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"content": "\u003cp>San Francisco Assemblymember Matt Haney will lead a bipartisan committee of state lawmakers to investigate solutions to the state’s opioid crisis, which kills thousands of people each year in California.\u003c/p>\n\u003cp>The 11-member committee named by Assembly Speaker Anthony Rendon includes four Republicans and encompasses representatives from rural and urban districts all around the state.\u003c/p>\n\u003cp>Haney said they will look for solutions from multiple points of view, including public health and criminal justice.\u003c/p>\n\u003cp>“If somebody needs a bed to get help, we need to have that available,” he said. “We need effective responses within our criminal justice system. 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Gavin Newsom\u003c/a>, who said he will instead direct state health officials to make their own recommendations for overdose prevention programs.\u003c/p>\n\u003cp>Haney said there’s no time to waste, and noted that this is a problem plaguing communities around the state, not just urban centers like San Francisco.\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"opioids\"]“I say this as a very strong supporter of safe injection sites: [The veto] can’t be used as a reason to not do everything that we possibly can right now,” he said.\u003c/p>\n\u003cp>“Some of my colleagues have said [safe injection sites are] not going to solve the problem, that we need to stop these drugs, we need to stop the drug dealing, we need to get people into treatment,” he added. “And what I said to them about that is, ‘Yes, yes and yes. So we had a small setback around the safe injection sites, but we need the yes, yes and yes to everything else in the meantime.”\u003c/p>\n\u003cp>Haney should expect the committee’s GOP lawmakers to push some of those other conversations, said Assemblymember Laurie Davies, a Republican who represents southern Orange County. She successfully pushed legislation this year that will make it easier to distribute fentanyl tests, which allow people to detect the presence of the deadly opioid in other drugs.\u003c/p>\n\u003cp>“There’s a lot of other things that we need to work on. But I’m just grateful that eyes are opening and they realize this is a crisis and we can do something to stop it,” she said, adding that one part of the conversation needs to be around prosecuting people who sell deadly fentanyl.\u003c/p>\n\u003cp>“This isn’t just an inner-city problem. It’s affecting every parent, it’s affecting every race and every color,” Davies said. “We’re losing men, women, children, no matter what the races, what their religion is, what their party affiliation is. This is something that affects every single Californian.”\u003c/p>\n\u003cp>One of those Californians who has been devastated by the impact of opioids is San Francisco resident Amy Cooper. She lost her son, John, to an overdose in 2014 — and then watched the dentist who had prescribed him the drugs without ever meeting him get acquitted at trial.\u003c/p>\n\u003cp>Cooper said since John’s death, she’s dedicated herself to advocating for solutions and educating people about the fentanyl problem. She said lawmakers need to focus on both education and accountability, including holding both doctors and pharmaceutical companies responsible.\u003c/p>\n\u003cp>“I can just tell you, 100%, we were uneducated and unaware. 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And it’s pure fentanyl.”\u003c/p>\n\u003cp>Jayme Congdon, a pediatrician and researcher at UC San Francisco, said the new select committee will be raising awareness as it does its work — and she also believes shedding light on the issue is the first step toward change.\u003c/p>\n\u003cp>Congdon said 250 teens are dying in California each year from opioids. That’s seven times the number of pediatric COVID-19 deaths the state has witnessed.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Because substance use and addiction are stigmatized issues, it’s just one of these topics that I think, you know, people think it’s not going to affect them or their families until it does,” she said. “We’re so pleased to see Assemblymember Haney is taking the lead on this issue so this crisis is hopefully going to start getting the attention that is warranted.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“I say this as a very strong supporter of safe injection sites: [The veto] can’t be used as a reason to not do everything that we possibly can right now,” he said.\u003c/p>\n\u003cp>“Some of my colleagues have said [safe injection sites are] not going to solve the problem, that we need to stop these drugs, we need to stop the drug dealing, we need to get people into treatment,” he added. “And what I said to them about that is, ‘Yes, yes and yes. So we had a small setback around the safe injection sites, but we need the yes, yes and yes to everything else in the meantime.”\u003c/p>\n\u003cp>Haney should expect the committee’s GOP lawmakers to push some of those other conversations, said Assemblymember Laurie Davies, a Republican who represents southern Orange County. She successfully pushed legislation this year that will make it easier to distribute fentanyl tests, which allow people to detect the presence of the deadly opioid in other drugs.\u003c/p>\n\u003cp>“There’s a lot of other things that we need to work on. But I’m just grateful that eyes are opening and they realize this is a crisis and we can do something to stop it,” she said, adding that one part of the conversation needs to be around prosecuting people who sell deadly fentanyl.\u003c/p>\n\u003cp>“This isn’t just an inner-city problem. It’s affecting every parent, it’s affecting every race and every color,” Davies said. “We’re losing men, women, children, no matter what the races, what their religion is, what their party affiliation is. This is something that affects every single Californian.”\u003c/p>\n\u003cp>One of those Californians who has been devastated by the impact of opioids is San Francisco resident Amy Cooper. She lost her son, John, to an overdose in 2014 — and then watched the dentist who had prescribed him the drugs without ever meeting him get acquitted at trial.\u003c/p>\n\u003cp>Cooper said since John’s death, she’s dedicated herself to advocating for solutions and educating people about the fentanyl problem. She said lawmakers need to focus on both education and accountability, including holding both doctors and pharmaceutical companies responsible.\u003c/p>\n\u003cp>“I can just tell you, 100%, we were uneducated and unaware. We had no idea that this was happening and that it was happening for our son. And then the results are just catastrophic,” she said.\u003c/p>\n\u003cp>Another aspect of the crisis that some hope to shed light on is the number of young people mistakenly buying drugs — often online — that turn out to be fentanyl. Lee Trope, a pediatric doctor at Santa Clara Valley Medical Center, said many of her patients seem to be experimenting with different substances and wind up becoming addicted to fentanyl or overdosing on it.\u003c/p>\n\u003cp>“They don’t realize what they’re buying, oftentimes on apps like Snapchat,” she said. “They think what they’re buying — they all call it ‘percs’ — they think they’re buying Percocet, which is a … less-potent opioid. And it’s pure fentanyl.”\u003c/p>\n\u003cp>Jayme Congdon, a pediatrician and researcher at UC San Francisco, said the new select committee will be raising awareness as it does its work — and she also believes shedding light on the issue is the first step toward change.\u003c/p>\n\u003cp>Congdon said 250 teens are dying in California each year from opioids. That’s seven times the number of pediatric COVID-19 deaths the state has witnessed.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Because substance use and addiction are stigmatized issues, it’s just one of these topics that I think, you know, people think it’s not going to affect them or their families until it does,” she said. “We’re so pleased to see Assemblymember Haney is taking the lead on this issue so this crisis is hopefully going to start getting the attention that is warranted.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Almost 2 million of California’s lowest-income and most medically fragile residents may have to switch health insurers as a result of a new strategy by the state to improve care in its Medicaid program, called Medi-Cal.\u003c/p>\n\u003cp>A first-ever statewide contracting competition to participate in Medi-Cal required commercial managed-care plans to rebid for their contracts and compete against others hoping to take those contracts away. The contracts will be revamped to require insurers to offer new benefits and meet stiffer benchmarks for care.\u003c/p>\n\u003cp>The long-planned reshuffle of insurers is likely to come with short-term pain. Four of the managed-care insurers, including Health Net and Blue Shield of California, stand to \u003ca href=\"https://www.dhcs.ca.gov/CalAIM/Documents/MCP-County-Enrollment-Table.pdf\">lose Medi-Cal contracts\u003c/a> in a little over a year, according to the \u003ca href=\"https://www.dhcs.ca.gov/formsandpubs/publications/oc/Documents/2022/22-10-MCP-Selections-8-25-22.pdf\">preliminary results of the bidding\u003c/a>, announced in late August. If the results stand, some enrollees in rural Alpine and El Dorado counties, as well as in populous Los Angeles, San Diego, Sacramento and Kern counties, will have to change health plans — and possibly doctors.[aside label='Related Coverage' tag='medicaid']“I’m still shocked and I’m still reeling from it,” said John Sturm, \u003ca href=\"https://www.dhcs.ca.gov/CalAIM/Documents/MCP-County-Enrollment-Table.pdf\">one of about 325,000 members of Community Health Group\u003c/a>, the largest Medi-Cal plan in San Diego County, which could lose its contract. “Which doctors can I keep? How long is it going to take me to switch plans? Are there contingency plans when, inevitably, folks slip through the cracks?”\u003c/p>\n\u003cp>Sturm, 54, who has three mental health conditions, largely because of childhood sexual abuse, said finding a psychologist and psychiatrist he could trust took a lot of time and effort. He pointed to \u003ca href=\"https://californiahealthline.org/news/article/california-medicaid-patients-struggle-to-fill-prescriptions-medi-cal-rx/\">the disruption caused by the rollout of Medi-Cal’s new prescription drug program\u003c/a> this year, despite assurances it would go smoothly.\u003c/p>\n\u003cp>“I have concerns, and I know other people in the community have concerns about what we’re being told versus what the reality is going to be,” Sturm said.\u003c/p>\n\u003cp>Arguably, the biggest loser in the bidding is Health Net, the largest commercial insurer in Medi-Cal, which stands to lose half its enrollees — including more than 1 million in Los Angeles County alone. St. Louis-based Centene Corp., which \u003ca href=\"https://www.latimes.com/california/story/2022-04-07/california-investigating-corporation-took-over-medicaid-drug-program\">California is investigating\u003c/a> over allegations it overcharged the state for prescription drugs, \u003ca href=\"https://www.prnewswire.com/news-releases/centene-completes-acquisition-of-health-net-300241037.html\">bought Health Net\u003c/a> in 2016, in part for its Medicaid business, of which LA is the crown jewel.\u003c/p>\n\u003cp>But the state’s health plan selections are not set in stone. The losing insurers are fiercely contesting the results in formal appeals that read like declarations of war on their competitors and on the state. Some of the losers essentially call their winning rivals liars.\u003c/p>\n\u003cp>The stakes are high, with contracts in play worth billions of dollars annually. Insurers that lose their appeals with the state Department of Health Care Services, which runs Medi-Cal, are likely to take their complaints to court. That could delay final decisions by months or years, causing a headache for the department, which wants coverage under the new contracts to start Jan. 1, 2024.\u003c/p>\n\u003cp>State officials hope to spend the rest of this year and all of 2023 ensuring that the chosen health plans are up to the task, which includes having enough participating providers to minimize disruptions in care.\u003c/p>\n\u003cp>“Member access and continuity are really our top priorities as part of this transition, and we have dedicated teams that will be working with the health plans on the transition planning and the continuity planning,” Michelle Baass, director of the department, told KHN.[pullquote size=\"medium\" align=\"right\" citation=\"John Sturm, Medi-Cal recipient\"]‘I have concerns, and I know other people in the community have concerns about what we’re being told versus what the reality is going to be.’[/pullquote]Baass also noted that enrollees have continuity-of-care rights. “For example, if a member is currently under the care of a doctor during the prior 12 months, the member has the right to continue seeing that doctor for up to 12 months, if certain conditions are met,” she said.\u003c/p>\n\u003cp>The competitive bidding process is an effort by the department to address persistent complaints that \u003ca href=\"https://californiahealthline.org/news/article/californias-reboot-of-troubled-medi-cal-puts-pressure-on-health-plans/\">it has not effectively monitored subpar health plans\u003c/a>.\u003c/p>\n\u003cp>Eight commercial insurers bid for Medi-Cal business in 21 counties. They were required to submit voluminous documents detailing every aspect of their operations, including past performance; the scope of their provider networks; and their capacity to meet the terms of the new, stricter contracts.\u003c/p>\n\u003cp>The new contracts contain numerous provisions intended to bolster quality, health care equity and transparency — and to boost accountability of the subcontractors to whom \u003ca href=\"https://californiahealthline.org/news/article/layers-of-subcontracted-services-confuse-and-frustrate-medi-cal-patients/\">health plans often outsource patient care\u003c/a>. For example, the plans and their subcontractors will be required to reach or exceed \u003ca href=\"https://www.dhcs.ca.gov/Documents/MCP-RFP-Issue-Brief.pdf\">the 50th percentile\u003c/a> among Medicaid plans nationally on a host of pediatric and maternal care measures — or face financial penalties.\u003c/p>\n\u003cp>They will also be on the hook for providing nonmedical social services that address socioeconomic factors, such as homelessness and food insecurity, in an ambitious $8.7 billion, \u003ca href=\"https://khn.org/news/article/california-medicaid-makeover-newsom-california-medi-cal-homeless-public-funds/\">five-year Medi-Cal initiative known as CalAIM\u003c/a>, that is already underway.\u003c/p>\n\u003cp>Local, publicly governed Medi-Cal plans, which cover about 70% of the \u003ca href=\"https://www.dhcs.ca.gov/dataandstats/statistics/Documents/FastFacts-March2022.pdf\">12.4 million Medi-Cal members who are in managed care\u003c/a>, did not participate in the bidding, though their performance has not always been top-notch. Kaiser Permanente, which this year negotiated a controversial deal with the state for an \u003ca href=\"https://californiahealthline.org/news/article/california-medicaid-contract-kaiser-permanente-key-details-missing/\">exclusive Medi-Cal contract\u003c/a> in 32 counties, was also exempt from the bidding. (KHN is not affiliated with Kaiser Permanente.)\u003c/p>\n\u003cp>But all Medi-Cal health insurers, including KP and the local plans, will have to commit to the same goals and requirements.\u003c/p>\n\u003cp>In addition to Health Net, both Blue Shield of California and Community Health Group — which have contracts with Medi-Cal only in San Diego County — are also big losers, as is Aetna, which lost bids in 10 counties.\u003c/p>\n\u003cp>Blue Shield, which lost in all 13 counties where it submitted bids, filed a fiercely worded appeal that accuses its rivals Anthem Blue Cross, Molina and Health Net of failing to disclose hundreds of millions of dollars in penalties against them. It accused those three plans of poor performance “and even mendacity” and said they filled their bids with “puffery,” which the state “bought, hook, line and sinker,” without “an iota of independent analysis.”\u003c/p>\n\u003cfigure id=\"attachment_11926773\" class=\"wp-caption alignnone\" style=\"max-width: 724px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11926773\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/09/GettyImages-1279766844.jpg\" alt=\"A hand in the foreground holds a card as someone reaches out to hold it from across a table.\" width=\"724\" height=\"483\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/GettyImages-1279766844.jpg 724w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/GettyImages-1279766844-160x107.jpg 160w\" sizes=\"(max-width: 724px) 100vw, 724px\">\u003cfigcaption class=\"wp-caption-text\">The competitive bidding process is an effort by the state Department of Health Care Services to address persistent complaints that it has not effectively monitored subpar health plans. \u003ccite>(Willie B. Thomas/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Health Net’s appeal slammed Molina, which beat it out in LA, Sacramento, Riverside and San Bernardino counties. Molina’s bid, Health Net said, “contains false, inaccurate and misleading information.” The whole bidding process, it said, was “highly flawed,” resulting in “erroneous contract awards that jeopardize the stability of Medi-Cal.”\u003c/p>\n\u003cp>In particular, Health Net said, the Department of Health Care Services “improperly reopened the procurement” after the deadline, which allowed Molina to make “comprehensive changes” that raised its score.\u003c/p>\n\u003cp>The protesting health plans are requesting that they be awarded contracts or that the bidding process start over from scratch.\u003c/p>\n\u003cp>Joseph Garcia, chief operating officer for Community Health Group, said, “It would be easiest for all concerned if they just added us. They don’t have to remove anybody.”\u003c/p>\n\u003cp>Community Health Group has garnered an outpouring of support from hospital executives, physician groups, community clinics and the heads of multiple publicly governed Medi-Cal plans, \u003ca href=\"https://californiahealthline.org/wp-content/uploads/sites/3/2022/09/Medi-Cal-Reprocurement-Letter-of-Support-for-CHG-1.pdf\">who sent a letter to Baass\u003c/a> saying they were “shocked, concerned, and very disappointed” by the state’s decision. They called Community Health Group “our strongest partner of 40 years,” for whom “equity is not a buzzword or a new priority,” noting that more than 85% of its staff is bilingual and multicultural.\u003c/p>\n\u003cp>Community Health Group noted in its appeal that it had lost by less than a point to Health Net, which won a San Diego contract — “a minuscule difference that in itself resulted from deeply flawed scoring.”\u003c/p>\n\u003cp>Garcia said that if Community Health Group loses its appeal, it will “absolutely” sue in state court. A hearing officer appointed by Baass to consider the appeals has set deadlines to receive written responses and rebuttals by October 7.\u003c/p>\n\u003cp>There is ample precedent for protracted legal battles in bidding for Medicaid contracts. In Louisiana, Centene and Aetna \u003ca href=\"https://www.thecentersquare.com/louisiana/rejected-bidders-for-louisiana-medicaid-contracts-file-protests-alleging-bias/article_2fe6ecec-c44c-11e9-833d-331f84e9c8f0.html\">protested the results of a 2019 rebidding process\u003c/a>, which led the state to nullify its awards and restart the bidding. The \u003ca href=\"https://ldh.la.gov/news/ldh-mco-contracts\">new results\u003c/a> were announced this year, with Centene and Aetna among the winners. In Kentucky, the state court of appeals \u003ca href=\"https://www.courier-journal.com/story/news/local/2022/09/15/kentucky-medicaid-contracts-upheld-by-court-anthem-is-out-as-mco/69494863007/\">issued a ruling\u003c/a> this month in a contested Medicaid procurement that had been held two years earlier.\u003c/p>\n\u003cp>Another factor could delay the new contract: California is juggling several massive Medi-Cal changes at the same time. Among them are the implementation of CalAIM and the \u003ca href=\"https://lao.ca.gov/Publications/Report/4423\">anticipated enrollment of nearly 700,000 unauthorized immigrants age 26-49\u003c/a> by January 2024, on top of nearly a quarter-million unauthorized immigrants age 50 and older who \u003ca href=\"https://californiahealthline.org/news/article/california-medicaid-older-unauthorized-immigrants/\">became eligible this year\u003c/a>. And then there’s the recalculation of enrollees’ eligibility, which will take place whenever the federal COVID-19-related public health emergency ends. That could push \u003ca href=\"https://www.dhcs.ca.gov/Documents/PHE-UOP/Medi-Cal-COVID-19-PHE-Unwinding-Plan.pdf\">2 million to 3 million\u003c/a> Californians out of Medi-Cal.\u003c/p>\n\u003cp>“Just hearing you list all those things gave me a minor panic attack,” said Abigail Coursolle, a senior attorney at the National Health Law Program. “They are making a lot of work for themselves in a short amount of time.”\u003c/p>\n\u003cp>But, Coursolle added, the state has “a very positive vision for improving access and improving the quality of services that people in Medi-Cal receive, and that’s very important.”\u003c/p>\n\u003cp>\u003cem>California Healthline is a service of the California Health Care Foundation produced by Kaiser Health News.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Almost 2 million of California's lowest-income and most medically fragile residents may have to switch health insurers as a result of a new strategy by the state to improve care in its Medicaid program.",
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"title": "Medi-Cal Shake-Up Might Create More Problems Than Solutions for Lower-Income Californians | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Almost 2 million of California’s lowest-income and most medically fragile residents may have to switch health insurers as a result of a new strategy by the state to improve care in its Medicaid program, called Medi-Cal.\u003c/p>\n\u003cp>A first-ever statewide contracting competition to participate in Medi-Cal required commercial managed-care plans to rebid for their contracts and compete against others hoping to take those contracts away. The contracts will be revamped to require insurers to offer new benefits and meet stiffer benchmarks for care.\u003c/p>\n\u003cp>The long-planned reshuffle of insurers is likely to come with short-term pain. Four of the managed-care insurers, including Health Net and Blue Shield of California, stand to \u003ca href=\"https://www.dhcs.ca.gov/CalAIM/Documents/MCP-County-Enrollment-Table.pdf\">lose Medi-Cal contracts\u003c/a> in a little over a year, according to the \u003ca href=\"https://www.dhcs.ca.gov/formsandpubs/publications/oc/Documents/2022/22-10-MCP-Selections-8-25-22.pdf\">preliminary results of the bidding\u003c/a>, announced in late August. If the results stand, some enrollees in rural Alpine and El Dorado counties, as well as in populous Los Angeles, San Diego, Sacramento and Kern counties, will have to change health plans — and possibly doctors.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“I’m still shocked and I’m still reeling from it,” said John Sturm, \u003ca href=\"https://www.dhcs.ca.gov/CalAIM/Documents/MCP-County-Enrollment-Table.pdf\">one of about 325,000 members of Community Health Group\u003c/a>, the largest Medi-Cal plan in San Diego County, which could lose its contract. “Which doctors can I keep? How long is it going to take me to switch plans? Are there contingency plans when, inevitably, folks slip through the cracks?”\u003c/p>\n\u003cp>Sturm, 54, who has three mental health conditions, largely because of childhood sexual abuse, said finding a psychologist and psychiatrist he could trust took a lot of time and effort. He pointed to \u003ca href=\"https://californiahealthline.org/news/article/california-medicaid-patients-struggle-to-fill-prescriptions-medi-cal-rx/\">the disruption caused by the rollout of Medi-Cal’s new prescription drug program\u003c/a> this year, despite assurances it would go smoothly.\u003c/p>\n\u003cp>“I have concerns, and I know other people in the community have concerns about what we’re being told versus what the reality is going to be,” Sturm said.\u003c/p>\n\u003cp>Arguably, the biggest loser in the bidding is Health Net, the largest commercial insurer in Medi-Cal, which stands to lose half its enrollees — including more than 1 million in Los Angeles County alone. St. Louis-based Centene Corp., which \u003ca href=\"https://www.latimes.com/california/story/2022-04-07/california-investigating-corporation-took-over-medicaid-drug-program\">California is investigating\u003c/a> over allegations it overcharged the state for prescription drugs, \u003ca href=\"https://www.prnewswire.com/news-releases/centene-completes-acquisition-of-health-net-300241037.html\">bought Health Net\u003c/a> in 2016, in part for its Medicaid business, of which LA is the crown jewel.\u003c/p>\n\u003cp>But the state’s health plan selections are not set in stone. The losing insurers are fiercely contesting the results in formal appeals that read like declarations of war on their competitors and on the state. Some of the losers essentially call their winning rivals liars.\u003c/p>\n\u003cp>The stakes are high, with contracts in play worth billions of dollars annually. Insurers that lose their appeals with the state Department of Health Care Services, which runs Medi-Cal, are likely to take their complaints to court. That could delay final decisions by months or years, causing a headache for the department, which wants coverage under the new contracts to start Jan. 1, 2024.\u003c/p>\n\u003cp>State officials hope to spend the rest of this year and all of 2023 ensuring that the chosen health plans are up to the task, which includes having enough participating providers to minimize disruptions in care.\u003c/p>\n\u003cp>“Member access and continuity are really our top priorities as part of this transition, and we have dedicated teams that will be working with the health plans on the transition planning and the continuity planning,” Michelle Baass, director of the department, told KHN.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Baass also noted that enrollees have continuity-of-care rights. “For example, if a member is currently under the care of a doctor during the prior 12 months, the member has the right to continue seeing that doctor for up to 12 months, if certain conditions are met,” she said.\u003c/p>\n\u003cp>The competitive bidding process is an effort by the department to address persistent complaints that \u003ca href=\"https://californiahealthline.org/news/article/californias-reboot-of-troubled-medi-cal-puts-pressure-on-health-plans/\">it has not effectively monitored subpar health plans\u003c/a>.\u003c/p>\n\u003cp>Eight commercial insurers bid for Medi-Cal business in 21 counties. They were required to submit voluminous documents detailing every aspect of their operations, including past performance; the scope of their provider networks; and their capacity to meet the terms of the new, stricter contracts.\u003c/p>\n\u003cp>The new contracts contain numerous provisions intended to bolster quality, health care equity and transparency — and to boost accountability of the subcontractors to whom \u003ca href=\"https://californiahealthline.org/news/article/layers-of-subcontracted-services-confuse-and-frustrate-medi-cal-patients/\">health plans often outsource patient care\u003c/a>. For example, the plans and their subcontractors will be required to reach or exceed \u003ca href=\"https://www.dhcs.ca.gov/Documents/MCP-RFP-Issue-Brief.pdf\">the 50th percentile\u003c/a> among Medicaid plans nationally on a host of pediatric and maternal care measures — or face financial penalties.\u003c/p>\n\u003cp>They will also be on the hook for providing nonmedical social services that address socioeconomic factors, such as homelessness and food insecurity, in an ambitious $8.7 billion, \u003ca href=\"https://khn.org/news/article/california-medicaid-makeover-newsom-california-medi-cal-homeless-public-funds/\">five-year Medi-Cal initiative known as CalAIM\u003c/a>, that is already underway.\u003c/p>\n\u003cp>Local, publicly governed Medi-Cal plans, which cover about 70% of the \u003ca href=\"https://www.dhcs.ca.gov/dataandstats/statistics/Documents/FastFacts-March2022.pdf\">12.4 million Medi-Cal members who are in managed care\u003c/a>, did not participate in the bidding, though their performance has not always been top-notch. Kaiser Permanente, which this year negotiated a controversial deal with the state for an \u003ca href=\"https://californiahealthline.org/news/article/california-medicaid-contract-kaiser-permanente-key-details-missing/\">exclusive Medi-Cal contract\u003c/a> in 32 counties, was also exempt from the bidding. (KHN is not affiliated with Kaiser Permanente.)\u003c/p>\n\u003cp>But all Medi-Cal health insurers, including KP and the local plans, will have to commit to the same goals and requirements.\u003c/p>\n\u003cp>In addition to Health Net, both Blue Shield of California and Community Health Group — which have contracts with Medi-Cal only in San Diego County — are also big losers, as is Aetna, which lost bids in 10 counties.\u003c/p>\n\u003cp>Blue Shield, which lost in all 13 counties where it submitted bids, filed a fiercely worded appeal that accuses its rivals Anthem Blue Cross, Molina and Health Net of failing to disclose hundreds of millions of dollars in penalties against them. It accused those three plans of poor performance “and even mendacity” and said they filled their bids with “puffery,” which the state “bought, hook, line and sinker,” without “an iota of independent analysis.”\u003c/p>\n\u003cfigure id=\"attachment_11926773\" class=\"wp-caption alignnone\" style=\"max-width: 724px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11926773\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/09/GettyImages-1279766844.jpg\" alt=\"A hand in the foreground holds a card as someone reaches out to hold it from across a table.\" width=\"724\" height=\"483\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/GettyImages-1279766844.jpg 724w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/GettyImages-1279766844-160x107.jpg 160w\" sizes=\"(max-width: 724px) 100vw, 724px\">\u003cfigcaption class=\"wp-caption-text\">The competitive bidding process is an effort by the state Department of Health Care Services to address persistent complaints that it has not effectively monitored subpar health plans. \u003ccite>(Willie B. Thomas/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Health Net’s appeal slammed Molina, which beat it out in LA, Sacramento, Riverside and San Bernardino counties. Molina’s bid, Health Net said, “contains false, inaccurate and misleading information.” The whole bidding process, it said, was “highly flawed,” resulting in “erroneous contract awards that jeopardize the stability of Medi-Cal.”\u003c/p>\n\u003cp>In particular, Health Net said, the Department of Health Care Services “improperly reopened the procurement” after the deadline, which allowed Molina to make “comprehensive changes” that raised its score.\u003c/p>\n\u003cp>The protesting health plans are requesting that they be awarded contracts or that the bidding process start over from scratch.\u003c/p>\n\u003cp>Joseph Garcia, chief operating officer for Community Health Group, said, “It would be easiest for all concerned if they just added us. They don’t have to remove anybody.”\u003c/p>\n\u003cp>Community Health Group has garnered an outpouring of support from hospital executives, physician groups, community clinics and the heads of multiple publicly governed Medi-Cal plans, \u003ca href=\"https://californiahealthline.org/wp-content/uploads/sites/3/2022/09/Medi-Cal-Reprocurement-Letter-of-Support-for-CHG-1.pdf\">who sent a letter to Baass\u003c/a> saying they were “shocked, concerned, and very disappointed” by the state’s decision. They called Community Health Group “our strongest partner of 40 years,” for whom “equity is not a buzzword or a new priority,” noting that more than 85% of its staff is bilingual and multicultural.\u003c/p>\n\u003cp>Community Health Group noted in its appeal that it had lost by less than a point to Health Net, which won a San Diego contract — “a minuscule difference that in itself resulted from deeply flawed scoring.”\u003c/p>\n\u003cp>Garcia said that if Community Health Group loses its appeal, it will “absolutely” sue in state court. A hearing officer appointed by Baass to consider the appeals has set deadlines to receive written responses and rebuttals by October 7.\u003c/p>\n\u003cp>There is ample precedent for protracted legal battles in bidding for Medicaid contracts. In Louisiana, Centene and Aetna \u003ca href=\"https://www.thecentersquare.com/louisiana/rejected-bidders-for-louisiana-medicaid-contracts-file-protests-alleging-bias/article_2fe6ecec-c44c-11e9-833d-331f84e9c8f0.html\">protested the results of a 2019 rebidding process\u003c/a>, which led the state to nullify its awards and restart the bidding. The \u003ca href=\"https://ldh.la.gov/news/ldh-mco-contracts\">new results\u003c/a> were announced this year, with Centene and Aetna among the winners. In Kentucky, the state court of appeals \u003ca href=\"https://www.courier-journal.com/story/news/local/2022/09/15/kentucky-medicaid-contracts-upheld-by-court-anthem-is-out-as-mco/69494863007/\">issued a ruling\u003c/a> this month in a contested Medicaid procurement that had been held two years earlier.\u003c/p>\n\u003cp>Another factor could delay the new contract: California is juggling several massive Medi-Cal changes at the same time. Among them are the implementation of CalAIM and the \u003ca href=\"https://lao.ca.gov/Publications/Report/4423\">anticipated enrollment of nearly 700,000 unauthorized immigrants age 26-49\u003c/a> by January 2024, on top of nearly a quarter-million unauthorized immigrants age 50 and older who \u003ca href=\"https://californiahealthline.org/news/article/california-medicaid-older-unauthorized-immigrants/\">became eligible this year\u003c/a>. And then there’s the recalculation of enrollees’ eligibility, which will take place whenever the federal COVID-19-related public health emergency ends. That could push \u003ca href=\"https://www.dhcs.ca.gov/Documents/PHE-UOP/Medi-Cal-COVID-19-PHE-Unwinding-Plan.pdf\">2 million to 3 million\u003c/a> Californians out of Medi-Cal.\u003c/p>\n\u003cp>“Just hearing you list all those things gave me a minor panic attack,” said Abigail Coursolle, a senior attorney at the National Health Law Program. “They are making a lot of work for themselves in a short amount of time.”\u003c/p>\n\u003cp>But, Coursolle added, the state has “a very positive vision for improving access and improving the quality of services that people in Medi-Cal receive, and that’s very important.”\u003c/p>\n\u003cp>\u003cem>California Healthline is a service of the California Health Care Foundation produced by Kaiser Health News.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cspan style=\"font-weight: 400\">Thanks to the efforts of organizers, public health officials and attendees themselves, the Folsom Street Fair in San Francisco, a celebration of kink and sexual liberation, continued despite the ongoing outbreak of MPX (also known as monkeypox).\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">MPX cases have been declining — with just two new cases last week compared to 30 on one day alone at the virus’s peak in late July. A\u003c/span>\u003cspan style=\"font-weight: 400\">s of September 21, \u003c/span>\u003ca href=\"https://sf.gov/data/mpx-case-counts\">\u003cspan style=\"font-weight: 400\">San Francisco, once an epicenter of the outbreak, had 794 total reported cases\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">. The \u003c/span>\u003ca href=\"https://www.cdc.gov/poxvirus/monkeypox/response/2022/us-map.html\">\u003cspan style=\"font-weight: 400\">U.S. Centers for Disease Control and Prevention\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> reported that California had a total of 4,886 cases on September 23.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Earlier this summer, when MPX cases began to increase and the \u003c/span>\u003ca href=\"https://www.kqed.org/news/11920864/lgbtq-community-hears-painful-echoes-of-aids-crisis-in-government-response-to-monkeypox\">\u003cspan style=\"font-weight: 400\">government response was still sluggish\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, leading to a callout by several LGBTQ+ advocates, many people who are in sexually open networks said they took their own precautions.\u003c/span>[pullquote size=\"medium\" align=\"right\" citation=\"Angel Adeyoha, executive director, Folsom Street\"]‘Our community is fantastic at mobilizing and getting on top of a health crisis.’[/pullquote]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When Folsom Street Executive Director and fair go-to Angel Adeyoha caught a break from a steady stream of demands, they said that, unlike earlier LGBTQ+ events — such as Up Your Alley in late July, which scaled back due to a spike in MPX cases — the fair is benefitting from a better moment. Adeyoha didn’t think the Folsom Street Fair would be a “super-spreader” event based on the safety protocols they were following from the San Francisco Department of Public Health, as well as having vaccine clinics and education on MPX available.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Our community is fantastic at mobilizing and getting on top of a health crisis,” said Adeyoha. “We have a lot of practice, so I think we did fantastic.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Fair operations lead Sarah Kidder organizes events for a living, and said the Folsom Street Fair is special when it comes to creating a culture of care.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“One of the things that I’ve noticed and appreciate about this event [is that] there’s just a sense of community and kindness throughout everything from just sort of politeness and interacting, as well as, like, putting recycling into the recycling [bins],” said Kidder. “There is a consideration and an inclusion element that is very refreshing to see. It’s very encouraging to see. And so that sense of community is expressed in a number of ways here.”\u003c/span>[aside postID=\"news_11920864,news_11926465,news_11920455\" label=\"Related Post\"]\u003cspan style=\"font-weight: 400\">Violet Moon of San José, clad in a black leather harness, said many events over the summer were postponed. Moon, who is gender-fluid, said the “Horse Market” finally took place this weekend, just before the fair.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“In the communities I’m in, I know that they did react quickly to it,” said Moon. “For example, there was a party that was supposed to happen around the time when MPX was first spiking, even before it had become a real worry on the national arena. And they went ahead and canceled that just out of an abundance of caution.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Fair first-timer Will Smyack said he and his partner decided to limit their sexual contacts as a precaution.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“[We] were open for a little bit, but because of monkeypox and everything, we’re not anymore just to be safe,” said Smyack. “But hopefully the vaccination can help. Not just us, but everybody.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Others said they simply tried to educate themselves on the symptoms and science of the latest virus, and adapt. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“In the kink scene that I belong to, we just had a rule about putting towels down on public furniture, basically making sure no naked body parts are touching surfaces,” said a festivalgoer who asked to go by “L,” because she described herself as a member of the “horny community” and said she’s in the running for a job as an elementary school teacher.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">L was seated in a folding chair outside the gates of the Folsom Street Fair with bunny ears, a bra and matching panties, and a fresh Band-Aid on her upper arm. She’d just gotten her MPX vaccine at one of two city Department of Public Health pop-up vaccine clinics at the fair; SFDPH came prepared with 2,000 doses, and the convenient offering seemed to be a draw for many.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">UCSF Professor of Medicine and Infectious Disease Specialist Peter Chin-Hong said when MPX came on the scene, San Francisco was instrumental in pushing the state and then the federal government to declare MPX an emergency to, for example, unlock resources for vaccines.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I think it was probably a month before vaccines started trickling in, in higher and higher numbers. It was an agonizing month,” said Chin-Hong.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">He said the revelation that one dose could be divided up to five times and administered under the skin was another coup. But there were other lessons learned from the city’s response to MPX: Chin-Hong said that, initially, the message from public health officials was too vague, in their effort to be sex-positive and not stigmatize men and transpeople who have sex with men. More recently, he said, they’ve gotten specific, something he said has likely led to 50% of that population voluntarily reducing their sexual behavior.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It was kind of average, just like, you know, here are the 12 ways you can get MPX,” said Chin-Hong. He said that’s changed to “… you can protect yourself by reducing the number of sexual partners, by cleaning your sex toys … I think the message did get out as to how you got it. You didn’t get it from a thrift store. \u003ca href=\"https://www.kqed.org/news/11922286/monkeypox-surfaces-air-transmission\">You didn’t get it from doing yoga\u003c/a> in an overheated Bikram yoga \u003c/span>\u003cspan style=\"font-weight: 400\">studio\u003c/span>\u003cspan style=\"font-weight: 400\">. You got it from intimate contact for hours. And that was the way that you protected yourself in the absence of not having enough vaccines.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Chin-Hong said having vaccine clinics at events like Folsom Street Fair became a strategy to correct another challenge: the disproportionate presence of MPX among Black and Latino men.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“If you’re lining up in a public line at [San Francisco] General [Hospital] to get a vaccine, everybody knows what group you’re part of. Maybe you’re not comfortable with that. So I think that’s still a big barrier and probably why there’s a bigger divide between minority populations and the general population,” said Chin-Hong, “I remember people were wearing hoodies in line because they just didn’t want to be seen.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Just a stone’s throw down Folsom Street, contestants tried their luck at winning a free T-shirt via the San Francisco Community Health Center’s public health “Jeopardy” game. The game featured an MPX category with questions like, “What is the Monkeypox incubation period?” (According to the CDC, \u003ca href=\"https://www.cdc.gov/poxvirus/monkeypox/clinicians/clinical-recognition.html\">the answer is three to 17 days\u003c/a>). It was part of a targeted outreach and street medicine campaign, executed by community groups and public health staff, and it seemed to be bearing fruit. But with cases still circulating and the likelihood they will rise again at some point, health experts say it’s still too early to put down one’s guard.\u003c/span>\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>\u003cspan style=\"font-weight: 400\">Thanks to the efforts of organizers, public health officials and attendees themselves, the Folsom Street Fair in San Francisco, a celebration of kink and sexual liberation, continued despite the ongoing outbreak of MPX (also known as monkeypox).\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">MPX cases have been declining — with just two new cases last week compared to 30 on one day alone at the virus’s peak in late July. A\u003c/span>\u003cspan style=\"font-weight: 400\">s of September 21, \u003c/span>\u003ca href=\"https://sf.gov/data/mpx-case-counts\">\u003cspan style=\"font-weight: 400\">San Francisco, once an epicenter of the outbreak, had 794 total reported cases\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">. The \u003c/span>\u003ca href=\"https://www.cdc.gov/poxvirus/monkeypox/response/2022/us-map.html\">\u003cspan style=\"font-weight: 400\">U.S. Centers for Disease Control and Prevention\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> reported that California had a total of 4,886 cases on September 23.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Earlier this summer, when MPX cases began to increase and the \u003c/span>\u003ca href=\"https://www.kqed.org/news/11920864/lgbtq-community-hears-painful-echoes-of-aids-crisis-in-government-response-to-monkeypox\">\u003cspan style=\"font-weight: 400\">government response was still sluggish\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, leading to a callout by several LGBTQ+ advocates, many people who are in sexually open networks said they took their own precautions.\u003c/span>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When Folsom Street Executive Director and fair go-to Angel Adeyoha caught a break from a steady stream of demands, they said that, unlike earlier LGBTQ+ events — such as Up Your Alley in late July, which scaled back due to a spike in MPX cases — the fair is benefitting from a better moment. Adeyoha didn’t think the Folsom Street Fair would be a “super-spreader” event based on the safety protocols they were following from the San Francisco Department of Public Health, as well as having vaccine clinics and education on MPX available.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Our community is fantastic at mobilizing and getting on top of a health crisis,” said Adeyoha. “We have a lot of practice, so I think we did fantastic.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Fair operations lead Sarah Kidder organizes events for a living, and said the Folsom Street Fair is special when it comes to creating a culture of care.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“One of the things that I’ve noticed and appreciate about this event [is that] there’s just a sense of community and kindness throughout everything from just sort of politeness and interacting, as well as, like, putting recycling into the recycling [bins],” said Kidder. “There is a consideration and an inclusion element that is very refreshing to see. It’s very encouraging to see. And so that sense of community is expressed in a number of ways here.”\u003c/span>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cspan style=\"font-weight: 400\">Violet Moon of San José, clad in a black leather harness, said many events over the summer were postponed. Moon, who is gender-fluid, said the “Horse Market” finally took place this weekend, just before the fair.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“In the communities I’m in, I know that they did react quickly to it,” said Moon. “For example, there was a party that was supposed to happen around the time when MPX was first spiking, even before it had become a real worry on the national arena. And they went ahead and canceled that just out of an abundance of caution.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Fair first-timer Will Smyack said he and his partner decided to limit their sexual contacts as a precaution.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“[We] were open for a little bit, but because of monkeypox and everything, we’re not anymore just to be safe,” said Smyack. “But hopefully the vaccination can help. Not just us, but everybody.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Others said they simply tried to educate themselves on the symptoms and science of the latest virus, and adapt. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“In the kink scene that I belong to, we just had a rule about putting towels down on public furniture, basically making sure no naked body parts are touching surfaces,” said a festivalgoer who asked to go by “L,” because she described herself as a member of the “horny community” and said she’s in the running for a job as an elementary school teacher.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">L was seated in a folding chair outside the gates of the Folsom Street Fair with bunny ears, a bra and matching panties, and a fresh Band-Aid on her upper arm. She’d just gotten her MPX vaccine at one of two city Department of Public Health pop-up vaccine clinics at the fair; SFDPH came prepared with 2,000 doses, and the convenient offering seemed to be a draw for many.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">UCSF Professor of Medicine and Infectious Disease Specialist Peter Chin-Hong said when MPX came on the scene, San Francisco was instrumental in pushing the state and then the federal government to declare MPX an emergency to, for example, unlock resources for vaccines.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I think it was probably a month before vaccines started trickling in, in higher and higher numbers. It was an agonizing month,” said Chin-Hong.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">He said the revelation that one dose could be divided up to five times and administered under the skin was another coup. But there were other lessons learned from the city’s response to MPX: Chin-Hong said that, initially, the message from public health officials was too vague, in their effort to be sex-positive and not stigmatize men and transpeople who have sex with men. More recently, he said, they’ve gotten specific, something he said has likely led to 50% of that population voluntarily reducing their sexual behavior.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It was kind of average, just like, you know, here are the 12 ways you can get MPX,” said Chin-Hong. He said that’s changed to “… you can protect yourself by reducing the number of sexual partners, by cleaning your sex toys … I think the message did get out as to how you got it. You didn’t get it from a thrift store. \u003ca href=\"https://www.kqed.org/news/11922286/monkeypox-surfaces-air-transmission\">You didn’t get it from doing yoga\u003c/a> in an overheated Bikram yoga \u003c/span>\u003cspan style=\"font-weight: 400\">studio\u003c/span>\u003cspan style=\"font-weight: 400\">. You got it from intimate contact for hours. And that was the way that you protected yourself in the absence of not having enough vaccines.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Chin-Hong said having vaccine clinics at events like Folsom Street Fair became a strategy to correct another challenge: the disproportionate presence of MPX among Black and Latino men.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“If you’re lining up in a public line at [San Francisco] General [Hospital] to get a vaccine, everybody knows what group you’re part of. Maybe you’re not comfortable with that. So I think that’s still a big barrier and probably why there’s a bigger divide between minority populations and the general population,” said Chin-Hong, “I remember people were wearing hoodies in line because they just didn’t want to be seen.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Just a stone’s throw down Folsom Street, contestants tried their luck at winning a free T-shirt via the San Francisco Community Health Center’s public health “Jeopardy” game. The game featured an MPX category with questions like, “What is the Monkeypox incubation period?” (According to the CDC, \u003ca href=\"https://www.cdc.gov/poxvirus/monkeypox/clinicians/clinical-recognition.html\">the answer is three to 17 days\u003c/a>). It was part of a targeted outreach and street medicine campaign, executed by community groups and public health staff, and it seemed to be bearing fruit. But with cases still circulating and the likelihood they will rise again at some point, health experts say it’s still too early to put down one’s guard.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Negotiations between Kaiser Permanente and the union representing its mental health care workers collapsed Wednesday night, \u003ca href=\"https://www.kqed.org/news/11922524/kaiser-mental-health-workers-in-northern-california-begin-open-ended-strike-over-staffing-shortages\">one month into a strike\u003c/a> that still has no end in sight.\u003c/p>\n\u003cp>The National Union of Healthcare Workers, which represents some 2,000 Kaiser psychologists, therapists, social workers and chemical dependency counselors in Northern California, said in a statement that Kaiser refused to consider proposals to increase staffing and provide therapists with additional time to complete crucial administrative work. The union has also demanded the company cap caseloads if therapists are unable to see patients as quickly as state law requires.\u003c/p>\n\u003cp>Kaiser declined to schedule future bargaining sessions, leaving workers and their many thousands of patients in an ongoing state of limbo, union officials said.\u003c/p>\n\u003cp>“It’s so frustrating to be on the front lines of a mental health crisis only to have your employer be in complete denial about it,” Matt Hannon, a Kaiser psychologist in South San Francisco, and a member of the union’s bargaining committee, said in a statement. “Kaiser officials showed once again that they have no interest in providing timely mental health care that complies with state law or meets the needs of patients.”\u003c/p>\n\u003cp>Kaiser said in a statement that it has already made extensive compromises, including concessions on pay, and that the union is essentially pushing for its workers to spend less time with patients in need.\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"kaiser-permanente\"]“Frustratingly, NUHW leadership continued to refuse to resolve any remaining issues or acknowledge how far Kaiser Permanente has already moved for the sake of reaching agreement,” a spokesperson for the Oakland-based company said.\u003c/p>\n\u003cp>But the union emphasizes that the ongoing fight is about staffing resources, not compensation, noting that it already agreed to Kaiser’s wage-increase offer. It argues that Kaiser has failed to meaningfully address the severe mental health staffing shortages at its facilities that have resulted in massive turnover rates among workers and excessive wait times for patients.\u003c/p>\n\u003cp>The union has also accused the company of not providing its mental health patients timely access to services during the strike, in violation of state law, a claim currently under investigation.\u003c/p>\n\u003cp>The California Department of Managed Health Care said in a statement that it is “concerned about the potential for immediate harm to enrollees based on the very serious nature of allegations that the plan is not providing timely appointments to enrollees required by the law.”\u003c/p>\n\u003cp>As part of their investigation, state regulators are assessing whether Kaiser made sufficient arrangements to provide out-of-network services to patients in anticipation of the strike.\u003c/p>\n\u003cp>When the investigation was announced, the health care giant said it was in the process of reaching agreements with hundreds of community-based mental health care providers to partially fill the void left by striking workers.\u003c/p>\n\u003cp>Kaiser also said it is aggressively working to recruit and hire more therapists.\u003c/p>\n\u003cp>But Fred Seavey, a NUHW research director, told KQED last month that Kaiser has a history of failing to provide timely care, even though it has the resources to do so.\u003c/p>\n\u003cp>“Members are paying their premiums. They deserve to receive the care that they need and they paid for,” Seavey said. “If an HMO doesn’t have enough providers available, then it must arrange for members to get care from out-of-network providers at no additional cost to the member.”\u003c/p>\n\u003cp>Union members say they are determined to keep striking until Kaiser makes more concessions, but as the strike enters its second month, and workers remain unpaid, many are feeling the financial impact of not receiving their paychecks.\u003c/p>\n\u003cp>“It’s been a hard month, but going without a paycheck is nothing compared to what our patients have endured for years at Kaiser waiting months between therapy sessions,” Kimberly Hollingsworth-Hornor, a Kaiser therapist in Fresno and bargaining committee member, said in a statement. “We are going to keep striking until Kaiser stops gambling with patient lives and works with therapists to create a system that provides patients the care they need to get better.”\u003c/p>\n\u003cp>\u003ci>KQED’s Sara Hossaini contributed reporting to this story.\u003c/i>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Negotiations between Kaiser Permanente and the union representing its mental health care workers collapsed Wednesday night, \u003ca href=\"https://www.kqed.org/news/11922524/kaiser-mental-health-workers-in-northern-california-begin-open-ended-strike-over-staffing-shortages\">one month into a strike\u003c/a> that still has no end in sight.\u003c/p>\n\u003cp>The National Union of Healthcare Workers, which represents some 2,000 Kaiser psychologists, therapists, social workers and chemical dependency counselors in Northern California, said in a statement that Kaiser refused to consider proposals to increase staffing and provide therapists with additional time to complete crucial administrative work. The union has also demanded the company cap caseloads if therapists are unable to see patients as quickly as state law requires.\u003c/p>\n\u003cp>Kaiser declined to schedule future bargaining sessions, leaving workers and their many thousands of patients in an ongoing state of limbo, union officials said.\u003c/p>\n\u003cp>“It’s so frustrating to be on the front lines of a mental health crisis only to have your employer be in complete denial about it,” Matt Hannon, a Kaiser psychologist in South San Francisco, and a member of the union’s bargaining committee, said in a statement. “Kaiser officials showed once again that they have no interest in providing timely mental health care that complies with state law or meets the needs of patients.”\u003c/p>\n\u003cp>Kaiser said in a statement that it has already made extensive compromises, including concessions on pay, and that the union is essentially pushing for its workers to spend less time with patients in need.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“Frustratingly, NUHW leadership continued to refuse to resolve any remaining issues or acknowledge how far Kaiser Permanente has already moved for the sake of reaching agreement,” a spokesperson for the Oakland-based company said.\u003c/p>\n\u003cp>But the union emphasizes that the ongoing fight is about staffing resources, not compensation, noting that it already agreed to Kaiser’s wage-increase offer. It argues that Kaiser has failed to meaningfully address the severe mental health staffing shortages at its facilities that have resulted in massive turnover rates among workers and excessive wait times for patients.\u003c/p>\n\u003cp>The union has also accused the company of not providing its mental health patients timely access to services during the strike, in violation of state law, a claim currently under investigation.\u003c/p>\n\u003cp>The California Department of Managed Health Care said in a statement that it is “concerned about the potential for immediate harm to enrollees based on the very serious nature of allegations that the plan is not providing timely appointments to enrollees required by the law.”\u003c/p>\n\u003cp>As part of their investigation, state regulators are assessing whether Kaiser made sufficient arrangements to provide out-of-network services to patients in anticipation of the strike.\u003c/p>\n\u003cp>When the investigation was announced, the health care giant said it was in the process of reaching agreements with hundreds of community-based mental health care providers to partially fill the void left by striking workers.\u003c/p>\n\u003cp>Kaiser also said it is aggressively working to recruit and hire more therapists.\u003c/p>\n\u003cp>But Fred Seavey, a NUHW research director, told KQED last month that Kaiser has a history of failing to provide timely care, even though it has the resources to do so.\u003c/p>\n\u003cp>“Members are paying their premiums. They deserve to receive the care that they need and they paid for,” Seavey said. “If an HMO doesn’t have enough providers available, then it must arrange for members to get care from out-of-network providers at no additional cost to the member.”\u003c/p>\n\u003cp>Union members say they are determined to keep striking until Kaiser makes more concessions, but as the strike enters its second month, and workers remain unpaid, many are feeling the financial impact of not receiving their paychecks.\u003c/p>\n\u003cp>“It’s been a hard month, but going without a paycheck is nothing compared to what our patients have endured for years at Kaiser waiting months between therapy sessions,” Kimberly Hollingsworth-Hornor, a Kaiser therapist in Fresno and bargaining committee member, said in a statement. “We are going to keep striking until Kaiser stops gambling with patient lives and works with therapists to create a system that provides patients the care they need to get better.”\u003c/p>\n\u003cp>\u003ci>KQED’s Sara Hossaini contributed reporting to this story.\u003c/i>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "when-should-you-get-your-2022-flu-shot",
"title": "When Should You Get Your 2022 Flu Shot?",
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"content": "\u003cp>\u003cem>Updated 11 a.m. Wednesday, September 21\u003c/em>\u003c/p>\n\u003cp>Even as the COVID-19 pandemic continues to claim lives across the country, the flu remains a potentially serious threat to your health.\u003c/p>\n\u003cp>Jump straight to:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#whenflushot\">When should I get my flu shot?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#boosterflushot\">Can I get a COVID booster and my flu shot at the same time?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#highrisk\">Which flu shot should I get if I’m 65 and older, I’m pregnant, or I need a shot for my kids?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#flushotnearme\">Where can I get a flu shot, with or without insurance?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>The Centers for Disease Control and Prevention estimates that, annually, the flu caused 140,000-710,000 hospitalizations and 12,000-52,000 deaths between 2010 and 2020. But the organization says that \u003ca href=\"https://www.cdc.gov/flu/fluvaxview/coverage-2021estimates.htm\">in the 2020-2021 flu season, only around half of adults got a flu shot\u003c/a>.\u003c/p>\n\u003cp>Getting a flu vaccine can prevent you from getting sick with the flu, which is a draining, unpleasant experience even if your symptoms are not severe. And if you \u003cem>do\u003c/em> get the flu, having a flu shot can also stop you from getting sick enough to have to go to the hospital (and be exposed to all the COVID risks hospital settings can bring).\u003c/p>\n\u003cp>The CDC says the flu vaccine also offers other potential health impacts, such as being associated with \u003ca class=\"tp-link-policy\" href=\"https://pubmed.ncbi.nlm.nih.gov/24150467/\" data-domain-ext=\"gov\">lower rates of certain cardiac events\u003c/a> for people who have heart disease. It’s also the best, safest way not only to protect \u003cem>yourself\u003c/em> against the influenza virus, but also to minimize the chance you will spread it to others — folks who could be at far higher risk for serious complications or even death if they were to become infected. \u003ca href=\"https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm\">Read more from the CDC about what the flu shot can do for you.\u003c/a>\u003c/p>\n\u003cp>And read on to find out whether you should be getting your flu shot right now, and where to find free or low-cost flu shot options near you.\u003c/p>\n\u003ch2>Will this flu season be bad?\u003c/h2>\n\u003cp>It’s true that \u003ca href=\"https://www.cdc.gov/flu/season/faq-flu-season-2020-2021.htm\">2020 saw a record-low number of flu cases\u003c/a> — most likely due to widespread mask-wearing, increased hygiene, social distancing and remote work and school.\u003c/p>\n\u003cp>Last year’s flu season also “didn’t surge in the numbers that people expected,” said UCSF professor of medicine Dr. Peter Chin-Hong — but “it did drag on for much longer.” Whereas a typical flu season peaks in February, Chin-Hong said that last year’s “went from October of 2021 to June of 2022 — so, a much longer tail than usually we would expect.”\u003c/p>\n\u003cp>So what about this winter’s flu risks? Chin-Hong said he and other medical professionals are “worried for several reasons.”\u003c/p>\n\u003cp>Along with the lifting of COVID restrictions, there’s the fact that \u003ca href=\"https://www.nbcnews.com/health/health-news/australia-flu-season-warning-sign-us-this-year-rcna40123\">Australia has just had its worst flu season in five years\u003c/a>. Because the continent’s winter happens during the United States’ summer, Australia’s flu season is traditionally an indicator of how bad ours might be — and, of concern, it was as “robust as any of the pre-pandemic flu seasons,” said Chin-Hong.\u003c/p>\n\u003cp>Dr. Michael Kim, vice president of medical affairs for MarinHealth, echoes these particular worries in the context of the lifting of COVID safety measures.\u003c/p>\n\u003cp>“I think we’re all concerned that flu season this year might be particularly severe, especially since people are not masking as much, as well as people haven’t been exposed to flu as much in the last couple of years,” said Kim.\u003c/p>\n\u003ch2>\u003ca id=\"whenflushot\">\u003c/a>Should I get a flu shot now, or wait?\u003c/h2>\n\u003cp>The recommendations medical professionals make about when to get a flu shot are based on the fact that it takes about two weeks after you get vaccinated for antibodies to develop and provide protection against the flu.\u003c/p>\n\u003cp>This flu season, the CDC says that September and October are “generally good times to be vaccinated against flu,” and that “\u003ca href=\"https://www.cdc.gov/flu/season/faq-flu-season-2022-2023.htm\">ideally, everyone should be vaccinated by the end of October\u003c/a>.”\u003c/p>\n\u003cfigure id=\"attachment_11838737\" class=\"wp-caption alignnone\" style=\"max-width: 1900px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11838737\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/09/shots2.png\" alt=\"\" width=\"1900\" height=\"1267\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/09/shots2.png 1900w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/09/shots2-800x533.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/09/shots2-1020x680.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/09/shots2-160x107.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/09/shots2-1536x1024.png 1536w\" sizes=\"auto, (max-width: 1900px) 100vw, 1900px\">\u003cfigcaption class=\"wp-caption-text\">It takes two weeks after your flu shot for your body to develop the antibodies it needs to protect you from the flu virus. \u003ccite>(Queen's University/Flickr)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Yes, there’s evidence, says Chin-Hong, that \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/28039340/\">your risk of getting the flu increases every month after your flu shot, due to the antibodies waning over time\u003c/a>.\u003c/p>\n\u003cp>But when medical professionals talk about strategically “waiting” to get a flu shot, they’re aiming that advice at those who are at particularly high risk for more serious complications related to the flu. That includes people over 65, those with chronic medical conditions, people who are pregnant or planning a pregnancy, and kids under 5.\u003c/p>\n\u003cp>Delaying inoculations for these populations is based on the idea of getting the shot at a time Chin-Hong calls “the sweet spot,” around mid-to-late October. Two weeks later, right around early November, the antibodies should have developed, just as flu season is getting serious. Think of it as getting the “biggest bang for your buck,” he said.\u003c/p>\n\u003cp>So if you’re in one of those vulnerable categories? Yes, you can think about waiting, says Chin-Hong. People over 65 might also consider requesting the special flu vaccines for this age group — read more about this below. As with all health matters, if you’re looking for advice, it’s best to consult your health care provider or someone you see regularly for your medical needs.\u003c/p>\n\u003cp>And what if you’re under 65, not pregnant and don’t have other risk factors for severe flu? If you can truly trust yourself to plan ahead and not forget to make the appointment, “getting it before the end of October is probably the best,” said Chin-Hong. But remember: Not only are you human and it might slip your mind, but predictions about how the flu season might behave are just that — predictions. The timing of this year’s flu season might surprise us, and throw previous notions of a “best time” to get the vaccine into disarray.\u003c/p>\n\u003cp>“Just like we can’t predict the next COVID surge, we don’t know if influenza will have a different pattern this year,” said Chin-Hong, noting how Australia’s particularly bad flu season started earlier than expected. So take that “October rule” with “a grain of salt,” he advised, and “get it [your flu shot] when you get it.”\u003c/p>\n\u003cp>What if you plan to get your flu shot in October with the best of intentions, but you still forget? If November 1 comes and goes and you realize you haven’t been vaccinated, all is not lost — since the CDC says that “vaccination after October can still provide protection during the peak of flu season,” which is usually February.\u003c/p>\n\u003cp>In other words, just go get the shot already — whenever that may be.\u003c/p>\n\u003cp>\u003cimg loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-11838740\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/09/shots3.png\" alt=\"\" width=\"1900\" height=\"1267\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/09/shots3.png 1900w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/09/shots3-800x533.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/09/shots3-1020x680.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/09/shots3-160x107.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/09/shots3-1536x1024.png 1536w\" sizes=\"auto, (max-width: 1900px) 100vw, 1900px\">\u003c/p>\n\u003ch2>\u003ca id=\"boosterflushot\">\u003c/a>Can I get my COVID booster and my flu shot at the same time?\u003c/h2>\n\u003cp>Yes, you can. Ashish Jha, White House COVID response coordinator, went so far in a September 6 briefing as to tell the audience “\u003ca href=\"https://www.whitehouse.gov/briefing-room/press-briefings/2022/09/06/press-briefing-by-white-house-covid-19-response-team-and-public-health-officials-88/\">I really believe this is why God gave us two arms\u003c/a> — one for the flu shot and the other one for the COVID shot.”\u003c/p>\n\u003cp>That “COVID shot” is the newly available COVID booster — that is, the \u003ca href=\"https://www.cdc.gov/media/releases/2022/s0901-covid-19-booster.html\">new Moderna and Pfizer booster shots of the reformulated COVID-19 vaccine\u003c/a>. The updated shots, called bivalent vaccines, target both the original strain of the coronavirus and the widespread BA.4/BA.5 omicron subvariants that have largely evaded previous boosters.\u003c/p>\n\u003cp>Anyone age 12 and up who got their last COVID vaccine shot at least two months ago — whether that was their primary vaccination series or their last booster shot — can now get an updated COVID booster. \u003ca href=\"https://www.kqed.org/news/11924327/where-can-i-find-a-new-omicron-covid-booster-shot-near-me\">Read more about how to find an updated COVID booster near you.\u003c/a>\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdc.gov/flu/season/faq-flu-season-2022-2023.htm#Flu-Vaccine-and-COVID-19-Vaccine-Coadministration\">The CDC confirms that it’s safe to get both the flu shot and the bivalent COVID booster at the same time\u003c/a> “if you are eligible and the timing coincides.” Several pharmacy chains are prompting those making an online appointment for a bivalent COVID booster to also “add on” a flu shot at the same time.\u003c/p>\n\u003cp>Getting both shots simultaneously certainly offers you convenience, said Chin-Hong: “It’s one-stop shopping and again: out of sight, out of mind.”\u003c/p>\n\u003cp>The only thing that might give you pause about getting your COVID bivalent booster and your flu shot: If you want to get your booster ASAP, some experts believe that \u003ca href=\"https://www.statnews.com/2022/09/09/doubling-up-on-covid-booster-flu-shot-may-have-downside/\">it might be slightly too early right now to get your flu shot\u003c/a>, considering how immunity from the vaccine wanes. That said, other medical professionals say that \u003ca href=\"https://www.statnews.com/2022/09/09/doubling-up-on-covid-booster-flu-shot-may-have-downside/\">the benefits of folks remembering to actually \u003cem>get\u003c/em> both their booster and their flu shot probably outweigh the downsides\u003c/a>, even if it means the timing of their flu vaccine is a little early.\u003c/p>\n\u003cp>Chin-Hong reiterated that “if you really wanted to optimize” the timing of your flu shot, yes, “sometime in October \u003cem>is\u003c/em> probably the best.” But ultimately, he says that just \u003cem>getting\u003c/em> the shots is better than not getting them at all.\u003c/p>\n\u003ch2>\u003ca id=\"highrisk\">\u003c/a>If I have risk factors for severe flu, what kind of flu shot should I get?\u003c/h2>\n\u003cp>If you’re age 65 or older, there’s something new for you to know this flu season: There are now three types of flu vaccines it’s recommended you get, because they’ll be even more effective for you than a regular flu shot.\u003c/p>\n\u003cp>Chin-Hong said folks in this age group should seek out these three types of vaccines because you’ll be getting “essentially a high-dose shot” or a vaccine that contains an “adjuvant” — which, in simple terms, “makes the flu shot more powerful in terms of waking up the immune system,” he said. \u003ca href=\"https://www.cdc.gov/flu/prevent/keyfacts.htm\">Read more about the three kinds of flu shots available to people age 65 and older.\u003c/a>\u003c/p>\n\u003cp>Pregnant people can get a regular flu shot, although there are some types of flu vaccine that are off-limits to pregnant people. The CDC says that getting vaccinated when you’re pregnant will not only help protect you from the flu, but also — if your baby is born during the immunity period — protect your infant in the first few months of their life, when they’re too young to get vaccinated themselves.\u003c/p>\n\u003cp>This benefit to the baby is also the reason that pregnant people are one of the few groups who might want to consider getting a flu shot \u003cem>early\u003c/em>, instead of waiting — to ensure their baby isn’t left completely unprotected for those first six months after birth, when they can’t get a vaccine. \u003ca href=\"https://www.cdc.gov/flu/prevent/keyfacts.htm\">Read more about the benefits of getting a flu shot if you’re pregnant.\u003c/a>\u003c/p>\n\u003cp>Children age 6 months and older can get a regular dose of the flu shot. \u003ca href=\"https://www.cdc.gov/flu/highrisk/children-high-risk.htm\">Flu can be particularly dangerous for kids\u003c/a>, and the CDC says that a 2022 study showed that flu vaccination reduced children’s risk of severe, life-threatening influenza by 75%.\u003c/p>\n\u003ch2>\u003ca id=\"flushotnearme\">\u003c/a>Where can I get a flu shot if I have insurance?\u003c/h2>\n\u003cp>If you have health insurance, a flu shot is available without extra cost as a preventive service from your usual health care provider, or at most pharmacies (see below).\u003c/p>\n\u003cp>It’s a good idea to wear a mask, maintain social distancing wherever possible while waiting for your shot, and dress in a top with sleeves you can easily pull up to your shoulder, to make receiving the injection even easier (and quicker).\u003c/p>\n\u003cp>\u003cstrong>Common places to find a flu shot appointment, walk-in site or drive-thru flu shot:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://www.vaccines.gov/find-vaccines/\">CDC’s Find Flu Vaccines tool\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://mydoctor.kaiserpermanente.org/ncal/cold-and-flu/prevention#/prevention\">Kaiser Permanente flu shots (Northern California) \u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.cvs.com/immunizations/flu\">CVS flu shots\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.walgreens.com/topic/pharmacy/seasonal-flu.jsp?ban=flu_fy21_influenzapage\">Walgreens flu shots \u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.riteaid.com/pharmacy/scheduler\">Rite Aid flu shots\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.costco.com/Pharmacy/adult-immunization-program.html\">Costco Pharmacy flu shots\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.albertsons.com/pharmacy/pharmacy-services/immunizations.html\">Albertsons (Safeway) flu shots\u003c/a>\u003c/li>\n\u003c/ul>\n\u003ch2>Where can I get a flu shot if I \u003cem>don’t\u003c/em> have health insurance?\u003c/h2>\n\u003cp>If you want a flu shot but don’t have health insurance, you can get the vaccine free of charge from several providers and community clinics around the Bay Area. (You can also technically use these free services even if you do have insurance, but you may consider choosing to free up these particular resources for those who are not covered.)\u003c/p>\n\u003cp>Your county’s own public health department may also be offering flu shots.\u003c/p>\n\u003cp>\u003cstrong>Places to get a free or low-cost flu shot in the Bay Area include:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://www.sfcdcp.org/aitc/aitc-regular-prices-low-cost-or-free-vaccines/\">San Francisco Department of Public Health’s AITC clinic\u003c/a> (offers a pay-what-you-can option, and says nobody will be refused for inability to pay)\u003c/li>\n\u003cli>\u003ca href=\"https://cchealth.org/immunization/clinics.php#Uninsured\">Contra Costa Public Health Immunization Clinic\u003c/a> (flu shots are $15 for adults over 19, but fees may be waived if you’re unable to pay)\u003c/li>\n\u003cli>\u003ca href=\"https://acphd.org/clinics/\">Alameda County Immunization Clinics\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cspan style=\"font-weight: 400\">[ad fullwidth]\u003c/span>\u003c/p>\n\u003ch2>And a reminder … the flu vaccine can’t give you the flu\u003c/h2>\n\u003cp>The virus that the flu shot contains has been inactivated or severely weakened, so \u003ca href=\"https://www.cdc.gov/flu/prevent/misconceptions.htm#:~:text=Can%20a%20flu%20vaccine%20give,protein%20from%20the%20flu%20virus.\">you just aren’t physically able to get the flu from your flu shot\u003c/a>, confirms the CDC.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdc.gov/flu/prevent/general.htm#side-effects\">The flu vaccine can cause side effects\u003c/a> like any medical product, but they’re “\u003ca href=\"https://www.cdc.gov/flu/prevent/general.htm\">generally mild and go away on their own within a few days\u003c/a>,” the agency says.\u003c/p>\n\u003cp>Common flu shot side effects can include soreness or swelling at the injection site, headache, fever, nausea and muscle aches. (But not the flu.)\u003c/p>\n\u003cp>\u003cem>This story contains reporting by KQED’s Alexander Gonzalez.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Updated 11 a.m. Wednesday, September 21\u003c/em>\u003c/p>\n\u003cp>Even as the COVID-19 pandemic continues to claim lives across the country, the flu remains a potentially serious threat to your health.\u003c/p>\n\u003cp>Jump straight to:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#whenflushot\">When should I get my flu shot?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#boosterflushot\">Can I get a COVID booster and my flu shot at the same time?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#highrisk\">Which flu shot should I get if I’m 65 and older, I’m pregnant, or I need a shot for my kids?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#flushotnearme\">Where can I get a flu shot, with or without insurance?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>The Centers for Disease Control and Prevention estimates that, annually, the flu caused 140,000-710,000 hospitalizations and 12,000-52,000 deaths between 2010 and 2020. But the organization says that \u003ca href=\"https://www.cdc.gov/flu/fluvaxview/coverage-2021estimates.htm\">in the 2020-2021 flu season, only around half of adults got a flu shot\u003c/a>.\u003c/p>\n\u003cp>Getting a flu vaccine can prevent you from getting sick with the flu, which is a draining, unpleasant experience even if your symptoms are not severe. And if you \u003cem>do\u003c/em> get the flu, having a flu shot can also stop you from getting sick enough to have to go to the hospital (and be exposed to all the COVID risks hospital settings can bring).\u003c/p>\n\u003cp>The CDC says the flu vaccine also offers other potential health impacts, such as being associated with \u003ca class=\"tp-link-policy\" href=\"https://pubmed.ncbi.nlm.nih.gov/24150467/\" data-domain-ext=\"gov\">lower rates of certain cardiac events\u003c/a> for people who have heart disease. It’s also the best, safest way not only to protect \u003cem>yourself\u003c/em> against the influenza virus, but also to minimize the chance you will spread it to others — folks who could be at far higher risk for serious complications or even death if they were to become infected. \u003ca href=\"https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm\">Read more from the CDC about what the flu shot can do for you.\u003c/a>\u003c/p>\n\u003cp>And read on to find out whether you should be getting your flu shot right now, and where to find free or low-cost flu shot options near you.\u003c/p>\n\u003ch2>Will this flu season be bad?\u003c/h2>\n\u003cp>It’s true that \u003ca href=\"https://www.cdc.gov/flu/season/faq-flu-season-2020-2021.htm\">2020 saw a record-low number of flu cases\u003c/a> — most likely due to widespread mask-wearing, increased hygiene, social distancing and remote work and school.\u003c/p>\n\u003cp>Last year’s flu season also “didn’t surge in the numbers that people expected,” said UCSF professor of medicine Dr. Peter Chin-Hong — but “it did drag on for much longer.” Whereas a typical flu season peaks in February, Chin-Hong said that last year’s “went from October of 2021 to June of 2022 — so, a much longer tail than usually we would expect.”\u003c/p>\n\u003cp>So what about this winter’s flu risks? Chin-Hong said he and other medical professionals are “worried for several reasons.”\u003c/p>\n\u003cp>Along with the lifting of COVID restrictions, there’s the fact that \u003ca href=\"https://www.nbcnews.com/health/health-news/australia-flu-season-warning-sign-us-this-year-rcna40123\">Australia has just had its worst flu season in five years\u003c/a>. Because the continent’s winter happens during the United States’ summer, Australia’s flu season is traditionally an indicator of how bad ours might be — and, of concern, it was as “robust as any of the pre-pandemic flu seasons,” said Chin-Hong.\u003c/p>\n\u003cp>Dr. Michael Kim, vice president of medical affairs for MarinHealth, echoes these particular worries in the context of the lifting of COVID safety measures.\u003c/p>\n\u003cp>“I think we’re all concerned that flu season this year might be particularly severe, especially since people are not masking as much, as well as people haven’t been exposed to flu as much in the last couple of years,” said Kim.\u003c/p>\n\u003ch2>\u003ca id=\"whenflushot\">\u003c/a>Should I get a flu shot now, or wait?\u003c/h2>\n\u003cp>The recommendations medical professionals make about when to get a flu shot are based on the fact that it takes about two weeks after you get vaccinated for antibodies to develop and provide protection against the flu.\u003c/p>\n\u003cp>This flu season, the CDC says that September and October are “generally good times to be vaccinated against flu,” and that “\u003ca href=\"https://www.cdc.gov/flu/season/faq-flu-season-2022-2023.htm\">ideally, everyone should be vaccinated by the end of October\u003c/a>.”\u003c/p>\n\u003cfigure id=\"attachment_11838737\" class=\"wp-caption alignnone\" style=\"max-width: 1900px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11838737\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/09/shots2.png\" alt=\"\" width=\"1900\" height=\"1267\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/09/shots2.png 1900w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/09/shots2-800x533.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/09/shots2-1020x680.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/09/shots2-160x107.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/09/shots2-1536x1024.png 1536w\" sizes=\"auto, (max-width: 1900px) 100vw, 1900px\">\u003cfigcaption class=\"wp-caption-text\">It takes two weeks after your flu shot for your body to develop the antibodies it needs to protect you from the flu virus. \u003ccite>(Queen's University/Flickr)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Yes, there’s evidence, says Chin-Hong, that \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/28039340/\">your risk of getting the flu increases every month after your flu shot, due to the antibodies waning over time\u003c/a>.\u003c/p>\n\u003cp>But when medical professionals talk about strategically “waiting” to get a flu shot, they’re aiming that advice at those who are at particularly high risk for more serious complications related to the flu. That includes people over 65, those with chronic medical conditions, people who are pregnant or planning a pregnancy, and kids under 5.\u003c/p>\n\u003cp>Delaying inoculations for these populations is based on the idea of getting the shot at a time Chin-Hong calls “the sweet spot,” around mid-to-late October. Two weeks later, right around early November, the antibodies should have developed, just as flu season is getting serious. Think of it as getting the “biggest bang for your buck,” he said.\u003c/p>\n\u003cp>So if you’re in one of those vulnerable categories? Yes, you can think about waiting, says Chin-Hong. People over 65 might also consider requesting the special flu vaccines for this age group — read more about this below. As with all health matters, if you’re looking for advice, it’s best to consult your health care provider or someone you see regularly for your medical needs.\u003c/p>\n\u003cp>And what if you’re under 65, not pregnant and don’t have other risk factors for severe flu? If you can truly trust yourself to plan ahead and not forget to make the appointment, “getting it before the end of October is probably the best,” said Chin-Hong. But remember: Not only are you human and it might slip your mind, but predictions about how the flu season might behave are just that — predictions. The timing of this year’s flu season might surprise us, and throw previous notions of a “best time” to get the vaccine into disarray.\u003c/p>\n\u003cp>“Just like we can’t predict the next COVID surge, we don’t know if influenza will have a different pattern this year,” said Chin-Hong, noting how Australia’s particularly bad flu season started earlier than expected. So take that “October rule” with “a grain of salt,” he advised, and “get it [your flu shot] when you get it.”\u003c/p>\n\u003cp>What if you plan to get your flu shot in October with the best of intentions, but you still forget? If November 1 comes and goes and you realize you haven’t been vaccinated, all is not lost — since the CDC says that “vaccination after October can still provide protection during the peak of flu season,” which is usually February.\u003c/p>\n\u003cp>In other words, just go get the shot already — whenever that may be.\u003c/p>\n\u003cp>\u003cimg loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-11838740\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/09/shots3.png\" alt=\"\" width=\"1900\" height=\"1267\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/09/shots3.png 1900w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/09/shots3-800x533.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/09/shots3-1020x680.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/09/shots3-160x107.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/09/shots3-1536x1024.png 1536w\" sizes=\"auto, (max-width: 1900px) 100vw, 1900px\">\u003c/p>\n\u003ch2>\u003ca id=\"boosterflushot\">\u003c/a>Can I get my COVID booster and my flu shot at the same time?\u003c/h2>\n\u003cp>Yes, you can. Ashish Jha, White House COVID response coordinator, went so far in a September 6 briefing as to tell the audience “\u003ca href=\"https://www.whitehouse.gov/briefing-room/press-briefings/2022/09/06/press-briefing-by-white-house-covid-19-response-team-and-public-health-officials-88/\">I really believe this is why God gave us two arms\u003c/a> — one for the flu shot and the other one for the COVID shot.”\u003c/p>\n\u003cp>That “COVID shot” is the newly available COVID booster — that is, the \u003ca href=\"https://www.cdc.gov/media/releases/2022/s0901-covid-19-booster.html\">new Moderna and Pfizer booster shots of the reformulated COVID-19 vaccine\u003c/a>. The updated shots, called bivalent vaccines, target both the original strain of the coronavirus and the widespread BA.4/BA.5 omicron subvariants that have largely evaded previous boosters.\u003c/p>\n\u003cp>Anyone age 12 and up who got their last COVID vaccine shot at least two months ago — whether that was their primary vaccination series or their last booster shot — can now get an updated COVID booster. \u003ca href=\"https://www.kqed.org/news/11924327/where-can-i-find-a-new-omicron-covid-booster-shot-near-me\">Read more about how to find an updated COVID booster near you.\u003c/a>\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdc.gov/flu/season/faq-flu-season-2022-2023.htm#Flu-Vaccine-and-COVID-19-Vaccine-Coadministration\">The CDC confirms that it’s safe to get both the flu shot and the bivalent COVID booster at the same time\u003c/a> “if you are eligible and the timing coincides.” Several pharmacy chains are prompting those making an online appointment for a bivalent COVID booster to also “add on” a flu shot at the same time.\u003c/p>\n\u003cp>Getting both shots simultaneously certainly offers you convenience, said Chin-Hong: “It’s one-stop shopping and again: out of sight, out of mind.”\u003c/p>\n\u003cp>The only thing that might give you pause about getting your COVID bivalent booster and your flu shot: If you want to get your booster ASAP, some experts believe that \u003ca href=\"https://www.statnews.com/2022/09/09/doubling-up-on-covid-booster-flu-shot-may-have-downside/\">it might be slightly too early right now to get your flu shot\u003c/a>, considering how immunity from the vaccine wanes. That said, other medical professionals say that \u003ca href=\"https://www.statnews.com/2022/09/09/doubling-up-on-covid-booster-flu-shot-may-have-downside/\">the benefits of folks remembering to actually \u003cem>get\u003c/em> both their booster and their flu shot probably outweigh the downsides\u003c/a>, even if it means the timing of their flu vaccine is a little early.\u003c/p>\n\u003cp>Chin-Hong reiterated that “if you really wanted to optimize” the timing of your flu shot, yes, “sometime in October \u003cem>is\u003c/em> probably the best.” But ultimately, he says that just \u003cem>getting\u003c/em> the shots is better than not getting them at all.\u003c/p>\n\u003ch2>\u003ca id=\"highrisk\">\u003c/a>If I have risk factors for severe flu, what kind of flu shot should I get?\u003c/h2>\n\u003cp>If you’re age 65 or older, there’s something new for you to know this flu season: There are now three types of flu vaccines it’s recommended you get, because they’ll be even more effective for you than a regular flu shot.\u003c/p>\n\u003cp>Chin-Hong said folks in this age group should seek out these three types of vaccines because you’ll be getting “essentially a high-dose shot” or a vaccine that contains an “adjuvant” — which, in simple terms, “makes the flu shot more powerful in terms of waking up the immune system,” he said. \u003ca href=\"https://www.cdc.gov/flu/prevent/keyfacts.htm\">Read more about the three kinds of flu shots available to people age 65 and older.\u003c/a>\u003c/p>\n\u003cp>Pregnant people can get a regular flu shot, although there are some types of flu vaccine that are off-limits to pregnant people. The CDC says that getting vaccinated when you’re pregnant will not only help protect you from the flu, but also — if your baby is born during the immunity period — protect your infant in the first few months of their life, when they’re too young to get vaccinated themselves.\u003c/p>\n\u003cp>This benefit to the baby is also the reason that pregnant people are one of the few groups who might want to consider getting a flu shot \u003cem>early\u003c/em>, instead of waiting — to ensure their baby isn’t left completely unprotected for those first six months after birth, when they can’t get a vaccine. \u003ca href=\"https://www.cdc.gov/flu/prevent/keyfacts.htm\">Read more about the benefits of getting a flu shot if you’re pregnant.\u003c/a>\u003c/p>\n\u003cp>Children age 6 months and older can get a regular dose of the flu shot. \u003ca href=\"https://www.cdc.gov/flu/highrisk/children-high-risk.htm\">Flu can be particularly dangerous for kids\u003c/a>, and the CDC says that a 2022 study showed that flu vaccination reduced children’s risk of severe, life-threatening influenza by 75%.\u003c/p>\n\u003ch2>\u003ca id=\"flushotnearme\">\u003c/a>Where can I get a flu shot if I have insurance?\u003c/h2>\n\u003cp>If you have health insurance, a flu shot is available without extra cost as a preventive service from your usual health care provider, or at most pharmacies (see below).\u003c/p>\n\u003cp>It’s a good idea to wear a mask, maintain social distancing wherever possible while waiting for your shot, and dress in a top with sleeves you can easily pull up to your shoulder, to make receiving the injection even easier (and quicker).\u003c/p>\n\u003cp>\u003cstrong>Common places to find a flu shot appointment, walk-in site or drive-thru flu shot:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://www.vaccines.gov/find-vaccines/\">CDC’s Find Flu Vaccines tool\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://mydoctor.kaiserpermanente.org/ncal/cold-and-flu/prevention#/prevention\">Kaiser Permanente flu shots (Northern California) \u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.cvs.com/immunizations/flu\">CVS flu shots\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.walgreens.com/topic/pharmacy/seasonal-flu.jsp?ban=flu_fy21_influenzapage\">Walgreens flu shots \u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.riteaid.com/pharmacy/scheduler\">Rite Aid flu shots\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.costco.com/Pharmacy/adult-immunization-program.html\">Costco Pharmacy flu shots\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.albertsons.com/pharmacy/pharmacy-services/immunizations.html\">Albertsons (Safeway) flu shots\u003c/a>\u003c/li>\n\u003c/ul>\n\u003ch2>Where can I get a flu shot if I \u003cem>don’t\u003c/em> have health insurance?\u003c/h2>\n\u003cp>If you want a flu shot but don’t have health insurance, you can get the vaccine free of charge from several providers and community clinics around the Bay Area. (You can also technically use these free services even if you do have insurance, but you may consider choosing to free up these particular resources for those who are not covered.)\u003c/p>\n\u003cp>Your county’s own public health department may also be offering flu shots.\u003c/p>\n\u003cp>\u003cstrong>Places to get a free or low-cost flu shot in the Bay Area include:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://www.sfcdcp.org/aitc/aitc-regular-prices-low-cost-or-free-vaccines/\">San Francisco Department of Public Health’s AITC clinic\u003c/a> (offers a pay-what-you-can option, and says nobody will be refused for inability to pay)\u003c/li>\n\u003cli>\u003ca href=\"https://cchealth.org/immunization/clinics.php#Uninsured\">Contra Costa Public Health Immunization Clinic\u003c/a> (flu shots are $15 for adults over 19, but fees may be waived if you’re unable to pay)\u003c/li>\n\u003cli>\u003ca href=\"https://acphd.org/clinics/\">Alameda County Immunization Clinics\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>\u003c/p>\n\u003ch2>And a reminder … the flu vaccine can’t give you the flu\u003c/h2>\n\u003cp>The virus that the flu shot contains has been inactivated or severely weakened, so \u003ca href=\"https://www.cdc.gov/flu/prevent/misconceptions.htm#:~:text=Can%20a%20flu%20vaccine%20give,protein%20from%20the%20flu%20virus.\">you just aren’t physically able to get the flu from your flu shot\u003c/a>, confirms the CDC.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdc.gov/flu/prevent/general.htm#side-effects\">The flu vaccine can cause side effects\u003c/a> like any medical product, but they’re “\u003ca href=\"https://www.cdc.gov/flu/prevent/general.htm\">generally mild and go away on their own within a few days\u003c/a>,” the agency says.\u003c/p>\n\u003cp>Common flu shot side effects can include soreness or swelling at the injection site, headache, fever, nausea and muscle aches. (But not the flu.)\u003c/p>\n\u003cp>\u003cem>This story contains reporting by KQED’s Alexander Gonzalez.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "Newsom Signs 'CARE Court' Plan, Overhauling Mental Health Care in California",
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"content": "\u003cp>\u003cem>Updated Wednesday 2 p.m.\u003c/em>\u003c/p>\n\u003cp>Gov. Gavin Newsom signed a controversial bill Wednesday overhauling the state’s approach to mental health care for people diagnosed with schizophrenia and other psychotic disorders.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The state Senate last month approved the\u003c/span> Community Assistance, Recovery and Empowerment Act, which will allow family members and first responders to ask a judge to draw up a treatment plan for people deemed to be suffering from those disorders. Those who refuse could be placed under a conservatorship and ordered to comply.\u003c/p>\n\u003cp>Currently, unhoused people with severe mental health disorders can be held against their will at psychiatric hospitals, but must be released after three days if they promise to follow up with other services and take prescribed medication.\u003c/p>\n\u003cp>The new law will let a court order a treatment plan for up to two years, which may include medication, housing and therapy.\u003cspan style=\"font-weight: 400\"> Participants will have access to a public defender and an advocate to help make decisions about treatment programs and housing. In turn, the behavioral health department in that county would be compelled to provide treatment.\u003c/span>\u003c/p>\n\u003cp>While it shares some elements of mental health programs in some other states, California’s new system will be the first of its kind in the country, according to state Sen. Tom Umberg, D-Santa Ana, who co-authored the law.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Standing outside Momentum for Health, a nonprofit mental health care provider in San José, Newsom on Wednesday said the bill was about redesigning a broken system \u003c/span>\u003cspan style=\"font-weight: 400\">that often leaves people cycling among homelessness, jail and emergency rooms. \u003c/span>\u003c/p>\n\u003cp>“I’m not interested in the status quo,” he said. “I’m not interested in the compassionless-ness of the approach we have today of people moralizing and normalizing that suffering on the streets and sidewalks.”\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But critics of the bill say it coerces people into care, which is less effective than voluntary treatment, and doesn’t provide the necessary health and housing resources.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">James Burch, deputy director of the Anti Police-Terror Project, which is part of a statewide coalition opposing CARE Court, called the bill’s signing “devastating.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It ignores the very stark reality that we’re living in in this moment,” he said. “We are tens of thousands of beds short in the Bay Area of the permanent housing that we need. … And we are woefully short on voluntary treatment programs.”\u003c/span>\u003c/p>\n\u003cp>[aside postID=news_11914873 hero='https://ww2.kqed.org/app/uploads/sites/10/2022/05/RS16522_GettyImages-73453883-qut-1020x682.jpg']\u003cspan style=\"font-weight: 400\">Gov. Gavin Newsom introduced the proposal in March. \u003c/span>It passed the Legislature with overwhelming support, despite vehement opposition from disability rights and homeless advocates.\u003c/p>\n\u003cp>“It was just a matter of months ago that we stood right here and we laid out a vision,” Newsom said Wednesday. “And here we are. We’ve made it a reality, and that is rare in politics, particularly on issues as vexing and challenging as this issue.”\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Santa Clara County Superior Court Judge Stephen Manley said every day he sees people caught in a cycle of homelessness, jail and emergency rooms, without ever getting the adequate care or housing they need. Manley oversees a \u003ca href=\"https://steinberginstitute.org/champion/stephen-v-manley/\" target=\"_blank\" rel=\"noopener noreferrer\">mental health care diversion court\u003c/a> for people awaiting trial for suspected crimes. \u003c/span>\u003c/p>\n\u003cp>“I think this is a major step towards building a system that is going to be effective, as opposed to the present system,” Manley said, “where these individuals simply cycle through our jails over to the emergency room of a hospital, back to the streets, back to the jail, back to the hospital. And it doesn’t stop.”\u003c/p>\n\u003cp>Assemblymember Suzette Martinez Valladares, R-Santa Clarita, said CARE Court was coming 10 years too late. She shared the story of her cousin, a Vietnam veteran, who was homeless and living in an encampment for five years before he died.\u003c/p>\n\u003cp>“I wish that my family had the tools that this bill is going to bring forward so that he might still be alive and with us,” she said, adding, “But there’s more work to be done. This bill is great, but we need resources for the programs, for the services, for the workforce that doesn’t currently exist.”\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The state faces a shortage of not only \u003c/span>\u003ca href=\"https://www.rand.org/pubs/research_reports/RRA1824-1-v2.html\">\u003cspan style=\"font-weight: 400\">psychiatric facilities\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, but also the \u003c/span>\u003ca href=\"https://healthforce.ucsf.edu/sites/healthforce.ucsf.edu/files/publication-pdf/California%E2%80%99s%20Current%20and%20Future%20Behavioral%20Health%20Workforce.pdf\">\u003cspan style=\"font-weight: 400\">health care staff\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> needed to operate those facilities. And Newsom’s administration estimates that between 7,000 and 12,000 people across the state will be eligible for CARE Court. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We’re guessing there will be demand for this,” said Michelle Doty Cabrera, executive director of the County Behavioral Health Directors Association of California. “There’s not a lot of give in terms of our workforce currently.”\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The state is allocating $65 million to implement CARE Court within the judicial system, as well as additional money for county behavioral health care agencies, which would manage cases. To help pay for start-up and training costs, the first seven counties to implement CARE Court will receive $26 million, with another $31 million going to counties across the state, Doty Cabrera said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Those first seven counties are Glenn, Orange, Riverside, San Diego, Stanislaus, Tuolumne and San Francisco, which will implement CARE Courts by Oct. 1, 2023. The remaining counties would have until Dec. 1, 2024.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“And, there’s an ongoing conversation around long-term funding,” Doty Cabrera said. The bill now requires the state to provide funding to county behavioral health care agencies for programs and services before counties are required to implement CARE Court. “What that is, what it looks like, how much — all of that is still to be worked out between counties and the state,” she said.\u003c/span>\u003c/p>\n\u003cp>[aside postID=news_11916040 hero='https://ww2.kqed.org/app/uploads/sites/10/2022/02/GettyImages-1236267426-1020x680.jpg']The other looming question is housing. \u003cspan style=\"font-weight: 400\">The current version of the bill allows judges to order other government agencies, such as housing authorities, to prioritize CARE Court participants for housing. But in more rural parts of the state, housing with the appropriate services just doesn’t exist, Doty Cabrera added. \u003c/span>\u003c/p>\n\u003cp>“Who exactly are we going to pull into the order?” she said. “No one. There is nothing.”\u003c/p>\n\u003cp>Last year, nearly 14,000 people experiencing homelessness voluntarily sought mental health services, but only half were placed into housing, according to a survey conducted earlier this year by the County Behavioral Health Directors Association of California.\u003c/p>\n\u003cp>Beyond the logistics, members of the Assembly grappled with CARE Court’s reliance on the judicial system. Although voluntary, the legislation also comes with a threat: Continued refusal could be used as a justification for conservatorship, where people could be forced into care against their will.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“At what point does compassion end and our desire to just get people off the streets and out of public sight begin?” said Assemblymember Al Muratsuchi, D-Torrance. “\u003c/span>I don’t think this is a great bill, but it seems to be the best idea that we have at this point to try to improve a god-awful situation.”\u003c/p>\n\u003cp>Others worry whether it will do more harm than good, by disproportionately affecting \u003cspan style=\"font-weight: 400\">Black residents in the state, who are diagnosed with schizophrenia, on average, \u003c/span>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274585/\">\u003cspan style=\"font-weight: 400\">three to four times more often\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> than white residents. Black residents also represent\u003c/span>\u003ca href=\"https://files.hudexchange.info/reports/published/CoC_PopSub_State_CA_2020.pdf\">\u003cspan style=\"font-weight: 400\"> 30% of those experiencing homelessness\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> in the state, but only 6.5% of the general population. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It’s Black men, Black trans folks, Black folks in general who will be the ones who are disproportionately forced into CARE Court and disproportionately affected by this horribly myopic legislation,” said Burch, of the Anti Police-Terror Project. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The bill requires an annual report on CARE Court, along with an independent, research-based entity to evaluate the effectiveness of the program, including “through the lens of health equity” to identify racial bias. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Now that CARE Court has been signed into law, Doty Cabrera said it will be critical to keep those concerns in mind as counties try to imagine all of the program’s “unknown variables.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“This is sort of like Chapter One of a novel,” she said. “We’ll be working on this for a long time to come.”\u003c/span>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Updated Wednesday 2 p.m.\u003c/em>\u003c/p>\n\u003cp>Gov. Gavin Newsom signed a controversial bill Wednesday overhauling the state’s approach to mental health care for people diagnosed with schizophrenia and other psychotic disorders.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The state Senate last month approved the\u003c/span> Community Assistance, Recovery and Empowerment Act, which will allow family members and first responders to ask a judge to draw up a treatment plan for people deemed to be suffering from those disorders. Those who refuse could be placed under a conservatorship and ordered to comply.\u003c/p>\n\u003cp>Currently, unhoused people with severe mental health disorders can be held against their will at psychiatric hospitals, but must be released after three days if they promise to follow up with other services and take prescribed medication.\u003c/p>\n\u003cp>The new law will let a court order a treatment plan for up to two years, which may include medication, housing and therapy.\u003cspan style=\"font-weight: 400\"> Participants will have access to a public defender and an advocate to help make decisions about treatment programs and housing. In turn, the behavioral health department in that county would be compelled to provide treatment.\u003c/span>\u003c/p>\n\u003cp>While it shares some elements of mental health programs in some other states, California’s new system will be the first of its kind in the country, according to state Sen. Tom Umberg, D-Santa Ana, who co-authored the law.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Standing outside Momentum for Health, a nonprofit mental health care provider in San José, Newsom on Wednesday said the bill was about redesigning a broken system \u003c/span>\u003cspan style=\"font-weight: 400\">that often leaves people cycling among homelessness, jail and emergency rooms. \u003c/span>\u003c/p>\n\u003cp>“I’m not interested in the status quo,” he said. “I’m not interested in the compassionless-ness of the approach we have today of people moralizing and normalizing that suffering on the streets and sidewalks.”\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But critics of the bill say it coerces people into care, which is less effective than voluntary treatment, and doesn’t provide the necessary health and housing resources.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">James Burch, deputy director of the Anti Police-Terror Project, which is part of a statewide coalition opposing CARE Court, called the bill’s signing “devastating.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It ignores the very stark reality that we’re living in in this moment,” he said. “We are tens of thousands of beds short in the Bay Area of the permanent housing that we need. … And we are woefully short on voluntary treatment programs.”\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cspan style=\"font-weight: 400\">Gov. Gavin Newsom introduced the proposal in March. \u003c/span>It passed the Legislature with overwhelming support, despite vehement opposition from disability rights and homeless advocates.\u003c/p>\n\u003cp>“It was just a matter of months ago that we stood right here and we laid out a vision,” Newsom said Wednesday. “And here we are. We’ve made it a reality, and that is rare in politics, particularly on issues as vexing and challenging as this issue.”\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Santa Clara County Superior Court Judge Stephen Manley said every day he sees people caught in a cycle of homelessness, jail and emergency rooms, without ever getting the adequate care or housing they need. Manley oversees a \u003ca href=\"https://steinberginstitute.org/champion/stephen-v-manley/\" target=\"_blank\" rel=\"noopener noreferrer\">mental health care diversion court\u003c/a> for people awaiting trial for suspected crimes. \u003c/span>\u003c/p>\n\u003cp>“I think this is a major step towards building a system that is going to be effective, as opposed to the present system,” Manley said, “where these individuals simply cycle through our jails over to the emergency room of a hospital, back to the streets, back to the jail, back to the hospital. And it doesn’t stop.”\u003c/p>\n\u003cp>Assemblymember Suzette Martinez Valladares, R-Santa Clarita, said CARE Court was coming 10 years too late. She shared the story of her cousin, a Vietnam veteran, who was homeless and living in an encampment for five years before he died.\u003c/p>\n\u003cp>“I wish that my family had the tools that this bill is going to bring forward so that he might still be alive and with us,” she said, adding, “But there’s more work to be done. This bill is great, but we need resources for the programs, for the services, for the workforce that doesn’t currently exist.”\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The state faces a shortage of not only \u003c/span>\u003ca href=\"https://www.rand.org/pubs/research_reports/RRA1824-1-v2.html\">\u003cspan style=\"font-weight: 400\">psychiatric facilities\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, but also the \u003c/span>\u003ca href=\"https://healthforce.ucsf.edu/sites/healthforce.ucsf.edu/files/publication-pdf/California%E2%80%99s%20Current%20and%20Future%20Behavioral%20Health%20Workforce.pdf\">\u003cspan style=\"font-weight: 400\">health care staff\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> needed to operate those facilities. And Newsom’s administration estimates that between 7,000 and 12,000 people across the state will be eligible for CARE Court. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We’re guessing there will be demand for this,” said Michelle Doty Cabrera, executive director of the County Behavioral Health Directors Association of California. “There’s not a lot of give in terms of our workforce currently.”\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The state is allocating $65 million to implement CARE Court within the judicial system, as well as additional money for county behavioral health care agencies, which would manage cases. To help pay for start-up and training costs, the first seven counties to implement CARE Court will receive $26 million, with another $31 million going to counties across the state, Doty Cabrera said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Those first seven counties are Glenn, Orange, Riverside, San Diego, Stanislaus, Tuolumne and San Francisco, which will implement CARE Courts by Oct. 1, 2023. The remaining counties would have until Dec. 1, 2024.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“And, there’s an ongoing conversation around long-term funding,” Doty Cabrera said. The bill now requires the state to provide funding to county behavioral health care agencies for programs and services before counties are required to implement CARE Court. “What that is, what it looks like, how much — all of that is still to be worked out between counties and the state,” she said.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The other looming question is housing. \u003cspan style=\"font-weight: 400\">The current version of the bill allows judges to order other government agencies, such as housing authorities, to prioritize CARE Court participants for housing. But in more rural parts of the state, housing with the appropriate services just doesn’t exist, Doty Cabrera added. \u003c/span>\u003c/p>\n\u003cp>“Who exactly are we going to pull into the order?” she said. “No one. There is nothing.”\u003c/p>\n\u003cp>Last year, nearly 14,000 people experiencing homelessness voluntarily sought mental health services, but only half were placed into housing, according to a survey conducted earlier this year by the County Behavioral Health Directors Association of California.\u003c/p>\n\u003cp>Beyond the logistics, members of the Assembly grappled with CARE Court’s reliance on the judicial system. Although voluntary, the legislation also comes with a threat: Continued refusal could be used as a justification for conservatorship, where people could be forced into care against their will.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“At what point does compassion end and our desire to just get people off the streets and out of public sight begin?” said Assemblymember Al Muratsuchi, D-Torrance. “\u003c/span>I don’t think this is a great bill, but it seems to be the best idea that we have at this point to try to improve a god-awful situation.”\u003c/p>\n\u003cp>Others worry whether it will do more harm than good, by disproportionately affecting \u003cspan style=\"font-weight: 400\">Black residents in the state, who are diagnosed with schizophrenia, on average, \u003c/span>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274585/\">\u003cspan style=\"font-weight: 400\">three to four times more often\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> than white residents. Black residents also represent\u003c/span>\u003ca href=\"https://files.hudexchange.info/reports/published/CoC_PopSub_State_CA_2020.pdf\">\u003cspan style=\"font-weight: 400\"> 30% of those experiencing homelessness\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> in the state, but only 6.5% of the general population. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It’s Black men, Black trans folks, Black folks in general who will be the ones who are disproportionately forced into CARE Court and disproportionately affected by this horribly myopic legislation,” said Burch, of the Anti Police-Terror Project. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The bill requires an annual report on CARE Court, along with an independent, research-based entity to evaluate the effectiveness of the program, including “through the lens of health equity” to identify racial bias. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Now that CARE Court has been signed into law, Doty Cabrera said it will be critical to keep those concerns in mind as counties try to imagine all of the program’s “unknown variables.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“This is sort of like Chapter One of a novel,” she said. “We’ll be working on this for a long time to come.”\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>A bill that would double the number of health clinics on K-12 school campuses is headed to Gov. Gavin Newsom for approval amid objections from anti-abortion-rights groups that claim the clinics would make it easier for students to end pregnancies.\u003c/p>\n\u003cp>\u003ca class=\"external\" href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220AB1940\" target=\"_blank\" rel=\"noopener noreferrer\">Assembly Bill 1940\u003c/a> would set aside $100 million for schools to build or expand an estimated 200 health clinics offering free medical care, dental services, mental health counseling, reproductive health care and other services for students and, in some cases, the surrounding community.\u003c/p>\n\u003cp>“There’s so much urgency, so much passion and need for this right now,” said Gabrielle Tilley, senior policy manager at the Los Angeles Trust for Children’s Health, one of the organizations supporting the bill. “We have the money, and we have a new awareness of the massive inequities in our state. This seems like a perfect time to make this happen.”\u003c/p>\n\u003cp>[aside postID='mindshift_59323,news_11924343']The current state budget does not include money for AB 1940, so the state would have to fund the bill in next year’s budget. Advocates are hopeful because it could bolster Newsom’s other priorities, including \u003ca href=\"https://edsource.org/2022/california-set-to-launch-hundreds-of-community-schools-with-635-million-in-grants/672246\">community schools\u003c/a>, the \u003ca href=\"https://edsource.org/2021/newsom-proposes-major-funding-increase-for-student-mental-health-services/654742\">Children and Youth Behavioral Health Initiative\u003c/a> and efforts to streamline Medi-Cal benefits — all of which are well funded in this year’s budget.\u003c/p>\n\u003cp>Advocates have been pushing for school-based health centers for decades. A similar law was passed in 2006 but was never funded, leaving districts to find alternative ways to pay for the infrastructure and services needed to create full-service health centers on K-12 campuses. Of the estimated 200 clinics that already exist, some are operated by school districts, and some are run by outside agencies, such as Planned Parenthood or St. John’s Community Health in Los Angeles.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Research shows that on-campus health clinics can have wide-reaching benefits for students as well as their families. \u003ca class=\"external\" href=\"https://static1.squarespace.com/static/610c101c733e257fb271ce0f/t/627a993193af0212875f1c2a/1652201780668/2022+SBHC+Impact+Report.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">School attendance for students who visited their campus health clinic rose five to seven days per year\u003c/a>, even when their attendance was declining prior to their first visit, according to a study of 23 school-based health centers in Los Angeles Unified School District. Good attendance is linked to higher graduation rates and better academic performance.\u003c/p>\n\u003cp>Students who visited school clinics also had lower discipline rates and were less likely to drop out of school, according to the California School-Based Health Alliance. The clinics also lowered health care costs generally, with fewer patients going to the emergency room or developing serious, preventable conditions.\u003c/p>\n\u003cp>According to the report, which was complied by the Los Angeles Trust for Children’s Health, the most common reasons students visited their campus health clinics were for vaccines, help to manage their weight, testing and treatment for sexually transmitted diseases, contraception, mental health counseling, help with substance abuse and treatment for chronic conditions such as asthma and diabetes.\u003c/p>\n\u003cp>Advocates say there is widespread support for the idea of basic medical care for children being available free at school. But some groups oppose clinics that provide reproductive health services for students under age 18, especially considering that \u003ca href=\"http://teenhealthlaw.org/wp-content/uploads/2019/08/2019CaMinorConsentConfChartFull.pdf\">California law allows minors to obtain treatment for sexual and reproductive health, substance abuse and mental health services without permission\u003c/a> from — or notification of — their parents.\u003c/p>\n\u003cp>[aside postID='education_535891,mindshift_59753']Their fear is that clinics will dispense pills that end a pregnancy, or refer pregnant students to outside clinics that provide surgical abortions, without parents’ knowledge or permission and paid for with public dollars.\u003c/p>\n\u003cp>“Public schools should not be places where children can get an abortion,” said Susan Swift, vice president of legal affairs for the Right to Life League, which seeks to ban abortions. “This is yet another attempt to separate parents and children, and they’re using the state Department of Education to do it. … This is a huge deal.”\u003c/p>\n\u003cp>As an alternative, Swift’s group would like to see schools notify parents immediately if a student is pregnant, refer students to prenatal care and offer information about adoption and parenting.\u003c/p>\n\u003cp>In light of the Supreme Court’s recent overturn of Roe v. Wade, Swift is hopeful that legislators will reconsider efforts to provide reproductive health services on campus, even in left-leaning California.\u003c/p>\n\u003cp>Services at school health clinics vary depending on the school, district and outside agency providing care, but in general, school-based health clinics do not provide abortions on campus, said Lisa Eisenberg, director of policy and external affairs for the California School-Based Health Alliance. If a pregnant student comes to a school-based health center, staff are likely to offer counseling and support and refer them to other resources, though each clinic is free to operate as it sees fit.\u003c/p>\n\u003cp>Meanwhile, in Los Angeles, \u003ca class=\"external\" href=\"https://boyleheightsbeat.com/wellness-center-at-mendez-high-will-benefit-students-and-the-community/\" target=\"_blank\" rel=\"noopener noreferrer\">Mendez High School in Boyle Heights last month unveiled a new, 6,500-square-foot health clinic\u003c/a> on campus. The largest such health center in LAUSD, the clinic has 12 rooms for medical, dental, optical and mental health visits. The center has two entrances — one for students and one for the public — and is expected to be a hub in the predominantly lower-income Latino community.\u003c/p>\n\u003cp>It’s also expected to aid students’ education and career planning by offering internships for students who hope to enter the medical field.\u003c/p>\n\u003cp>“The opening of the Sylvia Mendez Wellness Center will mark a historic milestone for the Boyle Heights community,” said Maria Brenes, executive director for InnerCity Struggle, a local community group, according to \u003ca href=\"https://achieve.lausd.net/site/default.aspx?PageType=3&DomainID=4&ModuleInstanceID=4466&ViewID=6446EE88-D30C-497E-9316-3F8874B3E108&RenderLoc=0&FlexDataID=117629&PageID=0\">a release from the district\u003c/a>. “After many years of organizing and advocacy by students, families, school leadership and community residents, the Wellness Center will be a reality that will serve as a much-needed health resource for our community.”\u003c/p>\n\u003cp>The district also opened a new wellness center that will serve two high schools in the San Fernando Valley. The $11.31 million Balboa Student and Family Wellness Center will provide medical and mental health services to students as well as their families and members of the community.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://edsource.org/2022/bill-would-help-more-california-schools-open-health-clinics-despite-opposition-from-anti-abortion-groups/677708\">\u003ci>\u003cspan style=\"font-weight: 400\">This story was first published by EdSource. \u003c/span>\u003c/i>\u003c/a>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A bill that would double the number of health clinics on K-12 school campuses is headed to Gov. Gavin Newsom for approval amid objections from anti-abortion-rights groups that claim the clinics would make it easier for students to end pregnancies.\u003c/p>\n\u003cp>\u003ca class=\"external\" href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220AB1940\" target=\"_blank\" rel=\"noopener noreferrer\">Assembly Bill 1940\u003c/a> would set aside $100 million for schools to build or expand an estimated 200 health clinics offering free medical care, dental services, mental health counseling, reproductive health care and other services for students and, in some cases, the surrounding community.\u003c/p>\n\u003cp>“There’s so much urgency, so much passion and need for this right now,” said Gabrielle Tilley, senior policy manager at the Los Angeles Trust for Children’s Health, one of the organizations supporting the bill. “We have the money, and we have a new awareness of the massive inequities in our state. This seems like a perfect time to make this happen.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The current state budget does not include money for AB 1940, so the state would have to fund the bill in next year’s budget. Advocates are hopeful because it could bolster Newsom’s other priorities, including \u003ca href=\"https://edsource.org/2022/california-set-to-launch-hundreds-of-community-schools-with-635-million-in-grants/672246\">community schools\u003c/a>, the \u003ca href=\"https://edsource.org/2021/newsom-proposes-major-funding-increase-for-student-mental-health-services/654742\">Children and Youth Behavioral Health Initiative\u003c/a> and efforts to streamline Medi-Cal benefits — all of which are well funded in this year’s budget.\u003c/p>\n\u003cp>Advocates have been pushing for school-based health centers for decades. A similar law was passed in 2006 but was never funded, leaving districts to find alternative ways to pay for the infrastructure and services needed to create full-service health centers on K-12 campuses. Of the estimated 200 clinics that already exist, some are operated by school districts, and some are run by outside agencies, such as Planned Parenthood or St. John’s Community Health in Los Angeles.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Research shows that on-campus health clinics can have wide-reaching benefits for students as well as their families. \u003ca class=\"external\" href=\"https://static1.squarespace.com/static/610c101c733e257fb271ce0f/t/627a993193af0212875f1c2a/1652201780668/2022+SBHC+Impact+Report.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">School attendance for students who visited their campus health clinic rose five to seven days per year\u003c/a>, even when their attendance was declining prior to their first visit, according to a study of 23 school-based health centers in Los Angeles Unified School District. Good attendance is linked to higher graduation rates and better academic performance.\u003c/p>\n\u003cp>Students who visited school clinics also had lower discipline rates and were less likely to drop out of school, according to the California School-Based Health Alliance. The clinics also lowered health care costs generally, with fewer patients going to the emergency room or developing serious, preventable conditions.\u003c/p>\n\u003cp>According to the report, which was complied by the Los Angeles Trust for Children’s Health, the most common reasons students visited their campus health clinics were for vaccines, help to manage their weight, testing and treatment for sexually transmitted diseases, contraception, mental health counseling, help with substance abuse and treatment for chronic conditions such as asthma and diabetes.\u003c/p>\n\u003cp>Advocates say there is widespread support for the idea of basic medical care for children being available free at school. But some groups oppose clinics that provide reproductive health services for students under age 18, especially considering that \u003ca href=\"http://teenhealthlaw.org/wp-content/uploads/2019/08/2019CaMinorConsentConfChartFull.pdf\">California law allows minors to obtain treatment for sexual and reproductive health, substance abuse and mental health services without permission\u003c/a> from — or notification of — their parents.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Their fear is that clinics will dispense pills that end a pregnancy, or refer pregnant students to outside clinics that provide surgical abortions, without parents’ knowledge or permission and paid for with public dollars.\u003c/p>\n\u003cp>“Public schools should not be places where children can get an abortion,” said Susan Swift, vice president of legal affairs for the Right to Life League, which seeks to ban abortions. “This is yet another attempt to separate parents and children, and they’re using the state Department of Education to do it. … This is a huge deal.”\u003c/p>\n\u003cp>As an alternative, Swift’s group would like to see schools notify parents immediately if a student is pregnant, refer students to prenatal care and offer information about adoption and parenting.\u003c/p>\n\u003cp>In light of the Supreme Court’s recent overturn of Roe v. Wade, Swift is hopeful that legislators will reconsider efforts to provide reproductive health services on campus, even in left-leaning California.\u003c/p>\n\u003cp>Services at school health clinics vary depending on the school, district and outside agency providing care, but in general, school-based health clinics do not provide abortions on campus, said Lisa Eisenberg, director of policy and external affairs for the California School-Based Health Alliance. If a pregnant student comes to a school-based health center, staff are likely to offer counseling and support and refer them to other resources, though each clinic is free to operate as it sees fit.\u003c/p>\n\u003cp>Meanwhile, in Los Angeles, \u003ca class=\"external\" href=\"https://boyleheightsbeat.com/wellness-center-at-mendez-high-will-benefit-students-and-the-community/\" target=\"_blank\" rel=\"noopener noreferrer\">Mendez High School in Boyle Heights last month unveiled a new, 6,500-square-foot health clinic\u003c/a> on campus. The largest such health center in LAUSD, the clinic has 12 rooms for medical, dental, optical and mental health visits. The center has two entrances — one for students and one for the public — and is expected to be a hub in the predominantly lower-income Latino community.\u003c/p>\n\u003cp>It’s also expected to aid students’ education and career planning by offering internships for students who hope to enter the medical field.\u003c/p>\n\u003cp>“The opening of the Sylvia Mendez Wellness Center will mark a historic milestone for the Boyle Heights community,” said Maria Brenes, executive director for InnerCity Struggle, a local community group, according to \u003ca href=\"https://achieve.lausd.net/site/default.aspx?PageType=3&DomainID=4&ModuleInstanceID=4466&ViewID=6446EE88-D30C-497E-9316-3F8874B3E108&RenderLoc=0&FlexDataID=117629&PageID=0\">a release from the district\u003c/a>. “After many years of organizing and advocacy by students, families, school leadership and community residents, the Wellness Center will be a reality that will serve as a much-needed health resource for our community.”\u003c/p>\n\u003cp>The district also opened a new wellness center that will serve two high schools in the San Fernando Valley. The $11.31 million Balboa Student and Family Wellness Center will provide medical and mental health services to students as well as their families and members of the community.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://edsource.org/2022/bill-would-help-more-california-schools-open-health-clinics-despite-opposition-from-anti-abortion-groups/677708\">\u003ci>\u003cspan style=\"font-weight: 400\">This story was first published by EdSource. \u003c/span>\u003c/i>\u003c/a>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Local, national and international media have \u003ca href=\"https://www.dailymail.co.uk/news/article-10439965/Photos-new-linkage-SF-facility-populated-drug-users-shooting-broad-daylight.html\">documented unhoused people using drugs in San Francisco’s Tenderloin\u003c/a> for decades, and residents critical of how the city is addressing drug use regularly share images of people using on social media.\u003c/p>\n\u003cp>Those images tend to swell in number as discussion of the Tenderloin and public drug use grows, like the public debate surrounding the supervised injection site bill recently vetoed by Gov. Gavin Newsom. Recent videos of people living on the streets shared by Michael Shellenberger, \u003ca href=\"https://calmatters.org/california-voter-guide-2022/governor/michael-shellenberger/\">a frequent critic of the city\u003c/a>, who wrote a book called “San Fransicko,” \u003ca href=\"https://mobile.twitter.com/ShellenbergerMD/status/1568237548274864128\">racked up millions of views\u003c/a>.\u003c/p>\n\u003cp>But sharing videos and photos of people who may be living in poverty, struggling with mental illness, or dealing with addiction has also raised ethical and privacy concerns with some advocates. After being seen on social media living on the streets and using drugs, people risk added difficulties getting jobs, or being seen by people they’re trying to escape.[pullquote size=\"medium\" align=\"right\" citation=\"Tracey Helton Mitchell, Daly City resident\"]‘The pictures that you really see a lot of are people just suffering, just suffering. If you really cared about them, you could black out their faces.’[/pullquote]\u003c/p>\n\u003cp>Tracey Helton Mitchell knows what it’s like to be shown on film in her worst moments. In the late ’90s, Mitchell was living in San Francisco and deep in the throes of a heroin addiction.\u003c/p>\n\u003cp>It’s a painful part of her past that millions of people have also seen. That experience was documented in Steven Okazaki’s documentary film “\u003ca href=\"https://www.youtube.com/watch?v=um4iziAIZck&t=1s\">Black Tar Heroin: The Dark End of the Street\u003c/a>.”\u003c/p>\n\u003cp>She agreed to participate in the film because she was convinced she was going to die of an overdose anonymously in a hotel or an alleyway somewhere in San Francisco.\u003cbr>\n\u003cb>\u003cbr>\n\u003c/b>“I was on heroin the whole time, really on heroin. There’s a part of the film where [the filmmaker] shows me doing laundry and I’d asked him, like, ‘Why was I doing laundry?’ Because I never did laundry,” Mitchell said. “And he said, ‘Because you always shot heroin. We had to film you doing something else.'”\u003c/p>\n\u003cp>Mitchell was sober by the time the film premiered in 1999. But she did not expect how popular it would be, or that she would lose her privacy.\u003c/p>\n\u003cp>“People were offering me drugs. People fell in love with this [person], you know, they had this relationship with this person that was in this movie,” she said. “And I do mean fall in love. I had weird stalkers, like I’m not exaggerating. And it has sort of a cult following now, people contact me every week about it still.”\u003c/p>\n\u003cp>Now more than two decades after the premiere of the documentary that changed Mitchell’s life, images, photos and videos of San Franciscans using drugs, or passed out, are regularly shared on social media.\u003c/p>\n\u003cp>Mitchell can understand why people want to capture what they see on the streets of San Francisco, because those images are one way to get the attention of political leaders.\u003c/p>\n\u003cp>But she’s also troubled that people seem to be using images for their own political gain without considering the person’s humanity.\u003c/p>\n\u003cp>“The pictures that you really see a lot of are people just suffering, just suffering. If you really cared about them, you could black out their faces,” Mitchell said. “It very simply boils down to, ‘Are we dehumanizing people by highlighting them at the worst moments of their life?'”\u003c/p>\n\u003cp>Navigating issues around social media and informed consent can also be complicated, Mitchell said. Someone might agree to be photographed one day, go into rehab, and no longer want the image online for the public to see. Family members might want the photos taken down.\u003c/p>\n\u003cp>It is \u003ca href=\"https://www.acludc.org/en/know-your-rights/know-your-rights-if-stopped-photographing-public\">generally legal to take photographs of people in public settings without their consent\u003c/a>. But advocates for people who are unhoused or use drugs say there are also privacy and ethical concerns when images of people are shared widely.\u003c/p>\n\u003cfigure id=\"attachment_11911803\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911803\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54977_004_KQED_TraceyHeltonMitchell_04052022-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54977_004_KQED_TraceyHeltonMitchell_04052022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54977_004_KQED_TraceyHeltonMitchell_04052022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54977_004_KQED_TraceyHeltonMitchell_04052022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54977_004_KQED_TraceyHeltonMitchell_04052022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54977_004_KQED_TraceyHeltonMitchell_04052022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Tracey Helton Mitchell talks with her son in their backyard in Daly City on April 5, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>People in the images could be fleeing domestic violence or other dangerous situations, said Jennifer Friedenbach, executive director of the Coalition on Homelessness.\u003c/p>\n\u003cp>Friedenbach said the way images are used to call for more criminalization of people who use drugs feels exploitative, like trolling.\u003c/p>\n\u003cp>“That could negatively impact them as they walk through life having better moments or [when they] are trying to get work,” Friedenbach said. “I just don’t think it’s ethical to do that to people.”\u003c/p>\n\u003cp>Ricci Wynne, who describes himself as in recovery, shared a video on Twitter in July showing kids getting off a bus amid a scene of apparent drug use in the Tenderloin. He said in an interview with CBS Bay Area that he was angered by what he saw and wants city leaders to take action.\u003c/p>\n\u003cp>The video garnered over 10,000 likes, and was featured in the Daily Mail tabloid in the U.K. and TMZ. Other accounts that regularly post videos showing despair on San Francisco streets focus on specific blocks or neighborhoods.\u003c/p>\n\u003cp>Adam Mesnick, who runs a controversial Twitter account called @bettersoma, said images are a way to bring attention to an ongoing problem.\u003c/p>\n\u003cp>He’s posted or shared videos of people using drugs, and people lying on the streets and suffering. Mesnick said he understands the criticism but his Twitter account is not the problem.\u003c/p>\n\u003cp>“It is a very valid opinion that you have a problem with the photo. But I have a bigger problem with the way the situation is being handled now,” he said.\u003c/p>\n\u003cp>Mesnick said the images he photographs are what he sees every day in San Francisco, and he gives people 10 dollars to take their photos and often tries to have conversations with them.\u003c/p>\n\u003cp>He said that personal interaction is more than what he’s seen a lot of the public do.\u003c/p>\n\u003cp>“I probably check on every single person underneath a blanket that I’ve ever seen in San Francisco since as far as I can remember backwards. And the reality is people just walk right by,” he said.\u003c/p>\n\u003cp>There are \u003ca href=\"https://niemanreports.org/articles/images-of-addiction-and-recovery/\">ways to ethically photograph or film people\u003c/a> who use drugs, said Graham MacIndoe, a photographer and teacher who documented his own active heroin addiction in a series of self-portraits entitled “\u003ca href=\"https://www.grahammacindoe.com/SOCIAL-JUSTICE/Coming-Clean/17\">Coming Clean\u003c/a>.” He said when asking for consent, it’s important to use plain language explaining how the photograph will be used and what it is for.\u003c/p>\n\u003cp>“I do think we should show all sides of the war on drugs and the crisis that’s happening right now,” he said, adding that that should include giving agency to people who use drugs or who are in treatment, and asking them what the solutions are.\u003c/p>\n\u003cp>“We’ve all seen those pictures, we’ve all seen people … in the Tenderloin or wherever, lying in corners, homeless, using drugs, whatever,” he said. “You add another picture to that pile of pictures and what does it do? Nothing. It just reinforces that there’s a problem. But it doesn’t bring us closer to a solution.”\u003c/p>\n\u003cp>He said too few photographs focus on solutions, particularly given that the country is far past the point of needing photos to raise awareness about the epidemic.\u003c/p>\n\u003cp>After the premiere of “Black Tar Heroin,” Tracey Helton Mitchell focused on caring for and treating people who use drugs. She went on to write a memoir, “\u003ca href=\"https://www.sealpress.com/titles/tracey-helton-mitchell/the-big-fix/9781580056045/\">The Big Fix: Hope After Heroin\u003c/a>,” and said she doesn’t regret being in the film because it helped so many people.\u003c/p>\n\u003cp>And she also doesn’t have many photos to remember that time in her life, which is why it’s also important to ask people being photographed if they’d like copies of their own images. People who are homeless often get their belongings stolen or thrown away, and lose everything.\u003c/p>\n\u003cp>The people Mitchell knew who took photos of her during that time in her life are no longer alive.\u003c/p>\n\u003cp>“The only pictures I have from the age of 18 to the age of 27 are mug shots and [photos from] ‘Black Tar Heroin.’ That’s it,” she said. “If I didn’t have that, it would be almost like I didn’t exist for 10 years\u003ci>.” \u003c/i>\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>Local, national and international media have \u003ca href=\"https://www.dailymail.co.uk/news/article-10439965/Photos-new-linkage-SF-facility-populated-drug-users-shooting-broad-daylight.html\">documented unhoused people using drugs in San Francisco’s Tenderloin\u003c/a> for decades, and residents critical of how the city is addressing drug use regularly share images of people using on social media.\u003c/p>\n\u003cp>Those images tend to swell in number as discussion of the Tenderloin and public drug use grows, like the public debate surrounding the supervised injection site bill recently vetoed by Gov. Gavin Newsom. Recent videos of people living on the streets shared by Michael Shellenberger, \u003ca href=\"https://calmatters.org/california-voter-guide-2022/governor/michael-shellenberger/\">a frequent critic of the city\u003c/a>, who wrote a book called “San Fransicko,” \u003ca href=\"https://mobile.twitter.com/ShellenbergerMD/status/1568237548274864128\">racked up millions of views\u003c/a>.\u003c/p>\n\u003cp>But sharing videos and photos of people who may be living in poverty, struggling with mental illness, or dealing with addiction has also raised ethical and privacy concerns with some advocates. After being seen on social media living on the streets and using drugs, people risk added difficulties getting jobs, or being seen by people they’re trying to escape.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Tracey Helton Mitchell knows what it’s like to be shown on film in her worst moments. In the late ’90s, Mitchell was living in San Francisco and deep in the throes of a heroin addiction.\u003c/p>\n\u003cp>It’s a painful part of her past that millions of people have also seen. That experience was documented in Steven Okazaki’s documentary film “\u003ca href=\"https://www.youtube.com/watch?v=um4iziAIZck&t=1s\">Black Tar Heroin: The Dark End of the Street\u003c/a>.”\u003c/p>\n\u003cp>She agreed to participate in the film because she was convinced she was going to die of an overdose anonymously in a hotel or an alleyway somewhere in San Francisco.\u003cbr>\n\u003cb>\u003cbr>\n\u003c/b>“I was on heroin the whole time, really on heroin. There’s a part of the film where [the filmmaker] shows me doing laundry and I’d asked him, like, ‘Why was I doing laundry?’ Because I never did laundry,” Mitchell said. “And he said, ‘Because you always shot heroin. We had to film you doing something else.'”\u003c/p>\n\u003cp>Mitchell was sober by the time the film premiered in 1999. But she did not expect how popular it would be, or that she would lose her privacy.\u003c/p>\n\u003cp>“People were offering me drugs. People fell in love with this [person], you know, they had this relationship with this person that was in this movie,” she said. “And I do mean fall in love. I had weird stalkers, like I’m not exaggerating. And it has sort of a cult following now, people contact me every week about it still.”\u003c/p>\n\u003cp>Now more than two decades after the premiere of the documentary that changed Mitchell’s life, images, photos and videos of San Franciscans using drugs, or passed out, are regularly shared on social media.\u003c/p>\n\u003cp>Mitchell can understand why people want to capture what they see on the streets of San Francisco, because those images are one way to get the attention of political leaders.\u003c/p>\n\u003cp>But she’s also troubled that people seem to be using images for their own political gain without considering the person’s humanity.\u003c/p>\n\u003cp>“The pictures that you really see a lot of are people just suffering, just suffering. If you really cared about them, you could black out their faces,” Mitchell said. “It very simply boils down to, ‘Are we dehumanizing people by highlighting them at the worst moments of their life?'”\u003c/p>\n\u003cp>Navigating issues around social media and informed consent can also be complicated, Mitchell said. Someone might agree to be photographed one day, go into rehab, and no longer want the image online for the public to see. Family members might want the photos taken down.\u003c/p>\n\u003cp>It is \u003ca href=\"https://www.acludc.org/en/know-your-rights/know-your-rights-if-stopped-photographing-public\">generally legal to take photographs of people in public settings without their consent\u003c/a>. But advocates for people who are unhoused or use drugs say there are also privacy and ethical concerns when images of people are shared widely.\u003c/p>\n\u003cfigure id=\"attachment_11911803\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911803\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54977_004_KQED_TraceyHeltonMitchell_04052022-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54977_004_KQED_TraceyHeltonMitchell_04052022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54977_004_KQED_TraceyHeltonMitchell_04052022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54977_004_KQED_TraceyHeltonMitchell_04052022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54977_004_KQED_TraceyHeltonMitchell_04052022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54977_004_KQED_TraceyHeltonMitchell_04052022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Tracey Helton Mitchell talks with her son in their backyard in Daly City on April 5, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>People in the images could be fleeing domestic violence or other dangerous situations, said Jennifer Friedenbach, executive director of the Coalition on Homelessness.\u003c/p>\n\u003cp>Friedenbach said the way images are used to call for more criminalization of people who use drugs feels exploitative, like trolling.\u003c/p>\n\u003cp>“That could negatively impact them as they walk through life having better moments or [when they] are trying to get work,” Friedenbach said. “I just don’t think it’s ethical to do that to people.”\u003c/p>\n\u003cp>Ricci Wynne, who describes himself as in recovery, shared a video on Twitter in July showing kids getting off a bus amid a scene of apparent drug use in the Tenderloin. He said in an interview with CBS Bay Area that he was angered by what he saw and wants city leaders to take action.\u003c/p>\n\u003cp>The video garnered over 10,000 likes, and was featured in the Daily Mail tabloid in the U.K. and TMZ. Other accounts that regularly post videos showing despair on San Francisco streets focus on specific blocks or neighborhoods.\u003c/p>\n\u003cp>Adam Mesnick, who runs a controversial Twitter account called @bettersoma, said images are a way to bring attention to an ongoing problem.\u003c/p>\n\u003cp>He’s posted or shared videos of people using drugs, and people lying on the streets and suffering. Mesnick said he understands the criticism but his Twitter account is not the problem.\u003c/p>\n\u003cp>“It is a very valid opinion that you have a problem with the photo. But I have a bigger problem with the way the situation is being handled now,” he said.\u003c/p>\n\u003cp>Mesnick said the images he photographs are what he sees every day in San Francisco, and he gives people 10 dollars to take their photos and often tries to have conversations with them.\u003c/p>\n\u003cp>He said that personal interaction is more than what he’s seen a lot of the public do.\u003c/p>\n\u003cp>“I probably check on every single person underneath a blanket that I’ve ever seen in San Francisco since as far as I can remember backwards. And the reality is people just walk right by,” he said.\u003c/p>\n\u003cp>There are \u003ca href=\"https://niemanreports.org/articles/images-of-addiction-and-recovery/\">ways to ethically photograph or film people\u003c/a> who use drugs, said Graham MacIndoe, a photographer and teacher who documented his own active heroin addiction in a series of self-portraits entitled “\u003ca href=\"https://www.grahammacindoe.com/SOCIAL-JUSTICE/Coming-Clean/17\">Coming Clean\u003c/a>.” He said when asking for consent, it’s important to use plain language explaining how the photograph will be used and what it is for.\u003c/p>\n\u003cp>“I do think we should show all sides of the war on drugs and the crisis that’s happening right now,” he said, adding that that should include giving agency to people who use drugs or who are in treatment, and asking them what the solutions are.\u003c/p>\n\u003cp>“We’ve all seen those pictures, we’ve all seen people … in the Tenderloin or wherever, lying in corners, homeless, using drugs, whatever,” he said. “You add another picture to that pile of pictures and what does it do? Nothing. It just reinforces that there’s a problem. But it doesn’t bring us closer to a solution.”\u003c/p>\n\u003cp>He said too few photographs focus on solutions, particularly given that the country is far past the point of needing photos to raise awareness about the epidemic.\u003c/p>\n\u003cp>After the premiere of “Black Tar Heroin,” Tracey Helton Mitchell focused on caring for and treating people who use drugs. She went on to write a memoir, “\u003ca href=\"https://www.sealpress.com/titles/tracey-helton-mitchell/the-big-fix/9781580056045/\">The Big Fix: Hope After Heroin\u003c/a>,” and said she doesn’t regret being in the film because it helped so many people.\u003c/p>\n\u003cp>And she also doesn’t have many photos to remember that time in her life, which is why it’s also important to ask people being photographed if they’d like copies of their own images. People who are homeless often get their belongings stolen or thrown away, and lose everything.\u003c/p>\n\u003cp>The people Mitchell knew who took photos of her during that time in her life are no longer alive.\u003c/p>\n\u003cp>“The only pictures I have from the age of 18 to the age of 27 are mug shots and [photos from] ‘Black Tar Heroin.’ That’s it,” she said. “If I didn’t have that, it would be almost like I didn’t exist for 10 years\u003ci>.” \u003c/i>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>The need for therapists, social workers, psychologists and psychiatrists is greater than ever. Under relentless pressure from the pandemic and inflation, wildfires, gun violence, racism and war, Californians are crying out for help.\u003c/p>\n\u003cp>But that doesn’t mean they can get it.\u003c/p>\n\u003cp>In every corner of mental health right now, a similar story is being told: There simply aren’t enough providers.\u003c/p>\n\u003cp>Patients receive lists of names from their insurers, only to learn none of the therapists on these so-called “ghost lists” will see them. Clinicians who do offer a spot often only accept cash.\u003c/p>\n\u003cp>Nonprofit mental health care providers report needing to have an offer letter ready at a job interview, fearing applicants will take another position if they wait.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Kaiser mental health care clinicians have been \u003ca href=\"https://www.kqed.org/news/11923034/were-drowning-why-kaiser-mental-health-workers-are-striking\">out on strike for weeks\u003c/a> now in Northern California, describing exhausting working conditions and long delays in care for their patients. Kaiser, for its part, points a finger at a familiar culprit: the mental health care provider shortage.\u003c/p>\n\u003cp>CalMatters spoke with more than two dozen mental health experts, public officials and providers around California to ask about the impacts of the mental health care provider shortage, and what can be done about it. Their responses ranged from desperate to hopeful.\u003c/p>\n\u003cp>All agree we are at a pivotal movement.\u003c/p>\n\u003cp>In part, that’s because Gov. Gavin Newsom’s administration is investing heavily in overhauling the state’s mental health care system. At the same time, the state recently enacted laws requiring insurers to provide timely access to mental health care. Some worry a lack of providers could jeopardize these bold new initiatives. Others see this as an opportunity to reimagine how mental health care in the state is delivered.\u003c/p>\n\u003cp>Here’s what the experts had to say:\u003c/p>\n\u003ch2>How big is the provider shortage problem?\u003c/h2>\n\u003cp>It depends on what part of the elephant you’re looking at, said Catherine Teare, associate director of the California Health Care Foundation’s People-Centered Care team. County mental health departments are struggling to hire. So are commercial health plans. So are nonprofits.\u003c/p>\n\u003cp>At the same time, she said, “the level of mental distress is increased.”\u003c/p>\n\u003cp>“For children or adults who need a lot, or need it urgently, it’s a scary time,” she said.\u003c/p>\n\u003cp>Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, told CalMatters that the number of licensed behavioral health care providers in the state increased by 20% between 2016 and 2020. But, that’s been offset by an increase in demand he calls “really unprecedented.”\u003c/p>\n\u003cp>For patients, how bad the shortage is depends, in part, on where you live, your insurance, your income, your age, the care you need and whether you want a clinician of color or one who speaks a language other than English.\u003c/p>\n\u003cp>\u003ca href=\"https://www.chcf.org/publication/californias-current-future-behavioral-health-workforce/\">A report\u003c/a> published by the University of California, San Francisco in 2018 — even before the \u003ca href=\"https://www.healthmanagement.com/wp-content/uploads/HMA-NCMW-Issue-Brief-10-27-21.pdf\">pandemic sent need skyrocketing\u003c/a> — predicted that by 2028, demand for psychologists and other therapists would be 40% more than supply. For kids, the shortage is especially dire: Close to a third of California’s 58 counties have \u003ca href=\"https://www.aacap.org/aacap/Advocacy/Federal_and_State_Initiatives/Workforce_Maps/Home.aspx\">no child and adolescent psychiatrists at all\u003c/a>, according to the American Academy of Child and Adolescent Psychiatry.[aside label=\"Related Stories\" postID=\"news_11924343,news_11924117,news_11923034\"]\u003ca href=\"https://www.chcf.org/wp-content/uploads/2022/07/MentalHealthAlmanac2022.pdf\">A new report\u003c/a> from the California Health Care Foundation shows that the Bay Area has 19 licensed psychiatrists and 73 licensed psychologists per 100,000 people — significantly more than the state averages of 12 and 44. At the other end of the spectrum, the San Joaquin Valley has six psychiatrists and 16 psychologists for the equivalent number of people.\u003c/p>\n\u003cp>Jessica Dominguez, a licensed marriage and family therapist at Kaiser Richmond who is currently on strike, said the Bay Area has plenty of providers.\u003c/p>\n\u003cp>“Throw a rock, you’re going to hit a therapist,” said Dominguez, who said she plans to leave the organization.\u003c/p>\n\u003cp>But others who work in the region, including Matthew Madaus, executive director of the Behavioral Health Collaborative of Alameda County, said “100% absolutely” there’s a shortage even in the Bay Area.\u003c/p>\n\u003cp>If you search for a behavioral health clinician on Indeed.com, Madaus said, it comes up with thousands of open positions within a 25-mile radius.\u003c/p>\n\u003cp>“It’s extraordinary the level of demand,” he said.\u003c/p>\n\u003cp>One problem: It’s difficult to capture how many clinicians don’t accept any insurance at all, and thus aren’t accessible to the vast majority of patients who can’t pay out of pocket.\u003c/p>\n\u003cp>What we do know: We need more and better data. For instance, some experts say the increase described by Ghaly does not reflect how many licensed providers are actually seeing patients, nor does it capture how many are seeing people who are uninsured or on Medi-Cal.\u003c/p>\n\u003cp>Democratic state Sen. Scott Wiener of San Francisco authored\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB964\"> a bill\u003c/a> this year that would require the Department of Health Care Access and Information to prepare a report for the Legislature by Jan. 1, 2024, describing the state of California’s behavioral health workforce, and how best to address the shortage. Senate Bill 964 is on the governor’s desk.\u003c/p>\n\u003cp>\u003ca href=\"https://workforce.org/wp-content/uploads/2022/08/San-Diego-Behavioral-Health-Workforce-Report-.pdf\">San Diego County has already researched the shortage.\u003c/a> Officials there estimate they currently have 17,000 behavioral health care workers and need an additional 8,100 to meet current demand. In the next five years, they anticipate needing another 10,000 workers, in part because so many will be retiring.\u003c/p>\n\u003ch2>What’s causing the shortage?\u003c/h2>\n\u003cp>Mental health care leaders will tell you the shortage itself is nothing new. But the pandemic has aggravated the problems. More providers have left their jobs, citing burnout. Or they’ve left the state, citing cost of living. New telehealth start-ups specializing in mental health treatment offer good pay and flexible hours; many experts said they have added to the demand by siphoning off providers from the public sector.[pullquote align=\"right\" size=\"medium\" citation=\"Catherine Teare, associate director of People-Centered Care, California Health Care Foundation\"]‘For children or adults who need a lot, or need it urgently, it’s a scary time.’[/pullquote]In a 2018 report on the \u003ca href=\"https://healthforce.ucsf.edu/publications/california-s-current-and-future-behavioral-health-workforce\">behavioral health workforce shortage\u003c/a>, Janet Coffman of UCSF also raised the concern that 45% of psychiatrists and 37% of psychologists would likely be retiring within a decade. The pandemic has accelerated this trend, she said.\u003c/p>\n\u003cp>Many clinicians say they’re simply exhausted. It’s not just that more people need help, but that many of them are coming in sicker, with mental health issues that have gone untreated.\u003c/p>\n\u003cp>“Our patient population has become so much more difficult to work with than it used to be a decade ago,” said Randall Hagar, legislative advocate and policy consultant for the Psychiatric Physicians Alliance of California.\u003c/p>\n\u003cp>As openings go unfilled, those who remain are left to carry more of the weight, he said.\u003c/p>\n\u003cp>Another problem Hagar and others mention: paperwork. Doctors spend some 40% of their time on paperwork, he said.\u003c/p>\n\u003cp>Many clinicians, especially providers of color, also say they are simply not getting enough emotional support from their employers. Dominguez, the Kaiser therapist, said she founded La Clinica, a nationally recognized pilot program to serve Spanish-speaking clients, in 2016. When tragedies happen in the community, she said, they affect clinicians, too. But, “you’re just expected to plug along and keep going,” she said.\u003c/p>\n\u003cp>Continually witnessing trauma can be exhausting, said Jeff Capps, a social worker with Pacific Clinics in Los Angeles. He emphasizes the need to make the work more sustainable for clinicians. That includes better pay.\u003c/p>\n\u003cp>“Sometimes in our field, the assumption is that since you get value out of your work, you don’t need to be as compensated,” he said.\u003c/p>\n\u003cp>A 2019 report by the health care consulting firm Milliman found that commercial plans in California, when setting rates, \u003ca href=\"https://www.milliman.com/en/insight/addiction-and-mental-health-vs-physical-health-widening-disparities-in-network-use-and-p\">pay primary care providers an average 15% more\u003c/a> than they pay behavioral health care providers.\u003c/p>\n\u003cp>Luke Bergmann, San Diego County’s director of behavioral health, said his county’s report on the provider shortage showed that, in some cases, people chose to work at Panda Express instead of substance use disorder clinics “because they simply cannot make as much.”\u003c/p>\n\u003cp>“People talk about loving the work,” he said. “For people to leave this work is an incredible emotional sacrifice.”\u003c/p>\n\u003cp>Candy Curiel, clinical director of Pacific Clinics for the Inland Empire, said inflation is making the situation even worse.\u003c/p>\n\u003cp>“Everything is so costly at this point, people feel they need to seek more money,” she said.\u003c/p>\n\u003ch2>Everyone is competing with everyone else. Is this a zero-sum game?\u003c/h2>\n\u003cp>Michelle Cabrera, executive director of the County Behavioral Health Directors Association of California, said the state’s mental health care system is so overwhelmed, everyone is poaching from each other.\u003c/p>\n\u003cp>“Let me be clear: It is a zero-sum game,” she said. “There’s only so many licensed or competent professionals in the state of California to do these jobs.”\u003c/p>\n\u003cp>In August, state Superintendent of Public Instruction Tony Thurmond announced that he had secured funding to \u003ca href=\"https://www.cde.ca.gov/nr/ne/yr22/yr22rel39.asp\">hire 10,000 additional mental health clinicians\u003c/a> to serve the state’s students. That effort is key to the Department of Education’s push to increase mental health care provided in schools.\u003c/p>\n\u003cp>Adrienne Shilton, senior policy advocate for the California Alliance of Child and Family Services, called the $200 million to establish a new scholarship program for master’s-level clinicians “a big win.”\u003c/p>\n\u003cp>But for Cabrera, the announcement “just puts fear at the heart of county behavioral health.”\u003c/p>\n\u003cp>She wonders how counties can possibly compete.\u003c/p>\n\u003cp>“I don’t know that we’ve really had a reckoning yet on the degree to which demand so far exceeds the available supply of providers in our state,” she said.[pullquote align=\"right\" size=\"medium\" citation=\"Karen Larsen, CEO, Steinberg Institute\"]‘We finally have all of this money and transformation coming. All these amazing things … and it couldn’t come at a worse time in terms of our workforce.’[/pullquote]This is the vicious circle for workers who are salaried. Nonprofit providers often pay less than schools and counties. Schools and counties, in turn, pay less than Kaiser and some of the new telehealth start-ups.\u003c/p>\n\u003cp>Nonprofit jobs that used to attract 40 or 50 applicants might only get two or three now, said Madaus, of the Behavioral Health Collaborative of Alameda County. Some nonprofits are looking at the possibility of providing free housing as an incentive, he said.\u003c/p>\n\u003cp>Even as it contributes to burnout, the increasing demand has, in some ways, opened new doors for clinicians.\u003c/p>\n\u003cp>Michael Torres, child and family clinical psychologist for Kaiser in San Leandro who is currently on strike, said that of 15 people on his team, six have left in the past year. Some are leaving to do telehealth, or to work in the private sector. Those positions can offer better work-life balance and more flexibility, he said. They also allow clinicians to see patients weekly or biweekly, he said, instead of every four to six weeks as often happens at Kaiser.\u003c/p>\n\u003cfigure id=\"attachment_11923074\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11923074\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut-800x533.jpg\" alt='people in red shirts carrying signs that read \"patients over profits\"' width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Kaiser mental health care workers and supporters march from Oakland Kaiser Medical Center to Kaiser’s corporate headquarters on Friday, Aug. 19, 2022, the fifth day of an open-ended strike. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>How will the provider shortage affect the Newsom administration’s big mental health care initiatives?\u003c/h2>\n\u003cp>Coming into office, Newsom made clear that he wanted to prioritize mental health. Over the past few years, his administration has championed a number of bold new initiatives. These include:\u003c/p>\n\u003cul>\n\u003cli>The \u003ca href=\"https://www.chhs.ca.gov/wp-content/uploads/2021/12/Children-and-Youth-Behavioral-Health-Initiative-Brief.pdf\">Children and Youth Behavioral Health Initiative\u003c/a>, a \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2022/08/KidsMentalHealthMasterPlan_8.18.22.pdf?emrc=6d3847\">$4.7 billion investment\u003c/a> meant to transform the children’s mental health care system.\u003c/li>\n\u003cli>CalAIM, a major transformation of the state’s Medi-Cal system.\u003c/li>\n\u003cli>\u003ca href=\"https://www.kqed.org/news/11924117/governors-care-court-plan-passes-assembly-clearing-way-to-become-law\">CARE Court\u003c/a>, a controversial proposal to compel people with serious mental illness into care and housing.\u003c/li>\n\u003c/ul>\n\u003cp>Lawmakers in recent years strengthened requirements that private insurers adhere to federal and state mental health parity laws — which require equal treatment of mental and physical health concerns.\u003c/p>\n\u003cp>But many of those tasked with implementing these efforts say they are worried.\u003c/p>\n\u003cp>“We have that conversation all the time,” said Madaus, of the Behavioral Health Collaborative of Alameda County. As new funding sources come online, he said, nonprofit executives consistently tell him: “I can’t take any more funding because I can’t hire more staff.”\u003c/p>\n\u003cp>Karen Larsen, chief executive officer of the Steinberg Institute, a nonprofit that advocates on mental health care policy, is also concerned. Prior to assuming her current role, Larsen spent two decades as head of Yolo County’s behavioral health department.\u003c/p>\n\u003cp>“We finally have all of this money and transformation coming,” she said. “All these amazing things … and it couldn’t come at a worse time in terms of our workforce.”\u003c/p>\n\u003cp>Ghaly says he shares that concern. But he adds that “incredible investments have been made,” not just in innovative programs, but in addressing the workforce shortage head-on.\u003c/p>\n\u003ch2>How do we increase the number of providers?\u003c/h2>\n\u003cp>Earlier this year, Josh Leonard, executive director of the East Bay Agency for Children, was struggling to fill openings for mental health clinicians. Over several months, the nonprofit — anticipating a bump in its contract with Alameda County — raised all clinicians’ salaries by at least 15%.\u003c/p>\n\u003cp>It worked. At least for now.\u003c/p>\n\u003cp>While Leonard’s not considering the workforce crisis over, he knows that decision was important.\u003c/p>\n\u003cp>Jessica Hernandez, a clinician there, agrees.\u003c/p>\n\u003cp>“For me it has helped out tremendously,” she said. “Now I want to stay longer.”[pullquote align=\"right\" size=\"medium\" citation=\"Janet Coffman, University of California San Francisco\"]‘We’re making much bigger investments in the behavioral health workforce than we have since I started engaging in this field in the ’90s.’[/pullquote]To make the work more appealing and sustainable, providers say a lot needs to change. Besides pay, other factors are also critical, including reducing paperwork, offering more flexibility and providing more support to therapists.\u003c/p>\n\u003cp>That last one has been key for Hernandez.\u003c/p>\n\u003cp>“They’re acknowledging that it’s really, really tough,” she said.\u003c/p>\n\u003cp>To meet growing need, new providers also must be brought in. Scholarships and loan repayment programs are helpful, but universities need more spots to train new clinicians.\u003c/p>\n\u003cp>Coffman, of UCSF, calls herself “cautiously optimistic.”\u003c/p>\n\u003cp>“We’re making much bigger investments in the behavioral health workforce than we have since I started engaging in this field in the ’90s,” she said.\u003c/p>\n\u003cp>This year’s budget allocates more than $360 million for the state to spend over the next three years on everything from recruiting high schoolers into behavioral health to expanding social work slots at public universities and helping psychiatry students with loan repayment.\u003c/p>\n\u003cp>Gov. Newsom also emphasized workforce development in his recent \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2022/08/KidsMentalHealthMasterPlan_8.18.22.pdf?emrc=6d3847\">master plan for kids’ mental health\u003c/a>. Some of the $4.7 billion will go toward bringing in 40,000 new mental health care workers, he said.\u003c/p>\n\u003ch2>Can we reimagine how mental health care is provided?\u003c/h2>\n\u003cp>Ultimately, getting mental health care to everyone who needs it is going to require both expanding our idea of who should provide that care — and how they should do it.\u003c/p>\n\u003cp>“If you only see the system in the context of what it currently is, yeah, we’re stuck by the provider shortage,” said Alex Briscoe, head of California Children’s Trust, an initiative to change the state’s mental health care system for children.\u003c/p>\n\u003cp>“But I would say that we can’t let that stop us, and I actually think it represents an opportunity,” Briscoe said.\u003c/p>\n\u003cp>For Briscoe, this includes team-based models — already used by some nonprofits — involving a therapist, a case worker, a parenting coach or housing or employment specialist, and a peer provider who has lived with mental illness and is uniquely positioned to support others in crisis.\u003c/p>\n\u003cp>It includes more people with shared life experiences and those who live in the local community, he said.\u003c/p>\n\u003cp>Mental health care workers are often middle-class white women, while many of the people they serve — especially on Medi-Cal — are lower-income people of color, said Dr. Rhea Boyd, a pediatrician and public health advocate who works with Briscoe at the California Children’s Trust. She wonders: What if we expanded the provider class so that it included the people who cut or braid your hair? What if the people who offered you mental health care lived on your block?\u003c/p>\n\u003cp>A lot of these things already exist informally, she said. What’s needed is a way to pay for them.\u003c/p>\n\u003cp>That’s starting to emerge.\u003c/p>\n\u003cp>Two years ago, the state finally authorized a pathway to \u003ca href=\"https://calmatters.org/health/2020/09/california-peer-mental-health/\">certify peer providers\u003c/a>, allowing organizations that employ them to bill Medi-Cal. California was the 49th state to do so.\u003c/p>\n\u003cp>Other new categories of workers are also being proposed. CalAIM created a job description called “community health workers,” trusted residents who do outreach in their own communities. And the state’s Children and Youth Behavioral Health Initiative is developing the role of behavioral health coaches, who work with young people on school campuses. Both would work in team-based models under the supervision of licensed providers.\u003c/p>\n\u003cp>Coffman and others say it’s also important to invest in career ladders, so people who enter the field as peer providers have the option to earn more advanced degrees.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“This is the opportunity California has in front of it,” said Ghaly, secretary of the California Health and Human Services Agency. “And it’s going to start by how transformative, innovative and successful we are in creating not just the workforce that we know but the workforce that we’ve yet to discover.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The need for therapists, social workers, psychologists and psychiatrists is greater than ever. Under relentless pressure from the pandemic and inflation, wildfires, gun violence, racism and war, Californians are crying out for help.\u003c/p>\n\u003cp>But that doesn’t mean they can get it.\u003c/p>\n\u003cp>In every corner of mental health right now, a similar story is being told: There simply aren’t enough providers.\u003c/p>\n\u003cp>Patients receive lists of names from their insurers, only to learn none of the therapists on these so-called “ghost lists” will see them. Clinicians who do offer a spot often only accept cash.\u003c/p>\n\u003cp>Nonprofit mental health care providers report needing to have an offer letter ready at a job interview, fearing applicants will take another position if they wait.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Kaiser mental health care clinicians have been \u003ca href=\"https://www.kqed.org/news/11923034/were-drowning-why-kaiser-mental-health-workers-are-striking\">out on strike for weeks\u003c/a> now in Northern California, describing exhausting working conditions and long delays in care for their patients. Kaiser, for its part, points a finger at a familiar culprit: the mental health care provider shortage.\u003c/p>\n\u003cp>CalMatters spoke with more than two dozen mental health experts, public officials and providers around California to ask about the impacts of the mental health care provider shortage, and what can be done about it. Their responses ranged from desperate to hopeful.\u003c/p>\n\u003cp>All agree we are at a pivotal movement.\u003c/p>\n\u003cp>In part, that’s because Gov. Gavin Newsom’s administration is investing heavily in overhauling the state’s mental health care system. At the same time, the state recently enacted laws requiring insurers to provide timely access to mental health care. Some worry a lack of providers could jeopardize these bold new initiatives. Others see this as an opportunity to reimagine how mental health care in the state is delivered.\u003c/p>\n\u003cp>Here’s what the experts had to say:\u003c/p>\n\u003ch2>How big is the provider shortage problem?\u003c/h2>\n\u003cp>It depends on what part of the elephant you’re looking at, said Catherine Teare, associate director of the California Health Care Foundation’s People-Centered Care team. County mental health departments are struggling to hire. So are commercial health plans. So are nonprofits.\u003c/p>\n\u003cp>At the same time, she said, “the level of mental distress is increased.”\u003c/p>\n\u003cp>“For children or adults who need a lot, or need it urgently, it’s a scary time,” she said.\u003c/p>\n\u003cp>Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, told CalMatters that the number of licensed behavioral health care providers in the state increased by 20% between 2016 and 2020. But, that’s been offset by an increase in demand he calls “really unprecedented.”\u003c/p>\n\u003cp>For patients, how bad the shortage is depends, in part, on where you live, your insurance, your income, your age, the care you need and whether you want a clinician of color or one who speaks a language other than English.\u003c/p>\n\u003cp>\u003ca href=\"https://www.chcf.org/publication/californias-current-future-behavioral-health-workforce/\">A report\u003c/a> published by the University of California, San Francisco in 2018 — even before the \u003ca href=\"https://www.healthmanagement.com/wp-content/uploads/HMA-NCMW-Issue-Brief-10-27-21.pdf\">pandemic sent need skyrocketing\u003c/a> — predicted that by 2028, demand for psychologists and other therapists would be 40% more than supply. For kids, the shortage is especially dire: Close to a third of California’s 58 counties have \u003ca href=\"https://www.aacap.org/aacap/Advocacy/Federal_and_State_Initiatives/Workforce_Maps/Home.aspx\">no child and adolescent psychiatrists at all\u003c/a>, according to the American Academy of Child and Adolescent Psychiatry.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003ca href=\"https://www.chcf.org/wp-content/uploads/2022/07/MentalHealthAlmanac2022.pdf\">A new report\u003c/a> from the California Health Care Foundation shows that the Bay Area has 19 licensed psychiatrists and 73 licensed psychologists per 100,000 people — significantly more than the state averages of 12 and 44. At the other end of the spectrum, the San Joaquin Valley has six psychiatrists and 16 psychologists for the equivalent number of people.\u003c/p>\n\u003cp>Jessica Dominguez, a licensed marriage and family therapist at Kaiser Richmond who is currently on strike, said the Bay Area has plenty of providers.\u003c/p>\n\u003cp>“Throw a rock, you’re going to hit a therapist,” said Dominguez, who said she plans to leave the organization.\u003c/p>\n\u003cp>But others who work in the region, including Matthew Madaus, executive director of the Behavioral Health Collaborative of Alameda County, said “100% absolutely” there’s a shortage even in the Bay Area.\u003c/p>\n\u003cp>If you search for a behavioral health clinician on Indeed.com, Madaus said, it comes up with thousands of open positions within a 25-mile radius.\u003c/p>\n\u003cp>“It’s extraordinary the level of demand,” he said.\u003c/p>\n\u003cp>One problem: It’s difficult to capture how many clinicians don’t accept any insurance at all, and thus aren’t accessible to the vast majority of patients who can’t pay out of pocket.\u003c/p>\n\u003cp>What we do know: We need more and better data. For instance, some experts say the increase described by Ghaly does not reflect how many licensed providers are actually seeing patients, nor does it capture how many are seeing people who are uninsured or on Medi-Cal.\u003c/p>\n\u003cp>Democratic state Sen. Scott Wiener of San Francisco authored\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB964\"> a bill\u003c/a> this year that would require the Department of Health Care Access and Information to prepare a report for the Legislature by Jan. 1, 2024, describing the state of California’s behavioral health workforce, and how best to address the shortage. Senate Bill 964 is on the governor’s desk.\u003c/p>\n\u003cp>\u003ca href=\"https://workforce.org/wp-content/uploads/2022/08/San-Diego-Behavioral-Health-Workforce-Report-.pdf\">San Diego County has already researched the shortage.\u003c/a> Officials there estimate they currently have 17,000 behavioral health care workers and need an additional 8,100 to meet current demand. In the next five years, they anticipate needing another 10,000 workers, in part because so many will be retiring.\u003c/p>\n\u003ch2>What’s causing the shortage?\u003c/h2>\n\u003cp>Mental health care leaders will tell you the shortage itself is nothing new. But the pandemic has aggravated the problems. More providers have left their jobs, citing burnout. Or they’ve left the state, citing cost of living. New telehealth start-ups specializing in mental health treatment offer good pay and flexible hours; many experts said they have added to the demand by siphoning off providers from the public sector.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>In a 2018 report on the \u003ca href=\"https://healthforce.ucsf.edu/publications/california-s-current-and-future-behavioral-health-workforce\">behavioral health workforce shortage\u003c/a>, Janet Coffman of UCSF also raised the concern that 45% of psychiatrists and 37% of psychologists would likely be retiring within a decade. The pandemic has accelerated this trend, she said.\u003c/p>\n\u003cp>Many clinicians say they’re simply exhausted. It’s not just that more people need help, but that many of them are coming in sicker, with mental health issues that have gone untreated.\u003c/p>\n\u003cp>“Our patient population has become so much more difficult to work with than it used to be a decade ago,” said Randall Hagar, legislative advocate and policy consultant for the Psychiatric Physicians Alliance of California.\u003c/p>\n\u003cp>As openings go unfilled, those who remain are left to carry more of the weight, he said.\u003c/p>\n\u003cp>Another problem Hagar and others mention: paperwork. Doctors spend some 40% of their time on paperwork, he said.\u003c/p>\n\u003cp>Many clinicians, especially providers of color, also say they are simply not getting enough emotional support from their employers. Dominguez, the Kaiser therapist, said she founded La Clinica, a nationally recognized pilot program to serve Spanish-speaking clients, in 2016. When tragedies happen in the community, she said, they affect clinicians, too. But, “you’re just expected to plug along and keep going,” she said.\u003c/p>\n\u003cp>Continually witnessing trauma can be exhausting, said Jeff Capps, a social worker with Pacific Clinics in Los Angeles. He emphasizes the need to make the work more sustainable for clinicians. That includes better pay.\u003c/p>\n\u003cp>“Sometimes in our field, the assumption is that since you get value out of your work, you don’t need to be as compensated,” he said.\u003c/p>\n\u003cp>A 2019 report by the health care consulting firm Milliman found that commercial plans in California, when setting rates, \u003ca href=\"https://www.milliman.com/en/insight/addiction-and-mental-health-vs-physical-health-widening-disparities-in-network-use-and-p\">pay primary care providers an average 15% more\u003c/a> than they pay behavioral health care providers.\u003c/p>\n\u003cp>Luke Bergmann, San Diego County’s director of behavioral health, said his county’s report on the provider shortage showed that, in some cases, people chose to work at Panda Express instead of substance use disorder clinics “because they simply cannot make as much.”\u003c/p>\n\u003cp>“People talk about loving the work,” he said. “For people to leave this work is an incredible emotional sacrifice.”\u003c/p>\n\u003cp>Candy Curiel, clinical director of Pacific Clinics for the Inland Empire, said inflation is making the situation even worse.\u003c/p>\n\u003cp>“Everything is so costly at this point, people feel they need to seek more money,” she said.\u003c/p>\n\u003ch2>Everyone is competing with everyone else. Is this a zero-sum game?\u003c/h2>\n\u003cp>Michelle Cabrera, executive director of the County Behavioral Health Directors Association of California, said the state’s mental health care system is so overwhelmed, everyone is poaching from each other.\u003c/p>\n\u003cp>“Let me be clear: It is a zero-sum game,” she said. “There’s only so many licensed or competent professionals in the state of California to do these jobs.”\u003c/p>\n\u003cp>In August, state Superintendent of Public Instruction Tony Thurmond announced that he had secured funding to \u003ca href=\"https://www.cde.ca.gov/nr/ne/yr22/yr22rel39.asp\">hire 10,000 additional mental health clinicians\u003c/a> to serve the state’s students. That effort is key to the Department of Education’s push to increase mental health care provided in schools.\u003c/p>\n\u003cp>Adrienne Shilton, senior policy advocate for the California Alliance of Child and Family Services, called the $200 million to establish a new scholarship program for master’s-level clinicians “a big win.”\u003c/p>\n\u003cp>But for Cabrera, the announcement “just puts fear at the heart of county behavioral health.”\u003c/p>\n\u003cp>She wonders how counties can possibly compete.\u003c/p>\n\u003cp>“I don’t know that we’ve really had a reckoning yet on the degree to which demand so far exceeds the available supply of providers in our state,” she said.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>This is the vicious circle for workers who are salaried. Nonprofit providers often pay less than schools and counties. Schools and counties, in turn, pay less than Kaiser and some of the new telehealth start-ups.\u003c/p>\n\u003cp>Nonprofit jobs that used to attract 40 or 50 applicants might only get two or three now, said Madaus, of the Behavioral Health Collaborative of Alameda County. Some nonprofits are looking at the possibility of providing free housing as an incentive, he said.\u003c/p>\n\u003cp>Even as it contributes to burnout, the increasing demand has, in some ways, opened new doors for clinicians.\u003c/p>\n\u003cp>Michael Torres, child and family clinical psychologist for Kaiser in San Leandro who is currently on strike, said that of 15 people on his team, six have left in the past year. Some are leaving to do telehealth, or to work in the private sector. Those positions can offer better work-life balance and more flexibility, he said. They also allow clinicians to see patients weekly or biweekly, he said, instead of every four to six weeks as often happens at Kaiser.\u003c/p>\n\u003cfigure id=\"attachment_11923074\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11923074\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut-800x533.jpg\" alt='people in red shirts carrying signs that read \"patients over profits\"' width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57894_032_KQED_KaiserStrikeOakland_08192022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Kaiser mental health care workers and supporters march from Oakland Kaiser Medical Center to Kaiser’s corporate headquarters on Friday, Aug. 19, 2022, the fifth day of an open-ended strike. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>How will the provider shortage affect the Newsom administration’s big mental health care initiatives?\u003c/h2>\n\u003cp>Coming into office, Newsom made clear that he wanted to prioritize mental health. Over the past few years, his administration has championed a number of bold new initiatives. These include:\u003c/p>\n\u003cul>\n\u003cli>The \u003ca href=\"https://www.chhs.ca.gov/wp-content/uploads/2021/12/Children-and-Youth-Behavioral-Health-Initiative-Brief.pdf\">Children and Youth Behavioral Health Initiative\u003c/a>, a \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2022/08/KidsMentalHealthMasterPlan_8.18.22.pdf?emrc=6d3847\">$4.7 billion investment\u003c/a> meant to transform the children’s mental health care system.\u003c/li>\n\u003cli>CalAIM, a major transformation of the state’s Medi-Cal system.\u003c/li>\n\u003cli>\u003ca href=\"https://www.kqed.org/news/11924117/governors-care-court-plan-passes-assembly-clearing-way-to-become-law\">CARE Court\u003c/a>, a controversial proposal to compel people with serious mental illness into care and housing.\u003c/li>\n\u003c/ul>\n\u003cp>Lawmakers in recent years strengthened requirements that private insurers adhere to federal and state mental health parity laws — which require equal treatment of mental and physical health concerns.\u003c/p>\n\u003cp>But many of those tasked with implementing these efforts say they are worried.\u003c/p>\n\u003cp>“We have that conversation all the time,” said Madaus, of the Behavioral Health Collaborative of Alameda County. As new funding sources come online, he said, nonprofit executives consistently tell him: “I can’t take any more funding because I can’t hire more staff.”\u003c/p>\n\u003cp>Karen Larsen, chief executive officer of the Steinberg Institute, a nonprofit that advocates on mental health care policy, is also concerned. Prior to assuming her current role, Larsen spent two decades as head of Yolo County’s behavioral health department.\u003c/p>\n\u003cp>“We finally have all of this money and transformation coming,” she said. “All these amazing things … and it couldn’t come at a worse time in terms of our workforce.”\u003c/p>\n\u003cp>Ghaly says he shares that concern. But he adds that “incredible investments have been made,” not just in innovative programs, but in addressing the workforce shortage head-on.\u003c/p>\n\u003ch2>How do we increase the number of providers?\u003c/h2>\n\u003cp>Earlier this year, Josh Leonard, executive director of the East Bay Agency for Children, was struggling to fill openings for mental health clinicians. Over several months, the nonprofit — anticipating a bump in its contract with Alameda County — raised all clinicians’ salaries by at least 15%.\u003c/p>\n\u003cp>It worked. At least for now.\u003c/p>\n\u003cp>While Leonard’s not considering the workforce crisis over, he knows that decision was important.\u003c/p>\n\u003cp>Jessica Hernandez, a clinician there, agrees.\u003c/p>\n\u003cp>“For me it has helped out tremendously,” she said. “Now I want to stay longer.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>To make the work more appealing and sustainable, providers say a lot needs to change. Besides pay, other factors are also critical, including reducing paperwork, offering more flexibility and providing more support to therapists.\u003c/p>\n\u003cp>That last one has been key for Hernandez.\u003c/p>\n\u003cp>“They’re acknowledging that it’s really, really tough,” she said.\u003c/p>\n\u003cp>To meet growing need, new providers also must be brought in. Scholarships and loan repayment programs are helpful, but universities need more spots to train new clinicians.\u003c/p>\n\u003cp>Coffman, of UCSF, calls herself “cautiously optimistic.”\u003c/p>\n\u003cp>“We’re making much bigger investments in the behavioral health workforce than we have since I started engaging in this field in the ’90s,” she said.\u003c/p>\n\u003cp>This year’s budget allocates more than $360 million for the state to spend over the next three years on everything from recruiting high schoolers into behavioral health to expanding social work slots at public universities and helping psychiatry students with loan repayment.\u003c/p>\n\u003cp>Gov. Newsom also emphasized workforce development in his recent \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2022/08/KidsMentalHealthMasterPlan_8.18.22.pdf?emrc=6d3847\">master plan for kids’ mental health\u003c/a>. Some of the $4.7 billion will go toward bringing in 40,000 new mental health care workers, he said.\u003c/p>\n\u003ch2>Can we reimagine how mental health care is provided?\u003c/h2>\n\u003cp>Ultimately, getting mental health care to everyone who needs it is going to require both expanding our idea of who should provide that care — and how they should do it.\u003c/p>\n\u003cp>“If you only see the system in the context of what it currently is, yeah, we’re stuck by the provider shortage,” said Alex Briscoe, head of California Children’s Trust, an initiative to change the state’s mental health care system for children.\u003c/p>\n\u003cp>“But I would say that we can’t let that stop us, and I actually think it represents an opportunity,” Briscoe said.\u003c/p>\n\u003cp>For Briscoe, this includes team-based models — already used by some nonprofits — involving a therapist, a case worker, a parenting coach or housing or employment specialist, and a peer provider who has lived with mental illness and is uniquely positioned to support others in crisis.\u003c/p>\n\u003cp>It includes more people with shared life experiences and those who live in the local community, he said.\u003c/p>\n\u003cp>Mental health care workers are often middle-class white women, while many of the people they serve — especially on Medi-Cal — are lower-income people of color, said Dr. Rhea Boyd, a pediatrician and public health advocate who works with Briscoe at the California Children’s Trust. She wonders: What if we expanded the provider class so that it included the people who cut or braid your hair? What if the people who offered you mental health care lived on your block?\u003c/p>\n\u003cp>A lot of these things already exist informally, she said. What’s needed is a way to pay for them.\u003c/p>\n\u003cp>That’s starting to emerge.\u003c/p>\n\u003cp>Two years ago, the state finally authorized a pathway to \u003ca href=\"https://calmatters.org/health/2020/09/california-peer-mental-health/\">certify peer providers\u003c/a>, allowing organizations that employ them to bill Medi-Cal. California was the 49th state to do so.\u003c/p>\n\u003cp>Other new categories of workers are also being proposed. CalAIM created a job description called “community health workers,” trusted residents who do outreach in their own communities. And the state’s Children and Youth Behavioral Health Initiative is developing the role of behavioral health coaches, who work with young people on school campuses. Both would work in team-based models under the supervision of licensed providers.\u003c/p>\n\u003cp>Coffman and others say it’s also important to invest in career ladders, so people who enter the field as peer providers have the option to earn more advanced degrees.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>California won’t allow teens age 15 and up to be vaccinated against the coronavirus without their parents’ consent.\u003c/p>\n\u003cp>State Sen. Scott Wiener, the bill’s author, announced Wednesday \u003ca href=\"https://sd11.senate.ca.gov/news/20220831-senator-wiener%E2%80%99s-statement-decision-pull-sb-866-teens-choose-vaccines-act\">he won’t put the measure up for a vote\u003c/a> in the state Assembly because it doesn’t have enough support to pass.\u003c/p>\n\u003cp>Minors age 12 to 17 in California already can receive vaccinations for hepatitis B and HPV, which prevent sexually transmitted diseases, without permission from their parents or guardians. The bill would have allowed teens 15 and older to receive any vaccine that has been approved by the U.S. Food and Drug Administration and Centers for Disease Control and Prevention, even if their parents objected.[aside label=\"Related Stories\" postID=\"education_534972,news_11911266,news_11918778\"]Wiener, a Democrat from San Francisco, blamed the lack of support on “months of harassment and misinformation” by “a small but highly vocal and organized minority of anti-vaxxers.”\u003c/p>\n\u003cp>“The anti-vaxxers may have prevailed in this particular fight, but the broader fight for science and health continues,” he said in a statement.\u003c/p>\n\u003cp>A coalition of groups opposed to vaccine mandates called it a “blatant, dangerous trampling of California parents’ and guardians’ ability to protect and care for their children.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>A Voice for Choice Advocacy said minors may not know their full medical history and the potential risks. And if they don’t tell their parents that they obtained the vaccine on their own, the group said parents may not know what’s wrong if their child has an adverse reaction.\u003c/p>\n\u003cp>Vaccine consent ages vary across the country. Alabama allows children to consent to vaccines starting at age 14, Oregon at 15 and Rhode Island and South Carolina at 16. Cities including Philadelphia and Washington, D.C., allow children age 11 and up to consent to COVID-19 vaccines, and in San Francisco the age is 12 and older.\u003c/p>\n\u003cp>The teen consent bill was one of several coronavirus-related bills that faced heavy opposition.\u003c/p>\n\u003cp>Gov. Gavin Newsom and Democratic Sen. Richard Pan both delayed until next year measures relating to school vaccinations, while Democratic Assemblymember Buffy Wicks withdrew her bill that would have forced all California businesses to require coronavirus vaccines for their employees.\u003c/p>\n\u003cp>Another bill from Pan still moving forward \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB1479\">would require that schools create COVID-19 testing plans\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Also still under consideration are a bill by Democratic Assemblymember Evan Low that \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billHistoryClient.xhtml?bill_id=202120220AB2098\">would make doctors spreading coronavirus misinformation or disinformation subject to discipline\u003c/a> for professional misconduct, and one by Democratic Assemblymember Akilah Weber that \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220AB1797\">would require health care providers, schools, child care facilities and others to disclose certain patient information\u003c/a> to the California Department of Public Health and local health officials.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California won’t allow teens age 15 and up to be vaccinated against the coronavirus without their parents’ consent.\u003c/p>\n\u003cp>State Sen. Scott Wiener, the bill’s author, announced Wednesday \u003ca href=\"https://sd11.senate.ca.gov/news/20220831-senator-wiener%E2%80%99s-statement-decision-pull-sb-866-teens-choose-vaccines-act\">he won’t put the measure up for a vote\u003c/a> in the state Assembly because it doesn’t have enough support to pass.\u003c/p>\n\u003cp>Minors age 12 to 17 in California already can receive vaccinations for hepatitis B and HPV, which prevent sexually transmitted diseases, without permission from their parents or guardians. The bill would have allowed teens 15 and older to receive any vaccine that has been approved by the U.S. Food and Drug Administration and Centers for Disease Control and Prevention, even if their parents objected.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Wiener, a Democrat from San Francisco, blamed the lack of support on “months of harassment and misinformation” by “a small but highly vocal and organized minority of anti-vaxxers.”\u003c/p>\n\u003cp>“The anti-vaxxers may have prevailed in this particular fight, but the broader fight for science and health continues,” he said in a statement.\u003c/p>\n\u003cp>A coalition of groups opposed to vaccine mandates called it a “blatant, dangerous trampling of California parents’ and guardians’ ability to protect and care for their children.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>A Voice for Choice Advocacy said minors may not know their full medical history and the potential risks. And if they don’t tell their parents that they obtained the vaccine on their own, the group said parents may not know what’s wrong if their child has an adverse reaction.\u003c/p>\n\u003cp>Vaccine consent ages vary across the country. Alabama allows children to consent to vaccines starting at age 14, Oregon at 15 and Rhode Island and South Carolina at 16. Cities including Philadelphia and Washington, D.C., allow children age 11 and up to consent to COVID-19 vaccines, and in San Francisco the age is 12 and older.\u003c/p>\n\u003cp>The teen consent bill was one of several coronavirus-related bills that faced heavy opposition.\u003c/p>\n\u003cp>Gov. Gavin Newsom and Democratic Sen. Richard Pan both delayed until next year measures relating to school vaccinations, while Democratic Assemblymember Buffy Wicks withdrew her bill that would have forced all California businesses to require coronavirus vaccines for their employees.\u003c/p>\n\u003cp>Another bill from Pan still moving forward \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB1479\">would require that schools create COVID-19 testing plans\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Also still under consideration are a bill by Democratic Assemblymember Evan Low that \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billHistoryClient.xhtml?bill_id=202120220AB2098\">would make doctors spreading coronavirus misinformation or disinformation subject to discipline\u003c/a> for professional misconduct, and one by Democratic Assemblymember Akilah Weber that \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220AB1797\">would require health care providers, schools, child care facilities and others to disclose certain patient information\u003c/a> to the California Department of Public Health and local health officials.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Life expectancy in the U.S. fell in 2021, for the second year in a row. It was the biggest drop in almost 100 years.\u003c/p>\n\u003cp>In 2019, someone born in the U.S. had a life expectancy of nearly 80 years. In 202o, because of the pandemic, that dropped to 77 years. In 2021 life-span dropped again — to 76.1 years. And \u003ca href=\"https://www.cdc.gov/nchs/data/vsrr/vsrr023.pdf\">for some Americans, life expectancy is even lower, according to a provisional analysis\u003c/a> from the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>“The results of this study are very disturbing,” says \u003ca href=\"https://familymedicine.vcu.edu/about/directories/steven-woolf-md-mph.html\">Dr. Steven Woolf,\u003c/a> a professor of population health and health equity at Virginia Commonwealth University. “This shows that U.S. life expectancy in 2021 was even lower than in 2020,” he says.\u003c/p>\n\u003cp>Other high-income countries have seen a rebound in life expectancy, which Woolf says makes the U.S. results, “all the more tragic.”\u003c/p>\n\u003cp>One of the most dramatic drops in life expectancy in 2021 was among American Indian and Alaskan Native people. Between 2020 and 2021 the life expectancy for this group fell by almost two years, from 67.1 in 2020 to 65.2 in 2021.\u003c/p>\n\u003cp>“That’s horrific,” Woolf says. “The losses in the Native American population have been terrible during the COVID-19 pandemic. And it reflects a lot of barriers that tribal communities face in getting access to care,” he says.\u003c/p>\n\u003cp>White Americans also saw a larger decrease in life expectancy in 2021 than Black and Hispanic Americans. This was the reverse of what happened in 2020 when Hispanic Americans saw a 4 year decline and Black Americans saw a 3 year drop. Life expectancy for white Americans declined by a year in 2021 to 76.4. Black Americans saw a 0.7 year decline to 70.8 years, Hispanic Americans saw a 0.2 year decline to 77.7 years. Asian Americans saw a 0.1 year decline to 83.5 years.\u003c/p>\n\u003cp>Woolf says the greater drop in life expectancy for white Americans could reflect attitudes in some parts of the country to vaccines and pandemic control measures. The U.S. health care system is fragmented he points out — public health is determined by the states, which means there were 50 different pandemic response plans. The states which were more relaxed about COVID restrictions and have lower vaccination rates saw higher excess deaths during the delta and omicron surges than states which had more aggressive vaccination campaigns, masking and other mitigation requirements.\u003c/p>\n\u003cp>\u003ca href=\"https://www.npr.org/2022/05/19/1098543849/pro-trump-counties-continue-to-suffer-far-higher-covid-death-tolls\">Death rates from COVID-19 in counties that went heavily for Donald Trump saw higher death rates\u003c/a> than counties that favored President Biden, according to \u003ca href=\"https://www.npr.org/2022/05/19/1098543849/pro-trump-counties-continue-to-suffer-far-higher-covid-death-tolls\">an NPR analysis\u003c/a>.\u003c/p>\n\u003cp>Injuries, heart disease, chronic liver disease and cirrhosis and suicide also contributed to the life expectancy decline. Increases in unintentional injuries in 2021 were largely driven by \u003ca href=\"https://www.npr.org/sections/health-shots/2022/07/20/1112331075/u-s-death-toll-from-drug-overdoses-is-rising-fast-among-black-and-indigenous-peo\">drug overdose deaths which increased during the pandemic\u003c/a>.\u003c/p>\n\u003cp>“The COVID-19 pandemic has in effect wiped out the health gains that the U.S. has made in the 20th century,” says John Haaga, a member of Maryland’s Commission on Aging. “To have this second year of crash basically wiping out the meager gains made during the century is really pretty shocking,” he says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The U.S. has been lagging for years in making improvements in things like heart disease — the country’s number one killer — and the life expectancy gap between the U.S. and other countries has been growing for decades, Haaga says.\u003c/p>\n\u003cp>“A lot of much poorer countries do much better than us in life expectancy,” he says. “It’s not genetics, it’s that we have been falling behind for 50 years.”\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2022 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=Life+expectancy+in+the+U.S.+continues+to+drop%2C+driven+by+COVID-19&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Life expectancy in the U.S. fell in 2021, for the second year in a row. It was the biggest drop in almost 100 years.\u003c/p>\n\u003cp>In 2019, someone born in the U.S. had a life expectancy of nearly 80 years. In 202o, because of the pandemic, that dropped to 77 years. In 2021 life-span dropped again — to 76.1 years. And \u003ca href=\"https://www.cdc.gov/nchs/data/vsrr/vsrr023.pdf\">for some Americans, life expectancy is even lower, according to a provisional analysis\u003c/a> from the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>“The results of this study are very disturbing,” says \u003ca href=\"https://familymedicine.vcu.edu/about/directories/steven-woolf-md-mph.html\">Dr. Steven Woolf,\u003c/a> a professor of population health and health equity at Virginia Commonwealth University. “This shows that U.S. life expectancy in 2021 was even lower than in 2020,” he says.\u003c/p>\n\u003cp>Other high-income countries have seen a rebound in life expectancy, which Woolf says makes the U.S. results, “all the more tragic.”\u003c/p>\n\u003cp>One of the most dramatic drops in life expectancy in 2021 was among American Indian and Alaskan Native people. Between 2020 and 2021 the life expectancy for this group fell by almost two years, from 67.1 in 2020 to 65.2 in 2021.\u003c/p>\n\u003cp>“That’s horrific,” Woolf says. “The losses in the Native American population have been terrible during the COVID-19 pandemic. And it reflects a lot of barriers that tribal communities face in getting access to care,” he says.\u003c/p>\n\u003cp>White Americans also saw a larger decrease in life expectancy in 2021 than Black and Hispanic Americans. This was the reverse of what happened in 2020 when Hispanic Americans saw a 4 year decline and Black Americans saw a 3 year drop. Life expectancy for white Americans declined by a year in 2021 to 76.4. Black Americans saw a 0.7 year decline to 70.8 years, Hispanic Americans saw a 0.2 year decline to 77.7 years. Asian Americans saw a 0.1 year decline to 83.5 years.\u003c/p>\n\u003cp>Woolf says the greater drop in life expectancy for white Americans could reflect attitudes in some parts of the country to vaccines and pandemic control measures. The U.S. health care system is fragmented he points out — public health is determined by the states, which means there were 50 different pandemic response plans. The states which were more relaxed about COVID restrictions and have lower vaccination rates saw higher excess deaths during the delta and omicron surges than states which had more aggressive vaccination campaigns, masking and other mitigation requirements.\u003c/p>\n\u003cp>\u003ca href=\"https://www.npr.org/2022/05/19/1098543849/pro-trump-counties-continue-to-suffer-far-higher-covid-death-tolls\">Death rates from COVID-19 in counties that went heavily for Donald Trump saw higher death rates\u003c/a> than counties that favored President Biden, according to \u003ca href=\"https://www.npr.org/2022/05/19/1098543849/pro-trump-counties-continue-to-suffer-far-higher-covid-death-tolls\">an NPR analysis\u003c/a>.\u003c/p>\n\u003cp>Injuries, heart disease, chronic liver disease and cirrhosis and suicide also contributed to the life expectancy decline. Increases in unintentional injuries in 2021 were largely driven by \u003ca href=\"https://www.npr.org/sections/health-shots/2022/07/20/1112331075/u-s-death-toll-from-drug-overdoses-is-rising-fast-among-black-and-indigenous-peo\">drug overdose deaths which increased during the pandemic\u003c/a>.\u003c/p>\n\u003cp>“The COVID-19 pandemic has in effect wiped out the health gains that the U.S. has made in the 20th century,” says John Haaga, a member of Maryland’s Commission on Aging. “To have this second year of crash basically wiping out the meager gains made during the century is really pretty shocking,” he says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"radiolab": {
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"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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"reveal": {
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"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"order": 16
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},
"science-friday": {
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"info": "Science Friday is a weekly science talk show, broadcast live over public radio stations nationwide. Each week, the show focuses on science topics that are in the news and tries to bring an educated, balanced discussion to bear on the scientific issues at hand. Panels of expert guests join host Ira Flatow, a veteran science journalist, to discuss science and to take questions from listeners during the call-in portion of the program.",
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