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"content": "\u003cp>Things at the opiate treatment program at San Francisco General Hospital look a good deal different these days from before the pandemic hit.\u003c/p>\n\u003cp>For starters, there’s now an option to pick up methadone from a mobile clinic stationed in the hospital’s shaded parking lot, rather than in the traditional clinic inside Ward 93. More crucially, patients can now get the dosage level they need, when they need it, and are able to take their medications home with them — allowances that were previously restricted.\u003c/p>\n\u003cp>In the spring of 2020, as many medical facilities limited their indoor services, the mobile clinic’s two vans set up shop, enabling patients to continue receiving their addiction-related medications and other treatments without interruption.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Early indicators suggest the changes have helped more patients stick with their substance-use treatments at the hospital’s 50-year-old Opiate Treatment Outpatient Program (OTOP).\u003c/p>\n\u003cp>“More people are coming, and more people are staying” with their treatment plan, said Dr. Lisa Fortuna, chief of psychiatry at SF General.\u003c/p>\n\u003cp>But as local and federal pandemic emergency orders — and many of the programs that came with them — come to an end, the future of the mobile clinic is uncertain.\u003c/p>\n\u003cp>Tamra Lombardo, a former heroin user who has received treatment from OTOP for nearly 10 years, said the outdoor site is more discreet and much easier to access compared to the hospital ward, which she frequented before the pandemic.\u003c/p>\n\u003cfigure id=\"attachment_11941679\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11941679 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\" alt=\"A woman with light brown skin and black hair pulled into a bun wearing a face mask fills medication.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Registered nurse Sheena Simon prepares medication inside a mobile methadone clinic operated by SF General’s Opiate Treatment Outpatient Program, on Feb. 10, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I haven’t missed no days here. It’s more convenient and a lot smoother. It’s way better, I think,” said Lombardo, 52, after picking up the cherry-flavored dose of methadone from one of the clinic’s vans on a recent Friday, with her dog Eddy at her side. Finding a program that works, she added, has allowed her to focus on her work as a caregiver.\u003c/p>\n\u003cp>Lombardo is one of about 600 OTOP patients, roughly 75% of whom now use the program’s mobile clinic, according to Hasija Sisic, a nurse manager. Participation in the program, which dropped considerably during the first year of the pandemic, has since rebounded and even exceeded pre-pandemic levels, according to data provided by the program.\u003c/p>\n\u003cp>That retention is sorely needed as cities throughout the region, and country, continue to grapple with an overdose epidemic driven by potent opioids like fentanyl. In San Francisco alone, \u003ca href=\"https://sf.gov/resource/2020/ocme-accidental-overdose-reports\">nearly 2,000 people have died of drug overdoses since 2020\u003c/a>, according to data from the Office of the Chief Medical Examiner.\u003c/p>\n\u003cp>Seven days a week, OTOP nurses work out of the clinic’s large white vans in the hospital parking lot, near Potrero Boulevard. On Monday through Friday, one of the vans also parks in the Bayview neighborhood. [pullquote align=\"right\" size=\"medium\" citation=\"Tamra Lombardo, patient, Opiate Treatment Outpatient Program\"]‘I don’t have to use the junk out there anymore. I’ve lost a lot of people I know to that.’[/pullquote]On a recent Friday afternoon, nurses outside the hospital dispensed methadone and buprenorphine — medications used to reduce withdrawal symptoms — while offering program patients snacks, water and canisters of naloxone, an overdose-reversal nasal spray.\u003c/p>\n\u003cp>After picking up their doses, patients talked with counselors in person or on iPads in heated booths inside the vans. At the start of the pandemic, the program gave out free mobile phones to almost all patients, many of whom lack reliable internet access, so they could be reached for daily check-ins.\u003c/p>\n\u003cp>Sisic said she hopes the mobile sites will continue to operate, even as emergency orders sunset.\u003c/p>\n\u003cp>“We are still talking to the state to at least consider that this might be a good option to keep, because there are a lot of regulations,” she said. “But it’s very needed and we do have the skills.”\u003c/p>\n\u003cp>Opioid withdrawal symptoms can be extremely painful and, in some cases, fatal. So when methadone was approved by the U.S. Food and Drug Administration in 1972, San Francisco became an early adopter in dispensing it. That effort was later incorporated into the city’s strategy to help combat HIV among injection drug users during the start of the AIDS epidemic in the early 1980s.\u003c/p>\n\u003cfigure id=\"attachment_11941681\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11941681 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\" alt=\"A woman with light skin and a purple bandana stands in the doorway of a large white van, with her dog on a leash outside.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Tamra Lombardo, a patient, speaks with a nurse at OTOP’s mobile methadone clinic at San Francisco General Hospital on Feb. 10, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But many health experts now argue that standard treatment for substance-use disorders has failed to keep pace with the ever-expanding landscape of increasingly potent and dangerous street drugs.\u003c/p>\n\u003cp>Treating the withdrawal symptoms of fentanyl, for example, an opioid that’s 50 times more potent than heroin, requires a higher initial dose of methadone than what’s typically allowed by the Substance Abuse and Mental Health Services Administration, the federal agency that regulates how opioid-treatment drugs are administered.\u003c/p>\n\u003cp>Before the pandemic, federal health authorities strictly regulated many aspects of opiate treatment programs in an effort to stem overdoses of methadone, which is itself an opioid. Rules around treatment dictate everything from dosage levels to when and where patients consume their medications.\u003c/p>\n\u003cp>Some of those rules were temporarily relaxed at the start of the pandemic, as drug treatment centers scrambled to prevent overcrowding and continue programs.[aside label=\"related coverage\" tag=\"opioid-crisis\"]Under the updated COVID-era federal regulations, health care providers can prescribe higher doses of methadone depending on a patient’s needs. Stabilized patients also have more access to take-home medications and can attend counseling by video or phone rather than in person.\u003c/p>\n\u003cp>Before the pandemic, “we couldn’t go up as quickly on dosage to get to the appropriate dosage that stops cravings of opioids,” said Dr. Andrew Tompkins, head of UCSF’s Division of Substance Abuse and Addiction Medicine. “And all counseling had to be face-to-face. We weren’t allowed to use telehealth or telephone.”\u003c/p>\n\u003cp>Now about 82% of patients in the program qualify for at least one take-home dose, up from the roughly 25% who qualified before the pandemic, Tompkins said.\u003c/p>\n\u003cp>And so far, \u003ca href=\"https://www.chcf.org/wp-content/uploads/2022/04/LearningCOVID19PandemicPoliciesMethadoneOpioidTreatment.pdf\">concerns about take-home methadone doses leading to increased overdoses “have not borne out” (PDF)\u003c/a>, according to a recent UCSF report. In observing opiate treatment programs in five different states, the study’s authors found no significant increase in methadone diversion or overdose after take-home regulations were relaxed in 2020, as compared to previous years.\u003c/p>\n\u003cp>The study goes on to suggest that expanding methadone and buprenorphine treatment options can begin to address some of that history of “medical racism and treatment segregation.”\u003c/p>\n\u003cp>A recently proposed federal rule change could make the loosened \u003ca href=\"https://www.hhs.gov/about/news/2022/12/13/samhsa-proposes-update-federal-rules-expand-access-opioid-use-disorder-treatment-help-close-gap-in-care.html\">opiate treatment rules permanent\u003c/a>. Specifically, it would allow providers to continue prescribing take-home doses of methadone and allow treatment programs to be initiated through telehealth consultations.\u003c/p>\n\u003cp>Being able to receive take-home medication has been a welcome change for patients like Debra Allen, a Tenderloin resident, who has attempted opioid treatment for years to combat her cocaine and heroin addiction.\u003c/p>\n\u003cp>The mobile clinic allows her to more easily hop on and off the bus to pick up her medication, and it’s a calmer environment than the buzzing methadone clinic inside the hospital, she said.\u003c/p>\n\u003cfigure id=\"attachment_11941680\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11941680\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\" alt=\"A Black woman drinks out of a disposable cup, as a nurse behind a window watches.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Patient Debra Allen takes her methadone dose while speaking with nurse Heather Cruz at OTOP’s mobile methadone clinic at San Francisco General Hospital on Feb. 10, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“This site is nice. I’ve been here a long time. Other ones are nasty and dirty. Here they keep the bathroom clean,” Allen said.\u003c/p>\n\u003cp>“You can be using so long you get immune and you have to go up [with your dosage],” she said, adding that this treatment approach “makes me not want heroin.”\u003c/p>\n\u003cp>Lombardo, one of the longtime patients, said she’ll keep returning for treatment as long as the vans are around.\u003c/p>\n\u003cp>“I don’t have to use the junk out there anymore. I’ve lost a lot of people I know to that,” she said. To other folks who might be considering treatment, she recommended the mobile clinics: “Take the time to try it. The more you put into it, the more you will get out of it.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Early indicators suggest the changes have helped more patients stick with their substance-use treatments at the hospital’s 50-year-old Opiate Treatment Outpatient Program (OTOP).\u003c/p>\n\u003cp>“More people are coming, and more people are staying” with their treatment plan, said Dr. Lisa Fortuna, chief of psychiatry at SF General.\u003c/p>\n\u003cp>But as local and federal pandemic emergency orders — and many of the programs that came with them — come to an end, the future of the mobile clinic is uncertain.\u003c/p>\n\u003cp>Tamra Lombardo, a former heroin user who has received treatment from OTOP for nearly 10 years, said the outdoor site is more discreet and much easier to access compared to the hospital ward, which she frequented before the pandemic.\u003c/p>\n\u003cfigure id=\"attachment_11941679\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11941679 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\" alt=\"A woman with light brown skin and black hair pulled into a bun wearing a face mask fills medication.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Registered nurse Sheena Simon prepares medication inside a mobile methadone clinic operated by SF General’s Opiate Treatment Outpatient Program, on Feb. 10, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I haven’t missed no days here. It’s more convenient and a lot smoother. It’s way better, I think,” said Lombardo, 52, after picking up the cherry-flavored dose of methadone from one of the clinic’s vans on a recent Friday, with her dog Eddy at her side. Finding a program that works, she added, has allowed her to focus on her work as a caregiver.\u003c/p>\n\u003cp>Lombardo is one of about 600 OTOP patients, roughly 75% of whom now use the program’s mobile clinic, according to Hasija Sisic, a nurse manager. Participation in the program, which dropped considerably during the first year of the pandemic, has since rebounded and even exceeded pre-pandemic levels, according to data provided by the program.\u003c/p>\n\u003cp>That retention is sorely needed as cities throughout the region, and country, continue to grapple with an overdose epidemic driven by potent opioids like fentanyl. In San Francisco alone, \u003ca href=\"https://sf.gov/resource/2020/ocme-accidental-overdose-reports\">nearly 2,000 people have died of drug overdoses since 2020\u003c/a>, according to data from the Office of the Chief Medical Examiner.\u003c/p>\n\u003cp>Seven days a week, OTOP nurses work out of the clinic’s large white vans in the hospital parking lot, near Potrero Boulevard. On Monday through Friday, one of the vans also parks in the Bayview neighborhood. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>On a recent Friday afternoon, nurses outside the hospital dispensed methadone and buprenorphine — medications used to reduce withdrawal symptoms — while offering program patients snacks, water and canisters of naloxone, an overdose-reversal nasal spray.\u003c/p>\n\u003cp>After picking up their doses, patients talked with counselors in person or on iPads in heated booths inside the vans. At the start of the pandemic, the program gave out free mobile phones to almost all patients, many of whom lack reliable internet access, so they could be reached for daily check-ins.\u003c/p>\n\u003cp>Sisic said she hopes the mobile sites will continue to operate, even as emergency orders sunset.\u003c/p>\n\u003cp>“We are still talking to the state to at least consider that this might be a good option to keep, because there are a lot of regulations,” she said. “But it’s very needed and we do have the skills.”\u003c/p>\n\u003cp>Opioid withdrawal symptoms can be extremely painful and, in some cases, fatal. So when methadone was approved by the U.S. Food and Drug Administration in 1972, San Francisco became an early adopter in dispensing it. That effort was later incorporated into the city’s strategy to help combat HIV among injection drug users during the start of the AIDS epidemic in the early 1980s.\u003c/p>\n\u003cfigure id=\"attachment_11941681\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11941681 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\" alt=\"A woman with light skin and a purple bandana stands in the doorway of a large white van, with her dog on a leash outside.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Tamra Lombardo, a patient, speaks with a nurse at OTOP’s mobile methadone clinic at San Francisco General Hospital on Feb. 10, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But many health experts now argue that standard treatment for substance-use disorders has failed to keep pace with the ever-expanding landscape of increasingly potent and dangerous street drugs.\u003c/p>\n\u003cp>Treating the withdrawal symptoms of fentanyl, for example, an opioid that’s 50 times more potent than heroin, requires a higher initial dose of methadone than what’s typically allowed by the Substance Abuse and Mental Health Services Administration, the federal agency that regulates how opioid-treatment drugs are administered.\u003c/p>\n\u003cp>Before the pandemic, federal health authorities strictly regulated many aspects of opiate treatment programs in an effort to stem overdoses of methadone, which is itself an opioid. Rules around treatment dictate everything from dosage levels to when and where patients consume their medications.\u003c/p>\n\u003cp>Some of those rules were temporarily relaxed at the start of the pandemic, as drug treatment centers scrambled to prevent overcrowding and continue programs.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Under the updated COVID-era federal regulations, health care providers can prescribe higher doses of methadone depending on a patient’s needs. Stabilized patients also have more access to take-home medications and can attend counseling by video or phone rather than in person.\u003c/p>\n\u003cp>Before the pandemic, “we couldn’t go up as quickly on dosage to get to the appropriate dosage that stops cravings of opioids,” said Dr. Andrew Tompkins, head of UCSF’s Division of Substance Abuse and Addiction Medicine. “And all counseling had to be face-to-face. We weren’t allowed to use telehealth or telephone.”\u003c/p>\n\u003cp>Now about 82% of patients in the program qualify for at least one take-home dose, up from the roughly 25% who qualified before the pandemic, Tompkins said.\u003c/p>\n\u003cp>And so far, \u003ca href=\"https://www.chcf.org/wp-content/uploads/2022/04/LearningCOVID19PandemicPoliciesMethadoneOpioidTreatment.pdf\">concerns about take-home methadone doses leading to increased overdoses “have not borne out” (PDF)\u003c/a>, according to a recent UCSF report. In observing opiate treatment programs in five different states, the study’s authors found no significant increase in methadone diversion or overdose after take-home regulations were relaxed in 2020, as compared to previous years.\u003c/p>\n\u003cp>The study goes on to suggest that expanding methadone and buprenorphine treatment options can begin to address some of that history of “medical racism and treatment segregation.”\u003c/p>\n\u003cp>A recently proposed federal rule change could make the loosened \u003ca href=\"https://www.hhs.gov/about/news/2022/12/13/samhsa-proposes-update-federal-rules-expand-access-opioid-use-disorder-treatment-help-close-gap-in-care.html\">opiate treatment rules permanent\u003c/a>. Specifically, it would allow providers to continue prescribing take-home doses of methadone and allow treatment programs to be initiated through telehealth consultations.\u003c/p>\n\u003cp>Being able to receive take-home medication has been a welcome change for patients like Debra Allen, a Tenderloin resident, who has attempted opioid treatment for years to combat her cocaine and heroin addiction.\u003c/p>\n\u003cp>The mobile clinic allows her to more easily hop on and off the bus to pick up her medication, and it’s a calmer environment than the buzzing methadone clinic inside the hospital, she said.\u003c/p>\n\u003cfigure id=\"attachment_11941680\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11941680\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\" alt=\"A Black woman drinks out of a disposable cup, as a nurse behind a window watches.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Patient Debra Allen takes her methadone dose while speaking with nurse Heather Cruz at OTOP’s mobile methadone clinic at San Francisco General Hospital on Feb. 10, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“This site is nice. I’ve been here a long time. Other ones are nasty and dirty. Here they keep the bathroom clean,” Allen said.\u003c/p>\n\u003cp>“You can be using so long you get immune and you have to go up [with your dosage],” she said, adding that this treatment approach “makes me not want heroin.”\u003c/p>\n\u003cp>Lombardo, one of the longtime patients, said she’ll keep returning for treatment as long as the vans are around.\u003c/p>\n\u003cp>“I don’t have to use the junk out there anymore. I’ve lost a lot of people I know to that,” she said. To other folks who might be considering treatment, she recommended the mobile clinics: “Take the time to try it. The more you put into it, the more you will get out of it.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>U.S. Department of Health and Human Services Secretary Xavier Becerra on Friday toured the country’s largest public nursing home, based in San Francisco, which continues to face threats of closure.\u003c/p>\n\u003cp>The one-hour tour marked Becerra’s first visit to Laguna Honda Hospital and Rehabilitation Center since he became head of the country’s health care arm in 2021.\u003c/p>\n\u003cp>“This tour was indispensable,” Becerra told KQED after the visit. “Going through, meeting a lot of the personnel, many who have been here for decades, it’s important to get a sense from them how they feel.” [pullquote align=\"right\" size=\"medium\" citation=\"Xavier Becerra, secretary, Dept. of Health and Human Services\"]‘This tour was indispensable. Going through, meeting a lot of the personnel, many who have been here for decades, it’s important to get a sense from them how they feel.’[/pullquote]He visited the facility to observe some of the areas and processes that Laguna Honda must bring up to code in order to get recertified, such as medicine storage and cleaning, and to see how patients with mental illness and substance use disorder are cared for at the facility.\u003c/p>\n\u003cp>Reporters were not allowed on the tour, but Becerra said he spoke to nurses and patients who told him they hope he will protect Laguna Honda.\u003c/p>\n\u003cp>“Most of them said, ‘Help us keep Laguna Honda open,’” Becerra said. “A facility like this is critical to a community, and a facility like this understands it has to meet standards so that anyone who needs to send their loved ones here can know that the health and safety that we would all expect is being provided.”\u003c/p>\n\u003cp>It’s been a year of constant uncertainty and crisis for staff and patients at Laguna Honda. In 2022, \u003ca href=\"https://abc7news.com/amp/laguna-honda-hospital-san-francisco-funding-mayor-london-breed-press-conference-healthcare-in-sf/11747735/\">federal regulators decertified the hospital\u003c/a> after it was found to be out of compliance on a number of safety issues, including medication storage, hygiene practices and having a lighter near an oxygen tank.\u003c/p>\n\u003cfigure id=\"attachment_11941889\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11941889 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/GettyImages-1405644957-800x534.jpg\" alt=\"Middle-aged Latino man with glasses looks toward the camera.\" width=\"800\" height=\"534\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/GettyImages-1405644957-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/GettyImages-1405644957-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/GettyImages-1405644957-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/GettyImages-1405644957.jpg 1024w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">US Secretary of Health and Human Services Xavier Becerra during a news conference at the headquarters of HHS June 28, 2022, in Washington, DC. \u003ccite>(Alex Wong/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Despite objections from hospital and city leaders, the regulators mandated that the hospital remove as many of the patients as possible while staff simultaneously worked toward regaining certification.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11920121/sf-officials-outraged-over-laguna-honda-patient-deaths-following-federally-mandated-transfers\">Regulators paused their initial transfer requirement\u003c/a> in July 2022, after reports that some of the 57 patients who had initially been moved from the hospital had died. In total, 12 former patients are confirmed to have died, nearly all of whom had been transferred last year to other skilled nursing facilities.\u003c/p>\n\u003cp>Becerra’s tour comes months after local and national leaders including Mayor London Breed and Sen. Dianne Feinstein called on Becerra to halt involuntary patient transfers out of the hospital, which previously held more than 700 patients and now has below 600.\u003c/p>\n\u003cp>Laguna Honda is still a licensed nursing facility. But losing certification with the Centers for Medicare and Medicaid Services, which Becerra oversees, would mean cutting the 156-year-old hospital from government subsidized health care plans, which the vast majority of Laguna Honda patients rely on.\u003c/p>\n\u003cp>The hospital is now working toward recertification, and CMS has agreed to continue Medicare and Medi-Cal payments through November. And any involuntary transfers will be paused until at least May.\u003c/p>\n\u003cp>Becerra, who previously served as California attorney general, toured the facility alongside Mayor London Breed, California Health and Human Services Agency Secretary Dr. Mark Ghaly, San Francisco City Attorney David Chiu, San Francisco Public Health Department Director Grant Colfax and Laguna Honda interim CEO Roland Pickens.[aside label=\"Related Stories\" postID=\"news_11940765,news_11921717\"]Regarding progress toward recertification, Colfax said that the hospital successfully met the 126 action items that regulators told the hospital to correct in January, and that they are on track to meet the 133 milestones required by the end of February.\u003c/p>\n\u003cp>“We are really supporting a new culture of accountability,” Colfax said.\u003c/p>\n\u003cp>Some of those changes have included repeated training for staff on infection control and prevention. More than 6,000 clinical observations take place every week, where staff check whether nurses and other staff are appropriately washing hands, wearing masks, cleaning and disinfecting, according to Pickens.\u003c/p>\n\u003cp>Pickens also shared that the hospital is continuing to explore options for how to better care for patients with mental illness and substance use disorders. That will be critical to operations moving forward, because the initial series of inspections that led to the hospital getting decertified were triggered after two nonfatal overdoses occurred at the hospital with substances brought from outside.\u003c/p>\n\u003cp>Recertification likely will not occur before May, Pickens said, but he did not further speculate on the exact timeline ahead.\u003c/p>\n\u003cp>“Laguna Honda is here to serve the needs of the San Francisco community. And in our community, we know we have individuals with substance use disorders and mental illness. That doesn’t go away just because someone becomes old or elderly,” Pickens said. “We are looking at how we provide those services … and will be proposing new models for how we can do a better job at that.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>He visited the facility to observe some of the areas and processes that Laguna Honda must bring up to code in order to get recertified, such as medicine storage and cleaning, and to see how patients with mental illness and substance use disorder are cared for at the facility.\u003c/p>\n\u003cp>Reporters were not allowed on the tour, but Becerra said he spoke to nurses and patients who told him they hope he will protect Laguna Honda.\u003c/p>\n\u003cp>“Most of them said, ‘Help us keep Laguna Honda open,’” Becerra said. “A facility like this is critical to a community, and a facility like this understands it has to meet standards so that anyone who needs to send their loved ones here can know that the health and safety that we would all expect is being provided.”\u003c/p>\n\u003cp>It’s been a year of constant uncertainty and crisis for staff and patients at Laguna Honda. In 2022, \u003ca href=\"https://abc7news.com/amp/laguna-honda-hospital-san-francisco-funding-mayor-london-breed-press-conference-healthcare-in-sf/11747735/\">federal regulators decertified the hospital\u003c/a> after it was found to be out of compliance on a number of safety issues, including medication storage, hygiene practices and having a lighter near an oxygen tank.\u003c/p>\n\u003cfigure id=\"attachment_11941889\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11941889 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/GettyImages-1405644957-800x534.jpg\" alt=\"Middle-aged Latino man with glasses looks toward the camera.\" width=\"800\" height=\"534\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/GettyImages-1405644957-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/GettyImages-1405644957-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/GettyImages-1405644957-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/GettyImages-1405644957.jpg 1024w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">US Secretary of Health and Human Services Xavier Becerra during a news conference at the headquarters of HHS June 28, 2022, in Washington, DC. \u003ccite>(Alex Wong/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Despite objections from hospital and city leaders, the regulators mandated that the hospital remove as many of the patients as possible while staff simultaneously worked toward regaining certification.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11920121/sf-officials-outraged-over-laguna-honda-patient-deaths-following-federally-mandated-transfers\">Regulators paused their initial transfer requirement\u003c/a> in July 2022, after reports that some of the 57 patients who had initially been moved from the hospital had died. In total, 12 former patients are confirmed to have died, nearly all of whom had been transferred last year to other skilled nursing facilities.\u003c/p>\n\u003cp>Becerra’s tour comes months after local and national leaders including Mayor London Breed and Sen. Dianne Feinstein called on Becerra to halt involuntary patient transfers out of the hospital, which previously held more than 700 patients and now has below 600.\u003c/p>\n\u003cp>Laguna Honda is still a licensed nursing facility. But losing certification with the Centers for Medicare and Medicaid Services, which Becerra oversees, would mean cutting the 156-year-old hospital from government subsidized health care plans, which the vast majority of Laguna Honda patients rely on.\u003c/p>\n\u003cp>The hospital is now working toward recertification, and CMS has agreed to continue Medicare and Medi-Cal payments through November. And any involuntary transfers will be paused until at least May.\u003c/p>\n\u003cp>Becerra, who previously served as California attorney general, toured the facility alongside Mayor London Breed, California Health and Human Services Agency Secretary Dr. Mark Ghaly, San Francisco City Attorney David Chiu, San Francisco Public Health Department Director Grant Colfax and Laguna Honda interim CEO Roland Pickens.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Regarding progress toward recertification, Colfax said that the hospital successfully met the 126 action items that regulators told the hospital to correct in January, and that they are on track to meet the 133 milestones required by the end of February.\u003c/p>\n\u003cp>“We are really supporting a new culture of accountability,” Colfax said.\u003c/p>\n\u003cp>Some of those changes have included repeated training for staff on infection control and prevention. More than 6,000 clinical observations take place every week, where staff check whether nurses and other staff are appropriately washing hands, wearing masks, cleaning and disinfecting, according to Pickens.\u003c/p>\n\u003cp>Pickens also shared that the hospital is continuing to explore options for how to better care for patients with mental illness and substance use disorders. That will be critical to operations moving forward, because the initial series of inspections that led to the hospital getting decertified were triggered after two nonfatal overdoses occurred at the hospital with substances brought from outside.\u003c/p>\n\u003cp>Recertification likely will not occur before May, Pickens said, but he did not further speculate on the exact timeline ahead.\u003c/p>\n\u003cp>“Laguna Honda is here to serve the needs of the San Francisco community. And in our community, we know we have individuals with substance use disorders and mental illness. That doesn’t go away just because someone becomes old or elderly,” Pickens said. “We are looking at how we provide those services … and will be proposing new models for how we can do a better job at that.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003ca href=\"https://www.kqed.org/news/11942625/cuando-puedo-recibir-una-segunda-vacuna-bivalente-de-refuerzo-contra-covid-19\">\u003cem>Leer en español.\u003c/em>\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Update, 4:05 p.m. Wednesday:\u003c/strong> The Centers for Disease Control and Prevention (CDC) have announced that as of Wednesday, \u003ca href=\"https://www.cdc.gov/media/releases/2023/s0419-covid-vaccines.html\">certain people who are at higher risk of severe illness, hospitalization or death from COVID can get a second bivalent booster shot\u003c/a> from Moderna or Pfizer — specifically, people age 65 and older, and people who are immunocompromised.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11945763/can-i-get-second-bivalent-booster-cdc-who-eligible\">Read more about who can now get a second dose of the bivalent vaccine, and how to find a vaccine near you.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Original story.\u003c/strong> It’s been almost six months since \u003ca href=\"https://www.kqed.org/news/11924327/where-can-i-find-a-new-omicron-covid-booster-shot-near-me\">the bivalent COVID vaccine booster became available\u003c/a>. And many people are now wondering, “When can I get my second bivalent booster dose?”\u003c/p>\n\u003cp>The short answer: As long as you’ve already got one dose of the bivalent COVID-19 booster shot, there’s no need to rush.\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#tellus\">Tell us: What else do you need information about right now?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>That’s according to Dr. Peter Chin-Hong, infectious disease expert at UCSF, who says that most healthy people who are up to date on their COVID vaccines can expect to get another booster shot after about a year.\u003c/p>\n\u003cp>“All roads lead to an annual COVID booster,” Chin-Hong told KQED. “We know so far that immunity from the booster in general should last for about a year.”\u003c/p>\n\u003cp>“If you’ve gotten the primary series, you have protection from serious disease, hospitalization and death for at least a year — probably even longer for most people,” he said.[aside postID=news_11924327 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/RS61679_GettyImages-1241629214-qut.jpg']\u003c/p>\n\u003cp>To \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html\">be up-to-date on COVID vaccinations\u003c/a>, a person must have completed their primary vaccine series \u003cem>and\u003c/em> received the most recently recommended booster, according to the Centers for Disease Control and Prevention (CDC). \u003ca href=\"https://www.kqed.org/news/11924327/where-can-i-find-a-new-omicron-covid-booster-shot-near-me\">Find where to get a COVID bivalent booster near you.\u003c/a>\u003c/p>\n\u003cp>The updated bivalent booster, which comes as a single dose, protects against both the original virus strain and the omicron variants that have emerged and remain dominant. Federal health agencies \u003ca href=\"https://www.kqed.org/news/11924327/where-can-i-find-a-new-omicron-covid-booster-shot-near-me\">authorized the updated booster for people ages 12 and older in September and for anyone over 6 months in December\u003c/a>.\u003c/p>\n\u003ch2>\u003ca id=\"secondbivalentboosterearly\">\u003c/a>Who needs an earlier bivalent booster?\u003c/h2>\n\u003cp>People 65 and older can qualify for a second bivalent booster shot at least four months after their original bivalent shot, according to\u003ca href=\"https://www.kqed.org/news/11945610/fda-approves-second-bivalent-covid-booster-shots-for-some-people\"> forthcoming guidance from the Food and Drug Administration (FDA) and CDC obtained by NPR\u003c/a>.\u003c/p>\n\u003cp>Anyone who is immunocompromised and who received the booster shot within two months may also qualify.\u003c/p>\n\u003cp>People who are immunocompromised or who have recently had procedures that could disrupt their immune system should ask their doctor about additional bivalent booster shots and whether that’s something they could benefit from, Chin-Hong said.\u003c/p>\n\u003cp>According to NPR, \u003ca href=\"https://www.kqed.org/news/11945610/fda-approves-second-bivalent-covid-booster-shots-for-some-people\">the FDA’s latest authorization applies to only the most recent COVID vaccine\u003c/a>, a bivalent shot that’s formulated to address the dominant omicron subvariants BA.4 and BA.5.\u003c/p>\n\u003cfigure id=\"attachment_11896509\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11896509\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/GettyImages-1344322689-scaled-e1638298015129.jpg\" alt=\"A woman in a mask receives a shot from a another woman in a white lab coat.\" width=\"1920\" height=\"1369\">\u003cfigcaption class=\"wp-caption-text\">Safeway pharmacist Shahrzad Khoobyari (right) administers a Pfizer COVID-19 booster shot into the arm of Chen Knifsend at a San Rafael vaccine clinic on Oct. 1, 2021. \u003ccite>(Justin Sullivan/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Most people, however, still need to get that first bivalent shot, Chin-Hong said.\u003c/p>\n\u003cp>Just 39% of San Franciscans have received the bivalent booster, compared with 86% who completed the vaccine’s initial series, according to data from the San Francisco Department of Public Health. Across California, around a quarter of residents have received the bivalent booster, and 61% got the initial vaccine.\u003c/p>\n\u003cp>That’s concerning, Chin-Hong said, because the majority of people who are testing positive for COVID in hospitals today are either not vaccinated or not up to date on their vaccines.\u003c/p>\n\u003cp>“More than 70% of the people being hospitalized right now haven’t gotten a single booster, and the rest are unvaccinated,” Chin-Hong said. “The vast majority of vaccinated people haven’t even gotten a booster. So that’s really the focus.”\u003c/p>\n\u003cp>Local health departments are encouraging everyone to \u003ca href=\"https://www.kqed.org/news/11924327/where-can-i-find-a-new-omicron-covid-booster-shot-near-me\">get the bivalent COVID booster\u003c/a> if they have not yet already.\u003c/p>\n\u003ch2>Your immunity and booster timing\u003c/h2>\n\u003cp>Immunity provided by a booster typically starts to wear off about five or six months after the jab.\u003c/p>\n\u003cp>\u003cem>But\u003c/em> the immune system doesn’t start from scratch when a vaccine’s immunity begins to wane.\u003c/p>\n\u003cp>The vaccine provides a blueprint to the body’s cells for how to protect against COVID, Chin-Hong explained — and a booster shot acts as a “reminder” to the immune system. For the majority of people who have been infected with COVID already, that experience provides them with a layer of immunity also.\u003c/p>\n\u003cp>“The more times your system gets reminded, the longer immunity lasts,” said Chin-Hong. “That, to me, is a victory — because as an infectious disease doctor, I’m more concerned that people don’t come into the hospital, are not put in the ICU and do not die.”\u003c/p>\n\u003cp>In January, an FDA committee met to discuss \u003ca href=\"https://www.kqed.org/news/11938916/fda-considers-major-shift-in-covid-vaccine-strategy\">simplifying the COVID vaccine schedule to a single annual dose for most people\u003c/a>.\u003c/p>\n\u003cp>Under that approach, most people would be advised to get the latest version of the vaccine annually, likely in the fall or winter, similar to the flu vaccine. And also like with the flu vaccine, drug manufacturers would update the annual shot to match the dominant variant that year — like the latest bivalent COVID booster was updated to target both the original coronavirus strain \u003cem>and\u003c/em> the dominant omicron variants.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003ch2>The future of finding a COVID vaccine\u003c/h2>\n\u003cp>The recommendation comes as \u003ca href=\"https://www.kqed.org/news/11941075/californias-covid-emergency-ends-feb-28-what-does-that-actually-mean-for-you\">local, state and federal authorities are winding down many COVID programs and funding streams\u003c/a> that have provided many accessible testing, vaccination and treatment clinics.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11941075/californias-covid-emergency-ends-feb-28-what-does-that-actually-mean-for-you\">COVID vaccinations will continue to be free or covered by insurance\u003c/a> after the federal COVID emergency order ends on May 11, U.S. health officials have announced. But these may be harder to come by.\u003c/p>\n\u003cp>People who don’t have insurance could face new costs after the federal emergency order ends. However, \u003ca href=\"https://www.ltfrespuestalatina.com/covid-vaccination-testing\">some clinics, including community-based sites in San Francisco, have said they will continue to provide free vaccines\u003c/a> to uninsured residents as long as supplies are available.\u003c/p>\n\u003cp>“Having just one bivalent booster is going to take you through the year,” Chin-Hong underscored. “If everyone got the bivalent booster that they’re supposed to do, that’s really the most important point.”\u003c/p>\n\u003ch2>\u003ca id=\"tellus\">\u003c/a>Tell us: What else do you need information about?\u003c/h2>\n\u003cp>At KQED News, we know that it can sometimes be hard to track down the answers to navigate life in the Bay Area in 2023. We’ve published \u003ca href=\"https://www.kqed.org/news/tag/coronavirus-resources-and-explainers\">clear, helpful explainers and guides about COVID\u003c/a>, \u003ca href=\"https://www.kqed.org/news/11936674/how-to-prepare-for-this-weeks-atmospheric-river-storm-sandbags-emergency-kits-and-more\">how to cope with intense winter weather\u003c/a> and \u003ca href=\"https://www.kqed.org/news/11821950/how-to-safely-attend-a-protest-in-the-bay-area\">how to exercise your right to protest safely\u003c/a>.\u003c/p>\n\u003cp>So tell us: What do you need to know more about? Tell us, and you could see your question answered online or on social media. What you submit will make our reporting stronger, and help us decide what to cover here on our site, and on KQED Public Radio, too.\u003c/p>\n\u003cp>[hearken id=\"10483\" src=\"https://modules.wearehearken.com/kqed/embed/10483.js\"]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "'Everyone can brace for that shot in the arm once a year,' said Dr. Peter Chin-Hong, an infectious disease expert at UCSF.\r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"https://www.kqed.org/news/11942625/cuando-puedo-recibir-una-segunda-vacuna-bivalente-de-refuerzo-contra-covid-19\">\u003cem>Leer en español.\u003c/em>\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Update, 4:05 p.m. Wednesday:\u003c/strong> The Centers for Disease Control and Prevention (CDC) have announced that as of Wednesday, \u003ca href=\"https://www.cdc.gov/media/releases/2023/s0419-covid-vaccines.html\">certain people who are at higher risk of severe illness, hospitalization or death from COVID can get a second bivalent booster shot\u003c/a> from Moderna or Pfizer — specifically, people age 65 and older, and people who are immunocompromised.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11945763/can-i-get-second-bivalent-booster-cdc-who-eligible\">Read more about who can now get a second dose of the bivalent vaccine, and how to find a vaccine near you.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Original story.\u003c/strong> It’s been almost six months since \u003ca href=\"https://www.kqed.org/news/11924327/where-can-i-find-a-new-omicron-covid-booster-shot-near-me\">the bivalent COVID vaccine booster became available\u003c/a>. And many people are now wondering, “When can I get my second bivalent booster dose?”\u003c/p>\n\u003cp>The short answer: As long as you’ve already got one dose of the bivalent COVID-19 booster shot, there’s no need to rush.\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#tellus\">Tell us: What else do you need information about right now?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>That’s according to Dr. Peter Chin-Hong, infectious disease expert at UCSF, who says that most healthy people who are up to date on their COVID vaccines can expect to get another booster shot after about a year.\u003c/p>\n\u003cp>“All roads lead to an annual COVID booster,” Chin-Hong told KQED. “We know so far that immunity from the booster in general should last for about a year.”\u003c/p>\n\u003cp>“If you’ve gotten the primary series, you have protection from serious disease, hospitalization and death for at least a year — probably even longer for most people,” he said.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>To \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html\">be up-to-date on COVID vaccinations\u003c/a>, a person must have completed their primary vaccine series \u003cem>and\u003c/em> received the most recently recommended booster, according to the Centers for Disease Control and Prevention (CDC). \u003ca href=\"https://www.kqed.org/news/11924327/where-can-i-find-a-new-omicron-covid-booster-shot-near-me\">Find where to get a COVID bivalent booster near you.\u003c/a>\u003c/p>\n\u003cp>The updated bivalent booster, which comes as a single dose, protects against both the original virus strain and the omicron variants that have emerged and remain dominant. Federal health agencies \u003ca href=\"https://www.kqed.org/news/11924327/where-can-i-find-a-new-omicron-covid-booster-shot-near-me\">authorized the updated booster for people ages 12 and older in September and for anyone over 6 months in December\u003c/a>.\u003c/p>\n\u003ch2>\u003ca id=\"secondbivalentboosterearly\">\u003c/a>Who needs an earlier bivalent booster?\u003c/h2>\n\u003cp>People 65 and older can qualify for a second bivalent booster shot at least four months after their original bivalent shot, according to\u003ca href=\"https://www.kqed.org/news/11945610/fda-approves-second-bivalent-covid-booster-shots-for-some-people\"> forthcoming guidance from the Food and Drug Administration (FDA) and CDC obtained by NPR\u003c/a>.\u003c/p>\n\u003cp>Anyone who is immunocompromised and who received the booster shot within two months may also qualify.\u003c/p>\n\u003cp>People who are immunocompromised or who have recently had procedures that could disrupt their immune system should ask their doctor about additional bivalent booster shots and whether that’s something they could benefit from, Chin-Hong said.\u003c/p>\n\u003cp>According to NPR, \u003ca href=\"https://www.kqed.org/news/11945610/fda-approves-second-bivalent-covid-booster-shots-for-some-people\">the FDA’s latest authorization applies to only the most recent COVID vaccine\u003c/a>, a bivalent shot that’s formulated to address the dominant omicron subvariants BA.4 and BA.5.\u003c/p>\n\u003cfigure id=\"attachment_11896509\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11896509\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/GettyImages-1344322689-scaled-e1638298015129.jpg\" alt=\"A woman in a mask receives a shot from a another woman in a white lab coat.\" width=\"1920\" height=\"1369\">\u003cfigcaption class=\"wp-caption-text\">Safeway pharmacist Shahrzad Khoobyari (right) administers a Pfizer COVID-19 booster shot into the arm of Chen Knifsend at a San Rafael vaccine clinic on Oct. 1, 2021. \u003ccite>(Justin Sullivan/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Most people, however, still need to get that first bivalent shot, Chin-Hong said.\u003c/p>\n\u003cp>Just 39% of San Franciscans have received the bivalent booster, compared with 86% who completed the vaccine’s initial series, according to data from the San Francisco Department of Public Health. Across California, around a quarter of residents have received the bivalent booster, and 61% got the initial vaccine.\u003c/p>\n\u003cp>That’s concerning, Chin-Hong said, because the majority of people who are testing positive for COVID in hospitals today are either not vaccinated or not up to date on their vaccines.\u003c/p>\n\u003cp>“More than 70% of the people being hospitalized right now haven’t gotten a single booster, and the rest are unvaccinated,” Chin-Hong said. “The vast majority of vaccinated people haven’t even gotten a booster. So that’s really the focus.”\u003c/p>\n\u003cp>Local health departments are encouraging everyone to \u003ca href=\"https://www.kqed.org/news/11924327/where-can-i-find-a-new-omicron-covid-booster-shot-near-me\">get the bivalent COVID booster\u003c/a> if they have not yet already.\u003c/p>\n\u003ch2>Your immunity and booster timing\u003c/h2>\n\u003cp>Immunity provided by a booster typically starts to wear off about five or six months after the jab.\u003c/p>\n\u003cp>\u003cem>But\u003c/em> the immune system doesn’t start from scratch when a vaccine’s immunity begins to wane.\u003c/p>\n\u003cp>The vaccine provides a blueprint to the body’s cells for how to protect against COVID, Chin-Hong explained — and a booster shot acts as a “reminder” to the immune system. For the majority of people who have been infected with COVID already, that experience provides them with a layer of immunity also.\u003c/p>\n\u003cp>“The more times your system gets reminded, the longer immunity lasts,” said Chin-Hong. “That, to me, is a victory — because as an infectious disease doctor, I’m more concerned that people don’t come into the hospital, are not put in the ICU and do not die.”\u003c/p>\n\u003cp>In January, an FDA committee met to discuss \u003ca href=\"https://www.kqed.org/news/11938916/fda-considers-major-shift-in-covid-vaccine-strategy\">simplifying the COVID vaccine schedule to a single annual dose for most people\u003c/a>.\u003c/p>\n\u003cp>Under that approach, most people would be advised to get the latest version of the vaccine annually, likely in the fall or winter, similar to the flu vaccine. And also like with the flu vaccine, drug manufacturers would update the annual shot to match the dominant variant that year — like the latest bivalent COVID booster was updated to target both the original coronavirus strain \u003cem>and\u003c/em> the dominant omicron variants.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch2>The future of finding a COVID vaccine\u003c/h2>\n\u003cp>The recommendation comes as \u003ca href=\"https://www.kqed.org/news/11941075/californias-covid-emergency-ends-feb-28-what-does-that-actually-mean-for-you\">local, state and federal authorities are winding down many COVID programs and funding streams\u003c/a> that have provided many accessible testing, vaccination and treatment clinics.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11941075/californias-covid-emergency-ends-feb-28-what-does-that-actually-mean-for-you\">COVID vaccinations will continue to be free or covered by insurance\u003c/a> after the federal COVID emergency order ends on May 11, U.S. health officials have announced. But these may be harder to come by.\u003c/p>\n\u003cp>People who don’t have insurance could face new costs after the federal emergency order ends. However, \u003ca href=\"https://www.ltfrespuestalatina.com/covid-vaccination-testing\">some clinics, including community-based sites in San Francisco, have said they will continue to provide free vaccines\u003c/a> to uninsured residents as long as supplies are available.\u003c/p>\n\u003cp>“Having just one bivalent booster is going to take you through the year,” Chin-Hong underscored. “If everyone got the bivalent booster that they’re supposed to do, that’s really the most important point.”\u003c/p>\n\u003ch2>\u003ca id=\"tellus\">\u003c/a>Tell us: What else do you need information about?\u003c/h2>\n\u003cp>At KQED News, we know that it can sometimes be hard to track down the answers to navigate life in the Bay Area in 2023. We’ve published \u003ca href=\"https://www.kqed.org/news/tag/coronavirus-resources-and-explainers\">clear, helpful explainers and guides about COVID\u003c/a>, \u003ca href=\"https://www.kqed.org/news/11936674/how-to-prepare-for-this-weeks-atmospheric-river-storm-sandbags-emergency-kits-and-more\">how to cope with intense winter weather\u003c/a> and \u003ca href=\"https://www.kqed.org/news/11821950/how-to-safely-attend-a-protest-in-the-bay-area\">how to exercise your right to protest safely\u003c/a>.\u003c/p>\n\u003cp>So tell us: What do you need to know more about? Tell us, and you could see your question answered online or on social media. What you submit will make our reporting stronger, and help us decide what to cover here on our site, and on KQED Public Radio, too.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cem>\u003ca href=\"#anchor\">This report contains a correction.\u003c/a>\u003c/em>\u003c/p>\n\u003cp>A San Francisco supervisor \u003ca href=\"https://twitter.com/HillaryRonen/status/1623737084463951873/photo/1\">refused to attend an event\u003c/a> with Health and Human Services Secretary Xavier Becerra this week, citing his agency’s failure to help resolve the ongoing regulatory crisis that threatens to close the Laguna Honda Hospital and Rehabilitation Center.\u003c/p>\n\u003cp>“Instead of offering to assist the City, Becerra and his employees have done everything to threaten and punish Laguna Honda and by extension its patients,” Supervisor Hillary Ronen wrote in a letter to the executive director of the San Francisco General Hospital Foundation, which held a gala on Thursday that featured Becerra as a guest speaker.\u003c/p>\n\u003cp>“I can’t possibly go to an event featuring someone who is causing so much harm to the poorest and most vulnerable residents in San Francisco,” Ronen told KQED. “I need people to understand the damage that the secretary is doing to the people of San Francisco and the impact, and this is my way of protesting in a polite and small way.”[aside label=\"more Laguna Honda coverage\" tag=\"laguna-honda-hospital\"]Ronen and the majority of her fellow supervisors, along with Mayor London Breed and Sen. Dianne Feinstein, have called on Becerra, California’s former attorney general, to refrain from requiring the hospital to remove patients while it works toward recertification.\u003c/p>\n\u003cp>The majority of residents at Laguna Honda, one of the largest skilled nursing facilities in the country, are older and require specialized care for conditions including dementia, physical and post-stroke rehabilitation, HIV and mental illness.\u003c/p>\n\u003cp>But last year, \u003ca href=\"https://abc7news.com/amp/laguna-honda-hospital-san-francisco-funding-mayor-london-breed-press-conference-healthcare-in-sf/11747735/\">after Laguna Honda failed a series of federal on-site safety inspections\u003c/a>, a division of Becerra’s agency suspended government-provided health care options like Medicare and Medi-Cal, which make up the bulk of its funding. The hospital was subsequently ordered to immediately begin transferring or discharging patients.\u003c/p>\n\u003cp>The result was disastrous: Twelve of the 57 patients initially transferred from the hospital last summer — some of whom had dementia and limited physical and cognitive ability — died within weeks or months of being relocated.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.kqed.org/news/11939987/feds-grant-reprieve-on-laguna-honda-patient-transfers-until-may\">hospital now has until at least May to hold off\u003c/a> on transferring its remaining patients, following an 11th-hour federal reprieve earlier this month.\u003c/p>\n\u003cp>“That is causing everyone unneeded stress. Just say [patient transfers] are off the table during the recertification process,” Ronen said.\u003c/p>\n\u003cp>Becerra, who has rarely spoken publicly about Laguna Honda, told reporters he’s optimistic the 156-year-old facility will remain open, saying, “Laguna Honda is showing good faith and trying to move forward.”\u003c/p>\n\u003cp>But Becerra also said his hands are tied.\u003c/p>\n\u003cp>“We are, by law, required to make sure that patients are cared for safely and with the care they’re supposed to have,” he said during a press event on Thursday at Wellman’s Pharmacy in San Francisco’s Chinatown. “That’s outlined very clearly. We have no choice by law but to say that the safety of patients must come first.”\u003c/p>\n\u003cp>Ronen said Becerra also declined an invitation this week from Mayor London Breed — whose cousin and grandmother both received care at Laguna Honda — to see the hospital for himself. Neither Breed nor Becerra responded to requests for comment by publication time.\u003c/p>\n\u003cp>On Saturday, a spokesperson for Becerra disputed that he had declined the invitation, saying, “He wants to visit Laguna Honda and plans to do so in the coming weeks.”\u003c/p>\n\u003cp>Ronen acknowledged the serious deficiencies the hospital was cited for last year, including improper medication storage and illicit substances on site, but insisted those issues could be resolved without the simultaneous threat of having to move patients out.\u003c/p>\n\u003cp>Ronen also said she was recently told that the hospital, which currently has an interim CEO, may have to hire a permanent leader in order to be federally recertified. But it’s been nearly impossible to find someone qualified to take over an institution that’s facing the constant threat of closure, she said.\u003c/p>\n\u003cp>“We are gumming up our entire hospital system, and frankly the homeless crisis in our streets is made worse by this,” Ronen said, pointing to how the hospital takes in many older, lower-income San Franciscans with complex health needs. “We are begging for fairness at this point.”\u003c/p>\n\u003cp>\u003cem>This story has been updated to include a response from a U.S. Health and Human Services spokesperson received on Feb. 11.\u003c/em>\u003c/p>\n\u003cp>\u003ca id=\"anchor\">\u003c/a>\u003cem>Feb. 13: The original version of this story stated that Health and Human Services Secretary Xavier Becerra was honored at a San Francisco General Hospital Foundation event on Feb. 9. In fact, he spoke at the event but was not officially honored.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Ronen and the majority of her fellow supervisors, along with Mayor London Breed and Sen. Dianne Feinstein, have called on Becerra, California’s former attorney general, to refrain from requiring the hospital to remove patients while it works toward recertification.\u003c/p>\n\u003cp>The majority of residents at Laguna Honda, one of the largest skilled nursing facilities in the country, are older and require specialized care for conditions including dementia, physical and post-stroke rehabilitation, HIV and mental illness.\u003c/p>\n\u003cp>But last year, \u003ca href=\"https://abc7news.com/amp/laguna-honda-hospital-san-francisco-funding-mayor-london-breed-press-conference-healthcare-in-sf/11747735/\">after Laguna Honda failed a series of federal on-site safety inspections\u003c/a>, a division of Becerra’s agency suspended government-provided health care options like Medicare and Medi-Cal, which make up the bulk of its funding. The hospital was subsequently ordered to immediately begin transferring or discharging patients.\u003c/p>\n\u003cp>The result was disastrous: Twelve of the 57 patients initially transferred from the hospital last summer — some of whom had dementia and limited physical and cognitive ability — died within weeks or months of being relocated.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.kqed.org/news/11939987/feds-grant-reprieve-on-laguna-honda-patient-transfers-until-may\">hospital now has until at least May to hold off\u003c/a> on transferring its remaining patients, following an 11th-hour federal reprieve earlier this month.\u003c/p>\n\u003cp>“That is causing everyone unneeded stress. Just say [patient transfers] are off the table during the recertification process,” Ronen said.\u003c/p>\n\u003cp>Becerra, who has rarely spoken publicly about Laguna Honda, told reporters he’s optimistic the 156-year-old facility will remain open, saying, “Laguna Honda is showing good faith and trying to move forward.”\u003c/p>\n\u003cp>But Becerra also said his hands are tied.\u003c/p>\n\u003cp>“We are, by law, required to make sure that patients are cared for safely and with the care they’re supposed to have,” he said during a press event on Thursday at Wellman’s Pharmacy in San Francisco’s Chinatown. “That’s outlined very clearly. We have no choice by law but to say that the safety of patients must come first.”\u003c/p>\n\u003cp>Ronen said Becerra also declined an invitation this week from Mayor London Breed — whose cousin and grandmother both received care at Laguna Honda — to see the hospital for himself. Neither Breed nor Becerra responded to requests for comment by publication time.\u003c/p>\n\u003cp>On Saturday, a spokesperson for Becerra disputed that he had declined the invitation, saying, “He wants to visit Laguna Honda and plans to do so in the coming weeks.”\u003c/p>\n\u003cp>Ronen acknowledged the serious deficiencies the hospital was cited for last year, including improper medication storage and illicit substances on site, but insisted those issues could be resolved without the simultaneous threat of having to move patients out.\u003c/p>\n\u003cp>Ronen also said she was recently told that the hospital, which currently has an interim CEO, may have to hire a permanent leader in order to be federally recertified. But it’s been nearly impossible to find someone qualified to take over an institution that’s facing the constant threat of closure, she said.\u003c/p>\n\u003cp>“We are gumming up our entire hospital system, and frankly the homeless crisis in our streets is made worse by this,” Ronen said, pointing to how the hospital takes in many older, lower-income San Franciscans with complex health needs. “We are begging for fairness at this point.”\u003c/p>\n\u003cp>\u003cem>This story has been updated to include a response from a U.S. Health and Human Services spokesperson received on Feb. 11.\u003c/em>\u003c/p>\n\u003cp>\u003ca id=\"anchor\">\u003c/a>\u003cem>Feb. 13: The original version of this story stated that Health and Human Services Secretary Xavier Becerra was honored at a San Francisco General Hospital Foundation event on Feb. 9. In fact, he spoke at the event but was not officially honored.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Children in California won’t have to get the coronavirus vaccine to attend schools, state public health officials confirmed Friday, ending \u003ca href=\"https://apnews.com/article/coronavirus-pandemic-health-education-california-gavin-newsom-575ef3be2c5c2600664fa48c08041abd\">one of the last major restrictions of the pandemic in the nation’s most populous state\u003c/a>.\u003c/p>\n\u003cp>Gov. Gavin Newsom first announced the policy in 2021, saying it would eventually apply to all of California’s 6.7 million public and private schoolchildren.[pullquote size=\"medium\" align=\"right\" citation=\"Jonathan Zachreson, founder, Reopen California Schools\"]‘This is long overdue. … A lot of families have been stressed from this decision and worried about it for quite some time.’[/pullquote]\u003c/p>\n\u003cp>But since then, the crisis first caused by a mysterious virus in late 2019 has mostly receded from public consciousness. COVID-19 is still widespread, but the availability of multiple vaccines has lessened the virus’s effects for many — offering relief to what had been an overwhelmed public health system.\u003c/p>\n\u003cp>Nearly all of the pandemic restrictions put in place by Newsom have been lifted, and he won’t be able to issue any new ones after Feb. 28, when \u003ca href=\"https://apnews.com/article/health-california-covid-gavin-newsom-government-and-politics-0a013cc71e580d33fe59f93bc6c2b16e\">the state’s coronavirus emergency declaration officially ends\u003c/a>.\u003c/p>\n\u003cp>One of the last remaining questions was what would happen to the state’s vaccine mandate for schoolchildren, a policy that came from the California Department of Public Health and was not affected by the lifting of the emergency declaration.\u003c/p>\n\u003cp>Friday, the Department of Public Health confirmed it was backing off its original plan.\u003c/p>\n\u003cp>“CDPH is not currently exploring emergency rulemaking to add COVID-19 to the list of required school vaccinations, but we continue to strongly recommend COVID-19 immunization for students and staff to keep everyone safer in the classroom,” the department said in a statement. “Any changes to required K-12 immunizations are properly addressed through the legislative process.”[aside postID=\"news_11938916,news_11938623\" label=\"Related Posts\"]The announcement was welcome news for Jonathan Zachreson, a father of three who lives in Roseville. Zachreson founded the group Reopen California Schools to oppose many of the state’s coronavirus policies. His activism led to him being elected to the Roseville City School District board in November.\u003c/p>\n\u003cp>“This is long overdue. … A lot of families have been stressed from this decision and worried about it for quite some time,” he said. “I wish CDPH would make a bigger statement publicly or Newsom would make a public statement … to let families know and school districts know that this is no longer going to be an issue for them.”\u003c/p>\n\u003cp>Representatives for Newsom did not respond to an email requesting comment.\u003c/p>\n\u003cp>California has had lots of influence over the country’s pandemic policies. It was the first state to issue a statewide stay-at-home order — and other states were swift to follow.\u003c/p>\n\u003cp>But most states did not follow California’s lead when it came to the vaccine mandate for public schools. Officials in Louisiana announced a similar mandate, \u003ca href=\"https://apnews.com/article/covid-health-louisiana-john-bel-edwards-government-and-politics-8701c884fa21879dd7fe06ab5abc2bee\">but later backed off\u003c/a>. Schools in the District of Columbia plan to require the COVID-19 vaccine starting in the fall.\u003c/p>\n\u003cp>Republican U.S. Rep. Kevin Kiley, a former member of the state Assembly who challenged Newsom in a failed recall attempt in 2021 over his pandemic policies, published a blog post declaring: “We won. To Gavin Newsom: You lost.”\u003c/p>\n\u003cp>Kevin Gordon, a lobbyist representing most of the state’s school districts, said he did not think the policy change was the result of political pressure by Republicans, but instead a reflection of the virus’s slowing transmission rates.\u003c/p>\n\u003cp>“The public’s appetite for these kinds of mandates is definitely not what it used to be,” he said. “If you started to now impose a heavy mandate when the amount of transmission is significantly lower than it was statewide, a one-size-fits-all solution doesn’t work right now.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Children in California won’t have to get the coronavirus vaccine to attend schools, state public health officials confirmed Friday, ending \u003ca href=\"https://apnews.com/article/coronavirus-pandemic-health-education-california-gavin-newsom-575ef3be2c5c2600664fa48c08041abd\">one of the last major restrictions of the pandemic in the nation’s most populous state\u003c/a>.\u003c/p>\n\u003cp>Gov. Gavin Newsom first announced the policy in 2021, saying it would eventually apply to all of California’s 6.7 million public and private schoolchildren.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But since then, the crisis first caused by a mysterious virus in late 2019 has mostly receded from public consciousness. COVID-19 is still widespread, but the availability of multiple vaccines has lessened the virus’s effects for many — offering relief to what had been an overwhelmed public health system.\u003c/p>\n\u003cp>Nearly all of the pandemic restrictions put in place by Newsom have been lifted, and he won’t be able to issue any new ones after Feb. 28, when \u003ca href=\"https://apnews.com/article/health-california-covid-gavin-newsom-government-and-politics-0a013cc71e580d33fe59f93bc6c2b16e\">the state’s coronavirus emergency declaration officially ends\u003c/a>.\u003c/p>\n\u003cp>One of the last remaining questions was what would happen to the state’s vaccine mandate for schoolchildren, a policy that came from the California Department of Public Health and was not affected by the lifting of the emergency declaration.\u003c/p>\n\u003cp>Friday, the Department of Public Health confirmed it was backing off its original plan.\u003c/p>\n\u003cp>“CDPH is not currently exploring emergency rulemaking to add COVID-19 to the list of required school vaccinations, but we continue to strongly recommend COVID-19 immunization for students and staff to keep everyone safer in the classroom,” the department said in a statement. “Any changes to required K-12 immunizations are properly addressed through the legislative process.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The announcement was welcome news for Jonathan Zachreson, a father of three who lives in Roseville. Zachreson founded the group Reopen California Schools to oppose many of the state’s coronavirus policies. His activism led to him being elected to the Roseville City School District board in November.\u003c/p>\n\u003cp>“This is long overdue. … A lot of families have been stressed from this decision and worried about it for quite some time,” he said. “I wish CDPH would make a bigger statement publicly or Newsom would make a public statement … to let families know and school districts know that this is no longer going to be an issue for them.”\u003c/p>\n\u003cp>Representatives for Newsom did not respond to an email requesting comment.\u003c/p>\n\u003cp>California has had lots of influence over the country’s pandemic policies. It was the first state to issue a statewide stay-at-home order — and other states were swift to follow.\u003c/p>\n\u003cp>But most states did not follow California’s lead when it came to the vaccine mandate for public schools. Officials in Louisiana announced a similar mandate, \u003ca href=\"https://apnews.com/article/covid-health-louisiana-john-bel-edwards-government-and-politics-8701c884fa21879dd7fe06ab5abc2bee\">but later backed off\u003c/a>. Schools in the District of Columbia plan to require the COVID-19 vaccine starting in the fall.\u003c/p>\n\u003cp>Republican U.S. Rep. Kevin Kiley, a former member of the state Assembly who challenged Newsom in a failed recall attempt in 2021 over his pandemic policies, published a blog post declaring: “We won. To Gavin Newsom: You lost.”\u003c/p>\n\u003cp>Kevin Gordon, a lobbyist representing most of the state’s school districts, said he did not think the policy change was the result of political pressure by Republicans, but instead a reflection of the virus’s slowing transmission rates.\u003c/p>\n\u003cp>“The public’s appetite for these kinds of mandates is definitely not what it used to be,” he said. “If you started to now impose a heavy mandate when the amount of transmission is significantly lower than it was statewide, a one-size-fits-all solution doesn’t work right now.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>A year has passed since a massive statewide effort called \u003ca href=\"https://www.dhcs.ca.gov/calaim\">CalAIM\u003c/a> began rolling out. Among several significant changes CalAIM promised: an overhaul of the availability of mental health care for young people insured by Medi-Cal, the public insurance program for lower-income Californians.\u003c/p>\n\u003cp>Advocates for youth mental health say they remain enthusiastic about CalAIM’s potential, using words like “game-changing” and “transformational.”\u003c/p>\n\u003cp>But they also say the new framework is being born at a tricky time. Three years into the pandemic, provider burnout and escalating patient need have combined to create a severe \u003ca href=\"https://calmatters.org/health/2022/09/california-shortage-mental-health-workers/\">mental health workforce shortage\u003c/a>. Meanwhile, community-based organizations that provide many of the mental health services outlined under CalAIM say they feel left out of the loop in important conversations about coming payment reforms.[pullquote size=\"medium\" align=\"right\" citation=\"Adrienne Shilton, director of public policy, California Alliance of Child and Family Services\"]‘Where are the people who are going to be delivering these services?’[/pullquote]\u003c/p>\n\u003cp>Gov. Gavin \u003ca href=\"https://ebudget.ca.gov/2023-24/pdf/BudgetSummary/HealthandHumanServices.pdf\">Newsom’s budget proposal (PDF)\u003c/a> — which would delay certain behavioral health investments to combat a \u003ca href=\"https://calmatters.org/california-budget/2023/01/california-budget-newsom-deficit/\">projected $22 billion deficit\u003c/a> — also risks hampering progress for CalAIM.\u003c/p>\n\u003cp>“Our members are really panicked right now,” said Adrienne Shilton, director of public policy for the nonprofit California Alliance of Child and Family Services. In September 2022, hers was one of a dozen organizations that signed \u003ca href=\"https://www.documentcloud.org/documents/23587669-final-dhcs-letter-on-rates-9-12-2022-2\">a letter to the state Department of Health Care Services\u003c/a> expressing concerns about a lack of transparency around the new rate structure.\u003c/p>\n\u003cp>“Providers must have the ability to plan and prepare alongside their county partners,” it said. Shilton’s organization also co-authored \u003ca href=\"https://calmatters.org/wp-content/uploads/2022/06/CA-Alliance-and-CBHDA-Feedback-on-BHCIP-Funding-Delays.pdf\">a letter Wednesday to legislators (PDF)\u003c/a>, decrying the proposed budget delays.\u003c/p>\n\u003cp>Shilton told CalMatters earlier that other issues CalAIM is meant to address, including alleviating burdensome documentation requirements, have yet to change the on-the-ground reality for many providers.[aside postID=\"news_11926757,news_11934623\" label=\"Related Posts\"]\u003ca href=\"https://www.dhcs.ca.gov/calaim\">CalAIM\u003c/a> is about much more than mental health. The initiative, short for California Advancing and Innovating Medi-Cal, is a five-year plan that began rolling out a year ago. It aims to provide children and adults insured by Medi-Cal with better access to a range of health and mental health services. It also strives to use a \u003ca href=\"https://calmatters.org/health/2022/02/california-medi-cal-reform/\">“whole person care”\u003c/a> approach to addressing social issues that affect health, including housing and food insecurity.\u003c/p>\n\u003cp>It also redesigns the payment system to more seamlessly integrate the county mental health plans and managed care organizations that pay for those services.\u003c/p>\n\u003cp>The relevance and urgency of addressing children’s mental health is especially clear: Racism. School closures. Online bullying. Climate disaster. A pandemic pocked with grief, loss and fear.\u003c/p>\n\u003cp>All of these factors have aggravated a youth mental health crisis that’s been raging for more than a decade. Incidence of \u003ca href=\"https://www.auditor.ca.gov/pdfs/reports/2019-125.pdf\">self-harm for young people, which increased dramatically (PDF)\u003c/a> even before the pandemic, has \u003ca href=\"https://calmatters.org/health/2021/09/children-suicide-residential-treatment-crisis-california/\">spiked further\u003c/a> in the past few years.\u003c/p>\n\u003cp>CalAIM has not yet significantly shifted the on-the-ground reality for many of these young people, experts say, but a number of important policy changes are officially underway:\u003c/p>\n\u003cul>\n\u003cli>About 40% of the state’s children and youth are insured by Medi-Cal. They no longer need a formal diagnosis to access specialty mental health services.\u003c/li>\n\u003cli>The state has simplified behavioral health documentation requirements.\u003c/li>\n\u003cli>A “No Wrong Door Policy” should make it easier for children and adults to receive behavioral health care no matter where they enter the system, replacing what can feel like a bureaucratic maze that varies by county.\u003c/li>\n\u003cli>An “enhanced care management” benefit provides services and case management to members of priority populations, including those who are unhoused, experiencing early psychosis or involved with the child welfare or criminal justice systems.\u003c/li>\n\u003c/ul>\n\u003cp>Other efforts, including changing the way mental health services are paid for, also are rolling out this year.\u003c/p>\n\u003cp>Newsom’s administration, which early on made behavioral health a signature issue, is simultaneously unveiling several other ambitious initiatives, all of which require additional staffing and funding: a statewide program to set up new court systems to address the needs of people with severe mental illness, known as \u003ca href=\"https://calmatters.org/housing/2022/09/california-lawmakers-approved-care-court-what-comes-next/\">CARE Court\u003c/a>; expanded crisis response services through state funding \u003ca href=\"https://calmatters.org/health/2022/07/california-mental-health-crisis-hotline/\">for a 988 hotline\u003c/a>; and a \u003ca href=\"https://calmatters.org/health/2022/03/california-children-mental-health-crisis/\">major initiative to improve mental health care for children and youth\u003c/a>, parts of which will be\u003ca href=\"https://www.chhs.ca.gov/wp-content/uploads/2022/10/CYBHI-101-Deck-September-2022.pdf\"> affected by the proposed budget delays (PDF)\u003c/a>.\u003c/p>\n\u003cp>Despite belt-tightening in other areas of the governor’s proposed January budget, CalAIM continues to be funded. Newsom’s proposal would dedicate more than $10 billion to CalAIM implementation, including \u003ca href=\"https://www.dhcs.ca.gov/CalAIM/Pages/CalBH-CBC.aspx\">$6.1 billion over five years\u003c/a> to improve local treatment services and pay for short-term stays in treatment facilities for people with serious mental and behavioral health illnesses.\u003c/p>\n\u003cp>“We’re committed. We’re not touching that,” he said in a press conference earlier this month.\u003c/p>\n\u003cp>The budget proposal does, however, delay more than $1.1 billion in other behavioral health investments over the next two years, including money intended to increase treatment capacity for adults and kids in crisis, and money for workforce development. These \u003ca href=\"https://www.infrastructure.buildingcalhhs.com/wp-content/uploads/2022/05/BHCIP-and-CCE-Infrastructure-Funds-Status-Legislative-Update-April-2022-Update.pdf\">investments were intended in part to shore up CalAIM’s goals (PDF)\u003c/a>, according to state documents.\u003c/p>\n\u003cp>“We’re concerned about the delays,” Shilton said. “This is funding outside of CalAIM but … the system is so stressed. Having this additional investment from the state was really beneficial.”\u003c/p>\n\u003cp>The governor’s office did not respond to questions about the proposed funding delays. He will revise his budget proposal in May, based on actual state revenue, and hammer out a final funding deal with legislators in June.\u003c/p>\n\u003cp>While CalAIM is an important step toward meeting the mental health needs of vulnerable young people, experts say staffing shortages, especially, are complicating the picture. As a result, some say, it’s not yet clear how and when official policy changes will translate into better mental health treatment for individuals. The proposed budget would delay nearly $400 million for health care workforce training, including some social work and behavioral health pipeline programs.\u003c/p>\n\u003cp>“Where are the people who are going to be delivering these services?” Shilton said.\u003c/p>\n\u003cp>Michelle Cabrera, executive director of the County Behavioral Health Directors Association of California, calls CalAIM “an uber-ambitious reform agenda that’s sitting on top of a system that’s really been through the storm.”\u003c/p>\n\u003cp>Counties are being asked to implement “ambitious, sweeping new reforms on top of the worst workforce crisis we’ve ever seen,” she said.\u003c/p>\n\u003cp>In an emailed response to CalMatters, the Department of Health Care Services said the Newsom administration is committed to “collaborating closely” with counties, health plans and others to plan, implement and monitor the various “unprecedented and intersecting initiatives.”\u003c/p>\n\u003cp>Still, community-based organizations that contract with counties and managed care organizations to provide mental health services say they are worried about the payment they will receive for their services and how that could affect their ability to recruit and retain necessary staff.\u003c/p>\n\u003cp>Jodi Kurata, chief executive officer of the Association of Community Human Service Agencies, which represents nonprofit organizations in Los Angeles, said the groups she works with are too overwhelmed dealing with workforce shortages to focus on the administrative transformation underway.\u003c/p>\n\u003cp>“The system right now is just so depleted,” she said.\u003c/p>\n\u003cp>She said she worries that inadequate rates could lead to a further exodus of nonprofit mental health care providers from the Medi-Cal system, a concern others have echoed.\u003c/p>\n\u003cp>The state says a preliminary draft of revised payment rates has been shared with counties. The Department of Health Care Services said it has committed to publishing a fee schedule in the first few months of this year.\u003c/p>\n\u003cp>Cabrera, of the County Behavioral Health Directors Association, said CalAIM’s new payment structure marks an important shift in that the state will now allow counties to pay providers without being capped, and will remove many burdensome documentation requirements. She said counties are just now seeing the new rates, and that the administration’s “aggressive” timeline will likely lead to a “bumpy ride this year” before ultimately resulting in a positive change.\u003c/p>\n\u003ch2>When care depends on your county\u003c/h2>\n\u003cp>Other longstanding funding problems remain unaddressed. This past fall, Young Minds Advocacy, a children’s mental health advocacy organization, published a report showing that \u003ca href=\"https://static1.squarespace.com/static/5e8cda3fbb668903f24a24ca/t/638787ce2c4a6b17b39c295f/1669826513743/30NOV2022_YMA_REPORT.pdf\">longstanding variability in the way the state funds county specialty mental health services has translated into disparities (PDF)\u003c/a> in the kinds of intensive care offered to young Medi-Cal enrollees.\u003c/p>\n\u003cp>For decades, said Patrick Gardner, an attorney who founded the advocacy organization, the state has underfunded certain counties, “and their performance has suffered accordingly, sometimes pretty dramatically.”\u003c/p>\n\u003cp>In his report, Gardner found that counties with significantly lower-than-average state funding generally provided young people with less intensive services than counties with significantly higher-than-average state funding. According to his report, in 2019–20, poorly funded San Joaquin and Madera counties provided just 16% and 17% of the estimated need for care, while the better-funded Santa Clara and Butte counties provided 86%.\u003c/p>\n\u003cp>While CalAIM is moving “in the right direction,” Gardner said, it fails to address this fundamental issue. (Cabrera contends that the analysis fails to capture the services that counties provide without billing Medi-Cal.)\u003c/p>\n\u003cp>Despite these concerns, many mental health care advocates say they are witnessing important changes to the way care is delivered under CalAIM.\u003c/p>\n\u003cp>“We are seeing shifts happening already,” said Leticia Galyean, CEO and president of Seneca Family of Agencies. She said her organization — which serves youth and families in 14 counties — is especially seeing “an immediate benefit” in terms of faster access to specialty mental health care for foster youth, unhoused youth and those involved in the juvenile justice system.\u003c/p>\n\u003cp>Brian Blalock, senior staff attorney at the Youth Law Center, which advocates for youth in the child welfare and juvenile justice systems, called CalAIM “the most important thing California has done in a long time.”\u003c/p>\n\u003cp>“There’s just tremendous opportunity there,” he said.\u003c/p>\n\u003cp>Now, he added, “we as a state can go in either direction — either we realize that promise, or we let this pass us by.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A year has passed since a massive statewide effort called \u003ca href=\"https://www.dhcs.ca.gov/calaim\">CalAIM\u003c/a> began rolling out. Among several significant changes CalAIM promised: an overhaul of the availability of mental health care for young people insured by Medi-Cal, the public insurance program for lower-income Californians.\u003c/p>\n\u003cp>Advocates for youth mental health say they remain enthusiastic about CalAIM’s potential, using words like “game-changing” and “transformational.”\u003c/p>\n\u003cp>But they also say the new framework is being born at a tricky time. Three years into the pandemic, provider burnout and escalating patient need have combined to create a severe \u003ca href=\"https://calmatters.org/health/2022/09/california-shortage-mental-health-workers/\">mental health workforce shortage\u003c/a>. Meanwhile, community-based organizations that provide many of the mental health services outlined under CalAIM say they feel left out of the loop in important conversations about coming payment reforms.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Gov. Gavin \u003ca href=\"https://ebudget.ca.gov/2023-24/pdf/BudgetSummary/HealthandHumanServices.pdf\">Newsom’s budget proposal (PDF)\u003c/a> — which would delay certain behavioral health investments to combat a \u003ca href=\"https://calmatters.org/california-budget/2023/01/california-budget-newsom-deficit/\">projected $22 billion deficit\u003c/a> — also risks hampering progress for CalAIM.\u003c/p>\n\u003cp>“Our members are really panicked right now,” said Adrienne Shilton, director of public policy for the nonprofit California Alliance of Child and Family Services. In September 2022, hers was one of a dozen organizations that signed \u003ca href=\"https://www.documentcloud.org/documents/23587669-final-dhcs-letter-on-rates-9-12-2022-2\">a letter to the state Department of Health Care Services\u003c/a> expressing concerns about a lack of transparency around the new rate structure.\u003c/p>\n\u003cp>“Providers must have the ability to plan and prepare alongside their county partners,” it said. Shilton’s organization also co-authored \u003ca href=\"https://calmatters.org/wp-content/uploads/2022/06/CA-Alliance-and-CBHDA-Feedback-on-BHCIP-Funding-Delays.pdf\">a letter Wednesday to legislators (PDF)\u003c/a>, decrying the proposed budget delays.\u003c/p>\n\u003cp>Shilton told CalMatters earlier that other issues CalAIM is meant to address, including alleviating burdensome documentation requirements, have yet to change the on-the-ground reality for many providers.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003ca href=\"https://www.dhcs.ca.gov/calaim\">CalAIM\u003c/a> is about much more than mental health. The initiative, short for California Advancing and Innovating Medi-Cal, is a five-year plan that began rolling out a year ago. It aims to provide children and adults insured by Medi-Cal with better access to a range of health and mental health services. It also strives to use a \u003ca href=\"https://calmatters.org/health/2022/02/california-medi-cal-reform/\">“whole person care”\u003c/a> approach to addressing social issues that affect health, including housing and food insecurity.\u003c/p>\n\u003cp>It also redesigns the payment system to more seamlessly integrate the county mental health plans and managed care organizations that pay for those services.\u003c/p>\n\u003cp>The relevance and urgency of addressing children’s mental health is especially clear: Racism. School closures. Online bullying. Climate disaster. A pandemic pocked with grief, loss and fear.\u003c/p>\n\u003cp>All of these factors have aggravated a youth mental health crisis that’s been raging for more than a decade. Incidence of \u003ca href=\"https://www.auditor.ca.gov/pdfs/reports/2019-125.pdf\">self-harm for young people, which increased dramatically (PDF)\u003c/a> even before the pandemic, has \u003ca href=\"https://calmatters.org/health/2021/09/children-suicide-residential-treatment-crisis-california/\">spiked further\u003c/a> in the past few years.\u003c/p>\n\u003cp>CalAIM has not yet significantly shifted the on-the-ground reality for many of these young people, experts say, but a number of important policy changes are officially underway:\u003c/p>\n\u003cul>\n\u003cli>About 40% of the state’s children and youth are insured by Medi-Cal. They no longer need a formal diagnosis to access specialty mental health services.\u003c/li>\n\u003cli>The state has simplified behavioral health documentation requirements.\u003c/li>\n\u003cli>A “No Wrong Door Policy” should make it easier for children and adults to receive behavioral health care no matter where they enter the system, replacing what can feel like a bureaucratic maze that varies by county.\u003c/li>\n\u003cli>An “enhanced care management” benefit provides services and case management to members of priority populations, including those who are unhoused, experiencing early psychosis or involved with the child welfare or criminal justice systems.\u003c/li>\n\u003c/ul>\n\u003cp>Other efforts, including changing the way mental health services are paid for, also are rolling out this year.\u003c/p>\n\u003cp>Newsom’s administration, which early on made behavioral health a signature issue, is simultaneously unveiling several other ambitious initiatives, all of which require additional staffing and funding: a statewide program to set up new court systems to address the needs of people with severe mental illness, known as \u003ca href=\"https://calmatters.org/housing/2022/09/california-lawmakers-approved-care-court-what-comes-next/\">CARE Court\u003c/a>; expanded crisis response services through state funding \u003ca href=\"https://calmatters.org/health/2022/07/california-mental-health-crisis-hotline/\">for a 988 hotline\u003c/a>; and a \u003ca href=\"https://calmatters.org/health/2022/03/california-children-mental-health-crisis/\">major initiative to improve mental health care for children and youth\u003c/a>, parts of which will be\u003ca href=\"https://www.chhs.ca.gov/wp-content/uploads/2022/10/CYBHI-101-Deck-September-2022.pdf\"> affected by the proposed budget delays (PDF)\u003c/a>.\u003c/p>\n\u003cp>Despite belt-tightening in other areas of the governor’s proposed January budget, CalAIM continues to be funded. Newsom’s proposal would dedicate more than $10 billion to CalAIM implementation, including \u003ca href=\"https://www.dhcs.ca.gov/CalAIM/Pages/CalBH-CBC.aspx\">$6.1 billion over five years\u003c/a> to improve local treatment services and pay for short-term stays in treatment facilities for people with serious mental and behavioral health illnesses.\u003c/p>\n\u003cp>“We’re committed. We’re not touching that,” he said in a press conference earlier this month.\u003c/p>\n\u003cp>The budget proposal does, however, delay more than $1.1 billion in other behavioral health investments over the next two years, including money intended to increase treatment capacity for adults and kids in crisis, and money for workforce development. These \u003ca href=\"https://www.infrastructure.buildingcalhhs.com/wp-content/uploads/2022/05/BHCIP-and-CCE-Infrastructure-Funds-Status-Legislative-Update-April-2022-Update.pdf\">investments were intended in part to shore up CalAIM’s goals (PDF)\u003c/a>, according to state documents.\u003c/p>\n\u003cp>“We’re concerned about the delays,” Shilton said. “This is funding outside of CalAIM but … the system is so stressed. Having this additional investment from the state was really beneficial.”\u003c/p>\n\u003cp>The governor’s office did not respond to questions about the proposed funding delays. He will revise his budget proposal in May, based on actual state revenue, and hammer out a final funding deal with legislators in June.\u003c/p>\n\u003cp>While CalAIM is an important step toward meeting the mental health needs of vulnerable young people, experts say staffing shortages, especially, are complicating the picture. As a result, some say, it’s not yet clear how and when official policy changes will translate into better mental health treatment for individuals. The proposed budget would delay nearly $400 million for health care workforce training, including some social work and behavioral health pipeline programs.\u003c/p>\n\u003cp>“Where are the people who are going to be delivering these services?” Shilton said.\u003c/p>\n\u003cp>Michelle Cabrera, executive director of the County Behavioral Health Directors Association of California, calls CalAIM “an uber-ambitious reform agenda that’s sitting on top of a system that’s really been through the storm.”\u003c/p>\n\u003cp>Counties are being asked to implement “ambitious, sweeping new reforms on top of the worst workforce crisis we’ve ever seen,” she said.\u003c/p>\n\u003cp>In an emailed response to CalMatters, the Department of Health Care Services said the Newsom administration is committed to “collaborating closely” with counties, health plans and others to plan, implement and monitor the various “unprecedented and intersecting initiatives.”\u003c/p>\n\u003cp>Still, community-based organizations that contract with counties and managed care organizations to provide mental health services say they are worried about the payment they will receive for their services and how that could affect their ability to recruit and retain necessary staff.\u003c/p>\n\u003cp>Jodi Kurata, chief executive officer of the Association of Community Human Service Agencies, which represents nonprofit organizations in Los Angeles, said the groups she works with are too overwhelmed dealing with workforce shortages to focus on the administrative transformation underway.\u003c/p>\n\u003cp>“The system right now is just so depleted,” she said.\u003c/p>\n\u003cp>She said she worries that inadequate rates could lead to a further exodus of nonprofit mental health care providers from the Medi-Cal system, a concern others have echoed.\u003c/p>\n\u003cp>The state says a preliminary draft of revised payment rates has been shared with counties. The Department of Health Care Services said it has committed to publishing a fee schedule in the first few months of this year.\u003c/p>\n\u003cp>Cabrera, of the County Behavioral Health Directors Association, said CalAIM’s new payment structure marks an important shift in that the state will now allow counties to pay providers without being capped, and will remove many burdensome documentation requirements. She said counties are just now seeing the new rates, and that the administration’s “aggressive” timeline will likely lead to a “bumpy ride this year” before ultimately resulting in a positive change.\u003c/p>\n\u003ch2>When care depends on your county\u003c/h2>\n\u003cp>Other longstanding funding problems remain unaddressed. This past fall, Young Minds Advocacy, a children’s mental health advocacy organization, published a report showing that \u003ca href=\"https://static1.squarespace.com/static/5e8cda3fbb668903f24a24ca/t/638787ce2c4a6b17b39c295f/1669826513743/30NOV2022_YMA_REPORT.pdf\">longstanding variability in the way the state funds county specialty mental health services has translated into disparities (PDF)\u003c/a> in the kinds of intensive care offered to young Medi-Cal enrollees.\u003c/p>\n\u003cp>For decades, said Patrick Gardner, an attorney who founded the advocacy organization, the state has underfunded certain counties, “and their performance has suffered accordingly, sometimes pretty dramatically.”\u003c/p>\n\u003cp>In his report, Gardner found that counties with significantly lower-than-average state funding generally provided young people with less intensive services than counties with significantly higher-than-average state funding. According to his report, in 2019–20, poorly funded San Joaquin and Madera counties provided just 16% and 17% of the estimated need for care, while the better-funded Santa Clara and Butte counties provided 86%.\u003c/p>\n\u003cp>While CalAIM is moving “in the right direction,” Gardner said, it fails to address this fundamental issue. (Cabrera contends that the analysis fails to capture the services that counties provide without billing Medi-Cal.)\u003c/p>\n\u003cp>Despite these concerns, many mental health care advocates say they are witnessing important changes to the way care is delivered under CalAIM.\u003c/p>\n\u003cp>“We are seeing shifts happening already,” said Leticia Galyean, CEO and president of Seneca Family of Agencies. She said her organization — which serves youth and families in 14 counties — is especially seeing “an immediate benefit” in terms of faster access to specialty mental health care for foster youth, unhoused youth and those involved in the juvenile justice system.\u003c/p>\n\u003cp>Brian Blalock, senior staff attorney at the Youth Law Center, which advocates for youth in the child welfare and juvenile justice systems, called CalAIM “the most important thing California has done in a long time.”\u003c/p>\n\u003cp>“There’s just tremendous opportunity there,” he said.\u003c/p>\n\u003cp>Now, he added, “we as a state can go in either direction — either we realize that promise, or we let this pass us by.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Federal regulators have agreed to continue to hold off on patient discharges and transfers out of Laguna Honda Hospital and Rehabilitation Center until at least May 19, 2023, San Francisco officials confirmed on Wednesday.\u003c/p>\n\u003cp>The reprieve comes just one day ahead of when the pause on patient transfers was set to expire.\u003c/p>\n\u003cp>“The transfers and discharge of residents has been arduous as many have complex healthcare needs, and Laguna Honda and City leadership have strongly advocated against the involuntary transfers,” a statement released Wednesday from Laguna Honda officials reads. “The vast majority of residents and their families are fighting to remain at Laguna Honda and this continued reprieve of involuntary transfers provides stability, continuity of care, and short-term relief.”\u003c/p>\n\u003cp>City leaders, residents and their loved ones celebrated the decision.\u003c/p>\n\u003cp>“Laguna Honda is a critical part of San Francisco’s ability to care for our most vulnerable residents and is essential to the future of our city,” said Mayor London Breed, whose grandmother lived the final years of her life at Laguna Honda. “We appreciate that CMS has agreed to continue this pause of transfers from Laguna Honda while we work collaboratively towards recertification,” she said, referring to the regulatory body, the Centers for Medicare and Medicaid Services.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Joe Urban, whose mother-in-law was a resident at Laguna Honda, said CMS “did the right thing.”\u003c/p>\n\u003cp>“Restarting the discharges would have killed a lot of San Franciscans,” Urban said. “There’s no need to do it if Laguna Honda is making progress towards recertification.”\u003c/p>\n\u003cp>But relief may be temporary. The hospital is still working to regain certification with CMS to participate in government-subsidized health care plans like Medicare and Medi-Cal, which cover the majority of patients at Laguna Honda.\u003c/p>\n\u003cp>“I’m worried that May will be here before you know it and we will go through this again,” said Tony Chicotel, staff attorney with California Advocates for Nursing Home Reform. “With each extension, [another extension] become increasingly unlikely, and at some point I think it will stop happening.”\u003c/p>\n\u003cp>[aside label='Related Coverage' tag='laguna-honda-hospital']In April 2022, CMS decertified Laguna Honda after a series of inspections found the hospital out of compliance with safety measures for a skilled nursing facility. The hospital was then required to create and implement a closure plan, which included transferring or discharging all of its residents by September 2022.\u003c/p>\n\u003cp>The hospital, city leaders and senior advocates pushed hard against the transfers, citing how it can be physically and emotionally traumatic for older people and people with disabilities to be uprooted.\u003c/p>\n\u003cp>Laguna Honda transferred 41 residents to other skilled nursing facilities and discharged an additional 16 residents. Of those, 12 people died — eight of them within weeks, and four within months, of leaving Laguna Honda.\u003c/p>\n\u003cp>After reports came in that some residents had died after being transferred, San Francisco sued the federal government for failing to provide adequate time to repeal the original citations.\u003c/p>\n\u003cp>The city and CMS came to an agreement in July 2022 to pause transfers until Feb. 2, 2023.\u003c/p>\n\u003cp>The hospital maintains that it is working to prepare for recertification in the meantime.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“This is the humane and compassionate thing to do for the residents of Laguna Honda, their families and staff,” said San Francisco City Attorney David Chiu. “We certainly hope we don’t cut things as close next time. I know that the staff at Laguna Honda will work and do everything they can to address the issues and get us to that recertification. Our hope is we aren’t in this place again.”\u003c/p>\n\n",
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"excerpt": "San Francisco officials had raised alarm bells about having to resume relocating the hospital's more than 550 remaining patients, many of whom are elderly and lower-income, to other facilities as early as Friday.\r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Federal regulators have agreed to continue to hold off on patient discharges and transfers out of Laguna Honda Hospital and Rehabilitation Center until at least May 19, 2023, San Francisco officials confirmed on Wednesday.\u003c/p>\n\u003cp>The reprieve comes just one day ahead of when the pause on patient transfers was set to expire.\u003c/p>\n\u003cp>“The transfers and discharge of residents has been arduous as many have complex healthcare needs, and Laguna Honda and City leadership have strongly advocated against the involuntary transfers,” a statement released Wednesday from Laguna Honda officials reads. “The vast majority of residents and their families are fighting to remain at Laguna Honda and this continued reprieve of involuntary transfers provides stability, continuity of care, and short-term relief.”\u003c/p>\n\u003cp>City leaders, residents and their loved ones celebrated the decision.\u003c/p>\n\u003cp>“Laguna Honda is a critical part of San Francisco’s ability to care for our most vulnerable residents and is essential to the future of our city,” said Mayor London Breed, whose grandmother lived the final years of her life at Laguna Honda. “We appreciate that CMS has agreed to continue this pause of transfers from Laguna Honda while we work collaboratively towards recertification,” she said, referring to the regulatory body, the Centers for Medicare and Medicaid Services.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Joe Urban, whose mother-in-law was a resident at Laguna Honda, said CMS “did the right thing.”\u003c/p>\n\u003cp>“Restarting the discharges would have killed a lot of San Franciscans,” Urban said. “There’s no need to do it if Laguna Honda is making progress towards recertification.”\u003c/p>\n\u003cp>But relief may be temporary. The hospital is still working to regain certification with CMS to participate in government-subsidized health care plans like Medicare and Medi-Cal, which cover the majority of patients at Laguna Honda.\u003c/p>\n\u003cp>“I’m worried that May will be here before you know it and we will go through this again,” said Tony Chicotel, staff attorney with California Advocates for Nursing Home Reform. “With each extension, [another extension] become increasingly unlikely, and at some point I think it will stop happening.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>In April 2022, CMS decertified Laguna Honda after a series of inspections found the hospital out of compliance with safety measures for a skilled nursing facility. The hospital was then required to create and implement a closure plan, which included transferring or discharging all of its residents by September 2022.\u003c/p>\n\u003cp>The hospital, city leaders and senior advocates pushed hard against the transfers, citing how it can be physically and emotionally traumatic for older people and people with disabilities to be uprooted.\u003c/p>\n\u003cp>Laguna Honda transferred 41 residents to other skilled nursing facilities and discharged an additional 16 residents. Of those, 12 people died — eight of them within weeks, and four within months, of leaving Laguna Honda.\u003c/p>\n\u003cp>After reports came in that some residents had died after being transferred, San Francisco sued the federal government for failing to provide adequate time to repeal the original citations.\u003c/p>\n\u003cp>The city and CMS came to an agreement in July 2022 to pause transfers until Feb. 2, 2023.\u003c/p>\n\u003cp>The hospital maintains that it is working to prepare for recertification in the meantime.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“This is the humane and compassionate thing to do for the residents of Laguna Honda, their families and staff,” said San Francisco City Attorney David Chiu. “We certainly hope we don’t cut things as close next time. I know that the staff at Laguna Honda will work and do everything they can to address the issues and get us to that recertification. Our hope is we aren’t in this place again.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "'Down to the Wire Again': SF Officials Blast Feds for Silence on Laguna Honda Patient-Transfer Decision, Just Days Before Deadline",
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"content": "\u003cp>\u003cstrong>Update, 6 p.m. Tuesday: \u003c/strong>Federal officials have yet to say whether they will allow San Francisco to continue postponing the transfer of hundreds of Laguna Honda Hospital patients to other skilled nursing facilities, frustrated city leaders said Tuesday.[pullquote align=\"right\" size=\"medium\" citation=\"San Francisco Supervisor Myrna Melgar\"]‘It is entirely possible that on Friday, Feb. 3, hundreds of San Franciscans residing at Laguna Honda will face the trauma of possible relocation again from being discharged.’[/pullquote]\u003c/p>\n\u003cp>The clock is ticking. If the Biden administration rejects the city’s requests to continue halting transfers, the hospital could be required to resume relocating its more than 550 remaining patients, many of whom are elderly and lower-income, to other skilled nursing facilities as early as Friday.\u003c/p>\n\u003cp>“It is entirely possible that on Friday, Feb. 3, hundreds of San Franciscans residing at Laguna Honda will face the trauma of possible relocation again from being discharged,” San Francisco Supervisor Myrna Melgar, whose district includes the hospital, said at Tuesday’s Board of Supervisors hearing. “The rigid bureaucracy of the U.S. government has put us into this position.”\u003c/p>\n\u003cp>Hospital officials have said they have no plans to resume transferring patients unless compelled to do so. Twelve of the 57 patients who were initially transferred from the hospital last summer — some of whom had dementia and limited physical and cognitive ability — died within weeks or months of being relocated.\u003c/p>\n\u003cp>“Laguna Honda strongly advocated against these transfers. We warned CMS (the Center for Medicare and Medicaid Services) that the four-month deadline to transfer nearly 700 residents to other facilities was entirely insufficient given the complex nature of our resident population and the lack of available beds at SNFs (skilled nursing facilities) anywhere in the region or the state,” hospital officials said in a public statement earlier this month in response to regulatory citations it received following the deaths of the transferred patients.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Roland Pickens, Laguna Honda’s interim CEO, said he is hopeful the current pause on patient transfers will be extended, allowing the hospital to continue working to address deficiencies cited by state and federal regulators.\u003c/p>\n\u003cp>At Tuesday’s hearing, other San Francisco leaders blasted federal officials for so far failing to respond to the city’s extension request, just days before the hospital could be required to resume patient transfers.\u003c/p>\n\u003cp>“This is a powerful and unaccountable bureaucracy,” Supervisor Rafael Mandelman said. “They [CMS] have done significant harm. They have created a ton of stress and anxiety for hundreds more people.”\u003c/p>\n\u003cp>\u003cstrong>Original story, 6 a.m. Tuesday: \u003c/strong>San Francisco officials are expected to find out this week whether federal regulators will allow the city to continue postponing the transfer of patients out of Laguna Honda Hospital.\u003c/p>\n\u003cp>An extension would allow patients and their families to breathe a temporary sigh of relief, just days before the recently decertified hospital could be required to resume relocating its more than 550 remaining charges.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11920121/sf-officials-outraged-over-laguna-honda-patient-deaths-following-federally-mandated-transfers\">Regulators paused their initial transfer requirement\u003c/a> in July 2022, after reports that some of the 57 patients who had initially been moved from the hospital had died. In total, 12 former patients are confirmed to have died, nearly all of whom had been transferred last year to other skilled nursing facilities.\u003c/p>\n\u003cp>San Francisco City Attorney David Chiu is now requesting that the pause on transfers extend until at least May 30, 2023, and the status of the relocation plan is scheduled to be addressed at a Board of Supervisors hearing on Tuesday afternoon.\u003c/p>\n\u003cp>“There is a moral and ethical imperative to not continue the transfers,” said Joseph Urban, a health care consultant whose mother-in-law, Betty Campbell, was a resident at Laguna Honda. “We’re down to the wire again.”\u003c/p>\n\u003cp>Citing Campbell’s frail state, Urban and his spouse turned down the hospital’s offer last summer to relocate her. The 86-year-old died recently at the hospital.\u003c/p>\n\u003cp>Opened in 1866, Laguna Honda is one of the oldest and largest public skilled nursing facilities in the country, treating a wide range of medical conditions including dementia, stroke, mental illness and HIV.\u003c/p>\n\u003cp>Although the hospital is still licensed, it was decertified last year by the federal Centers for Medicare and Medicaid Services (CMS) for a series of safety violations. That means it is no longer in good standing with government-provided health care options like Medicare and Medi-Cal, which fund medical costs for the vast majority of its patients.\u003c/p>\n\u003cp>After Laguna Honda lost certification, CMS required the hospital to create and implement a closure plan, including the transfer of all of its nearly 700 patients, many of them elderly and frail.\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"laguna-honda-hospital\"]At the same time, the hospital has been working with consultants to prepare for recertification.\u003c/p>\n\u003cp>“The focus of this meeting needs to be primarily on how the Board of Supervisors can be a force for protecting the most vulnerable: those who are now residents at Laguna Honda and those of us could need a bed there at any time,” Teresa Palmer, a former Laguna Honda physician and geriatrician, wrote in a letter to the board ahead of its Tuesday hearing. “Administration at Laguna Honda and consultants obviously need more time to ‘turn the ship around.’ In order to prevent death and harm to current and future residents, this time needs to be made available by CMS.”\u003c/p>\n\u003cp>Last month, the California Department of Public Health fined Laguna Honda $36,000 for providing inadequate care to the patients who died after their transfers. Nearly all of those patients, who ranged in age from 63 to 100, were considered severely disabled, including some who were on feeding tubes, living with dementia or nonverbal, the agency’s citations show.\u003c/p>\n\u003cp>The citations also noted that the patients who died were identified as “not discharge ready” because they were frail or otherwise not in a condition to be relocated.\u003c/p>\n\u003cp>The \u003ca href=\"https://abc7news.com/amp/laguna-honda-hospital-san-francisco-funding-mayor-london-breed-press-conference-healthcare-in-sf/11747735/\">current regulatory crisis facing Laguna Honda\u003c/a> began last spring, when federal regulators decertified the hospital after conducting a series of safety inspections triggered by two nonfatal drug overdoses the previous year.\u003c/p>\n\u003cp>Because San Francisco lacks an adequate supply of skilled nursing options, especially for people who rely on government health care plans like Medicare, most of those 57 patients were transferred out of the county. Two of the patients were sent to homeless shelters after discharge.\u003c/p>\n\u003cp>In August, city leaders responded to the relocation requirement and subsequent deaths by \u003ca href=\"https://www.kqed.org/news/11921717/san-francisco-sues-feds-over-forced-closure-of-laguna-honda-hospital/\">suing the federal government\u003c/a>, arguing that CMS had imposed an arbitrary and unrealistic closure deadline that didn’t give the city enough time to appeal the original infractions.\u003c/p>\n\u003cp>Several months later, however, the city agreed to drop the lawsuit in exchange for federal regulators temporarily halting the transfers and continuing to pay the $18 million in monthly Medicare and Medi-Cal costs for the remaining residents through November 2023.\u003c/p>\n\u003cp>Patricia McGinnis, executive director of California Advocates for Nursing Home Reform, called out the hurried transfers as a form of abuse and criticized state and federal regulators for pressuring the hospital to carry out the closure plan, despite the severe risk it posed to many patients.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“We call on CMS to stop the Laguna Honda closure before more residents are killed, and the Legislature to investigate CDPH and hold its leaders accountable,” she said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Update, 6 p.m. Tuesday: \u003c/strong>Federal officials have yet to say whether they will allow San Francisco to continue postponing the transfer of hundreds of Laguna Honda Hospital patients to other skilled nursing facilities, frustrated city leaders said Tuesday.\u003c/p>\u003c/div>",
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"content": "‘It is entirely possible that on Friday, Feb. 3, hundreds of San Franciscans residing at Laguna Honda will face the trauma of possible relocation again from being discharged.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The clock is ticking. If the Biden administration rejects the city’s requests to continue halting transfers, the hospital could be required to resume relocating its more than 550 remaining patients, many of whom are elderly and lower-income, to other skilled nursing facilities as early as Friday.\u003c/p>\n\u003cp>“It is entirely possible that on Friday, Feb. 3, hundreds of San Franciscans residing at Laguna Honda will face the trauma of possible relocation again from being discharged,” San Francisco Supervisor Myrna Melgar, whose district includes the hospital, said at Tuesday’s Board of Supervisors hearing. “The rigid bureaucracy of the U.S. government has put us into this position.”\u003c/p>\n\u003cp>Hospital officials have said they have no plans to resume transferring patients unless compelled to do so. Twelve of the 57 patients who were initially transferred from the hospital last summer — some of whom had dementia and limited physical and cognitive ability — died within weeks or months of being relocated.\u003c/p>\n\u003cp>“Laguna Honda strongly advocated against these transfers. We warned CMS (the Center for Medicare and Medicaid Services) that the four-month deadline to transfer nearly 700 residents to other facilities was entirely insufficient given the complex nature of our resident population and the lack of available beds at SNFs (skilled nursing facilities) anywhere in the region or the state,” hospital officials said in a public statement earlier this month in response to regulatory citations it received following the deaths of the transferred patients.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Roland Pickens, Laguna Honda’s interim CEO, said he is hopeful the current pause on patient transfers will be extended, allowing the hospital to continue working to address deficiencies cited by state and federal regulators.\u003c/p>\n\u003cp>At Tuesday’s hearing, other San Francisco leaders blasted federal officials for so far failing to respond to the city’s extension request, just days before the hospital could be required to resume patient transfers.\u003c/p>\n\u003cp>“This is a powerful and unaccountable bureaucracy,” Supervisor Rafael Mandelman said. “They [CMS] have done significant harm. They have created a ton of stress and anxiety for hundreds more people.”\u003c/p>\n\u003cp>\u003cstrong>Original story, 6 a.m. Tuesday: \u003c/strong>San Francisco officials are expected to find out this week whether federal regulators will allow the city to continue postponing the transfer of patients out of Laguna Honda Hospital.\u003c/p>\n\u003cp>An extension would allow patients and their families to breathe a temporary sigh of relief, just days before the recently decertified hospital could be required to resume relocating its more than 550 remaining charges.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11920121/sf-officials-outraged-over-laguna-honda-patient-deaths-following-federally-mandated-transfers\">Regulators paused their initial transfer requirement\u003c/a> in July 2022, after reports that some of the 57 patients who had initially been moved from the hospital had died. In total, 12 former patients are confirmed to have died, nearly all of whom had been transferred last year to other skilled nursing facilities.\u003c/p>\n\u003cp>San Francisco City Attorney David Chiu is now requesting that the pause on transfers extend until at least May 30, 2023, and the status of the relocation plan is scheduled to be addressed at a Board of Supervisors hearing on Tuesday afternoon.\u003c/p>\n\u003cp>“There is a moral and ethical imperative to not continue the transfers,” said Joseph Urban, a health care consultant whose mother-in-law, Betty Campbell, was a resident at Laguna Honda. “We’re down to the wire again.”\u003c/p>\n\u003cp>Citing Campbell’s frail state, Urban and his spouse turned down the hospital’s offer last summer to relocate her. The 86-year-old died recently at the hospital.\u003c/p>\n\u003cp>Opened in 1866, Laguna Honda is one of the oldest and largest public skilled nursing facilities in the country, treating a wide range of medical conditions including dementia, stroke, mental illness and HIV.\u003c/p>\n\u003cp>Although the hospital is still licensed, it was decertified last year by the federal Centers for Medicare and Medicaid Services (CMS) for a series of safety violations. That means it is no longer in good standing with government-provided health care options like Medicare and Medi-Cal, which fund medical costs for the vast majority of its patients.\u003c/p>\n\u003cp>After Laguna Honda lost certification, CMS required the hospital to create and implement a closure plan, including the transfer of all of its nearly 700 patients, many of them elderly and frail.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>At the same time, the hospital has been working with consultants to prepare for recertification.\u003c/p>\n\u003cp>“The focus of this meeting needs to be primarily on how the Board of Supervisors can be a force for protecting the most vulnerable: those who are now residents at Laguna Honda and those of us could need a bed there at any time,” Teresa Palmer, a former Laguna Honda physician and geriatrician, wrote in a letter to the board ahead of its Tuesday hearing. “Administration at Laguna Honda and consultants obviously need more time to ‘turn the ship around.’ In order to prevent death and harm to current and future residents, this time needs to be made available by CMS.”\u003c/p>\n\u003cp>Last month, the California Department of Public Health fined Laguna Honda $36,000 for providing inadequate care to the patients who died after their transfers. Nearly all of those patients, who ranged in age from 63 to 100, were considered severely disabled, including some who were on feeding tubes, living with dementia or nonverbal, the agency’s citations show.\u003c/p>\n\u003cp>The citations also noted that the patients who died were identified as “not discharge ready” because they were frail or otherwise not in a condition to be relocated.\u003c/p>\n\u003cp>The \u003ca href=\"https://abc7news.com/amp/laguna-honda-hospital-san-francisco-funding-mayor-london-breed-press-conference-healthcare-in-sf/11747735/\">current regulatory crisis facing Laguna Honda\u003c/a> began last spring, when federal regulators decertified the hospital after conducting a series of safety inspections triggered by two nonfatal drug overdoses the previous year.\u003c/p>\n\u003cp>Because San Francisco lacks an adequate supply of skilled nursing options, especially for people who rely on government health care plans like Medicare, most of those 57 patients were transferred out of the county. Two of the patients were sent to homeless shelters after discharge.\u003c/p>\n\u003cp>In August, city leaders responded to the relocation requirement and subsequent deaths by \u003ca href=\"https://www.kqed.org/news/11921717/san-francisco-sues-feds-over-forced-closure-of-laguna-honda-hospital/\">suing the federal government\u003c/a>, arguing that CMS had imposed an arbitrary and unrealistic closure deadline that didn’t give the city enough time to appeal the original infractions.\u003c/p>\n\u003cp>Several months later, however, the city agreed to drop the lawsuit in exchange for federal regulators temporarily halting the transfers and continuing to pay the $18 million in monthly Medicare and Medi-Cal costs for the remaining residents through November 2023.\u003c/p>\n\u003cp>Patricia McGinnis, executive director of California Advocates for Nursing Home Reform, called out the hurried transfers as a form of abuse and criticized state and federal regulators for pressuring the hospital to carry out the closure plan, despite the severe risk it posed to many patients.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We call on CMS to stop the Laguna Honda closure before more residents are killed, and the Legislature to investigate CDPH and hold its leaders accountable,” she said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cb>Lessons Learned From January’s Storm\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">The snowpack in the Sierra Nevada is high, at levels typically not seen until late April and it’s also double what it was at this time last year. The rain has gone a long way toward helping with drought conditions, but there are serious concerns about how much of the water we were able to store versus how much ran off into the ocean. We assess the damage from January’s storms and discuss Gov. Newsom and Pres. Biden’s tour of rain-ravaged areas in the Golden State.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Guests:\u003c/span>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Dan Brekke, KQED editor and reporter\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Brian Watt, KQED morning radio news anchor\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Zuckerberg SF General Hospital Celebrates 150 Years\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Zuckerberg San Francisco General Hospital is part of our social fabric, and for many, it’s a safety net. The hospital sees 100,000 patients each year, and many face food and housing insecurity on top of their health concerns. The hospital is celebrating 150 years of serving our community, and we speak with the leadership about this historic institution, its challenges and what lies ahead.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Guests:\u003c/span>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Dr. Susan Ehrlich, Zuckerberg SF General Hospital CEO\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Kim Meredith, Zuckerberg SF General Hospital Foundation CEO\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Something Beautiful: San Francisco Hearts\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">In 2004, The Hearts in San Francisco project debuted. There are 131 heart sculptures created by local artists and placed around San Francisco for all to enjoy. Each year new hearts are designed and the previous ones auctioned off in support of the hospital’s trauma center. According to the hospital, the funds raised go to accessible and equitable health care.\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cb>Lessons Learned From January’s Storm\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">The snowpack in the Sierra Nevada is high, at levels typically not seen until late April and it’s also double what it was at this time last year. The rain has gone a long way toward helping with drought conditions, but there are serious concerns about how much of the water we were able to store versus how much ran off into the ocean. We assess the damage from January’s storms and discuss Gov. Newsom and Pres. Biden’s tour of rain-ravaged areas in the Golden State.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Guests:\u003c/span>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Dan Brekke, KQED editor and reporter\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Brian Watt, KQED morning radio news anchor\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Zuckerberg SF General Hospital Celebrates 150 Years\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Zuckerberg San Francisco General Hospital is part of our social fabric, and for many, it’s a safety net. The hospital sees 100,000 patients each year, and many face food and housing insecurity on top of their health concerns. The hospital is celebrating 150 years of serving our community, and we speak with the leadership about this historic institution, its challenges and what lies ahead.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Guests:\u003c/span>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Dr. Susan Ehrlich, Zuckerberg SF General Hospital CEO\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Kim Meredith, Zuckerberg SF General Hospital Foundation CEO\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Something Beautiful: San Francisco Hearts\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">In 2004, The Hearts in San Francisco project debuted. There are 131 heart sculptures created by local artists and placed around San Francisco for all to enjoy. Each year new hearts are designed and the previous ones auctioned off in support of the hospital’s trauma center. According to the hospital, the funds raised go to accessible and equitable health care.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>In Madera County, one-fifth of residents live in poverty and many don’t have health insurance.\u003c/p>\n\u003cp>The last thing this largely rural, Latino-majority part of the San Joaquin Valley needed was for its only general hospital to close its doors.\u003c/p>\n\u003cp>But years of financial struggles forced the 106-bed Madera Community Hospital and its three clinics to shut down completely in early January. The \u003ca href=\"https://www.maderahospital.org/documents/Press-Release.jpg\">COVID-19 pandemic pushed the 51-year-old hospital over the brink\u003c/a>, hospital leaders said.[pullquote align=\"right\" size=\"medium\" citation=\"State Sen. Anna Caballero (D-Merced)\"]‘It’s a disaster. This is a facility that people depend on. This is a loss of services that is going to be really felt in many of our small communities.’[/pullquote]\u003c/p>\n\u003cp>Now the hospital’s board and local officials are scrambling for solutions, including searching for a new potential buyer. And Madera Community is just one example of California hospitals in financial distress. State lawmakers and industry leaders caution that other nonprofit hospitals are in a dire fiscal situation and, without assistance, could potentially close.\u003c/p>\n\u003cp>“It’s a disaster. This is a facility that people depend on,” said Democratic \u003ca href=\"https://calmatters.org/legislator-tracker/anna-caballero-1955/\">state Sen. Anna Caballero\u003c/a>, who represents the Madera area. “This is a loss of services that is going to be really felt in many of our small communities.”\u003c/p>\n\u003cp>Esther Vargas, 73, knows it. She said it was common for residents in her small community of La Vina to rely on physicians associated with Madera Community Hospital for a variety of health issues that many believe are linked to their area’s exposure to frequent fumigation and crop burning.\u003c/p>\n\u003cp>On particularly bad air days, she said, she can barely go outside without her throat closing up. Now, if she has an asthma attack, she’ll likely have to travel 20 miles farther to an emergency room in Fresno. “I’m going to miss having the hospital,” Vargas said in Spanish.\u003c/p>\n\u003cp>Madera Community, an independent nonprofit private hospital, was the only place adults could go for emergency services within the county. (Madera is also home to Valley Children’s, a pediatric hospital.) And until late December, the hospital was scheduled to be sold to Trinity Health, a nonprofit Catholic health care system that owns Saint Agnes Medical Center in Fresno. The state attorney general’s office, which regulates health care mergers that involve a nonprofit, said Trinity Health pulled out of negotiations after refusing to meet important conditions, which included price caps, as well as maintaining language services, charity programs and privileges for existing staff.\u003c/p>\n\u003cp>“These minimal conditions were necessary because without them, the communities could not be assured of even basic essential services,” the attorney general’s office said in a statement.\u003c/p>\n\u003cp>The California Hospital Association has pushed back on \u003ca href=\"https://oag.ca.gov/system/files/media/madera-community-hospital-decision-12152022.pdf\">the attorney general’s conditions (PDF)\u003c/a>, arguing that some of the requirements were too strict in a situation where the goal was to save a hospital from financial collapse. These conditions are supposed to protect consumers, but in this case, the industry association argues, they did the opposite, forcing the hospital to close and leaving Madera patients with less access to care.\u003c/p>\n\u003cfigure id=\"attachment_11938687\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11938687\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/010423-MaderCommnityHospital-LV_12-CM-copy-800x533.jpg\" alt='An electronic road sign that reads \"ER and Hospital Closed\" with trees and a big puddle in the backrgound' width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/010423-MaderCommnityHospital-LV_12-CM-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/010423-MaderCommnityHospital-LV_12-CM-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/010423-MaderCommnityHospital-LV_12-CM-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/010423-MaderCommnityHospital-LV_12-CM-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/010423-MaderCommnityHospital-LV_12-CM-copy.jpg 1568w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A road sign announcing the closure of the emergency room and all of Madera Community Hospital outside the main entrance on Jan. 2, 2023. \u003ccite>(Larry Valenzuela/CalMatters-CatchLight Local)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>‘At a tipping point’\u003c/h2>\n\u003cp>Madera Community Hospital’s \u003ca href=\"https://sieraarchiveexternal-oshpd-web-prd.azurewebsites.net/\">financial records\u003c/a>, as kept by the state, show the hospital had been unstable even years prior to the pandemic. The \u003ca href=\"https://www.maderahospital.org/documents/madera-initial-rpt-11032022-redacted.pdf\">hospital’s recent losses were tied to increases in day-to-day costs\u003c/a>, which are difficult to cover for long periods, especially for hospitals with limited reserves, according to one analysis prepared by health economists for the attorney general.\u003c/p>\n\u003cp>Caballero said Madera’s hospital officials first approached her last July in search of help. The state promised the hospital $5 million to keep services running while it finalized its negotiations with Trinity Health. That money was supposed to go to Madera Community Hospital early this year, but that aid is no longer available now that the hospital is closed, Caballero said.\u003c/p>\n\u003cp>The hospital now would likely need a lot more than $5 million to reopen its doors.\u003c/p>\n\u003cp>“They’re not the only hospital. There are other hospitals in very similar situations,” Caballero said. “So my guess is that whatever solution we come up with for Madera has to be able to work for other hospitals as well.”\u003c/p>\n\u003cp>Madera Community, like other hospitals that serve largely lower-income patients, for years had been underfunded, said Carmela Coyle, president of the California Hospital Association.\u003c/p>\n\u003cp>Those hospitals depend largely on government-funded programs, such as Medi-Cal, the state’s health insurance program for lower-income residents, and Medicare, the insurance program for those 65 and older and those with disabilities. Those programs tend to pay providers \u003ca href=\"https://www.aha.org/fact-sheets/2020-01-07-fact-sheet-underpayment-medicare-and-medicaid\">below the cost of care\u003c/a> and \u003ca href=\"https://www.kff.org/medicare/issue-brief/how-much-more-than-medicare-do-private-insurers-pay-a-review-of-the-literature/\">less than what private insurance pays\u003c/a>. In addition, the significant expenses of responding to the COVID-19 pandemic, including paying for expensive travel nurses who came from out of state or other parts of California, overwhelmed the hospital, Coyle said.[pullquote align=\"right\" size=\"medium\" citation=\"Gary Herbst, CEO, Kaweah Health Medical Center\"]‘I’m very frustrated with our state. The governor and the Legislature were celebrating their record $100 billion budget surplus last fiscal year, while hospitals have been pleading with the state for help.’[/pullquote]Trinity Health officials did not answer questions about what specifically in the attorney general’s conditions prompted it to pull out of the deal with Madera Community Hospital, but in a statement from Saint Agnes Medical Center, officials simply said they could not move forward given the “complex circumstances and the additional conditions imposed by the AG.”\u003c/p>\n\u003cp>Coyle said the conditions that set price caps on contract rates and services for a period of five years were likely a major concern. If a buyer is limited in how it can renegotiate contracts with insurance companies because of price caps, then it would be difficult for Trinity Health to pull Madera Community Hospital out of financial trouble, she said.\u003c/p>\n\u003cp>Mirroring a national trend, half of California’s \u003ca href=\"https://www.chcf.org/publication/2022-edition-california-hospitals/\">337 hospitals\u003c/a> are \u003ca href=\"https://www.kaufmanhall.com/sites/default/files/2022-11/KH-NHFR_2022-11.pdf\">operating in the red (PDF)\u003c/a>, Coyle said. And at least a handful of them could soon be in a situation like Madera’s or, at the least, be forced to make significant cuts, she said.\u003c/p>\n\u003cp>“We are at a tipping point. Madera is just the first one,” she said.\u003c/p>\n\u003cp>Late last year, 25-bed Hazel Hawkins Memorial Hospital in Hollister declared a financial emergency and announced it was running out of money. It implemented hiring freezes and wage reductions. The hospital recently received a $3 million loan from the \u003ca href=\"https://www.treasurer.ca.gov/chffa/\">California Health Facilities Financing Authority\u003c/a>, allowing it to keep operating for at least a couple of months.\u003c/p>\n\u003cp>“With this loan and other operational savings endeavors, we have extended the date the District will run out of cash to mid-March,” Mary Casillas, interim CEO of Hazel Hawkins, said in a statement. Casillas said the hospital’s plan is to search for other funding opportunities and partnerships that could help it extend this date.\u003c/p>\n\u003cp>Gary Herbst, CEO of Kaweah Health Medical Center in Visalia — \u003ca href=\"https://www.kaweahhealth.org/about-us/\">a 613-bed hospital\u003c/a> that is Tulare County’s largest — is another hospital official \u003ca href=\"https://www.visaliatimesdelta.com/story/opinion/2022/11/10/kaweah-health-ceo-gary-k-herbst-california-governor-gavin-newsom/10662524002/\">sounding the alarm\u003c/a>.\u003c/p>\n\u003cp>In just the first half of the fiscal year that ends in June, Kaweah has lost about $37 million. If that trend continues, Herbst said, he expects his hospital will see a record loss of about $75 million for fiscal year 2023. For comparison, in fiscal year 2019, prior to the pandemic, the hospital reported a net income of about $28 million, according to internal financial summaries shared with CalMatters.[aside label=\"Related Stories\" postID=\"news_11938546,news_11937928,news_11921717\"]Herbst noted that in the first years of the pandemic, some of the hospital’s losses were offset by federal COVID relief dollars, but that aid is now largely gone. Yet some of his largest expenses, including contracted labor, are ongoing. “Two months ago I had 240 bedside [registered nurses] that were traveling, and I’m paying $200 or more an hour for them,” Herbst said. “We’ve never been that high in contract labor.”\u003c/p>\n\u003cp>Looking to save money, his hospital laid off 130 employees last year, largely administrative staff, Herbst said. Also, top officials have taken pay cuts, the hospital has frozen 401(k) contributions, and now it’s looking to limit the number of elective surgeries it performs on Medi-Cal patients, Herbst said.\u003c/p>\n\u003cp>“I’m very frustrated with our state,” Herbst said. “The governor and the Legislature were celebrating their record $100 billion budget surplus last fiscal year, while hospitals have been pleading with the state for help.”\u003c/p>\n\u003cp>But the \u003ca href=\"https://calmatters.org/california-budget/2023/01/california-budget-newsom-deficit/\">state’s financial outlook\u003c/a> has changed dramatically, with the state now facing a deficit estimated at $22.5 billion. Still, the need is so great, Coyle said, that the hospital association is asking the state for $1.5 billion in one-time immediate financial relief.\u003c/p>\n\u003cp>While that money was not included in Gov. Gavin Newsom’s recent budget proposal, hospitals will lobby so that it is prioritized in the May budget revision, Coyle said. For a longer-term solution, hospital officials want the Legislature to improve Medi-Cal reimbursement rates.\u003c/p>\n\u003ch2>A community in need\u003c/h2>\n\u003cp>Madera County is largely rural, stretching from thousands of acres of almond orchards on the San Joaquin Valley floor to the Sierra Nevada and Yosemite National Park in the east. Many residents in the majority-Latino county work in agriculture, and the presence of thousands of Indigenous Oaxacans helped elect the \u003ca href=\"https://www.fresnobee.com/vida-en-el-valle/noticias/california-es/fresno/article256301187.html\">first person of Mixteca descent\u003c/a> to the Madera City Council in 2021. Census data shows that about 22% of county residents live in poverty and 60% of the 23,783 emergency room visits that Madera Community Hospital recorded from January to September last year involved Medi-Cal patients.\u003c/p>\n\u003cp>Research has shown the negative effects of hospital closures in rural communities, both on residents’ health and the local economy, as hospitals also tend to be large employers. One 2019 study showed that hospital closures in rural areas \u003ca href=\"https://www.nber.org/system/files/working_papers/w26182/w26182.pdf\">increased mortality rates (PDF)\u003c/a> for medical emergencies, such as strokes and sepsis, by nearly 9%.\u003c/p>\n\u003cp>“I think it’s going to lead to more death and more advanced disease that we will see in both the short term and the long term,” said Susana Ramirez, public health communication professor at UC Merced.\u003c/p>\n\u003cp>“We have all of these social, structural and environmental factors that contribute to bad health in this community and we have less infrastructure to help us get healthy,” Ramirez said.\u003c/p>\n\u003cp>Pedro Dominguez, 80, struggled to hold back tears during a recent interview with CalMatters in the Madera offices of the \u003ca href=\"https://www.centrobinacional.org/\">Binational Center for the Development of Oaxacan Indigenous Communities\u003c/a> as he described the situation facing the community. He wasn’t worried for himself, he said, but for his wife, who has severe asthma and other health issues. While they could find new doctors or drive to emergency care in Fresno or Clovis, he also worries about people who don’t have transportation or the money to do the same.\u003c/p>\n\u003cp>“Many people don’t know who to turn to,” Dominguez said in Spanish.\u003c/p>\n\u003cfigure id=\"attachment_11938685\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11938685\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/011223-Madera-Hospital-portrait-LV_04-CM-copy-800x533.jpg\" alt=\"An older Latino man with a blue shirt and a blue cap looks at the camera with arms crossed, looking worried, houses blurred out in the background.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/011223-Madera-Hospital-portrait-LV_04-CM-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/011223-Madera-Hospital-portrait-LV_04-CM-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/011223-Madera-Hospital-portrait-LV_04-CM-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/011223-Madera-Hospital-portrait-LV_04-CM-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/011223-Madera-Hospital-portrait-LV_04-CM-copy.jpg 1568w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Madera resident 80-year-old Pedro Dominguez standing near a busy street in town on Jan. 12, 2023. Dominguez said the recent closure of the hospital has him concerned for his wife, Elpidia Sanchez de Jesús, who suffers from asthma. \u003ccite>(Larry Valenzuela/CalMatters-CatchLight Local)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>For primary care, some are turning to \u003ca href=\"https://www.kvpr.org/local-news/2023-01-13/questions-still-left-as-madera-county-loses-hospital-three-clinics-in-one-month\">other local clinic systems\u003c/a> like Camarena Health, another nonprofit that operates 18 health centers in the county. But those clinics can only absorb so many new patients.\u003c/p>\n\u003cp>Both Madera and Fresno counties have declared emergencies due to the strain on local hospitals and emergency services. Robert Poythress, a Madera County supervisor and secretary of the hospital’s board of trustees, said the “domino effect” ranges from law enforcement increasingly leaving the county to take incarcerated people to Fresno hospitals, to Madera residents no longer being able to walk to the hospital for familiar medical assistance.\u003c/p>\n\u003cp>“There’s certain people that, other than the ER, aren’t going to miss Madera Community because they never used Madera Community,” Poythress said, explaining that some residents who can afford private insurance already prefer to see doctors in Fresno. “It’s the people who are the most disadvantaged, those are the people who are getting hurt the most.”\u003c/p>\n\u003cp>The closure of Madera’s only general hospital leaves the county’s public health department without a primary tool. Most of the county’s public health programs were in some way linked to the hospital, said Sara Bosse, public health director for Madera County.\u003c/p>\n\u003cp>“It impacts how referrals come to our programs,” Bosse said. “Many families were identified through labor and delivery, for example, as needing WIC (Women, Infants and Children) services or home visitation services. We were able to connect with people who were in critical moments of life and health.”\u003c/p>\n\u003cp>The department is now having to make those connections with hospitals outside its county, primarily in Fresno and Merced.\u003c/p>\n\u003cp>There is also the issue of transportation, which was already a chief concern. Now it’s going to be exacerbated as people will have to travel at least 30 minutes to the next closest hospital. People who relied on the hospital’s clinics will also need to find other primary care providers, which could delay care.\u003c/p>\n\u003cp>Elsa Mejia, the Madera mayor pro tem, said she’s been fielding questions from constituents, including many who are Indigenous Oaxacans like herself and her family, who are shocked by the closure and looking for assistance. She said officials working to reopen the hospital need to remember how urgently an “already disadvantaged community” like Madera needs a hospital.\u003c/p>\n\u003cp>“We already have issues here like poverty, access and language barriers,” Mejia said. “It was already very difficult for us and now it’s just gone, we’re stripped of it. It just makes everything a lot worse.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Under post-pandemic financial strain, the lone community hospital in the Central Valley county of Madera closed its doors this month. Legislators and industry officials say other hospitals across the state may suffer the same fate, with half of California's 337 hospitals estimated to be in the red.",
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"title": "A Central Valley Community Lost Its Only Hospital. More Statewide Closures May Follow | KQED",
"description": "Under post-pandemic financial strain, the lone community hospital in the Central Valley county of Madera closed its doors this month. Legislators and industry officials say other hospitals across the state may suffer the same fate, with half of California's 337 hospitals estimated to be in the red.",
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"headline": "A Central Valley Community Lost Its Only Hospital. More Statewide Closures May Follow",
"datePublished": "2023-01-20T13:39:36-08:00",
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"nprByline": "\u003ca href=\"https://calmatters.org/author/anaibarra/\">Ana B. Ibarra\u003c/a> and \u003ca href=\"https://calmatters.org/author/nicole-foy/\">Nicole Foy\u003c/a>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In Madera County, one-fifth of residents live in poverty and many don’t have health insurance.\u003c/p>\n\u003cp>The last thing this largely rural, Latino-majority part of the San Joaquin Valley needed was for its only general hospital to close its doors.\u003c/p>\n\u003cp>But years of financial struggles forced the 106-bed Madera Community Hospital and its three clinics to shut down completely in early January. The \u003ca href=\"https://www.maderahospital.org/documents/Press-Release.jpg\">COVID-19 pandemic pushed the 51-year-old hospital over the brink\u003c/a>, hospital leaders said.\u003c/p>\u003c/div>",
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"content": "‘It’s a disaster. This is a facility that people depend on. This is a loss of services that is going to be really felt in many of our small communities.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Now the hospital’s board and local officials are scrambling for solutions, including searching for a new potential buyer. And Madera Community is just one example of California hospitals in financial distress. State lawmakers and industry leaders caution that other nonprofit hospitals are in a dire fiscal situation and, without assistance, could potentially close.\u003c/p>\n\u003cp>“It’s a disaster. This is a facility that people depend on,” said Democratic \u003ca href=\"https://calmatters.org/legislator-tracker/anna-caballero-1955/\">state Sen. Anna Caballero\u003c/a>, who represents the Madera area. “This is a loss of services that is going to be really felt in many of our small communities.”\u003c/p>\n\u003cp>Esther Vargas, 73, knows it. She said it was common for residents in her small community of La Vina to rely on physicians associated with Madera Community Hospital for a variety of health issues that many believe are linked to their area’s exposure to frequent fumigation and crop burning.\u003c/p>\n\u003cp>On particularly bad air days, she said, she can barely go outside without her throat closing up. Now, if she has an asthma attack, she’ll likely have to travel 20 miles farther to an emergency room in Fresno. “I’m going to miss having the hospital,” Vargas said in Spanish.\u003c/p>\n\u003cp>Madera Community, an independent nonprofit private hospital, was the only place adults could go for emergency services within the county. (Madera is also home to Valley Children’s, a pediatric hospital.) And until late December, the hospital was scheduled to be sold to Trinity Health, a nonprofit Catholic health care system that owns Saint Agnes Medical Center in Fresno. The state attorney general’s office, which regulates health care mergers that involve a nonprofit, said Trinity Health pulled out of negotiations after refusing to meet important conditions, which included price caps, as well as maintaining language services, charity programs and privileges for existing staff.\u003c/p>\n\u003cp>“These minimal conditions were necessary because without them, the communities could not be assured of even basic essential services,” the attorney general’s office said in a statement.\u003c/p>\n\u003cp>The California Hospital Association has pushed back on \u003ca href=\"https://oag.ca.gov/system/files/media/madera-community-hospital-decision-12152022.pdf\">the attorney general’s conditions (PDF)\u003c/a>, arguing that some of the requirements were too strict in a situation where the goal was to save a hospital from financial collapse. These conditions are supposed to protect consumers, but in this case, the industry association argues, they did the opposite, forcing the hospital to close and leaving Madera patients with less access to care.\u003c/p>\n\u003cfigure id=\"attachment_11938687\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11938687\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/010423-MaderCommnityHospital-LV_12-CM-copy-800x533.jpg\" alt='An electronic road sign that reads \"ER and Hospital Closed\" with trees and a big puddle in the backrgound' width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/010423-MaderCommnityHospital-LV_12-CM-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/010423-MaderCommnityHospital-LV_12-CM-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/010423-MaderCommnityHospital-LV_12-CM-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/010423-MaderCommnityHospital-LV_12-CM-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/010423-MaderCommnityHospital-LV_12-CM-copy.jpg 1568w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A road sign announcing the closure of the emergency room and all of Madera Community Hospital outside the main entrance on Jan. 2, 2023. \u003ccite>(Larry Valenzuela/CalMatters-CatchLight Local)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>‘At a tipping point’\u003c/h2>\n\u003cp>Madera Community Hospital’s \u003ca href=\"https://sieraarchiveexternal-oshpd-web-prd.azurewebsites.net/\">financial records\u003c/a>, as kept by the state, show the hospital had been unstable even years prior to the pandemic. The \u003ca href=\"https://www.maderahospital.org/documents/madera-initial-rpt-11032022-redacted.pdf\">hospital’s recent losses were tied to increases in day-to-day costs\u003c/a>, which are difficult to cover for long periods, especially for hospitals with limited reserves, according to one analysis prepared by health economists for the attorney general.\u003c/p>\n\u003cp>Caballero said Madera’s hospital officials first approached her last July in search of help. The state promised the hospital $5 million to keep services running while it finalized its negotiations with Trinity Health. That money was supposed to go to Madera Community Hospital early this year, but that aid is no longer available now that the hospital is closed, Caballero said.\u003c/p>\n\u003cp>The hospital now would likely need a lot more than $5 million to reopen its doors.\u003c/p>\n\u003cp>“They’re not the only hospital. There are other hospitals in very similar situations,” Caballero said. “So my guess is that whatever solution we come up with for Madera has to be able to work for other hospitals as well.”\u003c/p>\n\u003cp>Madera Community, like other hospitals that serve largely lower-income patients, for years had been underfunded, said Carmela Coyle, president of the California Hospital Association.\u003c/p>\n\u003cp>Those hospitals depend largely on government-funded programs, such as Medi-Cal, the state’s health insurance program for lower-income residents, and Medicare, the insurance program for those 65 and older and those with disabilities. Those programs tend to pay providers \u003ca href=\"https://www.aha.org/fact-sheets/2020-01-07-fact-sheet-underpayment-medicare-and-medicaid\">below the cost of care\u003c/a> and \u003ca href=\"https://www.kff.org/medicare/issue-brief/how-much-more-than-medicare-do-private-insurers-pay-a-review-of-the-literature/\">less than what private insurance pays\u003c/a>. In addition, the significant expenses of responding to the COVID-19 pandemic, including paying for expensive travel nurses who came from out of state or other parts of California, overwhelmed the hospital, Coyle said.\u003c/p>\u003c/div>",
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"content": "‘I’m very frustrated with our state. The governor and the Legislature were celebrating their record $100 billion budget surplus last fiscal year, while hospitals have been pleading with the state for help.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Trinity Health officials did not answer questions about what specifically in the attorney general’s conditions prompted it to pull out of the deal with Madera Community Hospital, but in a statement from Saint Agnes Medical Center, officials simply said they could not move forward given the “complex circumstances and the additional conditions imposed by the AG.”\u003c/p>\n\u003cp>Coyle said the conditions that set price caps on contract rates and services for a period of five years were likely a major concern. If a buyer is limited in how it can renegotiate contracts with insurance companies because of price caps, then it would be difficult for Trinity Health to pull Madera Community Hospital out of financial trouble, she said.\u003c/p>\n\u003cp>Mirroring a national trend, half of California’s \u003ca href=\"https://www.chcf.org/publication/2022-edition-california-hospitals/\">337 hospitals\u003c/a> are \u003ca href=\"https://www.kaufmanhall.com/sites/default/files/2022-11/KH-NHFR_2022-11.pdf\">operating in the red (PDF)\u003c/a>, Coyle said. And at least a handful of them could soon be in a situation like Madera’s or, at the least, be forced to make significant cuts, she said.\u003c/p>\n\u003cp>“We are at a tipping point. Madera is just the first one,” she said.\u003c/p>\n\u003cp>Late last year, 25-bed Hazel Hawkins Memorial Hospital in Hollister declared a financial emergency and announced it was running out of money. It implemented hiring freezes and wage reductions. The hospital recently received a $3 million loan from the \u003ca href=\"https://www.treasurer.ca.gov/chffa/\">California Health Facilities Financing Authority\u003c/a>, allowing it to keep operating for at least a couple of months.\u003c/p>\n\u003cp>“With this loan and other operational savings endeavors, we have extended the date the District will run out of cash to mid-March,” Mary Casillas, interim CEO of Hazel Hawkins, said in a statement. Casillas said the hospital’s plan is to search for other funding opportunities and partnerships that could help it extend this date.\u003c/p>\n\u003cp>Gary Herbst, CEO of Kaweah Health Medical Center in Visalia — \u003ca href=\"https://www.kaweahhealth.org/about-us/\">a 613-bed hospital\u003c/a> that is Tulare County’s largest — is another hospital official \u003ca href=\"https://www.visaliatimesdelta.com/story/opinion/2022/11/10/kaweah-health-ceo-gary-k-herbst-california-governor-gavin-newsom/10662524002/\">sounding the alarm\u003c/a>.\u003c/p>\n\u003cp>In just the first half of the fiscal year that ends in June, Kaweah has lost about $37 million. If that trend continues, Herbst said, he expects his hospital will see a record loss of about $75 million for fiscal year 2023. For comparison, in fiscal year 2019, prior to the pandemic, the hospital reported a net income of about $28 million, according to internal financial summaries shared with CalMatters.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Herbst noted that in the first years of the pandemic, some of the hospital’s losses were offset by federal COVID relief dollars, but that aid is now largely gone. Yet some of his largest expenses, including contracted labor, are ongoing. “Two months ago I had 240 bedside [registered nurses] that were traveling, and I’m paying $200 or more an hour for them,” Herbst said. “We’ve never been that high in contract labor.”\u003c/p>\n\u003cp>Looking to save money, his hospital laid off 130 employees last year, largely administrative staff, Herbst said. Also, top officials have taken pay cuts, the hospital has frozen 401(k) contributions, and now it’s looking to limit the number of elective surgeries it performs on Medi-Cal patients, Herbst said.\u003c/p>\n\u003cp>“I’m very frustrated with our state,” Herbst said. “The governor and the Legislature were celebrating their record $100 billion budget surplus last fiscal year, while hospitals have been pleading with the state for help.”\u003c/p>\n\u003cp>But the \u003ca href=\"https://calmatters.org/california-budget/2023/01/california-budget-newsom-deficit/\">state’s financial outlook\u003c/a> has changed dramatically, with the state now facing a deficit estimated at $22.5 billion. Still, the need is so great, Coyle said, that the hospital association is asking the state for $1.5 billion in one-time immediate financial relief.\u003c/p>\n\u003cp>While that money was not included in Gov. Gavin Newsom’s recent budget proposal, hospitals will lobby so that it is prioritized in the May budget revision, Coyle said. For a longer-term solution, hospital officials want the Legislature to improve Medi-Cal reimbursement rates.\u003c/p>\n\u003ch2>A community in need\u003c/h2>\n\u003cp>Madera County is largely rural, stretching from thousands of acres of almond orchards on the San Joaquin Valley floor to the Sierra Nevada and Yosemite National Park in the east. Many residents in the majority-Latino county work in agriculture, and the presence of thousands of Indigenous Oaxacans helped elect the \u003ca href=\"https://www.fresnobee.com/vida-en-el-valle/noticias/california-es/fresno/article256301187.html\">first person of Mixteca descent\u003c/a> to the Madera City Council in 2021. Census data shows that about 22% of county residents live in poverty and 60% of the 23,783 emergency room visits that Madera Community Hospital recorded from January to September last year involved Medi-Cal patients.\u003c/p>\n\u003cp>Research has shown the negative effects of hospital closures in rural communities, both on residents’ health and the local economy, as hospitals also tend to be large employers. One 2019 study showed that hospital closures in rural areas \u003ca href=\"https://www.nber.org/system/files/working_papers/w26182/w26182.pdf\">increased mortality rates (PDF)\u003c/a> for medical emergencies, such as strokes and sepsis, by nearly 9%.\u003c/p>\n\u003cp>“I think it’s going to lead to more death and more advanced disease that we will see in both the short term and the long term,” said Susana Ramirez, public health communication professor at UC Merced.\u003c/p>\n\u003cp>“We have all of these social, structural and environmental factors that contribute to bad health in this community and we have less infrastructure to help us get healthy,” Ramirez said.\u003c/p>\n\u003cp>Pedro Dominguez, 80, struggled to hold back tears during a recent interview with CalMatters in the Madera offices of the \u003ca href=\"https://www.centrobinacional.org/\">Binational Center for the Development of Oaxacan Indigenous Communities\u003c/a> as he described the situation facing the community. He wasn’t worried for himself, he said, but for his wife, who has severe asthma and other health issues. While they could find new doctors or drive to emergency care in Fresno or Clovis, he also worries about people who don’t have transportation or the money to do the same.\u003c/p>\n\u003cp>“Many people don’t know who to turn to,” Dominguez said in Spanish.\u003c/p>\n\u003cfigure id=\"attachment_11938685\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11938685\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/011223-Madera-Hospital-portrait-LV_04-CM-copy-800x533.jpg\" alt=\"An older Latino man with a blue shirt and a blue cap looks at the camera with arms crossed, looking worried, houses blurred out in the background.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/011223-Madera-Hospital-portrait-LV_04-CM-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/011223-Madera-Hospital-portrait-LV_04-CM-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/011223-Madera-Hospital-portrait-LV_04-CM-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/011223-Madera-Hospital-portrait-LV_04-CM-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/011223-Madera-Hospital-portrait-LV_04-CM-copy.jpg 1568w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Madera resident 80-year-old Pedro Dominguez standing near a busy street in town on Jan. 12, 2023. Dominguez said the recent closure of the hospital has him concerned for his wife, Elpidia Sanchez de Jesús, who suffers from asthma. \u003ccite>(Larry Valenzuela/CalMatters-CatchLight Local)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>For primary care, some are turning to \u003ca href=\"https://www.kvpr.org/local-news/2023-01-13/questions-still-left-as-madera-county-loses-hospital-three-clinics-in-one-month\">other local clinic systems\u003c/a> like Camarena Health, another nonprofit that operates 18 health centers in the county. But those clinics can only absorb so many new patients.\u003c/p>\n\u003cp>Both Madera and Fresno counties have declared emergencies due to the strain on local hospitals and emergency services. Robert Poythress, a Madera County supervisor and secretary of the hospital’s board of trustees, said the “domino effect” ranges from law enforcement increasingly leaving the county to take incarcerated people to Fresno hospitals, to Madera residents no longer being able to walk to the hospital for familiar medical assistance.\u003c/p>\n\u003cp>“There’s certain people that, other than the ER, aren’t going to miss Madera Community because they never used Madera Community,” Poythress said, explaining that some residents who can afford private insurance already prefer to see doctors in Fresno. “It’s the people who are the most disadvantaged, those are the people who are getting hurt the most.”\u003c/p>\n\u003cp>The closure of Madera’s only general hospital leaves the county’s public health department without a primary tool. Most of the county’s public health programs were in some way linked to the hospital, said Sara Bosse, public health director for Madera County.\u003c/p>\n\u003cp>“It impacts how referrals come to our programs,” Bosse said. “Many families were identified through labor and delivery, for example, as needing WIC (Women, Infants and Children) services or home visitation services. We were able to connect with people who were in critical moments of life and health.”\u003c/p>\n\u003cp>The department is now having to make those connections with hospitals outside its county, primarily in Fresno and Merced.\u003c/p>\n\u003cp>There is also the issue of transportation, which was already a chief concern. Now it’s going to be exacerbated as people will have to travel at least 30 minutes to the next closest hospital. People who relied on the hospital’s clinics will also need to find other primary care providers, which could delay care.\u003c/p>\n\u003cp>Elsa Mejia, the Madera mayor pro tem, said she’s been fielding questions from constituents, including many who are Indigenous Oaxacans like herself and her family, who are shocked by the closure and looking for assistance. She said officials working to reopen the hospital need to remember how urgently an “already disadvantaged community” like Madera needs a hospital.\u003c/p>\n\u003cp>“We already have issues here like poverty, access and language barriers,” Mejia said. “It was already very difficult for us and now it’s just gone, we’re stripped of it. It just makes everything a lot worse.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "Are At-Home Rapid COVID Tests Still Reliable? What You Need to Know",
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"content": "\u003cp>As the COVID-19 pandemic enters its fourth year, a negative result on a little plastic at-home test feels a bit less comforting than it once did.\u003c/p>\n\u003cp>Still, you dutifully swab your nostrils before dinner parties, wait 15 minutes for the all-clear and then text the host “negative!” before leaving your KN95 mask at home.\u003c/p>\n\u003cp>It feels like the right thing to do, right?\u003c/p>\n\u003cp>The virus has mutated and \u003ca href=\"https://www.npr.org/sections/health-shots/2023/01/06/1147372029/new-covid-omicron-subvariant-spreading-fast-data\">then mutated again\u003c/a>, with the tests offering at least some sense of control as the Greek letters pile up. But some experts caution against putting too much faith in a negative result.\u003c/p>\n\u003cp>So it’s only fitting to do a reality check on what those rapid COVID-19 tests, also called antigen tests, can do — and what they can’t.\u003c/p>\n\u003ch2>Is the latest omicron variant tripping up at-home tests?\u003c/h2>\n\u003cp>For the most part, the answer is no.\u003c/p>\n\u003cp>That’s because as the virus evolves, scientists are mainly seeing changes in its spike protein, which is what the virus uses to attack and enter healthy cells. But the rapid antigen tests aren’t actually looking for that spike protein.\u003c/p>\n\u003cp>“[The tests] rely on detection of the nucleocapsid protein, which is the protein that is directly encapsulating the viral RNA,” says \u003ca href=\"https://connects.catalyst.harvard.edu/Profiles/display/Person/32693\">Dr. Robin Colgrove\u003c/a>, a professor at Harvard Medical School and chair of the Diagnostics Committee of the Infectious Diseases Society of America.\u003c/p>\n\u003cp>He says this interior protein really hasn’t changed much as the virus has mutated over the years. So, at least for now, the rapid tests can detect it.\u003c/p>\n\u003cp>Federal health agencies are monitoring the situation in case that changes. The Food and Drug Administration is working with the National Institutes of Health to study just how well the at-home tests work as the virus continues to evolve.\u003c/p>\n\u003cp>So far, the agencies have identified only one test — the \u003ca href=\"https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/sars-cov-2-viral-mutations-impact-covid-19-tests#63c123b8800ae\">Luminostics Inc. Clip COVID Rapid Antigen Test\u003c/a> — that has been rendered less reliable in the face of new variants. And even then, the FDA says “the impact does not appear to be significant.”\u003c/p>\n\u003ch2>Are antigen tests taking longer to show a positive?\u003c/h2>\n\u003cp>Some people report having negative antigen test results for days, despite having a known COVID-19 exposure and the telltale symptoms. Eventually, they test positive, but it can sometimes take as long as a week.\u003c/p>\n\u003cp>The phenomenon is somewhat mysterious, says Colgrove. He acknowledges that doctors are seeing it, but so far, it’s only anecdotal.\u003c/p>\n\u003cp>“What kind of an experiment would you have to do to answer that question?” he says, explaining that it would be difficult to study.\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"covid\"]Many factors could make it seem as though home tests are taking longer to register a positive result, such as the virus multiplying faster somewhere other than the nostrils in some patients, says \u003ca href=\"https://dlmp.uw.edu/faculty/baird\">Dr. Geoffrey Baird\u003c/a>, chair of the Department of Laboratory Medicine and Pathology at the University of Washington School of Medicine.\u003c/p>\n\u003cp>But Baird says perhaps the biggest factor is human error. After all, people doing these tests at home make mistakes and aren’t trained like those who are doing COVID-19 tests in a lab.\u003c/p>\n\u003cp>“There’s going to be some people who stick it in their mouth,” he says, explaining that not everyone follows the testing instructions as written. Some people even get mucus on the swab, mistakenly thinking mucus will have plenty of virus in it. “Actually you don’t want snot on the thing.”\u003c/p>\n\u003cp>And while, on average, people will get a positive antigen test result around the time they become infectious, Baird says it’s important to remember that there will always be plenty of people on either side of that average: those who test positive much earlier than most and those who test positive much later.\u003c/p>\n\u003ch2>How well do these tests really work?\u003c/h2>\n\u003cp>Antigen tests can be useful in certain situations (more on that in a minute), but Baird stresses that they have their limits. That was true even before the pandemic.\u003c/p>\n\u003cp>“Similar technology has existed for influenza for years and the recommendation was not to use them,” he says.\u003c/p>\n\u003cp>Antigen tests look for specific proteins inside the virus. Users typically swab their nostrils, and the tests take about 15 minutes to render a positive or negative result. But these at-home tests need much more virus to generate a positive result than a PCR test, which is done in a lab and involves letting trace amounts of viral genetic material “amplify” over time — usually a day or so. So even if very little virus is present, there should be enough to trigger a positive result (PCR tests may also keep turning up positive long after someone has cleared the infection).\u003c/p>\n\u003cp>Both kinds of tests have their advantages and disadvantages. And there are two measures of test performance to know about: \u003ca href=\"https://www.npr.org/sections/health-shots/2020/04/15/834497497/antibody-tests-for-coronavirus-can-miss-the-mark\">specificity and sensitivity\u003c/a>.\u003c/p>\n\u003cp>Specificity is how good the test is at avoiding false positives. And sensitivity is how good the test is at finding the virus.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/antigen-tests-guidelines.html#table1\">According to the CDC\u003c/a>, antigen and PCR tests are both good at avoiding false positives, but PCR tests are generally more sensitive than home tests. That means antigen tests aren’t all that useful for ruling \u003cem>out \u003c/em>COVID-19, but they can be valuable for confirming that cold really \u003cem>is \u003c/em>COVID-19.\u003c/p>\n\u003cp>If you don’t have any symptoms though, don’t count on antigen tests to give you a definitive answer on whether or not you’re in the clear. This is also what researchers found when they took a look at more than 100 studies of antigen tests and \u003ca href=\"https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013705.pub3/full\">published their findings\u003c/a> in the Cochrane Database of Systematic Reviews this past July.\u003c/p>\n\u003cp>“Rapid antigen tests are considerably less accurate when they are used in people with no signs or symptoms of infection, but do perform better in people who have been in contact with someone who has confirmed COVID‐19,” they wrote.\u003c/p>\n\u003cp>The same researchers also found that not all home tests were equally accurate. Their review included 49 different kinds of tests.\u003c/p>\n\u003cp>“We saw a lot of variation in the sensitivity of different brands of tests and our overall results combine findings from different studies that evaluated the same tests,” lead author Jacqueline Dinnes from the University of Birmingham \u003ca href=\"https://www.cochrane.org/podcasts/10.1002/14651858.CD013705.pub3\">said in a podcast\u003c/a> about the report.\u003c/p>\n\u003ch2>So what are these tests actually good for?\u003c/h2>\n\u003cp>Even though it seems like a good idea to have everyone take a rapid COVID-19 test the day of a gathering to make sure they’re negative, experts say that’s not how the tests were meant to be used.\u003c/p>\n\u003cp>“A positive test is almost always true,” Colgrove says. “So in a person with an exposure or a person with suggestive symptoms, if they do a test and it’s positive, you’re done. You have your diagnosis.”\u003c/p>\n\u003cp>It’s a \u003ca href=\"https://www.npr.org/sections/health-shots/2022/06/30/1108615724/positive-test-isolation\">slightly different story\u003c/a> if you are getting over COVID-19 and are testing to see whether you’re still positive.\u003c/p>\n\u003cp>But a negative “does not rule out” a COVID-19 infection, \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/testing.html\">according to the Centers for Disease Control and Prevention\u003c/a>. If someone tests negative, they’re supposed to take another antigen test 48 hours later to see if it turns positive. And if that person has a \u003ca href=\"https://www.fda.gov/medical-devices/safety-communications/home-covid-19-antigen-tests-take-steps-reduce-your-risk-false-negative-results-fda-safety\">known COVID exposure or symptoms\u003c/a>, the FDA \u003ca href=\"https://www.npr.org/2022/08/11/1117060962/covid-19-home-tests-fda\">recommends a third test \u003c/a>48 hours after that.\u003c/p>\n\u003cp>The best way to use the tests is to know their limits and follow instructions for retesting when you get a negative result.\u003c/p>\n\u003cp>“In a person who had suggestive symptoms now, in the middle of the epidemic where the prevalence of the infection is high, a single negative test is not enough to rule out infection,” Colgrove says.\u003c/p>\n\u003cp>If you have COVID-19 symptoms, even if your test is negative, it’s a good idea to be cautious and just stay home.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2023 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Is+it+time+for+a+reality+check+on+rapid+COVID+tests%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/em>\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>As the COVID-19 pandemic enters its fourth year, a negative result on a little plastic at-home test feels a bit less comforting than it once did.\u003c/p>\n\u003cp>Still, you dutifully swab your nostrils before dinner parties, wait 15 minutes for the all-clear and then text the host “negative!” before leaving your KN95 mask at home.\u003c/p>\n\u003cp>It feels like the right thing to do, right?\u003c/p>\n\u003cp>The virus has mutated and \u003ca href=\"https://www.npr.org/sections/health-shots/2023/01/06/1147372029/new-covid-omicron-subvariant-spreading-fast-data\">then mutated again\u003c/a>, with the tests offering at least some sense of control as the Greek letters pile up. But some experts caution against putting too much faith in a negative result.\u003c/p>\n\u003cp>So it’s only fitting to do a reality check on what those rapid COVID-19 tests, also called antigen tests, can do — and what they can’t.\u003c/p>\n\u003ch2>Is the latest omicron variant tripping up at-home tests?\u003c/h2>\n\u003cp>For the most part, the answer is no.\u003c/p>\n\u003cp>That’s because as the virus evolves, scientists are mainly seeing changes in its spike protein, which is what the virus uses to attack and enter healthy cells. But the rapid antigen tests aren’t actually looking for that spike protein.\u003c/p>\n\u003cp>“[The tests] rely on detection of the nucleocapsid protein, which is the protein that is directly encapsulating the viral RNA,” says \u003ca href=\"https://connects.catalyst.harvard.edu/Profiles/display/Person/32693\">Dr. Robin Colgrove\u003c/a>, a professor at Harvard Medical School and chair of the Diagnostics Committee of the Infectious Diseases Society of America.\u003c/p>\n\u003cp>He says this interior protein really hasn’t changed much as the virus has mutated over the years. So, at least for now, the rapid tests can detect it.\u003c/p>\n\u003cp>Federal health agencies are monitoring the situation in case that changes. The Food and Drug Administration is working with the National Institutes of Health to study just how well the at-home tests work as the virus continues to evolve.\u003c/p>\n\u003cp>So far, the agencies have identified only one test — the \u003ca href=\"https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/sars-cov-2-viral-mutations-impact-covid-19-tests#63c123b8800ae\">Luminostics Inc. Clip COVID Rapid Antigen Test\u003c/a> — that has been rendered less reliable in the face of new variants. And even then, the FDA says “the impact does not appear to be significant.”\u003c/p>\n\u003ch2>Are antigen tests taking longer to show a positive?\u003c/h2>\n\u003cp>Some people report having negative antigen test results for days, despite having a known COVID-19 exposure and the telltale symptoms. Eventually, they test positive, but it can sometimes take as long as a week.\u003c/p>\n\u003cp>The phenomenon is somewhat mysterious, says Colgrove. He acknowledges that doctors are seeing it, but so far, it’s only anecdotal.\u003c/p>\n\u003cp>“What kind of an experiment would you have to do to answer that question?” he says, explaining that it would be difficult to study.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Many factors could make it seem as though home tests are taking longer to register a positive result, such as the virus multiplying faster somewhere other than the nostrils in some patients, says \u003ca href=\"https://dlmp.uw.edu/faculty/baird\">Dr. Geoffrey Baird\u003c/a>, chair of the Department of Laboratory Medicine and Pathology at the University of Washington School of Medicine.\u003c/p>\n\u003cp>But Baird says perhaps the biggest factor is human error. After all, people doing these tests at home make mistakes and aren’t trained like those who are doing COVID-19 tests in a lab.\u003c/p>\n\u003cp>“There’s going to be some people who stick it in their mouth,” he says, explaining that not everyone follows the testing instructions as written. Some people even get mucus on the swab, mistakenly thinking mucus will have plenty of virus in it. “Actually you don’t want snot on the thing.”\u003c/p>\n\u003cp>And while, on average, people will get a positive antigen test result around the time they become infectious, Baird says it’s important to remember that there will always be plenty of people on either side of that average: those who test positive much earlier than most and those who test positive much later.\u003c/p>\n\u003ch2>How well do these tests really work?\u003c/h2>\n\u003cp>Antigen tests can be useful in certain situations (more on that in a minute), but Baird stresses that they have their limits. That was true even before the pandemic.\u003c/p>\n\u003cp>“Similar technology has existed for influenza for years and the recommendation was not to use them,” he says.\u003c/p>\n\u003cp>Antigen tests look for specific proteins inside the virus. Users typically swab their nostrils, and the tests take about 15 minutes to render a positive or negative result. But these at-home tests need much more virus to generate a positive result than a PCR test, which is done in a lab and involves letting trace amounts of viral genetic material “amplify” over time — usually a day or so. So even if very little virus is present, there should be enough to trigger a positive result (PCR tests may also keep turning up positive long after someone has cleared the infection).\u003c/p>\n\u003cp>Both kinds of tests have their advantages and disadvantages. And there are two measures of test performance to know about: \u003ca href=\"https://www.npr.org/sections/health-shots/2020/04/15/834497497/antibody-tests-for-coronavirus-can-miss-the-mark\">specificity and sensitivity\u003c/a>.\u003c/p>\n\u003cp>Specificity is how good the test is at avoiding false positives. And sensitivity is how good the test is at finding the virus.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/antigen-tests-guidelines.html#table1\">According to the CDC\u003c/a>, antigen and PCR tests are both good at avoiding false positives, but PCR tests are generally more sensitive than home tests. That means antigen tests aren’t all that useful for ruling \u003cem>out \u003c/em>COVID-19, but they can be valuable for confirming that cold really \u003cem>is \u003c/em>COVID-19.\u003c/p>\n\u003cp>If you don’t have any symptoms though, don’t count on antigen tests to give you a definitive answer on whether or not you’re in the clear. This is also what researchers found when they took a look at more than 100 studies of antigen tests and \u003ca href=\"https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013705.pub3/full\">published their findings\u003c/a> in the Cochrane Database of Systematic Reviews this past July.\u003c/p>\n\u003cp>“Rapid antigen tests are considerably less accurate when they are used in people with no signs or symptoms of infection, but do perform better in people who have been in contact with someone who has confirmed COVID‐19,” they wrote.\u003c/p>\n\u003cp>The same researchers also found that not all home tests were equally accurate. Their review included 49 different kinds of tests.\u003c/p>\n\u003cp>“We saw a lot of variation in the sensitivity of different brands of tests and our overall results combine findings from different studies that evaluated the same tests,” lead author Jacqueline Dinnes from the University of Birmingham \u003ca href=\"https://www.cochrane.org/podcasts/10.1002/14651858.CD013705.pub3\">said in a podcast\u003c/a> about the report.\u003c/p>\n\u003ch2>So what are these tests actually good for?\u003c/h2>\n\u003cp>Even though it seems like a good idea to have everyone take a rapid COVID-19 test the day of a gathering to make sure they’re negative, experts say that’s not how the tests were meant to be used.\u003c/p>\n\u003cp>“A positive test is almost always true,” Colgrove says. “So in a person with an exposure or a person with suggestive symptoms, if they do a test and it’s positive, you’re done. You have your diagnosis.”\u003c/p>\n\u003cp>It’s a \u003ca href=\"https://www.npr.org/sections/health-shots/2022/06/30/1108615724/positive-test-isolation\">slightly different story\u003c/a> if you are getting over COVID-19 and are testing to see whether you’re still positive.\u003c/p>\n\u003cp>But a negative “does not rule out” a COVID-19 infection, \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/testing.html\">according to the Centers for Disease Control and Prevention\u003c/a>. If someone tests negative, they’re supposed to take another antigen test 48 hours later to see if it turns positive. And if that person has a \u003ca href=\"https://www.fda.gov/medical-devices/safety-communications/home-covid-19-antigen-tests-take-steps-reduce-your-risk-false-negative-results-fda-safety\">known COVID exposure or symptoms\u003c/a>, the FDA \u003ca href=\"https://www.npr.org/2022/08/11/1117060962/covid-19-home-tests-fda\">recommends a third test \u003c/a>48 hours after that.\u003c/p>\n\u003cp>The best way to use the tests is to know their limits and follow instructions for retesting when you get a negative result.\u003c/p>\n\u003cp>“In a person who had suggestive symptoms now, in the middle of the epidemic where the prevalence of the infection is high, a single negative test is not enough to rule out infection,” Colgrove says.\u003c/p>\n\u003cp>If you have COVID-19 symptoms, even if your test is negative, it’s a good idea to be cautious and just stay home.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2023 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Is+it+time+for+a+reality+check+on+rapid+COVID+tests%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/em>\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>[dropcap]O[/dropcap]n a sunny October afternoon, a young woman exits the Planned Parenthood office in Napa carrying a small white paper bag. She hasn’t taken more than five steps toward her car before she’s approached: “Hi, can I give you some information about free resources?”\u003c/p>\n\u003cp>It’s the Friday before Halloween of 2022, four months after the Supreme Court issued its landmark decision that overturned Roe v. Wade, \u003ca href=\"https://www.npr.org/sections/health-shots/2022/06/24/1107126432/abortion-bans-supreme-court-roe-v-wade\">leading to bans on most abortions in about 13 states\u003c/a> (so far). It’s about a week before the midterms, when California voters will decide to \u003ca href=\"https://www.kqed.org/news/11931183/californians-vote-to-protect-abortion-in-constitution\">enshrine the right to an abortion in the state constitution\u003c/a>.\u003c/p>\n\u003cp>But today, here in Napa, the abortion conversation looks like this: A woman named Teresa Conemac sits on a stool steps away from the Planned Parenthood entrance, wearing scrubs and a badge that reads “client advocate,” praying and performing what she and her fellow volunteers with the Christian anti-abortion organization \u003ca href=\"https://www.40daysforlife.com/en/\">40 Days for Life\u003c/a> call “sidewalk counseling.” She talks to people approaching or exiting the clinic, and gives them pamphlets featuring widely debunked claims about the dangers of abortion and birth control.\u003c/p>\n\u003cfigure id=\"attachment_11937384\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59821_009_KQED_CrisisPregnancyCenter_11042022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11937384 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59821_009_KQED_CrisisPregnancyCenter_11042022-qut-800x533.jpg\" alt=\"a older white woman in orange scrubs talks to a Black woman in dark clothing outside a Planned Parenthood health clinic\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59821_009_KQED_CrisisPregnancyCenter_11042022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59821_009_KQED_CrisisPregnancyCenter_11042022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59821_009_KQED_CrisisPregnancyCenter_11042022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59821_009_KQED_CrisisPregnancyCenter_11042022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59821_009_KQED_CrisisPregnancyCenter_11042022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Conemac talks to a person leaving a Planned Parenthood clinic in Napa. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Conemac also tells them about resources at, and distributes cards for, the facility next door: the \u003ca href=\"https://www.youtube.com/watch?v=3xuUaKU87J8\">Napa Women’s Center\u003c/a>, opened by the Christian nonprofit Napa Valley Culture of Life in 2020. No medical professionals work at this facility, but a visitor can take a free pregnancy test, learn about adoption agencies and pick up pamphlets that inaccurately link abortion to \u003ca href=\"https://www.cancer.org/healthy/cancer-causes/medical-treatments/abortion-and-breast-cancer-risk.html\">breast cancer\u003c/a>, \u003ca href=\"https://www.nytimes.com/2019/05/30/well/can-an-abortion-affect-your-fertility.html\">infertility\u003c/a>, \u003ca href=\"https://www.apa.org/monitor/2022/09/news-facts-abortion-mental-health\">depression\u003c/a> and \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/22270271/\">death\u003c/a>.\u003c/p>\n\u003cp>The Napa Women’s Center is an anti-abortion center — sometimes known as a “crisis pregnancy center.” It’s one of approximately 3,000 such facilities across the country. Established by faith-based organizations, anti-abortion centers exist primarily to dissuade people from having abortions. They often attract clients by opening in close proximity to abortion care clinics and by advertising reproductive health services, despite the vast majority operating without medical licensing.\u003c/p>\n\u003cp>In Napa, it is no accident that an anti-abortion center operates right next to the city’s lone Planned Parenthood, in a state of uneasy tension, on one small city block. Connected by a 6-foot wooden fence, their facades are plain, and notably similar to the casual observer.\u003c/p>\n\u003cp>But behind those doors lie two vastly different worlds. For a pregnant person seeking health care, the choice of which one to enter comes with potentially life-changing consequences. None of the \u003ca href=\"https://www.kqed.org/news/11926949/newsom-signs-slate-of-abortion-protection-bills\">new state laws aimed at strengthening abortion rights\u003c/a> can help a patient who’s standing on the sidewalk outside, deciding between the two, confused about what they’re seeing. And as long as California fails to regulate anti-abortion centers, advocates say, calling itself a sanctuary state won’t change a thing about that.\u003c/p>\n\u003ch2>‘We don’t have a moment to lose’\u003c/h2>\n\u003cp>Anti-abortion centers have existed in some form since the late 1960s, when Catholic activists first sought to counter the growing legalization of abortion in the United States. After the U.S. Supreme Court ruled that the right to an abortion was protected by the Constitution in its 1973 Roe v. Wade decision — which, had it been upheld, would have celebrated a 50th anniversary Jan. 22 — the so-called crisis pregnancy center movement expanded to include evangelical Christians. That expansion led to networks like Heartbeat International, which operates more than 2,000 centers worldwide.\u003c/p>\n\u003cp>Anti-abortion centers proliferated throughout the ’90s and aughts, in part thanks to federal grants for abstinence-only education under President George W. Bush; many received further federal funds due to \u003ca href=\"https://www.kqed.org/news/11730464/california-sues-trump-administration-over-new-abortion-restrictions\">changes made to Title X under the Trump administration\u003c/a>. In 2019, for example, the California-based network of centers calling itself Obria Medical Clinics — which operates in Oakland, Redwood City, Union City and San José — was awarded $5.1 million over three years by the U.S. Department of Health and Human Services.\u003c/p>\n\u003cp>[aside label=\"Related Stories\" postID=\"news_11934819,news_11931183\"]But with the fall of Roe, abortion-rights advocates say these centers have assumed an even more powerful role in the landscape, becoming an increasingly valuable tool in the anti-abortion movement’s arsenal. At the same time, advocates charge, anti-abortion centers only intensify the inequities in abortion access along racial and socioeconomic lines.\u003c/p>\n\u003cp>These centers’ impact might be most dramatic in the \u003ca href=\"https://www.nytimes.com/interactive/2022/us/abortion-laws-roe-v-wade.html\">26 states that either recently banned or plan to heavily restrict abortions\u003c/a>, where even seeking out abortion information could put a pregnant person on the wrong side of the law. But advocates say anti-abortion centers also play a surprisingly significant role in blue states like California, where they \u003ca href=\"https://www.cwlc.org/report-shows-anti-abortion-cpcs-receive-federal-and-state-funding-to-mislead-clients-provide-few-services/#:~:text=The%20number%20of%20CPCs%20in,than%20CPCs%20in%20other%20states\">outnumber clinics that provide abortions by 20%\u003c/a> — and where as many as \u003ca href=\"https://law.ucla.edu/sites/default/files/PDFs/Center_on_Reproductive_Health/California_Abortion_Estimates.pdf?campaign_id=49&emc=edit_ca_20220627&instance_id=65130&nl=california-today®i_id=161520323&segment_id=96906&te=1&user_id=fa2fb80d2a88c6eb21eaedcb8ce6386f\">16,000 people are now expected to travel each year in search of abortion care (PDF)\u003c/a>.\u003c/p>\n\u003cp>“This is one of those issues where time is of the essence to the women who are involved, whose lives are at stake,” says former Los Angeles City Attorney Mike Feuer of the lack of regulation around anti-abortion centers. “And because of what’s happening nationally, we don’t have a moment to lose.”\u003c/p>\n\u003cp>In his last months as city attorney in 2022, Feuer successfully introduced a city ordinance that makes it punishable by up to $10,000 for a facility to “mislead women into believing they offer a full range of reproductive health services, including abortion or abortion referrals” when they do not.\u003c/p>\n\u003cp>“We may already be in a situation where women who are utterly desperate to exercise their full reproductive choices are coming to our city,” says Feuer. “And we need to ensure that when they do, no pregnancy center misleads them about their services and what their options are.”\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Christine Henneberg, Bay Area OB-GYN and author\"]‘Working at medical facilities, we have so many regulations on everything we do. But then these places that are \u003cem>not\u003c/em> medical facilities — that are disguising themselves as medical facilities — are totally unregulated? It makes no sense.’[/pullquote]Going unmentioned in LA’s new ordinance is how difficult it’s proven to regulate these facilities — Democratic lawmakers have been trying, and mostly failing, for years. Most recently, California’s 2015 \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB775\">Reproductive FACT Act\u003c/a> required reproductive health care facilities to inform clients about the state’s programs that provide low-cost or free contraception and abortion, and forced unlicensed centers to post notices acknowledging that they were not licensed health care providers.\u003c/p>\n\u003cp>In 2018, after the law was challenged by an anti-abortion legal organization, the \u003ca href=\"https://www.npr.org/2018/06/26/606427673/supreme-court-sides-with-california-anti-abortion-pregnancy-centers\">U.S. Supreme Court voted 5–4 to strike it down\u003c/a> on the grounds that it violated the First Amendment.\u003c/p>\n\u003cp>For \u003ca href=\"https://christinehenneberg.com/\">Christine Henneberg\u003c/a>, a Bay Area OB-GYN and abortion provider — who says “a fair number” of her patients have interacted with an anti-abortion center by the time they land in her office — the \u003ca href=\"https://www.latimes.com/opinion/story/2022-06-22/crisis-pregnancy-centers-abortion-deception-regulation\" target=\"_blank\" rel=\"noopener noreferrer\">continued lack of regulation\u003c/a> is “absurd.”\u003c/p>\n\u003cp>“Working at medical facilities, we have so many regulations on everything we do,” says Henneberg. “But then these places that are \u003cem>not\u003c/em> medical facilities — that are disguising themselves as medical facilities — are totally unregulated? It makes no sense.”\u003c/p>\n\u003cp>Absent meaningful regulation, some agencies have focused on education: In June of 2022, California Attorney General Rob Bonta issued \u003ca href=\"https://oag.ca.gov/news/press-releases/attorney-general-bonta-issues-consumer-alert-warning-californians-crisis\">a consumer alert about anti-abortion centers\u003c/a>. And the state’s new hub for abortion resources, abortion.ca.gov, includes a section on \u003ca href=\"https://abortion.ca.gov/find-a-provider/#fake-abortion-information\">how to spot the differences between such centers and legitimate clinics that offer abortion care\u003c/a>.\u003c/p>\n\u003cp>But to Henneberg, it’s unfair to put the onus of research on the consumer.\u003c/p>\n\u003cp>“When you send a patient to get their tonsils removed, the language is of informed consent: You tell them the risks, benefits and alternatives that you can offer them. That is the physician’s responsibility in an ethical sense, and it’s the law,” she says. “You don’t assume, oh, well, they can find out for themselves … it boggles my mind that anyone would think it’s the responsibility of the consumer seeking a legal service to figure this out on their own.”\u003c/p>\n\u003ch2>‘Patients get confused’\u003c/h2>\n\u003cp>Lynda Metz knew immediately that the building she’d entered wasn’t a health clinic. But it was 1995, she was 17, and the center had been the first thing listed when she looked up “pregnancy test” in the Yellow Pages. Pregnant and terrified in a strict Southern Baptist community north of Little Rock, Arkansas, she was happy to take whatever free services were closest to home.\u003c/p>\n\u003cp>“There was nothing clinical about it,” recalls Metz, who went on to have two children by the age of 20. “I peed on the stick, and then a woman pulled me into a room and took out her Bible … and kind of held me hostage for two hours. She showed me pictures of little plastic babies with arms and legs and said, ‘This is what your baby looks like now.’ There was nothing about how to [take care of myself]. Their focus was just baby, baby, baby.”\u003c/p>\n\u003cfigure id=\"attachment_11937406\" class=\"wp-caption aligncenter\" style=\"max-width: 1534px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11937406\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/Screen-Shot-2023-01-08-at-2.46.20-PM.png\" alt=\"a young teen girl with brown hair in a school photo at left, and in a portrait with her infant son on the right\" width=\"1534\" height=\"864\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2023-01-08-at-2.46.20-PM.png 1534w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2023-01-08-at-2.46.20-PM-800x451.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2023-01-08-at-2.46.20-PM-1020x574.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2023-01-08-at-2.46.20-PM-160x90.png 160w\" sizes=\"(max-width: 1534px) 100vw, 1534px\">\u003cfigcaption class=\"wp-caption-text\">On the left, Lynda Metz in a photo from her sophomore year of high school, the year before she became pregnant. On the right, Metz a month before her 18th birthday, with her son Matthew. \u003ccite>(Courtesy Lynda Metz)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nearly three decades later, search engines have taken the place of the Yellow Pages — with arguably more complicated results. Last August, responding to mounting public pressure, both \u003ca href=\"https://www.cnn.com/2022/08/23/tech/yelp-crisis-pregnancy-centers/index.html\">Yelp\u003c/a> and \u003ca href=\"https://www.washingtonpost.com/technology/2022/08/25/google-maps-abortions/\">Google Maps\u003c/a> announced that their apps would begin labeling so-called crisis pregnancy centers differently from health clinics that provide abortion care.\u003c/p>\n\u003cp>It would appear they’ve followed through, to a point: Up until July, a search for “abortion” on Google Maps returned nearly two dozen anti-abortion centers across the Bay Area’s nine counties, including one in San Francisco, one in Oakland and several in the South Bay. Six months later, that’s no longer the case. However, a search for “pregnancy center” or “women’s clinic” still returns most of these centers. And \u003ca href=\"https://www.bloomberg.com/graphics/2022-google-search-abortion-clinic-crisis-pregnancy-center-ads/\">paid advertisements for anti-abortion centers still regularly appear in Google’s search results\u003c/a> without any disclaimers.\u003c/p>\n\u003cp>Carly Thomsen, assistant professor of gender and sexuality at Middlebury College in Vermont, thinks the algorithm update was a small, overdue step in the right direction — but she doesn’t expect it to put much of a dent in anti-abortion centers’ business model.\u003c/p>\n\u003cp>“I can see how people would think crisis pregnancy centers are using technology to transform their approach, but I actually don’t think that’s true. I think technology has allowed them to make their same strategies more sophisticated and more wide-reaching,” says Thomsen, who recently co-authored a \u003ca href=\"https://www.nytimes.com/interactive/2022/05/12/opinion/crisis-pregnancy-centers-roe.html\">deeply researched opinion piece on these facilities for \u003cem>The New York Times\u003c/em>\u003c/a>. “And that strategy is to use scare tactics and deception to make claims about what they will offer you in terms of support, even though they’re never held accountable for any of these things.”\u003c/p>\n\u003cfigure id=\"attachment_11937631\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS60260_002_KQED_AlphaPregnancyCenter_11172022-qut-1.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11937631\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS60260_002_KQED_AlphaPregnancyCenter_11172022-qut-1-800x533.jpg\" alt='a mural that says \"live life love\" is seen on the side of a building labeled \"alpha pregnancy center\"' width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS60260_002_KQED_AlphaPregnancyCenter_11172022-qut-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS60260_002_KQED_AlphaPregnancyCenter_11172022-qut-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS60260_002_KQED_AlphaPregnancyCenter_11172022-qut-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS60260_002_KQED_AlphaPregnancyCenter_11172022-qut-1-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS60260_002_KQED_AlphaPregnancyCenter_11172022-qut-1.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Alpha Pregnancy Center, a faith-based anti-abortion center on Mission Street in the Excelsior neighborhood of San Francisco. After months of public pressure, Google Maps recently updated its algorithm so this center no longer appears when a user searches the word ‘abortion.’ \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As a graduate student at UC Santa Barbara, Thomsen was part of a successful effort in 2010 to ban anti-abortion centers from advertising on campus. It’s still the only school, to her knowledge, with that restriction.\u003c/p>\n\u003cp>But perhaps the most insidious tactic, says Thomsen, remains simple geography: By design, religious groups open anti-abortion centers in close proximity to clinics that offer abortion care. In Thomsen’s research on these geographic relationships, she found that more than 99% of clinics that offer abortion care nationwide have an anti-abortion center located close by.\u003c/p>\n\u003cp>“Any place there’s an abortion clinic, there’s a crisis pregnancy center,” she says. “And that’s very intentional.”\u003c/p>\n\u003cp>In other words, say experts: these facilities count on vulnerable people making mistakes.\u003c/p>\n\u003cp>That dynamic is especially evident in places like Napa, where anti-abortion activists work blatantly to direct people away from Planned Parenthood and toward the Napa Women’s Center.\u003c/p>\n\u003cp>“Patients get confused,” says Gloria Martinez, senior director of operations for Planned Parenthood Northern California, of the situation at those two facilities. “Especially if it’s their first time with us or visiting that location, and there’s this person out there in scrubs and this person is telling them, ‘Oh, come over here instead.’”\u003c/p>\n\u003cp>While a \u003ca href=\"https://napavalleyregister.com/news/local/napa-council-votes-for-30-foot-buffer-at-planned-parenthood-center-after-years-of-abortion/article_5338519e-c089-5a82-8bcd-562d833ea369.html\">so-called buffer zone\u003c/a> is supposed to render the clinic’s entrance off-limits to protesters, Martinez says local law enforcement seems hesitant to enforce it due to fears “that the opposition will take action against them” with lawsuits that claim the buffer violates their First Amendment rights.\u003c/p>\n\u003cp>The presence of protesters is one major reason this Napa location of Planned Parenthood is scheduled to close in 2023 after more than 20 years. It will reopen in a new, larger facility elsewhere in Napa — staff are hesitant to say exactly where, lest anti-abortion activists begin planning protests there as well — in the hopes of a better patient experience.\u003c/p>\n\u003cp>As for the current patient experience, it’s difficult to quantify exactly how many people who intend to visit Planned Parenthood end up at the anti-abortion center next door. But there are indicators. During the twice-yearly campaigns by 40 Days for Life — in which anti-abortion protesters are present in larger numbers for, yes, 40 days — Martinez says the no-show rate for appointments at that Planned Parenthood doubles: It normally hovers at around 19%, but during campaigns, the number “skyrockets to 40, sometimes 50%.”\u003c/p>\n\u003cfigure id=\"attachment_11937702\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59835_022_KQED_CrisisPregnancyCenter_11042022-qut-2.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11937702 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59835_022_KQED_CrisisPregnancyCenter_11042022-qut-2-800x533.jpg\" alt=\"The hand of an older white woman holds a pamphlet describing inaccurate side effects of abortions\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59835_022_KQED_CrisisPregnancyCenter_11042022-qut-2-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59835_022_KQED_CrisisPregnancyCenter_11042022-qut-2-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59835_022_KQED_CrisisPregnancyCenter_11042022-qut-2-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59835_022_KQED_CrisisPregnancyCenter_11042022-qut-2-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59835_022_KQED_CrisisPregnancyCenter_11042022-qut-2.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">40 Days for Life volunteer Teresa Conemac holds pamphlets she distributes outside Planned Parenthood in Napa. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“It’s just another barrier [for patients], when there are already so many barriers,” says Martinez. “So many of our patients are low-income, or maybe they’re facing a language barrier or a transportation barrier.\u003c/p>\n\u003cp>“And then this is another layer that they have to face: harassment. Harassment when seeking health care.”\u003c/p>\n\u003ch2>Targeting communities of color\u003c/h2>\n\u003cp>Even if a person mistakenly visits an anti-abortion center, then eventually finds their way to a clinic that offers abortion care, it’s difficult to overstate the trauma that such an experience can inflict, says Susy Chávez Herrera, communications director for California Latinas for Reproductive Justice in Los Angeles (CLRJ).\u003c/p>\n\u003cp>“It can be really intense, and it can really hurt a person’s well-being,” says Chávez Herrera. “Whether physically, by delaying a procedure that might be needed for medical reasons, or mentally, because of the toll it takes on folks who are seeking a medical service and met with this series of misinformation.”\u003c/p>\n\u003cp>That may be especially true considering the already vulnerable communities targeted by anti-abortion centers, according to advocates: immigrants, first-generation Americans, Black and Latinx people, young people and people from lower-income families living in rural areas.\u003c/p>\n\u003cfigure id=\"attachment_11938511\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2024/01/IMG_2166-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11938511\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2024/01/IMG_2166-800x529.jpg\" alt='pamphlets in English and Spanish on a shelf show a Black woman and a Latina woman who are pregnant. The pamphlet is titled \"the first 9 months\"' width=\"800\" height=\"529\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/IMG_2166-800x529.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/IMG_2166-1020x675.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/IMG_2166-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/IMG_2166-1536x1016.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/IMG_2166-2048x1355.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/IMG_2166-1920x1270.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Pamphlets available at the Alpha Pregnancy Center in San Francisco. The APC, unlike the majority of anti-abortion centers, has a medical license. \u003ccite>(Emma Silvers/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We know they target the Latinx community,” says Chávez Herrera. “Just driving down the street here in LA, you see billboards from these groups, with this misinformation, in neighborhoods that we know have largely Latinx communities. And we know these anti-abortion clinics set up shop in our communities.”\u003c/p>\n\u003cp>A study by The Alliance, a consortium of law organizations and policy groups studying reproductive justice, found that \u003ca href=\"https://alliancestateadvocates.org/wp-content/uploads/sites/107/Alliance-CPC-Study-Designed-to-Deceive.pdf\">some anti-abortion centers try to appeal to Black communities (PDF)\u003c/a> — which already face disproportionate maternal mortality rates — by “blackwashing” their websites or pamphlets, prominently featuring images of Black women.\u003c/p>\n\u003cp>In the Latinx community, advocates say anti-abortion centers prey on fears undocumented immigrants might have about visiting a government-funded health clinic, wary that it could lead to deportation; others note that anti-abortion centers make a point of advertising on Spanish-language radio.\u003c/p>\n\u003cfigure id=\"attachment_11937634\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.53.34-PM.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11937634\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.53.34-PM-800x439.png\" alt=\"a screenshot of a spanish language website of a crisis pregnancy center called real options medical clinics, featuring a woman in scrubs talking to another woman, a patient\" width=\"800\" height=\"439\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.53.34-PM-800x439.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.53.34-PM-1020x560.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.53.34-PM-160x88.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.53.34-PM-1536x844.png 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.53.34-PM-2048x1125.png 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.53.34-PM-1920x1055.png 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A screenshot from the website of Obria Medical Clinics, a network of anti-abortion centers that operates five facilities in the Bay Area, funded partially by federal grants it received under the Trump administration. Obria clinics also advertise that they accept Medi-Cal, which means their clinics receive reimbursements from the taxpayer-funded state program.\u003c/figcaption>\u003c/figure>\n\u003cp>Care Net, one of the two biggest national networks of anti-abortion centers, has had \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9189146/\">a programming arm explicitly devoted to outreach in Black and Latinx communities\u003c/a> since 2003, according to a study in the \u003cem>International Journal of Women’s Health\u003c/em>. Initially dubbed the “Urban Initiative,” tactics include advertising on Black Entertainment Television (BET) and “drawing comparisons between abortion and slavery.”\u003c/p>\n\u003cp>“There’s no question that they target communities of color,” says Thomsen. “So we also need to be talking about crisis pregnancy centers as something that is impeding racial justice.”\u003c/p>\n\u003cfigure id=\"attachment_11937639\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.51.42-PM.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11937639\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.51.42-PM-800x338.png\" alt=\"a Black woman is seen on a website for the Alpha Pregnancy Center, a Christian anti-abortion center \" width=\"800\" height=\"338\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.51.42-PM-800x338.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.51.42-PM-1020x431.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.51.42-PM-160x68.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.51.42-PM-1536x650.png 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.51.42-PM-2048x866.png 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.51.42-PM-1920x812.png 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A screenshot from the website of the Alpha Pregnancy Center, an anti-abortion center in San Francisco.\u003c/figcaption>\u003c/figure>\n\u003cp>One small step in the right direction, according to abortion rights advocates, is \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220AB2586\">Assembly Bill 2586\u003c/a>, which was signed by Gov. Gavin Newsom in September as a means of addressing “the reproductive and sexual health inequities that Black, Indigenous and other communities of color face” by issuing grants to community-based organizations that focus on culturally relevant care.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Carly Thomsen, assistant professor of gender and sexuality, Middlebury College\"]‘There’s no question that they target communities of color. So we also need to be talking about crisis pregnancy centers as something that is impeding racial justice.’[/pullquote]The bill’s text included a pointed section about how the “dissemination of misinformation … particularly at the hands of organizations with a demonstrated interest in limiting choice that often misrepresent themselves as health centers, imposes a harmful barrier to reproductive health care access, especially for communities most impacted by a number of other obstacles to care.”\u003c/p>\n\u003cp>While abortion-rights advocates applaud the bill — CLRJ endorsed it enthusiastically — some also note that funding legitimate reproductive health organizations does little to directly curtail the impact that anti-abortion centers have in communities of color, the result of decades of groundwork by anti-abortion activists.\u003c/p>\n\u003cp>“What we’re talking about is an organized campaign of misinformation,” says Chávez Herrera. “And that has been around since well before the repeal [of Roe v. Wade], even in states that are trying to protect abortion rights.”\u003c/p>\n\u003ch2>‘God works in mysterious ways’\u003c/h2>\n\u003cp>On the street in Napa, as Conemac and a fellow volunteer perform their “sidewalk counseling” next to signs they’ve brought that read “EXPOSE PLANNED PARENTHOOD,” people drive by and honk every few minutes in response. In some cases the honk is followed by a middle finger, or a yelled epithet. They also receive thumbs-up signals, and in one case a shout of “God bless you!”\u003c/p>\n\u003cp>But inside the Napa Women’s Center, it’s quiet; the paint and furniture are all soothing beige and pastels. In a room often used to counsel pregnant people, Julie Murillo, executive director of the center, declines to estimate what percentage of the people entering the center are doing so mistakenly, thinking they will be able to access birth control or abortion care. It happens, she says casually, “all the time.”\u003c/p>\n\u003cfigure id=\"attachment_11937694\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59827_012_KQED_CrisisPregnancyCenter_11042022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11937694\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59827_012_KQED_CrisisPregnancyCenter_11042022-qut-800x533.jpg\" alt=\"a car with signs that read 'expose planned parenthood' outside a crisis pregnancy center\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59827_012_KQED_CrisisPregnancyCenter_11042022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59827_012_KQED_CrisisPregnancyCenter_11042022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59827_012_KQED_CrisisPregnancyCenter_11042022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59827_012_KQED_CrisisPregnancyCenter_11042022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59827_012_KQED_CrisisPregnancyCenter_11042022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A car with signs for the organization 40 Days for Life sits outside the Napa Women’s Center, an anti-abortion center opened by faith-based nonprofit Napa Valley Culture of Life. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I tell them that we’re not Planned Parenthood, we’re the Napa Women’s Center, and then I ask them if we can help them on what they need,” she says. She’s seated by a shelf full of English and Spanish brochures with titles like “Life Before Birth,” “What You Need to Know About Abortion Procedures” and one advertising information about “abortion pill reversal” — an experimental hormonal treatment not approved by the FDA, which the American College of Obstetricians and Gynecologists has said is potentially dangerous and not supported by science.\u003c/p>\n\u003cp>“We’re not here to lie to anybody,” says Murillo. “We are here to try and tell them the truth about what happens to their bodies, and to help them make good decisions for their life.”\u003c/p>\n\u003cfigure id=\"attachment_11937683\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59850_038_KQED_CrisisPregnancyCenter_11042022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11937683 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59850_038_KQED_CrisisPregnancyCenter_11042022-qut-800x533.jpg\" alt=\"Three printed-out signs advertising, among other things, 'abortion pill reversal' in a row of glass panels in a front door.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59850_038_KQED_CrisisPregnancyCenter_11042022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59850_038_KQED_CrisisPregnancyCenter_11042022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59850_038_KQED_CrisisPregnancyCenter_11042022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59850_038_KQED_CrisisPregnancyCenter_11042022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59850_038_KQED_CrisisPregnancyCenter_11042022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Signs on the door for the Napa Women’s Center advertise ‘abortion pill reversal’ at the facility in Napa on Nov. 4, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Like most anti-abortion centers, the Napa Women’s Center has no medical professionals on staff. But the organization is in the process of recruiting a nurse practitioner; then, the center plans to begin offering ultrasounds, which anti-abortion activists consider a powerful tool in dissuading a person from having an abortion.\u003c/p>\n\u003cp>The Alpha Pregnancy Center in San Francisco may be an example of what many anti-abortion centers would like to achieve. The facility — which is not located near an abortion care clinic, and which states clearly on its website that it does not offer abortions — \u003ca href=\"https://www.alphapc.org/our-beginnings\">was founded by a group of pastors in 1983. \u003c/a>But the center completed a two-year process to obtain a medical license in 2015, and now has a full-time registered nurse overseeing its medical services, including ultrasounds.\u003c/p>\n\u003cp>For certified OB-GYNs like Henneberg, ultrasounds are also, notably, often the first indication that a patient has mistakenly been to an anti-abortion center before landing in a legitimate medical office.\u003c/p>\n\u003cp>“They’ll ask me questions like, ‘Do I have to look at the ultrasound?’ And I’ll say, ‘No, of course not.’ And they’ll say, ‘Oh, well, the other place made me look at the ultrasound, and I really don’t wanna see it,’” she says. In some cases, according to several reports, \u003ca href=\"https://19thnews.org/2021/10/crisis-pregnancy-centers-ultrasounds-accuracy-stakes/\">an anti-abortion center might perform an ultrasound, then show patients a falsified image of a fetus at a later stage of development\u003c/a> to dissuade them from seeking an abortion.\u003c/p>\n\u003cp>“If you probe a little, often you’ll hear, ‘Yeah, I went to this place first and they told me not to get [an abortion]. And they’re obviously usually annoyed by that,” says Henneberg. “That’s not why they went there.”\u003c/p>\n\u003cfigure id=\"attachment_11937400\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59830_014_KQED_CrisisPregnancyCenter_11042022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11937400\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59830_014_KQED_CrisisPregnancyCenter_11042022-qut-800x533.jpg\" alt=\"a gray building with words that say 'free pregnancy tests' and 'Napa Women's Center, health and wellness matter'\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59830_014_KQED_CrisisPregnancyCenter_11042022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59830_014_KQED_CrisisPregnancyCenter_11042022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59830_014_KQED_CrisisPregnancyCenter_11042022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59830_014_KQED_CrisisPregnancyCenter_11042022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59830_014_KQED_CrisisPregnancyCenter_11042022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Napa Women’s Center, a facility opened by faith-based nonprofit Napa Valley Culture of Life, advertises free pregnancy tests. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Murillo remains adamant that Napa Women’s Center staff are not out to trick anyone. And she says that while the center and 40 Days for Life share the same beliefs about abortion — they are hoping to “help people choose life” — they are separate organizations. (Technically, the two nonprofits do have separate tax ID numbers. But in a video advertising the Napa Women’s Center, Napa Valley Culture of Life president Gerry Cruz details how the center grew directly out of 40 Days for Life’s 2009 campaign in front of Planned Parenthood. Volunteers and staff are on a first-name basis, many belong to the same church, and so on.)\u003c/p>\n\u003cp>In discussing the center’s offerings, Murillo is especially proud of the center’s “baby boutique”: In exchange for watching videos on relationships, fetal development and parenting, visitors can earn points, which can be exchanged for diapers or formula.\u003c/p>\n\u003cp>As for Murillo, she comes from a wine and hospitality background. “God works in mysterious ways,” she says, by way of explaining how she landed in this profession, which amounts to a combination of unlicensed social work and, ostensibly, distributing medical information. “You never know where you’re going to end up, and sometimes you just say yes.”\u003c/p>\n\u003ch2>‘I felt tricked’\u003c/h2>\n\u003cp>There are encouraging signs, say some abortion-rights advocates, that anti-abortion centers may finally be garnering attention. In June, a group of four Democratic congressmembers including Sen. Elizabeth Warren introduced the \u003ca href=\"https://www.congress.gov/bill/117th-congress/senate-bill/4469/text?r=18&s=1\">Stop Anti-Abortion Disinformation Act\u003c/a>, which would have the Federal Trade Commission issue rules regarding deceptive advertising by anti-abortion centers. And the newly formed \u003ca href=\"https://oag.ca.gov/news/press-releases/attorney-general-bonta-launches-california-reproductive-rights-task-force\">California Reproductive Rights Task Force\u003c/a> lists “enforcing consumer protection laws against deceptive or unlawful conduct concerning reproductive healthcare” as one of its objectives.\u003c/p>\n\u003cp>But the anti-abortion movement may already be adjusting its strategies in response. Anti-abortion activists have explicitly stated that they view the Dobbs decision as a chance to expand their networks, including opening new centers. The National Institute of Family and Life Advocates has led an effort to help existing anti-abortion centers hire trained nurses and obtain medical licensing — potentially shielding them from lawsuits about false advertising. And some facilities have increasingly touted their so-called baby boutiques, branding themselves primarily as charities, though due to lack of oversight there’s very little data on how much they actually give away.\u003c/p>\n\u003cfigure id=\"attachment_11937697\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/GettyImages-1403119190-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11937697\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/GettyImages-1403119190-800x533.jpg\" alt=\"a white woman with short blond and gray hair in a pink suit speaks in front of the Capitol building\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/GettyImages-1403119190-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/GettyImages-1403119190-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/GettyImages-1403119190-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/GettyImages-1403119190-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/GettyImages-1403119190-2048x1365.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/GettyImages-1403119190-1920x1280.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sen. Elizabeth Warren (D-MA), seen here speaking about abortion rights at a press conference on June 15, 2022, is one of the members of Congress behind the Stop Anti-Abortion Disinformation Act, which would have the Federal Trade Commission issue rules regarding deceptive advertising by anti-abortion centers. \u003ccite>(Joe Raedle/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In the meantime, according to the Alliance study, as of a 2021 count, anti-abortion centers outnumbered clinics that offer abortion care nationally by an average ratio of 3 to 1.\u003c/p>\n\u003cp>In California, roughly 170 anti-abortion centers continue to operate — and at least 10 have received state funding through Medi-Cal reimbursements, also according to the Alliance study, which noted that “[i]nvestment of public money in CPCs is escalating, especially in the states, with virtually no government oversight, accountability, or transparency.” An untold number of centers also received both federal and state funds during the pandemic through the Paycheck Protection Program.\u003c/p>\n\u003cp>In Napa, as daylight wanes, the 40 Days for Life volunteers pack up their things; Conemac likes to focus on the hours of 10 a.m. to 3 p.m., since that’s when she believes Planned Parenthood pharmacists give out RU-486, otherwise known as the abortion pill. (This location does not perform surgical abortions.) In her place, a group of teenage volunteers from the organization gathers with anti-abortion signs, and stands laughing and talking, flanking the space between the two centers.\u003c/p>\n\u003cfigure id=\"attachment_11937681\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59814_039_KQED_CrisisPregnancyCenter_11042022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11937681 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59814_039_KQED_CrisisPregnancyCenter_11042022-qut-800x600.jpg\" alt=\"a row of young teens holds anti-abortion signs on the sidewalk in between a Planned Parenthood and a crisis pregnancy center. From across the street, they seem to be diverse in terms of ethnicity, age., and gender.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59814_039_KQED_CrisisPregnancyCenter_11042022-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59814_039_KQED_CrisisPregnancyCenter_11042022-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59814_039_KQED_CrisisPregnancyCenter_11042022-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59814_039_KQED_CrisisPregnancyCenter_11042022-qut-1536x1152.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59814_039_KQED_CrisisPregnancyCenter_11042022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Young volunteers for 40 Days for Life stand with anti-abortion signs on the sidewalk between Planned Parenthood and the Napa Women’s Center in Napa on Oct. 28, 2022. \u003ccite>(Emma Silvers/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Some of them look to be around 17. That’s the age Lynda Metz was when she first set foot in an anti-abortion center, scared and confused. Some 27 years later, Metz — now a proudly pro-abortion-rights grandmother still living in a conservative area of Arkansas — can’t help but think about her experience. For one, that center is still in operation, and occasionally she has to drive by it. Or she’ll see a sign from a local business announcing they donate to that facility, and she makes a mental note not to shop there.\u003c/p>\n\u003cp>She also makes a point to talk to other young women in her community, and lets them know they have options. However, as Arkansas is now a state where abortion is “completely banned with very limited exceptions,” according to the Guttmacher Institute, those options are severely limited: A person seeking an abortion has to drive \u003ca href=\"https://states.guttmacher.org/policies/arkansas/abortion-statistics\">an average of more than 300 miles one-way to visit a clinic\u003c/a> that offers them.\u003c/p>\n\u003cp>Mostly, when Metz thinks about her experience, it still feels fresh, and she still feels confused. She can place herself in that room, trapped with that woman and the Bible, realizing she was not going to receive any support or information about her health.\u003c/p>\n\u003cp>“I felt tricked,” she says. And nearly three decades later, she says, “I still just don’t understand. It’s not a necessary service. You are literally tricking people into thinking that this is a certified health clinic.\u003c/p>\n\u003cp>“I mean, how is this still legal?”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ci>This story has been updated to reflect The Associated Press’ new guidance on language to describe anti-abortion centers.\u003c/i>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "In California, a supposed sanctuary state for reproductive rights, Christian anti-abortion centers outnumber abortion care clinics by 20%.",
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"title": "Inside the Anti-Abortion Movement’s Crisis Pregnancy Centers",
"description": "In California, a supposed sanctuary state for reproductive rights, Christian crisis pregnancy centers outnumber abortion care clinics by 20%.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">O\u003c/span>\u003c/p>\u003cp>n a sunny October afternoon, a young woman exits the Planned Parenthood office in Napa carrying a small white paper bag. She hasn’t taken more than five steps toward her car before she’s approached: “Hi, can I give you some information about free resources?”\u003c/p>\n\u003cp>It’s the Friday before Halloween of 2022, four months after the Supreme Court issued its landmark decision that overturned Roe v. Wade, \u003ca href=\"https://www.npr.org/sections/health-shots/2022/06/24/1107126432/abortion-bans-supreme-court-roe-v-wade\">leading to bans on most abortions in about 13 states\u003c/a> (so far). It’s about a week before the midterms, when California voters will decide to \u003ca href=\"https://www.kqed.org/news/11931183/californians-vote-to-protect-abortion-in-constitution\">enshrine the right to an abortion in the state constitution\u003c/a>.\u003c/p>\n\u003cp>But today, here in Napa, the abortion conversation looks like this: A woman named Teresa Conemac sits on a stool steps away from the Planned Parenthood entrance, wearing scrubs and a badge that reads “client advocate,” praying and performing what she and her fellow volunteers with the Christian anti-abortion organization \u003ca href=\"https://www.40daysforlife.com/en/\">40 Days for Life\u003c/a> call “sidewalk counseling.” She talks to people approaching or exiting the clinic, and gives them pamphlets featuring widely debunked claims about the dangers of abortion and birth control.\u003c/p>\n\u003cfigure id=\"attachment_11937384\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59821_009_KQED_CrisisPregnancyCenter_11042022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11937384 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59821_009_KQED_CrisisPregnancyCenter_11042022-qut-800x533.jpg\" alt=\"a older white woman in orange scrubs talks to a Black woman in dark clothing outside a Planned Parenthood health clinic\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59821_009_KQED_CrisisPregnancyCenter_11042022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59821_009_KQED_CrisisPregnancyCenter_11042022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59821_009_KQED_CrisisPregnancyCenter_11042022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59821_009_KQED_CrisisPregnancyCenter_11042022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59821_009_KQED_CrisisPregnancyCenter_11042022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Conemac talks to a person leaving a Planned Parenthood clinic in Napa. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Conemac also tells them about resources at, and distributes cards for, the facility next door: the \u003ca href=\"https://www.youtube.com/watch?v=3xuUaKU87J8\">Napa Women’s Center\u003c/a>, opened by the Christian nonprofit Napa Valley Culture of Life in 2020. No medical professionals work at this facility, but a visitor can take a free pregnancy test, learn about adoption agencies and pick up pamphlets that inaccurately link abortion to \u003ca href=\"https://www.cancer.org/healthy/cancer-causes/medical-treatments/abortion-and-breast-cancer-risk.html\">breast cancer\u003c/a>, \u003ca href=\"https://www.nytimes.com/2019/05/30/well/can-an-abortion-affect-your-fertility.html\">infertility\u003c/a>, \u003ca href=\"https://www.apa.org/monitor/2022/09/news-facts-abortion-mental-health\">depression\u003c/a> and \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/22270271/\">death\u003c/a>.\u003c/p>\n\u003cp>The Napa Women’s Center is an anti-abortion center — sometimes known as a “crisis pregnancy center.” It’s one of approximately 3,000 such facilities across the country. Established by faith-based organizations, anti-abortion centers exist primarily to dissuade people from having abortions. They often attract clients by opening in close proximity to abortion care clinics and by advertising reproductive health services, despite the vast majority operating without medical licensing.\u003c/p>\n\u003cp>In Napa, it is no accident that an anti-abortion center operates right next to the city’s lone Planned Parenthood, in a state of uneasy tension, on one small city block. Connected by a 6-foot wooden fence, their facades are plain, and notably similar to the casual observer.\u003c/p>\n\u003cp>But behind those doors lie two vastly different worlds. For a pregnant person seeking health care, the choice of which one to enter comes with potentially life-changing consequences. None of the \u003ca href=\"https://www.kqed.org/news/11926949/newsom-signs-slate-of-abortion-protection-bills\">new state laws aimed at strengthening abortion rights\u003c/a> can help a patient who’s standing on the sidewalk outside, deciding between the two, confused about what they’re seeing. And as long as California fails to regulate anti-abortion centers, advocates say, calling itself a sanctuary state won’t change a thing about that.\u003c/p>\n\u003ch2>‘We don’t have a moment to lose’\u003c/h2>\n\u003cp>Anti-abortion centers have existed in some form since the late 1960s, when Catholic activists first sought to counter the growing legalization of abortion in the United States. After the U.S. Supreme Court ruled that the right to an abortion was protected by the Constitution in its 1973 Roe v. Wade decision — which, had it been upheld, would have celebrated a 50th anniversary Jan. 22 — the so-called crisis pregnancy center movement expanded to include evangelical Christians. That expansion led to networks like Heartbeat International, which operates more than 2,000 centers worldwide.\u003c/p>\n\u003cp>Anti-abortion centers proliferated throughout the ’90s and aughts, in part thanks to federal grants for abstinence-only education under President George W. Bush; many received further federal funds due to \u003ca href=\"https://www.kqed.org/news/11730464/california-sues-trump-administration-over-new-abortion-restrictions\">changes made to Title X under the Trump administration\u003c/a>. In 2019, for example, the California-based network of centers calling itself Obria Medical Clinics — which operates in Oakland, Redwood City, Union City and San José — was awarded $5.1 million over three years by the U.S. Department of Health and Human Services.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>But with the fall of Roe, abortion-rights advocates say these centers have assumed an even more powerful role in the landscape, becoming an increasingly valuable tool in the anti-abortion movement’s arsenal. At the same time, advocates charge, anti-abortion centers only intensify the inequities in abortion access along racial and socioeconomic lines.\u003c/p>\n\u003cp>These centers’ impact might be most dramatic in the \u003ca href=\"https://www.nytimes.com/interactive/2022/us/abortion-laws-roe-v-wade.html\">26 states that either recently banned or plan to heavily restrict abortions\u003c/a>, where even seeking out abortion information could put a pregnant person on the wrong side of the law. But advocates say anti-abortion centers also play a surprisingly significant role in blue states like California, where they \u003ca href=\"https://www.cwlc.org/report-shows-anti-abortion-cpcs-receive-federal-and-state-funding-to-mislead-clients-provide-few-services/#:~:text=The%20number%20of%20CPCs%20in,than%20CPCs%20in%20other%20states\">outnumber clinics that provide abortions by 20%\u003c/a> — and where as many as \u003ca href=\"https://law.ucla.edu/sites/default/files/PDFs/Center_on_Reproductive_Health/California_Abortion_Estimates.pdf?campaign_id=49&emc=edit_ca_20220627&instance_id=65130&nl=california-today®i_id=161520323&segment_id=96906&te=1&user_id=fa2fb80d2a88c6eb21eaedcb8ce6386f\">16,000 people are now expected to travel each year in search of abortion care (PDF)\u003c/a>.\u003c/p>\n\u003cp>“This is one of those issues where time is of the essence to the women who are involved, whose lives are at stake,” says former Los Angeles City Attorney Mike Feuer of the lack of regulation around anti-abortion centers. “And because of what’s happening nationally, we don’t have a moment to lose.”\u003c/p>\n\u003cp>In his last months as city attorney in 2022, Feuer successfully introduced a city ordinance that makes it punishable by up to $10,000 for a facility to “mislead women into believing they offer a full range of reproductive health services, including abortion or abortion referrals” when they do not.\u003c/p>\n\u003cp>“We may already be in a situation where women who are utterly desperate to exercise their full reproductive choices are coming to our city,” says Feuer. “And we need to ensure that when they do, no pregnancy center misleads them about their services and what their options are.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘Working at medical facilities, we have so many regulations on everything we do. But then these places that are \u003cem>not\u003c/em> medical facilities — that are disguising themselves as medical facilities — are totally unregulated? It makes no sense.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Going unmentioned in LA’s new ordinance is how difficult it’s proven to regulate these facilities — Democratic lawmakers have been trying, and mostly failing, for years. Most recently, California’s 2015 \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB775\">Reproductive FACT Act\u003c/a> required reproductive health care facilities to inform clients about the state’s programs that provide low-cost or free contraception and abortion, and forced unlicensed centers to post notices acknowledging that they were not licensed health care providers.\u003c/p>\n\u003cp>In 2018, after the law was challenged by an anti-abortion legal organization, the \u003ca href=\"https://www.npr.org/2018/06/26/606427673/supreme-court-sides-with-california-anti-abortion-pregnancy-centers\">U.S. Supreme Court voted 5–4 to strike it down\u003c/a> on the grounds that it violated the First Amendment.\u003c/p>\n\u003cp>For \u003ca href=\"https://christinehenneberg.com/\">Christine Henneberg\u003c/a>, a Bay Area OB-GYN and abortion provider — who says “a fair number” of her patients have interacted with an anti-abortion center by the time they land in her office — the \u003ca href=\"https://www.latimes.com/opinion/story/2022-06-22/crisis-pregnancy-centers-abortion-deception-regulation\" target=\"_blank\" rel=\"noopener noreferrer\">continued lack of regulation\u003c/a> is “absurd.”\u003c/p>\n\u003cp>“Working at medical facilities, we have so many regulations on everything we do,” says Henneberg. “But then these places that are \u003cem>not\u003c/em> medical facilities — that are disguising themselves as medical facilities — are totally unregulated? It makes no sense.”\u003c/p>\n\u003cp>Absent meaningful regulation, some agencies have focused on education: In June of 2022, California Attorney General Rob Bonta issued \u003ca href=\"https://oag.ca.gov/news/press-releases/attorney-general-bonta-issues-consumer-alert-warning-californians-crisis\">a consumer alert about anti-abortion centers\u003c/a>. And the state’s new hub for abortion resources, abortion.ca.gov, includes a section on \u003ca href=\"https://abortion.ca.gov/find-a-provider/#fake-abortion-information\">how to spot the differences between such centers and legitimate clinics that offer abortion care\u003c/a>.\u003c/p>\n\u003cp>But to Henneberg, it’s unfair to put the onus of research on the consumer.\u003c/p>\n\u003cp>“When you send a patient to get their tonsils removed, the language is of informed consent: You tell them the risks, benefits and alternatives that you can offer them. That is the physician’s responsibility in an ethical sense, and it’s the law,” she says. “You don’t assume, oh, well, they can find out for themselves … it boggles my mind that anyone would think it’s the responsibility of the consumer seeking a legal service to figure this out on their own.”\u003c/p>\n\u003ch2>‘Patients get confused’\u003c/h2>\n\u003cp>Lynda Metz knew immediately that the building she’d entered wasn’t a health clinic. But it was 1995, she was 17, and the center had been the first thing listed when she looked up “pregnancy test” in the Yellow Pages. Pregnant and terrified in a strict Southern Baptist community north of Little Rock, Arkansas, she was happy to take whatever free services were closest to home.\u003c/p>\n\u003cp>“There was nothing clinical about it,” recalls Metz, who went on to have two children by the age of 20. “I peed on the stick, and then a woman pulled me into a room and took out her Bible … and kind of held me hostage for two hours. She showed me pictures of little plastic babies with arms and legs and said, ‘This is what your baby looks like now.’ There was nothing about how to [take care of myself]. Their focus was just baby, baby, baby.”\u003c/p>\n\u003cfigure id=\"attachment_11937406\" class=\"wp-caption aligncenter\" style=\"max-width: 1534px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11937406\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/Screen-Shot-2023-01-08-at-2.46.20-PM.png\" alt=\"a young teen girl with brown hair in a school photo at left, and in a portrait with her infant son on the right\" width=\"1534\" height=\"864\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2023-01-08-at-2.46.20-PM.png 1534w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2023-01-08-at-2.46.20-PM-800x451.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2023-01-08-at-2.46.20-PM-1020x574.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2023-01-08-at-2.46.20-PM-160x90.png 160w\" sizes=\"(max-width: 1534px) 100vw, 1534px\">\u003cfigcaption class=\"wp-caption-text\">On the left, Lynda Metz in a photo from her sophomore year of high school, the year before she became pregnant. On the right, Metz a month before her 18th birthday, with her son Matthew. \u003ccite>(Courtesy Lynda Metz)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nearly three decades later, search engines have taken the place of the Yellow Pages — with arguably more complicated results. Last August, responding to mounting public pressure, both \u003ca href=\"https://www.cnn.com/2022/08/23/tech/yelp-crisis-pregnancy-centers/index.html\">Yelp\u003c/a> and \u003ca href=\"https://www.washingtonpost.com/technology/2022/08/25/google-maps-abortions/\">Google Maps\u003c/a> announced that their apps would begin labeling so-called crisis pregnancy centers differently from health clinics that provide abortion care.\u003c/p>\n\u003cp>It would appear they’ve followed through, to a point: Up until July, a search for “abortion” on Google Maps returned nearly two dozen anti-abortion centers across the Bay Area’s nine counties, including one in San Francisco, one in Oakland and several in the South Bay. Six months later, that’s no longer the case. However, a search for “pregnancy center” or “women’s clinic” still returns most of these centers. And \u003ca href=\"https://www.bloomberg.com/graphics/2022-google-search-abortion-clinic-crisis-pregnancy-center-ads/\">paid advertisements for anti-abortion centers still regularly appear in Google’s search results\u003c/a> without any disclaimers.\u003c/p>\n\u003cp>Carly Thomsen, assistant professor of gender and sexuality at Middlebury College in Vermont, thinks the algorithm update was a small, overdue step in the right direction — but she doesn’t expect it to put much of a dent in anti-abortion centers’ business model.\u003c/p>\n\u003cp>“I can see how people would think crisis pregnancy centers are using technology to transform their approach, but I actually don’t think that’s true. I think technology has allowed them to make their same strategies more sophisticated and more wide-reaching,” says Thomsen, who recently co-authored a \u003ca href=\"https://www.nytimes.com/interactive/2022/05/12/opinion/crisis-pregnancy-centers-roe.html\">deeply researched opinion piece on these facilities for \u003cem>The New York Times\u003c/em>\u003c/a>. “And that strategy is to use scare tactics and deception to make claims about what they will offer you in terms of support, even though they’re never held accountable for any of these things.”\u003c/p>\n\u003cfigure id=\"attachment_11937631\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS60260_002_KQED_AlphaPregnancyCenter_11172022-qut-1.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11937631\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS60260_002_KQED_AlphaPregnancyCenter_11172022-qut-1-800x533.jpg\" alt='a mural that says \"live life love\" is seen on the side of a building labeled \"alpha pregnancy center\"' width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS60260_002_KQED_AlphaPregnancyCenter_11172022-qut-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS60260_002_KQED_AlphaPregnancyCenter_11172022-qut-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS60260_002_KQED_AlphaPregnancyCenter_11172022-qut-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS60260_002_KQED_AlphaPregnancyCenter_11172022-qut-1-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS60260_002_KQED_AlphaPregnancyCenter_11172022-qut-1.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Alpha Pregnancy Center, a faith-based anti-abortion center on Mission Street in the Excelsior neighborhood of San Francisco. After months of public pressure, Google Maps recently updated its algorithm so this center no longer appears when a user searches the word ‘abortion.’ \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As a graduate student at UC Santa Barbara, Thomsen was part of a successful effort in 2010 to ban anti-abortion centers from advertising on campus. It’s still the only school, to her knowledge, with that restriction.\u003c/p>\n\u003cp>But perhaps the most insidious tactic, says Thomsen, remains simple geography: By design, religious groups open anti-abortion centers in close proximity to clinics that offer abortion care. In Thomsen’s research on these geographic relationships, she found that more than 99% of clinics that offer abortion care nationwide have an anti-abortion center located close by.\u003c/p>\n\u003cp>“Any place there’s an abortion clinic, there’s a crisis pregnancy center,” she says. “And that’s very intentional.”\u003c/p>\n\u003cp>In other words, say experts: these facilities count on vulnerable people making mistakes.\u003c/p>\n\u003cp>That dynamic is especially evident in places like Napa, where anti-abortion activists work blatantly to direct people away from Planned Parenthood and toward the Napa Women’s Center.\u003c/p>\n\u003cp>“Patients get confused,” says Gloria Martinez, senior director of operations for Planned Parenthood Northern California, of the situation at those two facilities. “Especially if it’s their first time with us or visiting that location, and there’s this person out there in scrubs and this person is telling them, ‘Oh, come over here instead.’”\u003c/p>\n\u003cp>While a \u003ca href=\"https://napavalleyregister.com/news/local/napa-council-votes-for-30-foot-buffer-at-planned-parenthood-center-after-years-of-abortion/article_5338519e-c089-5a82-8bcd-562d833ea369.html\">so-called buffer zone\u003c/a> is supposed to render the clinic’s entrance off-limits to protesters, Martinez says local law enforcement seems hesitant to enforce it due to fears “that the opposition will take action against them” with lawsuits that claim the buffer violates their First Amendment rights.\u003c/p>\n\u003cp>The presence of protesters is one major reason this Napa location of Planned Parenthood is scheduled to close in 2023 after more than 20 years. It will reopen in a new, larger facility elsewhere in Napa — staff are hesitant to say exactly where, lest anti-abortion activists begin planning protests there as well — in the hopes of a better patient experience.\u003c/p>\n\u003cp>As for the current patient experience, it’s difficult to quantify exactly how many people who intend to visit Planned Parenthood end up at the anti-abortion center next door. But there are indicators. During the twice-yearly campaigns by 40 Days for Life — in which anti-abortion protesters are present in larger numbers for, yes, 40 days — Martinez says the no-show rate for appointments at that Planned Parenthood doubles: It normally hovers at around 19%, but during campaigns, the number “skyrockets to 40, sometimes 50%.”\u003c/p>\n\u003cfigure id=\"attachment_11937702\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59835_022_KQED_CrisisPregnancyCenter_11042022-qut-2.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11937702 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59835_022_KQED_CrisisPregnancyCenter_11042022-qut-2-800x533.jpg\" alt=\"The hand of an older white woman holds a pamphlet describing inaccurate side effects of abortions\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59835_022_KQED_CrisisPregnancyCenter_11042022-qut-2-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59835_022_KQED_CrisisPregnancyCenter_11042022-qut-2-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59835_022_KQED_CrisisPregnancyCenter_11042022-qut-2-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59835_022_KQED_CrisisPregnancyCenter_11042022-qut-2-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59835_022_KQED_CrisisPregnancyCenter_11042022-qut-2.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">40 Days for Life volunteer Teresa Conemac holds pamphlets she distributes outside Planned Parenthood in Napa. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“It’s just another barrier [for patients], when there are already so many barriers,” says Martinez. “So many of our patients are low-income, or maybe they’re facing a language barrier or a transportation barrier.\u003c/p>\n\u003cp>“And then this is another layer that they have to face: harassment. Harassment when seeking health care.”\u003c/p>\n\u003ch2>Targeting communities of color\u003c/h2>\n\u003cp>Even if a person mistakenly visits an anti-abortion center, then eventually finds their way to a clinic that offers abortion care, it’s difficult to overstate the trauma that such an experience can inflict, says Susy Chávez Herrera, communications director for California Latinas for Reproductive Justice in Los Angeles (CLRJ).\u003c/p>\n\u003cp>“It can be really intense, and it can really hurt a person’s well-being,” says Chávez Herrera. “Whether physically, by delaying a procedure that might be needed for medical reasons, or mentally, because of the toll it takes on folks who are seeking a medical service and met with this series of misinformation.”\u003c/p>\n\u003cp>That may be especially true considering the already vulnerable communities targeted by anti-abortion centers, according to advocates: immigrants, first-generation Americans, Black and Latinx people, young people and people from lower-income families living in rural areas.\u003c/p>\n\u003cfigure id=\"attachment_11938511\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2024/01/IMG_2166-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11938511\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2024/01/IMG_2166-800x529.jpg\" alt='pamphlets in English and Spanish on a shelf show a Black woman and a Latina woman who are pregnant. The pamphlet is titled \"the first 9 months\"' width=\"800\" height=\"529\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/IMG_2166-800x529.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/IMG_2166-1020x675.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/IMG_2166-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/IMG_2166-1536x1016.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/IMG_2166-2048x1355.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/IMG_2166-1920x1270.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Pamphlets available at the Alpha Pregnancy Center in San Francisco. The APC, unlike the majority of anti-abortion centers, has a medical license. \u003ccite>(Emma Silvers/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We know they target the Latinx community,” says Chávez Herrera. “Just driving down the street here in LA, you see billboards from these groups, with this misinformation, in neighborhoods that we know have largely Latinx communities. And we know these anti-abortion clinics set up shop in our communities.”\u003c/p>\n\u003cp>A study by The Alliance, a consortium of law organizations and policy groups studying reproductive justice, found that \u003ca href=\"https://alliancestateadvocates.org/wp-content/uploads/sites/107/Alliance-CPC-Study-Designed-to-Deceive.pdf\">some anti-abortion centers try to appeal to Black communities (PDF)\u003c/a> — which already face disproportionate maternal mortality rates — by “blackwashing” their websites or pamphlets, prominently featuring images of Black women.\u003c/p>\n\u003cp>In the Latinx community, advocates say anti-abortion centers prey on fears undocumented immigrants might have about visiting a government-funded health clinic, wary that it could lead to deportation; others note that anti-abortion centers make a point of advertising on Spanish-language radio.\u003c/p>\n\u003cfigure id=\"attachment_11937634\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.53.34-PM.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11937634\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.53.34-PM-800x439.png\" alt=\"a screenshot of a spanish language website of a crisis pregnancy center called real options medical clinics, featuring a woman in scrubs talking to another woman, a patient\" width=\"800\" height=\"439\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.53.34-PM-800x439.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.53.34-PM-1020x560.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.53.34-PM-160x88.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.53.34-PM-1536x844.png 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.53.34-PM-2048x1125.png 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.53.34-PM-1920x1055.png 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A screenshot from the website of Obria Medical Clinics, a network of anti-abortion centers that operates five facilities in the Bay Area, funded partially by federal grants it received under the Trump administration. Obria clinics also advertise that they accept Medi-Cal, which means their clinics receive reimbursements from the taxpayer-funded state program.\u003c/figcaption>\u003c/figure>\n\u003cp>Care Net, one of the two biggest national networks of anti-abortion centers, has had \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9189146/\">a programming arm explicitly devoted to outreach in Black and Latinx communities\u003c/a> since 2003, according to a study in the \u003cem>International Journal of Women’s Health\u003c/em>. Initially dubbed the “Urban Initiative,” tactics include advertising on Black Entertainment Television (BET) and “drawing comparisons between abortion and slavery.”\u003c/p>\n\u003cp>“There’s no question that they target communities of color,” says Thomsen. “So we also need to be talking about crisis pregnancy centers as something that is impeding racial justice.”\u003c/p>\n\u003cfigure id=\"attachment_11937639\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.51.42-PM.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11937639\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.51.42-PM-800x338.png\" alt=\"a Black woman is seen on a website for the Alpha Pregnancy Center, a Christian anti-abortion center \" width=\"800\" height=\"338\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.51.42-PM-800x338.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.51.42-PM-1020x431.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.51.42-PM-160x68.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.51.42-PM-1536x650.png 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.51.42-PM-2048x866.png 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/Screen-Shot-2022-12-07-at-4.51.42-PM-1920x812.png 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A screenshot from the website of the Alpha Pregnancy Center, an anti-abortion center in San Francisco.\u003c/figcaption>\u003c/figure>\n\u003cp>One small step in the right direction, according to abortion rights advocates, is \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220AB2586\">Assembly Bill 2586\u003c/a>, which was signed by Gov. Gavin Newsom in September as a means of addressing “the reproductive and sexual health inequities that Black, Indigenous and other communities of color face” by issuing grants to community-based organizations that focus on culturally relevant care.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The bill’s text included a pointed section about how the “dissemination of misinformation … particularly at the hands of organizations with a demonstrated interest in limiting choice that often misrepresent themselves as health centers, imposes a harmful barrier to reproductive health care access, especially for communities most impacted by a number of other obstacles to care.”\u003c/p>\n\u003cp>While abortion-rights advocates applaud the bill — CLRJ endorsed it enthusiastically — some also note that funding legitimate reproductive health organizations does little to directly curtail the impact that anti-abortion centers have in communities of color, the result of decades of groundwork by anti-abortion activists.\u003c/p>\n\u003cp>“What we’re talking about is an organized campaign of misinformation,” says Chávez Herrera. “And that has been around since well before the repeal [of Roe v. Wade], even in states that are trying to protect abortion rights.”\u003c/p>\n\u003ch2>‘God works in mysterious ways’\u003c/h2>\n\u003cp>On the street in Napa, as Conemac and a fellow volunteer perform their “sidewalk counseling” next to signs they’ve brought that read “EXPOSE PLANNED PARENTHOOD,” people drive by and honk every few minutes in response. In some cases the honk is followed by a middle finger, or a yelled epithet. They also receive thumbs-up signals, and in one case a shout of “God bless you!”\u003c/p>\n\u003cp>But inside the Napa Women’s Center, it’s quiet; the paint and furniture are all soothing beige and pastels. In a room often used to counsel pregnant people, Julie Murillo, executive director of the center, declines to estimate what percentage of the people entering the center are doing so mistakenly, thinking they will be able to access birth control or abortion care. It happens, she says casually, “all the time.”\u003c/p>\n\u003cfigure id=\"attachment_11937694\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59827_012_KQED_CrisisPregnancyCenter_11042022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11937694\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59827_012_KQED_CrisisPregnancyCenter_11042022-qut-800x533.jpg\" alt=\"a car with signs that read 'expose planned parenthood' outside a crisis pregnancy center\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59827_012_KQED_CrisisPregnancyCenter_11042022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59827_012_KQED_CrisisPregnancyCenter_11042022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59827_012_KQED_CrisisPregnancyCenter_11042022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59827_012_KQED_CrisisPregnancyCenter_11042022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59827_012_KQED_CrisisPregnancyCenter_11042022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A car with signs for the organization 40 Days for Life sits outside the Napa Women’s Center, an anti-abortion center opened by faith-based nonprofit Napa Valley Culture of Life. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I tell them that we’re not Planned Parenthood, we’re the Napa Women’s Center, and then I ask them if we can help them on what they need,” she says. She’s seated by a shelf full of English and Spanish brochures with titles like “Life Before Birth,” “What You Need to Know About Abortion Procedures” and one advertising information about “abortion pill reversal” — an experimental hormonal treatment not approved by the FDA, which the American College of Obstetricians and Gynecologists has said is potentially dangerous and not supported by science.\u003c/p>\n\u003cp>“We’re not here to lie to anybody,” says Murillo. “We are here to try and tell them the truth about what happens to their bodies, and to help them make good decisions for their life.”\u003c/p>\n\u003cfigure id=\"attachment_11937683\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59850_038_KQED_CrisisPregnancyCenter_11042022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11937683 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59850_038_KQED_CrisisPregnancyCenter_11042022-qut-800x533.jpg\" alt=\"Three printed-out signs advertising, among other things, 'abortion pill reversal' in a row of glass panels in a front door.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59850_038_KQED_CrisisPregnancyCenter_11042022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59850_038_KQED_CrisisPregnancyCenter_11042022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59850_038_KQED_CrisisPregnancyCenter_11042022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59850_038_KQED_CrisisPregnancyCenter_11042022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59850_038_KQED_CrisisPregnancyCenter_11042022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Signs on the door for the Napa Women’s Center advertise ‘abortion pill reversal’ at the facility in Napa on Nov. 4, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Like most anti-abortion centers, the Napa Women’s Center has no medical professionals on staff. But the organization is in the process of recruiting a nurse practitioner; then, the center plans to begin offering ultrasounds, which anti-abortion activists consider a powerful tool in dissuading a person from having an abortion.\u003c/p>\n\u003cp>The Alpha Pregnancy Center in San Francisco may be an example of what many anti-abortion centers would like to achieve. The facility — which is not located near an abortion care clinic, and which states clearly on its website that it does not offer abortions — \u003ca href=\"https://www.alphapc.org/our-beginnings\">was founded by a group of pastors in 1983. \u003c/a>But the center completed a two-year process to obtain a medical license in 2015, and now has a full-time registered nurse overseeing its medical services, including ultrasounds.\u003c/p>\n\u003cp>For certified OB-GYNs like Henneberg, ultrasounds are also, notably, often the first indication that a patient has mistakenly been to an anti-abortion center before landing in a legitimate medical office.\u003c/p>\n\u003cp>“They’ll ask me questions like, ‘Do I have to look at the ultrasound?’ And I’ll say, ‘No, of course not.’ And they’ll say, ‘Oh, well, the other place made me look at the ultrasound, and I really don’t wanna see it,’” she says. In some cases, according to several reports, \u003ca href=\"https://19thnews.org/2021/10/crisis-pregnancy-centers-ultrasounds-accuracy-stakes/\">an anti-abortion center might perform an ultrasound, then show patients a falsified image of a fetus at a later stage of development\u003c/a> to dissuade them from seeking an abortion.\u003c/p>\n\u003cp>“If you probe a little, often you’ll hear, ‘Yeah, I went to this place first and they told me not to get [an abortion]. And they’re obviously usually annoyed by that,” says Henneberg. “That’s not why they went there.”\u003c/p>\n\u003cfigure id=\"attachment_11937400\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59830_014_KQED_CrisisPregnancyCenter_11042022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11937400\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59830_014_KQED_CrisisPregnancyCenter_11042022-qut-800x533.jpg\" alt=\"a gray building with words that say 'free pregnancy tests' and 'Napa Women's Center, health and wellness matter'\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59830_014_KQED_CrisisPregnancyCenter_11042022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59830_014_KQED_CrisisPregnancyCenter_11042022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59830_014_KQED_CrisisPregnancyCenter_11042022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59830_014_KQED_CrisisPregnancyCenter_11042022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59830_014_KQED_CrisisPregnancyCenter_11042022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Napa Women’s Center, a facility opened by faith-based nonprofit Napa Valley Culture of Life, advertises free pregnancy tests. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Murillo remains adamant that Napa Women’s Center staff are not out to trick anyone. And she says that while the center and 40 Days for Life share the same beliefs about abortion — they are hoping to “help people choose life” — they are separate organizations. (Technically, the two nonprofits do have separate tax ID numbers. But in a video advertising the Napa Women’s Center, Napa Valley Culture of Life president Gerry Cruz details how the center grew directly out of 40 Days for Life’s 2009 campaign in front of Planned Parenthood. Volunteers and staff are on a first-name basis, many belong to the same church, and so on.)\u003c/p>\n\u003cp>In discussing the center’s offerings, Murillo is especially proud of the center’s “baby boutique”: In exchange for watching videos on relationships, fetal development and parenting, visitors can earn points, which can be exchanged for diapers or formula.\u003c/p>\n\u003cp>As for Murillo, she comes from a wine and hospitality background. “God works in mysterious ways,” she says, by way of explaining how she landed in this profession, which amounts to a combination of unlicensed social work and, ostensibly, distributing medical information. “You never know where you’re going to end up, and sometimes you just say yes.”\u003c/p>\n\u003ch2>‘I felt tricked’\u003c/h2>\n\u003cp>There are encouraging signs, say some abortion-rights advocates, that anti-abortion centers may finally be garnering attention. In June, a group of four Democratic congressmembers including Sen. Elizabeth Warren introduced the \u003ca href=\"https://www.congress.gov/bill/117th-congress/senate-bill/4469/text?r=18&s=1\">Stop Anti-Abortion Disinformation Act\u003c/a>, which would have the Federal Trade Commission issue rules regarding deceptive advertising by anti-abortion centers. And the newly formed \u003ca href=\"https://oag.ca.gov/news/press-releases/attorney-general-bonta-launches-california-reproductive-rights-task-force\">California Reproductive Rights Task Force\u003c/a> lists “enforcing consumer protection laws against deceptive or unlawful conduct concerning reproductive healthcare” as one of its objectives.\u003c/p>\n\u003cp>But the anti-abortion movement may already be adjusting its strategies in response. Anti-abortion activists have explicitly stated that they view the Dobbs decision as a chance to expand their networks, including opening new centers. The National Institute of Family and Life Advocates has led an effort to help existing anti-abortion centers hire trained nurses and obtain medical licensing — potentially shielding them from lawsuits about false advertising. And some facilities have increasingly touted their so-called baby boutiques, branding themselves primarily as charities, though due to lack of oversight there’s very little data on how much they actually give away.\u003c/p>\n\u003cfigure id=\"attachment_11937697\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/GettyImages-1403119190-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11937697\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/GettyImages-1403119190-800x533.jpg\" alt=\"a white woman with short blond and gray hair in a pink suit speaks in front of the Capitol building\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/GettyImages-1403119190-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/GettyImages-1403119190-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/GettyImages-1403119190-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/GettyImages-1403119190-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/GettyImages-1403119190-2048x1365.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/GettyImages-1403119190-1920x1280.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sen. Elizabeth Warren (D-MA), seen here speaking about abortion rights at a press conference on June 15, 2022, is one of the members of Congress behind the Stop Anti-Abortion Disinformation Act, which would have the Federal Trade Commission issue rules regarding deceptive advertising by anti-abortion centers. \u003ccite>(Joe Raedle/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In the meantime, according to the Alliance study, as of a 2021 count, anti-abortion centers outnumbered clinics that offer abortion care nationally by an average ratio of 3 to 1.\u003c/p>\n\u003cp>In California, roughly 170 anti-abortion centers continue to operate — and at least 10 have received state funding through Medi-Cal reimbursements, also according to the Alliance study, which noted that “[i]nvestment of public money in CPCs is escalating, especially in the states, with virtually no government oversight, accountability, or transparency.” An untold number of centers also received both federal and state funds during the pandemic through the Paycheck Protection Program.\u003c/p>\n\u003cp>In Napa, as daylight wanes, the 40 Days for Life volunteers pack up their things; Conemac likes to focus on the hours of 10 a.m. to 3 p.m., since that’s when she believes Planned Parenthood pharmacists give out RU-486, otherwise known as the abortion pill. (This location does not perform surgical abortions.) In her place, a group of teenage volunteers from the organization gathers with anti-abortion signs, and stands laughing and talking, flanking the space between the two centers.\u003c/p>\n\u003cfigure id=\"attachment_11937681\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59814_039_KQED_CrisisPregnancyCenter_11042022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11937681 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/01/RS59814_039_KQED_CrisisPregnancyCenter_11042022-qut-800x600.jpg\" alt=\"a row of young teens holds anti-abortion signs on the sidewalk in between a Planned Parenthood and a crisis pregnancy center. From across the street, they seem to be diverse in terms of ethnicity, age., and gender.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59814_039_KQED_CrisisPregnancyCenter_11042022-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59814_039_KQED_CrisisPregnancyCenter_11042022-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59814_039_KQED_CrisisPregnancyCenter_11042022-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59814_039_KQED_CrisisPregnancyCenter_11042022-qut-1536x1152.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/01/RS59814_039_KQED_CrisisPregnancyCenter_11042022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Young volunteers for 40 Days for Life stand with anti-abortion signs on the sidewalk between Planned Parenthood and the Napa Women’s Center in Napa on Oct. 28, 2022. \u003ccite>(Emma Silvers/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Some of them look to be around 17. That’s the age Lynda Metz was when she first set foot in an anti-abortion center, scared and confused. Some 27 years later, Metz — now a proudly pro-abortion-rights grandmother still living in a conservative area of Arkansas — can’t help but think about her experience. For one, that center is still in operation, and occasionally she has to drive by it. Or she’ll see a sign from a local business announcing they donate to that facility, and she makes a mental note not to shop there.\u003c/p>\n\u003cp>She also makes a point to talk to other young women in her community, and lets them know they have options. However, as Arkansas is now a state where abortion is “completely banned with very limited exceptions,” according to the Guttmacher Institute, those options are severely limited: A person seeking an abortion has to drive \u003ca href=\"https://states.guttmacher.org/policies/arkansas/abortion-statistics\">an average of more than 300 miles one-way to visit a clinic\u003c/a> that offers them.\u003c/p>\n\u003cp>Mostly, when Metz thinks about her experience, it still feels fresh, and she still feels confused. She can place herself in that room, trapped with that woman and the Bible, realizing she was not going to receive any support or information about her health.\u003c/p>\n\u003cp>“I felt tricked,” she says. And nearly three decades later, she says, “I still just don’t understand. It’s not a necessary service. You are literally tricking people into thinking that this is a certified health clinic.\u003c/p>\n\u003cp>“I mean, how is this still legal?”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"id": "californiareportmagazine",
"title": "The California Report Magazine",
"tagline": "Your state, your stories",
"info": "Every week, The California Report Magazine takes you on a road trip for the ears: to visit the places and meet the people who make California unique. The in-depth storytelling podcast from the California Report.",
"airtime": "FRI 4:30pm-5pm, 6:30pm-7pm, 11pm-11:30pm",
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"officialWebsiteLink": "/californiareportmagazine",
"meta": {
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"order": 10
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM3NjkwNjk1OTAz",
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"rss": "https://ww2.kqed.org/news/tag/tcrmag/feed/podcast"
}
},
"city-arts": {
"id": "city-arts",
"title": "City Arts & Lectures",
"info": "A one-hour radio program to hear celebrated writers, artists and thinkers address contemporary ideas and values, often discussing the creative process. Please note: tapes or transcripts are not available",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/cityartsandlecture-300x300.jpg",
"officialWebsiteLink": "https://www.cityarts.net/",
"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
"site": "news",
"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
"subscribe": {
"tuneIn": "https://tunein.com/radio/City-Arts-and-Lectures-p692/",
"rss": "https://www.cityarts.net/feed/"
}
},
"closealltabs": {
"id": "closealltabs",
"title": "Close All Tabs",
"tagline": "Your irreverent guide to the trends redefining our world",
"info": "Close All Tabs breaks down how digital culture shapes our world through thoughtful insights and irreverent humor.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/02/CAT_2_Tile-scaled.jpg",
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"officialWebsiteLink": "/podcasts/closealltabs",
"meta": {
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"source": "kqed",
"order": 1
},
"link": "/podcasts/closealltabs",
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"rss": "https://feeds.megaphone.fm/KQINC6993880386",
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"id": "code-switch-life-kit",
"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"meta": {
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},
"link": "/radio/program/code-switch-life-kit",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.commonwealthclub.org/podcasts",
"meta": {
"site": "news",
"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"apple": "https://itunes.apple.com/us/podcast/commonwealth-club-of-california-podcast/id976334034?mt=2",
"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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}
},
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"meta": {
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"source": "kqed",
"order": 9
},
"link": "/forum",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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},
"freakonomics-radio": {
"id": "freakonomics-radio",
"title": "Freakonomics Radio",
"info": "Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. It is produced in partnership with WNYC.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/4s8b",
"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
"rss": "https://feeds.feedburner.com/freakonomicsradio"
}
},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
"info": "Hosted by Terry Gross, \u003cem>Fresh Air from WHYY\u003c/em> is the Peabody Award-winning weekday magazine of contemporary arts and issues. One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.",
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"link": "/radio/program/fresh-air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/381444908/podcast.xml"
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"here-and-now": {
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"rss": "https://feeds.npr.org/510051/podcast.xml"
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},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"officialWebsiteLink": "https://www.npr.org/series/423302056/hidden-brain",
"airtime": "SUN 7pm-8pm",
"meta": {
"site": "news",
"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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"rss": "https://feeds.npr.org/510308/podcast.xml"
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},
"how-i-built-this": {
"id": "how-i-built-this",
"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/how-i-built-this",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/3zxy",
"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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"rss": "https://feeds.npr.org/510313/podcast.xml"
}
},
"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
"imageAlt": "KQED Hyphenación",
"officialWebsiteLink": "/podcasts/hyphenacion",
"meta": {
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"source": "kqed",
"order": 15
},
"link": "/podcasts/hyphenacion",
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"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
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"amazon": "https://music.amazon.com/podcasts/6c3dd23c-93fb-4aab-97ba-1725fa6315f1/hyphenaci%C3%B3n",
"rss": "https://feeds.megaphone.fm/KQINC2275451163"
}
},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED The Political Mind of Jerry Brown",
"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
"site": "news",
"source": "kqed",
"order": 18
},
"link": "/podcasts/jerrybrown",
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"apple": "https://itunes.apple.com/us/podcast/id1492194549",
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}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/latino-usa",
"subscribe": {
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
}
},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Masters-of-Scale-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
"site": "radio",
"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
"subscribe": {
"apple": "http://mastersofscale.app.link/",
"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
"subscribe": {
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
"npr": "https://www.npr.org/podcasts/464615685/mind-shift-podcast",
"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"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.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"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?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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"stitcher": "https://www.stitcher.com/show/on-our-watch",
"rss": "https://feeds.npr.org/510360/podcast.xml"
}
},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"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",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
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"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
}
},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
"airtime": "MON-FRI 3pm-4pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.pbs.org/newshour/",
"meta": {
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"source": "pbs"
},
"link": "/radio/program/pbs-newshour",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
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},
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"filterData": {
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"filters": [
"Any Region"
]
},
"cuisine": {
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"userAgentReducer": {
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"requestOutcomesReducer": {
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"navPromosReducer": {
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"fetchFailed": false,
"hasFetched": true,
"promos": {
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"podcasts-radio": {},
"video-tv": {},
"events": {},
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}
}
}
