taken over a handful of distressed or closed hospitals in rural parts of the state, \u003ca href=\"https://americanam.org/locations/\">according to its website\u003c/a>. These include Coalinga Regional Medical Center, Glenn Medical Center and Colusa Medical Center.\u003c/p>\n\u003cp>Hazel Hawkins is part of a publicly governed health care district, and the deal would need to be approved by the district’s board and by county voters.[aside tag=\"hospital\" label=\"More Related Stories\"]Hospital leaders sought a partner that, among other things, “possessed the resources to guarantee a continuum of care delivery for the future needs of our county,” Mary Casillas, interim CEO at Hazel Hawkins, said in a statement.\u003c/p>\n\u003cp>Hazel Hawkins declared a fiscal crisis late last year, and in May filed for Chapter 9 bankruptcy, but has continued to provide services. Last month, the hospital \u003ca href=\"https://www.hazelhawkins.com/documents/content/7.27.23-SBHCD-Board-of-Directors-Meeting.pdf\">applied for $10 million (PDF)\u003c/a> from the state’s Distressed Hospital Loan Program. If the hospital is approved for this loan, it would be in addition to a separate $3 million loan it received from the state in January.\u003c/p>\n\u003cp>In its May bankruptcy filings, the hospital said it expected to run out of cash in November 2024. At least one group, the California Nurses Association, has questioned whether the hospital filed for bankruptcy prematurely. The nurses union said it has asked the hospital to explain how it calculates its projections but has not received answers.\u003c/p>\n\u003cp>According to its financial statements, the hospital reported earnings of just over \u003ca href=\"https://siera.hcai.ca.gov/ProfileCharacteristics.aspx\">$2 million in calendar year 2022\u003c/a>.\u003c/p>\n\u003cp>The union represents about 120 nurses at Hazel Hawkins. Filing for bankruptcy, according to the union, has prompted nurses to leave for jobs in other hospitals, leaving staff there shorthanded.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit \u003ca href=\"http://www.chcf.org/\">www.chcf.org\u003c/a> to learn more.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Of the 3 troubled California hospitals, 2 are especially vital to their communities because they’re the only emergency providers in their rural counties. Health-care chains could keep them afloat.",
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"title": "3 California Hospitals Declared Bankruptcy This Year. Health Chains Could Keep Them Alive | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Lea esta historia en \u003ca href=\"https://calmatters.org/calmatters-en-espanol/2023/08/tres-hospitales-de-california-se-declararon-en-bancarrota-este-ano-y-las-cadenas-de-servicios-de-salud-podrian-mantenerlos-con-vida/\">español\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>Three California hospitals that declared bankruptcy earlier this year are hashing out deals that could bring back or save much-needed health-care services for their communities.\u003c/p>\n\u003cp>Defunct Madera Community Hospital in the San Joaquin Valley, cash-strapped Beverly Community Hospital east of Los Angeles and Hazel Hawkins Memorial Hospital in rural San Benito County are trying to clinch lifelines in deals with health chains that have a reputation for revitalizing distressed hospitals.\u003c/p>\n\u003cp>The proposals are far from the finish line, but they present a glimpse of hope for residents who face longer journeys to emergency rooms and increased risk when local medical centers close. Two of the three — Madera Community and Hazel Hawkins — are the only hospitals in their counties.\u003c/p>\n\u003cp>“This is really great news. There will be a number of stages, and the first stage is for [partnering chains] to indicate their interest,” said state Sen. Anna Caballero, a Democrat whose district includes Madera and San Benito counties. “Now there’s a lot of work that has to happen in a very quick period of time.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Madera Community, which shut down at the start of the year, is trying to secure a management agreement with Adventist Health, \u003ca href=\"https://www.definitivehc.com/resources/healthcare-insights/top-largest-california-health-systems-number-beds#:~:text=Which%20health%20systems%20have%20the,the%20top%20of%20our%20list.\">the seventh largest health system\u003c/a> in the state. As proposed, Adventist would take over operations of \u003ca href=\"https://calmatters.org/health/2023/01/hospital-closure/\">the closed hospital\u003c/a> and its affiliated rural clinics. If all goes according to plan, Madera Community could reopen in six-to-nine months.\u003c/p>\n\u003cp>Adventist Health is also a candidate to buy Beverly Community Hospital in the city of Montebello outside of Los Angeles. That hospital has to secure a deal ahead of a key bankruptcy court deadline this week.\u003c/p>\n\u003cp>Meanwhile, Hazel Hawkins Memorial Hospital in Hollister recently announced a proposed “lease to own” partnership with American Advanced Management, a company that operates six other California hospitals.\u003c/p>\n\u003cp>The three are among a handful of hospitals that in the past year or so publicly announced their financial troubles. The state responded this spring with a \u003ca href=\"https://calmatters.org/health/2023/05/hospital-closures-california-2/\">$300 million interest-free loan program\u003c/a> that can provide emergency funds to hospitals. The state is expected to distribute the money later this month. The three bankrupt hospitals have already asked for $125 million.\u003c/p>\n\u003ch2>Saving Madera Community Hospital\u003c/h2>\n\u003cp>The proposed partnership in Madera is largely dependent on Madera Community securing an $80 million loan from the state’s \u003ca href=\"https://hcai.ca.gov/construction-finance/distressed-hospital-loan-program/\">Distressed Hospital Loan Program\u003c/a>.\u003c/p>\n\u003cp>Karen Paolinelli, chief executive of Madera Community Hospital, told CalMatters that while she recognizes the requested amount is substantial, her hospital is the only one that is currently closed. “It is very expensive to reopen a hospital,” she said. “We don’t want to just reopen, we want to be sustainable; we don’t want to be back here in a couple of years.”\u003c/p>\u003c/div>",
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"content": "‘We don’t want to just reopen, we want to be sustainable; we don’t want to be back here in a couple of years.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Madera is also awaiting \u003ca href=\"https://sd14.senate.ca.gov/news/press-release/caballero-bigelow-land-budget-deal-madera-hospital-allowing-it-continue-provide\">another $5 million in state funding\u003c/a> that was granted in last year’s budget but placed on hold when the hospital closed.\u003c/p>\n\u003cp>In a \u003ca href=\"https://calmatters.org/wp-content/uploads/2023/08/Madera-LOI-20230727-final.pdf\">letter outlining its terms (PDF)\u003c/a>, Adventist Health said it will require at least $55 million to fund staffing, supplies, maintenance, training and services in the first year, and another $30 million in the second year. Madera Community Hospital would have to pay Adventist a management fee.\u003c/p>\n\u003cp>In exchange, the health system would provide its management expertise and personnel to support Madera’s reopening. According to the proposal, Adventist would have the option to purchase the hospital after three years.\u003c/p>\n\u003cfigure id=\"attachment_11958264\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11958264\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/010423-MaderCommnityHospital-LV_08-CM-800x533.jpeg\" alt=\"Empty building covered with a tarp.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/010423-MaderCommnityHospital-LV_08-CM-800x533.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/010423-MaderCommnityHospital-LV_08-CM-1020x680.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/010423-MaderCommnityHospital-LV_08-CM-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/010423-MaderCommnityHospital-LV_08-CM-1536x1024.jpeg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/010423-MaderCommnityHospital-LV_08-CM-1920x1280.jpeg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/010423-MaderCommnityHospital-LV_08-CM.jpeg 2000w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Outlines of the Madera Community Hospital sign being covered by a tarp at the Emergency Room entrance of the hospital on Jan. 2, 2023. Madera County Sheriff Tyson Pogue announced a state of emergency for the county when the hospital shut its doors due to bankruptcy. \u003ccite>(Larry Valenzuela, CalMatters/CatchLight Local)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Paolinelli said a management agreement is the hospital’s best bet at reopening. It has not found a buyer for a straightforward sale. Paolinelli said she has not discussed with Adventist whether she will stay on as head of the hospital.\u003c/p>\n\u003cp>Adventist Health has experience reopening closed hospitals. For example, five years ago Adventist reopened and rebranded what was once known as \u003ca href=\"https://www.visaliatimesdelta.com/story/news/2019/04/30/tulare-regional-medical-center-no-more-adventist-makes-official/3621956002/\">Tulare Regional Medical Center\u003c/a>. That hospital is now Adventist Health Tulare.\u003c/p>\n\u003ch2>Obstacles to Beverly hospital’s sale\u003c/h2>\n\u003cp>Beverly Community, a 202-bed hospital in Montebello east of Los Angeles, filed for bankruptcy in April. It \u003ca href=\"https://beverly.org/public-notice-march-16-2023/\">suspended a number of services\u003c/a> by June, including maternity, pediatric and outpatient radiology.\u003c/p>\n\u003cp>The Attorney General’s office last month announced the conditional approval of the hospital’s sale to a Glendale-based chain called American Healthcare Systems. That proposed deal is quickly dissolving.\u003c/p>\n\u003cp>According to bankruptcy court documents, bondholders raised concerns about American Healthcare Systems’ ability to support the hospital financially. Recent filings show that Beverly Hospital is now exploring an alternative transaction with Adventist Health.\u003c/p>\n\u003cp>“Given Beverly Hospital’s critically low cash position and as of now uncertainty about state funding (from loan program), the bid from Adventist Health represents Beverly’s greatest chance of continuing to serve the community it has served for the past 75 years,” said Justin Bernbrock, a lawyer for Beverly Hospital.\u003c/p>\n\u003cp>This month will be key for the hospital. Beverly is losing about $5 million a month and projects to run out of cash by September, court documents show. The hospital applied for $35 million from the Distressed Hospital Loan Program.\u003c/p>\n\u003cp>On Thursday, the hospital is due to present a deal proposal to a bankruptcy court judge.\u003c/p>\n\u003ch2>Hazel Hawkins takes first step with potential partner\u003c/h2>\n\u003cp>The 25-bed Hazel Hawkins Memorial Hospital is San Benito County’s sole hospital. After months of looking for potential partners, management at Hazel Hawkins recently announced that it received a “letter of intent” from Modesto-based American Advanced Management.\u003c/p>\n\u003cp>The small chain is a private, for-profit company that operates six other hospitals in the state. It’s proposing to lease Hazel Hawkins \u003ca href=\"https://www.hazelhawkins.com/documents/content/8.7.23-SBHCD-Board-of-Directors-Special-Meeting.pdf\">for five-to-10 years (PDF)\u003c/a> before having the option to purchase the hospital.\u003c/p>\n\u003cp>American Advanced Management has taken over a handful of distressed or closed hospitals in rural parts of the state, \u003ca href=\"https://americanam.org/locations/\">according to its website\u003c/a>. These include Coalinga Regional Medical Center, Glenn Medical Center and Colusa Medical Center.\u003c/p>\n\u003cp>Hazel Hawkins is part of a publicly governed health care district, and the deal would need to be approved by the district’s board and by county voters.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Hospital leaders sought a partner that, among other things, “possessed the resources to guarantee a continuum of care delivery for the future needs of our county,” Mary Casillas, interim CEO at Hazel Hawkins, said in a statement.\u003c/p>\n\u003cp>Hazel Hawkins declared a fiscal crisis late last year, and in May filed for Chapter 9 bankruptcy, but has continued to provide services. Last month, the hospital \u003ca href=\"https://www.hazelhawkins.com/documents/content/7.27.23-SBHCD-Board-of-Directors-Meeting.pdf\">applied for $10 million (PDF)\u003c/a> from the state’s Distressed Hospital Loan Program. If the hospital is approved for this loan, it would be in addition to a separate $3 million loan it received from the state in January.\u003c/p>\n\u003cp>In its May bankruptcy filings, the hospital said it expected to run out of cash in November 2024. At least one group, the California Nurses Association, has questioned whether the hospital filed for bankruptcy prematurely. The nurses union said it has asked the hospital to explain how it calculates its projections but has not received answers.\u003c/p>\n\u003cp>According to its financial statements, the hospital reported earnings of just over \u003ca href=\"https://siera.hcai.ca.gov/ProfileCharacteristics.aspx\">$2 million in calendar year 2022\u003c/a>.\u003c/p>\n\u003cp>The union represents about 120 nurses at Hazel Hawkins. Filing for bankruptcy, according to the union, has prompted nurses to leave for jobs in other hospitals, leaving staff there shorthanded.\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 people have access to the care they need, when they need it, at a price they can afford. Visit \u003ca href=\"http://www.chcf.org/\">www.chcf.org\u003c/a> to learn more.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "SF’s Laguna Honda Hospital Reapplies for Medicaid Amid Closure Crisis",
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"content": "\u003cp>Laguna Honda Hospital and Rehabilitation Center has submitted its application to \u003ca href=\"https://www.kqed.org/news/11941887/health-secretary-xavier-becerra-visits-san-francisco-hospital-fighting-off-closure\">regain participation in Medicaid\u003c/a>. The government-subsidized health care plan supports 95% of patients at the hospital, but that funding was only temporarily granted while the hospital worked toward recertification with federal regulators.[pullquote size=\"medium\" align=\"right\" citation=\"Roland Pickens, interim CEO, Laguna Honda Hospital and Rehabilitation Center\"]‘This is really the culmination of all of the improvement work we have been doing over the last 18 months since the decertification happened.’[/pullquote] The move marks a turning point in the almost two-year regulatory crisis that threatened to shutter Laguna Honda, the state’s largest public nursing facility and home to nearly 500 medically fragile residents with needs ranging from stroke rehabilitation to dementia and mental health care.\u003c/p>\n\u003cp>“This is really the culmination of all of the improvement work we have been doing over the last 18 months since the decertification happened,” the hospital’s interim CEO Roland Pickens told KQED. “The most recent monitoring surveys went fairly well and gave us the confidence that we have made significant enough improvements and that we would be successful in attaining a recertification.”\u003c/p>\n\u003cp>In 2022, Laguna Honda was found out of compliance on several safety issues across multiple regulatory surveys that federal regulators administered after the hospital self-reported two nonfatal overdoses that occurred on-site.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>As a result of the findings, federal regulators stripped Laguna Honda from Medicare and Medi-Cal, subsidized health care plans that cover the vast majority of residents at the facility, most of whom have extremely low or fixed incomes.\u003c/p>\n\u003cp>Centers for Medicare and Medicaid Services required the hospital to craft and implement a plan to prepare for closure, and in return, the agency would temporarily sustain funding to the hospital. That plan involved assessing and relocating as many patients as possible in 2022.\u003c/p>\n\u003cp>Of the 57 residents who were transferred or discharged during that process, 12 died shortly after their relocations. Community members and government officials, including Mayor London Breed, Rep. Nancy Pelosi, and others, publicly decried the regulators’ decision and advocated for a different response. \u003ca href=\"https://www.kqed.org/news/11921717/san-francisco-sues-feds-over-forced-closure-of-laguna-honda-hospital\">The city sued the federal government\u003c/a> following the relocation deaths, and \u003ca href=\"https://www.kqed.org/news/11920121/sf-officials-outraged-over-laguna-honda-patient-deaths-following-federally-mandated-transfers\">the transfer process was paused\u003c/a> as part of a settlement agreement.\u003c/p>\n\u003cp>Since then, Laguna Honda has taken steps to address deficiencies in areas such as medication storage and hygiene control. Regulators marked just 33 areas for improvement in a June 2023 monitoring survey to check progress, compared to the first survey that had 124 findings, according to the San Francisco Department of Public Health.\u003c/p>\n\u003cp>The California Departments of Public Health and Health Care Services will review the application next to determine what is to follow.\u003c/p>\n\u003cfigure id=\"attachment_11958178\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11958178\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/RS62466_012_KQED_LagunaHondaHospital_01312023-qut.jpg\" alt='The entryway to a hospital driveway with a sign that reads, \"Main Hospital Entrance and Residences.\"' width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62466_012_KQED_LagunaHondaHospital_01312023-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62466_012_KQED_LagunaHondaHospital_01312023-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62466_012_KQED_LagunaHondaHospital_01312023-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62466_012_KQED_LagunaHondaHospital_01312023-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62466_012_KQED_LagunaHondaHospital_01312023-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A sign points to the main entrance to the Laguna Honda Hospital in San Francisco on Jan. 31, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Time is of the essence. The hospital is currently facing a deadline of Sept. 19 before the current temporary pause on involuntary transfers could resume. If relocations do resume, residents will have the right to appeal their transfer and must first be assessed for appropriate options.\u003c/p>\n\u003cp>It’s not clear exactly how long the process could take or whether the federal and state regulators could again delay the deadline. Pickens, however, said he hopes the regulatory process will be completed in time to prevent any additional involuntary transfers.\u003c/p>\n\u003cp>“I want to emphasize that applying for recertification is not the end of our work to improve our facility, but rather the beginning of a new era of excellence for Laguna Honda Hospital,” Pickens said in a letter to residents sent on Aug. 14.\u003c/p>\n\u003cp>Nursing home reform advocates and members of the Laguna Honda community welcomed the news of the reapplication. [pullquote size=\"medium\" align=\"right\" citation=\"Teresa Palmer, former physician, Laguna Honda Hospital and Rehabilitation Center\"]‘I’m thrilled they have applied. There is a lot of discipline involved and a lot of culture change involved, so this is a real relief to hear.’[/pullquote] “I’m thrilled they have applied. There is a lot of discipline involved and a lot of culture change involved, so this is a real relief to hear,” said Teresa Palmer, a former physician at Laguna Honda and organizer for the advocacy group the Gray Panthers.\u003c/p>\n\u003cp>Palmer is timid about the next steps for the hospital, which has had a troubled past, including a major abuse scandal in 2019 that was separate from the ongoing regulatory crisis.\u003c/p>\n\u003cp>“There really has been a good faith effort there [to address problems], but there has been so many years of mismanagement and a culture of retaliation of whistleblowing there for years, which was a problem and they really need to turn that around,” Palmer said.[aside label='More on California Health Care' tag='health-care'] San Francisco and many other parts of California lack enough skilled nursing beds to meet the current demand and need, and residents are often required to move out of the county to receive necessary care. The issue is even more pronounced for low-income elderly residents who rely on Medicare and Medi-Cal, typically those who can’t afford private nursing homes.\u003c/p>\n\u003cp>Pickens said that residents who were transferred to other facilities during the 2022 relocation process will receive priority to come back once the hospital can resume admitting new patients again.\u003c/p>\n\u003cp>New admissions have been on hold since the hospital was decertified. The hospital is currently licensed for over 780 beds but its current census is around 500, according to Pickens. \u003ca href=\"https://www.sfexaminer.com/lifestyles/health/laguna-honda-plans-to-cut-120-beds-amid-regulatory-turmoil/article_fa8cacd4-0229-11ed-bf2b-77b38812d44f.html#:~:text=As%20a%20regulatory%20crisis%20engulfs,and%20obtained%20by%20The%20Examiner.\">The hospital also stands to lose 120\u003c/a> of its 780 beds due to a new federal regulation that requires nursing homes like Laguna Honda to have no more than two beds per room.\u003c/p>\n\u003cp>“We want to officially be recertified into the federal programs, and once we have that recertification, we will then be pursuing getting those 120 beds back into our system,” Pickens told KQED. “We know that’s a big priority. First priority: get certified. Second priority is to get 120 beds back.”\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Laguna Honda Hospital and Rehabilitation Center has submitted its application to \u003ca href=\"https://www.kqed.org/news/11941887/health-secretary-xavier-becerra-visits-san-francisco-hospital-fighting-off-closure\">regain participation in Medicaid\u003c/a>. The government-subsidized health care plan supports 95% of patients at the hospital, but that funding was only temporarily granted while the hospital worked toward recertification with federal regulators.\u003c/p>\u003c/div>",
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"content": "‘This is really the culmination of all of the improvement work we have been doing over the last 18 months since the decertification happened.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp> The move marks a turning point in the almost two-year regulatory crisis that threatened to shutter Laguna Honda, the state’s largest public nursing facility and home to nearly 500 medically fragile residents with needs ranging from stroke rehabilitation to dementia and mental health care.\u003c/p>\n\u003cp>“This is really the culmination of all of the improvement work we have been doing over the last 18 months since the decertification happened,” the hospital’s interim CEO Roland Pickens told KQED. “The most recent monitoring surveys went fairly well and gave us the confidence that we have made significant enough improvements and that we would be successful in attaining a recertification.”\u003c/p>\n\u003cp>In 2022, Laguna Honda was found out of compliance on several safety issues across multiple regulatory surveys that federal regulators administered after the hospital self-reported two nonfatal overdoses that occurred on-site.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>As a result of the findings, federal regulators stripped Laguna Honda from Medicare and Medi-Cal, subsidized health care plans that cover the vast majority of residents at the facility, most of whom have extremely low or fixed incomes.\u003c/p>\n\u003cp>Centers for Medicare and Medicaid Services required the hospital to craft and implement a plan to prepare for closure, and in return, the agency would temporarily sustain funding to the hospital. That plan involved assessing and relocating as many patients as possible in 2022.\u003c/p>\n\u003cp>Of the 57 residents who were transferred or discharged during that process, 12 died shortly after their relocations. Community members and government officials, including Mayor London Breed, Rep. Nancy Pelosi, and others, publicly decried the regulators’ decision and advocated for a different response. \u003ca href=\"https://www.kqed.org/news/11921717/san-francisco-sues-feds-over-forced-closure-of-laguna-honda-hospital\">The city sued the federal government\u003c/a> following the relocation deaths, and \u003ca href=\"https://www.kqed.org/news/11920121/sf-officials-outraged-over-laguna-honda-patient-deaths-following-federally-mandated-transfers\">the transfer process was paused\u003c/a> as part of a settlement agreement.\u003c/p>\n\u003cp>Since then, Laguna Honda has taken steps to address deficiencies in areas such as medication storage and hygiene control. Regulators marked just 33 areas for improvement in a June 2023 monitoring survey to check progress, compared to the first survey that had 124 findings, according to the San Francisco Department of Public Health.\u003c/p>\n\u003cp>The California Departments of Public Health and Health Care Services will review the application next to determine what is to follow.\u003c/p>\n\u003cfigure id=\"attachment_11958178\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11958178\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/RS62466_012_KQED_LagunaHondaHospital_01312023-qut.jpg\" alt='The entryway to a hospital driveway with a sign that reads, \"Main Hospital Entrance and Residences.\"' width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62466_012_KQED_LagunaHondaHospital_01312023-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62466_012_KQED_LagunaHondaHospital_01312023-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62466_012_KQED_LagunaHondaHospital_01312023-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62466_012_KQED_LagunaHondaHospital_01312023-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62466_012_KQED_LagunaHondaHospital_01312023-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A sign points to the main entrance to the Laguna Honda Hospital in San Francisco on Jan. 31, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Time is of the essence. The hospital is currently facing a deadline of Sept. 19 before the current temporary pause on involuntary transfers could resume. If relocations do resume, residents will have the right to appeal their transfer and must first be assessed for appropriate options.\u003c/p>\n\u003cp>It’s not clear exactly how long the process could take or whether the federal and state regulators could again delay the deadline. Pickens, however, said he hopes the regulatory process will be completed in time to prevent any additional involuntary transfers.\u003c/p>\n\u003cp>“I want to emphasize that applying for recertification is not the end of our work to improve our facility, but rather the beginning of a new era of excellence for Laguna Honda Hospital,” Pickens said in a letter to residents sent on Aug. 14.\u003c/p>\n\u003cp>Nursing home reform advocates and members of the Laguna Honda community welcomed the news of the reapplication. \u003c/p>\u003c/div>",
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"content": "‘I’m thrilled they have applied. There is a lot of discipline involved and a lot of culture change involved, so this is a real relief to hear.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp> “I’m thrilled they have applied. There is a lot of discipline involved and a lot of culture change involved, so this is a real relief to hear,” said Teresa Palmer, a former physician at Laguna Honda and organizer for the advocacy group the Gray Panthers.\u003c/p>\n\u003cp>Palmer is timid about the next steps for the hospital, which has had a troubled past, including a major abuse scandal in 2019 that was separate from the ongoing regulatory crisis.\u003c/p>\n\u003cp>“There really has been a good faith effort there [to address problems], but there has been so many years of mismanagement and a culture of retaliation of whistleblowing there for years, which was a problem and they really need to turn that around,” Palmer said.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp> San Francisco and many other parts of California lack enough skilled nursing beds to meet the current demand and need, and residents are often required to move out of the county to receive necessary care. The issue is even more pronounced for low-income elderly residents who rely on Medicare and Medi-Cal, typically those who can’t afford private nursing homes.\u003c/p>\n\u003cp>Pickens said that residents who were transferred to other facilities during the 2022 relocation process will receive priority to come back once the hospital can resume admitting new patients again.\u003c/p>\n\u003cp>New admissions have been on hold since the hospital was decertified. The hospital is currently licensed for over 780 beds but its current census is around 500, according to Pickens. \u003ca href=\"https://www.sfexaminer.com/lifestyles/health/laguna-honda-plans-to-cut-120-beds-amid-regulatory-turmoil/article_fa8cacd4-0229-11ed-bf2b-77b38812d44f.html#:~:text=As%20a%20regulatory%20crisis%20engulfs,and%20obtained%20by%20The%20Examiner.\">The hospital also stands to lose 120\u003c/a> of its 780 beds due to a new federal regulation that requires nursing homes like Laguna Honda to have no more than two beds per room.\u003c/p>\n\u003cp>“We want to officially be recertified into the federal programs, and once we have that recertification, we will then be pursuing getting those 120 beds back into our system,” Pickens told KQED. “We know that’s a big priority. First priority: get certified. Second priority is to get 120 beds back.”\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"title": "College-Bound Californians Prepare For Abortion Bans Out of State",
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"content": "\u003cp>\u003ca href=\"#episode-transcript\">\u003ci>\u003cspan style=\"font-weight: 400\">View the full episode transcript.\u003c/span>\u003c/i>\u003c/a>\u003c/p>\n\u003cp>I’laysia Vital is about to leave Oakland to start college in Texas, where she’s excited to attend a historically Black university. But Texas is also one of more than a dozen states that has banned abortion.\u003c/p>\n\u003cp>KQED’s April Dembosky takes us inside a health clinic at Oakland Technical High School, where staff are helping college-bound students prepare for the barriers to reproductive health that await them in other states.\u003c/p>\n\u003cp id=\"embed-code\" class=\"inconsolata\">\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" frameborder=\"0\" height=\"200\" scrolling=\"no\" src=\"https://playlist.megaphone.fm/?e=KQINC3124767673&light=true\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\n\u003c/p>\n\u003cp>\u003cstrong>Links:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://www.kqed.org/science/1983772/college-bound-californians-prepare-for-rocky-reproductive-health-landscape-away-from-home\" target=\"_blank\" rel=\"noopener\">\u003cspan style=\"font-weight: 400\">College-Bound Californians Navigate Abortion Bans Away From Home\u003c/span>\u003c/a>\u003c/li>\n\u003c/ul>\n\u003ch2 id=\"episode-transcript\">Episode Transcript\u003c/h2>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This is a computer-generated transcript. While our team has reviewed it, there may be errors.\u003c/span>\u003c/i>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>I’m Ericka Cruz Guevara, and welcome to The Bay. Local News to Keep You Rooted. Okay, So if you’ve lived in California your whole life, you’re probably used to having a lot of rights when it comes to reproductive health. So moving to another state can be a shock, especially if you’re an incoming college student, especially if it’s to one of the dozen or so states that have banned abortion.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>They’re very focused on what they want to study and the environment they want to study in. And reproductive health care is not always the first thing they’re thinking of.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Today, we’re going inside a health clinic at Oakland Technical High School, and we’re going to meet a student preparing to navigate abortion bans away from home. Stay with us.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>I met I’laysia Vital in June, right after she graduated from Oakland Technical High School.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>April Dembosky is a health correspondent for KQED.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>She had taken classes in computer science there. Then she switched over to health, became very interested in that.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>I really like school. I like learning. I feel like my favorite hobby to do is learning something new and especially learning about the body. So I feel like.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>She wants to study kinesiology in college. She’s really into sports and wants to become an athletic trainer.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>I plan on starting to like go from high school level sports and then doing like the high school and like the private schools, then working my way up to like minor league. And then hopefully in the future I would be working for the big like NFL. That’s where I really want to go. Is the NFL all the way to the tippy top within like, like ten years?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>When she was looking at colleges, what what was she looking for?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>Well, last fall, her school organized a tour of historically black colleges and universities in the South. And she loved.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>It. I’ve always wanted to go to a colleges HBCU. I feel like it’s really just motivation and stuff to go see, like all black people thriving there.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>So when she visited TSU, in particular at Texas Southern University, she really fell in love with it.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>Toward Grambling I toward Southern Eye, toward Dillard. And I feel like TCU really spoke out because I liked how modern it was was a really big school. I like Houston just period I just like the city. So I feel like that was connected to me more.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>Plus, her grandparents live in Texas and she loved the idea of living near them.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>I wanted to go back there and like meet all my cousins and even see my grandma, my grandpa all the time because I’m like really close with them, but they live really far.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>So she applied to TSU and she got accepted and she’s about to move there this month.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>It’s like I’m excited for like my first day, really, and me moving all the way and then I get to decorate my dorm and decorate my stuff. So yeah, I’m excited about that.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Yeah. I mean, I feel like when you’re thinking about going to college, you are thinking about those practical things, like, do I have family nearby if I’m going to move far away or can I afford this? What major do I want to I see myself here. But when did I Leisa first start to realize that moving from California to Texas would mean going somewhere with actually fewer reproductive rights?\u003c/p>\n\u003cp style=\"font-weight: 400\">\n\u003c/p>\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>Last summer, the Supreme Court overturned Roe v Wade, and that got rid of the constitutional right to abortion that had been in place for 50 years. It left the decision to states. And after that happened, Ilesha started hearing about protests either here in the Bay Area locally or on social media.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>And I’ve seen people going to like the Planned Parenthood or to the clinics and being shut out or being like there’s protesters in front.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Protester \u003c/strong>Of and anybody that tells you your idea to have an abortion. It’s a stand against God.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>And they’re honking or like, pushing stuff like pushing people. And there was like, fights and stuff in the streets. I feel like it really brought to my attention that that was happening in a lot of states, like in the South. And that’s where I want to go anyway. So I think I kind of like did more research.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>A lot of us when we are looking for college, sometimes we’re looking for something really different from what we’ve known. I think I leisure was really attracted to those things and then didn’t realize that she was going to have to make some trade offs. Texas is one of the first states to ban abortion after the Supreme Court decision. There are more than a dozen states that ban the procedure now and more that restrict access. And so that’s what got Ilesha thinking. Maybe I need to prepare for this.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>Even like I said, I’ll take type before. When I’ve seen that grown ticked up. I feel like it really like show like it was a reality check that I really need to like get on top of it before I go because I know I’m going there first and I already have a lot of resources here in my high school.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>So she went to the clinic at her school for something they’re doing there this year called the senior sendoff appointment.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>When I’laysia and other Oakland Tech students need medical help, they often go to a place called the Technique Clinic. It’s this small purple building right on campus run by a nonprofit called La Clinica de La Raza. Students can go to the clinic between classes for everything from AI appointments to STD tests, and they don’t have to tell their parents or use their insurance plan either. There are about 300 school based clinics like this one all over the state. And April was able to shadow the staff there for a day to see how they helped the students. Can you introduce me to Aaron Cramer and tell me a little bit about what she does?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>Arin Kramer is a nurse practitioner at the tech clinic.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>And I’ve been working in adolescent medicine and school based health for about 15 years. And at the clinic.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>You know, when she is doing her job, she’s not just thinking about the medical care she gives or solving the health mysteries that are in front of her. But she’s thinking really holistically about her patients.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>These are kids that are like on the precipice of the rest of like of a whole new world. They’re about to become adults. They’re learning how they’re learning about their own bodies. They want to be autonomous. They want to be empowered.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>I followed her around for a day and, you know, a couple of patients that she was supposed to see that day canceled in the morning. And so she called them up.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>This is Arin, the nurse practitioner from the tech clinic. Just came in your call this morning. Sorry to call you so early.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>And it turns out the student really did want to come in for her appointment, that she just couldn’t get a ride. And then she sends an Uber to pick the student up and bring her to the clinic if you want.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>The other option is we do have a service that like an Uber service that can help you get to clinic if they have insurance. \u003cstrong>April Dembosky: \u003c/strong>So you can see all of these ways in which Nurse Kramer is trying to meet students where they’re at.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>All right, All right. Talk soon. Bye bye.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>But it seems pretty common for late people to canceled. But then does the follow up actually kind of…is that a helpful nudge?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong> Yes.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Well, I mean it sounds like Arin has a pretty close eye and ear towards like what students need. So I’m curious how she has started to sort of see the needs of her students shifting since the end of Roe v Wade.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>They have become a lot more proactive. So if you remember Roe v Wade, the decision to overturn it was at the end of June last year. And so, you know, students that year had already graduated. Most had already been moving on. And then, of course, in the wake is when we saw states starting to pass their own state laws banning or restricting access to the procedure.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>We’ve seen new changes in Georgia and other other states. So a lot of a lot of these things are just changing really dynamically.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>So this is really the first year that the nurses have really been incorporating this new legal landscape into the medical care that they provide.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>I had a patient recently who moved to Texas and did still it felt really worried about her access to getting prescriptions for the patch. So she we were able to dispense a year’s supply of the patch and she brought that with her to Texas.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>And I know I’laysia is one of these patients, someone who is feeling nervous about going to Texas and, you know, realizing sort of the roadblocks ahead in terms of reproductive health for her. I’m curious, April, if we have a sense of how common that is. This experience is like are there a lot of students going to conservative states for college and then sort of realizing that there will be these serious roadblocks when they get there?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>The nurses and the staff at the clinic have seen enough students who are headed to southern states that they have set up this senior sendoff appointment.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>A lot of the students, some of the students we talked to today really want to go to historically black colleges and universities and and have that incredible community experience. And to be in a state where they’re not supported with their reproductive health feels scary.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>They formalized this appointment where they want to talk to patients and make sure that they’re aware of the legal landscapes that they’re moving into. So they are proactively reaching out to seniors who are graduating, finding out where they’re going to college, where you’re thinking of going to college, and then taking the appropriate steps from there.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Let’s talk more about these senior sendoff appointments at the Technic Clinic. I know Erin and I’laysia were actually kind enough to let you sit in on Iglesias appointment. What did they talk about?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>They talked about life.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>So yeah. And I recently got accepted into TSU in Texas. So, yeah, I’m glad we have this one because I’m going straight to Texas. You are? Yeah. I think we start August 27.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>I’laysia Vital had just had a birthday.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>Me and my friends, we went to, like, party, like at Airbnb, and then we had, like, food there and they had a hot tub and, like, ping pong tables and stuff. So that’s all we did was. Yeah.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>Who planned to that thing?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>My mom.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>Oh, my God. You do have the best mom.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>Yeah.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>She asked her about her general health.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>Um, sleeping okay at night?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>Yeah.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>Okay.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>But then when it came time to talk about their birth control options, Nurse Kramer asked Alicia, So who are you talking to these days? And that is adolescent speak for who are you having sex with?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>All right. And tell me, who are you talking to these days?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>Uh, same person. Yeah.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>Off and on forever and ever. Can you remind me his name?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>And Nurse Kramer knows that this is how teenagers talk to each other about this kind of thing. And so for her, it’s a way of building trust and meeting students where they’re at and hopefully having an open, honest conversation. And then they talked a lot about different birth control options.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>And tell me a little bit about what you’re thinking in terms of birth control.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>I was looking at the the multiple choices and I’ve seen the the parent guard, the IUD one. Yeah. And I was like talking about that. I think the other.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>Kramer has a poster on the wall of the exam room that has, you know, little pictures or images of all the different birth control methods. And she would point to them and explain how each one worked. So Alecia was pretty clear that she didn’t want to rely on birth control pills or patches.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>Because I’m very forgetful. Even if I set my alarm or write it down, it’s still slipped my mind. So I think that.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>They talked about other long acting options. So they talked a lot about IUDs. These are tiny devices that get inserted into the uterus and they are very effective at preventing pregnancy. I. Liza wasn’t quite down with that. She didn’t quite like the sound of that. But she had had a hormonal implant before. And this is a tiny rod that gets inserted into the upper arm. And she was thinking about getting that again.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>I think I want to go back to the implant, the next implant, because it’s more it fits in my age range, I think, and I feel like it’s not like like a drastic change, but I just feel like I’d rather have something like it’s permanent but might not all the way permanent.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>She ultimately decided to go with the implant again, which is good for up to five years, that she would never have to think about it.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>And after you sign this than I might have, you just step out of the room for a second. We’ll set up the room, and then we’ll do it. Okay. 5 minutes. Okay. Other questions?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>No, I think you covered everything.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>Awesome.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Well, April, how much can this clinic help students once they’ve actually left the state? Like, would Alysha, for example, be able to, like, call Erin up while she’s in Texas?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>I’laysia can certainly call Arin up and Arin is very proactive about explaining to students we’re still here. They’re allowed to see their patients up until they’re 21. So any time that I Leisa came back home to visit her parents, for example, if she was there for break or over the summer, she’s more than welcome to come in to the technical clinic and get all the range of services for free. Nurse Cramer can write prescriptions, and if I Leisa comes back and says, you know, I don’t really like the implant, I want something else. Aaron will work with her to come up with something else. What’s less clear is we’re in this very strange time right now with each state codifying different laws. People, as we now know, are not just going to stay in one place. And so how these laws interact with each other when people cross state borders. There’s just so many questions around that. So Nurse Cramer herself wasn’t totally clear on whether she would be allowed to say write a prescription for a birth control method for Aleisha to pick up in Texas. There are just different kinds of rules around health care providers and what they’re allowed to do for people in other states when it comes to abortion services, that’s also unclear. There’s lots of talk right now about someone who’s a resident of Texas coming to a place like California for abortion care. The state of Texas says they have the right to sue the doctor in California who provided care to the Texas resident. California says, no, we have laws that protect doctors. So I think some of these things are it’s going to take time to see how they’re all going to play out.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>In the end, April, I mean, going to college is supposed to be a really exciting time. What is I Leisa looking forward to the most about leaving the nest and also going to her dream school Texas southern.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>Yeah. Like a lot of college bound teenagers, she’s thinking a lot about how she’s going to decorate her dorm room. Her twin sister is coming with her. They plan to bunk together, so they’re working out what kind of color scheme they’re going to go with. But Alisha is also really excited about college things, being independent, you know, moving on her own steam, going to classes, being on her own.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>It’s more adult than high school, like high schools like adult. But college is really, though, you’re not with your peers, especially if you like, leave and go to a different school, not in your hometown. So I’m really excited for the growing up part of it.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>April, thank you so much for sharing your reporting with us and joining us on the show. I appreciate it.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>Happy to do it.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>That was April Dembosy, a health correspondent for KQED. This 30 minute conversation with April was cut down and edited by producer Maria Esquinca. Allen Montecillo is our senior editor. He scored this episode and added all the tape. If you liked this episode, consider sharing it with a friend. Word of mouth is one of the best ways to help our show. I’m Ericka Cruz Guevara. Thank you for listening to the bay. Talk to you next time.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp style=\"font-weight: 400\">\n\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"#episode-transcript\">\u003ci>\u003cspan style=\"font-weight: 400\">View the full episode transcript.\u003c/span>\u003c/i>\u003c/a>\u003c/p>\n\u003cp>I’laysia Vital is about to leave Oakland to start college in Texas, where she’s excited to attend a historically Black university. But Texas is also one of more than a dozen states that has banned abortion.\u003c/p>\n\u003cp>KQED’s April Dembosky takes us inside a health clinic at Oakland Technical High School, where staff are helping college-bound students prepare for the barriers to reproductive health that await them in other states.\u003c/p>\n\u003cp id=\"embed-code\" class=\"inconsolata\">\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" frameborder=\"0\" height=\"200\" scrolling=\"no\" src=\"https://playlist.megaphone.fm/?e=KQINC3124767673&light=true\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\n\u003c/p>\n\u003cp>\u003cstrong>Links:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://www.kqed.org/science/1983772/college-bound-californians-prepare-for-rocky-reproductive-health-landscape-away-from-home\" target=\"_blank\" rel=\"noopener\">\u003cspan style=\"font-weight: 400\">College-Bound Californians Navigate Abortion Bans Away From Home\u003c/span>\u003c/a>\u003c/li>\n\u003c/ul>\u003c/div>",
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"content": "\u003cdiv class=\"post-content post-body\">\u003ch2 id=\"episode-transcript\">Episode Transcript\u003c/h2>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This is a computer-generated transcript. While our team has reviewed it, there may be errors.\u003c/span>\u003c/i>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>I’m Ericka Cruz Guevara, and welcome to The Bay. Local News to Keep You Rooted. Okay, So if you’ve lived in California your whole life, you’re probably used to having a lot of rights when it comes to reproductive health. So moving to another state can be a shock, especially if you’re an incoming college student, especially if it’s to one of the dozen or so states that have banned abortion.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>They’re very focused on what they want to study and the environment they want to study in. And reproductive health care is not always the first thing they’re thinking of.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Today, we’re going inside a health clinic at Oakland Technical High School, and we’re going to meet a student preparing to navigate abortion bans away from home. Stay with us.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>I met I’laysia Vital in June, right after she graduated from Oakland Technical High School.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>April Dembosky is a health correspondent for KQED.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>She had taken classes in computer science there. Then she switched over to health, became very interested in that.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>I really like school. I like learning. I feel like my favorite hobby to do is learning something new and especially learning about the body. So I feel like.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>She wants to study kinesiology in college. She’s really into sports and wants to become an athletic trainer.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>I plan on starting to like go from high school level sports and then doing like the high school and like the private schools, then working my way up to like minor league. And then hopefully in the future I would be working for the big like NFL. That’s where I really want to go. Is the NFL all the way to the tippy top within like, like ten years?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>When she was looking at colleges, what what was she looking for?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>Well, last fall, her school organized a tour of historically black colleges and universities in the South. And she loved.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>It. I’ve always wanted to go to a colleges HBCU. I feel like it’s really just motivation and stuff to go see, like all black people thriving there.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>So when she visited TSU, in particular at Texas Southern University, she really fell in love with it.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>Toward Grambling I toward Southern Eye, toward Dillard. And I feel like TCU really spoke out because I liked how modern it was was a really big school. I like Houston just period I just like the city. So I feel like that was connected to me more.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>Plus, her grandparents live in Texas and she loved the idea of living near them.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>I wanted to go back there and like meet all my cousins and even see my grandma, my grandpa all the time because I’m like really close with them, but they live really far.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>So she applied to TSU and she got accepted and she’s about to move there this month.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>It’s like I’m excited for like my first day, really, and me moving all the way and then I get to decorate my dorm and decorate my stuff. So yeah, I’m excited about that.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Yeah. I mean, I feel like when you’re thinking about going to college, you are thinking about those practical things, like, do I have family nearby if I’m going to move far away or can I afford this? What major do I want to I see myself here. But when did I Leisa first start to realize that moving from California to Texas would mean going somewhere with actually fewer reproductive rights?\u003c/p>\n\u003cp style=\"font-weight: 400\">\n\u003c/p>\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>Last summer, the Supreme Court overturned Roe v Wade, and that got rid of the constitutional right to abortion that had been in place for 50 years. It left the decision to states. And after that happened, Ilesha started hearing about protests either here in the Bay Area locally or on social media.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>And I’ve seen people going to like the Planned Parenthood or to the clinics and being shut out or being like there’s protesters in front.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Protester \u003c/strong>Of and anybody that tells you your idea to have an abortion. It’s a stand against God.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>And they’re honking or like, pushing stuff like pushing people. And there was like, fights and stuff in the streets. I feel like it really brought to my attention that that was happening in a lot of states, like in the South. And that’s where I want to go anyway. So I think I kind of like did more research.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>A lot of us when we are looking for college, sometimes we’re looking for something really different from what we’ve known. I think I leisure was really attracted to those things and then didn’t realize that she was going to have to make some trade offs. Texas is one of the first states to ban abortion after the Supreme Court decision. There are more than a dozen states that ban the procedure now and more that restrict access. And so that’s what got Ilesha thinking. Maybe I need to prepare for this.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>Even like I said, I’ll take type before. When I’ve seen that grown ticked up. I feel like it really like show like it was a reality check that I really need to like get on top of it before I go because I know I’m going there first and I already have a lot of resources here in my high school.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>So she went to the clinic at her school for something they’re doing there this year called the senior sendoff appointment.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>When I’laysia and other Oakland Tech students need medical help, they often go to a place called the Technique Clinic. It’s this small purple building right on campus run by a nonprofit called La Clinica de La Raza. Students can go to the clinic between classes for everything from AI appointments to STD tests, and they don’t have to tell their parents or use their insurance plan either. There are about 300 school based clinics like this one all over the state. And April was able to shadow the staff there for a day to see how they helped the students. Can you introduce me to Aaron Cramer and tell me a little bit about what she does?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>Arin Kramer is a nurse practitioner at the tech clinic.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>And I’ve been working in adolescent medicine and school based health for about 15 years. And at the clinic.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>You know, when she is doing her job, she’s not just thinking about the medical care she gives or solving the health mysteries that are in front of her. But she’s thinking really holistically about her patients.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>These are kids that are like on the precipice of the rest of like of a whole new world. They’re about to become adults. They’re learning how they’re learning about their own bodies. They want to be autonomous. They want to be empowered.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>I followed her around for a day and, you know, a couple of patients that she was supposed to see that day canceled in the morning. And so she called them up.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>This is Arin, the nurse practitioner from the tech clinic. Just came in your call this morning. Sorry to call you so early.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>And it turns out the student really did want to come in for her appointment, that she just couldn’t get a ride. And then she sends an Uber to pick the student up and bring her to the clinic if you want.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>The other option is we do have a service that like an Uber service that can help you get to clinic if they have insurance. \u003cstrong>April Dembosky: \u003c/strong>So you can see all of these ways in which Nurse Kramer is trying to meet students where they’re at.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>All right, All right. Talk soon. Bye bye.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>But it seems pretty common for late people to canceled. But then does the follow up actually kind of…is that a helpful nudge?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong> Yes.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Well, I mean it sounds like Arin has a pretty close eye and ear towards like what students need. So I’m curious how she has started to sort of see the needs of her students shifting since the end of Roe v Wade.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>They have become a lot more proactive. So if you remember Roe v Wade, the decision to overturn it was at the end of June last year. And so, you know, students that year had already graduated. Most had already been moving on. And then, of course, in the wake is when we saw states starting to pass their own state laws banning or restricting access to the procedure.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>We’ve seen new changes in Georgia and other other states. So a lot of a lot of these things are just changing really dynamically.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>So this is really the first year that the nurses have really been incorporating this new legal landscape into the medical care that they provide.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>I had a patient recently who moved to Texas and did still it felt really worried about her access to getting prescriptions for the patch. So she we were able to dispense a year’s supply of the patch and she brought that with her to Texas.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>And I know I’laysia is one of these patients, someone who is feeling nervous about going to Texas and, you know, realizing sort of the roadblocks ahead in terms of reproductive health for her. I’m curious, April, if we have a sense of how common that is. This experience is like are there a lot of students going to conservative states for college and then sort of realizing that there will be these serious roadblocks when they get there?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>The nurses and the staff at the clinic have seen enough students who are headed to southern states that they have set up this senior sendoff appointment.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>A lot of the students, some of the students we talked to today really want to go to historically black colleges and universities and and have that incredible community experience. And to be in a state where they’re not supported with their reproductive health feels scary.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>They formalized this appointment where they want to talk to patients and make sure that they’re aware of the legal landscapes that they’re moving into. So they are proactively reaching out to seniors who are graduating, finding out where they’re going to college, where you’re thinking of going to college, and then taking the appropriate steps from there.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Let’s talk more about these senior sendoff appointments at the Technic Clinic. I know Erin and I’laysia were actually kind enough to let you sit in on Iglesias appointment. What did they talk about?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>They talked about life.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>So yeah. And I recently got accepted into TSU in Texas. So, yeah, I’m glad we have this one because I’m going straight to Texas. You are? Yeah. I think we start August 27.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>I’laysia Vital had just had a birthday.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>Me and my friends, we went to, like, party, like at Airbnb, and then we had, like, food there and they had a hot tub and, like, ping pong tables and stuff. So that’s all we did was. Yeah.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>Who planned to that thing?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>My mom.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>Oh, my God. You do have the best mom.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>Yeah.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>She asked her about her general health.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>Um, sleeping okay at night?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>Yeah.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>Okay.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>But then when it came time to talk about their birth control options, Nurse Kramer asked Alicia, So who are you talking to these days? And that is adolescent speak for who are you having sex with?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>All right. And tell me, who are you talking to these days?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>Uh, same person. Yeah.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>Off and on forever and ever. Can you remind me his name?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>And Nurse Kramer knows that this is how teenagers talk to each other about this kind of thing. And so for her, it’s a way of building trust and meeting students where they’re at and hopefully having an open, honest conversation. And then they talked a lot about different birth control options.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>And tell me a little bit about what you’re thinking in terms of birth control.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>I was looking at the the multiple choices and I’ve seen the the parent guard, the IUD one. Yeah. And I was like talking about that. I think the other.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>Kramer has a poster on the wall of the exam room that has, you know, little pictures or images of all the different birth control methods. And she would point to them and explain how each one worked. So Alecia was pretty clear that she didn’t want to rely on birth control pills or patches.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>Because I’m very forgetful. Even if I set my alarm or write it down, it’s still slipped my mind. So I think that.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>They talked about other long acting options. So they talked a lot about IUDs. These are tiny devices that get inserted into the uterus and they are very effective at preventing pregnancy. I. Liza wasn’t quite down with that. She didn’t quite like the sound of that. But she had had a hormonal implant before. And this is a tiny rod that gets inserted into the upper arm. And she was thinking about getting that again.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>I think I want to go back to the implant, the next implant, because it’s more it fits in my age range, I think, and I feel like it’s not like like a drastic change, but I just feel like I’d rather have something like it’s permanent but might not all the way permanent.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>She ultimately decided to go with the implant again, which is good for up to five years, that she would never have to think about it.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>And after you sign this than I might have, you just step out of the room for a second. We’ll set up the room, and then we’ll do it. Okay. 5 minutes. Okay. Other questions?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>No, I think you covered everything.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Arin Kramer: \u003c/strong>Awesome.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>Well, April, how much can this clinic help students once they’ve actually left the state? Like, would Alysha, for example, be able to, like, call Erin up while she’s in Texas?\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>I’laysia can certainly call Arin up and Arin is very proactive about explaining to students we’re still here. They’re allowed to see their patients up until they’re 21. So any time that I Leisa came back home to visit her parents, for example, if she was there for break or over the summer, she’s more than welcome to come in to the technical clinic and get all the range of services for free. Nurse Cramer can write prescriptions, and if I Leisa comes back and says, you know, I don’t really like the implant, I want something else. Aaron will work with her to come up with something else. What’s less clear is we’re in this very strange time right now with each state codifying different laws. People, as we now know, are not just going to stay in one place. And so how these laws interact with each other when people cross state borders. There’s just so many questions around that. So Nurse Cramer herself wasn’t totally clear on whether she would be allowed to say write a prescription for a birth control method for Aleisha to pick up in Texas. There are just different kinds of rules around health care providers and what they’re allowed to do for people in other states when it comes to abortion services, that’s also unclear. There’s lots of talk right now about someone who’s a resident of Texas coming to a place like California for abortion care. The state of Texas says they have the right to sue the doctor in California who provided care to the Texas resident. California says, no, we have laws that protect doctors. So I think some of these things are it’s going to take time to see how they’re all going to play out.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>In the end, April, I mean, going to college is supposed to be a really exciting time. What is I Leisa looking forward to the most about leaving the nest and also going to her dream school Texas southern.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>Yeah. Like a lot of college bound teenagers, she’s thinking a lot about how she’s going to decorate her dorm room. Her twin sister is coming with her. They plan to bunk together, so they’re working out what kind of color scheme they’re going to go with. But Alisha is also really excited about college things, being independent, you know, moving on her own steam, going to classes, being on her own.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>I’laysia Vital: \u003c/strong>It’s more adult than high school, like high schools like adult. But college is really, though, you’re not with your peers, especially if you like, leave and go to a different school, not in your hometown. So I’m really excited for the growing up part of it.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>April, thank you so much for sharing your reporting with us and joining us on the show. I appreciate it.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>April Dembosky: \u003c/strong>Happy to do it.\u003c/p>\n\u003cp style=\"font-weight: 400\">\u003cstrong>Ericka Cruz Guevarra: \u003c/strong>That was April Dembosy, a health correspondent for KQED. This 30 minute conversation with April was cut down and edited by producer Maria Esquinca. Allen Montecillo is our senior editor. He scored this episode and added all the tape. If you liked this episode, consider sharing it with a friend. Word of mouth is one of the best ways to help our show. I’m Ericka Cruz Guevara. Thank you for listening to the bay. Talk to you next time.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp style=\"font-weight: 400\">\n\u003c/p>\n\u003c/div>"
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"content": "\u003cp>A large fire that broke out at the Schnitzer Steel recycling yard in West Oakland around 5:30 p.m. on Wednesday sent huge plumes of stinky smoke across the East Bay and has prompted ongoing concerns about potential air quality risks from the burning aluminum, tin, steel and iron that were present in the large scrap metal pile where officials said the fire began.\u003c/p>\n\u003cp>“With fires like this, the material that’s burning, the smoke contains more things in the particulate matter. It also likely has other toxic air contaminants, including metals and volatile organic compounds,” said Michael Flagg, principal air quality specialist, Bay Area Air Quality Management District. “So it is really important to pay attention to what’s going on, if you see smoke or smell smoke, take efforts to reduce your exposure.”[aside postID=science_1930023,science_1976747,science_1969271 label='Understanding Air Quality']Thursday morning the BAAQMD released \u003ca href=\"https://www.baaqmd.gov/~/media/files/compliance-and-enforcement/incident-reports/2023/incidentreport_schnitzersteel_081023-pdf.pdf?la=en&rev=a8df9411b6b44703a050860dd7ac5678\">an incident report (PDF)\u003c/a> stating that the “large dense gray smoke plume” traveled south and east during the night, reaching as far as Milpitas, but had then shifted and pushed north.\u003c/p>\n\u003cp>Oakland Fire Department officials reported that it took nearly four hours to get the fire fully under control Wednesday night. But as of Thursday morning, it still had not been completely extinguished.\u003c/p>\n\u003cp>“The most impacted areas were immediately downwind of the fire. So that was East Oakland, West Oakland and other areas along the I-80 corridor, which are historically overburdened communities that kind of experience a disproportionate impact and exposure to poor air pollution already,” said Flagg. He said smoke reached Moraga, Dublin and San Ramon, but then with a shift in wind it moved north all the way up to Martinez.\u003c/p>\n\u003cp>Residents near the Port of Oakland were originally advised on Wednesday to avoid the area around Jack London Square and to keep windows closed. By Thursday, impacts were expected to lessen but continue in parts of Alameda and Contra Costa counties.\u003c/p>\n\u003cp>“If you smell smoke, or you know that there’s high concentrations, our recommendation is to reduce your exposure, to stay inside, close your windows, air filtration, things like that, but mostly just to monitor the situation closely and pay attention to \u003ca href=\"https://twitter.com/AirDistrict\">district advisories\u003c/a>,” said Flagg.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But, while the air district issued an advisory, it is not forecasting an exceedance of the national air quality health standards and is not issuing a more severe Spare the Air Alert. You can see the most recent air quality data at \u003ca href=\"https://fire.airnow.gov/\">fire.airnow.gov\u003c/a>.\u003c/p>\n\u003cp>“Air District staff will continue to investigate this incident to determine if there were any violations of air quality regulations,” the advisory statement said. The Oakland Fire Department also \u003ca href=\"https://www.oaklandca.gov/news/2023/update-on-fire-incident-at-schnitzer-steel-radius-recycling\">said\u003c/a> their hazardous materials team and EPA representatives were on the site Wednesday night to administer tests and evaluate the situation.\u003c/p>\n\u003cp>Schnitzer Steel — \u003ca href=\"https://www.radiusrecycling.com/company/investors/news-release-details/22391\">which recently rebranded itself as Radius Recycling\u003c/a> — is a large scrap metal processing plant near the Port of Oakland that shreds cars and other large appliances. The fire started in a scrap metal pile. The cause is currently under investigation.\u003c/p>\n\u003cp>An initial response from fire crews contained the fire to a single debris pile, but it continued to grow rapidly, \u003ca href=\"https://twitter.com/OaklandFireCA/status/1689500888061382656\">according to Oakland Fire Chief Damon Covington\u003c/a>. Ultimately it required three engines, two fireboats from San Francisco and Alameda, and over 20 firefighters to get the fire under control. There were no injuries reported. However, because of the size of the debris pile, firefighters were unable to reach the origin of the fire and relied on Schnitzer cranes to pull apart the large debris pile.\u003c/p>\n\u003cp>“Until we can get all the way into the pile and put the fire out, we’re going to be out here for awhile,” Covington said late Wednesday night.\u003c/p>\n\u003cp>https://twitter.com/OaklandFireCA/status/1689500888061382656\u003c/p>\n\u003cp>An \u003ca href=\"https://www.oaklandca.gov/news/2023/update-on-fire-incident-at-schnitzer-steel-radius-recycling\">update\u003c/a> from Oakland Fire Department on Thursday said there was still a large amount of debris to untangle and crews continue to spray water on the pile to prevent any small fires that ignite from spreading. It is not uncommon for these kinds of large debris fires to smolder for some time, said officials.\u003c/p>\n\u003cp>“The company is grateful for the first responders who brought this situation to a safe conclusion,” said Tasion Kwamilele, public affairs manager for Schnitzer Steel/Radius Recycling.[aside postID=news_11832073 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2020/08/Schnitzer_Steel-1020x744.jpg']This \u003ca href=\"https://www.cbsnews.com/sanfrancisco/news/schnitzer-steel-environmental-violations-oakland-scrap-yard-fire/\">isn’t the first time\u003c/a> the Schnitzer Steel recycling yard has caught fire. There were previous large fires in 2018, 2010 and 2009. In 2020, \u003ca href=\"https://www.kqed.org/news/11832073/as-file-suit-against-state-agency-to-regulate-steel-recycler\">the Oakland A’s also sued\u003c/a> to have the waste materials created by the plant reclassified as hazardous. At the time, the A’s suit said there had been five smaller fires since 2018. (The A’s \u003ca href=\"https://www.sfchronicle.com/bayarea/article/State-Supreme-Court-rejects-Oakland-A-s-legal-17726660.php\">lost the suit\u003c/a> earlier this year on appeal to the California Supreme Court.)\u003c/p>\n\u003cp>In 2021, Schnitzer also \u003ca href=\"https://oag.ca.gov/news/press-releases/attorney-general-becerra-announces-41-million-settlement-schnitzer-steel\">paid $4.1 million\u003c/a> as part of a settlement over “the release of toxic air contaminants and hazardous particulates” in West Oakland and across the Oakland estuary. The settlement with the state Department of Justice, at the time, reported that investigations by the Alameda County District Attorney’s Office and the California Department of Toxic Substances Control found that Schnitzer was releasing particulate matter contaminated with hazardous metals — such as lead, cadmium and zinc.\u003c/p>\n\u003cp>\u003cem>Bay City News and KQED’s Giuliana Salomone contributed to this report. \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A large fire that broke out at the Schnitzer Steel recycling yard in West Oakland around 5:30 p.m. on Wednesday sent huge plumes of stinky smoke across the East Bay and has prompted ongoing concerns about potential air quality risks from the burning aluminum, tin, steel and iron that were present in the large scrap metal pile where officials said the fire began.\u003c/p>\n\u003cp>“With fires like this, the material that’s burning, the smoke contains more things in the particulate matter. It also likely has other toxic air contaminants, including metals and volatile organic compounds,” said Michael Flagg, principal air quality specialist, Bay Area Air Quality Management District. “So it is really important to pay attention to what’s going on, if you see smoke or smell smoke, take efforts to reduce your exposure.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Thursday morning the BAAQMD released \u003ca href=\"https://www.baaqmd.gov/~/media/files/compliance-and-enforcement/incident-reports/2023/incidentreport_schnitzersteel_081023-pdf.pdf?la=en&rev=a8df9411b6b44703a050860dd7ac5678\">an incident report (PDF)\u003c/a> stating that the “large dense gray smoke plume” traveled south and east during the night, reaching as far as Milpitas, but had then shifted and pushed north.\u003c/p>\n\u003cp>Oakland Fire Department officials reported that it took nearly four hours to get the fire fully under control Wednesday night. But as of Thursday morning, it still had not been completely extinguished.\u003c/p>\n\u003cp>“The most impacted areas were immediately downwind of the fire. So that was East Oakland, West Oakland and other areas along the I-80 corridor, which are historically overburdened communities that kind of experience a disproportionate impact and exposure to poor air pollution already,” said Flagg. He said smoke reached Moraga, Dublin and San Ramon, but then with a shift in wind it moved north all the way up to Martinez.\u003c/p>\n\u003cp>Residents near the Port of Oakland were originally advised on Wednesday to avoid the area around Jack London Square and to keep windows closed. By Thursday, impacts were expected to lessen but continue in parts of Alameda and Contra Costa counties.\u003c/p>\n\u003cp>“If you smell smoke, or you know that there’s high concentrations, our recommendation is to reduce your exposure, to stay inside, close your windows, air filtration, things like that, but mostly just to monitor the situation closely and pay attention to \u003ca href=\"https://twitter.com/AirDistrict\">district advisories\u003c/a>,” said Flagg.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But, while the air district issued an advisory, it is not forecasting an exceedance of the national air quality health standards and is not issuing a more severe Spare the Air Alert. You can see the most recent air quality data at \u003ca href=\"https://fire.airnow.gov/\">fire.airnow.gov\u003c/a>.\u003c/p>\n\u003cp>“Air District staff will continue to investigate this incident to determine if there were any violations of air quality regulations,” the advisory statement said. The Oakland Fire Department also \u003ca href=\"https://www.oaklandca.gov/news/2023/update-on-fire-incident-at-schnitzer-steel-radius-recycling\">said\u003c/a> their hazardous materials team and EPA representatives were on the site Wednesday night to administer tests and evaluate the situation.\u003c/p>\n\u003cp>Schnitzer Steel — \u003ca href=\"https://www.radiusrecycling.com/company/investors/news-release-details/22391\">which recently rebranded itself as Radius Recycling\u003c/a> — is a large scrap metal processing plant near the Port of Oakland that shreds cars and other large appliances. The fire started in a scrap metal pile. The cause is currently under investigation.\u003c/p>\n\u003cp>An initial response from fire crews contained the fire to a single debris pile, but it continued to grow rapidly, \u003ca href=\"https://twitter.com/OaklandFireCA/status/1689500888061382656\">according to Oakland Fire Chief Damon Covington\u003c/a>. Ultimately it required three engines, two fireboats from San Francisco and Alameda, and over 20 firefighters to get the fire under control. There were no injuries reported. However, because of the size of the debris pile, firefighters were unable to reach the origin of the fire and relied on Schnitzer cranes to pull apart the large debris pile.\u003c/p>\n\u003cp>“Until we can get all the way into the pile and put the fire out, we’re going to be out here for awhile,” Covington said late Wednesday night.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>An \u003ca href=\"https://www.oaklandca.gov/news/2023/update-on-fire-incident-at-schnitzer-steel-radius-recycling\">update\u003c/a> from Oakland Fire Department on Thursday said there was still a large amount of debris to untangle and crews continue to spray water on the pile to prevent any small fires that ignite from spreading. It is not uncommon for these kinds of large debris fires to smolder for some time, said officials.\u003c/p>\n\u003cp>“The company is grateful for the first responders who brought this situation to a safe conclusion,” said Tasion Kwamilele, public affairs manager for Schnitzer Steel/Radius Recycling.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>This \u003ca href=\"https://www.cbsnews.com/sanfrancisco/news/schnitzer-steel-environmental-violations-oakland-scrap-yard-fire/\">isn’t the first time\u003c/a> the Schnitzer Steel recycling yard has caught fire. There were previous large fires in 2018, 2010 and 2009. In 2020, \u003ca href=\"https://www.kqed.org/news/11832073/as-file-suit-against-state-agency-to-regulate-steel-recycler\">the Oakland A’s also sued\u003c/a> to have the waste materials created by the plant reclassified as hazardous. At the time, the A’s suit said there had been five smaller fires since 2018. (The A’s \u003ca href=\"https://www.sfchronicle.com/bayarea/article/State-Supreme-Court-rejects-Oakland-A-s-legal-17726660.php\">lost the suit\u003c/a> earlier this year on appeal to the California Supreme Court.)\u003c/p>\n\u003cp>In 2021, Schnitzer also \u003ca href=\"https://oag.ca.gov/news/press-releases/attorney-general-becerra-announces-41-million-settlement-schnitzer-steel\">paid $4.1 million\u003c/a> as part of a settlement over “the release of toxic air contaminants and hazardous particulates” in West Oakland and across the Oakland estuary. The settlement with the state Department of Justice, at the time, reported that investigations by the Alameda County District Attorney’s Office and the California Department of Toxic Substances Control found that Schnitzer was releasing particulate matter contaminated with hazardous metals — such as lead, cadmium and zinc.\u003c/p>\n\u003cp>\u003cem>Bay City News and KQED’s Giuliana Salomone contributed to this report. \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Ashley Hooks always planned to retire at Lakewood Regional Medical Center, where she has been a nurse for 12 years. But now, Hooks said, staffing issues are so bad and burnout so severe that she’s rethinking how she wants to spend the rest of her career.\u003c/p>\n\u003cp>Since the COVID-19 pandemic began, the \u003ca href=\"https://calmatters.org/health/coronavirus/2021/08/california-nurses-shortage/\">number of nurses at the hospital\u003c/a> dropped from just below 500 to 330 according to her union’s roster, said Hooks, who is 53.\u003c/p>\n\u003cp>“It wasn’t even this difficult during the height of the COVID pandemic,” she said.\u003c/p>\n\u003cp>Hooks’ stress reflects the pressure many California nurses are under because of steep understaffing that she and others say is driving many professionals out of the industry.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>According to the Hospital Association of Southern California, nursing vacancy rates among local hospitals exceed 30%. Prior to the pandemic, the average \u003ca href=\"https://hasc.org/wp-content/uploads/sites/3/2019/10/hasc.pdf\">vacancy rate was 6% (PDF)\u003c/a>.\u003c/p>\n\u003cp>“Within the last year-and-a-half or so, it’s really gotten worse,” Hooks said.\u003c/p>\n\u003cp>Now the Legislature is looking at several ideas to address the nursing shortage by bringing more early-career nurses into the field. But so far, the groups with most to gain — or lose — are at odds over how to solve the staffing problems afflicting California’s health care workforce.[pullquote size=\"medium\" align=\"right\" citation=\"Joanne Spetz, director, Institute for Health Policy Studies at UC San Francisco\"]‘There is a lot of trauma in the nursing workforce. The numbers are not good.’[/pullquote]Labor organizations and hospitals want nursing schools to prioritize certain applicants for admission, such as people who already have experience in the industry.\u003c/p>\n\u003cp>“We don’t have enough nurses entering the system as opportunities are opening up for them to leave the system,” said Peter Sidhu, a nurse and executive vice president of United Nurses Associations of California/Union of Health Care Professionals (UNAC/UHCP).\u003c/p>\n\u003cp>But the schools say that won’t help them graduate more nurses. They need more faculty and more hands-on training opportunities to increase class sizes.\u003c/p>\n\u003cp>Hospitals and unions say they don’t have much time to waste. Estimates show California faces a shortage of about 36,000 licensed nurses, according to the \u003ca href=\"https://healthforce.ucsf.edu/LongtermCare\">UC San Francisco Health Workforce Research Center on Long-Term Care\u003c/a>.\u003c/p>\n\u003cp>Preliminary data from a statewide survey conducted in 2022 shows nurses cut back on the number of hours worked per week since 2020, and nearly half the workforce reports symptoms of burnout, said Joanne Spetz, director of the Institute for Health Policy Studies at UC San Francisco, who has studied nursing workforce issues for more than a decade.\u003c/p>\n\u003cp>More nurses, even those as young as 35, are thinking about leaving the profession entirely or retiring within the next two years, and half of the workforce had at least one patient die of COVID-19, Spetz said.\u003c/p>\n\u003cp>“There is a lot of trauma in the nursing workforce,” Spetz said. “The numbers are not good.”\u003c/p>\n\u003ch2>Union-backed bills for nursing shortage\u003c/h2>\n\u003cp>Labor advocates say the nursing shortage creates a vicious cycle. The nurses on shift wind up doing more work. They get burned out and flee the industry, worsening the problem.\u003c/p>\n\u003cp>Service Employees International Union (SEIU) and the UNAC/UHCP turned their attention to the state’s community college system, where graduates can earn degrees to become nursing assistants, licensed vocational nurses or registered nurses. Both groups say community colleges offer the most affordable and efficient way to earn a nursing degree.\u003c/p>\n\u003cp>One of their ideas aims to help high school students get into nursing schools faster. Another would give entry-level workers the chance to move into more skilled and higher-paid positions like nursing.\u003c/p>\n\u003cfigure id=\"attachment_11957012\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11957012\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMNurses02.jpg\" alt='Health Care workers hold signs that read, \"Engineers & Scientists of California United for Our Patients.\"' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses02.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses02-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses02-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses02-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses02-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses02-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Some longtime California nurses said staffing issues are so bad and burnout is so severe that many are rethinking how they want to spend the rest of their careers. \u003ccite>(Rahul Lal/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sidhu’s union is sponsoring a \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240AB1695\">bill\u003c/a> that would create a pilot program for high school students who take extra classes to have preferential admission into a community college nursing program.\u003c/p>\n\u003cp>A \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB689\">second measure\u003c/a>, which is co-sponsored by SEIU and the California Hospital Association (CHA), would require community colleges to set aside 15% of enrollment slots for health care workers looking to further their education with a more advanced degree. They say helping current workers get higher-paying jobs within health care will help with retention.\u003c/p>\n\u003cp>“When we talk to our hospital members, workforce issues are the number one thing that keep them up at night,” said Jan Emerson-Shea, spokesperson for the CHA. “We also hear from employees that they’ve tried getting into community college programs, but because they’re so impacted, it can take them three, four or five years to get into the program.”\u003c/p>\n\u003ch2>California colleges skeptical of union bills\u003c/h2>\n\u003cp>But community college and some university nursing school leaders contend neither bill will boost the number of graduates. \u003ca href=\"https://calmatters.org/education/higher-education/2023/03/california-nursing-school/\">Nursing programs are full\u003c/a>, they say, and the proposals do nothing to expand the number of admission slots.\u003c/p>\n\u003cp>“These bills come up and I wonder who on earth would propose something like this to impact the community colleges without getting our input,” said Tammy Vant Hul, south region president of the California Organization of Associate Degree Nursing Program Directors.[aside label='More on California Health Care' tag='health-care']Vant Hul is also dean of nursing at Riverside City College, the second largest community college nursing program in the state. High school students would not have completed enough prerequisites to apply directly to a nursing program, much less be guaranteed admission, Vant Hul said, and existing health care workers already get additional points during the admissions process.\u003c/p>\n\u003cp>The problem isn’t generating career interest in nursing; it’s creating more spots, program leaders say.\u003c/p>\n\u003cp>Karen Bradley, president of the California Association of Colleges of Nursing, said nursing programs have an overabundance of competitive applicants.\u003c/p>\n\u003cp>“We have not had a dip at all in enrollment in my program. I have a waiting list,” said Bradley, who is also dean of California Baptist University’s nursing program. “Every dean is going to tell you that they have a waiting list or enough qualified applicants that they turn away students.”\u003c/p>\n\u003cp>About 14,000 new students enrolled in nursing programs during the 2020–21 school year, according to the \u003ca href=\"https://www.rn.ca.gov/pdfs/education/schoolrpt20-21.pdf\">Board of Registered Nursing’s annual school report (PDF)\u003c/a>. That’s about 1,000 fewer students than the previous two years due to smaller class sizes, but schools across the state received more than 55,000 applications, a 10-year record.\u003c/p>\n\u003cp>The bills’ sponsors say they have spoken with the California Community Colleges Chancellor’s Office, which has not taken a position on any of the workforce bills.\u003c/p>\n\u003cfigure id=\"attachment_11957013\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11957013\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMNurses03.jpg\" alt='Dozens of health care workers march in protest outside of a Kaiser Permanente building in Sacramento, California. One yellow and black sign reads, \"Patient Care Is In Crisis.\"' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses03.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses03-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses03-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses03-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses03-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses03-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">According to the Hospital Association of Southern California, nursing vacancy rates among local hospitals exceed 30%. Prior to the pandemic, the average vacancy rate was 6%. \u003ccite>(Rahul Lal/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Separate from the bills, the UNAC/UHCP lobbied for a \u003ca href=\"https://ebudget.ca.gov/2023-24/pdf/Enacted/BudgetSummary/HigherEducation.pdf\">$300 million investment (PDF)\u003c/a> over five years to double the state’s nursing school capacity. It was included in the \u003ca href=\"https://calmatters.org/politics/2023/06/california-budget-deal-what-you-need-to-know/\">state budget Gov. Gavin Newsom signed\u003c/a> earlier this summer.\u003c/p>\n\u003cp>The details of how the money will be spent have not been decided, Sidhu said, but it could be used to increase faculty salaries and overcome other factors that limit class sizes.\u003c/p>\n\u003ch2>More room needed for California nurse trainees\u003c/h2>\n\u003cp>Representatives for nursing programs say the money will be helpful, but they’re worried about other bottlenecks that they say prevent them from enrolling more students.\u003c/p>\n\u003cp>Lack of nursing faculty caps class sizes, for instance, with potential educators instead choosing to make more money working in health care. They also say hospitals are not offering enough opportunities for their students to get hands-on training.\u003c/p>\n\u003cp>“As we move forward with the nursing shortage, clinical placements are an issue. So many hospitals kind of downsized their willingness to bring on students during the pandemic, and those spots never came back,” said Linda Zorn, legislative chair for the California Organization of Associate Degree Nursing and executive director of economic and workforce development for Butte-Glenn Community College District.\u003c/p>\n\u003cp>A \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240AB1577\">third proposal\u003c/a> in the Legislature attempts to clear that hurdle by guaranteeing clinical placement spots for community college students. A mix of opponents are fighting the bill, including hospitals, four-year universities and some community college advocates who say it will take spots away from other students and overwhelm nursing staff.\u003c/p>\n\u003cp>“Some hospitals aren’t big enough. They can’t take on hundreds of students. They have 25 beds,” said Sarah Bridge, senior legislative advocate for the Association of Health Care Districts, which represents primarily small, rural hospitals in the state.\u003c/p>\n\u003cp>During the 2020–21 school year, the most commonly cited reason by nursing schools for decreasing class sizes was “unable to secure clinical placements,” according to the \u003ca href=\"https://www.rn.ca.gov/pdfs/education/schoolrpt20-21.pdf\">Board of Registered Nursing’s annual school report (PDF)\u003c/a>, in part due to workforce challenges resulting from the pandemic. The report states that more than 15,000 students were impacted by restricted training spots compared to roughly 2,200 students during the 2018–19 school year.[pullquote size=\"medium\" align=\"right\" citation=\"Linda Zorn, legislative chair, California Organization of Associate Degree Nursing\"]‘So many hospitals kind of downsized their willingness to bring on students during the pandemic, and those spots never came back.’[/pullquote]Bridge said many small and \u003ca href=\"https://calmatters.org/health/2023/05/hospital-closures-california-2/\">rural hospitals also are teetering on the edge of a financial crisis\u003c/a>. It costs about $7,000 to train one student, not including the salary cost of nurses who supervise students. Multiply that by the number of student trainees accepted and some hospitals can’t foot the bill, Bridge said.\u003c/p>\n\u003cp>Zorn said nursing schools know they have to be sensitive to how many students get sent to any one hospital, which is part of the reason many are skeptical of the bill. The number of student training spots recently has been limited by the profession’s thinly stretched workforce.\u003c/p>\n\u003cp>“It can close down the rural hospitals if you don’t have the correct staffing,” Zorn said.\u003c/p>\n\u003cp>Leaders from four-year degree programs also say the proposal would displace their nursing students in favor of community college students.\u003c/p>\n\u003cp>The bill sponsors say the intent of the legislation is to create more training capacity, not to displace existing students, as some critics have claimed, said Eric Robles, legislative director for the UNAC/UHCP.\u003c/p>\n\u003cp>“If hospitals are getting bailouts, I would sure hope everybody believes our nurse workforce needs a bailout too,” Robles said. “And that bailout can come through strengthening the pipeline, growing the workforce and maintaining the workforce.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Ashley Hooks always planned to retire at Lakewood Regional Medical Center, where she has been a nurse for 12 years. But now, Hooks said, staffing issues are so bad and burnout so severe that she’s rethinking how she wants to spend the rest of her career.\u003c/p>\n\u003cp>Since the COVID-19 pandemic began, the \u003ca href=\"https://calmatters.org/health/coronavirus/2021/08/california-nurses-shortage/\">number of nurses at the hospital\u003c/a> dropped from just below 500 to 330 according to her union’s roster, said Hooks, who is 53.\u003c/p>\n\u003cp>“It wasn’t even this difficult during the height of the COVID pandemic,” she said.\u003c/p>\n\u003cp>Hooks’ stress reflects the pressure many California nurses are under because of steep understaffing that she and others say is driving many professionals out of the industry.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>According to the Hospital Association of Southern California, nursing vacancy rates among local hospitals exceed 30%. Prior to the pandemic, the average \u003ca href=\"https://hasc.org/wp-content/uploads/sites/3/2019/10/hasc.pdf\">vacancy rate was 6% (PDF)\u003c/a>.\u003c/p>\n\u003cp>“Within the last year-and-a-half or so, it’s really gotten worse,” Hooks said.\u003c/p>\n\u003cp>Now the Legislature is looking at several ideas to address the nursing shortage by bringing more early-career nurses into the field. But so far, the groups with most to gain — or lose — are at odds over how to solve the staffing problems afflicting California’s health care workforce.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Labor organizations and hospitals want nursing schools to prioritize certain applicants for admission, such as people who already have experience in the industry.\u003c/p>\n\u003cp>“We don’t have enough nurses entering the system as opportunities are opening up for them to leave the system,” said Peter Sidhu, a nurse and executive vice president of United Nurses Associations of California/Union of Health Care Professionals (UNAC/UHCP).\u003c/p>\n\u003cp>But the schools say that won’t help them graduate more nurses. They need more faculty and more hands-on training opportunities to increase class sizes.\u003c/p>\n\u003cp>Hospitals and unions say they don’t have much time to waste. Estimates show California faces a shortage of about 36,000 licensed nurses, according to the \u003ca href=\"https://healthforce.ucsf.edu/LongtermCare\">UC San Francisco Health Workforce Research Center on Long-Term Care\u003c/a>.\u003c/p>\n\u003cp>Preliminary data from a statewide survey conducted in 2022 shows nurses cut back on the number of hours worked per week since 2020, and nearly half the workforce reports symptoms of burnout, said Joanne Spetz, director of the Institute for Health Policy Studies at UC San Francisco, who has studied nursing workforce issues for more than a decade.\u003c/p>\n\u003cp>More nurses, even those as young as 35, are thinking about leaving the profession entirely or retiring within the next two years, and half of the workforce had at least one patient die of COVID-19, Spetz said.\u003c/p>\n\u003cp>“There is a lot of trauma in the nursing workforce,” Spetz said. “The numbers are not good.”\u003c/p>\n\u003ch2>Union-backed bills for nursing shortage\u003c/h2>\n\u003cp>Labor advocates say the nursing shortage creates a vicious cycle. The nurses on shift wind up doing more work. They get burned out and flee the industry, worsening the problem.\u003c/p>\n\u003cp>Service Employees International Union (SEIU) and the UNAC/UHCP turned their attention to the state’s community college system, where graduates can earn degrees to become nursing assistants, licensed vocational nurses or registered nurses. Both groups say community colleges offer the most affordable and efficient way to earn a nursing degree.\u003c/p>\n\u003cp>One of their ideas aims to help high school students get into nursing schools faster. Another would give entry-level workers the chance to move into more skilled and higher-paid positions like nursing.\u003c/p>\n\u003cfigure id=\"attachment_11957012\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11957012\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMNurses02.jpg\" alt='Health Care workers hold signs that read, \"Engineers & Scientists of California United for Our Patients.\"' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses02.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses02-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses02-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses02-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses02-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses02-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Some longtime California nurses said staffing issues are so bad and burnout is so severe that many are rethinking how they want to spend the rest of their careers. \u003ccite>(Rahul Lal/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sidhu’s union is sponsoring a \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240AB1695\">bill\u003c/a> that would create a pilot program for high school students who take extra classes to have preferential admission into a community college nursing program.\u003c/p>\n\u003cp>A \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB689\">second measure\u003c/a>, which is co-sponsored by SEIU and the California Hospital Association (CHA), would require community colleges to set aside 15% of enrollment slots for health care workers looking to further their education with a more advanced degree. They say helping current workers get higher-paying jobs within health care will help with retention.\u003c/p>\n\u003cp>“When we talk to our hospital members, workforce issues are the number one thing that keep them up at night,” said Jan Emerson-Shea, spokesperson for the CHA. “We also hear from employees that they’ve tried getting into community college programs, but because they’re so impacted, it can take them three, four or five years to get into the program.”\u003c/p>\n\u003ch2>California colleges skeptical of union bills\u003c/h2>\n\u003cp>But community college and some university nursing school leaders contend neither bill will boost the number of graduates. \u003ca href=\"https://calmatters.org/education/higher-education/2023/03/california-nursing-school/\">Nursing programs are full\u003c/a>, they say, and the proposals do nothing to expand the number of admission slots.\u003c/p>\n\u003cp>“These bills come up and I wonder who on earth would propose something like this to impact the community colleges without getting our input,” said Tammy Vant Hul, south region president of the California Organization of Associate Degree Nursing Program Directors.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Vant Hul is also dean of nursing at Riverside City College, the second largest community college nursing program in the state. High school students would not have completed enough prerequisites to apply directly to a nursing program, much less be guaranteed admission, Vant Hul said, and existing health care workers already get additional points during the admissions process.\u003c/p>\n\u003cp>The problem isn’t generating career interest in nursing; it’s creating more spots, program leaders say.\u003c/p>\n\u003cp>Karen Bradley, president of the California Association of Colleges of Nursing, said nursing programs have an overabundance of competitive applicants.\u003c/p>\n\u003cp>“We have not had a dip at all in enrollment in my program. I have a waiting list,” said Bradley, who is also dean of California Baptist University’s nursing program. “Every dean is going to tell you that they have a waiting list or enough qualified applicants that they turn away students.”\u003c/p>\n\u003cp>About 14,000 new students enrolled in nursing programs during the 2020–21 school year, according to the \u003ca href=\"https://www.rn.ca.gov/pdfs/education/schoolrpt20-21.pdf\">Board of Registered Nursing’s annual school report (PDF)\u003c/a>. That’s about 1,000 fewer students than the previous two years due to smaller class sizes, but schools across the state received more than 55,000 applications, a 10-year record.\u003c/p>\n\u003cp>The bills’ sponsors say they have spoken with the California Community Colleges Chancellor’s Office, which has not taken a position on any of the workforce bills.\u003c/p>\n\u003cfigure id=\"attachment_11957013\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11957013\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/08/CMNurses03.jpg\" alt='Dozens of health care workers march in protest outside of a Kaiser Permanente building in Sacramento, California. One yellow and black sign reads, \"Patient Care Is In Crisis.\"' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses03.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses03-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses03-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses03-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses03-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/CMNurses03-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">According to the Hospital Association of Southern California, nursing vacancy rates among local hospitals exceed 30%. Prior to the pandemic, the average vacancy rate was 6%. \u003ccite>(Rahul Lal/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Separate from the bills, the UNAC/UHCP lobbied for a \u003ca href=\"https://ebudget.ca.gov/2023-24/pdf/Enacted/BudgetSummary/HigherEducation.pdf\">$300 million investment (PDF)\u003c/a> over five years to double the state’s nursing school capacity. It was included in the \u003ca href=\"https://calmatters.org/politics/2023/06/california-budget-deal-what-you-need-to-know/\">state budget Gov. Gavin Newsom signed\u003c/a> earlier this summer.\u003c/p>\n\u003cp>The details of how the money will be spent have not been decided, Sidhu said, but it could be used to increase faculty salaries and overcome other factors that limit class sizes.\u003c/p>\n\u003ch2>More room needed for California nurse trainees\u003c/h2>\n\u003cp>Representatives for nursing programs say the money will be helpful, but they’re worried about other bottlenecks that they say prevent them from enrolling more students.\u003c/p>\n\u003cp>Lack of nursing faculty caps class sizes, for instance, with potential educators instead choosing to make more money working in health care. They also say hospitals are not offering enough opportunities for their students to get hands-on training.\u003c/p>\n\u003cp>“As we move forward with the nursing shortage, clinical placements are an issue. So many hospitals kind of downsized their willingness to bring on students during the pandemic, and those spots never came back,” said Linda Zorn, legislative chair for the California Organization of Associate Degree Nursing and executive director of economic and workforce development for Butte-Glenn Community College District.\u003c/p>\n\u003cp>A \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240AB1577\">third proposal\u003c/a> in the Legislature attempts to clear that hurdle by guaranteeing clinical placement spots for community college students. A mix of opponents are fighting the bill, including hospitals, four-year universities and some community college advocates who say it will take spots away from other students and overwhelm nursing staff.\u003c/p>\n\u003cp>“Some hospitals aren’t big enough. They can’t take on hundreds of students. They have 25 beds,” said Sarah Bridge, senior legislative advocate for the Association of Health Care Districts, which represents primarily small, rural hospitals in the state.\u003c/p>\n\u003cp>During the 2020–21 school year, the most commonly cited reason by nursing schools for decreasing class sizes was “unable to secure clinical placements,” according to the \u003ca href=\"https://www.rn.ca.gov/pdfs/education/schoolrpt20-21.pdf\">Board of Registered Nursing’s annual school report (PDF)\u003c/a>, in part due to workforce challenges resulting from the pandemic. The report states that more than 15,000 students were impacted by restricted training spots compared to roughly 2,200 students during the 2018–19 school year.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Bridge said many small and \u003ca href=\"https://calmatters.org/health/2023/05/hospital-closures-california-2/\">rural hospitals also are teetering on the edge of a financial crisis\u003c/a>. It costs about $7,000 to train one student, not including the salary cost of nurses who supervise students. Multiply that by the number of student trainees accepted and some hospitals can’t foot the bill, Bridge said.\u003c/p>\n\u003cp>Zorn said nursing schools know they have to be sensitive to how many students get sent to any one hospital, which is part of the reason many are skeptical of the bill. The number of student training spots recently has been limited by the profession’s thinly stretched workforce.\u003c/p>\n\u003cp>“It can close down the rural hospitals if you don’t have the correct staffing,” Zorn said.\u003c/p>\n\u003cp>Leaders from four-year degree programs also say the proposal would displace their nursing students in favor of community college students.\u003c/p>\n\u003cp>The bill sponsors say the intent of the legislation is to create more training capacity, not to displace existing students, as some critics have claimed, said Eric Robles, legislative director for the UNAC/UHCP.\u003c/p>\n\u003cp>“If hospitals are getting bailouts, I would sure hope everybody believes our nurse workforce needs a bailout too,” Robles said. “And that bailout can come through strengthening the pipeline, growing the workforce and maintaining the workforce.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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},
"mindshift": {
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 12
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"morning-edition": {
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"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
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"onourwatch": {
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"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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},
"pbs-newshour": {
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},
"perspectives": {
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"order": 14
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"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
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"politicalbreakdown": {
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"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
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"order": 5
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"possible": {
"id": "possible",
"title": "Possible",
"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.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.possible.fm/",
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"source": "Possible"
},
"link": "/radio/program/possible",
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"spotify": "https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"
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},
"pri-the-world": {
"id": "pri-the-world",
"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
"airtime": "MON-FRI 2pm-3pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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