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"content": "\u003cp>Some 800 seafarers from around the world have received COVID-19 vaccinations at the Port of Oakland since May, part of an effort to ease an international crisis that has left hundreds of thousands of merchant ship crew members stuck at sea due to pandemic-related health concerns.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Seth Gomez, senior pharmacist, Alameda County Health Care for the Homeless\"]‘I think it’s important that we get as many people vaccinated as possible, regardless of where they call home.’[/pullquote]The local vaccine drive, organized by the International Maritime Center in Oakland, mirrors similar initiatives in a growing number of ports around the world to administer the single-dose Johnson & Johnson vaccine to stranded crews. Ports in India, the Philippines and Belgium have also recently launched their own programs to vaccinate stranded seafarers.\u003c/p>\n\u003cp>At the Port of Oakland, medical workers from Alameda County’s Health Care for the Homeless program and Contra Costa Health Services, in partnership with the health care company Curative, typically set up shop aboard docked ships, and vaccinate anyone willing to roll up their sleeves. Many crew members hail from countries that have been ravaged by the pandemic, where vaccines are still largely out of reach, said John Claassen, chairman of the International Maritime Center.\u003c/p>\n\u003cfigure id=\"attachment_11877727\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11877727 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/RS49575_009_PortofOakland_Vaccination_05272021-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49575_009_PortofOakland_Vaccination_05272021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49575_009_PortofOakland_Vaccination_05272021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49575_009_PortofOakland_Vaccination_05272021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49575_009_PortofOakland_Vaccination_05272021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49575_009_PortofOakland_Vaccination_05272021-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Crew members from the cargo ship Sea Hope get their temperatures checked before receiving the Johnson & Johnson vaccine during a vaccination drive at the Port of Oakland on May 27, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“These are people who are stuck aboard the ship, and their families are worried sick about them. In countries like the Philippines and India, they’re not getting the vaccines,” he said. “So here … they’re so happy they’re taking pictures.”\u003c/p>\n\u003cp>At the beginning of the pandemic, many governments shut down their borders and banned international shipping crews from coming ashore. That had devastating consequences not just for the world economy (an estimated 80% of global trade is moved by maritime transport), but also the roughly 2 million seafarers who operate the global fleet of merchant ships.\u003c/p>\n\u003cp>\u003ca href=\"https://www.imo.org/en/MediaCentre/HotTopics/Pages/FAQ-on-crew-changes-and-repatriation-of-seafarers.aspx\">The International Maritime Organization\u003c/a> estimates that as of March 2021, roughly 200,000 seafarers were still stranded on their ships, a logjam the group calls a humanitarian and economic crisis.\u003c/p>\n\u003cfigure id=\"attachment_11877718\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/RS49569_001_PortofOakland_Vaccination_05272021-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11877718\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/RS49569_001_PortofOakland_Vaccination_05272021-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49569_001_PortofOakland_Vaccination_05272021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49569_001_PortofOakland_Vaccination_05272021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49569_001_PortofOakland_Vaccination_05272021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49569_001_PortofOakland_Vaccination_05272021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49569_001_PortofOakland_Vaccination_05272021-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Crew members of the NYK Delphinus cargo ship wait to receive their Johnson & Johnson vaccines during a Port of Oakland vaccination drive on May 27, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Maritime workers are a crucial but often overlooked part of the vast global shipping industry, and have been impacted particularly hard by the pandemic, said Margaret Reasoner, a volunteer with the Oakland chapter of the International Maritime Center. One deck seaman on a container ship recently told her he had been stuck at sea for 14 months, she said.\u003c/p>\n\u003cp>[ad fullwidth]“Mariners are resilient people. They understand they’re going to be gone from their families, she said. But, “we don’t think, ‘I’ll go to work and I won’t see my family, I won’t see my kids, for 14 months.’ That’s a long time.”\u003c/p>\n\u003cp>Ships can’t afford to risk anyone on board contracting the virus, since containment is difficult and health care services limited.\u003c/p>\n\u003cfigure id=\"attachment_11879622\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/RS49592_026_PortofOakland_Vaccination_05272021-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11879622\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/RS49592_026_PortofOakland_Vaccination_05272021-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49592_026_PortofOakland_Vaccination_05272021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49592_026_PortofOakland_Vaccination_05272021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49592_026_PortofOakland_Vaccination_05272021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49592_026_PortofOakland_Vaccination_05272021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49592_026_PortofOakland_Vaccination_05272021-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A cargo ship crew member receives his vaccine during a pop-up event at the Port of Oakland on May 27, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Brian Helmle, a deckhand on the San Francisco Bay Ferry, and a member of the Inlandboatmen’s Union, recently volunteered to help vaccinate crew members of the MV Cape Orlando, docked just across the estuary in Alameda. Doing so, he said, is a good way to show international solidarity with other maritime workers.\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"port-of-oakland\"]“I have coworkers on the ferry boats who have been shipped out on deep-sea shipping lines, and they have told me stories about how hard the work is and how isolating it is,” he said. “And in times where there’s any kind of emergency, you know, health or war or anything like that, people go from being isolated to being in danger or stranded and unable to get home.”\u003c/p>\n\u003cp>Alameda County Health Care for the Homeless, one of the groups involved in the effort, is used to delivering vaccines to people where they are, said Seth Gomez, a senior pharmacist.\u003c/p>\n\u003cp>“Being a clinician first, and a pharmacist, I think it’s important that we get as many people vaccinated as possible, regardless of where they call home,” he said.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The local vaccine drive, organized by the International Maritime Center in Oakland, mirrors similar initiatives in a growing number of ports around the world to administer the single-dose Johnson & Johnson vaccine to stranded crews. Ports in India, the Philippines and Belgium have also recently launched their own programs to vaccinate stranded seafarers.\u003c/p>\n\u003cp>At the Port of Oakland, medical workers from Alameda County’s Health Care for the Homeless program and Contra Costa Health Services, in partnership with the health care company Curative, typically set up shop aboard docked ships, and vaccinate anyone willing to roll up their sleeves. Many crew members hail from countries that have been ravaged by the pandemic, where vaccines are still largely out of reach, said John Claassen, chairman of the International Maritime Center.\u003c/p>\n\u003cfigure id=\"attachment_11877727\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11877727 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/RS49575_009_PortofOakland_Vaccination_05272021-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49575_009_PortofOakland_Vaccination_05272021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49575_009_PortofOakland_Vaccination_05272021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49575_009_PortofOakland_Vaccination_05272021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49575_009_PortofOakland_Vaccination_05272021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49575_009_PortofOakland_Vaccination_05272021-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Crew members from the cargo ship Sea Hope get their temperatures checked before receiving the Johnson & Johnson vaccine during a vaccination drive at the Port of Oakland on May 27, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“These are people who are stuck aboard the ship, and their families are worried sick about them. In countries like the Philippines and India, they’re not getting the vaccines,” he said. “So here … they’re so happy they’re taking pictures.”\u003c/p>\n\u003cp>At the beginning of the pandemic, many governments shut down their borders and banned international shipping crews from coming ashore. That had devastating consequences not just for the world economy (an estimated 80% of global trade is moved by maritime transport), but also the roughly 2 million seafarers who operate the global fleet of merchant ships.\u003c/p>\n\u003cp>\u003ca href=\"https://www.imo.org/en/MediaCentre/HotTopics/Pages/FAQ-on-crew-changes-and-repatriation-of-seafarers.aspx\">The International Maritime Organization\u003c/a> estimates that as of March 2021, roughly 200,000 seafarers were still stranded on their ships, a logjam the group calls a humanitarian and economic crisis.\u003c/p>\n\u003cfigure id=\"attachment_11877718\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/RS49569_001_PortofOakland_Vaccination_05272021-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11877718\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/RS49569_001_PortofOakland_Vaccination_05272021-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49569_001_PortofOakland_Vaccination_05272021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49569_001_PortofOakland_Vaccination_05272021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49569_001_PortofOakland_Vaccination_05272021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49569_001_PortofOakland_Vaccination_05272021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49569_001_PortofOakland_Vaccination_05272021-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Crew members of the NYK Delphinus cargo ship wait to receive their Johnson & Johnson vaccines during a Port of Oakland vaccination drive on May 27, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Maritime workers are a crucial but often overlooked part of the vast global shipping industry, and have been impacted particularly hard by the pandemic, said Margaret Reasoner, a volunteer with the Oakland chapter of the International Maritime Center. 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"content": "\u003cdiv class=\"post-body\">\u003cp>“Mariners are resilient people. They understand they’re going to be gone from their families, she said. But, “we don’t think, ‘I’ll go to work and I won’t see my family, I won’t see my kids, for 14 months.’ That’s a long time.”\u003c/p>\n\u003cp>Ships can’t afford to risk anyone on board contracting the virus, since containment is difficult and health care services limited.\u003c/p>\n\u003cfigure id=\"attachment_11879622\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/RS49592_026_PortofOakland_Vaccination_05272021-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11879622\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/RS49592_026_PortofOakland_Vaccination_05272021-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49592_026_PortofOakland_Vaccination_05272021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49592_026_PortofOakland_Vaccination_05272021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49592_026_PortofOakland_Vaccination_05272021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49592_026_PortofOakland_Vaccination_05272021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49592_026_PortofOakland_Vaccination_05272021-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A cargo ship crew member receives his vaccine during a pop-up event at the Port of Oakland on May 27, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Brian Helmle, a deckhand on the San Francisco Bay Ferry, and a member of the Inlandboatmen’s Union, recently volunteered to help vaccinate crew members of the MV Cape Orlando, docked just across the estuary in Alameda. Doing so, he said, is a good way to show international solidarity with other maritime workers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“I have coworkers on the ferry boats who have been shipped out on deep-sea shipping lines, and they have told me stories about how hard the work is and how isolating it is,” he said. “And in times where there’s any kind of emergency, you know, health or war or anything like that, people go from being isolated to being in danger or stranded and unable to get home.”\u003c/p>\n\u003cp>Alameda County Health Care for the Homeless, one of the groups involved in the effort, is used to delivering vaccines to people where they are, said Seth Gomez, a senior pharmacist.\u003c/p>\n\u003cp>“Being a clinician first, and a pharmacist, I think it’s important that we get as many people vaccinated as possible, regardless of where they call home,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "theres-only-1-drug-for-postpartum-depression-why-does-kaiser-permanente-make-it-so-hard-to-get",
"title": "There's Only 1 Drug for Postpartum Depression. Why Does Kaiser Permanente Make It So Hard to Get?",
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"headTitle": "There’s Only 1 Drug for Postpartum Depression. Why Does Kaiser Permanente Make It So Hard to Get? | KQED",
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"content": "\u003cp>[dropcap]W[/dropcap]hen Miriam McDonald decided she wanted to have another baby at age 44, her doctor told her she had a better chance of winning the lottery. So when she got pregnant, she and her husband were thrilled. But within three days of giving birth to their son, everything turned.\u003c/p>\n\u003cp>“I was thinking, ‘Oh my God, what did I do?’ I just brought this baby into this world and I can barely take care of myself right now,” she said. “I feel exhausted. I haven’t slept in three days. I haven’t really eaten in three days.”\u003c/p>\n\u003cp>As the weeks went by, her depression got worse. She felt sad, but also indifferent. She didn’t want to hold her baby, she didn’t want to change him. She said she felt no connection with him at all.\u003c/p>\n\u003cp>This confused her – she never felt anything like this after her first two kids – and she worried her mood might hurt her son. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113321/#R2\">Untreated postpartum depression can affect babies’ cognitive and social development\u003c/a>. For the mother, it can be life or death. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113321/\">Suicide accounts for 20% of maternal deaths\u003c/a>.\u003c/p>\n\u003cp>“Every day, I was crying. Every day, I felt like I just wanted to die. Every day, I thought about ending my life,” said McDonald, who is Latina and works at UC Davis as an IT professional.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She went to Kaiser Permanente, her health care provider, for help. She said they put her on a merry-go-round of medication trial and error. The first drug her doctor prescribed made her anxious. The second drug gave her horrific nightmares. A third drug gave her auditory and visual hallucinations that took seven weeks to go away. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Then, her doctor retired. And when McDonald complained to her new doctor that she was still depressed four months after giving birth, the physician suggested more medications.\u003c/span>\u003c/p>\n\u003cp>“I was desperate,” McDonald said. “I was like, ‘I’m trying to help myself, but things are just getting worse.’ So what am I left with?”\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She started doing her own research and learned about a new treatment called brexanolone. It’s \u003ca href=\"https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-post-partum-depression\">the \u003c/a>\u003c/span>\u003cspan style=\"font-weight: 400\">first and only drug\u003c/span>\u003cspan style=\"font-weight: 400\"> approved by the U.S. Food and Drug Administration to treat postpartum depression, which \u003ca href=\"https://www.americashealthrankings.org/explore/health-of-women-and-children/measure/postpartum_depression/state/CA\">affects \u003c/a>\u003c/span>\u003cspan style=\"font-weight: 400\">1 out of 8 new mothers\u003c/span>\u003cspan style=\"font-weight: 400\"> in California. Instead of targeting the serotonin system in the brain, like most antidepressants, brexanolone works by rebalancing the stress hormones that can get out of kilter after having a baby. It’s delivered through an IV infusion over 2 1/2 days in the hospital. \u003c/span>\u003c/p>\n\u003cp>In \u003cspan style=\"font-weight: 400\">clinical trials\u003c/span>\u003cspan style=\"font-weight: 400\">, \u003ca href=\"https://www.fda.gov/media/121348/download\">75% of women who got brexanolone started to feel better\u003c/a> immediately after the three-day treatment. Half the women went into complete remission.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">McDonald wanted to try it. \u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_11879318\" class=\"wp-caption aligncenter\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11879318\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/trying-to-smile-1-scaled.jpg\" alt=\"\" width=\"2560\" height=\"1920\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-1536x1152.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-2048x1536.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-1920x1440.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">For the first year of her son’s life, Miriam McDonald says all her smiles were fake or strained. \u003ccite>(Courtesy Miriam McDonald)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">“People walk out of the hospital, wanting to be with their child, wanting to return home,” said \u003c/span>\u003ca href=\"https://www.med.unc.edu/psych/directory/riah-patterson/\">\u003cspan style=\"font-weight: 400\">Dr. Riah Patterson\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, who has been treating women with brexanolone at the University of North Carolina at Chapel Hill since it became available in summer 2019. “There is a hopefulness, a brightness. You can really see that transformation in the hospital room over those 60 hours. It’s pretty miraculous.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When McDonald asked her doctor for brexanolone, she said no. \u003c/span>\u003c/p>\n\u003cp>In an email, she said the existing studies were “not very impressive.” She told McDonald that she didn’t meet Kaiser’s criteria for the drug: She would have had to try and fail four medications and electroconvulsive therapy before she could try brexanolone. And all this had to happen within six months of having her baby, or she couldn’t try it at all.\u003c/p>\n\u003cp>How could anyone qualify, McDonald wondered?\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“This is crazy. By the time you even try one drug, that’s like four weeks out,” she said. “Another drug is four weeks out, another drug is four weeks out. There’s just no way.”\u003c/span>\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"State Sen. Scott Wiener, D-San Francisco\"]‘If Kaiser is making it effectively impossible to get a particular, important mental health treatment, that could definitely be a violation of our parity law.’[/pullquote]\u003cspan style=\"font-weight: 400\">Kaiser’s guidance is an outlier. KQED analyzed guidelines from a dozen health plans operating in California. Three of them require women to fail one medication before trying brexanolone. One plan – the state’s Medi-Cal program for low-income women – requires two fails. But Kaiser is the only system KQED found that recommends women first fail four drugs.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“That’s absurd,” said UNC’s Patterson, one of several experts in postpartum depression who, in turn, called Kaiser’s guidance “ridiculous,” “harsh,” “abusive” and “insane.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">It may also be illegal. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Under a \u003c/span>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB855\">\u003cspan style=\"font-weight: 400\">new state law that took effect in January\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> , health plans must conform to “generally accepted standards of care,” including nonprofit guidelines, scientific literature and expert consensus, when making decisions about mental health treatment.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“If Kaiser is making it effectively impossible to get a particular, important mental health treatment, that could definitely be a violation of our parity law,” said state Sen. Scott Wiener, D-San Francisco, the bill’s author. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Kaiser says it always follows the law. It says its integrated structure makes it different from traditional insurers. At Kaiser, a patient’s doctor determines whether a medication is necessary, not the health plan, and the criteria doctors use are recommendations, not requirements or prerequisites that patients need to “exhaust,” said Dr. Maria Koshy, Kaiser’s chair of psychiatry for Northern California. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“At the end of the day, this is an individual clinical decision by both the provider – the physician – and the patient,” she said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But former Kaiser clinicians and legislative experts familiar with Kaiser’s model say the culture around these recommendations is to follow them. Doctors get questioned or can face consequences if they don’t, said Wiener.\u003c/span>\u003c/p>\n\u003ch3>‘It Saved My Life’\u003c/h3>\n\u003cp>\u003cspan style=\"font-weight: 400\">McDonald’s physician followed the criteria as if they were prerequisites when she declined to prescribe brexanolone. Kaiser’s grievance department sent a letter to another woman, Yesenia Muñoz, denying brexanolone because she had not failed enough medications.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“When I talked to the caseworker at Kaiser that had denied the medication, he said that Zulresso was very expensive,” said Muñoz, referring to brexanolone’s brand name.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Brexanolone treatment costs $34,000 for the medication, plus the cost of the three-day hospital stay, which can tack on another $30,000, at least. Kaiser is not yet certified to administer the treatment in-house, so it must pay outside hospitals to provide it. It says it has plans to eventually open three of its own certified centers.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Muñoz was devastated by the denial. She was overwhelmed by postpartum depression and anxiety shortly after her daughter was born and, as a Latina, she said she was hesitant to seek help at first. When she did, none of the medications or therapies Kaiser offered her worked. She still felt suicidal.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I could get out the door sometimes and take the stroller and go walk, and my mind kept on saying, ‘If you just step in front of the car, it’s all going to go away,’ ” she remembers.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Muñoz got help from family and co-workers to appeal Kaiser’s decision to the state, and after reviewing her medical records, regulators ordered Kaiser to pay for the brexanolone treatment.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Muñoz went to UC Davis Medical Center to get it, and she started feeling better within the first day.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_11879428\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11879428\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/MunozAndBaby.jpg\" alt=\"Yesenia smiling holding baby\" width=\"1920\" height=\"1760\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/MunozAndBaby.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/MunozAndBaby-800x733.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/MunozAndBaby-1020x935.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/MunozAndBaby-160x147.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/MunozAndBaby-1536x1408.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">After Yesenia Muñoz received brexanolone to treat her postpartum depression, she felt blessed, connected with her daughter and ‘happy enough to want to live.’ \u003ccite>(Courtesy Yesenia Munoz)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">“The nurse came in and she said something funny and I laughed,” Muñoz said. “It was the first time I had laughed in so long.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She started looking through photos and videos of her daughter on her phone and she says it was like she was experiencing those moments for the first time. She started making plans for the future. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It was like a switch flicked and it made me happy enough to want to live,” she said. “It saved my life.”\u003c/span>\u003c/p>\n\u003ch3>‘There Is No Place Where We Say Kaiser Is Exempt’\u003c/h3>\n\u003cp>\u003cspan style=\"font-weight: 400\">In 2008, Congress passed a landmark federal law aimed at correcting imbalances in how insurers covered mental health treatments compared to physical health, later reinforced by the Affordable Care Act in 2010. \u003c/span>\u003cspan style=\"font-weight: 400\">But \u003c/span>\u003ca href=\"https://www.kqed.org/stateofhealth/series/state-of-mind\">\u003cspan style=\"font-weight: 400\">insurers found loopholes\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, creating overly restrictive or self-serving criteria that made it easy to deny services, and as a result, save money.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">California’s new law, \u003c/span>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB855\">\u003cspan style=\"font-weight: 400\">Senate Bill 855\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, is aimed at tightening those loopholes, and has been \u003c/span>\u003ca href=\"https://www.statnews.com/2020/10/14/new-california-law-should-serve-as-a-national-model-for-mental-health-care-reform/\">\u003cspan style=\"font-weight: 400\">hailed by advocates as a national model\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> for mental health reform. It requires health plans to use clinically based, expert-recognized criteria and guidelines in making medical decisions, with the goal of limiting arbitrary or cost-driven denials. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Kaiser raises questions about how precisely the new law applies to them, given its unique integrated structure, where doctors make determinations about what is medically necessary rather than the health plan side of the organization. Kaiser’s Dr. Koshy said SB 855’s requirement to comply with generally accepted standards of care “does not apply” to its brexanolone recommendations because they were developed and are used by doctors, not plan administrators. (When KQED asked Kaiser to provide the brexanolone policy its health plan uses, it said it didn’t have one.)\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We 100% intended this law to apply to the care people get at Kaiser,” said Julie Snyder, government affairs director at \u003ca href=\"https://steinberginstitute.org/\" target=\"_blank\" rel=\"noopener noreferrer\">the Steinberg Institute\u003c/a>, which co-sponsored the law. “There is no place where we say Kaiser is exempt.” \u003c/span>\u003c/p>\n\u003cp>[aside postID=stateofhealth_185796,stateofhealth_193386,stateofhealth_191734 label='Related Coverage']\u003cspan style=\"font-weight: 400\">Doctors at Kaiser have historically been “gatekeepers” for services in the system, said \u003ca href=\"https://psych-appeal.com/meiram-bendat-attorney-founder/\" target=\"_blank\" rel=\"noopener noreferrer\">Meiram Bendat\u003c/a>, an attorney and licensed psychotherapist who also advised on the law. It doesn’t matter if practice recommendations for brexanolone were written by doctors or administrators, or whether the recommendations are mandatory or optional – Bendat says they must be compliant with the law. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“If it’s inconsistent with generally accepted standards of care, then it has no place in California,” he said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Some of Kaiser’s recommended criteria for brexanolone are aligned with generally accepted standards of care; for example, reserving the drug for women who are six months or less postpartum, which was a criterion used in the \u003c/span>\u003ca href=\"https://www.fda.gov/media/121348/download\">\u003cspan style=\"font-weight: 400\">clinical trials the FDA relied on when it approved the drug\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But the recommendation to try four or five alternative treatments before considering brexanolone conflicts with the judgment of half a dozen women’s health experts interviewed for this story. They say there just isn’t enough time in the postpartum period. And there’s too much at stake. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Not only are babies at risk of developmental and emotional problems if their mother is depressed, \u003c/span>\u003ca href=\"https://neurosciencenews.com/paternal-anxiety-18177/#:~:text=Summary%3A%20A%20new%20study%20reports,this%20period%20was%20under%204%25.\">\u003cspan style=\"font-weight: 400\">husbands and partners are also at higher risk for depression and anxiety\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">. And because new moms are learning to breastfeed, and figuring out what’s part of the new normal and what’s not, it can take months just to recognize there’s a problem, said UNC’s Riah Patterson.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It takes so long for this illness to come to recognition and for someone to actually get into an appointment and actually be seen by a provider,” she said.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_11879416\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11879416\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/Riah-Patterson.jpg\" alt=\"\" width=\"1920\" height=\"1436\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Riah-Patterson.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Riah-Patterson-800x598.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Riah-Patterson-1020x763.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Riah-Patterson-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Riah-Patterson-1536x1149.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Riah Patterson discusses patients and treatment plans with her trainee, a third-year psychiatry resident at the Center for Women’s Mood Disorders at UNC-Chapel Hill. \u003ccite>(Courtesy Riah Patterson)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">Indeed, the FDA fast-tracked the approval of brexanolone in part because of how quickly it worked, allowing women to feel better and get back to their families in three days.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It’s new, it’s promising,” said Kaiser’s Koshy, but, she added, “it’s not a benign medication.” \u003c/span>\u003ca href=\"https://www.fda.gov/media/121348/download\">\u003cspan style=\"font-weight: 400\">Six women in the clinical trials experienced loss or near loss of consciousness,\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> which is why the FDA requires women to be continuously monitored in certified health centers when getting the infusion. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Also, the safety and efficacy data is limited, Koshy said. The clinical trials only compared brexanolone to placebo, not to alternative treatments. So while the data show brexanolone works better than nothing, there’s no data on whether it works better than Zoloft or electroconvulsive therapy. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Koshy says Kaiser is always reviewing practice recommendations as new evidence becomes available, but also acknowledged that Kaiser’s recommendations for brexanolone have not been updated since they were first developed two years ago, in July 2019. \u003c/span>\u003c/p>\n\u003cp>It is unclear what role the \u003ca href=\"https://dmhc.ca.gov/\">Department of Managed Health Care\u003c/a>, the state agency that regulates Kaiser, will play in resolving these questions. In a statement, the department said it will review any criteria or guidelines the Kaiser health plan uses for brexanolone, but said it does not have jurisdiction over physician decisions.\u003c/p>\n\u003cp>The DMHC also monitors patient complaints around new medications and treatments in order to identify problems with access to care. So far, \u003ca href=\"https://wpso.dmhc.ca.gov/imr/\">the DMHC has published two complaints about brexanolone in its public database\u003c/a> – both were filed by Kaiser patients.\u003c/p>\n\u003cp>\u003ca href=\"https://www.benefitscafe.com/insurance-companies/kaiserpermanente/\"> \u003cspan style=\"font-weight: 400\">Kaiser is the \u003c/span>\u003cspan style=\"font-weight: 400\">largest insurer in California\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">. It holds a 40% share of the market, covering 6.1 million patients. But at UC Davis, where Kaiser says it sends all patients who need brexanolone in Northern California, Kaiser patients are only 15% of those who got the drug, according to \u003c/span>\u003ca href=\"https://health.ucdavis.edu/team/search/1499/shannon-clark---obstetrics-and-gynecology-sacramento\">\u003cspan style=\"font-weight: 400\">Dr. Shannon Clark\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, a psychiatrist and OB-GYN overseeing the treatments. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She says of the 13 women who’ve been treated at UC Davis in the last two years, only two were from Kaiser. One was Muñoz, who was approved only after the state intervened. The other was Whitney Worthington. Both women canceled their coverage with Kaiser over the postpartum mental health care they received.\u003c/span>\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Marcus Worthington, husband of Whitney Worthington\"]‘The only thing that changed was that we were able to stir up enough dirt and I was able to pitch a big enough fit … It finally got on somebody’s radar who wasn’t going to ignore it.’[/pullquote]\u003cspan style=\"font-weight: 400\">Worthington struggled with depression for most of her adult life, but when she decided to get pregnant, she got help from her psychiatrist and therapist to wean off her antidepressant. It was a grueling withdrawal process. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“That was the worst two months of my life,” she said. “Feeling suicidal at times. It was just miserable.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She knew then that if she got depressed after her baby was born, she did not want to take medication because she wanted to have more children and didn’t want to go through withdrawal again. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When she ended up in the Kaiser ER with suicidal thoughts a few weeks after giving birth, she had to repeatedly decline offers — even threats — of medication. She saw a series of providers at two Kaiser hospitals and several told her she needed brexanolone. One said “it was her only hope.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But Worthington was also told by other Kaiser providers that it wasn’t necessary, that Kaiser didn’t offer it at all, and that cost was an issue. The official denial that came from Kaiser’s billing department offered no reason, said Marcus Worthington, Whitney’s husband. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">He spent weeks on the phone with multiple Kaiser representatives, fighting, negotiating and pleading, until a high-level administrator stepped in and personally approved it. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“The only thing that changed was that we were able to stir up enough dirt and I was able to pitch a big enough fit,” said Marcus, who is Latino and Native American. “I have a relatively Anglo-Saxon name and Whitney is a young white woman. Frankly, I think it all plays in that it finally got on somebody’s radar who wasn’t going to ignore it.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">After getting the treatment at UC Davis, Whitney says she could think clearly again and truly enjoy the last two months of maternity leave she had with her daughter. She called brexanolone “a total miracle.”\u003c/span>\u003c/p>\n\u003ch3>‘This Is How You Treat Postpartum Mental Health?’\u003c/h3>\n\u003cp>\u003cspan style=\"font-weight: 400\">Kaiser said it cannot comment on any individual cases because of privacy laws, but said generally, “We feel deep compassion for any patient experiencing the difficult and serious effects of postpartum depression, and our goal is always to support every patient’s safe return to a healthy mental state.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When Miriam McDonald called Kaiser’s grievance department to complain about her treatment, Kaiser sent the cops to her house for a welfare check.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The officers were calm and nice, McDonald said, but when she closed the door, she cried her eyes out.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\"> \u003c/span>\u003cspan style=\"font-weight: 400\">“It just brought me to a whole new low,” she said. “Why didn’t my doctor call me and talk to me first? I mean, this is how you treat postpartum mental health? How dare\u003c/span> \u003cspan style=\"font-weight: 400\">you.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">McDonald also appealed Kaiser’s denial of brexanolone to state regulators, \u003ca href=\"https://www.2020mom.org/\" target=\"_blank\" rel=\"noopener noreferrer\">with help from advocates at 2020 Mom\u003c/a>, but by the time she got there, the clock had already run out. She was past the six-month postpartum cutoff. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She never got brexanolone.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Still, she continued to fight for relief and eventually got Kaiser to cover a different treatment called \u003c/span>\u003ca href=\"https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625\">\u003cspan style=\"font-weight: 400\">transcranial magnetic stimulation\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, which uses an electromagnetic coil to stimulate nerve cells in the brain that control mood.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_11879420\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11879420\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/Out-of-the-fog.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Out-of-the-fog.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Out-of-the-fog-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Out-of-the-fog-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Out-of-the-fog-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Out-of-the-fog-1536x1152.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Miriam McDonald said she is finally feeling like herself again, a year and a half after her son’s birth. \u003ccite>(Courtesy Miriam McDonald)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>McDonald had to go five days a week for three months. Now, more than a year and a half after having her baby, she is finally feeling like herself again.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I can remember I woke up one day and I was excited. I had actual joy,” she remembers. “I got up and I walked into his room and I was like, ‘Hey, Nico! Hi! Hey, baby!’ And he jumped up from his crib and giggled and put his arms out. And I just swooped him up in my arms and cried. Because I was like, ‘I am so proud to be your mom.’ ”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Now when her son smiles at her, she genuinely smiles back. But she can’t help but grieve all the smiles she didn’t return. How she felt like she was barely there when her son took his first steps.\u003c/span>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I felt like I’ve been robbed really of all those moments,” she said, “of those little milestones, that I’m never going to get back.” \u003c/span>\u003c/p>\n\n",
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"excerpt": "Kaiser's practices around the new drug, brexanolone, may run afoul of a new California law designed to limit unfair denials of mental health treatment.",
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"title": "There's Only 1 Drug for Postpartum Depression. Why Does Kaiser Permanente Make It So Hard to Get? | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">W\u003c/span>\u003c/p>\u003cp>hen Miriam McDonald decided she wanted to have another baby at age 44, her doctor told her she had a better chance of winning the lottery. So when she got pregnant, she and her husband were thrilled. But within three days of giving birth to their son, everything turned.\u003c/p>\n\u003cp>“I was thinking, ‘Oh my God, what did I do?’ I just brought this baby into this world and I can barely take care of myself right now,” she said. “I feel exhausted. I haven’t slept in three days. I haven’t really eaten in three days.”\u003c/p>\n\u003cp>As the weeks went by, her depression got worse. She felt sad, but also indifferent. She didn’t want to hold her baby, she didn’t want to change him. She said she felt no connection with him at all.\u003c/p>\n\u003cp>This confused her – she never felt anything like this after her first two kids – and she worried her mood might hurt her son. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113321/#R2\">Untreated postpartum depression can affect babies’ cognitive and social development\u003c/a>. For the mother, it can be life or death. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113321/\">Suicide accounts for 20% of maternal deaths\u003c/a>.\u003c/p>\n\u003cp>“Every day, I was crying. Every day, I felt like I just wanted to die. Every day, I thought about ending my life,” said McDonald, who is Latina and works at UC Davis as an IT professional.\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\">She went to Kaiser Permanente, her health care provider, for help. She said they put her on a merry-go-round of medication trial and error. The first drug her doctor prescribed made her anxious. The second drug gave her horrific nightmares. A third drug gave her auditory and visual hallucinations that took seven weeks to go away. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Then, her doctor retired. And when McDonald complained to her new doctor that she was still depressed four months after giving birth, the physician suggested more medications.\u003c/span>\u003c/p>\n\u003cp>“I was desperate,” McDonald said. “I was like, ‘I’m trying to help myself, but things are just getting worse.’ So what am I left with?”\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She started doing her own research and learned about a new treatment called brexanolone. It’s \u003ca href=\"https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-post-partum-depression\">the \u003c/a>\u003c/span>\u003cspan style=\"font-weight: 400\">first and only drug\u003c/span>\u003cspan style=\"font-weight: 400\"> approved by the U.S. Food and Drug Administration to treat postpartum depression, which \u003ca href=\"https://www.americashealthrankings.org/explore/health-of-women-and-children/measure/postpartum_depression/state/CA\">affects \u003c/a>\u003c/span>\u003cspan style=\"font-weight: 400\">1 out of 8 new mothers\u003c/span>\u003cspan style=\"font-weight: 400\"> in California. Instead of targeting the serotonin system in the brain, like most antidepressants, brexanolone works by rebalancing the stress hormones that can get out of kilter after having a baby. It’s delivered through an IV infusion over 2 1/2 days in the hospital. \u003c/span>\u003c/p>\n\u003cp>In \u003cspan style=\"font-weight: 400\">clinical trials\u003c/span>\u003cspan style=\"font-weight: 400\">, \u003ca href=\"https://www.fda.gov/media/121348/download\">75% of women who got brexanolone started to feel better\u003c/a> immediately after the three-day treatment. Half the women went into complete remission.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">McDonald wanted to try it. \u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_11879318\" class=\"wp-caption aligncenter\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11879318\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/trying-to-smile-1-scaled.jpg\" alt=\"\" width=\"2560\" height=\"1920\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-1536x1152.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-2048x1536.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/trying-to-smile-1-1920x1440.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">For the first year of her son’s life, Miriam McDonald says all her smiles were fake or strained. \u003ccite>(Courtesy Miriam McDonald)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">“People walk out of the hospital, wanting to be with their child, wanting to return home,” said \u003c/span>\u003ca href=\"https://www.med.unc.edu/psych/directory/riah-patterson/\">\u003cspan style=\"font-weight: 400\">Dr. Riah Patterson\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, who has been treating women with brexanolone at the University of North Carolina at Chapel Hill since it became available in summer 2019. “There is a hopefulness, a brightness. You can really see that transformation in the hospital room over those 60 hours. It’s pretty miraculous.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When McDonald asked her doctor for brexanolone, she said no. \u003c/span>\u003c/p>\n\u003cp>In an email, she said the existing studies were “not very impressive.” She told McDonald that she didn’t meet Kaiser’s criteria for the drug: She would have had to try and fail four medications and electroconvulsive therapy before she could try brexanolone. And all this had to happen within six months of having her baby, or she couldn’t try it at all.\u003c/p>\n\u003cp>How could anyone qualify, McDonald wondered?\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“This is crazy. By the time you even try one drug, that’s like four weeks out,” she said. “Another drug is four weeks out, another drug is four weeks out. There’s just no way.”\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘If Kaiser is making it effectively impossible to get a particular, important mental health treatment, that could definitely be a violation of our parity law.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cspan style=\"font-weight: 400\">Kaiser’s guidance is an outlier. KQED analyzed guidelines from a dozen health plans operating in California. Three of them require women to fail one medication before trying brexanolone. One plan – the state’s Medi-Cal program for low-income women – requires two fails. But Kaiser is the only system KQED found that recommends women first fail four drugs.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“That’s absurd,” said UNC’s Patterson, one of several experts in postpartum depression who, in turn, called Kaiser’s guidance “ridiculous,” “harsh,” “abusive” and “insane.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">It may also be illegal. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Under a \u003c/span>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB855\">\u003cspan style=\"font-weight: 400\">new state law that took effect in January\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> , health plans must conform to “generally accepted standards of care,” including nonprofit guidelines, scientific literature and expert consensus, when making decisions about mental health treatment.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“If Kaiser is making it effectively impossible to get a particular, important mental health treatment, that could definitely be a violation of our parity law,” said state Sen. Scott Wiener, D-San Francisco, the bill’s author. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Kaiser says it always follows the law. It says its integrated structure makes it different from traditional insurers. At Kaiser, a patient’s doctor determines whether a medication is necessary, not the health plan, and the criteria doctors use are recommendations, not requirements or prerequisites that patients need to “exhaust,” said Dr. Maria Koshy, Kaiser’s chair of psychiatry for Northern California. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“At the end of the day, this is an individual clinical decision by both the provider – the physician – and the patient,” she said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But former Kaiser clinicians and legislative experts familiar with Kaiser’s model say the culture around these recommendations is to follow them. Doctors get questioned or can face consequences if they don’t, said Wiener.\u003c/span>\u003c/p>\n\u003ch3>‘It Saved My Life’\u003c/h3>\n\u003cp>\u003cspan style=\"font-weight: 400\">McDonald’s physician followed the criteria as if they were prerequisites when she declined to prescribe brexanolone. Kaiser’s grievance department sent a letter to another woman, Yesenia Muñoz, denying brexanolone because she had not failed enough medications.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“When I talked to the caseworker at Kaiser that had denied the medication, he said that Zulresso was very expensive,” said Muñoz, referring to brexanolone’s brand name.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Brexanolone treatment costs $34,000 for the medication, plus the cost of the three-day hospital stay, which can tack on another $30,000, at least. Kaiser is not yet certified to administer the treatment in-house, so it must pay outside hospitals to provide it. It says it has plans to eventually open three of its own certified centers.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Muñoz was devastated by the denial. She was overwhelmed by postpartum depression and anxiety shortly after her daughter was born and, as a Latina, she said she was hesitant to seek help at first. When she did, none of the medications or therapies Kaiser offered her worked. She still felt suicidal.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I could get out the door sometimes and take the stroller and go walk, and my mind kept on saying, ‘If you just step in front of the car, it’s all going to go away,’ ” she remembers.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Muñoz got help from family and co-workers to appeal Kaiser’s decision to the state, and after reviewing her medical records, regulators ordered Kaiser to pay for the brexanolone treatment.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Muñoz went to UC Davis Medical Center to get it, and she started feeling better within the first day.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_11879428\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11879428\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/MunozAndBaby.jpg\" alt=\"Yesenia smiling holding baby\" width=\"1920\" height=\"1760\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/MunozAndBaby.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/MunozAndBaby-800x733.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/MunozAndBaby-1020x935.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/MunozAndBaby-160x147.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/MunozAndBaby-1536x1408.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">After Yesenia Muñoz received brexanolone to treat her postpartum depression, she felt blessed, connected with her daughter and ‘happy enough to want to live.’ \u003ccite>(Courtesy Yesenia Munoz)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">“The nurse came in and she said something funny and I laughed,” Muñoz said. “It was the first time I had laughed in so long.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She started looking through photos and videos of her daughter on her phone and she says it was like she was experiencing those moments for the first time. She started making plans for the future. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It was like a switch flicked and it made me happy enough to want to live,” she said. “It saved my life.”\u003c/span>\u003c/p>\n\u003ch3>‘There Is No Place Where We Say Kaiser Is Exempt’\u003c/h3>\n\u003cp>\u003cspan style=\"font-weight: 400\">In 2008, Congress passed a landmark federal law aimed at correcting imbalances in how insurers covered mental health treatments compared to physical health, later reinforced by the Affordable Care Act in 2010. \u003c/span>\u003cspan style=\"font-weight: 400\">But \u003c/span>\u003ca href=\"https://www.kqed.org/stateofhealth/series/state-of-mind\">\u003cspan style=\"font-weight: 400\">insurers found loopholes\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, creating overly restrictive or self-serving criteria that made it easy to deny services, and as a result, save money.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">California’s new law, \u003c/span>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB855\">\u003cspan style=\"font-weight: 400\">Senate Bill 855\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, is aimed at tightening those loopholes, and has been \u003c/span>\u003ca href=\"https://www.statnews.com/2020/10/14/new-california-law-should-serve-as-a-national-model-for-mental-health-care-reform/\">\u003cspan style=\"font-weight: 400\">hailed by advocates as a national model\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> for mental health reform. It requires health plans to use clinically based, expert-recognized criteria and guidelines in making medical decisions, with the goal of limiting arbitrary or cost-driven denials. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Kaiser raises questions about how precisely the new law applies to them, given its unique integrated structure, where doctors make determinations about what is medically necessary rather than the health plan side of the organization. Kaiser’s Dr. Koshy said SB 855’s requirement to comply with generally accepted standards of care “does not apply” to its brexanolone recommendations because they were developed and are used by doctors, not plan administrators. (When KQED asked Kaiser to provide the brexanolone policy its health plan uses, it said it didn’t have one.)\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We 100% intended this law to apply to the care people get at Kaiser,” said Julie Snyder, government affairs director at \u003ca href=\"https://steinberginstitute.org/\" target=\"_blank\" rel=\"noopener noreferrer\">the Steinberg Institute\u003c/a>, which co-sponsored the law. “There is no place where we say Kaiser is exempt.” \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\">Doctors at Kaiser have historically been “gatekeepers” for services in the system, said \u003ca href=\"https://psych-appeal.com/meiram-bendat-attorney-founder/\" target=\"_blank\" rel=\"noopener noreferrer\">Meiram Bendat\u003c/a>, an attorney and licensed psychotherapist who also advised on the law. It doesn’t matter if practice recommendations for brexanolone were written by doctors or administrators, or whether the recommendations are mandatory or optional – Bendat says they must be compliant with the law. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“If it’s inconsistent with generally accepted standards of care, then it has no place in California,” he said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Some of Kaiser’s recommended criteria for brexanolone are aligned with generally accepted standards of care; for example, reserving the drug for women who are six months or less postpartum, which was a criterion used in the \u003c/span>\u003ca href=\"https://www.fda.gov/media/121348/download\">\u003cspan style=\"font-weight: 400\">clinical trials the FDA relied on when it approved the drug\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But the recommendation to try four or five alternative treatments before considering brexanolone conflicts with the judgment of half a dozen women’s health experts interviewed for this story. They say there just isn’t enough time in the postpartum period. And there’s too much at stake. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Not only are babies at risk of developmental and emotional problems if their mother is depressed, \u003c/span>\u003ca href=\"https://neurosciencenews.com/paternal-anxiety-18177/#:~:text=Summary%3A%20A%20new%20study%20reports,this%20period%20was%20under%204%25.\">\u003cspan style=\"font-weight: 400\">husbands and partners are also at higher risk for depression and anxiety\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">. And because new moms are learning to breastfeed, and figuring out what’s part of the new normal and what’s not, it can take months just to recognize there’s a problem, said UNC’s Riah Patterson.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It takes so long for this illness to come to recognition and for someone to actually get into an appointment and actually be seen by a provider,” she said.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_11879416\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11879416\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/Riah-Patterson.jpg\" alt=\"\" width=\"1920\" height=\"1436\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Riah-Patterson.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Riah-Patterson-800x598.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Riah-Patterson-1020x763.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Riah-Patterson-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Riah-Patterson-1536x1149.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Riah Patterson discusses patients and treatment plans with her trainee, a third-year psychiatry resident at the Center for Women’s Mood Disorders at UNC-Chapel Hill. \u003ccite>(Courtesy Riah Patterson)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">Indeed, the FDA fast-tracked the approval of brexanolone in part because of how quickly it worked, allowing women to feel better and get back to their families in three days.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It’s new, it’s promising,” said Kaiser’s Koshy, but, she added, “it’s not a benign medication.” \u003c/span>\u003ca href=\"https://www.fda.gov/media/121348/download\">\u003cspan style=\"font-weight: 400\">Six women in the clinical trials experienced loss or near loss of consciousness,\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> which is why the FDA requires women to be continuously monitored in certified health centers when getting the infusion. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Also, the safety and efficacy data is limited, Koshy said. The clinical trials only compared brexanolone to placebo, not to alternative treatments. So while the data show brexanolone works better than nothing, there’s no data on whether it works better than Zoloft or electroconvulsive therapy. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Koshy says Kaiser is always reviewing practice recommendations as new evidence becomes available, but also acknowledged that Kaiser’s recommendations for brexanolone have not been updated since they were first developed two years ago, in July 2019. \u003c/span>\u003c/p>\n\u003cp>It is unclear what role the \u003ca href=\"https://dmhc.ca.gov/\">Department of Managed Health Care\u003c/a>, the state agency that regulates Kaiser, will play in resolving these questions. In a statement, the department said it will review any criteria or guidelines the Kaiser health plan uses for brexanolone, but said it does not have jurisdiction over physician decisions.\u003c/p>\n\u003cp>The DMHC also monitors patient complaints around new medications and treatments in order to identify problems with access to care. So far, \u003ca href=\"https://wpso.dmhc.ca.gov/imr/\">the DMHC has published two complaints about brexanolone in its public database\u003c/a> – both were filed by Kaiser patients.\u003c/p>\n\u003cp>\u003ca href=\"https://www.benefitscafe.com/insurance-companies/kaiserpermanente/\"> \u003cspan style=\"font-weight: 400\">Kaiser is the \u003c/span>\u003cspan style=\"font-weight: 400\">largest insurer in California\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">. It holds a 40% share of the market, covering 6.1 million patients. But at UC Davis, where Kaiser says it sends all patients who need brexanolone in Northern California, Kaiser patients are only 15% of those who got the drug, according to \u003c/span>\u003ca href=\"https://health.ucdavis.edu/team/search/1499/shannon-clark---obstetrics-and-gynecology-sacramento\">\u003cspan style=\"font-weight: 400\">Dr. Shannon Clark\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, a psychiatrist and OB-GYN overseeing the treatments. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She says of the 13 women who’ve been treated at UC Davis in the last two years, only two were from Kaiser. One was Muñoz, who was approved only after the state intervened. The other was Whitney Worthington. Both women canceled their coverage with Kaiser over the postpartum mental health care they received.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘The only thing that changed was that we were able to stir up enough dirt and I was able to pitch a big enough fit … It finally got on somebody’s radar who wasn’t going to ignore it.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cspan style=\"font-weight: 400\">Worthington struggled with depression for most of her adult life, but when she decided to get pregnant, she got help from her psychiatrist and therapist to wean off her antidepressant. It was a grueling withdrawal process. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“That was the worst two months of my life,” she said. “Feeling suicidal at times. It was just miserable.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She knew then that if she got depressed after her baby was born, she did not want to take medication because she wanted to have more children and didn’t want to go through withdrawal again. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When she ended up in the Kaiser ER with suicidal thoughts a few weeks after giving birth, she had to repeatedly decline offers — even threats — of medication. She saw a series of providers at two Kaiser hospitals and several told her she needed brexanolone. One said “it was her only hope.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But Worthington was also told by other Kaiser providers that it wasn’t necessary, that Kaiser didn’t offer it at all, and that cost was an issue. The official denial that came from Kaiser’s billing department offered no reason, said Marcus Worthington, Whitney’s husband. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">He spent weeks on the phone with multiple Kaiser representatives, fighting, negotiating and pleading, until a high-level administrator stepped in and personally approved it. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“The only thing that changed was that we were able to stir up enough dirt and I was able to pitch a big enough fit,” said Marcus, who is Latino and Native American. “I have a relatively Anglo-Saxon name and Whitney is a young white woman. Frankly, I think it all plays in that it finally got on somebody’s radar who wasn’t going to ignore it.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">After getting the treatment at UC Davis, Whitney says she could think clearly again and truly enjoy the last two months of maternity leave she had with her daughter. She called brexanolone “a total miracle.”\u003c/span>\u003c/p>\n\u003ch3>‘This Is How You Treat Postpartum Mental Health?’\u003c/h3>\n\u003cp>\u003cspan style=\"font-weight: 400\">Kaiser said it cannot comment on any individual cases because of privacy laws, but said generally, “We feel deep compassion for any patient experiencing the difficult and serious effects of postpartum depression, and our goal is always to support every patient’s safe return to a healthy mental state.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When Miriam McDonald called Kaiser’s grievance department to complain about her treatment, Kaiser sent the cops to her house for a welfare check.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The officers were calm and nice, McDonald said, but when she closed the door, she cried her eyes out.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\"> \u003c/span>\u003cspan style=\"font-weight: 400\">“It just brought me to a whole new low,” she said. “Why didn’t my doctor call me and talk to me first? I mean, this is how you treat postpartum mental health? How dare\u003c/span> \u003cspan style=\"font-weight: 400\">you.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">McDonald also appealed Kaiser’s denial of brexanolone to state regulators, \u003ca href=\"https://www.2020mom.org/\" target=\"_blank\" rel=\"noopener noreferrer\">with help from advocates at 2020 Mom\u003c/a>, but by the time she got there, the clock had already run out. She was past the six-month postpartum cutoff. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She never got brexanolone.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Still, she continued to fight for relief and eventually got Kaiser to cover a different treatment called \u003c/span>\u003ca href=\"https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625\">\u003cspan style=\"font-weight: 400\">transcranial magnetic stimulation\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, which uses an electromagnetic coil to stimulate nerve cells in the brain that control mood.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_11879420\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11879420\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/Out-of-the-fog.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Out-of-the-fog.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Out-of-the-fog-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Out-of-the-fog-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Out-of-the-fog-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Out-of-the-fog-1536x1152.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Miriam McDonald said she is finally feeling like herself again, a year and a half after her son’s birth. \u003ccite>(Courtesy Miriam McDonald)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>McDonald had to go five days a week for three months. Now, more than a year and a half after having her baby, she is finally feeling like herself again.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I can remember I woke up one day and I was excited. I had actual joy,” she remembers. “I got up and I walked into his room and I was like, ‘Hey, Nico! Hi! Hey, baby!’ And he jumped up from his crib and giggled and put his arms out. And I just swooped him up in my arms and cried. Because I was like, ‘I am so proud to be your mom.’ ”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Now when her son smiles at her, she genuinely smiles back. But she can’t help but grieve all the smiles she didn’t return. How she felt like she was barely there when her son took his first steps.\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\">“I felt like I’ve been robbed really of all those moments,” she said, “of those little milestones, that I’m never going to get back.” \u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "some-disabled-californians-feel-abandoned-by-newsoms-golden-state-stimulus",
"title": "Some Disabled Californians Feel Abandoned by Newsom’s Golden State Stimulus",
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"headTitle": "Some Disabled Californians Feel Abandoned by Newsom’s Golden State Stimulus | KQED",
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"content": "\u003cp>\u003cem>Lea este artículo en \u003ca href=\"https://calmatters.org/calmatters-en-espanol/2021/06/algunos-californianos-discapacitados-se-sienten-abandonados-por-el-estimulo-golden-state-de-newsom/\" target=\"_blank\" rel=\"noopener noreferrer\">español\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>A $600 check would go a long way for Janet Clendenin.\u003c/p>\n\u003cp>The costs of the sugar-free foods she buys to manage her diabetes have risen sharply in South Lake Tahoe during the pandemic, Clendenin said. She usually has to crisscross the picturesque region by bus to find discounts at Dollar Tree, Grocery Outlet and Walmart.\u003c/p>\n\u003cp>So when she learned about Gov. Gavin Newsom’s plan to send $600 payments to the lowest-income Californians in February, Clendenin felt relief.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Charis Hill, disability activist\"]‘It’s really hard to see and read coverage of Newsom touting how great this is for middle-class people.’[/pullquote]Then came frustration.\u003c/p>\n\u003cp>Clendenin scoured the news for \u003ca href=\"https://calmatters.org/california-divide/2021/02/california-golden-state-stimulus-600-check/\" target=\"_blank\" rel=\"noopener noreferrer\">details on eligibility\u003c/a>. She learned that she could have qualified if she worked in 2020. But a constellation of diabetes, arthritis, migraines, back injuries and nerve pain made work impossible about six years ago. Given her disabilities, she could also have qualified if only she received Supplemental Security Income, a federal safety-net program for elderly, blind and disabled people with limited income.\u003c/p>\n\u003cp>But nowhere could Clendenin find mention of Social Security Disability Insurance, the other main federal program for people with disabilities, which sends her $1,056 a month.\u003c/p>\n\u003cp>“I couldn’t believe that we were left out,” said Clendenin. “How unfair is that?”\u003c/p>\n\u003cp>It’s a sentiment shared by many Californians on federal disability insurance, who have asked why Newsom’s stimulus payments skipped them over.\u003c/p>\n\u003cp>While California lawmakers automatically sent checks to 1.2 million people who receive SSI, the 1.2 million Californians on SSDI only qualify if they had income from work in 2020. But that’s rare — \u003ca href=\"https://www.cbpp.org/research/social-security/paul-n-van-de-water-promoting-opportunity-for-social-security-disability\" target=\"_blank\" rel=\"noopener noreferrer\">research shows\u003c/a> that \u003ca href=\"https://www.ssa.gov/disabilityresearch/documents/TTW5_Brief_2_DIcohort_REV2.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">fewer than 1 in 5 SSDI recipients work during a typical year\u003c/a>, often because they are limited by their disabilities or risk losing their benefits if they work too much.\u003c/p>\n\u003cp>[aside postID=\"news_11860924\" hero=\"https://ww2.kqed.org/app/uploads/sites/10/2021/02/RS47239_001_SanFrancisco_HenryZhang_02162021-qut-1020x680.jpg\"]Disability advocates say it’s the latest example of the state abandoning some of its most vulnerable residents during the pandemic, after having directed medical health providers to \u003ca href=\"https://www.sacbee.com/article243474286.html\" target=\"_blank\" rel=\"noopener noreferrer\">ration COVID-19 care to elderly and less-healthy people\u003c/a> last spring and \u003ca href=\"https://calmatters.org/health/coronavirus/2021/02/covid-advisory-group-rejects-higher-vaccine-priority-for-disabled-californians-and-those-with-chronic-conditions/\" target=\"_blank\" rel=\"noopener noreferrer\">deprioritize people with disabilities for vaccines\u003c/a> earlier this year — both policies that were \u003ca href=\"https://calmatters.org/health/coronavirus/2021/02/california-shifts-priorities-vaccine-chronic-conditions/\" target=\"_blank\" rel=\"noopener noreferrer\">reversed after considerable outcry\u003c/a>.\u003c/p>\n\u003cp>“Overall the state has been uneven in how it’s helped people with disabilities navigate the pandemic,” said Andrew Imparato, executive director of Disability Rights California. “A lot of people with disabilities have had to fend for themselves.”\u003c/p>\n\u003cp>Department of Finance spokesperson H.D. Palmer cites logistical challenges. California maintains an up-to-date list of residents who get SSI \u003ca href=\"https://www.cdss.ca.gov/inforesources/ssi-ssp\" target=\"_blank\" rel=\"noopener noreferrer\">because the state supplements the federal benefit by a few hundred dollars\u003c/a>, but doesn’t have access to the same information for SSDI.\u003c/p>\n\u003cp>“Trying to include SSDI … would be a time-consuming and laborious process with the feds that doesn’t line up with the intent of (the Golden State Stimulus) — to get immediate relief to Californians with whom we have an existing relationship,” Palmer wrote in an email.\u003c/p>\n\u003ch3>‘Make Hard Decisions Quickly’\u003c/h3>\n\u003cp>The Newsom administration may have also based the decision on a consideration of need.\u003c/p>\n\u003cp>California’s \u003ca href=\"https://calbudgetcenter.org/wp-content/uploads/2020/02/CA-Budget-Center-SSI-SSP-IB_Chart-4.-SSP-Individual-Grant-Up-to-FPL-Bar-Chart.png\" target=\"_blank\" rel=\"noopener noreferrer\">SSI recipients live in poverty by definition\u003c/a>. Elderly, blind and disabled people can only qualify if they have extremely low income and wealth, and they typically receive just $954.72 per month.\u003c/p>\n\u003cp>On the other hand, people with sufficient work history can qualify for monthly SSDI payments based on their former wages, with the \u003ca href=\"https://www.ssa.gov/OACT/ProgData/icp.html\" target=\"_blank\" rel=\"noopener noreferrer\">average national benefit at $1,280\u003c/a> per month.\u003c/p>\n\u003cp>Still, California’s SSDI recipients often face steep financial challenges. They are more than twice as likely to live in poverty compared to the rest of the population, according to calculations by Andrew Houtenville, an economist at the Institute on Disability at the University of New Hampshire. And people with disabilities often have to cover expensive medical equipment, appointments with specialists and drugs out-of-pocket.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Imparato acknowledged that the state was “trying to make hard decisions quickly” but “including everyone on SSDI probably would have been a more equitable thing to do than excluding them because you don’t have access to their program or because it’s not a means-tested program.”\u003c/p>\n\u003cp>There are some signs that lawmakers could still include SSDI recipients. Newsom’s proposed expansion of the Golden State Stimulus still requires approval from state legislators. Though they passed a placeholder budget to meet a June 15 deadline, state lawmakers continue to disagree with Newsom over how much surplus money the state has at its disposal and how to spend it.\u003c/p>\n\u003cp>According to a legislative staffer familiar with ongoing budget negotiations, some members of the Legislature are pushing the Newsom administration to expand eligibility for the Golden State Stimulus payments to Californians on SSDI, among other groups.\u003c/p>\n\u003ch3>The Evolution of the Golden State Stimulus\u003c/h3>\n\u003cp>Eligibility for Newsom’s Golden State Stimulus has gone through several twists and turns. In January, \u003ca href=\"https://calmatters.org/california-divide/2021/01/newsom-wants-extra-600-stimulus-for-low-wage-californians/\" target=\"_blank\" rel=\"noopener noreferrer\">Newsom announced a $2.4 billion plan to send $600 Golden State Stimulus checks\u003c/a> to approximately 4 million low-income workers.\u003c/p>\n\u003cp>[aside postID=news_11874637 hero='https://ww2.kqed.org/app/uploads/sites/10/2021/05/RS49132_013_SanFrancisco_MEDADairoRomero_05192021-qut-1020x680.jpg']By February, with the \u003ca href=\"https://twitter.com/GavinNewsom/status/1357089574288117760?s=20\" target=\"_blank\" rel=\"noopener noreferrer\">state’s revenue estimates swelling\u003c/a>, the Legislature negotiated and approved an even more generous \u003ca href=\"https://calmatters.org/california-divide/2021/02/california-600-stimulus-checks-undocumented-workers/\" target=\"_blank\" rel=\"noopener noreferrer\">$3.8 billion stimulus payment plan that included extra aid for undocumented workers\u003c/a>.\u003c/p>\n\u003cp>Under this plan, the state also sent $600 payments to certain Californians living in poverty — regardless of whether they work. That included very low-income families with children enrolled in CalWORKs, as well as recipients of SSI or the state’s alternative for some immigrant groups, known as the \u003ca href=\"https://www.cdss.ca.gov/inforesources/cash-assistance-for-immigrants\" target=\"_blank\" rel=\"noopener noreferrer\">Cash Assistance Program for Immigrants\u003c/a>.\u003c/p>\n\u003cp>It took Charis Hill several days of searching online and contacting their state assemblymember to discover that they did not automatically qualify. A Sacramento-based disability activist who lives on $1,027 per month from SSDI, Hill eventually deduced that they could qualify not because they were disabled, but rather because they had done freelance writing and speaking last year.\u003c/p>\n\u003cp>Hill would have to file taxes, something they hadn’t done in years because their earned income is far below the filing requirement. They decided it was worth it. Their expenses have jumped during the pandemic, especially as they’ve opted for grocery deliveries instead of shopping in stores because they are immunocompromised.\u003c/p>\n\u003cp>Hill said that, unlike many disabled people, they were fortunate to have internet access and a friend who could help them file their taxes. They were lucky to be able to work last year despite experiencing constant pain and fatigue from an inflammatory condition called axial spondyloarthritis. But, they said, it’s wrong that the Golden State Stimulus program is “basing a disabled person’s value on their ability to work.”\u003c/p>\n\u003cfigure id=\"attachment_11879468\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11879468\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/20210620_CalMatters_CharisHill_0075_A-scaled-1-800x533.jpeg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/20210620_CalMatters_CharisHill_0075_A-scaled-1-800x533.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/20210620_CalMatters_CharisHill_0075_A-scaled-1-1020x680.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/20210620_CalMatters_CharisHill_0075_A-scaled-1-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/20210620_CalMatters_CharisHill_0075_A-scaled-1-1536x1024.jpeg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/20210620_CalMatters_CharisHill_0075_A-scaled-1.jpeg 1568w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Charis Hill, a disability activist based in Sacramento, was able to get the Golden State Stimulus because they did some freelance work in 2020. But Hill says that it’s unfair that most Californians receiving federal disability insurance don’t currently qualify. \u003ccite>(Salgu Wissmath/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>When Newsom proposed a \u003ca href=\"https://calmatters.org/california-divide/2021/05/newsom-proposes-expanding-golden-state-stimulus-to-middle-class/\" target=\"_blank\" rel=\"noopener noreferrer\">second round of Golden State stimulus payments aimed at California’s middle class\u003c/a> in May, Hill was hopeful that other SSDI recipients would finally be able to benefit, too. However, as the details of Newsom’s plan emerged, there was still no mention of SSDI recipients.\u003c/p>\n\u003cp>“It’s really hard to see and read coverage of Newsom touting how great this is for middle-class people,” said Hill, when people with disabilities are “some of the most impoverished people in the whole country.”\u003c/p>\n\u003ch3>Financial Burden Can Fall to Caretakers\u003c/h3>\n\u003cp>Sydney Chandler manages the finances and health care of her cousin, Chris Batiste, who is paralyzed. Batiste breathes through an apparatus and communicates with Chandler through a laptop, blinks and head movements.\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"disability-rights\"]Chandler, who is a Los Angeles-based writer, said she was livid to learn that SSDI recipients were left out of the state stimulus. To her, it was just another obstacle in the arbitrary and bureaucratic maze that people with disabilities face in trying to attain a liveable income.\u003c/p>\n\u003cp>Caretakers often carry a significant financial burden. Batiste receives $975 per month in SSDI, and Chandler said she contributes over $1,000 more each month to help cover his rent and full-time nursing.\u003c/p>\n\u003cp>“If it wasn’t for me, he would be one of the homeless,” Chandler said, “and you’re telling me that you couldn’t set up a portal for SSDI (recipients) to input their information?”\u003c/p>\n\u003cp>\u003cem>This article is part of the California Divide, a collaboration among newsrooms examining income inequality and economic survival in California.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"title": "Some Disabled Californians Feel Abandoned by Newsom’s Golden State Stimulus | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Lea este artículo en \u003ca href=\"https://calmatters.org/calmatters-en-espanol/2021/06/algunos-californianos-discapacitados-se-sienten-abandonados-por-el-estimulo-golden-state-de-newsom/\" target=\"_blank\" rel=\"noopener noreferrer\">español\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>A $600 check would go a long way for Janet Clendenin.\u003c/p>\n\u003cp>The costs of the sugar-free foods she buys to manage her diabetes have risen sharply in South Lake Tahoe during the pandemic, Clendenin said. She usually has to crisscross the picturesque region by bus to find discounts at Dollar Tree, Grocery Outlet and Walmart.\u003c/p>\n\u003cp>So when she learned about Gov. Gavin Newsom’s plan to send $600 payments to the lowest-income Californians in February, Clendenin felt relief.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Then came frustration.\u003c/p>\n\u003cp>Clendenin scoured the news for \u003ca href=\"https://calmatters.org/california-divide/2021/02/california-golden-state-stimulus-600-check/\" target=\"_blank\" rel=\"noopener noreferrer\">details on eligibility\u003c/a>. She learned that she could have qualified if she worked in 2020. But a constellation of diabetes, arthritis, migraines, back injuries and nerve pain made work impossible about six years ago. Given her disabilities, she could also have qualified if only she received Supplemental Security Income, a federal safety-net program for elderly, blind and disabled people with limited income.\u003c/p>\n\u003cp>But nowhere could Clendenin find mention of Social Security Disability Insurance, the other main federal program for people with disabilities, which sends her $1,056 a month.\u003c/p>\n\u003cp>“I couldn’t believe that we were left out,” said Clendenin. “How unfair is that?”\u003c/p>\n\u003cp>It’s a sentiment shared by many Californians on federal disability insurance, who have asked why Newsom’s stimulus payments skipped them over.\u003c/p>\n\u003cp>While California lawmakers automatically sent checks to 1.2 million people who receive SSI, the 1.2 million Californians on SSDI only qualify if they had income from work in 2020. But that’s rare — \u003ca href=\"https://www.cbpp.org/research/social-security/paul-n-van-de-water-promoting-opportunity-for-social-security-disability\" target=\"_blank\" rel=\"noopener noreferrer\">research shows\u003c/a> that \u003ca href=\"https://www.ssa.gov/disabilityresearch/documents/TTW5_Brief_2_DIcohort_REV2.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">fewer than 1 in 5 SSDI recipients work during a typical year\u003c/a>, often because they are limited by their disabilities or risk losing their benefits if they work too much.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Disability advocates say it’s the latest example of the state abandoning some of its most vulnerable residents during the pandemic, after having directed medical health providers to \u003ca href=\"https://www.sacbee.com/article243474286.html\" target=\"_blank\" rel=\"noopener noreferrer\">ration COVID-19 care to elderly and less-healthy people\u003c/a> last spring and \u003ca href=\"https://calmatters.org/health/coronavirus/2021/02/covid-advisory-group-rejects-higher-vaccine-priority-for-disabled-californians-and-those-with-chronic-conditions/\" target=\"_blank\" rel=\"noopener noreferrer\">deprioritize people with disabilities for vaccines\u003c/a> earlier this year — both policies that were \u003ca href=\"https://calmatters.org/health/coronavirus/2021/02/california-shifts-priorities-vaccine-chronic-conditions/\" target=\"_blank\" rel=\"noopener noreferrer\">reversed after considerable outcry\u003c/a>.\u003c/p>\n\u003cp>“Overall the state has been uneven in how it’s helped people with disabilities navigate the pandemic,” said Andrew Imparato, executive director of Disability Rights California. “A lot of people with disabilities have had to fend for themselves.”\u003c/p>\n\u003cp>Department of Finance spokesperson H.D. Palmer cites logistical challenges. California maintains an up-to-date list of residents who get SSI \u003ca href=\"https://www.cdss.ca.gov/inforesources/ssi-ssp\" target=\"_blank\" rel=\"noopener noreferrer\">because the state supplements the federal benefit by a few hundred dollars\u003c/a>, but doesn’t have access to the same information for SSDI.\u003c/p>\n\u003cp>“Trying to include SSDI … would be a time-consuming and laborious process with the feds that doesn’t line up with the intent of (the Golden State Stimulus) — to get immediate relief to Californians with whom we have an existing relationship,” Palmer wrote in an email.\u003c/p>\n\u003ch3>‘Make Hard Decisions Quickly’\u003c/h3>\n\u003cp>The Newsom administration may have also based the decision on a consideration of need.\u003c/p>\n\u003cp>California’s \u003ca href=\"https://calbudgetcenter.org/wp-content/uploads/2020/02/CA-Budget-Center-SSI-SSP-IB_Chart-4.-SSP-Individual-Grant-Up-to-FPL-Bar-Chart.png\" target=\"_blank\" rel=\"noopener noreferrer\">SSI recipients live in poverty by definition\u003c/a>. Elderly, blind and disabled people can only qualify if they have extremely low income and wealth, and they typically receive just $954.72 per month.\u003c/p>\n\u003cp>On the other hand, people with sufficient work history can qualify for monthly SSDI payments based on their former wages, with the \u003ca href=\"https://www.ssa.gov/OACT/ProgData/icp.html\" target=\"_blank\" rel=\"noopener noreferrer\">average national benefit at $1,280\u003c/a> per month.\u003c/p>\n\u003cp>Still, California’s SSDI recipients often face steep financial challenges. They are more than twice as likely to live in poverty compared to the rest of the population, according to calculations by Andrew Houtenville, an economist at the Institute on Disability at the University of New Hampshire. And people with disabilities often have to cover expensive medical equipment, appointments with specialists and drugs out-of-pocket.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Imparato acknowledged that the state was “trying to make hard decisions quickly” but “including everyone on SSDI probably would have been a more equitable thing to do than excluding them because you don’t have access to their program or because it’s not a means-tested program.”\u003c/p>\n\u003cp>There are some signs that lawmakers could still include SSDI recipients. Newsom’s proposed expansion of the Golden State Stimulus still requires approval from state legislators. Though they passed a placeholder budget to meet a June 15 deadline, state lawmakers continue to disagree with Newsom over how much surplus money the state has at its disposal and how to spend it.\u003c/p>\n\u003cp>According to a legislative staffer familiar with ongoing budget negotiations, some members of the Legislature are pushing the Newsom administration to expand eligibility for the Golden State Stimulus payments to Californians on SSDI, among other groups.\u003c/p>\n\u003ch3>The Evolution of the Golden State Stimulus\u003c/h3>\n\u003cp>Eligibility for Newsom’s Golden State Stimulus has gone through several twists and turns. In January, \u003ca href=\"https://calmatters.org/california-divide/2021/01/newsom-wants-extra-600-stimulus-for-low-wage-californians/\" target=\"_blank\" rel=\"noopener noreferrer\">Newsom announced a $2.4 billion plan to send $600 Golden State Stimulus checks\u003c/a> to approximately 4 million low-income workers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>By February, with the \u003ca href=\"https://twitter.com/GavinNewsom/status/1357089574288117760?s=20\" target=\"_blank\" rel=\"noopener noreferrer\">state’s revenue estimates swelling\u003c/a>, the Legislature negotiated and approved an even more generous \u003ca href=\"https://calmatters.org/california-divide/2021/02/california-600-stimulus-checks-undocumented-workers/\" target=\"_blank\" rel=\"noopener noreferrer\">$3.8 billion stimulus payment plan that included extra aid for undocumented workers\u003c/a>.\u003c/p>\n\u003cp>Under this plan, the state also sent $600 payments to certain Californians living in poverty — regardless of whether they work. That included very low-income families with children enrolled in CalWORKs, as well as recipients of SSI or the state’s alternative for some immigrant groups, known as the \u003ca href=\"https://www.cdss.ca.gov/inforesources/cash-assistance-for-immigrants\" target=\"_blank\" rel=\"noopener noreferrer\">Cash Assistance Program for Immigrants\u003c/a>.\u003c/p>\n\u003cp>It took Charis Hill several days of searching online and contacting their state assemblymember to discover that they did not automatically qualify. A Sacramento-based disability activist who lives on $1,027 per month from SSDI, Hill eventually deduced that they could qualify not because they were disabled, but rather because they had done freelance writing and speaking last year.\u003c/p>\n\u003cp>Hill would have to file taxes, something they hadn’t done in years because their earned income is far below the filing requirement. They decided it was worth it. Their expenses have jumped during the pandemic, especially as they’ve opted for grocery deliveries instead of shopping in stores because they are immunocompromised.\u003c/p>\n\u003cp>Hill said that, unlike many disabled people, they were fortunate to have internet access and a friend who could help them file their taxes. They were lucky to be able to work last year despite experiencing constant pain and fatigue from an inflammatory condition called axial spondyloarthritis. But, they said, it’s wrong that the Golden State Stimulus program is “basing a disabled person’s value on their ability to work.”\u003c/p>\n\u003cfigure id=\"attachment_11879468\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11879468\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/20210620_CalMatters_CharisHill_0075_A-scaled-1-800x533.jpeg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/20210620_CalMatters_CharisHill_0075_A-scaled-1-800x533.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/20210620_CalMatters_CharisHill_0075_A-scaled-1-1020x680.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/20210620_CalMatters_CharisHill_0075_A-scaled-1-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/20210620_CalMatters_CharisHill_0075_A-scaled-1-1536x1024.jpeg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/20210620_CalMatters_CharisHill_0075_A-scaled-1.jpeg 1568w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Charis Hill, a disability activist based in Sacramento, was able to get the Golden State Stimulus because they did some freelance work in 2020. But Hill says that it’s unfair that most Californians receiving federal disability insurance don’t currently qualify. \u003ccite>(Salgu Wissmath/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>When Newsom proposed a \u003ca href=\"https://calmatters.org/california-divide/2021/05/newsom-proposes-expanding-golden-state-stimulus-to-middle-class/\" target=\"_blank\" rel=\"noopener noreferrer\">second round of Golden State stimulus payments aimed at California’s middle class\u003c/a> in May, Hill was hopeful that other SSDI recipients would finally be able to benefit, too. However, as the details of Newsom’s plan emerged, there was still no mention of SSDI recipients.\u003c/p>\n\u003cp>“It’s really hard to see and read coverage of Newsom touting how great this is for middle-class people,” said Hill, when people with disabilities are “some of the most impoverished people in the whole country.”\u003c/p>\n\u003ch3>Financial Burden Can Fall to Caretakers\u003c/h3>\n\u003cp>Sydney Chandler manages the finances and health care of her cousin, Chris Batiste, who is paralyzed. Batiste breathes through an apparatus and communicates with Chandler through a laptop, blinks and head movements.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Chandler, who is a Los Angeles-based writer, said she was livid to learn that SSDI recipients were left out of the state stimulus. To her, it was just another obstacle in the arbitrary and bureaucratic maze that people with disabilities face in trying to attain a liveable income.\u003c/p>\n\u003cp>Caretakers often carry a significant financial burden. Batiste receives $975 per month in SSDI, and Chandler said she contributes over $1,000 more each month to help cover his rent and full-time nursing.\u003c/p>\n\u003cp>“If it wasn’t for me, he would be one of the homeless,” Chandler said, “and you’re telling me that you couldn’t set up a portal for SSDI (recipients) to input their information?”\u003c/p>\n\u003cp>\u003cem>This article is part of the California Divide, a collaboration among newsrooms examining income inequality and economic survival in California.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Laura, 76, has not seen a doctor for years.\u003c/p>\n\u003cp>The former farmworker, who did not want her last name used because of her immigration status, said she is losing her eyesight and her feet are often swollen and in pain.\u003c/p>\n\u003cp>A grandmother, Laura also suffers from headaches and shortness of breath, months after she became seriously ill with COVID-19 during the winter surge. Through it all, she has relied on home remedies and not sought medical care because she lacks health insurance, she said, in Spanish.\u003c/p>\n\u003cp>“I don’t have any money. And at my age, there’s no work,” said Laura, who picked watermelon, zucchini, pumpkin and other crops for more than 20 years in fields in Southern California.\u003c/p>\n\u003cp>But Laura may soon get access to the medical services she desperately needs, at little or no cost.\u003c/p>\n\u003cp>California is on the verge of a historic step to offer public health insurance to low-income undocumented older adults — a population that has been particularly vulnerable during the COVID-19 pandemic but left out of federal assistance programs and other safety nets.\u003c/p>\n\u003cp>Gov. Gavin Newsom and legislative leaders are expected to announce an expansion to the Medi-Cal program in the coming days as part of a final deal on the state budget, according to advocates and legislative aides.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The most recent negotiations in Sacramento have centered on the lower age limit for those who will be newly eligible: 50 and older, as lawmakers have previously proposed; 60 and older, as Newsom offered; or somewhere in between.\u003c/p>\n\u003cp>“We are as certain as we can be that there will be something that comes into the final budget,” said Sarah Dar, who directs health and public benefits policy at the California Immigrant Policy Center. “And it’s really just a matter of ‘What’s the age they land on?‘”\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Luz Gallegos, director of TODEC, a legal center and immigrant justice organization\"]‘California continues to step up and defend all Californians, especially those who are most vulnerable, who don’t have any access to safety nets, but who contribute to our state economy, have been paying taxes… and have seen nothing in return.’[/pullquote]\u003c/p>\n\u003cp>In 2014, then-state Sen. Ricardo Lara introduced the first (unsuccessful) \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billAnalysisClient.xhtml?bill_id=201320140SB1005\">bill\u003c/a> to make undocumented immigrants eligible for public health coverage.\u003c/p>\n\u003cp>Since then, California has enrolled undocumented children in full-scope Medi-Cal, offering free or low-cost preventative care, doctor visits, prescriptions, dental care, vision care and other services. Last year, the state became the first in the nation to offer health coverage to undocumented young adults through age 25.\u003c/p>\n\u003cp>But more than 1.3 million undocumented Californians are projected to lack health insurance next year, remaining the largest uninsured group in the state, according to a \u003ca href=\"https://laborcenter.berkeley.edu/undocumented-californians-projected-to-remain-the-largest-group-of-uninsured-in-the-state-in-2022/\">report\u003c/a> by the UC Berkeley Labor Center.\u003c/p>\n\u003cp>Estimates vary, but depending on the final age cutoff that Newsom and legislative leaders decide for this year’s budget, roughly 80,000 to more than 200,000 undocumented Californians could gain access to Medi-Cal, including many who have worked essential jobs that are key to the state’s economy.\u003c/p>\n\u003cp>Immigrant and health advocates who have pushed California for years to extend health coverage to undocumented immigrants savored the realization that finally, older adults will most likely be eligible for coverage.\u003c/p>\n\u003cp>“At last, justice does prevail. We are in a historic moment as Californians,” said Luz Gallegos, the executive director of TODEC, a legal center and immigrant justice organization in the Inland Empire and Coachella Valley.\u003c/p>\n\u003cp>“California continues to step up and defend all Californians, especially those who are most vulnerable, who don’t have any access to safety nets, but who contribute to our state economy, have been paying taxes … and have seen nothing in return,” she added.\u003c/p>\n\u003cfigure id=\"attachment_11879325\" class=\"wp-caption aligncenter\" style=\"max-width: 1242px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11879325\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/Gallegos.jpg\" alt=\"\" width=\"1242\" height=\"806\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Gallegos.jpg 1242w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Gallegos-800x519.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Gallegos-1020x662.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Gallegos-160x104.jpg 160w\" sizes=\"auto, (max-width: 1242px) 100vw, 1242px\">\u003cfigcaption class=\"wp-caption-text\">Luz Gallegos works on COVID-19 vaccine outreach for farmworkers in Thermal, Calif. this spring. \u003ccite>(Courtesy TODEC)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The governor’s budget \u003ca href=\"http://www.ebudget.ca.gov/2021-22/pdf/Revised/BudgetSummary/HealthandHumanServices.pdf\">revision\u003c/a> from May includes nearly $860 million in annual state funds to expand Medi-Cal to low-income undocumented adults age 60 and older, with some of that funding available next year. The Legislature’s \u003ca href=\"https://abgt.assembly.ca.gov/sites/abgt.assembly.ca.gov/files/Floor%20Report%20of%20the%202021-22%20Budget%20-%20%28June%2011%2C%202021%20Version%29.pdf\">proposal\u003c/a> dedicates $1.3 billion in annual funds to cover undocumented adults age 50 and older once the program is fully established.\u003c/p>\n\u003cp>[aside label='Related Coverage' tag='undocumented-immigrants']Gallegos, who was born in the U.S. to farmworker immigrant parents, said this likely win is personal for her. In recent years, her undocumented uncle died from cancer, she said, after he delayed seeking medical care because he was uninsured. During the pandemic, farmworkers she knows died from COVID-19 while several others became ill with the virus.\u003c/p>\n\u003cp>“We honor their lives by continuing the struggle so we don’t see no more lives taken away from our communities,” said Gallegos, her voice breaking.\u003c/p>\n\u003cp>Currently, low-income undocumented immigrants who are 26 and older are eligible for limited Medi-Cal, which only covers health care emergencies or prenatal care if they are pregnant. Undocumented immigrants are excluded from the Affordable Care Act, and cannot purchase coverage through Covered California, the state’s ACA health exchange.\u003c/p>\n\u003cp>If they are not insured by an employer or able to purchase a private plan, they must generally rely on county health programs, which vary greatly throughout the state.\u003c/p>\n\u003cp>Last year, Gov. Newsom \u003ca href=\"https://www.kqed.org/news/11814885/as-pandemic-batters-californias-economy-plan-to-insure-undocumented-seniors-in-doubt\">proposed\u003c/a> offering full-scope Medi-Cal to undocumented seniors age 65 and older. But the plan didn’t go through, as the state projected a severe economic downturn and tax losses in the billions of dollars.\u003c/p>\n\u003cp>But the financial picture for California is starkly different this year, with the state logging an eye-popping budget surplus of \u003ca href=\"https://www.kqed.org/news/11874125/californias-historic-budget-surplus-is-it-76-billion-or-38-billion\">$76 billion\u003c/a>. In addition, the pandemic highlighted how “interconnected” public health really is, with all of us having to think about whether people around us wore masks, stood far enough apart, or were vaccinated, said Dar, with the California Immigrant Policy Center.\u003c/p>\n\u003cp>“And so to give health care access to this community would mean a healthier and stronger state for all Californians,” said Dar. “Increased productivity, better health outcomes, better public health.”\u003c/p>\n\u003cp>Some opponents have argued that funds to provide health coverage to undocumented people would be better spent on other needs, such as helping struggling U.S. citizens afford their own health insurance.\u003c/p>\n\u003cp>About two in three Californians support the idea of providing health coverage to undocumented immigrants, according to a \u003ca href=\"https://www.ppic.org/wp-content/uploads/ppic-statewide-survey-californians-and-their-government-march-2021.pdf\">recent survey\u003c/a> by the Public Policy Institute of California. But many Republicans oppose it, with nearly eight in 10 saying that they are not in favor.\u003c/p>\n\u003cp>This year, Illinois became the \u003ca href=\"https://www.povertylaw.org/article/health-coverage-available-to-undocumented-seniors-in-illinois/#:~:text=Fortunately%2C%20Illinois%20has%20become%20the,citizens%20age%2065%20or%20older.\">first state\u003c/a> to extend health insurance to undocumented seniors age 65 and older.\u003c/p>\n\u003cp>Former farmworker Laura hopes she will gain access to health coverage — and low-cost medical care — in California, where she has lived since the late 1980s, most recently in Riverside county.\u003c/p>\n\u003cp>“It would help me a lot to go to the doctor and get my eyes checked out,” Laura said. “It would be the best.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Laura, 76, has not seen a doctor for years.\u003c/p>\n\u003cp>The former farmworker, who did not want her last name used because of her immigration status, said she is losing her eyesight and her feet are often swollen and in pain.\u003c/p>\n\u003cp>A grandmother, Laura also suffers from headaches and shortness of breath, months after she became seriously ill with COVID-19 during the winter surge. Through it all, she has relied on home remedies and not sought medical care because she lacks health insurance, she said, in Spanish.\u003c/p>\n\u003cp>“I don’t have any money. And at my age, there’s no work,” said Laura, who picked watermelon, zucchini, pumpkin and other crops for more than 20 years in fields in Southern California.\u003c/p>\n\u003cp>But Laura may soon get access to the medical services she desperately needs, at little or no cost.\u003c/p>\n\u003cp>California is on the verge of a historic step to offer public health insurance to low-income undocumented older adults — a population that has been particularly vulnerable during the COVID-19 pandemic but left out of federal assistance programs and other safety nets.\u003c/p>\n\u003cp>Gov. Gavin Newsom and legislative leaders are expected to announce an expansion to the Medi-Cal program in the coming days as part of a final deal on the state budget, according to advocates and legislative aides.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The most recent negotiations in Sacramento have centered on the lower age limit for those who will be newly eligible: 50 and older, as lawmakers have previously proposed; 60 and older, as Newsom offered; or somewhere in between.\u003c/p>\n\u003cp>“We are as certain as we can be that there will be something that comes into the final budget,” said Sarah Dar, who directs health and public benefits policy at the California Immigrant Policy Center. “And it’s really just a matter of ‘What’s the age they land on?‘”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In 2014, then-state Sen. Ricardo Lara introduced the first (unsuccessful) \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billAnalysisClient.xhtml?bill_id=201320140SB1005\">bill\u003c/a> to make undocumented immigrants eligible for public health coverage.\u003c/p>\n\u003cp>Since then, California has enrolled undocumented children in full-scope Medi-Cal, offering free or low-cost preventative care, doctor visits, prescriptions, dental care, vision care and other services. Last year, the state became the first in the nation to offer health coverage to undocumented young adults through age 25.\u003c/p>\n\u003cp>But more than 1.3 million undocumented Californians are projected to lack health insurance next year, remaining the largest uninsured group in the state, according to a \u003ca href=\"https://laborcenter.berkeley.edu/undocumented-californians-projected-to-remain-the-largest-group-of-uninsured-in-the-state-in-2022/\">report\u003c/a> by the UC Berkeley Labor Center.\u003c/p>\n\u003cp>Estimates vary, but depending on the final age cutoff that Newsom and legislative leaders decide for this year’s budget, roughly 80,000 to more than 200,000 undocumented Californians could gain access to Medi-Cal, including many who have worked essential jobs that are key to the state’s economy.\u003c/p>\n\u003cp>Immigrant and health advocates who have pushed California for years to extend health coverage to undocumented immigrants savored the realization that finally, older adults will most likely be eligible for coverage.\u003c/p>\n\u003cp>“At last, justice does prevail. We are in a historic moment as Californians,” said Luz Gallegos, the executive director of TODEC, a legal center and immigrant justice organization in the Inland Empire and Coachella Valley.\u003c/p>\n\u003cp>“California continues to step up and defend all Californians, especially those who are most vulnerable, who don’t have any access to safety nets, but who contribute to our state economy, have been paying taxes … and have seen nothing in return,” she added.\u003c/p>\n\u003cfigure id=\"attachment_11879325\" class=\"wp-caption aligncenter\" style=\"max-width: 1242px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11879325\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/Gallegos.jpg\" alt=\"\" width=\"1242\" height=\"806\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Gallegos.jpg 1242w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Gallegos-800x519.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Gallegos-1020x662.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/Gallegos-160x104.jpg 160w\" sizes=\"auto, (max-width: 1242px) 100vw, 1242px\">\u003cfigcaption class=\"wp-caption-text\">Luz Gallegos works on COVID-19 vaccine outreach for farmworkers in Thermal, Calif. this spring. \u003ccite>(Courtesy TODEC)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The governor’s budget \u003ca href=\"http://www.ebudget.ca.gov/2021-22/pdf/Revised/BudgetSummary/HealthandHumanServices.pdf\">revision\u003c/a> from May includes nearly $860 million in annual state funds to expand Medi-Cal to low-income undocumented adults age 60 and older, with some of that funding available next year. The Legislature’s \u003ca href=\"https://abgt.assembly.ca.gov/sites/abgt.assembly.ca.gov/files/Floor%20Report%20of%20the%202021-22%20Budget%20-%20%28June%2011%2C%202021%20Version%29.pdf\">proposal\u003c/a> dedicates $1.3 billion in annual funds to cover undocumented adults age 50 and older once the program is fully established.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Gallegos, who was born in the U.S. to farmworker immigrant parents, said this likely win is personal for her. In recent years, her undocumented uncle died from cancer, she said, after he delayed seeking medical care because he was uninsured. During the pandemic, farmworkers she knows died from COVID-19 while several others became ill with the virus.\u003c/p>\n\u003cp>“We honor their lives by continuing the struggle so we don’t see no more lives taken away from our communities,” said Gallegos, her voice breaking.\u003c/p>\n\u003cp>Currently, low-income undocumented immigrants who are 26 and older are eligible for limited Medi-Cal, which only covers health care emergencies or prenatal care if they are pregnant. Undocumented immigrants are excluded from the Affordable Care Act, and cannot purchase coverage through Covered California, the state’s ACA health exchange.\u003c/p>\n\u003cp>If they are not insured by an employer or able to purchase a private plan, they must generally rely on county health programs, which vary greatly throughout the state.\u003c/p>\n\u003cp>Last year, Gov. Newsom \u003ca href=\"https://www.kqed.org/news/11814885/as-pandemic-batters-californias-economy-plan-to-insure-undocumented-seniors-in-doubt\">proposed\u003c/a> offering full-scope Medi-Cal to undocumented seniors age 65 and older. But the plan didn’t go through, as the state projected a severe economic downturn and tax losses in the billions of dollars.\u003c/p>\n\u003cp>But the financial picture for California is starkly different this year, with the state logging an eye-popping budget surplus of \u003ca href=\"https://www.kqed.org/news/11874125/californias-historic-budget-surplus-is-it-76-billion-or-38-billion\">$76 billion\u003c/a>. In addition, the pandemic highlighted how “interconnected” public health really is, with all of us having to think about whether people around us wore masks, stood far enough apart, or were vaccinated, said Dar, with the California Immigrant Policy Center.\u003c/p>\n\u003cp>“And so to give health care access to this community would mean a healthier and stronger state for all Californians,” said Dar. “Increased productivity, better health outcomes, better public health.”\u003c/p>\n\u003cp>Some opponents have argued that funds to provide health coverage to undocumented people would be better spent on other needs, such as helping struggling U.S. citizens afford their own health insurance.\u003c/p>\n\u003cp>About two in three Californians support the idea of providing health coverage to undocumented immigrants, according to a \u003ca href=\"https://www.ppic.org/wp-content/uploads/ppic-statewide-survey-californians-and-their-government-march-2021.pdf\">recent survey\u003c/a> by the Public Policy Institute of California. But many Republicans oppose it, with nearly eight in 10 saying that they are not in favor.\u003c/p>\n\u003cp>This year, Illinois became the \u003ca href=\"https://www.povertylaw.org/article/health-coverage-available-to-undocumented-seniors-in-illinois/#:~:text=Fortunately%2C%20Illinois%20has%20become%20the,citizens%20age%2065%20or%20older.\">first state\u003c/a> to extend health insurance to undocumented seniors age 65 and older.\u003c/p>\n\u003cp>Former farmworker Laura hopes she will gain access to health coverage — and low-cost medical care — in California, where she has lived since the late 1980s, most recently in Riverside county.\u003c/p>\n\u003cp>“It would help me a lot to go to the doctor and get my eyes checked out,” Laura said. “It would be the best.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>California on Friday announced it is offering residents a digital record of their coronavirus vaccination that they can use to access businesses or events that require proof of inoculation.\u003c/p>\n\u003cp>The state’s public health and technology departments said the \u003ca href=\"https://myvaccinerecord.cdph.ca.gov/\">Digital COVID-19 Vaccine Record\u003c/a> tool will allow Californians to access their record from the state’s immunization registry. It will show the same information as the paper cards issued by the Centers for Disease Control and Prevention to document coronavirus vaccinations.\u003c/p>\n\u003cp>“We are better enabling Californians to verify their vaccination status to ensure our state is in a better position to encourage the best practices in reducing the spread of COVID-19,” said State Epidemiologist Dr. Erica Pan at a press call Friday morning.\u003c/p>\n\u003cp>As of Thursday, more than 19 million Californians have been fully vaccinated and 3.5 million partially vaccinated, according to the California Department of Public Health.\u003c/p>\n\u003cp>To \u003ca href=\"https://myvaccinerecord.cdph.ca.gov/\" target=\"_blank\" rel=\"noopener noreferrer\">receive their digital vaccine record\u003c/a>, users will input their name, date of birth and email or phone, and they will be asked to create a 4-digit PIN. The record will include a QR code and users can save it to their phones.\u003c/p>\n\u003cp>https://twitter.com/CAPublicHealth/status/1405938234283249664?s=20\u003c/p>\n\u003cp>The digital vaccine card is free and acts as a backup in case people lose or damage their paper CDC card.\u003c/p>\n\u003cp>State officials acknowledged at a press call Friday morning that some Californians — likely fewer than 10% — will encounter some difficulty in obtaining their digital record because of outdated contact information or for other reasons.\u003c/p>\n\u003cp>Those experiencing problems can call the COVID-19 Hotline at 1-833-422-4255 or get help through the website’s \u003ca href=\"https://chat.myturn.ca.gov/?id=17\" target=\"_blank\" rel=\"noopener noreferrer\">virtual assistant\u003c/a>.\u003c/p>\n\u003cp>Following a drop in coronavirus cases and rise in vaccinations, California this week lifted a slew of pandemic-related restrictions. Vaccinated people are no longer required to wear masks at most indoor locations, though the unvaccinated still must do so. Everyone must continue to wear masks in some places, such as on mass transit and in health facilities.\u003c/p>\n\u003cp>Additionally, \u003ca href=\"https://www.kqed.org/news/11878490/california-drops-workplace-mask-rule-for-vaccinated-workers\" target=\"_blank\" rel=\"noopener noreferrer\">vaccinated employees can unmask in workplaces\u003c/a>. State workplace regulators on Thursday approved revised rules allowing fully vaccinated employees the same freedoms on and off the job, including ending most mask and physical distancing requirements. Newsom immediately issued an executive order waiving the usual 10-day legal review and allowing the changes to take effect as soon as they are filed with the secretary of state.\u003c/p>\n\u003cp>[aside postID=news_11878490 hero='https://ww2.kqed.org/app/uploads/sites/10/2021/06/Getty-workplacemasks-1020x625.jpg']The rules apply in almost every workplace in the state, including offices, factories and retailers. They come after weeks of confusion as the California Occupational Safety and Health Standards Board flip-flopped over changes.\u003c/p>\n\u003cp>The measures adopted in a 5-1 vote, with one member absent, now conform with general state guidelines that took effect Tuesday by ending most mask rules for vaccinated people. Employers can require workers to show proof of vaccination or allow them to self-report and keep a record.\u003c/p>\n\u003cp>Unvaccinated workers are still required to wear masks.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Everybody, regardless of vaccination status, must wear masks on mass transit and in health facilities.\u003c/p>\n\u003cp>What constitutes proof of vaccination has also prompted confusion: Will only paper cards do, or can photos of the cards or digital confirmations do?\u003c/p>\n\u003cp>California already has a confidential public health database on the tens of millions of people who’ve been vaccinated. Earlier this week, Gov. Gavin Newsom said the state was working on a way for people to show that they have been vaccinated without having to carry their paper card but denied calling the electronic verification system a “vaccine passport.”\u003c/p>\n\u003cp>[aside postID=news_11877048 hero='https://ww2.kqed.org/app/uploads/sites/10/2021/06/GettyImages-1210618045-1-1020x680.jpg']About two dozen states have banned state-required vaccine passports and some, including Texas, also barred businesses from requiring vaccinations.\u003c/p>\n\u003cp>Newsom on Monday noted that the electronic verification system isn’t mandatory.\u003c/p>\n\u003cp>“It’s not a passport, it’s not a requirement,” he said.\u003c/p>\n\u003cp>Under the workplace rule changes, employers also have the right to require everyone to remain masked — vaccinated or not. And vaccinated employees will still be able to \u003ca href=\"https://www.kqed.org/news/11877048/californias-mask-mandate-ends-june-15-heres-why-some-fully-vaccinated-people-will-keep-wearing-them\" target=\"_blank\" rel=\"noopener noreferrer\">wear masks if they choose\u003c/a> without facing retaliation.\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"mask-mandate\"]The changes also end physical distancing in workplaces except for certain workers during major outbreaks. Vaccinated employees won’t need to be tested or quarantine unless they show symptoms, even if they have close contact with an infected person.\u003c/p>\n\u003cp>The California Chamber of Commerce, which represents more than 14,000 members, said the changes “will help employers move forward and fully reopen.”\u003c/p>\n\u003cp>“What’s very difficult is to figure out what the balance is so that we’re doing the most good for the most people, but not at all dismissing the vulnerable in our population,” said Chris Laszcz-Davis, a management representative on the Cal/OSHA Standards Board.\u003c/p>\n\u003cp>But board member Laura Stock, an occupational safety expert who cast the lone opposition vote, warned that the pandemic is not over.\u003c/p>\n\u003cp>“This has real consequences that people can get sick and die due to exposure in the workplace,” Stock said.\u003c/p>\n\u003cp>\u003cem>KQED’s Julie Chang contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California on Friday announced it is offering residents a digital record of their coronavirus vaccination that they can use to access businesses or events that require proof of inoculation.\u003c/p>\n\u003cp>The state’s public health and technology departments said the \u003ca href=\"https://myvaccinerecord.cdph.ca.gov/\">Digital COVID-19 Vaccine Record\u003c/a> tool will allow Californians to access their record from the state’s immunization registry. It will show the same information as the paper cards issued by the Centers for Disease Control and Prevention to document coronavirus vaccinations.\u003c/p>\n\u003cp>“We are better enabling Californians to verify their vaccination status to ensure our state is in a better position to encourage the best practices in reducing the spread of COVID-19,” said State Epidemiologist Dr. Erica Pan at a press call Friday morning.\u003c/p>\n\u003cp>As of Thursday, more than 19 million Californians have been fully vaccinated and 3.5 million partially vaccinated, according to the California Department of Public Health.\u003c/p>\n\u003cp>To \u003ca href=\"https://myvaccinerecord.cdph.ca.gov/\" target=\"_blank\" rel=\"noopener noreferrer\">receive their digital vaccine record\u003c/a>, users will input their name, date of birth and email or phone, and they will be asked to create a 4-digit PIN. The record will include a QR code and users can save it to their phones.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>The digital vaccine card is free and acts as a backup in case people lose or damage their paper CDC card.\u003c/p>\n\u003cp>State officials acknowledged at a press call Friday morning that some Californians — likely fewer than 10% — will encounter some difficulty in obtaining their digital record because of outdated contact information or for other reasons.\u003c/p>\n\u003cp>Those experiencing problems can call the COVID-19 Hotline at 1-833-422-4255 or get help through the website’s \u003ca href=\"https://chat.myturn.ca.gov/?id=17\" target=\"_blank\" rel=\"noopener noreferrer\">virtual assistant\u003c/a>.\u003c/p>\n\u003cp>Following a drop in coronavirus cases and rise in vaccinations, California this week lifted a slew of pandemic-related restrictions. Vaccinated people are no longer required to wear masks at most indoor locations, though the unvaccinated still must do so. Everyone must continue to wear masks in some places, such as on mass transit and in health facilities.\u003c/p>\n\u003cp>Additionally, \u003ca href=\"https://www.kqed.org/news/11878490/california-drops-workplace-mask-rule-for-vaccinated-workers\" target=\"_blank\" rel=\"noopener noreferrer\">vaccinated employees can unmask in workplaces\u003c/a>. State workplace regulators on Thursday approved revised rules allowing fully vaccinated employees the same freedoms on and off the job, including ending most mask and physical distancing requirements. Newsom immediately issued an executive order waiving the usual 10-day legal review and allowing the changes to take effect as soon as they are filed with the secretary of state.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The rules apply in almost every workplace in the state, including offices, factories and retailers. They come after weeks of confusion as the California Occupational Safety and Health Standards Board flip-flopped over changes.\u003c/p>\n\u003cp>The measures adopted in a 5-1 vote, with one member absent, now conform with general state guidelines that took effect Tuesday by ending most mask rules for vaccinated people. Employers can require workers to show proof of vaccination or allow them to self-report and keep a record.\u003c/p>\n\u003cp>Unvaccinated workers are still required to wear masks.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>About two dozen states have banned state-required vaccine passports and some, including Texas, also barred businesses from requiring vaccinations.\u003c/p>\n\u003cp>Newsom on Monday noted that the electronic verification system isn’t mandatory.\u003c/p>\n\u003cp>“It’s not a passport, it’s not a requirement,” he said.\u003c/p>\n\u003cp>Under the workplace rule changes, employers also have the right to require everyone to remain masked — vaccinated or not. And vaccinated employees will still be able to \u003ca href=\"https://www.kqed.org/news/11877048/californias-mask-mandate-ends-june-15-heres-why-some-fully-vaccinated-people-will-keep-wearing-them\" target=\"_blank\" rel=\"noopener noreferrer\">wear masks if they choose\u003c/a> without facing retaliation.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The changes also end physical distancing in workplaces except for certain workers during major outbreaks. Vaccinated employees won’t need to be tested or quarantine unless they show symptoms, even if they have close contact with an infected person.\u003c/p>\n\u003cp>The California Chamber of Commerce, which represents more than 14,000 members, said the changes “will help employers move forward and fully reopen.”\u003c/p>\n\u003cp>“What’s very difficult is to figure out what the balance is so that we’re doing the most good for the most people, but not at all dismissing the vulnerable in our population,” said Chris Laszcz-Davis, a management representative on the Cal/OSHA Standards Board.\u003c/p>\n\u003cp>But board member Laura Stock, an occupational safety expert who cast the lone opposition vote, warned that the pandemic is not over.\u003c/p>\n\u003cp>“This has real consequences that people can get sick and die due to exposure in the workplace,” Stock said.\u003c/p>\n\u003cp>\u003cem>KQED’s Julie Chang contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "california-drops-workplace-mask-rule-for-vaccinated-workers",
"title": "Cal/OSHA Ditches Workplace Mask Mandate for Vaccinated Workers",
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"content": "\u003cp>California regulators on Thursday approved revised workplace pandemic rules that allow employees who are fully vaccinated against the coronavirus the same freedoms as when they are off the job, including ending most mask requirements.\u003c/p>\n\u003cp>The revised regulations approved by the governor-appointed California Occupational Safety & Health Standards Board come after weeks of confusion. The rules adopted in a 5-1 vote now conform with general state guidelines that took effect Tuesday by ending most mask rules for vaccinated people.\u003c/p>\n\u003cp>Gov. Gavin Newsom immediately issued an executive order waiving the usual 10-day legal review. The new rules will take effect as soon as they are filed with the secretary of state.\u003c/p>\n\u003cp>“I have a draft executive order ready to go immediately after they vote to make clarifications public and to provide more certainty,” Newsom said.\u003c/p>\n\u003cp>The rules apply in almost every workplace in the state, including offices, factories and retailers.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>They are intended to ensure that workers are protected while businesses resume normal or near-normal activity, Eric Berg, deputy chief of research and standards for California’s Division of Occupational Safety and Health, known as Cal/OSHA, told the board.\u003c/p>\n\u003cp>Business groups had sought the changes, arguing that rules for businesses should conform with state guidelines patterned after the latest federal Centers for Disease Control and Prevention recommendations.\u003c/p>\n\u003cp>Board member Laura Stock, an occupational safety expert who cast the lone opposition vote, said that even though people are tired of restrictions, the pandemic is not over.\u003c/p>\n\u003cp>“This has real consequences that people can get sick and die due to exposure in the workplace,” Stock said.\u003c/p>\n\u003cp>She said the rules go too far by eliminating physical distancing and workplace partitions and allowing workers to self-report their vaccination status.\u003c/p>\n\u003cp>Mitch Steiger, a legislative advocate for the California Labor Federation, AFL-CIO, similarly objected that the measures “essentially pretend that the pandemic is over.”\u003c/p>\n\u003cp>David Thomas, the board’s chair, thanked who spoke in support or opposition to the rules and acknowledged that coming with up with latest iteration of the guidelines has not been easy.\u003c/p>\n\u003cp>“I do appreciate the time and concern and hours we’ve spent in these meetings to get to this conclusion, but I’d be remiss if I didn’t thank you guys, it’s a lot of work, and a lot of responsibility,” said Thomas.\u003c/p>\n\u003cp>[aside label=\"More coverage\" tag=\"face-masks\"]\u003c/p>\n\u003cp>The move comes after the board did a double-twisting backflip in recent weeks when it first postponed, then rejected, then adopted, then rescinded rules that would have allowed workers to forgo masks only if every employee in a room was fully vaccinated against the coronavirus.\u003c/p>\n\u003cp>Fully vaccinated employees will not need to wear masks, except in locations like mass transit and classrooms, where they are required for everyone, or in the event of outbreaks.\u003c/p>\n\u003cp>Physical distancing also will end except for certain workers during major outbreaks. Vaccinated employees won’t need to be tested or quarantine unless they show symptoms, even if they have close contact with an infected person.\u003c/p>\n\u003cp>Employers must document that workers who skip masks indoors are indeed fully vaccinated. But employers have the choice of requiring workers to show proof of vaccination or allowing employees to self-report their status, with the employer keeping a record of who does the latter.\u003c/p>\n\u003cp>They also could decide to require everyone to remain masked — vaccinated or not. And vaccinated employees will still be able to wear masks if they choose without facing retaliation.\u003c/p>\n\u003cp>The governor’s office released a statement saying the workplace regulations, initially implemented in November 2020, “remain an important component of the state’s ongoing response, providing balanced worker protections that support California’s continued progress in recovering from the pandemic.”\u003c/p>\n\u003cp>Rob Lapsley, president of the California Business Roundtable, said the rules don’t fully conform to the state’s other standards. Others argued that they still will cause confusion.\u003c/p>\n\u003cp>That’s because of the requirement that employers provide masks and keep track of employees’ vaccination status, record-keeping that he and others said could create liability and privacy issues.\u003c/p>\n\u003cp>“They do remain a significant barrier to fully reopening the economy,” Lapsley said.\u003c/p>\n\u003cp>Katie Hansen, senior legislative director for the California Restaurant Association, said it is unrealistic to expect unvaccinated employees to remain masked until emergency work rules expire early next year, while others generally drop their face coverings.\u003c/p>\n\u003cp>The California Chamber of Commerce took a milder approach, thanking Newsom for eliminating confusion by pledging to conform workplace rules with the state’s loosened pandemic precautions.\u003c/p>\n\u003cp>That includes immediately ending social distancing obligations instead of waiting until July 31, as Cal/OSHA had initially proposed.\u003c/p>\n\u003cp>The chamber also praised a rule change that will require employers to provide the most effective N95 masks for free to unvaccinated employees upon request.\u003c/p>\n\u003cp>But others objected that the rule still will require employers to stockpile masks and compete with health care workers, despite Newsom’s promise to provide a one-month supply of the masks.\u003c/p>\n\u003cp>There were 700 California workplace outbreaks and more than 10,000 infections in the last 30 days, Cal/OSHA’s Berg said, but he said the N95s are the best alternative as other protections wane.\u003c/p>\n\u003cp>Robert Moutrie, a chamber of commerce policy advocate, called the latest proposal a “measured step” that opens too quickly for some businesses and not quickly enough for others.\u003c/p>\n\u003cp>”But we do think that this is a good step in that direction,” Moutrie said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>KQED’s Alex Hall contributed to this report.\u003c/em>\u003c/p>\n\n",
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"title": "Cal/OSHA Ditches Workplace Mask Mandate for Vaccinated Workers | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California regulators on Thursday approved revised workplace pandemic rules that allow employees who are fully vaccinated against the coronavirus the same freedoms as when they are off the job, including ending most mask requirements.\u003c/p>\n\u003cp>The revised regulations approved by the governor-appointed California Occupational Safety & Health Standards Board come after weeks of confusion. The rules adopted in a 5-1 vote now conform with general state guidelines that took effect Tuesday by ending most mask rules for vaccinated people.\u003c/p>\n\u003cp>Gov. Gavin Newsom immediately issued an executive order waiving the usual 10-day legal review. The new rules will take effect as soon as they are filed with the secretary of state.\u003c/p>\n\u003cp>“I have a draft executive order ready to go immediately after they vote to make clarifications public and to provide more certainty,” Newsom said.\u003c/p>\n\u003cp>The rules apply in almost every workplace in the state, including offices, factories and retailers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>They are intended to ensure that workers are protected while businesses resume normal or near-normal activity, Eric Berg, deputy chief of research and standards for California’s Division of Occupational Safety and Health, known as Cal/OSHA, told the board.\u003c/p>\n\u003cp>Business groups had sought the changes, arguing that rules for businesses should conform with state guidelines patterned after the latest federal Centers for Disease Control and Prevention recommendations.\u003c/p>\n\u003cp>Board member Laura Stock, an occupational safety expert who cast the lone opposition vote, said that even though people are tired of restrictions, the pandemic is not over.\u003c/p>\n\u003cp>“This has real consequences that people can get sick and die due to exposure in the workplace,” Stock said.\u003c/p>\n\u003cp>She said the rules go too far by eliminating physical distancing and workplace partitions and allowing workers to self-report their vaccination status.\u003c/p>\n\u003cp>Mitch Steiger, a legislative advocate for the California Labor Federation, AFL-CIO, similarly objected that the measures “essentially pretend that the pandemic is over.”\u003c/p>\n\u003cp>David Thomas, the board’s chair, thanked who spoke in support or opposition to the rules and acknowledged that coming with up with latest iteration of the guidelines has not been easy.\u003c/p>\n\u003cp>“I do appreciate the time and concern and hours we’ve spent in these meetings to get to this conclusion, but I’d be remiss if I didn’t thank you guys, it’s a lot of work, and a lot of responsibility,” said Thomas.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The move comes after the board did a double-twisting backflip in recent weeks when it first postponed, then rejected, then adopted, then rescinded rules that would have allowed workers to forgo masks only if every employee in a room was fully vaccinated against the coronavirus.\u003c/p>\n\u003cp>Fully vaccinated employees will not need to wear masks, except in locations like mass transit and classrooms, where they are required for everyone, or in the event of outbreaks.\u003c/p>\n\u003cp>Physical distancing also will end except for certain workers during major outbreaks. Vaccinated employees won’t need to be tested or quarantine unless they show symptoms, even if they have close contact with an infected person.\u003c/p>\n\u003cp>Employers must document that workers who skip masks indoors are indeed fully vaccinated. But employers have the choice of requiring workers to show proof of vaccination or allowing employees to self-report their status, with the employer keeping a record of who does the latter.\u003c/p>\n\u003cp>They also could decide to require everyone to remain masked — vaccinated or not. And vaccinated employees will still be able to wear masks if they choose without facing retaliation.\u003c/p>\n\u003cp>The governor’s office released a statement saying the workplace regulations, initially implemented in November 2020, “remain an important component of the state’s ongoing response, providing balanced worker protections that support California’s continued progress in recovering from the pandemic.”\u003c/p>\n\u003cp>Rob Lapsley, president of the California Business Roundtable, said the rules don’t fully conform to the state’s other standards. Others argued that they still will cause confusion.\u003c/p>\n\u003cp>That’s because of the requirement that employers provide masks and keep track of employees’ vaccination status, record-keeping that he and others said could create liability and privacy issues.\u003c/p>\n\u003cp>“They do remain a significant barrier to fully reopening the economy,” Lapsley said.\u003c/p>\n\u003cp>Katie Hansen, senior legislative director for the California Restaurant Association, said it is unrealistic to expect unvaccinated employees to remain masked until emergency work rules expire early next year, while others generally drop their face coverings.\u003c/p>\n\u003cp>The California Chamber of Commerce took a milder approach, thanking Newsom for eliminating confusion by pledging to conform workplace rules with the state’s loosened pandemic precautions.\u003c/p>\n\u003cp>That includes immediately ending social distancing obligations instead of waiting until July 31, as Cal/OSHA had initially proposed.\u003c/p>\n\u003cp>The chamber also praised a rule change that will require employers to provide the most effective N95 masks for free to unvaccinated employees upon request.\u003c/p>\n\u003cp>But others objected that the rule still will require employers to stockpile masks and compete with health care workers, despite Newsom’s promise to provide a one-month supply of the masks.\u003c/p>\n\u003cp>There were 700 California workplace outbreaks and more than 10,000 infections in the last 30 days, Cal/OSHA’s Berg said, but he said the N95s are the best alternative as other protections wane.\u003c/p>\n\u003cp>Robert Moutrie, a chamber of commerce policy advocate, called the latest proposal a “measured step” that opens too quickly for some businesses and not quickly enough for others.\u003c/p>\n\u003cp>”But we do think that this is a good step in that direction,” Moutrie said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>KQED’s Alex Hall contributed to this report.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "whats-actually-changed-in-california-now-the-state-has-reopened",
"title": "What's Actually Changed in California Now That the State Has Reopened?",
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"content": "\u003cp>\u003cem>\u003ca href=\"https://www.kqed.org/news/11878067/la-gran-reapertura-de-california-que-ha-cambiado-y-que-no-el-15-de-junio\">Leer en español\u003c/a>\u003c/em>\u003c/p>\n\u003cp>California’s grand reopening day is finally here, but it comes with a few asterisks.\u003c/p>\n\u003cp>This Tuesday, our 15-month-long ordeal of public health restrictions, mandates, bans and color-coded tiers to stem the COVID-19 pandemic will finally come to an end. As Gov. Gavin Newsom \u003ca href=\"https://www.kqed.org/news/11868240/newsom-announces-plan-to-open-up-business-as-usual-in-california-by-june-15\">said in April\u003c/a> and reaffirmed in May, June 15 is when “we can start to open up…business as usual.”\u003c/p>\n\u003cp>But as that much-touted date approaches, the governor’s promise of a sudden milestone is colliding with the loophole-ridden gradualism of California labor law, local control and the imperatives of fighting a diminishing — but not defeated — virus that has killed 62,500 Californians and counting.\u003c/p>\n\u003cp>Some mixed messages along the way have added to the confusion. So what will — and won’t — actually happen on Tuesday? Many of your questions, answered.\u003c/p>\n\u003ch3>Will I be able to sit inside a bar, work out at a gym or go to the movies?\u003c/h3>\n\u003cp>Probably.\u003c/p>\n\u003cp>The average Californian can expect things to look fairly back-to-normal in most of the ways that matter.\u003c/p>\n\u003cp>Moving “\u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Beyond-Blueprint-Framework.aspx\">beyond the blueprint\u003c/a>,” to use the state’s branding, and instead using federal health guidance for public places means that most businesses can dispense with social distancing requirements, capacity limits and forced closures.\u003c/p>\n\u003cp>But there’s a difference between “can” and “must.”\u003c/p>\n\u003cp>Counties will still be free to impose their own public health restrictions if they choose to — but only if they’re stricter than what the state is requiring. So far, no counties have said that they’ll part ways with the state’s rules, though a few, \u003ca href=\"https://www.nbcbayarea.com/news/coronavirus/what-will-the-bay-area-look-like-when-california-reopens-on-june-15/2561205/\">like San Francisco\u003c/a>, say they’re still mulling over their options.\u003c/p>\n\u003cp>Even so, businesses aren’t taking any chances. On Tuesday, more than 35 business groups sent a letter to county governments across the state begging them to stick to the statewide rules.\u003c/p>\n\u003cp>Though business groups, who don’t relish the idea of getting sued, are hoping for consistent, cheap and easy-to-follow standards, your favorite restaurant, movie theater or hair salon is also free to impose its own public health restrictions.\u003c/p>\n\u003cp>That means you shouldn’t be surprised if you still spot a few “No Mask, No Service” signs after June 15.\u003c/p>\n\u003ch3>Can I go to a concert?\u003c/h3>\n\u003cp>Depends. Are we talking open mic at the local bar or Beyoncé at an arena?\u003c/p>\n\u003cp>The state has said it will \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Beyond-Blueprint-QA.aspx\">impose additional restrictions on “mega events.”\u003c/a> That’s defined as anything that draws more than 5,000 people indoors or 10,000 outside. (Sorry, nameless dude playing a melodica into a loop pedal, you are not a mega event).\u003c/p>\n\u003cp>According to the most recent state guidance, concerts, conventions and other indoor mega events will only be open to people who can prove that they’ve either been vaccinated (by showing a vaccination card, a photo of the card, or documentation from a doctor) or that they tested negative for the coronavirus in the last 72 hours. That kind of proof won’t necessarily be required at outdoor events such as baseball games, but the state is recommending that stadiums either impose such a rule or require masking.\u003c/p>\n\u003cfigure id=\"attachment_11878044\" class=\"wp-caption alignnone\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11878044\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/GettyImages-1233049916-scaled.jpg\" alt=\"Three people sitting inside a bar without facemasks.\" width=\"2560\" height=\"1707\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233049916-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233049916-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233049916-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233049916-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233049916-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233049916-2048x1365.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233049916-1920x1280.jpg 1920w\" sizes=\"(max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">Fully vaccinated customers gather at the bar inside Risky Business, a private members-only club in the North Hollywood neighborhood of Los Angeles, California on May 21, 2021. \u003ccite>(Patrick T. Fallon/AFP via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Once I’m inside the bar, gym or movie theater, can I finally take this mask off?\u003c/h3>\n\u003cp>Yes, if you’re vaccinated.\u003c/p>\n\u003cp>California’s public health officials confirmed Wednesday that along with relaxed social distancing, the state will also drop its mask mandate on June 15 and instead adopt the recommendations of the federal Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Dr. Mark Ghaly, Health and Human Services Secretary\"]‘We are not requiring businesses to, for example, have somebody at the door checking for vaccine status as a way to comply with this.’[/pullquote]That means vaccinated adults should feel free to go mask-less in most public spaces. There are still exceptions for venues where the potential for many vulnerable people congregating in a confined place is high: hospitals and other health care settings, school classrooms, prisons and jails, public transit and nursing homes.\u003c/p>\n\u003cp>If you’re unvaccinated, you’ll still be required to wear a mask indoors in most public places, though it’s not entirely clear if or how that will be enforced. On Wednesday, Health and Human Services Secretary Mark Ghaly said that businesses can require masks of all customers, implement a vaccination verification system or simply go with the honor system.\u003c/p>\n\u003cp>“We are not requiring businesses to, for example, have somebody at the door checking for vaccine status as a way to comply with this,” he said.\u003c/p>\n\u003cfigure id=\"attachment_11878051\" class=\"wp-caption alignnone\" style=\"max-width: 1024px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11878051\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/0682021_ReopeningJune15_PU_Sized_08.jpg\" alt=\"Two people working at the grill of a restaurant.\" width=\"1024\" height=\"682\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/0682021_ReopeningJune15_PU_Sized_08.jpg 1024w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/0682021_ReopeningJune15_PU_Sized_08-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/0682021_ReopeningJune15_PU_Sized_08-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/0682021_ReopeningJune15_PU_Sized_08-160x107.jpg 160w\" sizes=\"(max-width: 1024px) 100vw, 1024px\">\u003cfigcaption class=\"wp-caption-text\">Alex Armstrong, 51 and his wife, Paula Armstrong, 45, prepare pick up orders during lunch hour at their Long Beach restaurant, VBurger, on June 8, 2021. ‘It’s been very challenging for us, but we couldn’t back out,’ said Armstrong of opening mid-pandemic last year. \u003ccite>(Pablo Unzueta for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>What about when I’m at work?\u003c/h3>\n\u003cp>For anyone who has a job, doesn’t work from home and spends their work hours with other human beings, this Q&A just got a lot more complicated.\u003c/p>\n\u003cp>Since last November, the state’s workplace safety regulator has been requiring most employees across the state to mask up and maintain 6 feet of distance from one another when possible. They’ve also required stores, restaurants and other employers to provide personal protective equipment to their staff, offer testing when necessary and, in some cases, set up pathogen-blocking furnishings such as plexiglass shields.\u003c/p>\n\u003cp>Those requirements seem to be on the way out, but not on June 15.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Rachel Michelin, president of the California Retailers Association\"]‘We can’t be the mask police. This totally contradicts the messaging that came out of the governor’s office, which was June 15, we’re opening up the economy.’[/pullquote]Wednesday night, the state’s Occupational Safety and Health Board agreed to take the new state public health mask guidance into account and vote on new workplace rules on June 17. If affirmed, those rules wouldn’t ordinarily become official policy until June 28. But on Monday, Newsom vowed to sign an executive order putting the rules into effect immediately.\u003c/p>\n\u003cp>The board unanimously voted to revoke a vote last week to adopt new workplace rules that would let workers go without a mask, but only so long as they and all their colleagues are vaccinated. Employers would have also been required to provide N95 masks to staff.\u003c/p>\n\u003cp>That idea did not go over well with the state’s business interests. How, they asked, is an employer supposed to find out which workers are not vaccinated? What if vaccinated employees, chafing at their masks, begin harassing their unvaccinated colleagues? How expensive are all these masks going to be?\u003c/p>\n\u003cp>[aside label ='Related Coverage' tag='coronavirus']“We can’t be the mask police,” said Rachel Michelin, president of the California Retailers Association. “This totally contradicts the messaging that came out of the governor’s office, which was June 15, we’re opening up the economy.”\u003c/p>\n\u003cp>California’s business interests lobbied the governor directly, asking him to do an end run around the state’s workplace safety regulators and issue an executive order to “align” workplace guidelines with guidance from the state public health department and federal CDC. They renewed that request after the Cal/OSHA decision Wednesday night, urging Newsom to provide all employers with “consistency and certainty.”\u003c/p>\n\u003cp>Newsom declined on Friday to say whether he would act on that request. On Wednesday, Ghaly said the administration was “in no way predisposing or pushing for one outcome over the other” but for now was simply leaving it up to the workplace safety board.\u003c/p>\n\u003ch3>Presumably state agencies will be abiding by the state public health guidelines?\u003c/h3>\n\u003cp>You might think that. And that might very well be the case. But at least for now, it appears to be up to the agencies themselves.\u003c/p>\n\u003cp>On Monday night — just hours before the state’s reopening at midnight — the California Department of Human Resources sent an advisory to department heads across state government. State offices that serve the public directly, like offices and stores across the state, will not be required “to inquire about a member of the public’s vaccine status.”\u003c/p>\n\u003cp>Instead, the advisory read, agencies “should provide notice to all customers, guests and members of the public that face coverings are required for unvaccinated individuals. If an individual without a face covering enters a state building, the department should assume the individual is complying with the requirement.”\u003c/p>\n\u003cp>State employers are also being told to keep their flexible work-from-home policies in place.\u003c/p>\n\u003cfigure id=\"attachment_11878049\" class=\"wp-caption alignnone\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11878049\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/GettyImages-1233471456-scaled.jpg\" alt=\"\" width=\"2560\" height=\"1707\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233471456-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233471456-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233471456-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233471456-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233471456-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233471456-2048x1365.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233471456-1920x1280.jpg 1920w\" sizes=\"(max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">Gov. Gavin Newsom speaks at a press conference to discuss the state reopening at Universal Studios in Hollywood, California on June 15, 2021. California will let fully vaccinated workers go maskless after June 17, Governor Gavin Newsom said on Monday. \u003ccite>(Patrick T. Fallon/AFP via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Is the state still going to be in a state of emergency?\u003c/h3>\n\u003cp>Yes.\u003c/p>\n\u003cp>Does that mean the state isn’t actually going to reopen?\u003c/p>\n\u003cp>No.\u003c/p>\n\u003cp>When the governor was asked on Friday whether, come June 15, he would also rescind the state of emergency proclamation that he issued in the early days of the pandemic in March 2020, Newsom — to the surprise of many and dismay of some — said that he would not.\u003c/p>\n\u003cp>So how can the state possibly reopen for “business as usual” when it’s simultaneously under an emergency?\u003c/p>\n\u003cp>The answer might be that the definition of “state of emergency” under California law doesn’t necessarily mean “emergency” in the everyday “something is on fire” sense of the word.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Brandon Stracener, California Constitution Center at UC Berkeley\"]‘Abruptly terminating the emergency would cancel all that wholesale … A gradual transition process that involves the Legislature is far better, and permits a rapid response to any unexpected surge in the pandemic.’[/pullquote]While the California Emergency Services Act does give the governor exceptionally broad powers to govern by fiat during a period of crisis, in practice the governor has evoked that power during the pandemic to administer various public health and economic relief programs and to collect federal aid.\u003c/p>\n\u003cp>“Abruptly terminating the emergency would cancel all that wholesale,” said Brandon Stracener, research fellow at the California Constitution Center at UC Berkeley. “A gradual transition process that involves the Legislature is far better, and permits a rapid response to any unexpected surge in the pandemic.”\u003c/p>\n\u003cp>With executive orders empowered by the proclamation, Newsom has loosened regulations to allow more people to administer vaccines, banned water shut-offs on homes with delinquent utility bills, given cities the ability to freeze commercial evictions, allowed local governments and courts to conduct public hearings over Zoom and given businesses on state roads the freedom to set up parklets and other street-side services.\u003c/p>\n\u003cp>The governor is hoping to extend some of the programs long past June 15 — either as long as the effects of the pandemic coursing through the state last, or until the Legislature can make it permanent by statute.\u003c/p>\n\u003cp>On June 2, for example, the governor’s office assured local governments that they would still be allowed to hold meetings remotely. “The Governor recognizes,” Cabinet Secretary Ana Matosantos wrote in an open letter, “the importance of an orderly return to the ordinary conduct of public meetings of state and local agencies and boards.”\u003c/p>\n\u003cp>Some local governments are deciding to return somewhat to normal; San Francisco Mayor London Breed presided over four weddings at City Hall to mark its reopening Monday.\u003c/p>\n\u003cp>Republicans in the Legislature have long bristled at the governor’s unprecedented use of executive power during the pandemic, and are now attacking him leading up to an all-but-certain recall election this fall. On Monday, Assemblymembers Kevin Kiley of Rocklin and James Gallagher of Yuba City and state Sen. Melissa Melendez from Riverside County demanded that the administration explain what justified the continued proclamation of the emergency.\u003c/p>\n\u003cp>Some emergencies from recent wildfires and past droughts are still active, Newsom’s office notes. State law does give the Legislature the ultimate check on the governor’s emergency powers. All they need to do is pass a resolution declaring the emergency to be over. But they haven’t. And with Democrats enjoying supermajorities in both the Assembly and Senate, they aren’t likely to anytime soon.\u003c/p>\n\u003cfigure id=\"attachment_11859270\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11859270\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/02/RS46696_011_Sacramento_InaugurationDay_01202021-qut.jpg\" alt=\"State Capitol in Sacramento\" width=\"1920\" height=\"1278\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/02/RS46696_011_Sacramento_InaugurationDay_01202021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/02/RS46696_011_Sacramento_InaugurationDay_01202021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/02/RS46696_011_Sacramento_InaugurationDay_01202021-qut-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/02/RS46696_011_Sacramento_InaugurationDay_01202021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/02/RS46696_011_Sacramento_InaugurationDay_01202021-qut-1536x1022.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A fence lines the perimeter of the state Capitol building in Sacramento on Inauguration Day, Jan. 20, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>What about the state Capitol?\u003c/h3>\n\u003cp>The halls of state government will be reopening on June 15, too. But befitting a deliberative body, it’ll be doing so at a slower pace.\u003c/p>\n\u003cp>Starting on Tuesday, the building will be open to a maximum of 500 members of the public. Masks will still be required and social distancing guidelines will still be in effect. After that, the rules committees in both the Assembly and Senate will “continue to assess increasing capacity to a total of 1,000 members of the public as soon as the week of June 21st,” according to a statement released Friday by legislative leaders.\u003c/p>\n\u003cp>Since the beginning of the pandemic, lobbyists, reporters and the general public have been permitted to enter the Capitol only under very limited and supervised conditions.\u003cbr>\n[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "California reopens on June 15. We have answers on where you still need to wear masks, what are the health restrictions for offices and workspaces, and what else is reopening.",
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"title": "What's Actually Changed in California Now That the State Has Reopened? | KQED",
"description": "California reopens on June 15. We have answers on where you still need to wear masks, what are the health restrictions for offices and workspaces, and what else is reopening.",
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"headline": "What's Actually Changed in California Now That the State Has Reopened?",
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"nprByline": "\u003ca href=\"https://calmatters.org/author/ben-christopher/\">Ben Christopher\u003c/a>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>\u003ca href=\"https://www.kqed.org/news/11878067/la-gran-reapertura-de-california-que-ha-cambiado-y-que-no-el-15-de-junio\">Leer en español\u003c/a>\u003c/em>\u003c/p>\n\u003cp>California’s grand reopening day is finally here, but it comes with a few asterisks.\u003c/p>\n\u003cp>This Tuesday, our 15-month-long ordeal of public health restrictions, mandates, bans and color-coded tiers to stem the COVID-19 pandemic will finally come to an end. As Gov. Gavin Newsom \u003ca href=\"https://www.kqed.org/news/11868240/newsom-announces-plan-to-open-up-business-as-usual-in-california-by-june-15\">said in April\u003c/a> and reaffirmed in May, June 15 is when “we can start to open up…business as usual.”\u003c/p>\n\u003cp>But as that much-touted date approaches, the governor’s promise of a sudden milestone is colliding with the loophole-ridden gradualism of California labor law, local control and the imperatives of fighting a diminishing — but not defeated — virus that has killed 62,500 Californians and counting.\u003c/p>\n\u003cp>Some mixed messages along the way have added to the confusion. So what will — and won’t — actually happen on Tuesday? Many of your questions, answered.\u003c/p>\n\u003ch3>Will I be able to sit inside a bar, work out at a gym or go to the movies?\u003c/h3>\n\u003cp>Probably.\u003c/p>\n\u003cp>The average Californian can expect things to look fairly back-to-normal in most of the ways that matter.\u003c/p>\n\u003cp>Moving “\u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Beyond-Blueprint-Framework.aspx\">beyond the blueprint\u003c/a>,” to use the state’s branding, and instead using federal health guidance for public places means that most businesses can dispense with social distancing requirements, capacity limits and forced closures.\u003c/p>\n\u003cp>But there’s a difference between “can” and “must.”\u003c/p>\n\u003cp>Counties will still be free to impose their own public health restrictions if they choose to — but only if they’re stricter than what the state is requiring. So far, no counties have said that they’ll part ways with the state’s rules, though a few, \u003ca href=\"https://www.nbcbayarea.com/news/coronavirus/what-will-the-bay-area-look-like-when-california-reopens-on-june-15/2561205/\">like San Francisco\u003c/a>, say they’re still mulling over their options.\u003c/p>\n\u003cp>Even so, businesses aren’t taking any chances. On Tuesday, more than 35 business groups sent a letter to county governments across the state begging them to stick to the statewide rules.\u003c/p>\n\u003cp>Though business groups, who don’t relish the idea of getting sued, are hoping for consistent, cheap and easy-to-follow standards, your favorite restaurant, movie theater or hair salon is also free to impose its own public health restrictions.\u003c/p>\n\u003cp>That means you shouldn’t be surprised if you still spot a few “No Mask, No Service” signs after June 15.\u003c/p>\n\u003ch3>Can I go to a concert?\u003c/h3>\n\u003cp>Depends. Are we talking open mic at the local bar or Beyoncé at an arena?\u003c/p>\n\u003cp>The state has said it will \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Beyond-Blueprint-QA.aspx\">impose additional restrictions on “mega events.”\u003c/a> That’s defined as anything that draws more than 5,000 people indoors or 10,000 outside. (Sorry, nameless dude playing a melodica into a loop pedal, you are not a mega event).\u003c/p>\n\u003cp>According to the most recent state guidance, concerts, conventions and other indoor mega events will only be open to people who can prove that they’ve either been vaccinated (by showing a vaccination card, a photo of the card, or documentation from a doctor) or that they tested negative for the coronavirus in the last 72 hours. That kind of proof won’t necessarily be required at outdoor events such as baseball games, but the state is recommending that stadiums either impose such a rule or require masking.\u003c/p>\n\u003cfigure id=\"attachment_11878044\" class=\"wp-caption alignnone\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11878044\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/GettyImages-1233049916-scaled.jpg\" alt=\"Three people sitting inside a bar without facemasks.\" width=\"2560\" height=\"1707\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233049916-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233049916-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233049916-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233049916-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233049916-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233049916-2048x1365.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233049916-1920x1280.jpg 1920w\" sizes=\"(max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">Fully vaccinated customers gather at the bar inside Risky Business, a private members-only club in the North Hollywood neighborhood of Los Angeles, California on May 21, 2021. \u003ccite>(Patrick T. Fallon/AFP via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Once I’m inside the bar, gym or movie theater, can I finally take this mask off?\u003c/h3>\n\u003cp>Yes, if you’re vaccinated.\u003c/p>\n\u003cp>California’s public health officials confirmed Wednesday that along with relaxed social distancing, the state will also drop its mask mandate on June 15 and instead adopt the recommendations of the federal Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘We are not requiring businesses to, for example, have somebody at the door checking for vaccine status as a way to comply with this.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>That means vaccinated adults should feel free to go mask-less in most public spaces. There are still exceptions for venues where the potential for many vulnerable people congregating in a confined place is high: hospitals and other health care settings, school classrooms, prisons and jails, public transit and nursing homes.\u003c/p>\n\u003cp>If you’re unvaccinated, you’ll still be required to wear a mask indoors in most public places, though it’s not entirely clear if or how that will be enforced. On Wednesday, Health and Human Services Secretary Mark Ghaly said that businesses can require masks of all customers, implement a vaccination verification system or simply go with the honor system.\u003c/p>\n\u003cp>“We are not requiring businesses to, for example, have somebody at the door checking for vaccine status as a way to comply with this,” he said.\u003c/p>\n\u003cfigure id=\"attachment_11878051\" class=\"wp-caption alignnone\" style=\"max-width: 1024px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11878051\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/0682021_ReopeningJune15_PU_Sized_08.jpg\" alt=\"Two people working at the grill of a restaurant.\" width=\"1024\" height=\"682\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/0682021_ReopeningJune15_PU_Sized_08.jpg 1024w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/0682021_ReopeningJune15_PU_Sized_08-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/0682021_ReopeningJune15_PU_Sized_08-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/0682021_ReopeningJune15_PU_Sized_08-160x107.jpg 160w\" sizes=\"(max-width: 1024px) 100vw, 1024px\">\u003cfigcaption class=\"wp-caption-text\">Alex Armstrong, 51 and his wife, Paula Armstrong, 45, prepare pick up orders during lunch hour at their Long Beach restaurant, VBurger, on June 8, 2021. ‘It’s been very challenging for us, but we couldn’t back out,’ said Armstrong of opening mid-pandemic last year. \u003ccite>(Pablo Unzueta for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>What about when I’m at work?\u003c/h3>\n\u003cp>For anyone who has a job, doesn’t work from home and spends their work hours with other human beings, this Q&A just got a lot more complicated.\u003c/p>\n\u003cp>Since last November, the state’s workplace safety regulator has been requiring most employees across the state to mask up and maintain 6 feet of distance from one another when possible. They’ve also required stores, restaurants and other employers to provide personal protective equipment to their staff, offer testing when necessary and, in some cases, set up pathogen-blocking furnishings such as plexiglass shields.\u003c/p>\n\u003cp>Those requirements seem to be on the way out, but not on June 15.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘We can’t be the mask police. This totally contradicts the messaging that came out of the governor’s office, which was June 15, we’re opening up the economy.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Wednesday night, the state’s Occupational Safety and Health Board agreed to take the new state public health mask guidance into account and vote on new workplace rules on June 17. If affirmed, those rules wouldn’t ordinarily become official policy until June 28. But on Monday, Newsom vowed to sign an executive order putting the rules into effect immediately.\u003c/p>\n\u003cp>The board unanimously voted to revoke a vote last week to adopt new workplace rules that would let workers go without a mask, but only so long as they and all their colleagues are vaccinated. Employers would have also been required to provide N95 masks to staff.\u003c/p>\n\u003cp>That idea did not go over well with the state’s business interests. How, they asked, is an employer supposed to find out which workers are not vaccinated? What if vaccinated employees, chafing at their masks, begin harassing their unvaccinated colleagues? How expensive are all these masks going to be?\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“We can’t be the mask police,” said Rachel Michelin, president of the California Retailers Association. “This totally contradicts the messaging that came out of the governor’s office, which was June 15, we’re opening up the economy.”\u003c/p>\n\u003cp>California’s business interests lobbied the governor directly, asking him to do an end run around the state’s workplace safety regulators and issue an executive order to “align” workplace guidelines with guidance from the state public health department and federal CDC. They renewed that request after the Cal/OSHA decision Wednesday night, urging Newsom to provide all employers with “consistency and certainty.”\u003c/p>\n\u003cp>Newsom declined on Friday to say whether he would act on that request. On Wednesday, Ghaly said the administration was “in no way predisposing or pushing for one outcome over the other” but for now was simply leaving it up to the workplace safety board.\u003c/p>\n\u003ch3>Presumably state agencies will be abiding by the state public health guidelines?\u003c/h3>\n\u003cp>You might think that. And that might very well be the case. But at least for now, it appears to be up to the agencies themselves.\u003c/p>\n\u003cp>On Monday night — just hours before the state’s reopening at midnight — the California Department of Human Resources sent an advisory to department heads across state government. State offices that serve the public directly, like offices and stores across the state, will not be required “to inquire about a member of the public’s vaccine status.”\u003c/p>\n\u003cp>Instead, the advisory read, agencies “should provide notice to all customers, guests and members of the public that face coverings are required for unvaccinated individuals. If an individual without a face covering enters a state building, the department should assume the individual is complying with the requirement.”\u003c/p>\n\u003cp>State employers are also being told to keep their flexible work-from-home policies in place.\u003c/p>\n\u003cfigure id=\"attachment_11878049\" class=\"wp-caption alignnone\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11878049\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/GettyImages-1233471456-scaled.jpg\" alt=\"\" width=\"2560\" height=\"1707\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233471456-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233471456-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233471456-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233471456-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233471456-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233471456-2048x1365.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/GettyImages-1233471456-1920x1280.jpg 1920w\" sizes=\"(max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">Gov. Gavin Newsom speaks at a press conference to discuss the state reopening at Universal Studios in Hollywood, California on June 15, 2021. California will let fully vaccinated workers go maskless after June 17, Governor Gavin Newsom said on Monday. \u003ccite>(Patrick T. Fallon/AFP via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Is the state still going to be in a state of emergency?\u003c/h3>\n\u003cp>Yes.\u003c/p>\n\u003cp>Does that mean the state isn’t actually going to reopen?\u003c/p>\n\u003cp>No.\u003c/p>\n\u003cp>When the governor was asked on Friday whether, come June 15, he would also rescind the state of emergency proclamation that he issued in the early days of the pandemic in March 2020, Newsom — to the surprise of many and dismay of some — said that he would not.\u003c/p>\n\u003cp>So how can the state possibly reopen for “business as usual” when it’s simultaneously under an emergency?\u003c/p>\n\u003cp>The answer might be that the definition of “state of emergency” under California law doesn’t necessarily mean “emergency” in the everyday “something is on fire” sense of the word.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘Abruptly terminating the emergency would cancel all that wholesale … A gradual transition process that involves the Legislature is far better, and permits a rapid response to any unexpected surge in the pandemic.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>While the California Emergency Services Act does give the governor exceptionally broad powers to govern by fiat during a period of crisis, in practice the governor has evoked that power during the pandemic to administer various public health and economic relief programs and to collect federal aid.\u003c/p>\n\u003cp>“Abruptly terminating the emergency would cancel all that wholesale,” said Brandon Stracener, research fellow at the California Constitution Center at UC Berkeley. “A gradual transition process that involves the Legislature is far better, and permits a rapid response to any unexpected surge in the pandemic.”\u003c/p>\n\u003cp>With executive orders empowered by the proclamation, Newsom has loosened regulations to allow more people to administer vaccines, banned water shut-offs on homes with delinquent utility bills, given cities the ability to freeze commercial evictions, allowed local governments and courts to conduct public hearings over Zoom and given businesses on state roads the freedom to set up parklets and other street-side services.\u003c/p>\n\u003cp>The governor is hoping to extend some of the programs long past June 15 — either as long as the effects of the pandemic coursing through the state last, or until the Legislature can make it permanent by statute.\u003c/p>\n\u003cp>On June 2, for example, the governor’s office assured local governments that they would still be allowed to hold meetings remotely. “The Governor recognizes,” Cabinet Secretary Ana Matosantos wrote in an open letter, “the importance of an orderly return to the ordinary conduct of public meetings of state and local agencies and boards.”\u003c/p>\n\u003cp>Some local governments are deciding to return somewhat to normal; San Francisco Mayor London Breed presided over four weddings at City Hall to mark its reopening Monday.\u003c/p>\n\u003cp>Republicans in the Legislature have long bristled at the governor’s unprecedented use of executive power during the pandemic, and are now attacking him leading up to an all-but-certain recall election this fall. On Monday, Assemblymembers Kevin Kiley of Rocklin and James Gallagher of Yuba City and state Sen. Melissa Melendez from Riverside County demanded that the administration explain what justified the continued proclamation of the emergency.\u003c/p>\n\u003cp>Some emergencies from recent wildfires and past droughts are still active, Newsom’s office notes. State law does give the Legislature the ultimate check on the governor’s emergency powers. All they need to do is pass a resolution declaring the emergency to be over. But they haven’t. And with Democrats enjoying supermajorities in both the Assembly and Senate, they aren’t likely to anytime soon.\u003c/p>\n\u003cfigure id=\"attachment_11859270\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11859270\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/02/RS46696_011_Sacramento_InaugurationDay_01202021-qut.jpg\" alt=\"State Capitol in Sacramento\" width=\"1920\" height=\"1278\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/02/RS46696_011_Sacramento_InaugurationDay_01202021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/02/RS46696_011_Sacramento_InaugurationDay_01202021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/02/RS46696_011_Sacramento_InaugurationDay_01202021-qut-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/02/RS46696_011_Sacramento_InaugurationDay_01202021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/02/RS46696_011_Sacramento_InaugurationDay_01202021-qut-1536x1022.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A fence lines the perimeter of the state Capitol building in Sacramento on Inauguration Day, Jan. 20, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>What about the state Capitol?\u003c/h3>\n\u003cp>The halls of state government will be reopening on June 15, too. But befitting a deliberative body, it’ll be doing so at a slower pace.\u003c/p>\n\u003cp>Starting on Tuesday, the building will be open to a maximum of 500 members of the public. Masks will still be required and social distancing guidelines will still be in effect. After that, the rules committees in both the Assembly and Senate will “continue to assess increasing capacity to a total of 1,000 members of the public as soon as the week of June 21st,” according to a statement released Friday by legislative leaders.\u003c/p>\n\u003cp>Since the beginning of the pandemic, lobbyists, reporters and the general public have been permitted to enter the Capitol only under very limited and supervised conditions.\u003cbr>\n\u003c/p>\u003c/div>",
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"content": "\u003cp>The COVID-19 pandemic put a spotlight on the importance of child care, in-home care and support for the elderly as well as for members of the disability community across the nation. Now, one of the most contentious parts of negotiations with Republicans over President Biden’s infrastructure plan has to do with the administration’s inclusion of \u003ca href=\"https://www.theatlantic.com/ideas/archive/2021/04/why-care-work-infrastructure/618588/\" target=\"_blank\" rel=\"noopener noreferrer\">$400 billion in spending for at-home care for the elderly and people with disabilities\u003c/a>, with the administration arguing that such domestic work is as essential to a functioning economy as roads and bridges.\u003c/p>\n\u003cp>KQED’s Mina Kim spoke with \u003ca href=\"https://www.pbs.org/newshour/brief/375509/ai-jen-poo\" target=\"_blank\" rel=\"noopener noreferrer\">Ai-jen Poo\u003c/a>, director of the \u003ca href=\"https://www.domesticworkers.org/press/spokespersons/ai-jen-poo/\" target=\"_blank\" rel=\"noopener noreferrer\">National Domestic Workers Alliance\u003c/a>, about domestic workers and what it means to include this work in the infrastructure plan.\u003c/p>\n\u003cp>\u003cem>The following interview has been edited for length and clarity.\u003c/em>\u003c/p>\n\u003ch3>\u003cstrong>Why Care Work Is Best Described as Infrastructure\u003c/strong>\u003c/h3>\n\u003cp>\u003cstrong>Ai-jen Poo:\u003c/strong> We’ve always talked about how domestic work, the work that happens inside of our homes to take care of our family members, our children, our loved ones with disabilities, our aging loved ones, really is the work that makes all other work possible. Having access to care makes it possible for all of us to go out into the world and do what we do every single day.[pullquote size=\"medium\" align=\"right\" citation=\"Ai-jen Poo, director of the National Domestic Workers Alliance\"]‘If you think about the definition of infrastructure, it’s really that which enables society and the economy to function. And what could be more fundamental than having the ability to take care of your loved ones as you prepare to work and participate in our workforce and economy?’[/pullquote]\u003c/p>\n\u003cp>If you think about the definition of infrastructure, it’s really that which enables society and the economy to function. And what could be more fundamental than having the ability to take care of your loved ones as you prepare to work and participate in our workforce and economy?\u003c/p>\n\u003cp>Even if you think about the traditional definition of infrastructure, roads, bridges, tunnels, all of the people who are rebuilding our bridges and fixing our tunnels, they need care, too. So maybe it’s the first form of infrastructure before anything else.\u003c/p>\n\u003ch3>‘Single Greatest Opportunity in Generations’\u003c/h3>\n\u003cp>\u003cem>What do you think about the fact that care work is now in a presidential infrastructure bill?\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Ai-jen Poo:\u003c/strong> I think it’s the single greatest opportunity we’ve had in generations to establish the kind of policies and programs we need to support our ability to care for our families as we work. It’s necessary.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Even before the pandemic, many of us were simmering in a care crisis. We have a situation where the baby boom generation is aging into retirement at a rate of 10,000 people per day, turning 65 every 8 seconds. We’ve basically added an entire generation onto our lifespan and we haven’t adopted any of our systems or policy to support a quality of life and the care we need as we live longer. On both ends of the generational spectrum, we need more care than ever before at a time when we have less of it. Our default care infrastructure in previous generations was just expecting that women will stay home and be full-time family caregivers.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Ai-jen Poo, director of the National Domestic Workers Alliance\"]‘The fact that the work as a profession has always been associated with women of color has profoundly shaped the way that we’ve treated this work in law, policy and in culture.’[/pullquote]We need programs, policies, systems and a strong care workforce to support us. There are over 2.5 million [care workers], and they’re overwhelmingly women — 92% women and majority women of color, including many immigrant women. This is actually the part of the economy with the highest concentration of undocumented immigrants of any workforce. They are also majority primary income earners for their families and majority mothers of small children.\u003c/p>\n\u003cp>We have a workforce who is essential not only to the families they support, but their own families and communities. And it’s also a workforce that has always been majority women of color. Some of the first domestic workers in the U.S. were enslaved Black women. And the fact that the work as a profession has always been associated with women of color has profoundly shaped the way that we’ve treated this work in law, policy and in culture.\u003c/p>\n\u003cp>Starting in the 1930s, when we were putting our foundational labor laws into place, this workforce was excluded intentionally as a result of racism and the legacy of slavery in our country. And it created a situation of extreme insecurity when domestic workers entered a crisis like a pandemic — it just became incredibly exacerbated.\u003c/p>\n\u003cfigure id=\"attachment_11877959\" class=\"wp-caption aligncenter\" style=\"max-width: 1355px\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/RS49609_015_SanFrancisco_AlexPadillaMissionKids_06012021-qut.jpg\" alt=\"\" width=\"1355\" height=\"1003\" class=\"size-full wp-image-11877959\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49609_015_SanFrancisco_AlexPadillaMissionKids_06012021-qut.jpg 1355w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49609_015_SanFrancisco_AlexPadillaMissionKids_06012021-qut-800x592.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49609_015_SanFrancisco_AlexPadillaMissionKids_06012021-qut-1020x755.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49609_015_SanFrancisco_AlexPadillaMissionKids_06012021-qut-160x118.jpg 160w\" sizes=\"auto, (max-width: 1355px) 100vw, 1355px\">\u003cfigcaption class=\"wp-caption-text\">Sen. Alex Padilla speaks with children during a visit to Mission Kids Preschool in San Francisco on June 1, 2021. The visit was part of Padilla’s ‘Infrastructure Listening Tour.’ \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Structural Problems in Pay and Working Conditions\u003c/h3>\n\u003cp>\u003cem>Could you talk a little bit more about some of the more common structural problems that you see regarding pay and working conditions?\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Ai-jen Poo:\u003c/strong> Eighty-two percent of domestic workers didn’t have a single paid sick day. When the second stay-at-home orders came down, you saw dramatic losses in jobs and income because there’s no job security, there’s no contract or work agreement. The wages are essentially poverty wages. \u003c/p>\n\u003cp>So most domestic workers didn’t have the savings to be able to fall back on. I remember in March of 2020, in the first weeks of the pandemic, we held a meeting on Zoom with some of our members and one of them held her phone up to the Zoom screen to show us that she literally had 1 cent left in her bank account.\u003c/p>\n\u003ch3>What Investing in the Care Economy Looks Like\u003c/h3>\n\u003cp>\u003cem>When you say investment in care workers and the care economy, what does it look like?\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Ai-jen Poo:\u003c/strong> The Biden \u003ca href=\"https://www.whitehouse.gov/briefing-room/statements-releases/2021/03/31/fact-sheet-the-american-jobs-plan/\" target=\"_blank\" rel=\"noopener noreferrer\">American Jobs Plan\u003c/a> proposed a $400 billion investment in Medicaid, home and community-based care. What that money would do is expand access to home and community-based services and care for the elderly, and people with disabilities. And it would support raising wages and access to benefits for the workforce.\u003c/p>\n\u003cp>Right now, the average annual income of a home care worker is $17,000 per year. I don’t know a single community where that is sustainable, let alone enough to raise a family on. \u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Ai-jen Poo, director of the National Domestic Workers Alliance\"]‘If you’re a parent or you’re a primary caregiver for a family member who needs assistance with activities of daily life, you know that it’s an impossible choice between work and family members who need you for their basic human needs.’[/pullquote]What we end up seeing is high rates of turnover because people simply cannot survive and sustain themselves doing this work … because the wages are so poor and the conditions are so tough, we have huge parts of this country that we call home care deserts or direct care deserts because people can’t get the support that they need in order to live in their communities. They end up either having to go into a nursing home or having to rely on overstretched family caregivers who have to make impossible choices about whether or not they can work. The money to Medicaid would specifically raise wages for the home care workforce and strengthen that workforce so that they can stay and sustain themselves doing this work.\u003c/p>\n\u003cp>It would expand access to the services for over 800,000 people who are on waiting lists and the millions more who don’t even know there’s a waiting list to wait on.\u003c/p>\n\u003ch3>A Cultural Shift\u003c/h3>\n\u003cp>\u003cem>What evidence do you have that there is a tangible cultural shift happening here?\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Ai-jen Poo:\u003c/strong> I do feel this incredible rage, we call it the “mom’s rage,” that incredible frustration that moms are feeling and have felt throughout the pandemic. \u003c/p>\n\u003cp>If you’re a parent or you’re a primary caregiver for a family member who needs assistance with activities of daily life, you know that it’s an impossible choice between work and family members who need you for their basic human needs.\u003c/p>\n\u003cp>The kind of rage that I’m feeling, especially from women who disproportionately bear the brunt of caregiving responsibilities in our country, and especially women of color who’ve been pushed out of the workforce by the millions, almost 5 million women pushed out of the workforce in the pandemic because of caregiving challenges. That is an indicator that something is very broken.\u003c/p>\n\u003cp>If we are to pull ourselves back from the regression to 1988 women’s workforce participation levels, we’re going to have to rebuild and build something really different. I think people know that in their guts. This cultural norm that we have around care being an individual responsibility and a responsibility of individual families is one that is very deep. It’s not like we’re going to move past it overnight. And it’s not that it isn’t the responsibility of women and families and individuals, but it is about what is our responsibility collectively to each other as a society to ensure that we have real choices and real agency when it comes to the people we love.\u003c/p>\n\u003ch3>\u003cstrong>Protections for Undocumented Domestic Workers\u003c/strong>\u003c/h3>\n\u003cp>\u003cem>Can you comment on protections for undocumented domestic workers?\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Ai-jen Poo:\u003c/strong> There are a tremendous number of undocumented workers — essential workers in this industry. [aside tag=\"undocumented\" label=\"Related Stories\"] We’ve been working really hard to make sure that we seize upon this moment as we’re imagining an economic recovery that is inclusive and supportive of essential workers and includes undocumented domestic workers and care workers that have kept us safe through the pandemic.\u003c/p>\n\u003cp>Sen. Alex Padilla from California has introduced legislation to create a path to citizenship for the 5 million essential workers across industries through this time of crisis, and so we are very busy trying to get support for that legislation. \u003c/p>\n\u003cp>It could be really transformative and it would be inclusive of domestic workers, so let the senator know that you really support his efforts and help us get people signed on to that bill.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>We need programs, policies, systems and a strong care workforce to support us. There are over 2.5 million [care workers], and they’re overwhelmingly women — 92% women and majority women of color, including many immigrant women. This is actually the part of the economy with the highest concentration of undocumented immigrants of any workforce. They are also majority primary income earners for their families and majority mothers of small children.\u003c/p>\n\u003cp>We have a workforce who is essential not only to the families they support, but their own families and communities. And it’s also a workforce that has always been majority women of color. Some of the first domestic workers in the U.S. were enslaved Black women. And the fact that the work as a profession has always been associated with women of color has profoundly shaped the way that we’ve treated this work in law, policy and in culture.\u003c/p>\n\u003cp>Starting in the 1930s, when we were putting our foundational labor laws into place, this workforce was excluded intentionally as a result of racism and the legacy of slavery in our country. And it created a situation of extreme insecurity when domestic workers entered a crisis like a pandemic — it just became incredibly exacerbated.\u003c/p>\n\u003cfigure id=\"attachment_11877959\" class=\"wp-caption aligncenter\" style=\"max-width: 1355px\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/06/RS49609_015_SanFrancisco_AlexPadillaMissionKids_06012021-qut.jpg\" alt=\"\" width=\"1355\" height=\"1003\" class=\"size-full wp-image-11877959\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49609_015_SanFrancisco_AlexPadillaMissionKids_06012021-qut.jpg 1355w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49609_015_SanFrancisco_AlexPadillaMissionKids_06012021-qut-800x592.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49609_015_SanFrancisco_AlexPadillaMissionKids_06012021-qut-1020x755.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/06/RS49609_015_SanFrancisco_AlexPadillaMissionKids_06012021-qut-160x118.jpg 160w\" sizes=\"auto, (max-width: 1355px) 100vw, 1355px\">\u003cfigcaption class=\"wp-caption-text\">Sen. Alex Padilla speaks with children during a visit to Mission Kids Preschool in San Francisco on June 1, 2021. The visit was part of Padilla’s ‘Infrastructure Listening Tour.’ \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Structural Problems in Pay and Working Conditions\u003c/h3>\n\u003cp>\u003cem>Could you talk a little bit more about some of the more common structural problems that you see regarding pay and working conditions?\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Ai-jen Poo:\u003c/strong> Eighty-two percent of domestic workers didn’t have a single paid sick day. When the second stay-at-home orders came down, you saw dramatic losses in jobs and income because there’s no job security, there’s no contract or work agreement. The wages are essentially poverty wages. \u003c/p>\n\u003cp>So most domestic workers didn’t have the savings to be able to fall back on. I remember in March of 2020, in the first weeks of the pandemic, we held a meeting on Zoom with some of our members and one of them held her phone up to the Zoom screen to show us that she literally had 1 cent left in her bank account.\u003c/p>\n\u003ch3>What Investing in the Care Economy Looks Like\u003c/h3>\n\u003cp>\u003cem>When you say investment in care workers and the care economy, what does it look like?\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Ai-jen Poo:\u003c/strong> The Biden \u003ca href=\"https://www.whitehouse.gov/briefing-room/statements-releases/2021/03/31/fact-sheet-the-american-jobs-plan/\" target=\"_blank\" rel=\"noopener noreferrer\">American Jobs Plan\u003c/a> proposed a $400 billion investment in Medicaid, home and community-based care. What that money would do is expand access to home and community-based services and care for the elderly, and people with disabilities. And it would support raising wages and access to benefits for the workforce.\u003c/p>\n\u003cp>Right now, the average annual income of a home care worker is $17,000 per year. I don’t know a single community where that is sustainable, let alone enough to raise a family on. \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘If you’re a parent or you’re a primary caregiver for a family member who needs assistance with activities of daily life, you know that it’s an impossible choice between work and family members who need you for their basic human needs.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>What we end up seeing is high rates of turnover because people simply cannot survive and sustain themselves doing this work … because the wages are so poor and the conditions are so tough, we have huge parts of this country that we call home care deserts or direct care deserts because people can’t get the support that they need in order to live in their communities. They end up either having to go into a nursing home or having to rely on overstretched family caregivers who have to make impossible choices about whether or not they can work. The money to Medicaid would specifically raise wages for the home care workforce and strengthen that workforce so that they can stay and sustain themselves doing this work.\u003c/p>\n\u003cp>It would expand access to the services for over 800,000 people who are on waiting lists and the millions more who don’t even know there’s a waiting list to wait on.\u003c/p>\n\u003ch3>A Cultural Shift\u003c/h3>\n\u003cp>\u003cem>What evidence do you have that there is a tangible cultural shift happening here?\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Ai-jen Poo:\u003c/strong> I do feel this incredible rage, we call it the “mom’s rage,” that incredible frustration that moms are feeling and have felt throughout the pandemic. \u003c/p>\n\u003cp>If you’re a parent or you’re a primary caregiver for a family member who needs assistance with activities of daily life, you know that it’s an impossible choice between work and family members who need you for their basic human needs.\u003c/p>\n\u003cp>The kind of rage that I’m feeling, especially from women who disproportionately bear the brunt of caregiving responsibilities in our country, and especially women of color who’ve been pushed out of the workforce by the millions, almost 5 million women pushed out of the workforce in the pandemic because of caregiving challenges. That is an indicator that something is very broken.\u003c/p>\n\u003cp>If we are to pull ourselves back from the regression to 1988 women’s workforce participation levels, we’re going to have to rebuild and build something really different. I think people know that in their guts. This cultural norm that we have around care being an individual responsibility and a responsibility of individual families is one that is very deep. It’s not like we’re going to move past it overnight. And it’s not that it isn’t the responsibility of women and families and individuals, but it is about what is our responsibility collectively to each other as a society to ensure that we have real choices and real agency when it comes to the people we love.\u003c/p>\n\u003ch3>\u003cstrong>Protections for Undocumented Domestic Workers\u003c/strong>\u003c/h3>\n\u003cp>\u003cem>Can you comment on protections for undocumented domestic workers?\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Ai-jen Poo:\u003c/strong> There are a tremendous number of undocumented workers — essential workers in this industry. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp> We’ve been working really hard to make sure that we seize upon this moment as we’re imagining an economic recovery that is inclusive and supportive of essential workers and includes undocumented domestic workers and care workers that have kept us safe through the pandemic.\u003c/p>\n\u003cp>Sen. Alex Padilla from California has introduced legislation to create a path to citizenship for the 5 million essential workers across industries through this time of crisis, and so we are very busy trying to get support for that legislation. \u003c/p>\n\u003cp>It could be really transformative and it would be inclusive of domestic workers, so let the senator know that you really support his efforts and help us get people signed on to that bill.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Last spring, only weeks into the pandemic, Christina Garcia was spending her days struggling to help her two young sons adjust to online schooling when she got such a heavy, painful period she could barely stand. After a few days, her vision began to blur and she found herself too weak to open a jar.\u003c/p>\n\u003cp>Garcia’s regular OB-GYN — like most medical offices at the time — was closed, and she was terrified by the prospect of spending hours waiting in an emergency room shoulder to shoulder with people who might have COVID-19.\u003c/p>\n\u003cp>By the time she stumbled into the newly opened \u003ca href=\"https://www.scvmc.org/clinics-and-locations/Bascom/Pages/Overview.aspx\">Bascom OB-GYN urgent care clinic\u003c/a> at the Santa Clara Valley Medical Center, clutching a pillow to her belly, Garcia was pale and dehydrated from blood loss and certain she was dying.\u003c/p>\n\u003cp>“If I didn’t get to the clinic when I did, I think, things could have ended up very different,” said Garcia, 34, who underwent an emergency hysterectomy for uterine fibroids.\u003c/p>\n\u003cp>Her story illustrates a long-standing gap in women’s health care. For years, many women with common but urgent conditions like painful urinary tract infections or excessive bleeding in the aftermath of a miscarriage have faced a grim choice between waiting weeks for an appointment with their regular OB-GYN or braving hours in an ER waiting room.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Urgent care OB-GYN clinics have begun popping up around the country in recent years, and the COVID pandemic has increased demand. While no data is available on the number of urgent care clinics for women, they are part of a surge of interest in urgent care clinics in general and other alternative models like retail clinics and so-called digital-first health care startups. One of these, the New York-based women’s health startup Tia (“aunt” in Spanish), won $24 million in venture capital funding last spring and is opening physical clinics nationwide.\u003c/p>\n\u003cp>“It’s clear that access and convenience are increasingly more important to consumers than seeing a specific provider,” said Rob Rohatsch, chief medical officer at Solv, an app that books urgent care appointments.\u003c/p>\n\u003cp>The Urgent Care Association has \u003ca href=\"https://www.ucaoa.org/Portals/80/pdfs/benchmarking/UCA-BenchmarkSurvey19_v1.pdf?ver=2020-02-21-182523-333\">reported\u003c/a> steadily \u003ca href=\"https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2698143\">increasing visits by people\u003c/a> who use its members’ walk-in clinics as an alternative to hospital emergency departments. Traffic to these clinics has surged during the past year, according to Solv.\u003c/p>\n\u003cp>The Bascom clinic had been a nearly decadelong dream of Drs. \u003ca href=\"https://www.doximity.com/pub/cheryl-pan-md\">Cheryl Pan\u003c/a> and \u003ca href=\"https://www.linkedin.com/in/anita-sit-54593960/\">Anita Sit\u003c/a>, two obstetrician-gynecologists at the Santa Clara Valley Medical Center, a sprawling public hospital that serves as the regional trauma center, treating critical cases like car accidents and gunshot victims and relegating people suffering less life-threatening problems to long waits.\u003c/p>\n\u003cp>“Women — perhaps pregnant or bleeding — could be sitting there 12 to 14 hours, depending on the time of day,” Pan said.\u003c/p>\n\u003cp>After the onset of the pandemic, doctors worried that women with serious or even deadly issues like Garcia’s might avoid seeking treatment for fear of contracting COVID. ER visits \u003ca href=\"https://www.contagionlive.com/view/emergency-departments-unprecedented-drop-visits-covid19\">plummeted an unprecedented 42%\u003c/a> in the early months of the pandemic, according to the Centers for Disease Control and Prevention. \u003ca href=\"https://www.cdc.gov/mmwr/volumes/69/wr/mm6923e1.htm\">A June CDC report noted that\u003c/a>, while the number of ER visits for heart attacks had increased, visits for nonspecific chest pain had decreased, suggesting that people might be risking their lives by avoiding the ER.\u003c/p>\n\u003cp>“You can imagine that a woman with three kids at home might be even more scared,” Sit said. “We just couldn’t keep sending women having miscarriages to wait hours in the COVID tent.”\u003c/p>\n\u003cp>Instead, women can now be triaged over the phone and seen within a day or two at the Bascom OB-GYN urgent care clinic — much the way they would at their local Planned Parenthood branch for contraceptives or a sexually transmitted disease screening. Bascom is equipped to treat conditions from severe morning sickness to ectopic pregnancies that require emergency surgery. In its first year, the clinic has treated some 1,300 women and served as a backup to local clinics that provide basic reproductive health services in counties hundreds of miles away.\u003c/p>\n\u003cp>It’s still in its pilot phase, however, operating weekdays from 8:30 a.m. to 5 p.m., which “leaves a big chunk of off-hours that we cannot serve women,” Sit acknowledges.\u003c/p>\n\u003cp>A handful of other clinics have taken the concept of urgent care for women a step further. Dr. Miriam Mackovic runs \u003ca href=\"https://www.completewomencare.com/about-us/about-complete-women-care/\">Complete Women Care\u003c/a>, a chain of four clinics in the Los Angeles area that also has an emergency care center in Long Beach, which is staffed 24/7 with a nurse practitioner and equipped with a lab and a pharmacy. Women who walk in are typically seen within 30 minutes, according to Mackovic, and every patient receives a follow-up call the next day.\u003c/p>\n\u003cp>One woman who turned up at a Complete Women Care clinic said that, after desperately seeking treatment at an ER one Saturday night for a nasty yeast infection, she got a bill in the mail for $1,500.\u003c/p>\n\u003cp>“In the middle of the night, urgent care centers are closed. OB-GYN offices are definitely closed. So, what is her option except the ER?” asked Mackovic, an obstetrician-gynecologist who also has an MBA.\u003c/p>\n\u003cp>Mackovic ticked off cautionary tales of patients who’ve arrived at her clinics from as far away as Arizona and Nevada after suffering for weeks while trying to schedule routine operations for uterine cysts or twisted ovaries.\u003c/p>\n\u003cp>“The medical advances are here. Most emergencies can be resolved on an outpatient basis — a woman can have a hysterectomy with just a fine incision and be home the same day,” Mackovic said. “But a woman who has a miscarriage calls her OB, who says there’s no openings for weeks, so she goes to the ER, and the physician says: Are you dying? No? Then follow up with your OB-GYN.”\u003c/p>\n\u003cp>Fees for the uninsured — around 20% of Mackovic’s clientele — run from $100 to around $600, she said.\u003c/p>\n\u003cp>Women in the United States have for years \u003ca href=\"https://www.commonwealthfund.org/publications/issue-briefs/2018/dec/womens-health-us-compared-ten-other-countries\">lagged behind\u003c/a> those in other rich countries in both their access to health care and their health status. America has the highest \u003ca href=\"https://www.vox.com/2020/1/30/21113782/pregnancy-deaths-us-maternal-mortality-rate\">maternal mortality rate\u003c/a> among developed nations.\u003c/p>\n\u003cp>Some women see a doctor only in an emergency.\u003c/p>\n\u003cp>“We have diagnosed so many cancers in the last few years because women walked in for another reason,” said Dr. Adeeti Gupta, founder and CEO of a chain of open-daily clinics in New York City called\u003ca href=\"https://walkingyn.com/\"> Walk In GYN Care\u003c/a> that provides comprehensive care without appointments.\u003c/p>\n\u003cp>Gupta’s three clinics have grown steadily since she opened them seven years ago, largely out of frustration with the months-long wait for an appointment at her own Queens OB-GYN practice. But after the coronavirus hit the city hard, she has seen an uptick in patients — 40% in one location.\u003c/p>\n\u003cp>The country needs more accessible, comprehensive women’s health care to treat everything from the menstrual pains of adolescents to the hot flashes of postmenopausal grannies, Gupta said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“The thing about women,” she said, “is their problems never stop.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Last spring, only weeks into the pandemic, Christina Garcia was spending her days struggling to help her two young sons adjust to online schooling when she got such a heavy, painful period she could barely stand. After a few days, her vision began to blur and she found herself too weak to open a jar.\u003c/p>\n\u003cp>Garcia’s regular OB-GYN — like most medical offices at the time — was closed, and she was terrified by the prospect of spending hours waiting in an emergency room shoulder to shoulder with people who might have COVID-19.\u003c/p>\n\u003cp>By the time she stumbled into the newly opened \u003ca href=\"https://www.scvmc.org/clinics-and-locations/Bascom/Pages/Overview.aspx\">Bascom OB-GYN urgent care clinic\u003c/a> at the Santa Clara Valley Medical Center, clutching a pillow to her belly, Garcia was pale and dehydrated from blood loss and certain she was dying.\u003c/p>\n\u003cp>“If I didn’t get to the clinic when I did, I think, things could have ended up very different,” said Garcia, 34, who underwent an emergency hysterectomy for uterine fibroids.\u003c/p>\n\u003cp>Her story illustrates a long-standing gap in women’s health care. For years, many women with common but urgent conditions like painful urinary tract infections or excessive bleeding in the aftermath of a miscarriage have faced a grim choice between waiting weeks for an appointment with their regular OB-GYN or braving hours in an ER waiting room.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Urgent care OB-GYN clinics have begun popping up around the country in recent years, and the COVID pandemic has increased demand. While no data is available on the number of urgent care clinics for women, they are part of a surge of interest in urgent care clinics in general and other alternative models like retail clinics and so-called digital-first health care startups. One of these, the New York-based women’s health startup Tia (“aunt” in Spanish), won $24 million in venture capital funding last spring and is opening physical clinics nationwide.\u003c/p>\n\u003cp>“It’s clear that access and convenience are increasingly more important to consumers than seeing a specific provider,” said Rob Rohatsch, chief medical officer at Solv, an app that books urgent care appointments.\u003c/p>\n\u003cp>The Urgent Care Association has \u003ca href=\"https://www.ucaoa.org/Portals/80/pdfs/benchmarking/UCA-BenchmarkSurvey19_v1.pdf?ver=2020-02-21-182523-333\">reported\u003c/a> steadily \u003ca href=\"https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2698143\">increasing visits by people\u003c/a> who use its members’ walk-in clinics as an alternative to hospital emergency departments. Traffic to these clinics has surged during the past year, according to Solv.\u003c/p>\n\u003cp>The Bascom clinic had been a nearly decadelong dream of Drs. \u003ca href=\"https://www.doximity.com/pub/cheryl-pan-md\">Cheryl Pan\u003c/a> and \u003ca href=\"https://www.linkedin.com/in/anita-sit-54593960/\">Anita Sit\u003c/a>, two obstetrician-gynecologists at the Santa Clara Valley Medical Center, a sprawling public hospital that serves as the regional trauma center, treating critical cases like car accidents and gunshot victims and relegating people suffering less life-threatening problems to long waits.\u003c/p>\n\u003cp>“Women — perhaps pregnant or bleeding — could be sitting there 12 to 14 hours, depending on the time of day,” Pan said.\u003c/p>\n\u003cp>After the onset of the pandemic, doctors worried that women with serious or even deadly issues like Garcia’s might avoid seeking treatment for fear of contracting COVID. ER visits \u003ca href=\"https://www.contagionlive.com/view/emergency-departments-unprecedented-drop-visits-covid19\">plummeted an unprecedented 42%\u003c/a> in the early months of the pandemic, according to the Centers for Disease Control and Prevention. \u003ca href=\"https://www.cdc.gov/mmwr/volumes/69/wr/mm6923e1.htm\">A June CDC report noted that\u003c/a>, while the number of ER visits for heart attacks had increased, visits for nonspecific chest pain had decreased, suggesting that people might be risking their lives by avoiding the ER.\u003c/p>\n\u003cp>“You can imagine that a woman with three kids at home might be even more scared,” Sit said. “We just couldn’t keep sending women having miscarriages to wait hours in the COVID tent.”\u003c/p>\n\u003cp>Instead, women can now be triaged over the phone and seen within a day or two at the Bascom OB-GYN urgent care clinic — much the way they would at their local Planned Parenthood branch for contraceptives or a sexually transmitted disease screening. Bascom is equipped to treat conditions from severe morning sickness to ectopic pregnancies that require emergency surgery. In its first year, the clinic has treated some 1,300 women and served as a backup to local clinics that provide basic reproductive health services in counties hundreds of miles away.\u003c/p>\n\u003cp>It’s still in its pilot phase, however, operating weekdays from 8:30 a.m. to 5 p.m., which “leaves a big chunk of off-hours that we cannot serve women,” Sit acknowledges.\u003c/p>\n\u003cp>A handful of other clinics have taken the concept of urgent care for women a step further. Dr. Miriam Mackovic runs \u003ca href=\"https://www.completewomencare.com/about-us/about-complete-women-care/\">Complete Women Care\u003c/a>, a chain of four clinics in the Los Angeles area that also has an emergency care center in Long Beach, which is staffed 24/7 with a nurse practitioner and equipped with a lab and a pharmacy. Women who walk in are typically seen within 30 minutes, according to Mackovic, and every patient receives a follow-up call the next day.\u003c/p>\n\u003cp>One woman who turned up at a Complete Women Care clinic said that, after desperately seeking treatment at an ER one Saturday night for a nasty yeast infection, she got a bill in the mail for $1,500.\u003c/p>\n\u003cp>“In the middle of the night, urgent care centers are closed. OB-GYN offices are definitely closed. So, what is her option except the ER?” asked Mackovic, an obstetrician-gynecologist who also has an MBA.\u003c/p>\n\u003cp>Mackovic ticked off cautionary tales of patients who’ve arrived at her clinics from as far away as Arizona and Nevada after suffering for weeks while trying to schedule routine operations for uterine cysts or twisted ovaries.\u003c/p>\n\u003cp>“The medical advances are here. Most emergencies can be resolved on an outpatient basis — a woman can have a hysterectomy with just a fine incision and be home the same day,” Mackovic said. “But a woman who has a miscarriage calls her OB, who says there’s no openings for weeks, so she goes to the ER, and the physician says: Are you dying? No? Then follow up with your OB-GYN.”\u003c/p>\n\u003cp>Fees for the uninsured — around 20% of Mackovic’s clientele — run from $100 to around $600, she said.\u003c/p>\n\u003cp>Women in the United States have for years \u003ca href=\"https://www.commonwealthfund.org/publications/issue-briefs/2018/dec/womens-health-us-compared-ten-other-countries\">lagged behind\u003c/a> those in other rich countries in both their access to health care and their health status. America has the highest \u003ca href=\"https://www.vox.com/2020/1/30/21113782/pregnancy-deaths-us-maternal-mortality-rate\">maternal mortality rate\u003c/a> among developed nations.\u003c/p>\n\u003cp>Some women see a doctor only in an emergency.\u003c/p>\n\u003cp>“We have diagnosed so many cancers in the last few years because women walked in for another reason,” said Dr. Adeeti Gupta, founder and CEO of a chain of open-daily clinics in New York City called\u003ca href=\"https://walkingyn.com/\"> Walk In GYN Care\u003c/a> that provides comprehensive care without appointments.\u003c/p>\n\u003cp>Gupta’s three clinics have grown steadily since she opened them seven years ago, largely out of frustration with the months-long wait for an appointment at her own Queens OB-GYN practice. But after the coronavirus hit the city hard, she has seen an uptick in patients — 40% in one location.\u003c/p>\n\u003cp>The country needs more accessible, comprehensive women’s health care to treat everything from the menstrual pains of adolescents to the hot flashes of postmenopausal grannies, Gupta said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>It’s been 40 years since the first AIDS cases were reported by the federal government. The decades have brought pain, death and community trauma, but also life-saving medical breakthroughs, perseverance and hope.\u003c/p>\n\u003cp>That journey was honored at Golden Gate Park at the National AIDS Memorial Grove on June 5, as Dr. Anthony Fauci, House Speaker Nancy Pelosi and AIDS activists recalled another pandemic, another struggle, in another time.\u003c/p>\n\u003cp>Rev. Fr. Rusty Smith, executive director of \u003ca href=\"https://www.maitrisf.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Maitri Compassionate Care\u003c/a> spoke to KQED about his work in hospice. Maitri, located in San Francisco’s Duboce Triangle neighborhood, provides hospice care for low-income and homeless people living with AIDS, as well as people who need 24-hour respite care or recovery support after gender affirmation surgery. [pullquote size=\"medium\" align=\"right\" citation=\"Rev. Rusty Smith, executive director of Maitri Compassionate Care\"]‘They actually don’t even need our wisdom about how they got there and what happened to them. What they actually need is care and partnership.’[/pullquote]\u003c/p>\n\u003cp>Smith has been doing this work for over three decades. In the early 1980s during the AIDS crisis, he served as a Catholic seminarian and then became a priest. At the same time, he was the case manager and hospice caregiver at several hospices where people were dying from AIDS. As he sat beside those dying alone, he promised to never forget them.\u003c/p>\n\u003cp>In the following interview, Smith reflects on his past experience and shares how things have changed over the years.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cem>The following has been edited for length and clarity.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>You were working 40 years ago when AIDS was first discovered. What was that like?\u003c/strong>\u003c/p>\n\u003cp>Everyone died. I was a young person, and everyone I worked with, they were people like me. They were people that were in their 20s. And I saw them die within six months. No one I worked with during that time period survived AIDS. Everyone died.\u003c/p>\n\u003cp>Back in that time, in the early ’80s, everyone was afraid to touch and be close and hold people who had AIDS. And there were no or few religious leaders or clergy that allowed themselves to be present for people as they died, so many people died completely by themselves because of the shame involved. And even when I would go and do hospital visitation, we would have to completely gown up.\u003c/p>\n\u003cp>The promises I made were to people who had nobody left. And all of us that were activists, we all said to each other — and to the people that we loved and cared for — that we will never forget you, that we will say the story of your passing. And we made promises to them that we would not stop until there was a cure and until the stigma was gone. And that’s what that entire world was like. There were often weeks and months where I would go to four or five funerals, of men that were young — it wasn’t their time to die.\u003c/p>\n\u003cp>\u003cstrong>How have things changed over the years?\u003c/strong>\u003c/p>\n\u003cp>The face of AIDS has just completely changed. In the early ’80s, everyone within my community — the gay and queer community — primarily gay Caucasian men were dying. Now, it is a vast diversity of all different colors of people, and very strong components of that is poverty and a lack of stable housing, and access to care and services.\u003c/p>\n\u003cp>The other large part of this population that has changed is our \u003ca href=\"https://www.cdc.gov/media/releases/2021/p0414-trans-HIV.html\" target=\"_blank\" rel=\"noopener noreferrer\">transgender women of color \u003c/a>\u003ca href=\"https://www.cdc.gov/media/releases/2021/p0414-trans-HIV.html\" target=\"_blank\" rel=\"noopener noreferrer\">community\u003c/a>. They are being dramatically impacted by HIV and AIDS, and we are seeing that reoccurrence explode when at the very same time in other communities HIV/AIDS is being reduced. But within these communities it’s growing and it’s becoming more difficult to deal with.\u003c/p>\n\u003cp>\u003cstrong>Can you elaborate on why it’s becoming more difficult to deal with?\u003c/strong>\u003c/p>\n\u003cp>I am a white, privileged gay man. It’s not hard for me to go to the doctor and get my needs met. [But] in the early ’80s, it was horrible for me to go to the doctor. It was horrible for me to have to ask for the services I needed because doctors then judged me and shamed me about being openly gay and having gay sex.\u003c/p>\n\u003cp>Today, people who self-identify as being transgender are experiencing those same kinds of oppressive characteristics of medical care, health care, access to care and services, and additionally, access to safe and clean and affordable housing.\u003c/p>\n\u003cp>For many of us who have been through this journey a long time, are things better for people living with HIV/AIDS? Yes, they are. Can you have better access to better medications? Yes, you can. But for those that live on the margins, the same stigmas and obstacles exist that existed actually in the early ’80s. It’s just a different population group.\u003c/p>\n\u003cp>\u003cstrong>A \u003ca href=\"https://www.sfdph.org/dph/files/reports/RptsHIVAIDS/AnnualReport2019_Indigo_20200908_Web.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">2019 report\u003c/a> by the San Francisco Department of Public Health found that the HIV/AIDS population is also getting older. Specifically, it states that as of Dec. 31, 2019, 69% of persons living with HIV were aged 50 years and older. What are your thoughts on this aging population?\u003c/strong>\u003c/p>\n\u003cp>I know this may feel like a mixed celebration, but that is the most amazing news you could imagine — the fact that we as a population are aging, and HIV and AIDS has not killed us.\u003c/p>\n\u003cp>But there’s also that scary news of how do we take care of people when we’ve spent so many years just trying to preserve life? Now that we see an aging population, we have to, I think, reconstruct ourselves into what is long-term care.\u003c/p>\n\u003cp>\u003cstrong>What are some lessons we learned from 40 years ago that we can use today for those living with HIV/AIDS?\u003c/strong>\u003c/p>\n\u003cp>We’re good at [giving care]. We actually know how to do this. The people who come to Maitri, they don’t receive fair care, they receive remarkable care.\u003c/p>\n\u003cp>In the early 1980s, my clients would go to a clinic that was dirty, that often had people working there that disliked and hated them and that treated them badly. Right now, people who come for care and services here find extraordinary care, best practice care, staff that are highly trained and that are kind and gentle. [aside tag=\"aids, hiv\" label=\"More Related Stories\"]\u003c/p>\n\u003cp>The lessons we learned when people are in those circumstances is they don’t need our judgment. They actually don’t even need our wisdom about how they got there and what happened to them. What they actually need is care and partnership.\u003c/p>\n\u003cp>\u003cstrong>You’ve been doing this for over 30 years. What keeps you going?\u003c/strong>\u003c/p>\n\u003cp>One of our residents was getting ready to be discharged into housing, who came here amazingly sick and was resistant to being loved, but we would not allow him not to be.\u003c/p>\n\u003cp>That’s what keeps me here — every staff member here. We do this for the people who are living and struggling with that disease.\u003c/p>\n\u003cp>\u003cstrong>For those living with long-term COVID, any lessons that can be taken from people living with long-term HIV/AIDS?\u003c/strong>\u003c/p>\n\u003cp>I think the instruction here is follow the science, do what the doctors tell you to do, ask questions, do advocacy, but recognize that you’re not by yourself. That actually is what all of us in the ’80s discovered.\u003c/p>\n\u003cp>Being by yourself and dying and struggling with the disease is horrific. COVID-19, I personally feel, has allowed us and invited us to be closer together. And I think that’s the lesson of this disease.\u003c/p>\n\u003cp>\u003cstrong>Any final thoughts?\u003c/strong>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>There is a belief that HIV/AIDS has actually gone away. So much work within the service provider HIV/AIDS community is about prevention and helping people function at the highest level of autonomy possible, even if they do have AIDS. But the promise we made in the early ’80s that still hasn’t happened: We promised that we will work until we found a cure, and we still do not have a cure. We found a vaccine for COVID in a year. [For HIV/AIDs] it’s been 40 years. We still need a cure.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Smith has been doing this work for over three decades. In the early 1980s during the AIDS crisis, he served as a Catholic seminarian and then became a priest. At the same time, he was the case manager and hospice caregiver at several hospices where people were dying from AIDS. As he sat beside those dying alone, he promised to never forget them.\u003c/p>\n\u003cp>In the following interview, Smith reflects on his past experience and shares how things have changed over the years.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>The following has been edited for length and clarity.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>You were working 40 years ago when AIDS was first discovered. What was that like?\u003c/strong>\u003c/p>\n\u003cp>Everyone died. I was a young person, and everyone I worked with, they were people like me. They were people that were in their 20s. And I saw them die within six months. No one I worked with during that time period survived AIDS. Everyone died.\u003c/p>\n\u003cp>Back in that time, in the early ’80s, everyone was afraid to touch and be close and hold people who had AIDS. And there were no or few religious leaders or clergy that allowed themselves to be present for people as they died, so many people died completely by themselves because of the shame involved. And even when I would go and do hospital visitation, we would have to completely gown up.\u003c/p>\n\u003cp>The promises I made were to people who had nobody left. And all of us that were activists, we all said to each other — and to the people that we loved and cared for — that we will never forget you, that we will say the story of your passing. And we made promises to them that we would not stop until there was a cure and until the stigma was gone. And that’s what that entire world was like. There were often weeks and months where I would go to four or five funerals, of men that were young — it wasn’t their time to die.\u003c/p>\n\u003cp>\u003cstrong>How have things changed over the years?\u003c/strong>\u003c/p>\n\u003cp>The face of AIDS has just completely changed. In the early ’80s, everyone within my community — the gay and queer community — primarily gay Caucasian men were dying. Now, it is a vast diversity of all different colors of people, and very strong components of that is poverty and a lack of stable housing, and access to care and services.\u003c/p>\n\u003cp>The other large part of this population that has changed is our \u003ca href=\"https://www.cdc.gov/media/releases/2021/p0414-trans-HIV.html\" target=\"_blank\" rel=\"noopener noreferrer\">transgender women of color \u003c/a>\u003ca href=\"https://www.cdc.gov/media/releases/2021/p0414-trans-HIV.html\" target=\"_blank\" rel=\"noopener noreferrer\">community\u003c/a>. They are being dramatically impacted by HIV and AIDS, and we are seeing that reoccurrence explode when at the very same time in other communities HIV/AIDS is being reduced. But within these communities it’s growing and it’s becoming more difficult to deal with.\u003c/p>\n\u003cp>\u003cstrong>Can you elaborate on why it’s becoming more difficult to deal with?\u003c/strong>\u003c/p>\n\u003cp>I am a white, privileged gay man. It’s not hard for me to go to the doctor and get my needs met. [But] in the early ’80s, it was horrible for me to go to the doctor. It was horrible for me to have to ask for the services I needed because doctors then judged me and shamed me about being openly gay and having gay sex.\u003c/p>\n\u003cp>Today, people who self-identify as being transgender are experiencing those same kinds of oppressive characteristics of medical care, health care, access to care and services, and additionally, access to safe and clean and affordable housing.\u003c/p>\n\u003cp>For many of us who have been through this journey a long time, are things better for people living with HIV/AIDS? Yes, they are. Can you have better access to better medications? Yes, you can. But for those that live on the margins, the same stigmas and obstacles exist that existed actually in the early ’80s. It’s just a different population group.\u003c/p>\n\u003cp>\u003cstrong>A \u003ca href=\"https://www.sfdph.org/dph/files/reports/RptsHIVAIDS/AnnualReport2019_Indigo_20200908_Web.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">2019 report\u003c/a> by the San Francisco Department of Public Health found that the HIV/AIDS population is also getting older. Specifically, it states that as of Dec. 31, 2019, 69% of persons living with HIV were aged 50 years and older. What are your thoughts on this aging population?\u003c/strong>\u003c/p>\n\u003cp>I know this may feel like a mixed celebration, but that is the most amazing news you could imagine — the fact that we as a population are aging, and HIV and AIDS has not killed us.\u003c/p>\n\u003cp>But there’s also that scary news of how do we take care of people when we’ve spent so many years just trying to preserve life? Now that we see an aging population, we have to, I think, reconstruct ourselves into what is long-term care.\u003c/p>\n\u003cp>\u003cstrong>What are some lessons we learned from 40 years ago that we can use today for those living with HIV/AIDS?\u003c/strong>\u003c/p>\n\u003cp>We’re good at [giving care]. We actually know how to do this. The people who come to Maitri, they don’t receive fair care, they receive remarkable care.\u003c/p>\n\u003cp>In the early 1980s, my clients would go to a clinic that was dirty, that often had people working there that disliked and hated them and that treated them badly. Right now, people who come for care and services here find extraordinary care, best practice care, staff that are highly trained and that are kind and gentle. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The lessons we learned when people are in those circumstances is they don’t need our judgment. They actually don’t even need our wisdom about how they got there and what happened to them. What they actually need is care and partnership.\u003c/p>\n\u003cp>\u003cstrong>You’ve been doing this for over 30 years. What keeps you going?\u003c/strong>\u003c/p>\n\u003cp>One of our residents was getting ready to be discharged into housing, who came here amazingly sick and was resistant to being loved, but we would not allow him not to be.\u003c/p>\n\u003cp>That’s what keeps me here — every staff member here. We do this for the people who are living and struggling with that disease.\u003c/p>\n\u003cp>\u003cstrong>For those living with long-term COVID, any lessons that can be taken from people living with long-term HIV/AIDS?\u003c/strong>\u003c/p>\n\u003cp>I think the instruction here is follow the science, do what the doctors tell you to do, ask questions, do advocacy, but recognize that you’re not by yourself. That actually is what all of us in the ’80s discovered.\u003c/p>\n\u003cp>Being by yourself and dying and struggling with the disease is horrific. COVID-19, I personally feel, has allowed us and invited us to be closer together. And I think that’s the lesson of this disease.\u003c/p>\n\u003cp>\u003cstrong>Any final thoughts?\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Amid a pandemic that has pushed millions of \u003ca href=\"https://www.census.gov/library/stories/2021/03/moms-work-and-the-pandemic.html\" target=\"_blank\" rel=\"noopener noreferrer\">mothers out of the workplace\u003c/a>, caused \u003ca href=\"https://www.latimes.com/california/story/2021-05-24/obamacare-made-iuds-affordable-one-reason-behind-californias-covid-baby-bust\" target=\"_blank\" rel=\"noopener noreferrer\">fertility rates to plunge\u003c/a> and \u003ca href=\"https://jamanetwork.com/journals/jamapediatrics/fullarticle/2779182\" target=\"_blank\" rel=\"noopener noreferrer\">heightened the risk of death for pregnant women\u003c/a>, Gov. Gavin Newsom and state Democratic lawmakers are seeking a slate of health proposals for low-income families and children.\u003c/p>\n\u003cp>Newsom, a self-described feminist and the father of four young children, has long advocated family-friendly health and economic policies. Flush with a projected \u003ca href=\"https://www.kqed.org/news/11874125/californias-historic-budget-surplus-is-it-76-billion-or-38-billion\" target=\"_blank\" rel=\"noopener noreferrer\">budget surplus of $75.7 billion\u003c/a>, state politicians have come up with myriad legislative and budget proposals to make poorer families healthier and wealthier.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Assemblymember Cristina Garcia (D-Bell Gardens)\"]‘We don’t need to balance the budget on half of the population that has a uterus.’[/pullquote]They include ending sales taxes on \u003ca href=\"https://esd.dof.ca.gov/dofpublic/public/trailerBill/pdf/414\" target=\"_blank\" rel=\"noopener noreferrer\">menstrual products and diapers\u003c/a>; adding benefits such as doulas and early childhood trauma screenings to Medi-Cal, the state’s Medicaid program; allowing pregnant women to retain Medi-Cal coverage for a year after giving birth; and a pilot program to provide a universal basic income to low-income new parents.\u003c/p>\n\u003cp>“COVID-19 laid inequity bare for all to see,” Assemblymember Wendy Carrillo (D-Los Angeles) said in a written statement. She is the co-author of Senate Bill 65, led by Sen. Nancy Skinner (D-Berkeley), which would pour hundreds of millions of dollars into family and health care programs annually, focusing on minority groups that Carrillo said were “pushed out of the social safety net by the prior White House.”\u003c/p>\n\u003cp>Newsom and the Democratic-controlled legislature are unified on major health care and social safety-net expansions, which would direct billions in health benefits and cash assistance to the state’s most vulnerable residents and low-income parents. Legislative Democrats for years have pushed a progressive agenda to help struggling parents and families, featuring proposals like those to permanently end taxes on menstrual products and diapers — \u003ca href=\"https://lao.ca.gov/Publications/Report/4040\" target=\"_blank\" rel=\"noopener noreferrer\">expected to cost the state millions\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We don’t need to balance the budget on half of the population that has a uterus,” said Assemblymember Cristina Garcia (D-Bell Gardens), who has \u003ca href=\"https://www.politico.com/states/california/story/2019/05/07/newsom-to-unveil-may-budget-thursday-with-focus-on-low-income-families-1009021\" target=\"_blank\" rel=\"noopener noreferrer\">for years sought an end\u003c/a> to the “pink tax” on diapers and menstrual products.\u003c/p>\n\u003cp>Skinner, chair of the Senate budget committee, is among the powerful lawmakers who’ve put forward legislation to make childbirth safer and parenthood more affordable. Her bill, which cleared the Senate and was up for consideration this week in the state Assembly, has several features that would dramatically expand maternal health care (transgender men also get pregnant and give birth).\u003c/p>\n\u003cp>[aside tag='childbirth' label='Maternity in California']Before the pandemic, Medi-Cal covered mothers only up to 60 days after their pregnancies ended unless their income fell below a certain line or they had a mental health diagnosis. Skinner’s bill, part of a \u003ca href=\"https://www.kff.org/womens-health-policy/issue-brief/expanding-postpartum-medicaid-coverage/\" target=\"_blank\" rel=\"noopener noreferrer\">broader national push\u003c/a> to improve birth outcomes, would expand full Medi-Cal coverage to 12 months after the end of a pregnancy. Other \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB65\" target=\"_blank\" rel=\"noopener noreferrer\">parts of the bill\u003c/a> would intensify state reporting and reviews of fetal and pregnancy-related deaths and severe maternal morbidity, expand housing benefits for families that have a pregnant member, and increase training programs for midwives.\u003c/p>\n\u003cp>Newsom’s $268 billion budget blueprint includes about $200 million a year to fully implement the expansion of Medi-Cal coverage for new mothers, with matching dollars from the federal government until those funds expire in 2027. If the expansion were not renewed, the state would revert to previous Medi-Cal qualifications.\u003c/p>\n\u003cp>\u003ca href=\"https://www.chcf.org/publication/2019-edition-maternity-care-in-california/\" target=\"_blank\" rel=\"noopener noreferrer\">Medi-Cal covered 45% of all births\u003c/a> in California in 2017, the last year for which data could be found.\u003c/p>\n\u003cp>“Not all postpartum issues end at 60 days, and when patients lose insurance, we can’t address them in the usual way,” said Dr. Yen Truong, an OB-GYN who works with the American College of Obstetricians and Gynecologists on legislative issues in California.\u003c/p>\n\u003cp>About half of pregnancy-related deaths occur during the pregnancy or on the day of delivery, but about 12% take place \u003ca href=\"https://www.cdc.gov/mmwr/volumes/68/wr/mm6818e1.htm\" target=\"_blank\" rel=\"noopener noreferrer\">between seven weeks and a year\u003c/a> after giving birth, according to the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>The U.S. had 17.4 early maternal deaths per 100,000 live births in 2018, according to the most recent CDC data with state figures. California’s rate, \u003ca href=\"https://www.cdc.gov/nchs/maternal-mortality/MMR-2018-State-Data-508.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">11.7 per 100,000\u003c/a>, was among the lowest in the nation, but the state collects data on maternal deaths in a way that could result in underestimates.\u003c/p>\n\u003cp>California’s overall numbers also obscure stark racial disparities. Statewide, Black infants averaged \u003ca href=\"https://www.cdph.ca.gov/Programs/CHSI/CDPH%20Document%20Library/CHSP_2021_ADA_FINAL.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">7.8 deaths per 1,000 live births\u003c/a>, compared with an average of three deaths among white babies. Data from 2013 from \u003ca href=\"http://publichealth.lacounty.gov/owh/docs/DataReport/2017-HealthIndicatorsforWomeninLACounty.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Los Angeles County\u003c/a> showed Black women had pregnancy-related deaths at rates more than four times as high as the overall rate in the state’s largest county.\u003c/p>\n\u003cp>“Given our state’s wealth and medical advancements, this is unacceptable,” Skinner, vice chair of the Legislative Women’s Caucus, said in a news release.\u003c/p>\n\u003cp>Democrats also appear unified on another aspect of Skinner’s bill: a pilot program to test a universal basic income program for struggling families. The bill would give $1,000 a month to low-income expectant and new parents with kids under 2 years old in counties that decide to participate. Newsom has also proposed \u003ca href=\"http://www.ebudget.ca.gov/2021-22/pdf/Revised/BudgetSummary/HealthandHumanServices.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">$35 million over five years\u003c/a> for pilot programs for universal basic income.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Rose Kapolczynski, a campaign consultant\"]‘The budget surplus is allowing many things that were called impossible to be possible, and that includes health care bills.’[/pullquote]These issues could play well, especially among women, and improve Newsom’s standing going into a \u003ca href=\"https://www.kqed.org/news/11875264/new-poll-shows-support-idling-for-newsom-recall-effort\" target=\"_blank\" rel=\"noopener noreferrer\">recall election\u003c/a> later this year, said Rose Kapolczynski, a longtime campaign consultant to former U.S. Sen. Barbara Boxer who has worked on reproductive health care issues in Sacramento.\u003c/p>\n\u003cp>Indefinitely rescinding sales taxes on diapers and menstrual products — the taxes have been \u003ca href=\"https://www.kcra.com/article/sales-tax-for-tampons-diapers-eliminated-in-california-for-2-years/30463779\" target=\"_blank\" rel=\"noopener noreferrer\">temporarily lifted since early last year\u003c/a> — is a particular no-brainer because of its bipartisan appeal, she said.\u003c/p>\n\u003cp>“It’s hard for Republicans to attack something that is a tax cut, and sales taxes are regressive, so progressives would like it,” Kapolczynski said.\u003c/p>\n\u003cp>As for Medi-Cal expansions, Kapolczynski said that even though it wouldn’t affect most Californians, the pandemic has made health care even more important to voters. “The budget surplus is allowing many things that were called impossible to be possible, and that includes health care bills,” she said.\u003c/p>\n\u003cp>[aside tag=\"california-budget\" label=\"More California budget coverage\"]Investing in California’s young families could help close the racial gap in maternal and infant mortality, said \u003ca href=\"https://www.bwwla.org/nourbese-flint-ma/\" target=\"_blank\" rel=\"noopener noreferrer\">Nourbese Flint\u003c/a>, executive director of the Black Women for Wellness Action Project, which endorsed Skinner’s bill.\u003c/p>\n\u003cp>Flint is especially excited about the possibility of covering doulas through Medi-Cal. Doulas, trained as emotional and physical supports for women in pregnancy and postpartum, have been linked to \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5538578/\" target=\"_blank\" rel=\"noopener noreferrer\">lower odds of cesarean births\u003c/a> and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595013/\" target=\"_blank\" rel=\"noopener noreferrer\">greater satisfaction with the birth experience\u003c/a>. If doulas saved Medi-Cal money by reducing cesarean births, that could enable the state to renegotiate payments for labor and delivery, according to \u003ca href=\"http://analyses.chbrp.com/document/view.php?id=1496\" target=\"_blank\" rel=\"noopener noreferrer\">an analysis by the independent California Health Benefits Review Program\u003c/a>. Under Newsom’s proposed budget, Medi-Cal coverage of doulas would cost about \u003ca href=\"http://www.ebudget.ca.gov/2021-22/pdf/Revised/BudgetSummary/HealthandHumanServices.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">$4.4 million a year\u003c/a>.\u003c/p>\n\u003cp>California’s would become the first Medicaid program to include “full spectrum” doula coverage, meaning it would include care for women who have abortions, miscarriages and stillbirths, said Amy Chen, a senior attorney at the \u003ca href=\"https://healthlaw.org/about/\" target=\"_blank\" rel=\"noopener noreferrer\">National Health Law Program\u003c/a>.\u003c/p>\n\u003cp>“California has always led the country and been a little bit in front of where our federal government is when it comes to covering folks,” Flint said.\u003c/p>\n\u003cp>\u003cem>California Healthline correspondent Angela Hart contributed to this report.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"https://khn.org/about-us/\" target=\"_blank\" rel=\"noopener noreferrer\">KHN\u003c/a> (Kaiser Health News), a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). \u003ca href=\"https://www.kff.org/about-us/\" target=\"_blank\" rel=\"noopener noreferrer\">KFF\u003c/a> is an endowed nonprofit organization providing information on health issues to the nation.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Amid a pandemic that has pushed millions of \u003ca href=\"https://www.census.gov/library/stories/2021/03/moms-work-and-the-pandemic.html\" target=\"_blank\" rel=\"noopener noreferrer\">mothers out of the workplace\u003c/a>, caused \u003ca href=\"https://www.latimes.com/california/story/2021-05-24/obamacare-made-iuds-affordable-one-reason-behind-californias-covid-baby-bust\" target=\"_blank\" rel=\"noopener noreferrer\">fertility rates to plunge\u003c/a> and \u003ca href=\"https://jamanetwork.com/journals/jamapediatrics/fullarticle/2779182\" target=\"_blank\" rel=\"noopener noreferrer\">heightened the risk of death for pregnant women\u003c/a>, Gov. Gavin Newsom and state Democratic lawmakers are seeking a slate of health proposals for low-income families and children.\u003c/p>\n\u003cp>Newsom, a self-described feminist and the father of four young children, has long advocated family-friendly health and economic policies. Flush with a projected \u003ca href=\"https://www.kqed.org/news/11874125/californias-historic-budget-surplus-is-it-76-billion-or-38-billion\" target=\"_blank\" rel=\"noopener noreferrer\">budget surplus of $75.7 billion\u003c/a>, state politicians have come up with myriad legislative and budget proposals to make poorer families healthier and wealthier.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘We don’t need to balance the budget on half of the population that has a uterus.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>They include ending sales taxes on \u003ca href=\"https://esd.dof.ca.gov/dofpublic/public/trailerBill/pdf/414\" target=\"_blank\" rel=\"noopener noreferrer\">menstrual products and diapers\u003c/a>; adding benefits such as doulas and early childhood trauma screenings to Medi-Cal, the state’s Medicaid program; allowing pregnant women to retain Medi-Cal coverage for a year after giving birth; and a pilot program to provide a universal basic income to low-income new parents.\u003c/p>\n\u003cp>“COVID-19 laid inequity bare for all to see,” Assemblymember Wendy Carrillo (D-Los Angeles) said in a written statement. She is the co-author of Senate Bill 65, led by Sen. Nancy Skinner (D-Berkeley), which would pour hundreds of millions of dollars into family and health care programs annually, focusing on minority groups that Carrillo said were “pushed out of the social safety net by the prior White House.”\u003c/p>\n\u003cp>Newsom and the Democratic-controlled legislature are unified on major health care and social safety-net expansions, which would direct billions in health benefits and cash assistance to the state’s most vulnerable residents and low-income parents. Legislative Democrats for years have pushed a progressive agenda to help struggling parents and families, featuring proposals like those to permanently end taxes on menstrual products and diapers — \u003ca href=\"https://lao.ca.gov/Publications/Report/4040\" target=\"_blank\" rel=\"noopener noreferrer\">expected to cost the state millions\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We don’t need to balance the budget on half of the population that has a uterus,” said Assemblymember Cristina Garcia (D-Bell Gardens), who has \u003ca href=\"https://www.politico.com/states/california/story/2019/05/07/newsom-to-unveil-may-budget-thursday-with-focus-on-low-income-families-1009021\" target=\"_blank\" rel=\"noopener noreferrer\">for years sought an end\u003c/a> to the “pink tax” on diapers and menstrual products.\u003c/p>\n\u003cp>Skinner, chair of the Senate budget committee, is among the powerful lawmakers who’ve put forward legislation to make childbirth safer and parenthood more affordable. Her bill, which cleared the Senate and was up for consideration this week in the state Assembly, has several features that would dramatically expand maternal health care (transgender men also get pregnant and give birth).\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Before the pandemic, Medi-Cal covered mothers only up to 60 days after their pregnancies ended unless their income fell below a certain line or they had a mental health diagnosis. Skinner’s bill, part of a \u003ca href=\"https://www.kff.org/womens-health-policy/issue-brief/expanding-postpartum-medicaid-coverage/\" target=\"_blank\" rel=\"noopener noreferrer\">broader national push\u003c/a> to improve birth outcomes, would expand full Medi-Cal coverage to 12 months after the end of a pregnancy. Other \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB65\" target=\"_blank\" rel=\"noopener noreferrer\">parts of the bill\u003c/a> would intensify state reporting and reviews of fetal and pregnancy-related deaths and severe maternal morbidity, expand housing benefits for families that have a pregnant member, and increase training programs for midwives.\u003c/p>\n\u003cp>Newsom’s $268 billion budget blueprint includes about $200 million a year to fully implement the expansion of Medi-Cal coverage for new mothers, with matching dollars from the federal government until those funds expire in 2027. If the expansion were not renewed, the state would revert to previous Medi-Cal qualifications.\u003c/p>\n\u003cp>\u003ca href=\"https://www.chcf.org/publication/2019-edition-maternity-care-in-california/\" target=\"_blank\" rel=\"noopener noreferrer\">Medi-Cal covered 45% of all births\u003c/a> in California in 2017, the last year for which data could be found.\u003c/p>\n\u003cp>“Not all postpartum issues end at 60 days, and when patients lose insurance, we can’t address them in the usual way,” said Dr. Yen Truong, an OB-GYN who works with the American College of Obstetricians and Gynecologists on legislative issues in California.\u003c/p>\n\u003cp>About half of pregnancy-related deaths occur during the pregnancy or on the day of delivery, but about 12% take place \u003ca href=\"https://www.cdc.gov/mmwr/volumes/68/wr/mm6818e1.htm\" target=\"_blank\" rel=\"noopener noreferrer\">between seven weeks and a year\u003c/a> after giving birth, according to the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>The U.S. had 17.4 early maternal deaths per 100,000 live births in 2018, according to the most recent CDC data with state figures. California’s rate, \u003ca href=\"https://www.cdc.gov/nchs/maternal-mortality/MMR-2018-State-Data-508.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">11.7 per 100,000\u003c/a>, was among the lowest in the nation, but the state collects data on maternal deaths in a way that could result in underestimates.\u003c/p>\n\u003cp>California’s overall numbers also obscure stark racial disparities. Statewide, Black infants averaged \u003ca href=\"https://www.cdph.ca.gov/Programs/CHSI/CDPH%20Document%20Library/CHSP_2021_ADA_FINAL.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">7.8 deaths per 1,000 live births\u003c/a>, compared with an average of three deaths among white babies. Data from 2013 from \u003ca href=\"http://publichealth.lacounty.gov/owh/docs/DataReport/2017-HealthIndicatorsforWomeninLACounty.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Los Angeles County\u003c/a> showed Black women had pregnancy-related deaths at rates more than four times as high as the overall rate in the state’s largest county.\u003c/p>\n\u003cp>“Given our state’s wealth and medical advancements, this is unacceptable,” Skinner, vice chair of the Legislative Women’s Caucus, said in a news release.\u003c/p>\n\u003cp>Democrats also appear unified on another aspect of Skinner’s bill: a pilot program to test a universal basic income program for struggling families. The bill would give $1,000 a month to low-income expectant and new parents with kids under 2 years old in counties that decide to participate. Newsom has also proposed \u003ca href=\"http://www.ebudget.ca.gov/2021-22/pdf/Revised/BudgetSummary/HealthandHumanServices.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">$35 million over five years\u003c/a> for pilot programs for universal basic income.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>These issues could play well, especially among women, and improve Newsom’s standing going into a \u003ca href=\"https://www.kqed.org/news/11875264/new-poll-shows-support-idling-for-newsom-recall-effort\" target=\"_blank\" rel=\"noopener noreferrer\">recall election\u003c/a> later this year, said Rose Kapolczynski, a longtime campaign consultant to former U.S. Sen. Barbara Boxer who has worked on reproductive health care issues in Sacramento.\u003c/p>\n\u003cp>Indefinitely rescinding sales taxes on diapers and menstrual products — the taxes have been \u003ca href=\"https://www.kcra.com/article/sales-tax-for-tampons-diapers-eliminated-in-california-for-2-years/30463779\" target=\"_blank\" rel=\"noopener noreferrer\">temporarily lifted since early last year\u003c/a> — is a particular no-brainer because of its bipartisan appeal, she said.\u003c/p>\n\u003cp>“It’s hard for Republicans to attack something that is a tax cut, and sales taxes are regressive, so progressives would like it,” Kapolczynski said.\u003c/p>\n\u003cp>As for Medi-Cal expansions, Kapolczynski said that even though it wouldn’t affect most Californians, the pandemic has made health care even more important to voters. “The budget surplus is allowing many things that were called impossible to be possible, and that includes health care bills,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Investing in California’s young families could help close the racial gap in maternal and infant mortality, said \u003ca href=\"https://www.bwwla.org/nourbese-flint-ma/\" target=\"_blank\" rel=\"noopener noreferrer\">Nourbese Flint\u003c/a>, executive director of the Black Women for Wellness Action Project, which endorsed Skinner’s bill.\u003c/p>\n\u003cp>Flint is especially excited about the possibility of covering doulas through Medi-Cal. Doulas, trained as emotional and physical supports for women in pregnancy and postpartum, have been linked to \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5538578/\" target=\"_blank\" rel=\"noopener noreferrer\">lower odds of cesarean births\u003c/a> and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595013/\" target=\"_blank\" rel=\"noopener noreferrer\">greater satisfaction with the birth experience\u003c/a>. If doulas saved Medi-Cal money by reducing cesarean births, that could enable the state to renegotiate payments for labor and delivery, according to \u003ca href=\"http://analyses.chbrp.com/document/view.php?id=1496\" target=\"_blank\" rel=\"noopener noreferrer\">an analysis by the independent California Health Benefits Review Program\u003c/a>. Under Newsom’s proposed budget, Medi-Cal coverage of doulas would cost about \u003ca href=\"http://www.ebudget.ca.gov/2021-22/pdf/Revised/BudgetSummary/HealthandHumanServices.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">$4.4 million a year\u003c/a>.\u003c/p>\n\u003cp>California’s would become the first Medicaid program to include “full spectrum” doula coverage, meaning it would include care for women who have abortions, miscarriages and stillbirths, said Amy Chen, a senior attorney at the \u003ca href=\"https://healthlaw.org/about/\" target=\"_blank\" rel=\"noopener noreferrer\">National Health Law Program\u003c/a>.\u003c/p>\n\u003cp>“California has always led the country and been a little bit in front of where our federal government is when it comes to covering folks,” Flint said.\u003c/p>\n\u003cp>\u003cem>California Healthline correspondent Angela Hart contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"https://khn.org/about-us/\" target=\"_blank\" rel=\"noopener noreferrer\">KHN\u003c/a> (Kaiser Health News), a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). \u003ca href=\"https://www.kff.org/about-us/\" target=\"_blank\" rel=\"noopener noreferrer\">KFF\u003c/a> is an endowed nonprofit organization providing information on health issues to the nation.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Amid Ongoing Debate, State Senate Approves Bill to Decriminalize Psychedelic Drugs in California",
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"content": "\u003cp>The California Senate approved legislation to decriminalize the possession or sharing of psychedelic drugs, Tuesday.\u003c/p>\n\u003cp>\u003ca href=\"https://sd11.senate.ca.gov/news/20210218-senator-wiener-introduces-legislation-decriminalize-possession-and-personal-use\">Senate Bill 519\u003c/a>, introduced by state Sen. Scott Wiener, D-San Francisco, now heads to the state Assembly.\u003c/p>\n\u003cp>“This is a big step for this legislation and for our movement to end the war on drugs and to take a more health and science-based approach and to move away from criminalization of drugs,” Wiener said in a Twitter video posted on Tuesday.\u003c/p>\n\u003cp>https://twitter.com/Scott_Wiener/status/1399867521612881921?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1399867521612881921%7Ctwgr%5E%7Ctwcon%5Es1_&ref_url=https%3A%2F%2Ffox40.com%2Fnews%2Flocal-news%2Fcalifornia-senate-passes-bill-to-decriminalize-psychedelic-drugs%2F\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>The legislation would allow doctors to prescribe psychedelics for treating mental health disorders such as depression and PTSD. It would also allow psychedelics for personal use, and expunge criminal records for people with prior convictions for possession.\u003c/p>\n\u003cp>In May, the medical journal Nature Medicine published results of \u003ca href=\"https://www.nature.com/articles/s41591-021-01336-3\">a study using the psychedelic drug MDMA\u003c/a>, also known as ecstasy, to treat post-traumatic stress disorder among research participants who received the drug, along with counseling. Sixty-seven percent felt their condition had improved to the extent that they no longer qualified for a diagnosis of PTSD.\u003c/p>\n\u003cp>This study adds to a small but growing body of scientific literature exploring the use of psychedelics like MDMA, LSD and psilocybin as therapy for a range of mental health conditions, including depression, eating disorders and end-of-life anxiety. The bill now working its way through the state Legislature aims to build on this momentum.\u003c/p>\n\u003cp>While many veterans and drug advocacy groups support the bill, opponents say the legislation would lead to an increased rate of psychedelic drugs sold and recreationally used. On May 14, \u003ca href=\"https://www.kqed.org/forum/2010101883458/ca-could-become-the-latest-state-to-decriminalize-psychedelics\">KQED Forum host April Dembosky\u003c/a> talked to the following people involved in this debate:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Juliana Mercer\u003c/strong>, a Marine Corps veteran who used psychedelic therapy to overcome her trauma from her time serving in Iraq and Afghanistan\u003c/li>\n\u003cli>\u003cstrong>Sen. Scott Wiener\u003c/strong>, represents San Francisco in the state Senate\u003c/li>\n\u003cli>\u003cstrong>Dr. Jeffrey Lieberman\u003c/strong>, former president of the American Psychiatric Association and chairman of the Department of Psychiatry, Columbia University College of Physicians and Surgeons\u003c/li>\n\u003cli>\u003cstrong>Larry Morse, \u003c/strong>legislative director, California District Attorneys Association\u003c/li>\n\u003cli>\u003cstrong>Dr. Robert Grant\u003c/strong>, professor of medicine at UCSF and prominent academic voice around decriminalization and psychedelic therapy\u003c/li>\n\u003c/ul>\n\u003cp>\u003cem>The following interview has been edited for length and clarity.\u003c/em>\u003c/p>\n\u003ch3>A Veteran’s Personal Experience\u003c/h3>\n\u003cp>\u003cem>Juliana Mercer graduated military boot camp one week before Sept. 11, 2001, and served in the United States Marines for 16 years. She served two tours of duty, one in Iraq and one in Afghanistan.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Juliana Mercer:\u003c/strong> Between Iraq and Afghanistan, where I saw the traumas of war in between those two deployments, I spent five years working with our wounded in San Diego at the naval hospital, and I did everything that was non-medical for helping them in a holistic way to get back into their lives with their injuries.\u003c/p>\n\u003cp>During those five years I saw the direct result of war; not just the physical trauma, but the mental trauma. And I did my job every day and did it happily because I was helping my brothers and sisters. But losing quite a few fellow Marines and other veterans to suicide between two war deployments really took a toll on me.\u003c/p>\n\u003cp>I didn’t realize that they had taken a toll on me because I was doing my job every day. A few years after exiting the service and continuing to work with nonprofits that help veterans, I felt just this loss of purpose. Even though I was doing purposeful work, I had a loss of who my authentic self was. My first interaction with these medicines really opened up the acknowledgment that I had suffered a lot of loss, and there was a lot of grief in there. It started to help me unpack all of the grief that I had, and hadn’t revisited because I was so busy doing my job and taking care of my Marines.\u003cspan style=\"font-weight: 400\">[aside postID=\"science_1956693\"]\u003c/span>\u003c/p>\n\u003cp>\u003cem>Mercer eventually connected with the \u003ca href=\"https://www.heroicheartsproject.org/\">Heroic Hearts Project\u003c/a>, which specializes in ayahuasca therapy with military veterans, and traveled to a retreat center in Costa Rica for treatment.\u003c/em>\u003c/p>\n\u003cp>We were there for 10 days and we had four sessions with ayahuasca. And these sessions where you drink the medicine, which is the root that’s found in the Amazon, administered by a shaman.\u003c/p>\n\u003cp>You go into these sessions with intentions of what you want to accomplish and what you want to bring up. I think a session lasts anywhere from six to 12 hours. The ayahuasca and psychedelic medicines really opens you up. They open up your heart and they let you start looking inside of yourself, figuring out what the blockages are.\u003c/p>\n\u003cp>These sessions are [like] 10 years of therapy.\u003c/p>\n\u003ch3>The Proposed Legislation Around Psychedelics\u003c/h3>\n\u003cp>\u003cstrong>State Sen. Scott Wiener:\u003c/strong> The legislation is sponsored by [the Heroic Hearts Project], as well as another group of vets that also works with veterans experiencing PTSD, addiction, other mental health challenges, and combat veterans.\u003c/p>\n\u003cp>And right now, these groups are having to send these combat veterans to other countries, to Costa Rica, to Peru, to Mexico to get treatment. We think to ourselves how outrageous it is that these are people who have gone to war for our country, who have sustained terrible injuries — physical and mental — serving our country, and we’re making it illegal for them to get effective treatment in the U.S. and forcing them to travel to another country.\u003c/p>\n\u003cp>I watched what was happening in Oregon and in various cities around the country as part of the movement towards drug decriminalization. The war on drugs has failed. Incarcerating people for using drugs doesn’t work. We need to take a health-based approach. And for psychedelics in particular, the mounting evidence of the health benefits of all of these substances is just extraordinary. People whose lives are being saved.\u003c/p>\n\u003cp>And yet we have stuck with this terrible criminalization approach and say, no, you can’t have your medicine, it’s illegal. And if you possess your medicine, you might get arrested and go to jail. And so the bill simply decriminalizes the possession of psychedelics. It actually does not authorize doctors to prescribe. That would require a change in federal law so that the doctors wouldn’t lose their prescribing privileges. But that, we hope, will happen at some point. But for now, we want to make sure that California stops arresting and prosecuting people for possessing psychedelics. [pullquote size=\"medium\" align=\"right\" citation=\"Scott Wiener, D-San Francisco\"]‘We want to make sure that California stops arresting and prosecuting people for possessing psychedelics.’[/pullquote]\u003c/p>\n\u003cp>We want to effectively decriminalize it and move towards legalization, and then create pathways for people to expunge their records. It’s hard to describe how destructive the war on drugs has been. It has cost this country untold billions. A lot of people have criminal records because they were low-level drug offenses, and we want to make sure that they can clear their records and not have those convictions hanging over them, which can have implications for housing and for employment. So it’s about saying, “Listen, we made a mistake by criminalizing these substances. We’re moving away from that now.”\u003c/p>\n\u003ch3>What Could the Drawbacks of Decriminalizing Psychedelics Be?\u003c/h3>\n\u003cp>\u003cstrong>Dr. Jeffrey Lieberman, Columbia University:\u003c/strong> Hopefully we won’t commit the same mistake that we did in the ’60s where things got out of control, and they were used recreationally.\u003c/p>\n\u003cp>First, let me just say that I completely agree with the legislation. These drugs should not be criminalized. There should be decriminalization. Secondly, I enthusiastically endorse their study for therapeutic uses for various types of conditions. [aside postID=\"science_1970825\"]\u003c/p>\n\u003cp>But at the same time, I’m very concerned that we’re rushing headlong to a point where practice is leaping ahead of knowledge. And the first way in which this is evident is the fact that “psychedelics” is the term that’s being used to define a certain group of psychoactive drugs. But it’s being used in a way that’s not precise.\u003c/p>\n\u003cp>Psychedelics really refer to compounds that have been used by Indigenous peoples ritualistically for centuries, and then synthetically replicated. Ecstasy, MDMA, ketamine, ibogaine are not classical psychedelics. They have different clinical effects and they have different potential uses.\u003c/p>\n\u003cp>All of these drugs do have some potential uses. The problem is they have not been studied sufficiently to know what they are. So if we let the genie out of the bottle too soon, and base it on the enthusiasm of true believers who have had positive experiences, we’re potentially risking trouble.\u003c/p>\n\u003cp>If this is such a big thing socially for our population and people are benefiting from it and want to have access to it, why isn’t it being studied in the way that rigorously and systematically it should be?\u003c/p>\n\u003cp>\u003cstrong>Larry Morse, California District Attorneys Association:\u003c/strong> I endorse completely what Dr. Lieberman said about the lack of adequate studies that we are talking about: powerful, powerful drugs, LSD.\u003c/p>\n\u003cp>I’m of the generation where I literally remember being with people having an extraordinarily bad experience with LSD all through the evening. And it is a flight of naivete to believe that if we make this more readily accessible, legalize this, that it is not going to be used by kids. They are going to get access to it.\u003c/p>\n\u003cp>We are talking about making a drug more readily available. And it is just denial to suggest that it will not fall into the hands of 15-, 16-, 17-year-olds who will have terrible, terrible, terrifying experiences that have significant likelihood or possibility of long-term effects.\u003c/p>\n\u003cp>Psychosis, paranoia, schizophrenia. This is not like some really strong weed. These are powerful drugs that have dramatic effects on people’s moods and can lead to just horrific consequences.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003ch3>The Prevalence and Equity of Psychedelic Medicines\u003c/h3>\n\u003cp>\u003cstrong>Dr. Robert Grant, UCSF:\u003c/strong> Psychedelics are already in widespread use in the United States. Surveys have shown that something like 30 million Americans have used psychedelic medicines in their lives and something like 1 million use them on any given year.\u003c/p>\n\u003cp>So these medicines are being used. They’re being used largely in a criminalized context where people have to be very shy about talking about how they’ve used psychedelics, and under what circumstances, and who provided them, and whether that was a good setting for their work.\u003c/p>\n\u003cp>The huge advantage of this particular legislation is that it allows for all of that underground use, which is already happening, to come out and be more public — so that people can talk about when their use of psychedelics went well, and when it went badly. These kinds of open discussions are not possible now because of criminalization, and decriminalization will change that.\u003c/p>\n\u003cp>\u003cem>Three-quarters of the participants in the trial cited in Nature Medicine’s \u003ca href=\"https://www.nature.com/articles/s41591-021-01336-3\">study of MDMA and PTSD\u003c/a> were white. What do we know about the effectiveness of this drug, and access to it, for people of color?\u003c/em>\u003c/p>\n\u003cp>Clinical trials in general tend to recruit predominantly white populations, and we think that that’s an issue of trust — that researchers need to do more to establish trust with communities of color. [pullquote size=\"medium\" align=\"right\" citation=\"Dr. Robert Grant, UCSF\"]‘We do know that communities of color are using these therapies. And we also know that communities of color and queer communities are at much higher risk of having PTSD. So the unmet medical need for those communities of color is enormous, and larger than in other populations.’[/pullquote]\u003c/p>\n\u003cp>We do know that communities of color are using these therapies. And we also know that communities of color and queer communities are at much higher risk of having PTSD. So the unmet medical need for those communities of color is enormous, and larger than in other populations.\u003c/p>\n\u003cp>Medicalization pathways left there on their own without decriminalization will be difficult and delayed, and will have even more difficulty recruiting people of color while we have criminalization laws on the books. So this decriminalization law, I believe, will make it easier for the National Institutes of Health to fund these studies, and that will make it easier for people of color to participate in those studies. And it’ll make it easier for people who are using these medicines therapeutically to talk about their experiences.\u003c/p>\n\u003cp>\u003cem>Listen to \u003ca href=\"https://www.kqed.org/forum/2010101883458/ca-could-become-the-latest-state-to-decriminalize-psychedelics\" target=\"_blank\" rel=\"noopener noreferrer\">KQED Forum\u003c/a> to hear the full episode.\u003c/em>\u003c/p>\n\u003cp>\u003cem>The original version of this story was published on May 16.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The California Senate approved legislation to decriminalize the possession or sharing of psychedelic drugs, Tuesday.\u003c/p>\n\u003cp>\u003ca href=\"https://sd11.senate.ca.gov/news/20210218-senator-wiener-introduces-legislation-decriminalize-possession-and-personal-use\">Senate Bill 519\u003c/a>, introduced by state Sen. Scott Wiener, D-San Francisco, now heads to the state Assembly.\u003c/p>\n\u003cp>“This is a big step for this legislation and for our movement to end the war on drugs and to take a more health and science-based approach and to move away from criminalization of drugs,” Wiener said in a Twitter video posted on Tuesday.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp> \u003c/p>\n\u003cp>The legislation would allow doctors to prescribe psychedelics for treating mental health disorders such as depression and PTSD. It would also allow psychedelics for personal use, and expunge criminal records for people with prior convictions for possession.\u003c/p>\n\u003cp>In May, the medical journal Nature Medicine published results of \u003ca href=\"https://www.nature.com/articles/s41591-021-01336-3\">a study using the psychedelic drug MDMA\u003c/a>, also known as ecstasy, to treat post-traumatic stress disorder among research participants who received the drug, along with counseling. Sixty-seven percent felt their condition had improved to the extent that they no longer qualified for a diagnosis of PTSD.\u003c/p>\n\u003cp>This study adds to a small but growing body of scientific literature exploring the use of psychedelics like MDMA, LSD and psilocybin as therapy for a range of mental health conditions, including depression, eating disorders and end-of-life anxiety. The bill now working its way through the state Legislature aims to build on this momentum.\u003c/p>\n\u003cp>While many veterans and drug advocacy groups support the bill, opponents say the legislation would lead to an increased rate of psychedelic drugs sold and recreationally used. On May 14, \u003ca href=\"https://www.kqed.org/forum/2010101883458/ca-could-become-the-latest-state-to-decriminalize-psychedelics\">KQED Forum host April Dembosky\u003c/a> talked to the following people involved in this debate:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Juliana Mercer\u003c/strong>, a Marine Corps veteran who used psychedelic therapy to overcome her trauma from her time serving in Iraq and Afghanistan\u003c/li>\n\u003cli>\u003cstrong>Sen. Scott Wiener\u003c/strong>, represents San Francisco in the state Senate\u003c/li>\n\u003cli>\u003cstrong>Dr. Jeffrey Lieberman\u003c/strong>, former president of the American Psychiatric Association and chairman of the Department of Psychiatry, Columbia University College of Physicians and Surgeons\u003c/li>\n\u003cli>\u003cstrong>Larry Morse, \u003c/strong>legislative director, California District Attorneys Association\u003c/li>\n\u003cli>\u003cstrong>Dr. Robert Grant\u003c/strong>, professor of medicine at UCSF and prominent academic voice around decriminalization and psychedelic therapy\u003c/li>\n\u003c/ul>\n\u003cp>\u003cem>The following interview has been edited for length and clarity.\u003c/em>\u003c/p>\n\u003ch3>A Veteran’s Personal Experience\u003c/h3>\n\u003cp>\u003cem>Juliana Mercer graduated military boot camp one week before Sept. 11, 2001, and served in the United States Marines for 16 years. She served two tours of duty, one in Iraq and one in Afghanistan.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Juliana Mercer:\u003c/strong> Between Iraq and Afghanistan, where I saw the traumas of war in between those two deployments, I spent five years working with our wounded in San Diego at the naval hospital, and I did everything that was non-medical for helping them in a holistic way to get back into their lives with their injuries.\u003c/p>\n\u003cp>During those five years I saw the direct result of war; not just the physical trauma, but the mental trauma. And I did my job every day and did it happily because I was helping my brothers and sisters. But losing quite a few fellow Marines and other veterans to suicide between two war deployments really took a toll on me.\u003c/p>\n\u003cp>I didn’t realize that they had taken a toll on me because I was doing my job every day. A few years after exiting the service and continuing to work with nonprofits that help veterans, I felt just this loss of purpose. Even though I was doing purposeful work, I had a loss of who my authentic self was. My first interaction with these medicines really opened up the acknowledgment that I had suffered a lot of loss, and there was a lot of grief in there. It started to help me unpack all of the grief that I had, and hadn’t revisited because I was so busy doing my job and taking care of my Marines.\u003cspan style=\"font-weight: 400\">\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>\u003c/p>\n\u003cp>\u003cem>Mercer eventually connected with the \u003ca href=\"https://www.heroicheartsproject.org/\">Heroic Hearts Project\u003c/a>, which specializes in ayahuasca therapy with military veterans, and traveled to a retreat center in Costa Rica for treatment.\u003c/em>\u003c/p>\n\u003cp>We were there for 10 days and we had four sessions with ayahuasca. And these sessions where you drink the medicine, which is the root that’s found in the Amazon, administered by a shaman.\u003c/p>\n\u003cp>You go into these sessions with intentions of what you want to accomplish and what you want to bring up. I think a session lasts anywhere from six to 12 hours. The ayahuasca and psychedelic medicines really opens you up. They open up your heart and they let you start looking inside of yourself, figuring out what the blockages are.\u003c/p>\n\u003cp>These sessions are [like] 10 years of therapy.\u003c/p>\n\u003ch3>The Proposed Legislation Around Psychedelics\u003c/h3>\n\u003cp>\u003cstrong>State Sen. Scott Wiener:\u003c/strong> The legislation is sponsored by [the Heroic Hearts Project], as well as another group of vets that also works with veterans experiencing PTSD, addiction, other mental health challenges, and combat veterans.\u003c/p>\n\u003cp>And right now, these groups are having to send these combat veterans to other countries, to Costa Rica, to Peru, to Mexico to get treatment. We think to ourselves how outrageous it is that these are people who have gone to war for our country, who have sustained terrible injuries — physical and mental — serving our country, and we’re making it illegal for them to get effective treatment in the U.S. and forcing them to travel to another country.\u003c/p>\n\u003cp>I watched what was happening in Oregon and in various cities around the country as part of the movement towards drug decriminalization. The war on drugs has failed. Incarcerating people for using drugs doesn’t work. We need to take a health-based approach. And for psychedelics in particular, the mounting evidence of the health benefits of all of these substances is just extraordinary. People whose lives are being saved.\u003c/p>\n\u003cp>And yet we have stuck with this terrible criminalization approach and say, no, you can’t have your medicine, it’s illegal. And if you possess your medicine, you might get arrested and go to jail. And so the bill simply decriminalizes the possession of psychedelics. It actually does not authorize doctors to prescribe. That would require a change in federal law so that the doctors wouldn’t lose their prescribing privileges. But that, we hope, will happen at some point. But for now, we want to make sure that California stops arresting and prosecuting people for possessing psychedelics. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>We want to effectively decriminalize it and move towards legalization, and then create pathways for people to expunge their records. It’s hard to describe how destructive the war on drugs has been. It has cost this country untold billions. A lot of people have criminal records because they were low-level drug offenses, and we want to make sure that they can clear their records and not have those convictions hanging over them, which can have implications for housing and for employment. So it’s about saying, “Listen, we made a mistake by criminalizing these substances. We’re moving away from that now.”\u003c/p>\n\u003ch3>What Could the Drawbacks of Decriminalizing Psychedelics Be?\u003c/h3>\n\u003cp>\u003cstrong>Dr. Jeffrey Lieberman, Columbia University:\u003c/strong> Hopefully we won’t commit the same mistake that we did in the ’60s where things got out of control, and they were used recreationally.\u003c/p>\n\u003cp>First, let me just say that I completely agree with the legislation. These drugs should not be criminalized. There should be decriminalization. Secondly, I enthusiastically endorse their study for therapeutic uses for various types of conditions. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But at the same time, I’m very concerned that we’re rushing headlong to a point where practice is leaping ahead of knowledge. And the first way in which this is evident is the fact that “psychedelics” is the term that’s being used to define a certain group of psychoactive drugs. But it’s being used in a way that’s not precise.\u003c/p>\n\u003cp>Psychedelics really refer to compounds that have been used by Indigenous peoples ritualistically for centuries, and then synthetically replicated. Ecstasy, MDMA, ketamine, ibogaine are not classical psychedelics. They have different clinical effects and they have different potential uses.\u003c/p>\n\u003cp>All of these drugs do have some potential uses. The problem is they have not been studied sufficiently to know what they are. So if we let the genie out of the bottle too soon, and base it on the enthusiasm of true believers who have had positive experiences, we’re potentially risking trouble.\u003c/p>\n\u003cp>If this is such a big thing socially for our population and people are benefiting from it and want to have access to it, why isn’t it being studied in the way that rigorously and systematically it should be?\u003c/p>\n\u003cp>\u003cstrong>Larry Morse, California District Attorneys Association:\u003c/strong> I endorse completely what Dr. Lieberman said about the lack of adequate studies that we are talking about: powerful, powerful drugs, LSD.\u003c/p>\n\u003cp>I’m of the generation where I literally remember being with people having an extraordinarily bad experience with LSD all through the evening. And it is a flight of naivete to believe that if we make this more readily accessible, legalize this, that it is not going to be used by kids. They are going to get access to it.\u003c/p>\n\u003cp>We are talking about making a drug more readily available. And it is just denial to suggest that it will not fall into the hands of 15-, 16-, 17-year-olds who will have terrible, terrible, terrifying experiences that have significant likelihood or possibility of long-term effects.\u003c/p>\n\u003cp>Psychosis, paranoia, schizophrenia. This is not like some really strong weed. These are powerful drugs that have dramatic effects on people’s moods and can lead to just horrific consequences.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch3>The Prevalence and Equity of Psychedelic Medicines\u003c/h3>\n\u003cp>\u003cstrong>Dr. Robert Grant, UCSF:\u003c/strong> Psychedelics are already in widespread use in the United States. Surveys have shown that something like 30 million Americans have used psychedelic medicines in their lives and something like 1 million use them on any given year.\u003c/p>\n\u003cp>So these medicines are being used. They’re being used largely in a criminalized context where people have to be very shy about talking about how they’ve used psychedelics, and under what circumstances, and who provided them, and whether that was a good setting for their work.\u003c/p>\n\u003cp>The huge advantage of this particular legislation is that it allows for all of that underground use, which is already happening, to come out and be more public — so that people can talk about when their use of psychedelics went well, and when it went badly. These kinds of open discussions are not possible now because of criminalization, and decriminalization will change that.\u003c/p>\n\u003cp>\u003cem>Three-quarters of the participants in the trial cited in Nature Medicine’s \u003ca href=\"https://www.nature.com/articles/s41591-021-01336-3\">study of MDMA and PTSD\u003c/a> were white. What do we know about the effectiveness of this drug, and access to it, for people of color?\u003c/em>\u003c/p>\n\u003cp>Clinical trials in general tend to recruit predominantly white populations, and we think that that’s an issue of trust — that researchers need to do more to establish trust with communities of color. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>We do know that communities of color are using these therapies. And we also know that communities of color and queer communities are at much higher risk of having PTSD. So the unmet medical need for those communities of color is enormous, and larger than in other populations.\u003c/p>\n\u003cp>Medicalization pathways left there on their own without decriminalization will be difficult and delayed, and will have even more difficulty recruiting people of color while we have criminalization laws on the books. So this decriminalization law, I believe, will make it easier for the National Institutes of Health to fund these studies, and that will make it easier for people of color to participate in those studies. And it’ll make it easier for people who are using these medicines therapeutically to talk about their experiences.\u003c/p>\n\u003cp>\u003cem>Listen to \u003ca href=\"https://www.kqed.org/forum/2010101883458/ca-could-become-the-latest-state-to-decriminalize-psychedelics\" target=\"_blank\" rel=\"noopener noreferrer\">KQED Forum\u003c/a> to hear the full episode.\u003c/em>\u003c/p>\n\u003cp>\u003cem>The original version of this story was published on May 16.\u003c/em>\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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"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"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": {
"id": "reveal",
"title": "Reveal",
"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.",
"airtime": "SAT 4pm-5pm",
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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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